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Die inneralevitischen Diskussionen zum Alevitum lassen sich zu einer Grundsatzfrage zur Identität bündeln: Ist das Alevitum innerhalb oder außerhalb des Islam zu verorten? Für viele alevitische Erbpriester der älteren Generation ist diese Frage einfach zu beantworten: Das Alevitum ist der wahre Kern des Islam. Es ist der auf Geheimwissen aufbauende, wahre Islam, den Ali und seine Abkömmlinge gelehrt und innerhalb ihrer eingeschworenen Gemeinschaften tradiert haben. Einige alevitische Erbpriester (Dede / Pir) beziehen ihr geistiges Amt und das damit verbundene Wissen aus einer Abstammung von Ali und lassen die Lehre des Alevitums in der Frühphase des Islam beginnen. In den Buyruk sollen deutliche Hinweise bestehen, dass die Lehre mit den ersten treuen Anhängern Muhammeds entstanden sei und nur Abkömmlinge Ali´s berechtigt sind, auf dieses schriftlich fixierte aber mündlich gelehrte Wissen zuzugreifen. Die gegenteilige Sicht sieht die Ursprünge des Alevitums nicht in der Frühphase des Islams und lehnt bezüglich der Entstehung des Alevitums eine geographische Verortung in der arabischsprachigen Welt kategorisch ab. Betrachtet man diesen Grundsatzstreit als Folge einer Identitätskrise, so müssen die Ursachen in der Entwicklungsgeschichte der Aleviten gesucht werden. Hier scheint das Verhältnis zu Schriftlichkeit und Schriften an sich ein wichtiger Faktor zu sein. Auch wenn unter den Aleviten die weit verbreitete Annahme dominiert, dass das Alevitum auf mündlicher Überlieferung basiert, bilden zahlreiche Schriften die Grundlagen jener mündlichen Überlieferungen aus denen Aleviten ihre religiösen, soziokuluturellen und auch politischen Grundsätze ableiten. Besonders hervorzuheben sind die als Buyruk bekannten Schriften, die inhaltlich bisher kaum analysiert wurden. Die Buyruk sind Träger eines speziellen Narratives, in denen Muhammed und Ali die Hauptfiguren sind und als Begründer der Religion dargestellt werden. Der Glaube, dass von Muhammed an Ali diktiertes esoterisches Wissen sich über die 12 Imame tradiert und erhalten haben soll, spiegelt sich letztendlich in der mündlichen wie auch schriftlichen Überlieferung des Alevitums wider. Auch wenn diese Schriften in der Tradition der Aleviten ihren festen Platz hatten, so scheinen sie seit Mitte des 20. Jahrhunderts an Bedeutung und Präsenz verloren zu haben. In dieser Untersuchung werden Ursachen für den Verlust der Bedeutung der Buyruk kurz skizziert und das Narrativ von esoterischem Wissen im Besitz der Ali´s dargelegt.

Objective: Aggression is a significant problem seen in psychiatric clinics, which can cause physical and psychological trauma. The aim of this study is to investigate aggression and restriction methods in psychiatric settings of a training and research hospital. Method: This descriptive study was conducted in psychiatry services and the Alcohol and Substance Addiction Research Treatment and Education Center between April 1, 2014 and March 31, 2015. The data were collected retrospectively reviewing the completed registration forms immediately after the incident by the clinical nurses. Results: The number of aggression events in the services was 554. It was found that the majority of the events were intended and actual self-harm and occured in the general psychiatry service. The majority of the events were seen during shift hours in august and in summer. Examining restriction methods it was found that no restraining method was used and therapeutic interviews were conducted in the majority of events and that the most commonly used restriction methods were mechanical restraint and intramuscular medication used with mechanical restraint. Discussion: It is a positive result that restriction methods were not used in the majority of events. The treatment activities must be planned outside normal working hours and in the evening to increase the interaction between patients and staff. Studies regarding recognition, reporting, controlling of aggression that became an important problem for safety of patient and staff in psychiatry services should be done.

Empathy can be defined as the ability to understand the other's thoughts and feelings. It contains both cognitive and emotional components.The aim of this study was to investigate the empathy ability of patients with alcohol dependency in association with cognitive and emotional functions, after acute detoxification and during long-term abstinence.Thirty-three alcohol dependent inpatients that completed a detoxification process and stayed abstinent throughout the study, and 33 healthy comparison subjects that matched the patients for age, gender, and education level were included in the study. All the participants were administered the Facial Emotion Identification Test (FEIT), Facial Emotion Discrimination Test (FEDT), Trail Making Test (TMT), Digit Span Test (DST), Auditory Consonant Trigram Test (ACT), and Empathy Quotient Scale (EQS). All the tests were repeated after 3 months of abstinence.At the first evaluation conducted after detoxification, patients performed significantly worse than healthy comparisons in almost all tests. At the second evaluation, which was conducted after 3 months of abstinence, the patients improved significantly in all measures, and no significant differences were detected between the patient and comparison groups. There were significant correlations between the test scores and EQS score.Alcohol dependency has deleterious effects on empathy ability, and cognitive and emotional functions. Those impairments can improve with abstinence. Empathy ability has strong relationships with cognitive and emotional functions.

