Evaluation of Psychological Resilience, Alexithymia, and Impulsivity Characteristics in Persons Who Attempted Suicide with Drugs.

OBJECTIVE: In this study, it was aimed to research the connection between psychological resilience, alexithymia, depression, anxiety and impulsivity in patients who attempted suicide with drugs. METHODS: The patient group (n = 66) who attempted suicide with drugs and the control group (n = 66) without any psychiatric diagnosis were examined in the study. Sociodemographic data form, Psychological Resilience Scale, Toronto Alexithymia Scale (TAS-20), Beck Depression Inventory, Beck Anxiety Inventory, Barratt Impulsivity Scale (BIS-11) were used in the study. RESULTS: It was found that PRS dedication and challenge are significantly higher in the control group (p = .039 and p = .003, respectively). When the undiagnosed group who attempted suicide were compared with the control group, it was observed that there is a significant difference between BIS-11 total and TAS total after bonferonni correction (respectively; p = .002; p = .001), while, there is no statistically significant difference in terms of PRS total score (p = .483). CONCLUSION: It was observed that patients who attempted suicide with drugs had low levels of psychological resilience, high alexithymia levels. In the absence of an additional diagnosis of depression, psychological resilience did not differ in terms of suicide attempts. In the suicide group, those who did not receive any additional diagnosis were not more impulsive than those who were depressed.

The relationships among impulsivity, anxiety sensitivity and nonsuicidal self-injury characteristics in patients with phobias

Abstract Background: The relationship between impulsivity and nonsuicidal self-injury (NSSI) has been revealed in several mental disorders other than phobias. Objectives: The purpose of this study was to examine the relationships among impulsivity, anxiety sensitivity, and NSSI characteristics in patients with phobias, and to compare these relationships with healthy controls. Methods: The sample of this study consisted of outpatients (n = 109) who had been diagnosed with social phobia, agoraphobia or simple phobia in addition to healthy individuals (n = 51) serving as the control group. Data collection tools were the socio-demographic form, the Barratt Impulsivity Scale (BIS-11), the Inventory of Statements About Self-Injury (ISAS), and the Anxiety Sensitivity Index (ASI-3). Results: Mean BIS-11 and ASI-3 scores in the social phobia and agoraphobia groups were found to be significantly higher than those in the control group. In addition, a positive correlation was found between ISAS and cognitive anxiety sensitivity scores in the agoraphobia and simple phobia groups. Discussion: The study revealed a positive correlation between cognitive anxiety sensitivity and NSSI in both the agoraphobia and simple phobia groups. The results of this study indicate that anxiety sensitivity may play a regulatory role between impulsivity and NSSI in some sub-groups of phobia.

T102C polymorphism of serotonin-2A receptor gene in Turkish schizophrenia patients: Association with cognitive impairment and soft neurological signs.

AIM: Previous studies have shown an association between the T102C polymorphism of the serotonin-2A receptor gene and schizophrenia. In addition, an association of this polymorphism with clinical phenotypes in schizophrenia such as treatment response and cognitive impairment has been observed. MATERIALS AND METHODS: In this case-control study conducted in Turkish Caucasians, we compared T102C polymorphism genotype and allele frequencies in 76 schizophrenic patients and 165 healthy controls. We also investigated interaction of this polymorphism with clinical and cognitive variables in patients. RESULTS: No significant difference was observed in the distribution of the three genotypes (T/T, T/C and C/C) and in the allele frequencies in controls and patients with schizophrenia. No evidence of association was detected at various clinical phenotypes including symptom severity, suicidality, treatment response, age of disease onset, number of hospitalizations and history of violence (in co-dominant, dominant, or recessive models). However, as compared to the C/C genotype, patients with 1 or 2 copies of the T allele were characterized by better stroop test performances and less "motor coordination" soft neurological signs. CONCLUSION: Further research is needed to elucidate the impact of T102C polymorphism on neurocognitive functions in both healthy and patient populations.

The association between Internet addiction and dissociation among Turkish college students.

