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  1. Home
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Browsing by Author "Taskin, EO"

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    The relationship between separation individuation and depression in first grade students of university
    Taskin, EO; Yüksel, EG; Özmen, E
    Objective: The purpose of this study was to find out the relationship between separation individuation and depression in university students. Methods: The sample consisted of 1026 first grade students of Celal Bayar University consisted the sample of this research a Sociodemographic Form, The Separation Individuation Test of Adolescence (SITA) and Beck Depression Inventory (BDI) were used in this study. Statistical significance of the relationship between SITA subscale scores and BDI scores was assessed by Pearson correlation test and between SITA subscale scores and depression according to the cut-off values of BDI was assessed by using Student's Nest. Results: 20.6% of the students had depression according to the cut-off values of BDI. The mean score of the BDI was 10.98 +/- 9.02. There was a statistically significant negative correlation between the scores of SITA subscales 'peer enmeshment, 'practicing-mirroring' and 'healthy separation' which indicates positive separation individuation process and BDI scores when there was a statistically significant positive correlation between the scores of SITA subscales which indicates difficulties with separation individuation issues 'separation anxiety', 'engulfment anxiety, 'dependency denial' and 'rejection expectancy' and BDI scores. The scores of 'separation anxiety, 'engulfment anxiety, 'dependency denial' and 'rejection expectancy' subscales of SITA were significantly higher in the students with depression according to the cut-off values of BDI when healthy separation subscale scores were significantly higher in the students with depression according to the cut-off values of BDI. Conclusion: In this study, it has seen that there was a relationship between depression and separation-individuation process in adolescence. Difficulties with separation individuation issues in adolescence, in other words failure in achieve developmental tasks during adolescence could cause depression. (Anatolian Journal of Psychiatry 2009; 10:174480)
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    Public attitudes to schizophrenia in rural Turkey
    Taskin, EO; Sen, FS; Aydemir, O; Demet, MM; Ozmen, E; Icelli, I
    Background The aim of this study was to determine the public's attitudes and their correlates towards patients with schizophrenia in rural areas. Methods The study was carried out in a village near Manisa City, Turkey. Two hundred and eight subjects completed the public survey form which consists of ten items screening demographic and health status and 32 items rating attitudes towards schizophrenia. Results Half of the subjects stated that persons with schizophrenia are aggressive and that they should not be free in the community. More than half of the subjects stated that they would be irritated about having a neighbour with schizophrenia (61.5%), that they would not rent their home to a person with schizophrenia (58.2%), that they do not want to work with a person with schizophrenia (61.1%), and that they would not get married to a person with schizophrenia (85.6%). Conclusions The public in rural areas sufficiently recognises schizophrenia but has a tendency to stigmatise schizophrenic patients. Their attitudes are generally negative and rejective. They do not want close contact with schizophrenic patients. Interpretation of schizophrenia as a mental illness leads to more negative attitudes and increases the social distance.
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    The association of self-esteem, depression and body satisfaction with obesity among Turkish adolescents
    Ozmen, D; Ozmen, E; Ergin, D; Cetinkaya, AC; Sen, N; Dundar, PE; Taskin, EO
    Background: The purpose of this study was to determine the prevalence of overweight and obesity and to examine the effects of actual weight status, perceived weight status and body satisfaction on self-esteem and depression in a high school population in Turkey. Methods: A cross-sectional survey of 2101 tenth-grade Turkish adolescents aged 15 - 18 was conducted. Body mass index (BMI) was calculated using weight and height measures. The overweight and obesity were based on the age- and gender-spesific BMI cut-off points of the International Obesity Task Force values. Self-esteem was measured using the Rosenberg Self-Esteem Scale, and depression was measured using Children's Depression Inventory. Logistic regression analysis was used to examine relationships among the variables. Results: Based on BMI cut-off points, 9.0% of the students were overweight and 1.1% were obese. Logistic regression analysis indicated that ( 1) being male and being from a higher socio-economical level were important in the prediction of overweight based on BMI; ( 2) being female and being from a higher socio-economical level were important in the prediction of perceived overweight; ( 3) being female was important in the prediction of body dissatisfaction; ( 4) body dissatisfaction was related to low self-esteem and depression, perceived overweight was related only to low self-esteem but actual overweight was not related to low self-esteem and depression in adolescents. Conclusion: The results of this study suggest that school-based adolescents in urban Turkey have a lower risk of overweight and obesity than adolescents in developed countries. The findings of this study suggest that psychological well-being of adolescents is more related to body satisfaction than actual and perceived weight status is.
