Situation awareness in obsessive-compulsive disorder.

Past studies have suggested that OCD patients suffer memory impairment on tasks using complex stimuli that require memory for combined elements to be maintained, but not for more simplistic memory tests. We tested this with 42 OCD patients and 42 healthy controls performed a computerized situation awareness task. In addition, participants completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Maudsley Obsessive-Compulsive Inventory (MOCI). The OCD patients had poorer accuracy in integration/comprehension and perception levels than controls. There were significant correlations between situational awareness scores (i.e., visuo-spatial monitoring and processing) and Y-BOCS obsession-compulsion and slowness and doubt scores of MOCI in OCD patients. In addition, there were also significant correlations between situational awareness and controlling, cleaning, slowness, rumination and total scores of MOCI in control group. Results indicated that (I) OCD patients have problems of perception, integration, and comprehension of complex visual perceptions; (II) situation awareness deficits associated with severity and prevalence of obsessions and compulsions.

Neurological soft signs in obsessive compulsive disorder with good and poor insight.

OBJECTIVE: Obsessive compulsive disorder (OCD) is a clinically heterogeneous disorder; OCD with poor insight has been suggested to be a specific clinical subtype. Neurological soft signs (NSSs) may be helpful to identify the specific subtypes of OCD patients. METHODS: In the present study, we aimed to compare OCD patients with poor insight with OCD patients having good insight, and healthy individuals. Sixty-four OCD patients (38 with good insight and 26 with poor insight), and 32 healthy subjects were enrolled in the present study. The Overvalued Ideas Scale (OVIS) was used to determine OCD patients with poor insight. NSSs were assessed by using the Neurological Evaluation Scale (NES). RESULTS: Two OCD groups had significantly higher total NES scores compared to controls (p=.000). Compared to healthy controls, OCD patients with poor insight performed significantly worse on all NES subscales, and they had significantly more NSSs on motor coordination, and sensory integration subscales compared to the OCD with good insight group. CONCLUSION: Our results suggested that OCD patients with poor insight exhibit more extensive neurodevelopmental impairments compared to OCD patients with good insight.

Characteristics of suicidal behavior in a Turkish sample.

BACKGROUND: Suicidal behavior is one of the most important problems in psychiatric clinics. Several sociodemographic and clinical characteristics may have different effects on suicidal behavior. AIMS: To examine the sociodemographic and clinical characteristics of a sample of 144 suicide attempters admitted to a Turkish emergency clinic for a suicide attempt. METHODS: All subjects were interviewed by a consultant psychiatrist. For all individuals, data on DSM-IV psychiatric diagnoses, sociodemographic data, Beck's Hopelessness Scale (BHS), Becks's Suicidal Ideation Scale (SIS), and Beck's Suicidal Intention Scale (BSIS) were collected. RESULTS: The majority of suicide attempters were females characterized by low educational status and low religious orientation. Drug overdose was the most common method of suicide attempt and conflict within the family was the most frequent psychological stress factor. Three-quarters of attempters (74.6%) met DSM-IV criteria for at least one psychiatric diagnosis. Of these, 28.5% met criteria for major depressive disorder. Suicide attempters with depression tended to be immigrant, urban dwellers with high scores on the suicide intent scale. CONCLUSIONS: In the present study, the findings are useful in showing the risk factors related to suicidal behavior.

Schizophrenia with obsessive-compulsive disorder and obsessive-compulsive disorder with poor insight: a neuropsychological comparison.

Schizophrenia patients with obsessive-compulsive disorder (OCD) may be a subgroup of schizophrenia, and OCD patients with poor insight may show psychotic-like symptoms. The aim of this work is to compare the neuropsychological performance of those patients with schizophrenic patients who do not have OCD symptoms and with OCD patients who have good insight. The sample consisted of 89 patients (16 OCD-schizophrenic patients, 30 non-OCD schizophrenic patients, 30 OCD patients with good insight, 13 OCD patients with poor insight). Neuropsychological evaluation included executive functions, verbal and visual memory and attention tasks. While schizophrenic patients with OCD did not differ from the non-OCD schizophrenia and OCD with poor insight groups on long-term visual and verbal memory performance, they showed poorer performance than the OCD group on long-term visual and verbal memory tests. Considering executive function, the OCD group with poor insight performed significantly worse than their counterparts with good insight, and the latter group performed better than the schizophrenia patients. The results of this study suggest that the neuropsychological performance of schizophrenia patients with OCD did not differ from that of non-OCD schizophrenic patients, and that OCD patients with poor insight were more likely to share similar cognitive characteristics with the schizophrenia groups. Our results also provide neuropsychological support for the hypothesis that OCD and schizophrenia may be a spectrum disorders.

