Why Do Adolescents Relapse? A Multicenter, Cross-sectional Study.

Background: Adolescents use drugs once, then use them regularly, then start and stop many times. In addiction treatment, relapse is a major barrier to recovery. Relapse is more common among adolescents and is a major problem. Thus, this study aimed to identify the factors impacting the duration of relapse in adolescents. Methods: This is a multicenter, cross-sectional study. A total of 157 adolescents who applied to 4 different child and adolescent addiction treatment centers between January 2020 and March 2020 were included in the study. The "Addiction Profile Survey Adolescent Form" was administered to the participants face to face. According to the duration of relapse determined with this form, the cases were analyzed separately as before and after 1 month. Results: The sample consisted of 112 (71.34%) males and 45 (28.66%) females, with a mean age of 17.1 ± 0.8 years. Cannabis use (P = .010), late treatment initiation (P = .003), less psychosocial (P = .001), outpatient (P = .006), and inpatient (P = .006) treatment history were significantly associated with relapse before 1 month. Cannabis users were approximately 4 times more likely to relapse in less than a month, while ecstasy users were approximately 4 times more likely to relapse over a month (OR = 0.26, CI = 0.1-0.69), (OR = 4.16, CI = 1.26-13.78). In the multiple logistic regression analysis performed to determine the factors predicting the duration of relapse, it was found that not attending school (P = .018) and receiving less inpatient treatment (P = .019) predicted relapse occurred within 1 month. Conclusion: This study is considered remarkable in terms of demonstrating the necessity of early interventions and post-treatment care services. Currently, there are very few studies in the literature that investigate the factors that contribute to relapse in addicted adolescents. According to our literature review, no study examined factors affecting relapse duration in adolescents.

Life Chart of Substance Use Career: A Clinical Profile Study from Turkey.

Background: The "career approach," developed to understand substance use and treatment, is important because it can broadly encompass the complexity of addiction patterns and help to better illustrate the chronic and recurrent nature, correlations, and consequences of addiction. The current study aimed to examine the substance use career and patterns of patients diagnosed with substance use disorder. Methods: The authors created a questionnaire that included questions inquiring at what age several substance use-related life events occurred. The Addiction Profile Index was used to collect sociodemographic data and measure substance use disorder severity. Descriptive statistics and group comparisons were conducted to evaluate the data. Results: Of the cases (n = 400), 72.7% began using substances before the age of 18, but only 12.4% (n = 68) sought treatment by that age. There were approximately 8 years between starting substance use and seeking treatment. Substance use was noticed by the family approximately 5 years after it started. There was a difference between males and females in terms of the age of experiencing adverse life events due to substance use, with females being earlier (P = .030). Similarly, individuals with opioid use disorder experienced adverse life events due to substance use at an earlier age than the non-opioid group (P = .001). Conclusion: Identifying patient characteristics associated with the course of use in people who use different substances of choice and examining the differences in lifelong substance use patterns among these groups will help develop targeted treatment services and policies.

The pathway to care of patients with SUD who presented at addiction treatment centers (AMATEM) in Turkey.

AIM: Recent studies have shown that alcohol and drug use in Turkey is rising year on year. In order to prevent and treat substance use disorder (SUD), many Alcohol and Drug Research, Treatment and Training Centres (AMATEM) have been established in Turkey. The purpose of this study was to investigate the pathway to care of patients who presented at AMATEM. METHOD: A total 235 patients with SUD between16-69 age groups who presented at AMATEMs in 2017 were included in this study. A sociodemographic form and a structured self-report questionnaire consisting of 36 items assessing the pathways of care were given to all the patients. Data were analysed with descriptive statistics using SPSS software. RESULTS: The majority of the patients included in the study were single (55%) and male (96%). Patients mostly had a secondary school level of education (51%) and social security (65%). The majority of the patients stated that they used more than one substance (44%), opiates (20%) or alcohol (18%). CONCLUSION: This is the first study evaluating the pathway of care in patients with SUD in Turkey. It was observed that a significant majority of patients with SUD presented to AMATEMs and patients who applied to different health institutions stated that they were mostly informed about SUD and AMATEM. There were also patients with negative attitudes towards AMATEMs and non-medical treatment seeking behavior other than AMATEM. Families, relatives and friends of patients with SUD have an important place in reaching the treatment.

