ISSN 1302-0099 | e-ISSN 2146-7153
TURKISH JOURNAL CLINICAL PSYCHIATRY - Turkish J Clin Psy: 4 (4)
Volume: 4  Issue: 4 - 2001
RESEARCH ARTICLE
1. Evaluation of WISC-R Profiles in Children with Learning Disorders
Şebnem Soysal, Aylin İLDEN KOÇKAR, Emel ERDOĞAN, Selahattin Şenol, Kıvılcım GÜCÜYENER
Pages 225 - 231
Learning is not only the acquisition of a new skill or the spe-cia-lization in a certain academical area but a life time process which involves emotional, social and personality development. Any defects in this process many effect a person's whole life. Children who are diagnosed as having learning disorders not only have low academical grades their lives are effected in many areas. Therefore the effort to understand the effects of learning disabilities on the cognitive functions has brought the development of test batteries which are used in the assesment of attention, perception and comprehension abilities. One of the most effective of these batteries is the Wechsler Intelligence Scale for Children (WISC-R). This study was done in order to understand the assesment value of WISC-R in learning disabilities on the attention and perception processes, and the profile ofWISC-R's subtests which assess these processes, according to the group and sex factors. The study was conducted over a one-year period on children who applied to Gazi University Pediatrics Department Child Neurology Unit and Child Psychiatry Department with articulation, learning and perception problems. 20 children were diagnosed as having learning disabilities according to DSM-1V criteria, who also had no other comorbid psychiatric or neurologic disorder and had not started to use medication. The control group which consisted of 20 children had similar backgrounds in terms of age, sex and socioeconomic status and they had no psychiatric disorder previously. 2 (Group: Study Group, Control Group) x 2 (Sex) ANOVA was employed with the WISC-R scores of the study and control groups see significant differences in the group-sex variables. Sex by group interaction effect was not found. In the regression analysis the verbal IQ was found as the best predictor of learning disability. Concordant with the literature, WISC-R was found to be a good differentiating tool for learning disabilities. It is thought that new perceptions in the diagnosis and treatment of WISC-R will be provided by the assesment of reading and writing abilities by other neuropsychological tests, since WISC-R does not assess these dimensions.

2. Suicide Attempt History of the Inpatient Drug Users
Cüneyt Evren, Kültegin Ögel, Duran Çakmak
Pages 232 - 240
Studies show that suicide risk is higher among addicts than ge-neral population. Early prediction of preventable mortality reason suicide, in this population with high risk is important. The aim of this study is to compare sociodemographic and drug use related characteristics, according to presence of suicide behavior in the past. Semi-structured sociodemographic form, which also included questions about drug use characteristics, have been applied to drug users who were inpatient treatment at the AMATEM clinic in the years between 1997 and 2000. A total of25.2% of the drug users reported having attempted suicide once or several times; the proportion was higher among females, singles, living alone, unemployed, low educational status, alcohol and drug use in family, having health, social and criminal problems because of drug use, dangerous and harmful behavior under the effect of drug, age of first drug use and age of starting heavy drug use was early and main drug of choice and first used drug was benzodiazepine type mostly. The rate of self-reported suicidal behavior among drug users is high. In this population suicide ideation and suicide history must be taken carefully and protective measures must be planned.

3. Relationship Between Serum Lipid Levels and Psychiatric Symptoms
Ramazan ÖZCANKAYA, Namık DELİBAŞ
Pages 241 - 248
This study had been performed between June 1999 and February 2000 in psychiatry outpatient clinic. 267 consecutive patients met the study criteria were included in this study. Control subjects consisted of 44 medically and mentally healthy persons. Control and study groups were matched by sex, age, body mass index. Brief Symptom Inventory (BSI) developed by Derogatis LR and adapted by Sahin and Durak was applied to control and study groups at the first interview. Subjects were examined as 10 subgroups for somatization, obsessive-compulsive disorder, sensitivity among persons, depression, anxiety disorder, hostility, phobic anxiety, paranoid ideation, psychotism and additional items. Total cholesterol, HDL-C, LDL-C, VLDL-C and triglyceride levels were measured in control and study subjects. Total cholesterol levels were significantly lower in the depression and hostility subgroups (p<0.05) than the control group. No significant relation between lipid parameters and anxiety groups, and psychotism was found. As a result, low level of serum total cholesterol, LDL- C ve TG may be imporant factor for depression and hostility.

REVIEW
4. The Importance of Pharmacogenetics on the Drug Therapy of Psychiatric Diseases
Şükrü AYNACIOĞLU
Pages 249 - 252
The main factors responsible for the variability of interindividual drug response are genetic factors. Interindividual differences observed in the efficacy and toxicity of many drugs are associated with genetic polymorphisms of drug metabolizing enzymes, transporter proteins, receptors and other drug targets. Many drug metabolizing enzymes are polymorphic and interindividual and interethnic differences of enzyme activities due to these polymorphisms may lead to ineffective drug therapy or drug toxicity. Poor metabolizers for the cytochrome P450 2D6 (CYP2D6) enzyme activity are more sensitive to the side effects of many drugs such as antidepressants and antipsychotic drugs, used for the treatment of psychiatric diseases. Ineffective drug therapy may occur in ultrarapid metabolizers, who have an increased enzyme activity, due to the rapid metabolism of drugs. Therefore, identifying the gene polymorphisms in drug metabolizing enzymes and other systems responsible for drug kinetics and dynamics may increase the success of pharmacotherapy.

5. Administration of Modified Electroconvulsive Treatment with Anesthesia and Muscle Relaxants
Cebrail KISA, Nesrin DİLBAZ
Pages 253 - 260
The basic principle of electroconvulsive therapy (ECT) which is an effective intervention in certain mental disorders rely on electrically induced seizures. In recent years with the determination of indications for use of ECT, the innovation in ECT techniques and devices and the administration of anesthesia and muscle relaxants during ECT have contributed to a growing acceptance of this modality. In this article the administration of modified ECT with an anesthesia and muscle relaxants which were introduced to increase the safety as well as patient acceptability is reviewed.

6. Antidepressant Augmentation Treatments
Hakan Türkçapar, Süreyya Özel ERVATAN
Pages 261 - 267
Despite attempts to optimize antidepressant therapy, a substantial number of patients still fail to respond to the antidepressant prescribed. Up to 30% percent of patients with major depression fail to respond to conventional treatment. All antidepressant re- gi-mens are associated with a latency period of 1-2 weeks before begining ofnotiecable clinical effects. Another problem with the antidepressant treatment is loss of efficacy or emergen-ce of depressive symptoms despite ongoing antidepresant tre-at-ment. That's why alternative approaches are still required. Aug-menta- tion treatment is one of these alternative strategies. In this paper, beside major augmentation strategies such as lit-hium and thyroid hormone augmentation, novel strategies such as pindolol and atypical antipsychotics augmentation of an-tidepres- sant treatment is reviewed in view of the recent literature.

7. The Place of Day Hospitals in Psychiatric Rehabilitation
Melike Güney
Pages 268 - 276
After giving a brief history of day hospitals in general, this paper aims to describe the holistic therapeutic approach applied at the day hospital of the psychiatry department of Ankara University.

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