Amaç: Bu çalýþmada, üniversite öðrencilerinin stres veren yaþam olaylarý, kullandýklarý biliþsel duygu düzenleme stratejileri ve biliþsel baþa çýkma tarzlarý ile depresif ve kaygý belirti düzeyleri arasýndaki iliþkiler incelenmiþtir. Bu amaçla öncelikle Biliþsel Duygu Düzenleme Ölçeði'nin Türkçe'ye uyarlamasý, geçerlik ve güvenirlik çalýþmalarý yapýlmýþtýr. Yöntem: ilk aþamada Hacettepe Üniversite- si'nin farklý bölümlerine devam eden 203 öðrenciye ulaþýlarak uyarlanan ölçeklerin geçerlik- güvenirlik kont- rolleri yapýlmýþ, ikinci aþamada 215 öðrenciye daha ulaþýlarak toplam 418 katýlýmcý ile çalýþma son- landýrýlmýþtýr. Araþtýrmada Demografik Bilgi Formu, Yaþam Olaylarý Listesi, Biliþsel Duygu Düzenleme Ölçeði, Stresle Baþa Çýkma Tarzlarý Ölçeði, Beck Depresyon Envanteri ve Durumluk Sürekli Kaygý Envanteri uygulan- mýþtýr. Bulgular: Biliþsel Duygu Düzenleme Ölçeði'nin tüm test ve alt ölçeklerinin iç tutarlýlýklarýnýn tatmin edici düzeyde olduðu görülmüþtür. Ölçeðin alt boyutlarýnýn, Stresle Baþa Çýkma Tarzlarý Ölçeði alt boyutlarýyla örtüþtüðü gözlenmiþtir. Sonuç: Regresyon analizlerine göre, depresif belirtileri ve kaygý düzeyini "çaresiz yak- laþým", "kendine güvenli yaklaþým" ve "iyimser yaklaþým"ýn açýkladýðý görülmüþtür. "Kabul" ve "olumlu yeniden odak- lanma" stratejileri depresif belirtilerdeki azalmayý, "rumi- nasyon" ve "felaketleþtirme" stratejileri kaygý belirti- lerindeki artýþý açýklarken, "kabul" stratejisinin, depresif ve kaygý belirti düzeylerinin her ikisinde de azalmayý açýk- ladýðý görülmüþtür.

Objectives: In this study, the relationships among stress- ful life events, cognitive emotion regulation strategies, cognitive coping styles and the level of depression and anxiety symptoms are examined. Firstly, reliability and validity of The Turkish version of Cognitive Emotion Regulation Questionnaire was examined. Method: The study was conducted in two steps. For the validity and reliability study, sample was 203 university students from various departments of Hacettepe University, and main study sample consisted of 418 university students by adding 215 students from the same university to the initial sample. The subjects were administered Turkish version of Cognitive Emotion Regulation Questionnaire, Demographic Information Form, State-Trait Anxiety Inventory, Beck Depression Inventory, Ways of Coping Inventory. Results: Results revealed that internal consis- tency of Cognitive Emotion Regulation Questionnaire and it's subscales were satisfactory. Dimensions of both of Cognitive Emotion Regulation Questionnaire and Ways of Coping Inventory were consistent. Conclusion: Based on the regression analyses, it is found that "help- less", "self confident" and "optimist " approaches explained depressive symptoms and anxiety levels. Beside this, "Acceptance" and "Positive Refocusing" were predicted the decline in depressive symptoms, while "Rumination" and "Catastrophizing" predicted the rise in anxiety scores. "Acceptance" strategy explained the decrease in the level of anxiety as it does in explaining the decrease in the level of depressive symptoms.