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    Mirtazapine Combination in Treatment-Resistant Major Depressive Disorder: A Retrospective Evaluation of Six Weeks
    Aydemir, O; Deveci, A; Taskin, EO
    Objective: Despite the adequate time and dose of antidepressant treatment, approximately one-third of the patients with major depression do not respond. In previous trials, mirtazapine combination was found lobe efficacious in treatment-resistant depression which is non-response to two previous adequate antidepressant drug treatments from different classes. In this present study, it is aimed to assess the efficacy and the tolerability of mirtazapine combination treatment in patients with treatment-resistant major depression by retrospective chart review. Method: During the period between August 2004 and July 2005, all the charts of the patients with treatment resistant major depressive disorder were selected. For the assessment, Hamilton Depression Rating Scale (HAM-D) and Clinical Global Impression (CGI) were used. For the assessment of adverse effects, the report of the patients was considered. Forty-three in- or outpatients with major depression who previously received two antidepressants of different groups and did not respond (<50% of symptom reduction in HAM-D) to either treatment were assessed. Of the 43 patients who fulfilled the inclusion criteria, 39 patients had complete data for the assessment. The study was based on the chart records of 39 patients. At the time of assessment, 18 (41.9%) patients were receiving venlafaxine, and 25 (58.1%) patients were receiving an SSRI (15 on citalopram, 6 on sertraline, and 4 on paroxetine). Result: The mean age of the study group was 42.2 +/- 12.9, and 74.4% (n=32) female. Of the whole sample, 14 (32.6%) patients were having their first episode, whereas 29(67.4%) patients had a recurrent major depression. Ten (23.3%) patients were inpatients and 33 (76.7%) patients were outpatients. The mean HDRS score was decreased from 23.1 +/- 5.1 to 7.3 +/- 5.6 at the end of the assessment of six weeks, and 21 (53.8%) patients achieved remission (HDRS<7). When the primary antidepressant was taken into consideration, patients on venlafaxine had significantly more remission rate compared to patients on selective serotonin reuptake inhibitors (SSRI). In 27.9% (n=12) of the patients, adverse events were emerged, and weight gain was predominant with 8 patients. In two patients who were dropped out due to adverse events, one patient experienced weight gain (8 kg/4 weeks) and the other had anxiety and agitation. Discussion: Mirtazapine combination treatment is an efficacious and well-tolerated alternative in treatment-resistant major depression. When the primary antidepressant is venlafaxine, this combination therapy seems to be more effective.
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    Obsessive-compulsive disorder in a dermatology outpatient clinic
    Demet, MM; Deveci, A; Taskin, EO; Ermertcan, AT; Yurtsever, F; Deniz, F; Bayraktar, D; Ozturkcan, S
    Objective: The aims of present study were to (a) to determine the prevalence of obsessive-compulsive disorder (OCD) in dermatological patients, (b) to determine the possible relationship between dermatological lesions and OCD and (c) to determine the clinical and phenomenological features of the OCD subgroup. Method: The sample consisted of 166 out of 250 consecutively presenting dermatological patients who agreed to participate in the study. The subjects were assessed with the Structured Clinical Interview for DSM-IV Turkish Version (SCID-I) and also completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Results: Of the whole sample, 41 (24.7%) met DSM-IV criteria for OCD. Only 14.6% of them had previously been diagnosed as OCD. The mean score of Y-BOCS in the OCD group was 17.05 +/- 9.75. The most common obsessions were contamination (61 %) and pathologic doubt (53.7%), while washing (61%) and checking (51.2%) were the most frequent compulsions. Those suffering from diseases of sebaceous glands were the only group that showed a significant difference between the OCD and non-OCD group. onclusion: There is a high prevalence of OCD in dermatological patients, although the nature of the relationship between OCD and dermatology has not previously been ascertained. Genetic-based studies and future researches focused on individual anxiety, and sensitivity may provide information that better explains this relationship. (c) 2005 Elsevier Inc. All rights reserved.