Predictors of Relapse to Alcohol and Substance Use: Are There Any Differences between 3 and 12 Months after Inpatient Treatment?

Understanding the factors that lead to relapse is important for developing effective treatment strategies. The aim of this study is to examine sociodemographic and clinical factors that predict relapse 3 and 12 months after inpatient treatment in patients with alcohol and substance use disorders. 247 patients were included in the study. A sociodemographic data form and the Addiction Profile Index-Clinical Form (API-C) were filled out during the first days of hospitalization and relapse information was obtained through outpatient interviews. Logistic regression analysis was used to assess predictive factors. Rates of relapse for the 3rd and 12th months were 40.5% and 74.6%, respectively. Motivation to quit substance use, risk of depression, being on probation, and being employed predicted relapse within the 3-month period. At the 12th month, substance use intensity and motivation to quit were the factors associated with relapse. To conclude, motivation to quit is critical to maintaining both early and sustained remission. Moreover, divergent factors may be relevant at different stages of treatment. Defining relapse predictors early in the process and being vigilant to the change in the needs of patients as the treatment continues may help to develop a more effective and focused treatment plan.

Fentanyl use disorder characterized by unprescribed use of transdermal patches: a case report.

BACKGROUND: Fentanyl is a synthetic opioid with analgesic potency 75-100 times higher than that of morphine, and its analgesic effect is used for pain treatment, mostly in cancer patients. Using fentanyl patches may reduce misuse potential due to the transdermal route of administration, long-acting action, sustained release delivery property, and maintenance of steady-state serum concentration of the drug. Although there have been reports of transdermal fentanyl patches (TFPs) misuse via transmucosal, trans-nasal, intravenous, and oral routes of administration, fentanyl use disorder via the transdermal route is very rare. CASE: In this case report, we present a patient with a history of substance use disorder who developed fentanyl use disorder via transdermal route after using unprescribed TFP in order to quit opium gum. The CARE guidance was followed in the preparation of this case report. CONCLUSION: The risk of use disorder may be higher, especially in individuals with a history of substance use disorders. This risk should be taken into account when clinicians prescribe this medication.

The Validity aand Reliability of the Addiction Outcome Assessment Index (AOAI). / Bagimlilik Seyir Indeksi (BASI)’nin Geçerlik ve Güvenilirlik Çalismasi.

OBJECTIVE: The objective of this study was to develop a short scale that assesses the progress and recovery in addiction treatment with respect to all relevant areas, and to determine its validity and reliability. METHOD: After scanning the literature and consulting the experts, a pool of questions was. The pilot form was tested in 10 cases then a final 8-item scale was generated. Clinical sample of the study consisted of 307 alcohol/substance users who applied Turkish Green Crescent Outpatient Counselling Center for psychosocial treatment between March 2016 and March 2017. Non-clinical sample of the study is composed by 102 randomly chosen participants without a history of psychiatric disorder. The reliability of the Addiction Outcome Assessment Index (AOAI) questions was determined by computing the Cronbach's alpha coefficient, and the factor structure analysis was determined by varimax rotation. Analysis of the reliability of the change between sessions was conducted via Reliable Change Index-(RCI). RESULTS: The Cronbach's alpha coefficient for the total Outcome Assessment Index (AOAI) was 0.80. Therapists' total correlation coefficient was 0.75. Explanatory Factor Analysis revealed 2 factors which explains 43.96% of the total variance. The difference between groups' AOAI-Turkish (BASI) mean score was statistically significant. Cut-off point was determined as 8.63. RCI was 3.5. AOAI's first session mean score was 14.92±5.63, the mean score decreased at the tenth session to 9.4±4.71. CONCLUSION: The results showed that AOAI is a valid and reliable questionnaire that can be used to measure the progress of different dimensions of alcohol and substance use.

