Search

In this paper, functional confusion defined as clinical condition which is the patient can not focus on a certain issue, reply the questions and explain his/her story during psychiatric interview is focused. It is hypothesized that functional confusion seem most prevelant in patients with borderline personality disorder and somatic symptom and related disorders. Relationship between inability of mentalization, dissociation, cognitive disturbances and functional confusion seen in patients with borderline personality disorder is emphasized. Similarities are explained between alexitimia and can not expression of emotional complaints in the patients with somatic symptoms and related disorders. Relationship between somatoform dissociation and confusion has been discussed. In the article, also it has been argued that childhood traumatic experiences might play a role on vulnerability to functional confusion. Functional confusion may contribute to emergence of clinical conditions and severity of illness in adulthood period. Patients with functional confusion should be treated with psychotropic medications including low dose antipsychotic drugs rather than psychotherapeutic interventions. [ABSTRACT FROM AUTHOR]

Intimacy or love is completely defined as a personal relationship or sometimes a specific component of personal relationships or even a particular emotion that someone feels for another. Love is appearing as a psychological concept in the area of psychology in recent years. The definition of love depends on culture and people. Love comes with the concepts such as intimacy, attachment, respect and mature love. In this context, love is evaluated conceptually in this paper in order to fill the lack of the papers on this subject in Turkey. The main purpose of this study is to evaluate the theories that have different approaches about love. [ABSTRACT FROM AUTHOR]

Each individual experience cancer in a different way. While some perceive cancer as a complex and traumatic experience by developing some psychosocial and additional physical problems, others overcome cancer-related difficulties by gaining benefits such as posttraumatic growth owing to their resilience. Successful adjustment to life-threatening illnesses such as cancer require resilience. Posttraumatic growth ensures a deeper perspective and strength to people after traumatic events. Hence, individuals having higher levels of posttraumatic growth feel powerful enough to handle the problems in their life and can easily adapt to cancer process by focusing on the positive outcomes of trauma, having improved coping mechanisms and an improved psychological well-being. Resilience and posttraumatic growth have strong mutual relations and this phenomenon should be considered for a qualified cancer care. In this paper, we aimed to provide a better understanding of resilience and posttraumatic growth and relations of these two concepts with cancer experience. [ABSTRACT FROM AUTHOR]

Despite its severe morbidity and mortality, studies regarding the psychosocial treatments of anorexia nervosa are limited in number. This paper aims to present the general outlines of various psychosocial interventions developed for the treatment of anorexia nervosa and to provide an up-to-date review of the randomized-controlled studies on the effectiveness of these approaches. Reviewed studies were classified by age spectrum of samples under two main headings: adolescents and mixed samples of adults and adolescents. Specific issues about other variables were then discussed separately. [ABSTRACT FROM AUTHOR]

Schizophrenia is an early onset disorder that impacts the individuals deeply for their lifetimes. The disorder causes setbacks in quality of life, social interactions, general hygiene and a number of other aspects without full recovery. Increase in mortality and lifetime reductions of up to 10 years are observed during this chronic and destructive process. Possible causes of death include medical conditions that affect general health as well as suicide. This paper reviews comorbid medical disorders and conditions in patients with schizophrenia. [ABSTRACT FROM AUTHOR]

Transition to adulthood has been experienced a complex and varied process in the modern societies. These continuous changes in the age and criteria of transition to adulthood. Scientific studies have been studied adulthood and transition to adulthood with various theories. Among these, a new distinguished approach emerging adulthood is especially interesting with its suggestion of a different life period. In this paper based on, Turkey's demographic indicators such as population structure, growth rate, people's transition to adulthood is presented and discussed in terms of employment-unemployment, education, overage marriage and parenting ages. [ABSTRACT FROM AUTHOR]

Oxytocin is a neuropeptide that plays critical role in mother-infant bonding, pair bonding and prosocial behaviors. Several neuropsychiatric disorders such as autism, schizophrenia, affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, alcohol/substance addiction, aggression, suicide, eating disorders and personality disorders show abnormalities of oxytocin system. These findings have given rise to the studies searching therapeutic use of oxytocin for psychiatric disorders. The studies of oxytocin interventions in psychiatric disorders yielded potentially promising findings. This paper reviews the role of oxytocin in emotions, behavior and its effects in psychiatric disorders. [ABSTRACT FROM AUTHOR]