Psychiatric disorders and functioning in hepatitis B virus carriers.

The authors compared asymptomatic hepatitis B virus carriers and healthy subjects in terms of their psychological state. Participants (43 asymptomatic hepatitis B virus carriers and 43 healthy comparison subjects) completed self-report questionnaires. Psychiatric disorders and psychosocial functioning were evaluated with structured clinical interviews and the Global Assessment of Functioning scale. Hepatitis B virus carriers were more likely to have psychiatric disorders than comparison subjects (30.2% vs. 11.6%). Also, carriers had significantly higher depression and anxiety scores and lower Global Assessment of Functioning scores than did comparison subjects. Worries about contamination and illnesses related to hepatitis B infection were associated with the presence of psychiatric disorder. The results suggest that asymptomatic hepatitis B virus carriers need emotional support.

[Psychiatric disorders in cancer patients and associated factors]. / Kanser hastalarinda psikiyatrik bozukluklar ve iliskili etmenler.

OBJECTIVE: There is a high prevalence of psychiatric disorders, especially depression and anxiety, among cancer patients. If they are left untreated, especially depressive disorders, they may result in poor treatment compliance, increased hospital stays and reduced quality of life. The aim of this prospective study is to investigate the prevalence of psychiatric morbidity among cancer patients and the factors that predict psychiatric morbidity. METHOD: One hundred and fifty patients with the diagnosis of cancer who were treated in different departments of the Pamukkale University Hospital were included in this study. Psychiatric diagnoses were made according to the criteria of DSM-IV with the SCID-I interview. In addition, all patients were evaluated using the General Health Questionnaire (GHQ) and the Hospital and Anxiety Depression Scale (HADS). RESULTS: 28.7% of cancer patients were found to have a DSM-IV Axis I diagnosis. The most common diagnoses were adjustment disorder with depressed mood (14%) and major depressive disorder (11.3%). Female gender, awareness of the diagnosis of cancer, history of previous premorbid psychiatric disorders and stress factors were correlated with psychiatric morbidity. CONCLUSION: In this study, the most common diagnoses were adjustment disorder with depressed mood and major depressive disorder, suicidal ideations were also frequently found. Awareness of the nature of the illness, female gender and the duration of the illness were the parameters which predicted psychiatric morbidity. Careful attention should be paid to cancer patients in order to diagnose and treat their psychiatric disorders. Furthermore, two screening instruments (GHQ and HADS) performed satisfactorily for screening of psychiatric disorders in cancer patients.

[An anorexia nervosa case and an approach to this case with pharmacotherapy and psychodrama techniques]. / Bir anoreksiya nervosa olgusu ve bu olguya farmakoterapi ile birlikte psikodrama teknikleri ile yaklasim.

Anorexia nervosa in an eating disorder that primarily affects female adolescents and is more commonly seen in westernized countries. Although it is a sociocultural problem of developed societies, nowadays it is also increasing rapidly in developing cultures such as Turkey. Difficulties in the treatment of anorexia nervosa have directed clinicians to understand the disorder better. Although it is well known that various factors play a role in the etiology of anorexia nervosa, psychodynamic factors also have considerable importance. In addition, social and familial interactions contribute to the development of anorexia nervosa. In the light of these facts, treatment with psychotherapy and pharmacotherapy might be used to cure this disorder. In this article, the definitive features and process of anorexia nervosa along with its psychodynamics were discussed on the basis of a case. In the treatment of the patient, psychodrama techniques with drugs were thought to be useful. The patient became aware of the unfavourable relationship and improved by the use of this method. Thus she gained emotional-cognitive insight.