Comparison of Individuals With and Without the Risk of Post-Traumatic Stress Disorder in Terms of Substance Use Features and Psychological Problems According to Their Substance Preferences.

Objective: There are multiple studies that show that exposure to a traumatic life event is a significant factor in the development and continuation of addiction. When post-traumatic stress disorder (PTSD) is added to an alcohol-substance use disorder, the course of treatment is negatively affected. This study aimed to compare people with and without the risk of PTSD in terms of substance use features and psychological problems on the basis of their substance preferences. Methods: The study was conducted with 614 individuals hospitalized in an addiction recovery center because of an alcohol and substance use disorder. Development of the addiction profile index (BAPI) clinical form was used to measure the addiction features and their severity, psychological condition, and some personal characteristics of the patients. The Kocaeli short screening scale for psychological trauma was used to determine traumatic life events and evaluate traumatic stress symptoms. Results: PTSD frequency of the participants with an alcohol-substance use disorder was 29.8% (n = 162). Considering the frequency of PTSD risk, 29.2% (n = 98) of the participants with opioid use disorder, 33.3% (n = 13) of the participants with cannabis use disorder, and 35.7% (n = 20) of the participants with alcohol use disorder had a risk of PTSD. Participants with PTSD symptoms had higher scores in substance use features, diagnosis, effect of substance use on life, cravings, greater addiction severity, difficulty in anger control, more excitement seeking behaviors, safe behavior deficiency, depression, and anxiety. Conclusion: Substance use features and psychological problems varied in individuals with and without the risk of PTSD. Configuration of the treatment plan considering this differentiation is significant in terms of the course of the treatment.

Efficacy and Safety of Gamma Ventral Capsulotomy for Treatment-Resistant Obsessive-Compulsive Disorder: A Single-Center Experience.

BACKGROUND: Obsessive-compulsive disorder (OCD) is a chronic disease with a lifetime prevalence of 3% and is associated with severe impairment in familial and socio-occupational functioning. Gamma ventral capsulotomy (GVC) is a treatment choice in carefully chosen patients, with few published reports. In this study, we aimed to report the efficacy and safety of GVC in 21 patients with treatment-resistant OCD. METHODS: This is a retrospective single-center study. Twenty-one patients meeting the selection criteria were included. Patients were considered responders if there were ≥35% reduction in post-GVC Yale-Brown Obsessive Compulsive Scale scores and considered in remission if scores were ≤8. The mean and median clinical follow-up durations were 60.7 and 56 months, respectively (range, 38-149 months). RESULTS: The mean baseline Yale-Brown Obsessive Compulsive Scale score of 35.7 (n = 21) decreased to 15.3 (n = 20) at 36 months follow-up evaluation (P < 0.0001). Fifteen patients (75%) achieved a full response. Of those patients, 7 (35%) were considered to be in remission. There were no partial responders, and 5 patients (25%) were classified as nonresponders. The pre-GVC mean Beck Depression Inventory-II score of 35.1 (n = 21) decreased to 13.8 (n = 20) at 36 months follow-up evaluation (P < 0.0001). Three patients (14.3%) had a transient post-GVC headache that resolved within a week, and 2 patients (9.5%) had persistent headaches that responded to 2-week oral corticosteroid treatment. A brain cyst developed after GVC in 2 patients (10%). No clinically notable abnormalities were seen on neurologic examination at any follow-up. CONCLUSIONS: Gamma ventral capsulotomy is a reasonable treatment method in select patients with treatment-resistant OCD.