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    Serum brain-derived neurotrophic factor level in dysthymia: A comparative study with major depressive disorder
    Aydemir, O; Deveci, A; Taskin, EO; Taneli, F; Esen-Danaci, A
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    THE RELATIONSHIP BETWEEN GENDER AND DEPRESSION, SELF-ESTEEM, HOPELESSNESS, SUBMISSIVE ACTS, GUILT, SHAME AND ANGER IN ADOLESCENTS
    Özmen, E; Özmen, D; Çetinkaya, AÇ; Taskin, EO; Dündar, PE
    Literature Review and Objective: Although there were a number of research findings on gender differences in mental health problems, it is not known that it is a universal phenomenon or not. The purpose of this study was to investigate the relationship between gender and depression, self-esteem, hopelessness, submissive acts, guilt, shame and anger in Turkish adolescents. Methods: A cross-sectional survey of 1185 ninth-grade Turkish adolescents aged 14-19 was conducted. 708 (59.7 %) of the students were male and the mean age of students was 15.53+/-0.72. Hopelessness was measured by using Beck Hopelessness Scale (BHS), self-esteem was measured by using the Rosenberg Self-Esteem Scale (SES), depression was measured by using Children's Depression Inventory (CDI), guilt and shame was measured by using Guilt and Shame Scale (GSS), submissive acts was measured by using Submissive Acts Scale (SAS), anger was measured by using The State-Trait Anger Scale (STAS). Student's t-test was used to find out the relationship between gender and depression, self-esteem, hopelessness, submissive acts, guilt, shame and anger in adolescents. Results: The findings indicate that the mean score of the SAS and BHS, anger control subscale of STAS of the boys were higher than that of the girls and the mean score of the CDI, guilt subscale of GSS, shame subscale of GSS, SES, trait anger subscale of STAS, anger-in subscale of STAS and anger-out subscale of STAS of the girls were higher than that of the boys. While there were statistically significant associations between gender and the SAS, BHS, CDI, guilt subscale of GSS, shame subscale of GSS, trait anger subscale of STAS, anger-out subscale of STAS and anger control subscale of STAS mean scores; no relationship was found between gender and the anger-in subscale of STAS and SES mean scores. Conclusion: The results of this study point out that there are gender differences in hopelessness, depression, guilt, shame, submissive acts and anger levels but not in self-esteem levels in Turkish adolescents. The findings suggest that psychological gender differences are seen not only in individualistic societies, but also in collectivistic societies.
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    Sexual dysfunction in female subjects with fibromyalgia
    Tikiz, C; Muezzinoglu, T; Pirildar, T; Taskin, EO; Firat, A; Tuzun, C
    Purpose: We investigated sexual function in females with fibromyalgia (FM) and evaluate whether coexistent major depression (MD) has an additional negative effect on sexual function. Materials and Methods: A total of 100 female subjects were enrolled in the study, including 40 with FM only, 27 with FM plus MD and 33 healthy volunteers as a control group. The diagnosis of MD was made according to Structured Clinical Interview for Diagnostic and Statistical Manual-IV interview and the Hamilton Depression Rate Scale was used to grade depression. Widespread pain and quality of life were assessed with the Lattinen Pain Scale and Fibromyalgia Impact Questionnaire, respectively. The Female Sexual Function Index (FSFI) was used to assess sexual dysfunction. Results: All subjects were comparable in age, occupation and education. Mean FSFI total score +/- SD was significantly decreased in the FM and FM plus MD groups compared with that in healthy controls (21.83 +/- 5.84 and 22.43 +/- 7.0 vs 28.10 +/- 6.52, respectively, p = 0.001). However, the FSFI score was not significantly different between patients with FM only and FM plus MD (p > 0.05). Correlation analysis revealed a negative moderate correlation between total Lattinen pain score and FSFI score in the FM only and FM plus MD groups (r = -0.366, p = 0.047 and r = -0.403, p = 0.018, respectively). FSFI score did not correlate with FIQ and HDRS scores (p > 0.05). Conclusions: This study demonstrates that female patients with FM have distinct sexual dysfunction compared with healthy controls and coexistent MD has no additional negative effect on sexual function. Thus, female subjects with FM should be evaluated in terms of sexual function to provide better quality of life.
