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Objectives We sought to obtain an overview of electroconvulsive therapy (ECT) practice in Psychiatry Clinic of Derince Research and Training Hospital which has 25 inbeds and is a new kind of governmental administration for new health policy of Turkey. Methods From January 2011 to October 2012, a form enquiring about evaluation of ECT was filled retrospectively. Results The total number of patients, admitted for psychiatry during the survey period was 77012. A total of 82 patients (10.06% among inpatients and 0.106% in all psychiatric admissions) received 514 sessions of ECT from 815 psychiatric inpatients. Seven patients had multiple hospitalizations. Patients with severe depressive episode with/without psychotic symptoms (include bipolar affective disorder current episode severe depression) received ECT most frequently (54.9%), followed by patients with bipolar affective disorder, current episode manic with/without psychotic symptoms (19.5%), schizophrenia (18.3%), and schizoaffective disorders (3.7%) respectively. All of the patients were reported to have insufficient response to medication and 19 patients had suicidalty (23.1%). There were no pregnant patients. All patients received modified ECT. There were no ECT-related deaths or injuries. 5 (6%) patients needed intervention for bradicardia and one patient had hypersensitivity to anesthetic medication during the survey. Conclusion The majority of patients who received ECT were diagnosed with severe depression with/without psychotic symptoms. Suicidalty and insufficient response to medication had an important role at decision of ECT. These results suggest that ECT is still safe and assumes an important role in daily practice of inpatient clinics.

Objective Using movies in psychiatric group therapy & rehabilitation classes provides ‘Entertainment, Education, Empowerment’ for the participants. We have provided such a setting where severely ill psychiatric inpatients. We aimed to describe the “Watching Cinema- Group Therapy” implementation for 500 inpatients in one year. Method Selected movie clips were watched in the morning and group therapy session took place in the afternoon. The patients were instructed to watch the film closely, and if required, ask for certain scenes to be replayed for a better understanding. It was followed by review of the film. Results We observed that these activities have encouraged the patients to talk about their beliefs, thoughts and feelings while discussing the characters and stories. We have also used as a reward for the patients who have therapeutic alliance. It motivated them to do something instead of being stayed in the room. Short movie scenes were more useful to follow up the films for the patients who have been administrated high doses of drugs. Conclusions It is the ingenuity and creative approaches of the educators and healers using movies in favor of behavioral health improvement. Movies are strong and important tools to be used for positive as well as productive means in treatment and teaching.

ObjectiveOne of the important purposes of health interventions is to enhance the quality of life (QOL). In mental health practice quality of life is related to disorders and treatment but also identification of high-risk group in healty subjects for lower QOL is necessary. Personality disorders in choronic diseases are reported to be related with lower QOL. In this study we investigated how character and temperament effect quality of life (QOL) in ‘healthy’ people.Methods70 healthy subjects (32 women, 38 men) with no physical and psychiatric diagnosis assessed with SCID-I are included to the study. They were examined using Temperament and Character Inventory (TCI) and WHO-QOL-Brief.ResultsHarm Avoidance (HA) and Reward Dependence (RD) scores was negatively correlated with Physical Health domain of QOL. Self directedness (SD) scores were positively correlated environmental domains of QOL (p< 0.05). Marital status was associated with QOL as singles had higher QOL in physical, psychological and environmental domains (p< 0.05). In multiple linear regression models; HA and RD predicted lower Physical Health and marital status predicted Environmental Health scores of QOL.ConclusionIn this study SD had significant correlations with environmental domains of QOL and higher HA and RD scores predicted lower QOL scores in Physical Health. With a bigger sample size all associations may occur clearly so an underground to identify risky temperament and character traits for lower QOL may be provided.

ObjectiveAffective temperaments (AT) are suggested as antecedents of mood disorders (MD) currently. MD especially depression is very common in epilepsy. In this study we investigated AT in epilepsy as probable predictors of MD.Methods83 epileptic patients and 83 healthy controls were included and evaluated using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version (TEMPS-A) and SCID-I.ResultsIn epilepsy group 16 depressive, 3 cyclotimic, 12 irritable, 9 anxious temperaments; in healthy group 4 depressive, 3 irritable, 4 anxious temperaments were diagnosed. The difference was significant in depressive (x2: 8.36, p< 0.05) and irritable temperament (x2: 6.06, p< 0.05). Depressive, cyclotimic, irritable, anxious temperaments mean scores were significantly higher in epilepstics (depressive 8.35±4,37; cyclotimic 9,86± 4,67; irritable 7,00±4,58; anxious 9,18±5,94) than healthy controls (depressive 5,89±3,68; cyclotimic 6,87±4,55; irritable 3,39±3,57; anxious 5,11±4,78) (all p< 0,001). 16 patients in epilepsy group and 6 patients in control group were diagnosed as Major Depressive Disorder (MDD) and the difference was significant (x2: 5,38, p< 0,05). Anxious temperament predicted MDD in epileptics and none of the temperaments were significant predictor of MDD in controls in logistic regression analysis.ConclusionEpileptic patients had higher scores at all AT except hypertimic. Anxious and irritable temperaments were diagnosed more in epileptics and anxious temperament was related with MDD. The tendency of epileptics to MD are known but this is the first study shows tendency of epileptics to AT. Further investigations are needed to explain the etiology and treatment relationship between MD and AT in epilepsy.