Psychometric properties of the Turkish versions of the Drug Use Disorders Identification Test (DUDIT) and the Drug Abuse Screening Test (DAST-10) in the prison setting.

The aim of this study was to evaluate psychometric properties of the Drug Use Disorders Identification Test (DUDIT) and the Drug Abuse Screening Test (DAST-10) in prisoners with (n = 124) or without (n = 78) drug use disorder. Participants were evaluated with the DUDIT, the DAST-10, and the Addiction Profile Index-Short (API-S). The DUDIT and the DAST-10 were found to be psychometrically sound drug abuse screening measures with high convergent validity when compared with each other (r = 0.86), and API-S (r = 0.88 and r = 0.84, respectively), and to have a Cronbach's α of 0.93 and 0.87, respectively. In addition, a single component accounted for 58.28% of total variance for DUDIT, whereas this was 47.10% for DAST-10. The DUDIT had sensitivity and specificity scores of 0.95 and 0.79, respectively, when using the optimal cut-off score of 10, whereas these scores were 0.88 and 0.74 for the DAST-10 when using the optimal cut-off score of 4. Additionally, both the DUDIT and the DAST-10 showed good discriminant validity as they differentiated prisoners with drug use disorder from those without. Findings support the Turkish versions of both the DUDIT and the DAST-10 as reliable and valid drug abuse screening instruments that measure unidimensional constructs.

The development, validity, and reliability of the Addiction Profile Index (API).

OBJECTIVE: The objective of this study was to develop a practical questionnaire for multidimensional assessment of problems associated with alcohol and substance abuse that would also be useful for treatment planning. MATERIALS AND METHODS: The Addiction Profile Index (API) is a self-report questionnaire consisting of 37 items and the following 5 subscales: characteristics of substance use; dependency diagnosis; the effects of subsance use on the user; craving; motivation to quit using substances. The study included 345 alcohol and/or substance abusers from 2 addiction treatment clinics and a prison addiction service. The validity of the questionnaire was assessed using the Michigan Alcoholism Screening Test (MAST), Readiness to Change Questionnaire (SOCRATES), Penn Alcohol Craving Scale (PACS), Drug Craving Scale (DCS), Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and Addiction Severity Index (ASI). RESULTS: The Cronbach's alpha coefficient for the total API was 0.89 and for the subscales it ranged from 0.63 to 0.86. Item-total correlation coefficients ranged from 0.42 to 0.89. The Spearman Brown split-half method coefficient for the total API was 0.83. In all, 4 factors were obtained using explanatory factor analysis that represented 52.3% of the total variance. The API craving subscale was observed to be consistent with PACS and the API motivation subscale was consistent with SOCRATES. The API total score was strongly correlated with the mean MAST score, and the composite ASI medical status, substance use, legal status, and family social relations subscale scores. Based on ROC analyses, the area under curve was 0.90. With a total API cut-off score of 4, the scale's sensitivity and specificity 0.85 was 0.78, respectively. CONCLUSION: The findings show that the API is a valid and reliable questionnaire that can be used to measure the severity of different dimensions of substance dependency.

Cognitive behavioral therapy-based brief intervention for volatile substance misusers during adolescence: a follow-up study.

Of 62 males admitted for treatment in Turkey in 2008 with a diagnosis of volatile substance misuse (VSM) dependency, half were randomly allocated to receive a cognitive behavioral therapy (CBT)-based brief intervention and an education program and half participated only in the education program. One year after treatment, 38.2% of the experimental group and 58.1% of the control group had continued VSM during the last three months. This statistically significant difference indicates that CBT-based brief intervention is associated with reducing VSM in adolescents. Factors associated with abstinence after treatment are identified and study limitations are noted.

Juvenile offences among hospitalized adolescent inhalant users in Istanbul: a comparison regarding place of residence.