Many patients diagnosed with bipolar disorder respond incompletely or unsatisfactorily to available treatments. Defining refractoriness in bipolar disorder is a complex issue and should concern and include either every phase and pole or the disorder as a whole. There are only limited and sometimes confusing data on the treatment of refractory bipolar patients. The objective of this paper was to review the evidence for treatment options in treatment resistant patients on depressive, manic attack and maintenance period as found in randomized controlled trials with special attention to the definition and assessment of treatment resistance. [ABSTRACT FROM AUTHOR]

There are a connection between the face recognition, the social relationship and the development of self. There must be a reason that people recognize faces through an important and complex module like the language functions. People know each other, recognize their friends and enemies and make friends through their faces. These show its fundamental role in the world. Like the integrity builds by collective self in inner world, integrity is established through face outside worlds. Researches and comments about the center of self in the brain are made based on neurological disorders like prosopagnosia. Especially some investigations about the evoked potentials will provide us a scientific basic for this subject. This paper addresses the relationship between facial recognition and self-development in terms of neuropsychological aspects. [ABSTRACT FROM AUTHOR]

Cognitive behavioral therapy is still one of the most important treatment modalities in social anxiety disorder with a high level of evidence. However, some patients do not fully benefit from these therapies and this fact leads to ongoing search for new approaches. This paper reviews use of cognitive behavioral therapy in social anxiety disorder studies and discusses related updated concepts. The frequent use of computer-assisted therapy for most of recent studies was found noteworthy. Recent studies regarding social anxiety disorder focused on concepts such as attention bias, biased information processing, attention training, judgment biases, internet-based cognitive behavioral therapies and social mishap exposure. Internet-based cognitive-behavioral therapy seemed to be a good option for people who were unable to access face to face treatment. [ABSTRACT FROM AUTHOR]

Awareness about child physical and emotional abuse -as well as sexual abuse- is increasing day by day. It is stated that the physical or emotional harm given to a child can result in serious psychological problems both in short and long terms. In addition to this, it is known that, the traditional discipline styles, especially applied in developing countries, can be physically and emotionally harmful and sometimes abusive. The stress level of the parent determines the parent's choice of discipline style and psychopathologies such as attention deficit hyperactivity disorder seem to be riskfull for physical and emotional abuse because they increase the stress level of parents. This paper will review the literature related to the probability of exposure to physically or emotionally abusive discipline styles for children with attention deficit hyperactivity disorder and also the literarture related to the consequences of these abusive discipline styles on these children. [ABSTRACT FROM AUTHOR]

Social cognition represents the mental processes of social interaction between oneself and others. In recent years, the interest in social cognition skills has increased in cases with eating disorders. Anorexia nervosa is an eating disorder that is associated with the multiple factors in etiology. Treatment of anorexia nervosa is still controversial. The youths diagnosed with anorexia nervosa are known to be as the most difficult group in eating disorders for building therapeutic relations. Studies, mostly suggests that there are difficulties in social cognitive functions in patients with anorexia nervosa. However, there are studies that reported different results. It seems that, the majority of studies which evaluate the social cognitive functions in patients with anorexia nervosa, are carried out with the adult age group. There are limited number of studies in child and adolescent age group. The purpose of this paper was to examine the studies of social cognitive skills in children and adolescents diagnosed with anorexia nervosa and present the general characteristics. [ABSTRACT FROM AUTHOR]

Along with a growing elderly population in the world and in our country, elder abuse and neglect has been a major problem. The purpose of this study is to identify and systematically review the studies investigating elder abuse and neglect in Turkey. Evaluation of the studies on elder abuse and neglect in Turkey showed that the elderly are often abused by family members and they are often exposed to emotional, physical, economic and psychological abuse. All of the studies reviewed in this paper were descriptive cross-sectional studies investigating elder abuse and neglect. The studies reviewed presented significant results revealing the prevalence of elder abuse and neglect in Turkey. In conclusion, this systematic review revealed that research on this issue in Turkey is insufficient and there is a need for studies conducted with larger samples covering an entire city. [ABSTRACT FROM AUTHOR]

