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.

[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.