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    Attitudes of patients attending a psychiatric outpatient clinic towards depression
    Taskin, EO; Yüksel, EG; Deveci, A; Özmen, E
    Objective: The aim of this study was to determine the knowledge and attitudes of patients attending a psychiatric outpatient clinic towards depression and factors that influenced them. Methods: This study is carried out on patients who attending Psychiatric Outpatient Clinic of Celal Bayar University Hospital. The study was carried out in 200 subjects who have been selected by systematic sampling method. In this study, a 32-item questionnaire designed for rating the attitudes toward depression by PAREM (Psychiatric Research and Education Centre) was used by adding one item to find out the attitudes toward depression. In addition, a 8-item sociodemographic questionnaire designed by authors and a 5-item questionnaire which was designed by authors and included the patients knowledge and opinions about their illness and illness characteristics of patients were applied. Results: Most of the subjects (83.5%) believed that depression due to social problems. Half of subjects stated that they would not get married with a person with depression (50.5%). Twenty-eight of subjects stated that patients with depression might be aggressive. The patients suffering from a depressive episode toward depression answered the items Mrs. F. has a somatic disease (p=0.030), Persons with depression don't recover completely (p=0.003) and persons with depression are aggressive (p=0.029) as I agree more than the patients not suffering from a depressive episode; but answered the items I can work with a person with depression (p=0.004) and I would get married to a person with depression as I agree less than the patients not suffering from a depressive episode. Conclusions: Psychiatric outpatients have more correct knowledge than lay people about depression and treatment of depression. Most of the patients believed that depression is associated with social problems. Attitudes of the psychiatric outpatients toward patient with depression are more positive and more tolerant than lay people. However, patients with depressive episode have more negative and discriminative attitudes toward patients with depression and desire for social distance from patients with depression. (Anatolian Journal of Psychiatry 2009; 10: 100-108)
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    The Assessment of Parental Anxiety in Pediatric Surgery Cases
    Asik, K; Erbuyun, K; Taskin, EO; Yilmaz, O; Demet, A; Tekin, I; Ok, G; Asik, EA
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    Are pain syndromes equivalents of depression? A comparative study on the level of brain-derived neurotrophic factor
    Aydemir, O; Deveci, A; Taskin, EO; Taneli, F; Selcuki, D; Cerrahoglu, L; Esen-Danaci, A
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    Serum Brain-Derived Neurotrophic Factor Levels in Pain Syndromes: A Comparative Study with Major Depression
    Taskin, EO; Aydemir, Ö; Deveci, A; Taneli, F; Selçuki, D; Cerrahoglu, L; Danaci, AE
    Objective: In this study, it is aimed to compare the level of Brain-Derived Neurotrophic Factor (BDNF) of patients with migraine and fibromyalgia to that of depressive patients and healthy subjects in order to answer the question whether stress is related to pain syndromes. Methods: In the migraine group 27 patients and in the fibromyalgia group 19 patients without any previous antidepressant treatment and psychiatric diagnosis were included. In the depression group, 24 patients with at least eight weeks of antidepressant-free period were invited to the study. In the depression group no co-morbid diagnosis in the first axis was made. Twenty-six subjects without any previous psychiatric diagnosis and psychiatric treatment consisted the control group. For making diagnosis of depression and other first axis disorders Structured Clinical Interview for DSM-IV (SCID-1) was used in all study groups. For the assessment of the severity of depression Hamilton Depression Rating Scale (HAM-D) was applied. The diagnosis of migraine was made according to the criteria of International Headache Society. For the diagnosis of the fibromyalgia the criteria of American College of Rheumatology was used. The severity of pain was assessed with visual analogue scale (VAS) in the migraine and fibromyalgia groups. Serum BDNF was kept at -70 degrees C before testing, and assayed with an ELISA Kit (Promega; Madison, WI, USA), after dilution with the Block and Sample solution provided with the kit. The data were subjected to Kruskal Wallis Test in the comparison of serum BDNF levels. Results: The serum