Neuroimaging has been used in antisocial personality disorder since the invention of computed tomography and new modalities are introduced as technology advances. Magnetic resonance imaging, diffusion tensor imaging, functional magnetic resonance imaging and radionuclide imaging are such techniques that are currently used in neuroimaging. Although neuroimaging is an indispensible tool for psychiatric reseach, its clinical utility is questionable until new modalities become more accessible and regularly used in clinical practice. The aim of this paper is to provide clinicians with an introductory knowledge on neuroimaging in antisocial personality disorder including basic physics principles, current contributions to general understanding of pathophysiology in antisocial personality disorder and possible future applications of neuroimaging. [ABSTRACT FROM AUTHOR]

Although psychostimulants have been used for the treatment of attention deficit hyperactivity disorder for approximately 70 years, little is known about the long term effects of these drugs on developing brain. The observable effects of psychostimulants are influenced by the timing of exposure, the age of examination after drug exposure and sex. Preclinical studies point out that chronic psychostimulant exposure before adolescence cause reverse sensitization or tolerance and this leads to reduction in stimulant effectiveness in adolesecence and adulthood. Preclinical studies show the potential long term effects of psychostimulants. But it is necessary to investigate the relationship between preclinical effects and clinical practice. A developmental approach is needed to understand the impact of pediatric medications on the brain that includes assessment at multiple ages to completely characterize the long term effects of these medications. The aim of this paper is to review the effects of psychostimulants on developing brain. [ABSTRACT FROM AUTHOR]

The reality of the individual that is experienced and transmitted to the external world mainly stems from one's internal reality. A number of concepts and theories has been developed to explain how we percept the external world, construct the representations of those perceptions and what are the common shared internal experiences about that. Prominent concepts on this issue include internalization, identification, incorporation and introjection. However, from the days those concepts suggested until today there has been no consensus on boundaries between them. Thus, these concepts sometimes seem to be used interchangeably or understood as defense mechanisms. In this paper we tried to give comprehensive information about these concepts in terms of their historical development and contend. [ABSTRACT FROM AUTHOR]

In 1975 Fieve and Dunner made the distinction between hypomania and mania as hypomania does not usually cause social and occupational impairment and hospitalization is not needed, moreover patients do not experience psychosis. Bipolar disorder type I is defined by the presence of manic and depressive episodes and differs from Bipolar disorder type II characterized with hipomanic and depressive episodes. Bipolar disorder type I and II do not differ in their depressive episodes. It is still point of contention whether bipolar type II is a variant of bipolar disorder type I or is positioned on the spectrum between bipolar type I and unipolar disorder. Even there are some similarities in characteristics of depressive episodes and outcome features of different bipolar disorder subtypes, there are differences that can be useful in differential diagnosis and treatment. This paper aims to focus on those differences between bipolar disorder type I and II. [ABSTRACT FROM AUTHOR]

American Psychiatry Association has scheduled to release The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in May 2013. According to the main changes being proposed about autism, there will be one unified Autism Spectrum Disorder diagnosis in the DSM-5 classification. This unified diagnosis will eliminate the distinct diagnostic categories under Pervasive Developmental Disorders in the DSM-IV-TR, namely autistic disorder, asperger syndrome, pervasive developmental disorder-not otherwise specified, and childhood disintegrative disorder. Rett syndrome will be excluded from autism spectrum disorder due to its genetic basis. In addition, severity of symptoms will be measured among individuals with autism spectrum disorder based on the support level required due to the impairment in their lives. The basic rationale behind this revision is that it is better to conceptualize autism as a spectrum including various individuals whose symptoms in different developmental areas range from mild to severe. It is aimed to increase the specificity of autism diagnosis by using one single diagnostic category with its specified severity rather than differentiating several subtypes. The major concern raised over the DSM-5 proposal has been the possibility that some of the individuals who were diagnosed with pervasive developmental disorder according to the DSM-IV-TR might not get a diagnosis in this new system. After the DSM-5 is released, clinical, legal, and educational rearrengements regarding the use of new autism spectrum disorder diagnostic criteria are expected to accelerate worldwide and in Turkey. This paper aims to review briefly the upcoming autism spectrum disorder diagnosis planned to appear in the DSM-5, the rationale of the proposed revision, main critics to the DSM-5 draft that has been publicized, and some of the regulations expected to occur in practice after the changes. [ABSTRACT FROM AUTHOR]