Dans cette etude, les normes du Rorschach de la population âgee en Turquie ont ete etudiees. Afin de les determiner, nous avons fait passer le Rorschach a 156 personnes âgees de 65 et 84 ans, qui se situaient dans trois niveaux socio-economiques differents (50% d’hommes, 50% de femmes, indemnes de troubles psychiques ou neurologiques). Parmi ces valeurs normatives, il y a des indicateurs fondamentaux du psychogramme comme le nombre moyen de reponses, les pourcentages de reponses humaines, animales et globales, ainsi que le F% et le RC%. En outre, nous avons examine les contenus de reponses, les localisations, les composantes affectives et kinesthesiques distribuees en fonction de differentes tranches d’âge, de sexe, de niveau socio-economique. Ces donnees ont ete interpretees a la lumiere de l’approche psychanalytique.

Introduction Increasing evidence from clinical practice, as well as from epidemiological and basic research shows that there are gender differences in clinical features of schizophrenia, and this may be related to estrogens. There may be a relationship between earlier puberty and later onset of the disease, because of the protective effects of estrogens in women with schizophrenia. In this study, our aim was to analyze the correlation between age of menarche and age of onset of schizophrenia and to investigate the protective effects of estrogens in schizophrenia. Method In this study, we included 289 patients who were diagnosed with schizophrenia. Those with mental deficiency or organic brain disorders were excluded from the study. All subjects were given a socio-demographic form to determine their personal information, age at menarche, age at first odd behavior, age at onset of the disease and first hospitalization. Data on factors which may affect the association between age at onset of schizophrenia and age at menarche such as family history, head or birth trauma etc. were recorded on the information form. Results We found out that age at menarche was negatively associated with age at first odd behavior and age at first psychotic symptoms. Conclusion Our study verifies the protective effects of estrogens and shows that the earlier puberty may be the cause of later onset of schizophrenia. A gender-sensitive approach in psychiatry improves our understanding of mental illness and our therapeutic strategies.

Background: It is still unclear whether insight has a direct association with social functioning in schizophrenia, independent of its association with symptoms. Aim: This study aimed to investigate the relationship of insight and its dimensions with social functioning in schizophrenia. Methods: A total of 170 outpatients with schizophrenia were included in this study. All patients were evaluated with the Scale to Assess Unawareness of Mental Disorder (SUMD), Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance Scale (PSP). Patients with impaired insight and patients with unimpaired insight were compared for PSP score through independent samples t test. Pearson’s correlation analysis was used to determine the correlations between study variables. Multiple stepwise linear regression analysis was used in order to determine the variables that predict social performance. Results: The PSP score of patients with impaired insight was significantly lower than that of patients with unimpaired insight. There were significant correlations between insight dimensions and PSP score. PANSS negative scale score, awareness of achieved effects of medication and awareness of anhedonia/asociality were significant predictors of social performance. Conclusion: Insight has a significant impact on social functioning in schizophrenia, and some, but not all, insight dimensions have direct impact on social performance, independent of their association with symptoms.

Background: The aim of this study was to investigate the executive functions in patients with sporadic schizophrenia (SS) and familial schizophrenia (FS), and the executive functions in their parents. Methods: The study included 30 patients with FS and their 37 parents with a positive family history of schizophrenia; 30 patients with SS and their 44 parents; 30 controls matched with the patients for gender, age and education, and 40 controls matched with the parents for gender, age and education (211 subjects in total). All the subjects were interviewed with the Structured Clinical Interview for DSM-IV-Axis I (SCID-I). The executive functions were assessed using the Verbal Fluency Test (VFT), the Trail Making Test (TMT), the Wisconsin Card Sorting Test (WCST) and the Stroop Test. Results: Patients with FS and their parents, and patients with SS performed significantly worse than their controls on the VFT, TMT, WCST and the Stroop test. There were no statistically significant differences between parents of patients with SS and their controls on any of the tests except for the Stroop color score. FS parents performed significantly worse than SS parents on all tests. FS patients performed significantly worse than SS patients on the VFT, TMT, Stroop test. Conclusion: Previous studies that investigated the cognitive functions of relatives of patients with schizophrenia brought out inconsistent results. The present study investigated relatives with and without a family history of schizophrenia separately and found that executive functions were impaired only in parents with a positive family history of schizophrenia. These findings suggest that impairment in executive functions may represent a genetic endophenotype for schizophrenia.