BDNF level of the depression group (21.2 +/- 11.3 ng/ml) was statistically lower (p < 0.0001) than the level of the migraine group (32.2 +/- 10.1 ng/ml), fibromyalgia group (30.7 +/- 8.9 ng/ml) and the control group (31.4 +/- 8.8 ng/ml). The level of BDNF was not significantly different in the migraine, fibromyalgia and control groups. There was no significant correlation between serum BDNF levels, and age and gender. In pain syndromes there was no signification correlation between serum BDNF levels, and mean scores of HAM-D and VAS (r= 0.085; p= 0.579 and r= 0.191; p= 0.204 respectively). Similarly there was no significant correlation between serum BDNF levels and HAM-D scores in the depression group (r=0.122; p= 0.579). Conclusions: Even though the pain syndromes were suggested to be associated with stress, in this present work, serum BDNF level as one of the markers of stress does not support this hypothesis. This might be related to the factor that in pain syndromes such as fibromyalgia or migraine, serum BDNF level may be affected by the alteration in peripheral platelet functions. Furthermore in a limited chronic stress serum BDNF levels tend to be not affected and this may play a significant role in our results.
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    The effect of locus of control on attitudes towards depression and schizophrenia
    Özmen, E; Özmen, D; Deveci, A; Taskin, EO
    Objective: There is no consensus about the effects of personality traits on attitudes toward mental illness. The purpose of this study was to determine the effect of locus of control on attitudes toward depression and schizophrenia. Methods: A cross-sectional survey of 196 university students was conducted. Attitudes toward depression and schizophrenia were assessed by a questionnaire designed by the authors and locus of control was measured by using Internal-External Locus of Control Scale developed by Rotter. Results: The items of the attitudes questionnaire were analyzed one by one to find out the effect of locus of control to attitudes toward mental disorders. There is a statistically significant difference between the participants who answered the item as 'I agree' and 'I don't agree' in one out of 15 items of depression part and two out of 15 items of schizophrenia part of the questionnaire. Discussion: Although many studies have shown that an individual's belief about locus of control has an important influence on his/her attitudes and behaviors, in this study it was seen that locus of control had no or minimal effect on attitudes toward depression and schizophrenia. But there is a need to implement new studies to illuminate the subject.
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    Mirtazapine augmentation in treatment-resistant major depressive disorder: an open-label, six-week trial
    Aydemir, O; Taskin, EO; Deveci, A
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    Case report
    Yüksel, EG; Taskin, EO; Ovali, GY; Karaçam, M; Danaci, AE
    Carbon monoxide (CO) intoxication is usually a serious condition, which can result in neurological disturbances or death. In some patients with CO intoxication, but not usually, a biphasic pattern can be seen. In this condition, after antitoxic treatment, patients may completely recover and after a short recovery period, neurological and/or psychiatric symptoms appear again. This condition is known as delayed encepholopathy and its ocurrence rote is between 0.06% and 11.8%. Herein, we report a case with delayed encephalopathy after CO intoxication, which began with neurological symptoms and continued with obsessive-compulsive disorder, depression, kleptomania, and psychotic disorder. The 41-year-oldfemale patient had no psychiatric or neurological symptoms or disorders prior to CO intoxication. Increased signal intensity changes in the basal region of the left temporal lobe (including the cortex and subcortical white matter), globus pallidus (bilateral), and cerebellar cortical and subcortical white matter (bilaterally symmetrical) was detected on axial T2-weighted magnetic resonance imaging (MRI). In addition, there were atrophic changes in both cerebellar hemispheres. To the best of our knowledge, this is the first case of kleptomania described after CO intoxication in the literature. We discuss the organic etiology of kleptomania and the other psychiatric symptoms of this patient in the light of recent research. We concluded that the kleptomania seen in this patient was related to concurrent lesions in the temporal lobe and globus pallidus, in other words, her kleptomania may have been related to dysfunction simultaneously seen in both the temporolimbic and frontal-subcortical circuits.