Oxidative stress can be defined as imbalance between prooxidant molecules produced during body metabolism and members of antioxidant system for favor of former. Oxidative stress, which is included in the pathogenesis of cancer, aging, cardiovascular and neurodegenerative disorders, is also considered for pathogenetic mechanisms underlying psychiatric disorders including schizophrenia, mood disorders, attention deficit hyperactivity disorder. Due to important role of antioxidant vitamins in antioxidant defense mechanisms, vitamin supplementation therapies are considered in addition to conventional treatment choices for psychiatric disorders. This paper will attempt to review the biochemical, molecular and genetic data on biological processes related to vitamins A, C and E. Besides, the circumstances under which the antioxidant vitamin supplementation could be used in psychiatry and the factors that should be taken into consideration during these therapies will be discussed. [ABSTRACT FROM AUTHOR]

Living organizms show cyclic rhythmicity in a variety of physiological, hormonal, behavioral, and psychological processes. Sleep-wake cycles, body temperature, hormone levels, mood and cognition display a circadian rhythm in humans. Delays, advances or desynchronizations of circadian rhythm are known to be strongly associated with mental illness especially mood disorders such as bipolar disorder, major depression and seasonal affective disorder. Furthermore, some of the mood stabilizers, sleep deprivation and light treatment are employed to treat mood disorders by shifting circadian rhythm. This paper reviews the relationship between mood disorders and circadian rhythm, and describes treatment options by altering circadian rhythm. [ABSTRACT FROM AUTHOR]

Comorbid psychiatric disorders, frequent hospitalization, multiple outpatient treatment, prior history of hypertension, obesity and lipid dysregulation are associated with higher risk of metabolic syndrome in children. Side effects of antipsychotic drugs and their management have recently become a major subject of research due to enhanced antipsychotic drug usage in child and adolescents. Prevention strategies are usually preferred to secondary or tertiary strategies in the management of metabolic syndrome associated with antipsychotic drugs. Clinicians should present multidisciplinary approach to endocrine and metabolic side effects due to antipsychotic use in pediatric patient groups and avoid multiple drug use in such patients. In this paper, we briefly reviewed metabolic side effects of second generation antipsychotic drugs in child and adolescent population, possible mechanisms of susceptibility to metabolic syndrome and pharmacological and non pharmacological treatment approach to prevention of weight gain. [ABSTRACT FROM AUTHOR]

The type of attachment defined in the early stages of life and thought to be continuous, is a phenomenon that shapes the pattern of how a person makes contact with others. The clinical appearance of every type of attachment is different and each one has prospective and retrospective phenomenological reflections. In all stages of life and in close relationships, it can be observed if a person gets in close contact with someone else and if this relation bears supportive and protective qualities. According to attachment theorists, once it is defined as safe or unsafe during nursing period, it shows little change. Starting from Bowlby's work, unsafe attachment type is considered as the determining factor of psychopathology in the later periods of life, while safe attachment is considered as in relation with healthy processes. The nature's original model is safe attachment. Anxious/indecisive attachment, an unsafe attachment type, is associated with anxiety disorders and depressive disorder, while avoidant attachment is associated with behavior disorder and other extroverted pathologies. Disorganized/disoriented attachment is considered to be together with dissociative disorder. The aim of this paper is to review attachment theory and the relation between attachment and psychopathology. [ABSTRACT FROM AUTHOR]

Excessive weight gain, hyperglycemia, type 2 diabetes and hyperlipidemia are significant clinical adverse effects that appear as a result of the treatment with second generation atypical antipsychotic drugs. These drugs possibly cause weight gain by stimulating appetite and increasing insulin resistance. Amantadine, nizatidine, ranitidine, famotidine, topiramate, reboxetine and metformin are notified as the effective drugs which were used in order to prevent the weight gain due to atypical antipsychotic drugs. As an antidiabetic agent, metformin draws attention due to reducing weight gain and correcting insulin resistance. The aim of this paper was to evaluate studies searching fort he effect of metformin on weight-gain due to atypical antipsychotics. [ABSTRACT FROM AUTHOR]