Epilepsy is accompanied by many psychiatric disorders and continues to be a disease that disturbs the functioning and quality of life (QOL) of patients.To assess the frequency of psychiatric disorders occurring in epileptic patients, determine depression and anxiety levels, and compare the results with healthy controls. The effect of epilepsy on QOL and the effects of social support on epilepsy were also assessed.50 epileptic patients and 50 controls were compared using the Structured Clinical Interview for DSM-IV (SCID-I), Beck Depression Inventory, Beck Anxiety Scale, Multi-dimensional Scale of Perceived Social Support (MSPSS) and the World Health Organization Quality of Life Assessment-Brief (WHOQOL-Brief).44% of epileptic patients had psychiatric disorders, with depression being the most common diagnoses (28%). In terms of psychiatric comorbidity, there was a significant difference between the groups. The depression and anxiety scores of epileptic patients were significantly higher and there was no difference between the groups in terms of MSPSS scores. Psychological and physical subscale scores of WHOQOL-Brief were significantly lower in epileptic patients. In the epileptic group, a multi-variate analysis of covariance demonstrated that depression was a significant covariate for physical and psychological domains, anxiety was a significant covariate for psychological domain, social support was a significant covariate for social and environmental domains, and age of epilepsy onset was a significant covariate for physical domain of QOL.Epilepsy needs multi-dimensional analysis because of its chronic nature, frequently accompanying psychiatric disorders, its negative effects on QOL and the important role social support plays. The clinicians' handling of patients at an early stage can play an important role in preventing the negative results of epilepsy.

The aim of this study was to compare deficit schizophrenia patients with non-deficit schizophrenia patients for negative and positive symptome scores, rate of summer births, and rate of familial history of psychosis.110 patients with schizophrenia diagnosed via Structured Clinical Interview for DSM-IV (SCID-I) aged between 18-65 were included in the study. All the patients were evaluated using the Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), and The Schedule for the Deficit Syndrome (SDS), and sociodemographic information was obtained.The deficit syndrome group had higher negative and positive scores compared to the non-deficit group. The rate of summer births were higher in the deficit group. Although the rate of positive family history for psychosis was higher in deficit group compared with the non-deficit group, the difference did not achieve statistical significance.Our results that depict higher severity of negative and positive symptom scores and higher rate of summer births with deficit schizophrenia, provides more evidence that deficit and non-deficit schizophrenia are different subtypes having different pathophysiologies. But statistically nonsignificant difference of positive familial history between two groups suggests that the thesis of deficit schizophrenia may be related to genetic factors more than enviromental factors needs to be invesigated further.

The aim of this study was to investigate the dropout predictors for patients with schizophrenia in a natu ralistic follow-up study design. After a baseline evaluation with the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), and the UKU Side Effects Rating Scale (UKU), 382 patients with schizo phrenia were scheduled for follow-up in monthly visits for one year. However, the majority of the patients (64%) dropped out prior to completion of the one-year follow-up. Patients who were less educated, had no national healthcare social security system coverage, and suffered from later onset of the illness dropped out with greater frequency. There were no differences in baseline BPRS total and subscale scores between patients who completed the one-year follow-up or dropped out; dropout patients had higher BPRS suspiciousness scores. Compliance to medication was also higher in patients who completed the one-year followup. We found no differences in compliance among the patients who took atypical antipsychotics, typical antipsychotics, or a combination of the two. Age of onset and BPRS suspiciousness scores were inversely correlated with the duration of follow-up. The patients who took haloperidol dropped out earlier than those who took risperidone, clozapine, or olanzapine. There were no differences between patients taking depot antipsychotic medications versus those taking oral antipsychotics in terms of treatment compliance, duration of follow-up, and dropout rates. Our findings suggest that dropout and compliance remain severe problems in the treatment of patients with schizophrenia, and that these problems are multifaceted, involving patient-related, treatment setting-related, and treatment-related factors.

Atrial fibrillation is a serious side effect of antipsychotic drugs, it is very rare but can be fatal. In this case report, a subject who developed an atrial fibrillation after receiving clozapine and olanzapine has been presented.A 49 year-old female patient with a 10-year history of schizophrenia with no additional disease history was admitted to the hospital with the diagnosis of schizophrenia. Clozapine was started to be given as 12,5 mg/day and then it was gradually increased for the patient. After the development of atrial fibrillation when the clozapine dose was at 100 mg/day (25th day of the treatment), the patient was monitored with daily ECG and no medicine was given in this period. Then, after one week, the clozapine was started to be given as 12.5 mg/day and it was increased to a dose of 100 mg per day. Meanwhile, a single dose of 10 mg of olanzapine velotab was given to the patient with no cardiac problems to prevent agitation and atrial fibrillation developed again after that. Holter ECG was within normal limits. Clozapine treatment was discontinued when the treatment dose was 250 mg/day, because atrial fibrillation developed again. After a drug-free one week, atrial fibrillation did not occur during the following haloperidol, risperidone, quetiapine treatments.It is especially very important to monitor the cardiac side-effects in the patients who are using atypical antipsyhotic drugs and ECG monitorization is equally important. More studies are needed to be made towards the research of the antipsychotic arrhythmia relationship.