PURPOSE: This study aimed to investigate Internet use patterns and Internet addiction among young adult university students and to examine the correlation between excessive Internet use and dissociative symptoms. METHODS: The study was conducted among 1034 students, aged between 18 and 27 years. Internet Addiction Scale, Dissociative Experiences Scale, and a sociodemographic query form were used in the collection of data. Pearson correlation analysis, the t test, and χ(2) test were used for data analysis. RESULTS: According to the Internet Addiction Scale, 9.7% of the study sample was addicted to the Internet. The Pearson correlation analysis results revealed a significant positive correlation between dissociative experiences and Internet addiction (r = 0.220; P < .001) and weekly Internet use (r = 0.227; P < .001). Levels of Internet addiction were significantly higher among male students than female students (P < .001). The Internet use pattern also differed significantly between sexes. CONCLUSIONS: According to the results of this study, Internet addiction is a relatively frequent phenomenon among young adult college students in Turkey. Excessive Internet use is associated with higher levels of dissociative symptoms.

Perpetrators of homicide with schizophrenia: sociodemographic characteristics and clinical factors in the eastern region of Turkey.

In this study, we aimed to describe the social and clinical characteristics and offense details in a sample of people with schizophrenia convicted of homicide in the eastern region of Turkey. This study was performed in Elazig Mental Hospital between November 2004 and May 2007. We included 43 men and 6 women with schizophrenia convicted of homicide who were hospitalized in the forensic psychiatry unit for compulsory treatment. Preset data recording forms were used. The first part of the forms contained questions regarding the age, sex, marital status, residence, educational status, and occupation of the patients. The second part of the forms included questions about some clinical features of patients with schizophrenia: the presence of schizophrenia in any family member, duration of the disease, subtype of schizophrenia, previous contact with mental health services, types of antipsychotics (first and last drug used), and adherence to antipsychotic medication. The third part of the forms dealt with alcohol-substance abuse and features of the victim (sex of the victim and whether the victim was a stranger, partner, or an ex-partner in the family or an acquaintance). The mean +/- SD age of our patients was 36.98 +/- 10.07 years, and 55.1% of the patients were unmarried. In our sample, 42.9% of the patients were primary school graduates and 75.5% were unemployed. Of the perpetrators, 14.3% never had contact with mental health services. However, 85.7% of patients had previous contact with mental health services. We found that 85.7% of the patients were paranoid subtype and 85.7% were not using their medication regularly and that treatment compliance was considerably low. We found that haloperidol and trifluoperazine were the most preferred antipsychotic drugs, particularly being the first drugs used during treatment (haloperidol, 71.4%; trifluoperazine, 10.2%) and the last antipsychotics used before the offence (haloperidol, 46.9%; trifluoperazine, 20.4%). In 38.8% of cases, schizophrenia was present in the first-degree relatives. We also found that 69.4% of victims were one of the family members. In our sample, 24.5% of patients were using alcohol and 4.1% were using cannabis. It is plausible that rendering more effective communication might allow earlier intervention for unrecognized and possibly unrecognizable risk factors of homicidal acts in people with schizophrenia.

Childhood trauma and dissociation in women with pseudoseizure-type conversion disorder.

BACKGROUND: Conversion disorder is thought to be associated with psychological factors because of the presence of conflict and other stressors prior to the condition. AIM: The aim of this study is to compare adult patients with pseudoseizure-type conversion disorder with healthy control group in terms of childhood trauma, dissociative disorder and family history of psychiatric disorders. METHOD: 56 female patients were admitted to the general psychiatry hospital outpatient clinic between January and July 2005. All patients had a negative experience about their families just before having the conversion. Diagnosis was made according to the DSM-IV criteria. A control group consisting of similar patient demographics of the disease group has been selected. Socio-demographic information forms, the Childhood Trauma Questionnaire (CTQ) and Dissociation Questionnaire (DIS-Q), were completed on the patients. RESULTS: CTQ total (t=12.12, P<0.001) and subscales, emotional abuse and emotional neglect (EA-EN) (t=12.74, P<0.001), physical abuse (PA) (t=10.05, P<0.001), and sexual abuse (SA) (t=7.69, P<0.001) were significantly high in the conversion group. DIS-Q mean points were statistically higher in the conversion group (t=11.05, P<0.001). CONCLUSIONS: The findings suggest that pseudoseizures (conversion disorder) should be included within dissociative disorders in DSM system as in ICD. It is usually uncommon for the patient to tell about childhood trauma without being specially questioned about this issue. Thus, it would be helpful to uncover these experiences by using related scales in conversion disorder patients.