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Amaç: Bu araþtýrmada Malatya ilinde, 2005 yýlýnda inti- har giriþimiyle baþvuran olgularýn bazý sosyodemografik deðiþkenler açýsýndan deðerlendirilmesi ve bazý risk etkenlerinin saptanmasý amaçlanmýþtýr. Yöntem: Araþtýrmanýn evreni Ocak - Mayýs 2005 tarihleri arasýnda Turgut Özal Týp Merkezi Acil Servisi veya diðer servislere intihar giriþimiyle baþvuran, ayaktan ya da yatýrýlarak izle- nen ve araþtýrmaya katýlmayý kabul eden 50 olgudan oluþmuþtur. Psikotik bulgularý olan, deliryum tablosunda olan hastalar çalýþmaya alýnmamýþtýr. Veri toplama aþa- masýnda, psikiyatrik görüþme yapýldýktan sonra, Beck Depresyon Ölçeði (BDÖ), Beck Anksiyete Ölçeði (BAÖ), Beck Umutsuzluk Ölçeði (BUÖ) ve sosyodemografik veri formu uygulanmýþtýr. Bulgular: Olgularýn %64'ünü kadýn, %36'sýný erkek bireyler oluþturmaktaydý. Kadýn olgularýn yaþ ortalamasý 25.9±7.6, erkeklerin 32.3±13.7 idi. Çalýþ- mamýzda intihar giriþimi evli kadýnlarda (%59.4) ve bekâr erkeklerde (%55.6) daha sýk görülmüþtür. Bekarlarda ruh- sal hastalýk daha erken yaþlarda (p=0.001), dul ve boþan- mýþ olanlarda ise daha geç yaþlarda (p=0.025) baþlamýþtýr. Olgularýn %36'sý uyum bozukluðu, %32'si depresyon tanýsý alýrken sadece %20'si herhangi bir taný almamýþtýr. Olgularýn %32'sinin öyküsünde intihar giriþi- mi mevcuttu. %90'ý þiddet içermeyen yöntemlerle intihar giriþiminde bulunmuþtu. Olgularýn %54'ünün intihar giri- þiminden üç ay öncesinde psikososyal stresörleri mevcut- tu ve bunlarýn büyük çoðunluðunu ailesel sorunlar oluþ- turmaktaydý. Sonuç: Çalýþmamýz; intihar giriþimlerini önleme açýsýndan psikiyatrik bozukluklarýn tedavi edilme- si, intihar giriþimi ile iliþkili klinik ve sosyodemografik özelliklerin dikkate alýnmasý gerekliliðini ortaya koymuþ- tur.

Objectives: The aim of this study was to investigate the risk factors and determine the socio demographic vari- ables of patients who attempted suicide in Malatya, in 2005. Method: The sample group of this research con- sisted of 50 patients who attended to the Emergency Department or other medical departments of Turgut Özal Medical Center with suicide attempt between January and April 2005 and were followed up either in or outpatient setting, and agreed to participate in the study. Patients who had psychotic symptoms and deliri- um were in the exclusion criteria. The socio-demograph- ical data sheet, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Beck Hopelessness Scale (BHS) were applied following the clinical interview. Results: Of all patients, 64% were female. The mean ages of women and men were 25.9 ± 7.6 and 32.3 ± 13.7, respectively. In our study, suicide attempts were more common among married women (59.4%) and single men (55.6%). Mental disorders had started at an earlier age in singles (p=0.001), and at a later age in widows and divorced (p=0.025). While 36% of the patients were diagnosed as adjustment disorder, 32% was diagnosed as depression and only 20% did not receive any specific diagnosis. A history of suicide attempts was determined in 32% of the cases and 90% of our patients had suicide attempts with non-violent methods. Psychosocial stressors were present in 54 % of patients three months prior to the sui- cide attempt and the majority of these were family prob- lems. Conclusion: It is essential to recognize some clinic and socio-demographic characteristics related to suicide attempts and psychiatric disorders have to be treated in order to prevent suicide attempts.