In this research, juvenile offenses and associated behaviors among adolescent inhalant users in Istanbul were investigated and inhalant users living in the street were compared to inhalant users living with their families. An interview questionnaire developed by the researchers was administered to 200 male adolescent inhalant users who were hospitalized during 2002-2003. More than half of the sample had committed juvenile offenses at least once in their lifetime, 16.3% had entered a house of corrections, 91.5% had friends who committed juvenile offenses, and the majority had been taken to a police station at least once in their lifetime. The rates for juvenile offenses, being taken to the police station, committing crimes to obtain money to buy drugs, and obtaining income through illegal activities were higher among adolescents living in the street than adolescents living with their families. Although the juvenile offense rate was higher among adolescents living in the street, it can be suggested that both groups live in subcultures that have a tendency towards crime, and inhalant use is part of these subcultures. Juvenile offense interventions can be useful for all inhalant users.

Dilated cardiomyopathy associated with toluene abuse.

The use of paint thinner and glue to achieve an euphoric state has been associated with serious social and health problems in children and young adults. We present the case of a 21-year-old man with dilated cardiomyopathy occurring following abuse of paint thinner and glue containing toluene as main compound. After cessation of toluene abuse, the patient recovered rapidly and completely. Because of the increasing prevalence of toluene abuse, harmful effects of this volatile agent on the heart are also discussed.

[Development and reliability study of the adolescent inhalant use severity scale]. / Ergenlerde uçucu madde kullanimi siddetini degerlendirme ölçeginin gelistirilmesi ve güvenilirlik çalismasi.

OBJECTIVE: To develop a scale in order to investigate the severity of inhalant use in adolescents and to conduct reliability and validity studies of this scale. METHOD: A questionnaire was developed by conducting interviews with two groups: professionals working with adolescent inhalant users and inhalant-using adolescents. This questionnaire was developed into a 21-item scale. This was applied by two different interviewers to 50 adolescents at Bakirköy Mental Health Hospital Inhalant Use Research and Treatment Center for Children and Adolescents. Two other professionals applied the Visual Analog Scale to the same 50 adolescents to evaluate the severity of inhalant use. The correlation between the two interviewer scores and the scores obtained from the Visual Analog Scale and the 21-item scale was evaluated. Addicts and non-addicts were evaluated using SCID-I and the scores of addicts and non-addicts were compared. Test re-test reliability of the scale was evaluated by applying the scale in the 10-15 days following the first administration. RESULTS: The correlation between the questionnaire scores and the Visual Analog Scale scores was adequate (0.72). The mean scores of addicts were higher than those of non-addicts (p<0.001). The Cronbach alpha value was 0.84. Three items had no internal consistency and the same items' interrater and test re-test reliability correlations were low. CONCLUSION: It is thought that when the 3 inconsistent items are removed the 18-item Yeniden Inhalant Use Severity Scale (YUKUD) is a reliable and valid measure to evaluate the severity of inhalant use in adolescents and that it can be used in related research.

Public opinions and beliefs about the treatment of depression in urban Turkey.

BACKGROUND: Although attitudes towards psychiatric illness influence its presentation, detection, recognition, treatment adherence and rehabilitation, the lay public's opinions and beliefs about the treatment of depression have not been investigated sufficiently. OBJECTIVE: The aim of this study was to determine public opinions and beliefs about the treatment of depression and the influence of perception and causal attributions on attitudes towards treatment of depression in urban areas. METHODS: This study was carried out with a representative sample in Istanbul, which is the biggest metropolis in Turkey. Seven hundred and seven subjects completed the public survey form which consisted of 32 items rating attitudes towards depression. RESULTS: The public believes that psychological and social interventions are more effective than pharmacotherapy, and that the medicines used in treatment of depression are harmful and addictive. There was a general reluctance to consult a physician for depression, and psychiatrists were felt to be more helpful than general practitioners. The public viewed depression as treatable. A high educational level and perceiving depression as a disease is associated with positive beliefs and opinions about the treatment of depression; but the perception of depressive patients as aggressive is associated with negative beliefs and opinions about the treatment of depression. CONCLUSION: The beliefs that "psychological and social interventions are more effective than pharmacotherapy" and "antidepressants are harmful and addictive" must specifically be taken into account in clinical practice and in anti-stigma campaigns. Additional studies are needed to understand the public's tendency to conceptualise depression as a psychosocial problem. In clinical practice, depression should be introduced as a bio-psychosocial disease whatever its cause: biological, psychological or social. In addition, the differences between extreme worry and disease, and the lack of aggressiveness of depressive patients, must be emphasised.

