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Öğe Assessment of psychopathological aspects and psychiatric comorbidities in patients affected by tinnitus(Springer, 2008) Belli, Şeyda; Belli, Hasan; Bahçebaşı, Talat; Özçetin, Adnan; Alpay, Emrehan; Ertem, ÜmitThe aim of present study was to determine the psychiatric symptoms and comorbidities in patients affected by tinnitus. The study sample, between June 2004 and September 2005, consisted of 180 Turkish adults living in Elazig. Ninety consecutive tinnitus patients were enrolled on their first visit to the outpatients clinic. Control subjects were recruited partly from the social surroundings of the authors. All subjects with significant medical and/or psychiatric pathologies, such as schizophrenia, manic-depressive psychosis, dementia, and behavioural disorders with social withdrawal or suicidal risk, were excluded, as were those unwilling to take part in the study. For the psychopathological examination, patients underwent the Structured Clinical Interview for DSM-III-R (SCID-I, SCID-II). Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Symptom Check list-90 (Revised) (SCL-90-R) were also administered to patients with tinnitus and control subjects. SCL-90-R subscales scores, Beck Anxiety Inventory and Beck Depression Inventory scores were significantly higher in tinnitus patients than in normal control subjects. Twenty-four patients (26.70%) with tinnitus had at least one psychiatric diagnosis. Five control subjects (5.60%) had at least one psychiatric diagnosis. There were significant differences between the two groups (P < 0.001). Anxiety disorders and somatoform disorders were significantly higher in tinnitus patients than in normal control subjects. We conclude that psychiatric symptoms (such as symptoms of anxiety, depression or somatization) among patients with tinnitus should alert clinicians for the presence of a chronic and complex psychiatric condition (Axis-I and Axis-II disorders).Öğe Childhood trauma and dissociation in women with pseudoseizure-type conversion disorder(Taylor & Francis As, 2009) Özçetin, Adnan; Belli, Hasan; Ertem, Ümit; Bahçebaşı, Talat; Ataoğlu, Ahmet; Canan, FatihBackground: Conversion disorder is thought to be associated with psychological factors because of the presence of conflict and other stressors prior to the condition. Aim: The aim of this study is to compare adult patients with pseudoseizure-type conversion disorder with healthy control group in terms of childhood trauma, dissociative disorder and family history of psychiatric disorders. Method : 56 female patients were admitted to the general psychiatry hospital outpatient clinic between January and July 2005. All patients had a negative experience about their families just before having the conversion. Diagnosis was made according to the DSM-IV criteria. A control group consisting of similar patient demographics of the disease group has been selected. Socio-demographic information forms, the Childhood Trauma Questionnaire (CTQ) and Dissociation Questionnaire (DIS-Q), were completed on the patients. Results: CTQ total (t = 12.12, P < 0.001) and subscales, emotional abuse and emotional neglect (EA-EN) (t = 12.74, P < 0.001), physical abuse (PA) (t = 10.05, P < 0.001), and sexual abuse (SA) (t = 7.69, P < 0.001) were significantly high in the conversion group. DIS-Q mean points were statistically higher in the conversion group (t = 11.05, P < 0.001). Conclusions: The findings suggest that pseudoseizures (conversion disorder) should be included within dissociative disorders in DSM system as in ICD. It is usually uncommon for the patient to tell about childhood trauma without being specially questioned about this issue. Thus, it would be helpful to uncover these experiences by using related scales in conversion disorder patients.Öğe Perpetrators of homicide with schizophrenia: sociodemographic characteristics and clinical factors in the eastern region of Turkey(W B Saunders Co-Elsevier Inc, 2010) Belli, Hasan; Özçetin, Adnan; Ertem, Ümit; Tüylüoğlu, Emel; Namlı, Mustafa; Bayık, Yılmaz; Şimşek, DüzgünIn this study, we aimed to describe the social and clinical characteristics and offense details in a sample of people with schizophrenia convicted of homicide in the eastern region of Turkey. This study was performed in Elazig Mental Hospital between November 2004 and May 2007. We included 43 men and 6 women with schizophrenia convicted of homicide who were hospitalized in the forensic psychiatry unit for compulsory treatment. Preset