Background Cannabis is clearly the most popular illicit drug in North America, Europe and in other parts of the world. Evidence is accumulating for the involvement of the endocannabinoid system in emotional processing. However, only few studies examined emotional processing in chronic, heavy cannabis users and these studies were performed in cannabis dependent patients who were abstinent for 12–48 hours. The aim of this study was to investigate facial emotion identification and discrimination abilities in patients with cannabis dependence who were abstinent for at least 1 month. Methods The study included 30 males with cannabis dependency according to DSM-IV criteria and who had been abstinent for at least 1 month and 30 healthy controls. All the subjects were evaluated with Facial Emotion Identification Test (FEIT) and Facial Emotion Discrimination Test (FEDT). Results The main finding of this study was the presence of deficits in both identification and discrimination of facial emotions in cannabis dependent patients during abstinence. In addition, when we examined negative and positive emotions separately, we found out that abstinent cannabis dependent patients performed significantly worse than controls in the identification of negative emotions but not positive emotions. Conclusions Our findings indicate that facial emotion recognition deficits which have previously been observed in current cannabis users are still detectable in abstinent cannabis dependent patients and do not improve quickly with abstinence (an average of 3.2 months).

Valproate is a mood-stabilizing anticonvulsant. It is also used in the management of agitation, irritability and impulsive aggressive behavior. Here we report on a 35-year-old male with bipolar dis...

Objective Atrial fibrillation is a serious side effect of antipsychotic drugs, it is very rare but can be fatal. In this case report, a subject who developed an atrial fibrillation after receiving clozapine and olanzapine has been presented. Case A 49 year-old female patient with a 10-year history of schizophrenia with no additional disease history was admitted to the hospital with the diagnosis of schizophrenia. Clozapine was started to be given as 12,5 mg/day and then it was gradually increased for the patient. After the development of atrial fibrillation when the clozapine dose was at 100 mg/day (25th day of the treatment), the patient was monitored with daily ECG and no medicine was given in this period. Then, after one week, the clozapine was started to be given as 12.5 mg/day and it was increased to a dose of 100 mg per day. Meanwhile, a single dose of 10 mg of olanzapine velotab was given to the patient with no cardiac problems to prevent agitation and atrial fibrillation developed again after that. Holter ECG was within normal limits. Clozapine treatment was discontinued when the treatment dose was 250 mg/day, because atrial fibrillation developed again. After a drug-free one week, atrial fibrillation did not occur during the following haloperidol, risperidone, quetiapine treatments. Conclusion It is especially very important to monitor the cardiac side-effects in the patients who are using atypical antipsyhotic drugs and ECG monitorization is equally important. More studies are needed to be made towards the research of the antipsychotic arrhythmia relationship.

Introduction The aim of the present cross-sectional study was to investigate the prevalence of intimate partner physical violence among depressive Turkish women, as well as the association of intimate partner physical violence with attachment patterns, childhood traumas, and socio-demographic factors. Methods The study included 100 women diagnosed with depressive disorder and 30 healthy women. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV axis I disorders, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Adult Attachment Style Questionnaire (AASQ), and Childhood Trauma Questionnaire (CTQ) were used for clinical assessment. Results It was found that 64% of the women diagnosed with depression were suffering from intimate partner physical violence. In these women, the severity of depression and anxiety symptoms was higher, suicidal ideation and suicide attempts were more common, and the diagnosis of double depression was more prevalent. These women also achieved higher scores in the avoidant and ambivalent subscales of AASQ and higher total scores and higher scores in the physical abuse subscale of CTQ. The partner's and the woman's experiences of physical violence in their families during their childhood predicted intimate partner physical violence for women suffering from depression. Conclusion The investigation of domestic violence contributes to the treatment of depression and also to the recognition and prevention of domestic violence that has profound effects on successive generations.

There are concurrently with different results of studies about cognitive functions of Obsessive-Compulsive Disorder (OCD), impairment in non-verbal memory and executive functioning in OCD, has shown consistent results in several studies. In this study, 62 OCD patients and 40 healthy controls were participated. Firstly, cognitive functions of OCD group and healthy control group were compared in terms of scores in Stroop Test, Wisconsin Cart Sorting Test (WCST), Auditory Consonant Trigram Test (ACTT), Controlled Word Association Test (CWAT), Rey Auditory Verbal Learning Test (RAVLT), Digit Span Test (DST). And then, two patient groups of OCD patients (patients with autogenous obsessions and patients with reactive obsessions) were compared in terms of the scores of same tests, with a hypothesis that claims, cognitive functions of patients with autogenous obsessions, who shown schizotypal personality features and thought disorder in higher ratio, will show more impairment than cognitive functions of patients with reactive obsessions. Significant impairment was found in OCD patients in terms of Stroop test and WCST scores when compared to scores of healthy controls. There was no difference pointed out between cognitive functions of patients with autogenous obsessions and reactive obsessions. Due to limited number of patients with autogenous obsessions in current study, any future research with greater sample size will be helpful to explain the cognitive functions in OCD with autogenous and reactive obsessions.