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Bu gözden geçirmenin amacý biyolojik, psikolojik ve sosyal bileþenleri olan bir bozukluk olarak kavramsal- laþtýrýlan obezitenin tedavisiyle ilgili biyolojik, aðýrlýklý olarak da psikolojik yaklaþýmlara dair genel bir çerçeve çizmek ve Türkçe yazýnda bu alanda görünen boþluðu doldurmaktýr. Bu amaçla PubMed, Web of Science ve GoogleScholar veri tabanlarý esas alýnarak alandaki yazýn taranmýþtýr. Taramada "obezite", "diyet", "cerrahi", "tedavi", "biliþsel", "davranýþçý" ,"ilaç" ve "psikoterapi" anahtar sözcükleri ve bu sözcüklerin Ýngilizce karþýlýklarý çeþitli kombinasyonlarda kullanýlmýþtýr. Tarama sonucun- da güncel yayýnlar ve tekrar edilebilirliði olan veriler göz- den geçirmeye dahil edilmiþtir. Birçok yöntemin obezitenin tedavisinde anlamlý bir düzeyde yararlý olduðu söylenebilir. Ancak obeziteyle mücadelede tek bir yöntemin tüm kiþilerde baþarýlý olmasý mümkün gözük- memektedir. Özellikle morbid obezler gibi bazý hasta gru- plarýnda farmakolojik ve cerrahi tedavilerin uygulan- abilirliði ve etkinliði tespit edilmiþtir. Ancak bu gruba girmeyen hastalarýn birçoðunda psikolojik yöntemler baþta olmak üzere birden fazla yöntemin bir arada kul- lanýlmasý gerekmektedir. Her ne kadar bu tedavi kombi- nasyonlarýndan olumlu sonuçlar alýndýðý gözlenmiþ olsa da özellikle diyetle saðlanan baþarýnýn devam etti- rilmesinde daha etkin psikolojik yöntemlerin geliþtirilme- sine ihtiyaç vardýr. Tedavinin uzun süreli etkisinin göreceli baþarýsý göz önüne alýndýðýnda toplumsal düzeyde yapýlacak önleyici çalýþmalarýn obezitenin görülme sýk- lýðýný azaltmak adýna umut verici olabileceði düþünülebilir.

The objective of the review is to provide general infor- mation about approaches for biological and mostly psy- chological treatments of obesity conceptualized as a dis- order which has biological, psychological and social components. Another aim of the current review is to fill the gap in the literature regarding these approaches. In order to find out the relevant literature, the search was conducted based on the Pub Med, Web of Science and Google Scholar data bases. The combination of key words consisting of "obesity", "diet", "surgery", "treat- ment", "cognitive", "behavioral", "pharmacological", and "psychotherapy" and their Turkish counterparts were used during the literature search. Up to date papers and re-testable data were included in this article. It can be concluded that various treatment modalities in treat- ment of obesity are significantly beneficial. However it does not seem to be the case that one obesity treatment is useful for everyone. It is reported that pharmacother- apy and surgical interventions were effective especially for some patient sub-groups such as the people with morbid obesity. Rather than the people with morbid obesity, the other sub-groups need multi-treatment methods. In this regard, the foremost approach which is the psychological method is required to be integrated into the treatment of obesity. Although these kind of combined interventions show favorable results, further psychological interventions should be improved for pre- vention of relapse of obesity after desired results achieved with the help of diet. When relatively long term effects of interventions are considered, public based pre- vention studies may be more promising in terms of decreasing the prevalence of obesity.