ObjectiveHealth is not only the absence of disorders also it needs a good feeling of well-being: Quality of life. The relation between QOL and the psychobiology, genetics, development and evolution of thoughts, emotions and temperaments should not be ignored. In this study we investigated how affective temperaments effect quality of life (QOL) in ‘healthy’people.Methods72 healthy subjects (33 women, 39 men) with no physical and psychiatric diagnosis assessed with SCID-I are included to the study. The subjects were examined using TEMPS-A for affective temperaments and WHO-QOL Brief for QOL.ResultsDepressive temperament (DT) scores was negatively correlated with psychological and environmental domains of quality of life (p< 0.05) and anxious temperament (AT) was negatively correlated with physical, psychological and environmental domains of QOL (p< 0.05). Marital status was associated with QOL as singles had higher QOL in physical, psychological and environmental domains (p< 0.05). In linear regression analysis with AT and DT and marital status as independent variables; AT scores predicted low QOL in Physical Health and marital status predicted Environmental Health.ConclusionDT had significant correlations with psychological and environmental domains of QOL and higher AT scores predicted lower QOL scores in Physical Health so this study suggests that healthy subjects may have lower QOL only due to higher scores in anxious temperament. A clear understanding of the association between Affective Temperaments and QOL may support a step to provide a better well-being in healthy people.

ObjectiveAffective Temperaments (AT) in epilepsy is waiting for a clear understanding as antecedents of mood disorders. Recent studies suggest that perception of stigma (PS) correlates with high anxiety and depression scores in epilepsy patients.In this study we investigated if there is association between AT, PS and depression in epilepsy.MethodsConsequent 71 outpatients (40 women 31 men) with epilepsy were included in the study and examined using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version (TEMPS-A), Epilepsy Stigma Scale, SCID-I for DSM IV for the diagnosis of depression.ResultsDepressive temperament (DT) scores were positively correlated with PS scores (r:0,247, p< 0.05) in whole group. PS scores were significantly higher in epileptics with MDD group (n:14) than epileptics without MDD(n:57) (t -3.052, p< 0.05). than the patients were divided into groups as patients with DT (n:10), patients with MDD (n: 9) and patients with MDD and DT (n: 5). In One Way ANOVA analysis there was difference between groups. By Tukey HSD the Perception of Stigma was not different between DT and MDD grup but DT+MDD group was significantly higher than DT group.ConclusionRecent studies suggest that a crucial part of inherited factors of depression is mediated by ATs and in some studies DT is founded to be related with recurrent depressive disorder. This study suggest that there may be an association between PS, DT and MDD alone but coexistence of MDD and DT is a higher risk for higher levels of stigma perception.

ObjectiveThere is retrospective evidence of a correlation between psychosis in multiple sclerosis (MS) however comorbidity of Psychosis in MS patients is a less frequent condition and the treatment of this condition seems to be hard and complex.Case32 years old, male patient with MS had psychotic symptoms simultaneously with exacerbations of MS symptoms for three times in three years.The first psychiatric episode was one year after he had the diagnosis of MS due to episodes of difficulty in walking and determination of demyelination plagues by MRI. Irritability, delusions of jealousness and persecutions, agitation, drug refusal were occurred simultaneously with the exacerbated symptoms of MS as right sided hemiparesia. He had been hospitalized and treated with olanzapine and high dose of corticosteroids. After this first episode he had two simultaneous episodes of psychosis with similar symptoms to previous one and exacerbations of MS with more severe symptoms as additional urinary incontinence. He was treated with olanzapine and corticosteroids in all episodes. The psychotic symptoms were remitted and the symptoms of MS were improved partially.ConclusionPsychosis is not a prominent feature of MS, occurring in 5% of cases. The relationship between lesions of the central nervous system and psychiatric illness has not been established yet. Some reports have implicated the contribution of acute demyelination to psychosis. In this case the simultaneous episodes of MS symptoms and psychosis suggest a common etiology. Prospective studies are required both about the common etiology and treatment.

ObjectivesPersonality and behavioral changes in epilepsy is known for a while. But neither quantitative characteristics nor etiology of these changes are not clear yet. There are many studies focusing on personality disorders in epilepsy using different methods. Cloninger has developed a psychobiological model of personality which provides to evaluate personality in a dimensional way.MethodsIn this present study, we examined the relationship between the Cloninger's dimensional psychobiologic model of personality and epilepsy. 73 outpatients of epilepsy and 70 healthy controls were examined using SCID I, Temperament and Character Inventory (TCI) and a questionnaire for epilepsy.ResultsEpilepsy patients had higher harm avoidance (HA) and lower persistence, self-directedness (SD), cooperativeness scores than healthy controls.In epileptic subjects no correlation was determined between TCI traits and age and duration of epilepsy. HA scores were higher in women. Subjects with partial seizures had higher HA scores and lower SD scores than generalized ones. Self Transcendence (ST) scores were different in groups due to frequency of epileptic seizures in One Way ANOVA but not corrected with Tukey HSD. Existence of comorbid depression was represented with lower ST scores. In multiple linear regression models only MDD predicted lower scores of SD.ConclusionsThis study confirms existence of specific personality changes among the epileptics by dimensional personality model of Cloninger and indicates a relationship between the characteristics of epilepsy and psychiatric comorbidity. Further investigations are needed for a clear understanding of common etiology of epilepsy and personality changes.