Neuroleptic malignant syndrome (NMS) is a rare life-threatening condition associated with the use of antipsychotics and other drugs that influence dopaminergic transmission. Although NMS is typically associated with classical antipsychotics, it can also be induced by atypical antipsychotics. In this paper, we report a case of NMS associated with clozapine use.A 27-year-old male was diagnosed as schizophrenia in 2006 and zuclopenthixol depot was administered parenterally. Following the second injection, NMS was diagnosed and he was switched to clozapine. After 4 years of clozapine use, one day, he suddenly stopped eating, stayed in bed all day, and had incontinence. Upon examination at our hospital the patient had muscle rigidity, high fever, leukocytosis, and a high creatine phosphokinase level, and NMS was diagnosed. He was put on bromocriptine. NMS resolved, but psychotic relapse and catatonia developed. 10 sessions of electro convulsive treatment (ECT) were administered. Quetiapine 25 mg/day was introduced and titrated up to 600 mg/day afterwards. He has been using quetiapine 600 mg/day for 18 months and at the time this manuscript was written has not had any signs of psychosis or NMS.NMS is usually induced by the use of agents with high dopaminergic affinity. Incomplete or extraordinary NMS cases have been reported due to clozapine and atypical antipsychotics. The presented case is noteworthy due to the complete and typical presentation of NMS. It should always be kept in mind that all atypical antipsychotics including clozapine have the probability to induce NMS although not common.

Childhood traumatic experiences are widely known risk factors in the development of various psychiatric disorders and unfavorable behavior patterns, including suicide attempts. Moreover, in the course of some psychiatric disorders, suicide attempts are more frequent in patients with childhood traumatic experiences. This study explores the influence of childhood traumatic experiences on suicide attempts in patients with major depression.Our study involved 30 patients with major depressive disorder in full remission who had attempted suicide, and 30 patients with major depressive disorder in full remission who had never attempted suicide, as well as 30 healthy controls matched with patients for age, gender, and education. All the subjects were interviewed with Structural Clinical Interview for DSM-IV (SCID-I). Subsequently, all subjects were administered Childhood Trauma Questionnaire (CTQ).Patients who had attempted suicide reported significantly higher CTQ scores for emotional abuse and emotional neglect, physical abuse, and sexual abuse than healthy controls. Moreover, patients who had attempted suicide reported significantly higher CTQ scores for each three subdomains than patients who had never attempted suicide. There were no significant difference between patients who had never attempted suicide and healthy controls in any of the CTQ subdomains.Childhood trauma may be a risk factor for suicide attempts in patients with depression. Inquiring childhood traumatic experiences could make an important contribution to predict suicide risk in patients with depression.

Objective: Depression is the most widely studied complication in dialysis patients. In patients with chronic renal failure, changes in body image are considered to be associated with invasive treatment interventions. In addition, sexual problems are common in dialysis patients. In this study, hemodialysis and peritoneal dialysis patients are investigated for depression, anxiety, body image, sexual satisfaction, and dyadic adjustment. Methods: Hemodialysis patients ( n = 36), peritoneal dialysis patients ( n = 54), and healthy controls ( n = 30) were included in the study. All the subjects were assessed with Structured Clinical Interview for DSM-IV, Body Image Scale, Beck Depression Inventory, Beck Anxiety Scale, Golombok-Rust Inventory for Sexual Satisfaction, and Dyadic Adjustment Scale. Results: Depression (20.64 + 15.20) and anxiety levels (14.72 + 12.36) were significantly higher in hemodialysis group compared to peritoneal dialysis (13.54 + 12.51; 12.74 + 11.21) and control groups (7.17 + 5.58; 9.86 + 9.19). In peritoneal dialysis group, as depression and anxiety levels increased, body image was disturbed and sexual satisfaction decreased. In peritoneal dialysis group, body image (86.98 + 23.63) was better than hemodialysis group (101.58 + 26.51) and was not different from the control group (83.67 + 22.11). In hemodialysis group, as depression and anxiety levels increased, body image was disturbed. In both groups, long-term dialysis disturbed body image. Conclusion: Patients should be informed about the impacts of dialysis. Clinicians may wish to monitor dialysis-users for anxiety, depression, dyadic adjustment, and body image difficulties at follow-up appointments. Interventions that target intimate partner interventions, appearance-related beliefs, and anxiety depression may be of benefit to this population.