Public attitudes to depression in urban Turkey - the influence of perceptions and causal attributions on social distance towards individuals suffering from depression.

BACKGROUND: The aim of this study was to determine public attitudes towards patients with depression and the influence of perception and causal attributions on social distance towards individuals suffering from depression in urban areas. METHODS: This study was carried out with a representative sample in Istanbul which is the biggest metropolis in Turkey. Seven hundred and seven subjects completed the public survey form which consisted of ten items screening the demographic features and health status of the participants, and 32 items rating attitudes towards depression. RESULTS: The respondents' attitudes towards depression were very negative and nearly half of the subjects perceived people with depression as dangerous. More than half of the subjects stated that they would not marry a person with depression, and nearly half of the subjects stated that they would not rent their house to a person with depression. One-quarter of the subjects stated that depressive patients should not be free in the community. The subjects who considered depression as a disease and who believed that weakness of personality and social problems cause depression had negative attitudes towards depression. CONCLUSIONS: In Istanbul, people recognise depression well, but their attitudes towards it are fairly negative. The urban public has unfavourable attitudes towards depression and a tendency to isolate patients from the society. Notwithstanding the high prevalence, there is still considerable stigmatisation associated with depression.

[Tobacco, alcohol and substance use prevalence among elementary and secondary school students in nine cities of Turkey]. / Dokuz Ilde Ilk ve Ortaögretim Ogrencilerinde Tütün, Alkol ve Madde Kullanim Yayginligi.

OBJECTIVE: Previous studies in Turkey regarding substance use have failed to take into consideration the elementary school students. The purpose of the present study is to determine prevalence of tobacco, alcohol, and substance use among elementary and secondary school students in Turkey. METHOD: The study was conducted in 9 big cities that were selected from different geographic regions of Turkey. According to the student population size of the cities, a sample of 1250 or 2500 students were selected from each city. The questionnaire was administered to 11.989 elementary school students, and 12.270 secondary school students. In elementary school students' questionnaire, for the substances other than tobacco, alcohol, inhalants and cannabis a general term "drug" was used. RESULTS: Overall, Izmir had the highest rate of substance use. The prevalence of tobacco use at least once in life time was found to be 16.1% in the elementary school. The lifetime prevalence was found to be 15.4% for alcohol use and 1.7% for inhalants and for general term "drug". The prevalence of tobacco use at least once in life time was 55.9%, for alcohol use it was 45.0%, for cannabis use 4.0%, for inhalant use 5.1%, and for heroin and ecstasy use 2.5% among secondary school students. A significant difference was found between males and females in terms of tobacco, alcohol and other drug use both in the elementary and the secondary school. The risk for substance use was found to be greater in private schools than public schools. CONCLUSION: Although the prevalence of substance use among elementary and secondary school students is low when compared to the findings from other countries. It was observed that especially the prevalence of tobacco use was quite high.

Factors associated with Ecstasy use in Turkish students.