During the menstrual cycle, pregnancy and breast-feeding periods, as well as in menopausal and post-menopausal periods, the physiological and psychological processes that change according to the hormonal fluctuations influence every women similarly and each one differently. These physiological processes are controlled by neuroendocrine sequences, of which the hypothalamo-pituitaryadrenal axis and the hypothalamo-pituitary-gonadal axis are the most important ones. The hypothalamo-pituitary-gonadal axis affects mood, anxiety, cognition and pain. The interaction of these hormones with mood and behavior is bidirectional. The differences in phenomenology and epidemiology of mood disorders with regards to gender can be explained with the effects of hormones. All of the periods mentioned above are related with mood disorders at terms of risk factors, disease symptoms, progress of disease and response to treatment. Epidemiologic data supports the relationship between the mood disorders and reproductive processes. The prevalence of major depression increases in women with the menarche and ceases in post- menopausal period. Similarly, the initial symptoms of bipolar disorder begins around the menarche period in 50% of the cases. Despite proper treatment, some female patients with major depression experience recurrence during the premenstrual period of their menstrual cycles. The conformity and change in a woman's brain during pregnancy is controlled dominantly by the neuroendocrine systems, while it is controlled by the external stimuli actively related to the baby during nursing period. The changes that occur are closely related to postpartum mood disorders. Again, all the changes and suspension of medication during this procedure are risk factors for early depressive and dysphoric situations. Variables of a wide range, from follicle stimulating hormone, melatonin, and sleep to body mass index interact with mood disorders in menopausal and post-menopausal periods. Interest on the effects of gonadal steroids on the central nervous system has grown parallel with our increasing knowledge. In the last decade, the place of hormonal treatments in the treatment of mood disorders have been discussed continously. During this period, along with the anti-depressant efficacy of estrogen, anti-manic efficacy of tamoxifen was also demonstrated in several studies. In this paper, the complex relationship between the physiological changes and the mood disorders during a menstrual cycle, pregnancy, nursing, menopausal and post-menopausal periods are briefly reviewed and discussed over the reproductive hormones in the context of etiology, phenomenology and treatment. [ABSTRACT FROM AUTHOR]

Although the importance of long-term prophylactic treatment is certain in bipolar disorder, there is stil debate on how to which patients and evaluate the treatment response. Efficacious long-term treatment can reduce morbidity and mortality significantly and improve quality of life of bipolar patients. The concept of ideal response should also be defined very clearly in order to discuss the difficulties of measuring the effectiveness of the prophylactic treatment. The aims of this paper are to determine whether our currently methods and criteria are valid, reliable and sensitive evaluating the efficacy of the treatment response and to briefly inform the clinicians about the drugs used in pharmacologic prophylaxis in accordance with relevant data. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is a chronic, lifelong neurobehavioral disorder with childhood-onset, which seriously impairs the affected adults in a variety of daily living functions like academic, social and occupational functioning. Prevalence of ADHD declines with age in the general population. The approximate prevalence rates of ADHD is 8% in childhood, 6% in adolescence and 4% in adulthood. The unclear validity of DSM-IV diagnostic criteria for this condition can lead to reduced prevalence rates by underestimation of the prevalence of adult ADHD. The disorder is characterized by behavioral symptoms of inattention, hyperactivity, and impulsivity across the life cycle and is associated with considerable morbidity and disability. Although its etiology remains unclear, considerable evidence documents its strong neurobiological and genetic underpinnings. ADHD is associated with a high percentage of comorbid psychiatric disorders in every lifespan. In adulthood between 65-89% of all patients with ADHD suffer from one or more additional psychiatric disorders, above all mood and anxiety disorders, substance use disorders and personality disorders, which complicate the clinical picture in terms of diagnostics, treatment and outcome issues. The high comorbidity with other psychiatric disorders, the resulting deficits in social competences and risky health behavior that often go along with a diminished life quality must be stressed in these patients. Preventive and therapeutic interventions should be taken at an early stage to counteract the possible negative influences of ADHD on functioning and relationships. In this paper, we reviewed the historical aspects, epidemiology, neurobiology, comorbidity, diagnostic difficulties and clinical features of adult ADHD. [ABSTRACT FROM AUTHOR]

With the introduction of new technologies, computer and internet use have become an unavoidable necessity in our daily lives. Internet was originally designed to facilitate communication and research. However the dramatic increase in use of internet in recent years has led to its pathologic use. Turkey, as a developing country with an increasing rate of internet access and computer use is at high risk for this disorder. In our country, this disorder is especially seen in young people who are more skilled in internet and computer use. And because their excessive internet use has led to negative consequences in their academic, social and family lives, patients and their families began search of treatment for this disorder. So clinicians must be aware of this newly emerging disorder and they should be able to apply the appropriate therapeutic interventions. This paper aims to summarize the pharmacological and cognitive-behavioral treatment of internet addiction. [ABSTRACT FROM AUTHOR]