ISSN 1302-0099 | e-ISSN 2146-7153
TURKISH JOURNAL CLINICAL PSYCHIATRY - Turkish J Clin Psy: 3 (4)
Volume: 3  Issue: 4 - 2000
REVIEW
1. Multidisciplinary Approach in the Analysis of Executive Functions: From Cognitive Psychology to Neuroradiology
Sirel KARAKAŞ, Muammer KARAKAŞ
Pages 215 - 227
The present study is on executive functions, a high control mechanism of cognitive processes. The paper demonstrates the usefulness of the multidisiciplinary approach in understanding the subfunctions of this complex control mechanism. It shows that in the endeavor for understanding this phenomena, scientific branches may complete one another, reciprocally compensating for insufficiencies of each other. The science of cognitive psychology studies basic cognitive processes. In this field, a 'high control'junction that controls others is found experimentally untestable; accordingly, the study of executive functions is considered outside the realm of cognitive psychology. Meanwhile, the field of neuropsychology can study executive junctions. In this field, such complex functions have been rendered measurable through neuropsychological tests, foremost of which are Wisconsin Card Sorting Test (WCST) and Stroop Test. Statistical analyses have shown that WCST measures three and Stroop Test TBAG version (TÜBİTAK Basic Sciences Research Group) two different properties. According to these results, these two tests measure different aspects of the 'executive functionsFurthermore they study inhibition, a process of central importance to this complex phenomenon from different perspectives. Central importance to this complex phenomenon from different perspectives. Finally the field of neuroradiology has shown that areas in prefrontal lobes are differen-tially activated by WCST and Stroop tasks. Studies that use functional magnetic resonance imaging (fMRG) have demonstrated that Stroop tasks are related to the activation of a widespread parallel processing system in the left frontal lobe. WCST performance, on the other hand, was found to be localized predominantly to a more confined part of the right hemisphere. Demonstrating the utility of the multidisciplinary approach in differentiating between different aspects of such a complex phenomenon as the executive functions, the present study may lead to the adoption of this approach in other studies where similar cognitive functions are investigated.

RESEARCH ARTICLE
2. Adolescent Psychological Problems and Their Relation-ships with Suicidal Behavior
Mehmet ESKİN
Pages 228 - 234
This study investigated the psychological problems and their relationship with suicidal behavior in adolescents. Psychological problems are measured by GHQ-12. Suicidal behavior was measured as current suicidal ideation, suicidal ideation within the past-twelve months and suicidal attempts within the past-twelve months. Participants of the study were 422 (XA4) male and 537 (%56) female (N=959) high school students. %61.5 of the students scored above the cut-ojf point of 2 on GHQ-12. There were more girls than boys among those who scored above the cut-off point. Students who thought and those who attempted to kill themselves scored higher than those who did not think and attempt to kill themselves on the GHQ-12. Three regression analyses were carried out in order to find out which of the GHQ items predict the suicidal thoughts and attempts. According to the results of these analyses "being unable to sleep due to worries" appeared as an independent predictor of suicidal thoughts and attempts. Results from the study were discussed by comparing them with findings from other investigations using the GHQ- 12.

3. Alexithymia, Hopelessness and Depression in Social Phobic Patients: A Study with a Control Group
Mustafa SOLMAZ, Kemal Sayar, Akil Özer, Mücahit Öztürk, Burçin ACAR
Pages 235 - 241
Alexithymia is reported to be prevalent in anxiety disorders such as posttraumatic stress disorder and panic disorder. This study aims at searching the prevalence of alexithymia in social phobia and also assessing the levels of hopelessness, depression and anxiety in social phobic patients. 24 patients who were diagnosed as generalized social phobia according to DSM-IV criteria by two psychiatrists and twenty- four age, gender and education matched healthy controls were taken in the study. Subjects were assessed by self-report measures on depression, anxiety, hopelessness and alexithymia. The patient group was also given Liebowitz Social Anxiety and Sheehan Disability scales and correlation analysis was performed between psychometric measures. Social phobic patients scored significantly higher than healthy controls on the measures of depression, anxiety hopelessness, alexithymia and suicidal ideation. Disability in the family life was associated with alexithymia, depression and anxiety whereas no association was found between social anxiety and disability scores. Alexithymia was independent of depression and anxiety. Social phobia shows high rates of comorbidity with major depression. Anxiety hopelessness and suicidal ideation are prevalent in social phobic patients. Alexithymia also comes out as a prevalent personality trait in this group of patients.