AIMS: The purpose of this study was to establish the factors associated with Ecstasy use in secondary school students in Turkey. DESIGN, SETTING AND PARTICIPANTS: This is a survey of a representative sample drawn from cities in different geographical regions in Turkey in 1998 and 2001. The questionnaire was administered to a total of 18,556 and 11,911 10th-grade students in 1998 and 2001, respectively. MEASUREMENTS: The questionnaire administered in the study was adapted from the questionnaires used in 'Monitoring the Future' study in the United States and ESPAD (the European School Survey Project on Alcohol and Other Drugs). It included questions about demographic characteristics, family characteristics, school life, social contacts and use of substances. FINDINGS: While the percentage of those who used Ecstasy at least once in their life-times was 2.65% in 1998, the figure reached 3.31% in 2001. Male gender, older age, use of alcohol, cannabis, heroin and cocaine, non-medical use of psychotherapeutic drugs and participation in a meeting concerning the adverse effects of substance use were found to be significant variables predicting 'ever use' of Ecstasy in both years by logistic regression analysis. CONCLUSIONS: Ecstasy use, while low in Turkey, appears to be on the increase and follows a pattern in terms of correlates that is similar to other illicit drugs. Whatever the causes behind the rise in Ecstasy use, creative, personalized and informative educational programmes should be conducted in all educational institutions to curb Ecstasy use.

[Relatives' beliefs and attitudes towards schizophrenia: an epidemiological investigation]. / Sizofrenisi olan hastalarin yakinlarinin sizofreniye yönelik tutumlari.

OBJECTIVE: To examine relatives' beliefs and attitudes towards schizophrenia. METHOD: Data were derived from the demographic and schizophrenia modules of the questionnaire developed for the survey called "Attitudes Towards Mental Disorders". The questionnaire was administered 98 adult relatives of schizophrenic patients who had participated in psychiatric outpatient treatment programs in Istanbul, Izmir and Adana. RESULTS: Although all identified the case described as a mental disorder, only 76.5% determined the term schizophrenia as a mental disorder. Social problems (62.9%) and weakness of will (65.3%) were the most commonly endorsed causes of schizophrenia. Almost all of the respondents preferred medical methods and psychiatrists for the treatment of schizophrenic patients. 72.2% of the sample held the opinion that people with schizophrenia are dangerous and 91.8% believed that these patients could not take responsibility for their own lives. The attitudes of the subjects living in Istanbul and those who stated that "schizophrenia is an illness or a mental disorder" were more negative than the others with respect to social distance characteristics. CONCLUSION: Most of the relatives of schizophrenic patients identified a mental disorder when a schizophrenia case was described, but they had insufficient information about the term schizophrenia. Labeling patients as mentally ill had a negative effect on relatives' attitudes towards schizophrenia. The results of this study underlined the need for education programs for the relatives of patients, and the demands of the relatives concerning treatment modalities with psychosocial components.

[The knowledge and attitudes of the public towards depression: an Istanbul population sample]. / Depresyon ile ilgili bilgi ve tutumlar: Istanbul ornegi.

OBJECTIVE: To assess the public's knowledge and attitudes towards depression and associated sociodemographic factors. METHOD: The survey was conducted in 2000 using face-to-face interviews in the homes of 707 adults in 24 different districts of Istanbul. Logistic regression analysis was used to assess the influence of sociodemographic factors on attitudes towards depression. RESULTS: The results indicate that 78.9% diagnosed the depression vignette as a mental disorder. 86.6% of the sample considered "social environmental factors" and 68.2% "weak personality" to be as the cause of depression. 43.4% of the population thought that people with depression are aggressive, and 22.8% believe that their freedom should be restricted. 51.9% percent of the subjects thought that the patient defined in the vignette should consult a physician. 94.5% percent of the respondents who thought of depression as an illness believe that depression is treatable and 54.9% of the respondents consider that the drugs used to treat depression have serious side effects. When the effect of sociodemographic factors on community attitudes was analyzed by logistic regression, age was found to have the most significant influence on community attitudes towards depression. CONCLUSION: The results suggest that the public identifies depression as an illness, has a tendency to perceive depression as a social problem, believes that depression could be treated by drugs, has incorrect knowledge about drugs and treatment, and is in doubt about the acceptance of depressive patients in society.