data recording forms were used. The first part of the forms contained questions regarding the age, sex, marital status, residence, educational status, and occupation of the patients. The second part of the forms included questions about some clinical features of patients with schizophrenia: the presence of schizophrenia in any family member, duration of the disease, subtype of schizophrenia, previous contact with mental health services, types of antipsychotics (first and last drug used), and adherence to antipsychotic medication. The third part of the forms dealt with alcohol-substance abuse and features of the victim (sex of the victim and whether the victim was a stranger, partner, or an ex-partner in the family or an acquaintance). The mean +/- SD age of our patients was 36.98 +/- 10.07 years, and 55.1% of the patients were unmarried. In our sample, 42.9% of the patients were primary school graduates and 75.5% were unemployed. Of the perpetrators, 14.3% never had contact with mental health services. However, 85.7% of patients had previous contact with mental health services. We found that 85.7% of the patients were paranoid subtype and 85.7% were not using their medication regularly and that treatment compliance was considerably low. We found that haloperidol and trifluoperazine were the most preferred antipsychotic drugs, particularly being the first drugs used during treatment (haloperidol, 71.4%; trifluoperazine, 10.2%) and the last antipsychotics used before the offence (haloperidol, 46.9%; trifluoperazine, 20.4%). In 38.8% of cases, schizophrenia was present in the first-degree relatives. We also found that 69.4% of victims were one of the family members. In our sample, 24.5% of patients were using alcohol and 4.1% were using cannabis. It is plausible that rendering more effective communication might allow earlier intervention for unrecognized and possibly unrecognizable risk factors of homicidal acts in people with schizophrenia. (C) 2010 Elsevier Inc. All rights reserved.Öğe Some sociodemographic features and factors associated with treatment in patients with schizoprenia(2007) Belli, Hasan; Özçetin, A.; Ertem, Ü.; Alpay, Emre; Bahçebaşı, Talat; Kıran, Ü.K.; Bayık, YılmazObjective: To define clinical features and sociodemographic characteristics of patients with schizophrenia according to disease subgroups in the less developed East and South-Eastern regions of Turkey where people live in wide family systems, to determine the factors affecting treatment including drug selection and to figure out substance abuse pattern. Methods: Three hundred and twenty nine are male and 134 female, total 463 patients with ages ranging from 15-65 who presented to the state hospital outpatient clinic together with their families and who were decided to be admitted and treated inpatiently were included in this study. Results: 87.5% of the patients were unoccupied, 26.3% were not able to read or write and 36.7% were primary school graduate. 84.7% of the patients were from lower socioeconomic group and 60.3% were single. 62.4% of the patients met the diagnosis criteria for paranoid, 22.7% disorganized, 8.2% residual and 6.7% undifferentiated types of schizophrenia diagnosis. 17.1% have not used any substance while 76.0% were smoking and the remaining was smoking in addition to alcohol and/or marihuana. Typical antipsychotics were the first choice in drug selection at the beginning of treatment with a percentage 95.9 (n=444) and this rate decreased to 76.3% in long term management. Discussion: Typical antipsychotics remained as the first choice in the treatment of our patients. Regular medication use seemed shows strong positive relation to hospitalization number but showed weak positive relation to age, living with the family, duration of treatment and being married. In other words, patients' being in constant relationship with his/her physician and receiving social support from their relatives had positive input in the treatment. Negative relation between the first used medication and substance abuse, occupation, low socioeconomic status seemed to prevent regular use of medications. We can increase compliance by using the support given by the family and the close social relationships as well as our culture's avoidance type impact on substance abuse. We can also increase life quality and productivity of our patients by directing our limited economical reserves toward use of atypical antipsychotics which have less side effects and more effect on negative symptoms of the disease.