4. Prevalance of Substance Use Among High School Students in İstanbul
Kültegin Ögel, Defne TAMAR, Cüneyt Evren, Duran ÇAKMAK
Pages 242 - 245
In order to search extend of tobacco, alcohol and substance use among high school students in Istanbul, we evaluate İstanbul data of the study which was done in 15 cities in Turkey. In this study a questionnaire was given 7849 second grade high school students in April and May 1998 in İstanbul. 65.1% of students use tobacco at least once in a lifetime, 22.5% of them use at least one cigarette every day. 18% of them use alcohol at least once in last 30 days. Lifetime rate of cannabis use is 3.6%, lifetime rate volatile use is 8.6%, lifetime rate of other drugs use is 3.3%. When we compare with previous studies we found an increase in volatile use. These finding shows us that there is a significant increase in volatile use.

5. Effects of Olanzapine and Haloperidol on Prolactin Levels in Schizophrenic Patients
Ertuğrul EŞEL, Mustafa Baştürk, Saffet GÖNÜL, Mustafa KULA, Tayfun TURAN, İhsan YABANOĞLU, Seher SOFUOĞLU
Pages 246 - 249
It has been proposed that new atypical antipsychotics causes minimal prolactin elevation compared to traditional antipsychotic agents because they spare dopamine blockade within the tuberoinfundibular tract. The aim of this study was to compare the effects of olanzapine and haloperidol on prolactin secretion in male schizophrenic patients. Twenty-nine male schizophrenic inpatients were included in the study. Fifteen of them were given olanzapine in a fixed dose of 10 mg/day and 14 of them were given haloperidol in a fixed dose of 10 mg/day for 6 weeks after a 2-week drug washout. Fifteen age-matched healthy control subjects were used as control group. Prolactin levels were measured both before and after 6-week treatment period in patients. At the end of the 6th week, prolactin values observed with olanzapine treatment were significantly less than those observed with haloperidol, but not different from those of controls. No significant correlation was found between prolactin values and any clinical correlates. Our data indicate that short-term olanzapine treatment causes minimal elevations in prolactin secretion in male schizophrenic patients in contrast to haloperidol. This finding is consistent with the previous reports and may be attributed to olanzapine's differential effects on dopamine neurotransmission.

6. The Relatioiship Between the Changes of Iron Metabolism and Akathisia Scores in Patients Taking Neuroleptic Drugs
Ali Çayköylü, İrfan Coşkun, Şenol ANAÇ, Hülya Aksoy, İsmet KIRPINAR
Pages 250 - 254
Akathisia is an important side effect which specifically appears in the administration of conventional neuroleptics. Etiopatogenesis of akathisia has not been defined completely so far. However, it is thought that some defects in iron metabolism are related on the emergence of akathisia. Moreover, some contradictory results have been obtained with respect to the studies of iron metabolism. In this study we investigate whether there is a close relationship between serum iron levels and akathisia in those patients with neuroleptic induced akathisia. Neuroleptic induced akathisia appears quite often and severely in the patients with lower serum iron level and percent saturation. It is also indicated that the serum iron levels and percent saturation decreased significantly due to neuroleptic administration in the patients with akathisia. In the light of these results the patients with low serum iron concentration show a considerable tendency can be increased through the decrease of serum iron concentrations by neuroleptics.

REVIEW
7. Loss of Antidepressant Efficacy During Maintenance Treatment: Causes and Diagnostic Difficulties
Levent SEVİNÇOK, Nevzat Yüksel
Pages 255 - 262
The effect of the antidepressants disappear in some of the patients during the maintenance treatment. Poor treatment compliance, the loss of an initial plasebo response, the loss of a true drug effect, the changes in the pathogenesis of depressive disorder are among the possible explanations for it. It is required to evaluate the pharmacological effects of such drugs in the brain when discussing the loss of effect during the certain phases of antdepressant treatment.

8. Language Development of Infants and Children
Elvan KARACAN
Pages 263 - 268
Biological, neurological, psychosocial, psychosexual and cognitive development effects each other in the developmental period. Language development is an important part of this coordinated development and learning process which begins after birth. All babies start to learn language by the means of speech sounds in their own language. Language development is closely related with brain maturation and by the age of 3 an almost maturated language acquisition is expected. In this paper properties and milestones of language development in infants and children take place.

CASE REPORT
9. Obsessive Compulsive Disorder Masked By a Headache: A Case Report
Şebnem Soysal, Çağlar ÇITAK, Dilşad Foto Özdemir, Kıvılcım GÜCÜYENER, Ayşe Serdaroğlu
Pages 269 - 272
Headache is a common disorder in childhood, which is a part of different disease as well as psychological problems. It misleads the clinicians because of duration so it causes a wrong diagnosis. While determining treatment strategy for headache comorbidity must be carefully evaluated. So that we want present a 15-year- old girl who was admitted to the emergency room with the complaint of headache. Her physical examination, laboratory and radiologic evaluation were all normal. Her psychometric evaluation revealed that she has got obsessive compulsive disorder. In the light of this case; we discussed the effect an psychological disorder on the symptom of headache in childhood.

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