The present study aimed to investigate the perceived level of burden of care and its correlates in family members of schizophrenia patients.The study included 239 schizophrenic patients that were followed-up at the psychiatric outpatient clinics of Izmir Ataturk Education and Research Hospital, and Celal Bayar University Medical School, and 239 of their primary caregivers. Patients were assessed using the Positive and Negative Syndrome Scale (PANNS), Global Assessment of Functioning Scale (GAF), Social Functioning Scale (SFS), Brief Cognitive State Examination (BCE), and UKU Side Effect Rating Scale. Their primary caregivers were assessed using the Perceived Family Burden Scale (PFBS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI).Caregiver PFBS scores ere correlated with male patients, female caregivers, inadequate social support, economic difficulty, the presence of chronic physical disorder in the caregivers, patient violence toward the caregivers, total duration of illness, the number of patient hospitalizations, PANNS total and subscale scores, and SFS, BDI, and BAI scores. Perceived burden of care was predicted by the severity of the patients' positive symptoms, SFS independence/competence and interpersonal functioning subscale scores, and caregivers' anxiety and depression levels.In order to decrease the burden of care in schizophrenia we recommend effective management of patient symptoms, enhancement of patient social functioning, interventions that target caregivers with high levels anxiety and depression, and social support provided by healthcare professionals.

Deficits in recognition of facial emotions have been widely reported in patients with schizophrenia. Previous studies that examined recognition of facial emotions in relatives of patients with schizophrenia brought out inconsistent results.In this study, we aimed to examine facial emotion identification and discrimination abilities in patients with schizophrenia and their healthy siblings to find out whether familial vulnerability to schizophrenia is associated with deficits in facial emotion recognition.Patients with schizophrenia (n=57), their unaffected biological siblings (n=58) and healthy controls (n=58) were included in the study. The three groups did not differ significantly for gender, age and education level. All the participants were evaluated with the Facial Emotion Identification Test (FEIT) and Facial Emotion Discrimination Test (FEDT).Patients with schizophrenia performed significantly worse than controls on FEIT and FEDT. Siblings performed significantly better than patients and significantly worse than controls on FEIT and FEDT.Impaired performance of siblings on facial emotion identification and discrimination tasks provides evidence for the hypothesis that facial emotion recognition deficits are transmitted in families and may represent a heritable endophenotype of schizophrenia.

Impaired social functioning is a characteristic feature of schizophrenia. The aim of this study was to determine the factors that predict social functioning in schizophrenia.The study included 100 patients that met DSM-IV diagnostic criteria for schizophrenia. All the patients were evaluated using the Scale for the Assessment of Negative Symptoms, Scale for the Assessment of Positive Symptoms, Calgary Depression Scale for Schizophrenia, Facial Emotion Identification Test, Facial Emotion Discrimination Test, Digit Span Test, Rey's Auditory Verbal Learning Test, Trail Making Test, and Social Functioning Scale. Marital status, living arrangements, and working status of the patients were also recorded. Pearson's correlation analysis and multiple stepwise regression analysis were used to determine the relationships between the research variables and social functioning. Categorical variables were compared with the independent samples t test.Negative symptoms, level of education, and facial emotion identification were significant predictors of social functioning total score. Negative symptoms were the most important predictor of almost all domains of social functioning. Age and duration of illness were not associated with social functioning. There were no gender differences in terms of social functioning. Married patients had higher social functioning scores. Employed patients had lower negative symptom scores and higher social functioning scores.Negative symptoms were the most important predictors of social functioning in our study.