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Çocukluk çaðý travma öyküsünün, bir çok psikiyatrik hastalýk ile iliþkisi olduðu bilinmektedir. Dissosiyatif bozukluklar, en çok üzerinde durulan bozukluklardandýr. Dissosiyatif bozukluklarda paylaþýlan ortak tema geçmiþe ait belleðin, kimliðin farkýnda oluþun ve bedenden gelen duyumlarla bedensel hareketlerin kontrolü arasýndaki normal entegrasyonun kýsmi veya tam kaybýdýr. Bu hastalýk grubunda bir organik hastalýk ya da patofizyolo- jik bozukluða ait kanýtlar da yoktur ve belirtiler beden veya akýl iþlevinin nasýl bozulacaðý veya iþlev görmeye- ceðine iliþkin hastanýn düþüncelerine karþýlýk gelir. Dissosiyatif bozukluklarýn en önemli özelliði neredeyse her ruh fonksiyonunu etkileyebilmesidir. Dissosiyatif amnezi, depersonalizasyon, derealizasyon, kimlik bocala- masý ve kimlik deðiþikliði dissosiyatif psikopatolojinin temel özellikleridir Dissosiyatif bozukluklar kiþilik bozuk- luklarý dahil bir çok psikiyatrik bozukluða eþlik edebilir veya psikiyatrik bozukluklarýn belirtileri içinde bulunabilir. Bu nedenle doðru tanýnýn konulmasý ve ayýrýcý tanýnýn dikkatle yapýlmasý önemli bir konudur. Dissosiyatif bozukluklara taný koymakta ise Uluslararasý Hastalýk Sýnýflandýrmasý (ICD-10) ve Psikiyatride Hastalýklarýn Tanýsal ve istatistiksel Sýnýflandýrmasý El Kitabý (DSM-lV- TR) kullanýlmaktadýr. ICD-10 ve DSM-lV-TR' de nozolojik durum açýsýndan farklýlýklar olmakla birlikte temel temalar deðiþmemiþtir. Bu çerçevede çocukluk çaðýnda yaþadýðý bir travma sonrasý dissosiasyon semptomlarý olan hasta üzerinden dissosiyatif bozuklukta ayýrýcý taný anlatýlacaktýr.

It is known that there is a relationship between many psychiatric disorder and childhood trauma history. Dissociative disorders are most often investigated disor- ders. The common theme shared by dissociative disor- ders is a partial or complete loss of normal integration between memories of the past, awareness of identity, and immediate sensations and control of bodily move- ments. This group of illnesses also lacks the evidence of proximate organic illness or pathophysiological distur- bance, and the symptoms correspond to the ideas of the patient about how parts of body or mind malfunction or fail to function. The most important feature of dissco- ciative disorders that these disorders can affect almost every psychological function. The main features of this psychopathology includes that dissociative amnesia, depersonalization, derealization, confusion of identity and changing of identity. A number of psychiatric disor- ders, including personality disorders, either have disso- ciative disorder comorbidity or contain dissociative symptoms in their diagnostic criteria. Therefore, It is important that diagnose and diffreantial diagnose with dissociative disorders should make carefully. International Classification of Diseases (ICD-10) and Diagnostic and Statistical Manual of Mental DisordersIt is known that there is a relationship between many psychiatric disorder and childhood trauma history. Dissociative disorders are most often investigated disor- ders. The common theme shared by dissociative disor- ders is a partial or complete loss of normal integration between memories of the past, awareness of identity, and immediate sensations and control of bodily move- ments. This group of illnesses also lacks the evidence of proximate organic illness or pathophysiological distur- bance, and the symptoms correspond to the ideas of the patient about how parts of body or mind malfunction or fail to function. The most important feature of dissco- ciative disorders that these disorders can affect almost every psychological function. The main features of this psychopathology includes that dissociative amnesia, depersonalization, derealization, confusion of identity and changing of identity. A number of psychiatric disor- ders, including personality disorders, either have disso- ciative disorder comorbidity or contain dissociative symptoms in their diagnostic criteria. Therefore, It is important that diagnose and diffreantial diagnose with dissociative disorders should make carefully. International Classification of Diseases (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) can be use for diagnose of dissociative dis- orders. In spite of the differences between nosological status, the basic themes remain unchanged. In this con- text, our patient who after a trauma experienced in childhood and we confused about this patient's current diagnosis are explained. (DSM-IV-TR) can be use for diagnose of dissociative dis- orders. In spite of the differences between nosological status, the basic themes remain unchanged. In this con- text, our patient who after a trauma experienced in childhood and we confused about this patient's current diagnosis are explained.

