Executive dysfunctions and depression in Behçet's disease without explicit neurological involvement.

This study aims to assess the executive functions and depression status in patients with Behçet's disease without explicit neurological involvement and to evaluate cognitive functions in this group of patients independent of accompanying depression. In the present study, 30 patients with Behçet's disease in the non-active phase of their illness and 30 healthy volunteers were included. In the evaluation of depression levels, Beck Depression Inventory was employed. The executive functions of the patients were evaluated by Wisconsin Card Sorting Test (WCST) and Stroop Test (ST). Beck Depression Inventory scores measured in the Behçet's disease group, in which no clinically serious depression was observed, were higher than the control group. Then, it was observed that the scores of neuropsychological tests of the Behçet's disease group were found to be significantly lower, especially in WCST, while significant relations were revealed between Beck Depression Inventory scores and WCST, ST scores. The authors' findings suggest that there may be factors other than depression causing executive impairment in patients with Behçet's disease without explicit neurological symptoms. Executive dysfunctions may occur in association with mild depressive states due to chronic disease stress or silent and/or future neurological involvement of Behçet's disease, especially in the frontal lobes.

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.

[The Boratav Depression Screening Scale (Bordepta): a sensitive scale for recognizing depression in epidemiologic studies and primary health care]. / Boratav Depresyon Tarama Olçegi (Bordepta): epidemiyolojik calismalar ve birinci basamak saglik hizmetinde depresyonu tanimaya duyarli bir olçek.

OBJECTIVE: To develop a sensitive scale able to recognize depression in epidemiological surveys and primary health care. METHOD: The research was designed as an initial preliminary investigation followed by two subgroup studies. The preliminary study involved the selection of queries that would constitute the scale, based on the rule of brief reply. The first sub-study was intended to test the reliability and validity of the developed scale in a group of patients previously diagnosed with depressive disorder (n=60) and/or generalized anxiety disorder (n=61). The second sub-study aimed to determine the sensitivity, specificity and appropriate cut-off points of the scale, based on results obtained from non-psychiatric patients (n=96) and normal subjects (n=7). RESULTS: Item analysis showed a significant correlation varying from 0.501 to 0.729 between each item and total scale score. The Cronbach alpha value of the scale was 0.9005. Clinician-oriented vs. self report rating reliability correlation coefficient values were 0.534 to 0.850 (Kappa) and 0.856 (Pearson) for items and total scale score respectively. The concurrent validity of the scale as correlated with The Beck Depression Inventory and Trait Anxiety Scale were 0.812 and 0.763 respectively. The discriminant validity of items in terms of P values determined by chi-square testing was 0.021 to 0.0001. The sensitivity and specificity of the scale were 97.6% and 82% respectively at a cut-off point of 6.5, and 85.7% and 95.1% at 7.5. CONCLUSION: Boratav depression screening scale is valid and reliable, including optimal sensitivity and specificity for recognizing depression in epidemiologic studies and primary health care.

[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.

[Dysthymic disorder in primary health care]. / Birinci basamak saglik hizmetlerinde distimik bozukluk.

OBJECTIVE: The aim of this study was to investigate the epidemiological and clinical characteristics of dysthymic disorder of the primary health care level. METHOD: Parts of the Composite International Diagnostic Interview (i.e. sections on demographic variables and depressive and dysthymic disorders) the General Health Assessment Form, the Brief Disability Questionnaire, and a Patient Assessment Form were applied to 1997 consecutive patients seen by primary care physicians in 10 cities. RESULTS: The frequency of dysthymic disorder according to DSM-IV criteria in the primary care patients studied was 3.5%. "Fatigue or loss of energy", "diminished ability to think or concentrate", "indecisiveness", "insomnia" and "hopelessness" were the most frequent symptoms. 73.9% of patients with dysthymic disorder also had a chronic disorder and 78.3% of patients with dysthymic disorder met the criteria for major depressive disorder. 71.4% of patients with dysthymic disorder presented only somatic complaints to general practitioners. Disability ratios were higher in patients with dysthymic disorder than in patients without. General practitioners recognised depression in only 13.8% of patients with dysthymic disorder. CONCLUSION: General practitioners can not recognise dysthymic disorder in primary health care patients. This result emphasises the need for research on the failure to recognise dysthymic disorder in primary health care patients.