iSERT DOKU ONARIMI Ç N ZENOGRAFT ÜRET MLevent Mete ÖzgürbüzÖZSunulan çalışmanın amacı sert doku onarımında kullanılmak üzere sığırkemiğinden zenograft üretme sürecinin geliştirilmesidir. Danalar herhangi birhastalık transfer riskini ortadan kaldırmak üzere dikkatle seçilmiş, veterinerkontrolünde kesim gerçekleştirilmiş ve femur kemikleri çıkarılmıştır. Bu kemikler+2ºC dereceye soğutulmuş ve yüzey sıcaklığının artmasını önlemek için süreklisoğuk su akımı altında dikdörtgen parçalar halinde kesilmiştir. Bu kemikparçalarından istenmeyen bölümlerin çıkarılması ve böylece zenograftınhazırlanması için çözücü esaslı bir süreç uygulanmıştır. Parçalar şu farklıçözücüler ile farklı koşullarda etkileştirilmiştir: (1) etil alkol ile; (2) iyonik olmayanbir deterjan ile; (3) bir tuz çözeltisi ile (NaCl); (4) aseton ile; (5) hidrojen peroksitçözeltisi ile; (6) NaOH çözeltisi ile; ve son olarak (7) bir ultrasonik banyoda saf suile. Temizleme sürecinden sonra, zenograftlar 35ºC'de kurutulmuş, plastikpaketlere konulmuş ve bir gamma sterilizatör sisteminde 18 kGy radyasyondozunda sterillenmiştir. Üretilen zenograftların makro yapıları bir optik mikroskopve bir taramalı elektron mikroskop (SEM) kullanılarak incelenmiş ve ortalamagözenek boyutları 100-400 µm aralığında bulunmuştur. Enerji dağılım spektrumu(EDS) inorganik yapının hidroksiapatit' den oluştuğunu göstermiş ve Ca/P oranı1.88 olarak bulunmuştur. FTIR spektrumları ile üretilen zenograftların,hidoksiapatite ilave olarak kollajen de içerdikleri gösterilmiştir. X-ışını difraktometrespektrumları zenograftlardaki hidroksiapatit kristal yapısını göstermiştir. Termalgravimetrik analiz (TGA) zenogarftların %9 su ve %26 kollajen içerdiğinigöstermiştir. Zenogrfatların sıkışma direnci 297 kgf olarak bulunmuştur. MTTtestleri zenograftların sitotoksisitesinin %10'un altında olduğunu göstermiştir.Anahtar Kelimeler: Kalsiyum Fosfat Seramikleri, kemik graftları, zenograft, Kemikiyileştirilmesi, sert doku onarımıDanışman: Prof. Dr.Erhan Pişkin, Hacettepe Üniversitesi, Kimya MühendisliğiBölümü, Biyomühendislik ABD, 06532, Beytepe/Ankara iiPRODUCTION OF XENOGRAFTS FOR HARD TISSUEREPAIRLevent Mete ÖzgürbüzABSTRACTThe aim of this study is to develop a production procedure of xenografts of frombovine bones for hard tissue repair. Calfs have been selected carefully in order toeliminate any disease transmission risk, sacrificed under veterinary control, andfemur bones collected. These bones have been cooled down to +2ºC and cut intorectangular pieces under continuous cold water flow in order to prevent anincrease in the surface temperature. In order to eliminate the undesirable parts ofthese bone pieces and prepare the zenografts, a solvent based cleaning processhas been applied. The pieces have been treated with different solvents at differentconditions which are as follows: (1) with ethanol; (2) with a nonionic detergent; (3)with a salt solution (NaCl); (4) with acetone; (5) with hydrogen peroxide solution;(6) with NaOH solution; and finally (7) in an ultrasonic bath with pure water Afterthe cleaning process, the xenograft have been dried at 35ºC, put in plasticpackaging, and and then sterilized in a gamma-irradiation sterilization system witha radiation dose of 18 kGy.The macrostructures of the zenografts produced have been investigated by usingan optical and an Scanning Electron Microscopes (SEM), and average pore sizeswere obtained in the range of 100-400 µm. The energy distribution spectra (EDS)have shown that the inorganic structure compose of hydroxyapatite with a Ca/Pratio of 1.88. In addition to hydroxyapatite, existances of collagen in the xenograftsproduced have been demonstrated in the FTIR spectra. X-ray diffraction spectrahave exhibited the crystalline hydroxyapatite structure within the xenografts.Thermal gravimetric analysis (TGA) has demonstrated that the xenografts containabout 9% water and 26% collagen. The compression strength of the xenograftshave been measured as 297 kgf. The MTT tests have shown that cytotoxicity ofthe xenografts is less than 10%.iiiKeywords: Hard tissue repair; Xenografts; Bovine bones; Production; Solventbased cleaning processSupervisor: Prof.Dr. Erhan Pişkin, Hacettepe University, Chemical EngineeringDepartment and Bioengineering Division, Beytepe, 06800, Ankara, Turkey 82

To investigate patients with schizophrenia and their parents for frontal lobe functions and to compare the results with control groups matched for age, gender and education level.Twenty-one patients with schizophrenia and their parents (n = 42) were included in the study along with 25 healthy controls matched with patients for age, gender and education level and 20 controls matched with parents for age, gender and education level were also included in the study. All the subjects were interviewed with Structured Clinical Interview for DSM-IV (SCID) and were given tests of frontal lobe functions (Category naming, Luria's hand series, Trailmaking, Stroop, Wisconsin card sorting test).(1). Compared with the matched controls, the patients with schizophrenia performed significantly worse in Category naming, Luria's hand series, Trailmaking and Wisconsin card sorting tests. (2). Compared to the control group matched with the parents, no significant differences were found on any of the tests.The lack of any difference in the performance of parents of patients with schizophrenia in frontal lobe function tests compared to controls matched for age and education level does not support the genetic hypothesis for schizophrenia. This indicates that the impairment in frontal lobe functions may be specific to schizophrenia itself.

Background This study aims to investigate the efficacy of fluoxetine and paroxetine on the levels of depression–anxiety, quality of life, disability, and metabolic control in type II diabetes mellitus (DM) patients. Methods The patients were first applied the Hospital Anxiety-Depression Scale (HADS). After a psychiatric interview with patients who had scores above the cut-off point, those who were diagnosed as having a major depressive disorder according to DSM-IV criteria were applied the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). Twenty three patients who scored 16 or above on the HDRS were included in the study and given the Short Form-36 (SF-36), and the Brief Disability Questionnaire (BDQ) and HbA1c levels were measured. Patients were randomized on 20 mg/day fluoxetine or 20 mg/day paroxetine treatment. The patients were evaluated with the same scales at the 2 nd , 4 th , 6 th , and the 12 th weeks. Results Both groups showed a statistically significant decrease in HDRS, HARS, and BDQ scores with comparison to the index assessment. At the end of treatment, though not statistically significant, a decrease was observed in HbA1c values of the fluoxetine-administered group. Conclusions Fluoxetine and paroxetine effectively reduce the severity of major depressive disorder in type II DM patients. There is need for further and longer-lasting monitoring studies with more patients in order to determine whether there is any difference in terms of their effects on glycemic control.