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Venöz tromboemboli (VTE) geliþiminde ileri yaþ, sigara kullanýmý, travma, hareketsizlik gibi bazý kazanýlmýþ ve protein C, S ve antitrombin III eksikliði, disfibrinojenemi gibi kalýtýmsal risk faktörleri rol oynamaktadýr. Konvansiyonel antipsikotik (AP) kullanýmý ile VTE geliþme riskinin arttýðýna iliþkin bazý çalýþmalar ve olgu sunumlarý yayýnlanmýþtýr. Özellikle düþük güçlü antipsikotiklerin kul- lanýmýna baðlý olarak venöz tromboemboli geliþtiði bilin- mektedir. Günümüze kadar VTE geliþimi için risk klozapin ile sýnýrlýyken, günümüzde olanzapin ve risperidon ile VTE iliþkisi olgu sunumlarý ve sýnýrlý sayýda çalýþma ile bildirilmiþtir. Atipik AP'lerin kullanýmýna baðlý geliþen VTE'nin sebebi tam olarak bilinmemekle birlikte, bu ilaçlarýn kullanýmýna baðlý geliþen kilo artýþý, yüksek beden kitle indeksi (BKÝ), hareketsiz yaþam biçiminin VTE için risk faktörü olabileceði düþünülmüþtür. Atipik anti- psikotikler son yýllarda baþta þizofreni olmak üzere birçok psikiyatrik hastalýðýn tedavisinde yaygýn olarak kullanýl- maktadýr ve yan etkilerin oluþum riskinde artýþ bildirilmiþtir. Bu olgu sunumu ile atipik AP'ler ve kimi zaman ani ölüme yol açabilen VTE arasýndaki iliþkiye dikkat çekmek istedik.

There are acquired risk factors such as age, smoking, trauma, immobilation and genetic risk factors such as protein C, S and antitrombin III deficiency, disfibrinogen- emy playing role in the development of Venous Thromboembolism (VTE). Association between conven- tional antipsychotic medications and VTE has been strengthened as a result of the published studies and case reports. Specially it is known that low potency antipsychotic drugs were more associated with VTE develops than high potency antipsychotics (8). Uptill now, the risk of development VTE was limited by clozap- ine, contemporarily the association between other sec- onder generation antipsychotics especially with olanza- pine and risperidone was reported by case reports and limited studies. The biological mechanism antipsycotic induced VTE is unkown, also it is thought that putting on weight , high body mass index (BMI), sedative life style developing with the use of these drugs could be the risk factors. Atypical antipsychotics are widely used for mental disorders firstly as schizophrenia and an increased risk of adverse effects have been reported. With this case report, we wanted to draw attention to the relation between atypical APs and VTE -which some- times can cause sudden death.

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Tek doz kas içi haloperidol ve klorpromazin uygulanmasý ile geliþen miksödem koma (MK) olgusu sunulmuþtur. Miksödem koma, nadir görülen fakat ölümcül seyir izleyebilen, hipotiroidizmin (HT) en önemli formudur. Olgumuzda, miksödem koma tablosunu tetiklediði bili- nen sebeplerin dýþlanmasýyla, kas içi uygulanan tedavi olasý sebep haline gelmiþtir. Literatürde belli antipsikotik- ler ve antidepresanlar ile geliþen miksödem koma olgu- larý mevcuttur, fakat tek doz kas içi haloperidol ve klor- promazin uygulanmasý ile geliþen miksödem koma olgusu bildirilmemiþtir.

To describe a case of myxedema coma (MC) associated with single dose of combination of intramuscular haloperidol and chlorpromazine. Myxedema coma, the most significant form of hypothyroidism (HT), is a rare but potentially fatal condition. The known precipitating causes of myxedema coma were ruled out in this patient, which left intramuscular medications as the likely cause. Cases of hypothyroidism caused by certain atypical antipsychotics and antidepressants are found in the lit- erature, but none was reported with single dose of intra- muscular haloperidol and chlorpromazine therapy.

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