Assessment of psychopathological aspects and psychiatric comorbidities in patients affected by tinnitus.

The aim of present study was to determine the psychiatric symptoms and comorbidities in patients affected by tinnitus. The study sample, between June 2004 and September 2005, consisted of 180 Turkish adults living in Elazig. Ninety consecutive tinnitus patients were enrolled on their first visit to the outpatients clinic. Control subjects were recruited partly from the social surroundings of the authors. All subjects with significant medical and/or psychiatric pathologies, such as schizophrenia, manic-depressive psychosis, dementia, and behavioural disorders with social withdrawal or suicidal risk, were excluded, as were those unwilling to take part in the study. For the psychopathological examination, patients underwent the Structured Clinical Interview for DSM-III-R (SCID-I, SCID-II). Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Symptom Check list-90 (Revised) (SCL-90-R) were also administered to patients with tinnitus and control subjects. SCL-90-R subscales scores, Beck Anxiety Inventory and Beck Depression Inventory scores were significantly higher in tinnitus patients than in normal control subjects. Twenty-four patients (26.70%) with tinnitus had at least one psychiatric diagnosis. Five control subjects (5.60%) had at least one psychiatric diagnosis. There were significant differences between the two groups (P < 0.001). Anxiety disorders and somatoform disorders were significantly higher in tinnitus patients than in normal control subjects. We conclude that psychiatric symptoms (such as symptoms of anxiety, depression or somatization) among patients with tinnitus should alert clinicians for the presence of a chronic and complex psychiatric condition (Axis-I and Axis-II disorders).

Paradoxical therapy in conversion reaction.

Paradoxical therapy consists of suggesting that the patient intentionally engages in the unwanted behaviour such as performing compulsive ritual or wanting a conversion attack. In this study, the subjects were selected by the emergency unit psychiatrist from patients who were admitted to the emergency unit with pseudoseizure. The diagnoses was based on DSM-IV criteria. Paradoxical intention was applied to half of the 30 patients with conversion disorders; the other half were treated with diazepam in order to examine the efficiency of the paradoxical intention versus diazepam. In both groups the differences of the anxiety scores at the beginning of the study were found to be insignificant (z=1.08, p=0.28). Of the 15 patients who completed paradoxical intention treatment, 14 (93.3%) responded favorably to paradoxical intention. On the other hand of 15 patients who completed diazepam therapy, 9 (60%) responded well to therapy and 6 patients carried on their conversion symptoms at the end of 6 weeks. Paradoxical intention-treated patients appeared to have greater improvements in anxiety scores (z=2.43, p<0.015) and conversion symptoms (t=2.27, p=0.034) than the diazepam-treated patients. The results of the present study are encouraging in that paradoxical intention can be effective in the treatment of conversion disorder.

Evaluation of dexamethasone suppression test in fibromyalgia patients with or without depression.

OBJECTIVE: While in most healthy persons dexamethasone administration suppresses cortisol synthesis from the adrenal cortex, such suppression is not usually observed in patients with depression. We set out to investigate whether the dexamethasone suppression test (DST) reveals any neurobiological relationship between fibromyalgia (FM) and depression related to the hypothalamic-pituitary-adrenal (HPA) axis. METHOD: To discover a relationship between depression and FM we performed the DST in 20 FM patients with depression, 26 FM patients without depression and 20 healthy subjects serving as a control group. RESULTS: Compared with the control group the cortisol level was found to be significantly higher in response to the DST in FM patients with depression (p = 0.03; z: -2.165), but not in those without depression (p = 0.153; z: -1.429). The cortisol level was not found to be statistically significant when patients with FM without depression were compared with the control group (p = 0.249; z: -1.152). In 7 FM patients with depression the DST failed to suppress cortisol; this was statistically significant compared with FM patients without depression (p = 0.014) and the control group(p = 0.008). Among FM patients without depression cortisol was not suppressed in one case. Cortisol was suppressed in all the controls. There was no statistically significant difference in cortisol suppression between FM patients without depression and the control group (p = 1.00). CONCLUSION: Our findings show that the DST reveals no neurobiological relationship between FM and depression related to the HPA axis.