Brain imaging techniques are commonly used to define changes in the structure and functions of the brain in schizophrenic patients. The relationships between brain images and the cluster of symptoms provide us with more information about heterogeneous forms of schizophrenia. The aim of this study is to compare the regional blood flow of deficit and nondeficit syndrome schizophrenic patients.Forty schizophrenic patients under the age of 65, without physical or neurological illness, mental retardation, a history of substance abuse, or ECT over the previous six months were included in the study. The Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, UKU Side Effect Rating Scale, Hamilton Rating Scale for Depression and The Schedule for the Deficit Syndrome (SDS) were used to evaluate the patients. The regional cerebral blood flow was measured semiquantitatively by SPECT imaging using radiopharmaceutical Tc 99m-HMPAO.There was a significant reduction in the regional blood flow of deficit syndrome patients compared to nondeficit ones in the left frontal cortex (p= 0.002), right frontal cortex (p= 0.006) and right temporal cortex (p= 0.04).We suggest that dysfunctions in some neuroanatomic structures are related to deficit syndrome and the concept of deficit syndrome is important for understanding underlying pathophysiologic mechanisms.

Schizophrenia may cause disability leading to restrictions on many domains of daily life such as hygiene, self-management, vocational and leisure activities, and family and social relationships. The aim of this study was to assess the level of disability with the Brief Disability Questionnaire (BDQ), developed by the World Health Organization, and to identify the clinical correlates and predictors of disability during a 1-year follow-up period in 382 patients with schizophrenia. All patients were assessed at the beginning of the study, and 168 (44%) of them were re-evaluated after 1 year. Total disability scores of the patients with schizophrenia were significantly decreased at follow-up. Female patients seemed to be more disabled than males.. Disability showed a positive correlation with the total, positive symptoms and negative symptoms scores on the Brief Psychiatric Rating Scale, as well as scores on the UKU Side Effects Rating Scale. Patients with the disorganized subtype of schizophrenia and residual symptoms were more disabled than patients with other subtype diagnoses. Negative symptoms and duration of untreated psychosis were significant predictors of disability after 1 year. Early-onset schizophrenia had a twofold increased risk for developing disability. Disability in schizophrenia is a clinical phenomenon closely linked to negative symptoms and poor outcome. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Correction of a skeletal Class II malocclusion with functional appliances has been accepted as a viable treatment modality. However, its mechanism of action is still disputed. This retrospective study compared 20 Class II patients treated with the functional magnetic system (FMS) with Class I and Class II groups (the control groups) of 20 untreated subjects each. Dental and skeletal changes were compared using serial lateral cephalograms. The FMS group differed significantly from the control groups in 15 of 24 parameters. The great increase in articulare-gnathion distance (3.07 mm) attributed to the attractive magnetic component of the FMS dictates a prolonged propulsion of the mandible. The skeletal:dental response ratio was 1:2 for the anterior region and 1:1 for the posterior region. The dental and skeletal parameters demonstrated a synergistic response in the maxilla and a competitive response in the mandible. This means that greater maxillary molar distal movement and incisor retroclination resulted in a more significant restraint of point A. In contrast, increasing the mandibular molar mesial movement and the incisor proclination accompanied less advancement of the pogonion. Although the skeletal contribution to the resolution of the malocclusion was less than the dental contribution (anteriorly, one third), the functional correction response was found to be regulated by skeletal factors. (Am J Orthod Dentofacial Orthop 2001;120:416-26).

Object: Interest in the association between female sex hormones and mental diseases is not new. A possible association betweeen schizophrenia and estrogens is remarkable. Research on the subject suggested that, women with schizophrenia have chronic gonadal hypofunction and hypoestrogenism. With regard to the hypotesis claiming; insufficient functioning of the sexual glands and estrogen defficiency in women with schizophrenia, the onset of the puberty may be later. In this study,our aim is to examine whether there is difference between women with schizophrenia and mentally healty women considering the age at menarche. Methods: In this study, we included 289 patients who were diagnosed with schizophrenia and 339 mentally healty individuals from the internal medicine outpatient clinic as control group. SCID-I is used to confirm the disorder in schizophrenia group, and to exclude any mental ilness in the control group. Those with mental retardation or organic brain disorders were excluded from the study. Individuals personal information and age at menarche is determined with a sociodemografic form in consultation with the patient and a relative. Results: Compared to controls, the mean age at menarche was higher in women with schizophrenia, but this difference is not statistically significant. Discussion: This supports hypothesis that hypoestrogenism in women with schizophrenia may be caused by neuroleptic treatment. However the participation of the internal medicine patients instead of the healty controls is the limitation of our study. Internal diseases may have influence on the onset of puberty.