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    Serum BDNF levels in conversion disorder: A comparative study with depression
    Deveci, A; Aydemir, O; Taskin, EO; Taneli, F; Esen-Danaci, A
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    The prevalence of suicide ideation and suicide attempts in Manisa city centre
    Deveci, A; Taskin, EO; Dündar, PE; Demet, MM; Kaya, E; Özmen, E; Dinç, G
    Objective: Suicide attempts are a major public health problem. This study aimed to investigate the lifetime prevalence of suicide ideation and suicide attempts in Manisa city centre. Risk factors related to suicide ideations and attempts were also studied. Method: This study was carried out in Manisa city centre. Using cluster and systematic samples, data were collected from 1086 persons 15-65 years old. Separate questions were asked about the lifetime occurrence of suicide ideation (Have you ever seriously thought about committing suicide?), and suicide attempts (Have you ever attempted suicide?). A form for suicide attempters was used to determine the characteristics of the attempts. Results: The lifetime prevalences of suicide ideation and suicide attempts were 6.6% (n=72) and 2.3% (n=25), respectively. Marital problems were the most common stressor in suicide attempts (44%, n=11). Approximately two thirds of the suicide attempters used a drug overdose for suicide. Of all the suicide attempters, 24% (n=6) had made previous attempts. The essential risk factors for suicide ideation were being female (p=0.012), smoking (p=0.001), consuming alcohol (p=0.028), having a previous psychiatric disorder (p < 0.0001), and a family history of psychiatric disorders (p=0.021). The essential risk factors for suicide attempts were smoking (p=0.005), having a previous psychiatric disorder (p < 0.0001), and a family history of psychiatric disorders (p=0.029). Conclusion: The results of the present study suggest that suicide attempts must be carefully evaluated in subjects with previous psychiatric disorders, previous suicide attempts and a family history of psychiatric disorders. It is necessary to know the clinical and demographic features related to suicide attempts.
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    Attitudes of Resident Physicians Working in a University Hospital Towards Schizophrenia
    Taskin, EO; Ascibasi, K; Cokmus, FP; Özmen, E
    Objective: To evaluate the attitudes of resident physicians working in a university hospital (future specialists) towards schizophrenia. Methods: The data of 170 resident physicians who completed the questionnaires in full were included in the research. The data collection procedure was completed in 6 months by two resident psychiatrists using the sealed envelope method for the questionnaires (an 11-item socio-demographic and an 8-item professional information form and a 32-item attitude towards schizophrenia survey that was prepared by the Psychiatric Research and Training Center). The effect of the sociodemographic and occupational variables on the responses to the questionnaire items was tested using logistic regression analysis. Results: The mean age of the participants was 28.07 +/- 2.40 (min=24-max=42) years. Approximately 98.8% (n=168) described schizophrenia as a 'disorder' and 78.2% (n=133) as a 'psychiatric disorder.' Some 64.1% (n=109) of the participants stated that schizophrenia was a congenital disease, 81.2% (n=138) said it was a curable disease, 85.9% (n=145) though that it could be treated with medication, 60% (n=102) believed that the medications used for treating schizophrenia would cause dependence, and 81.8% (n=139) stated that the medications used would involve serious adverse effects. Nearly 70.6% (n=120) of the participants stated that they could work with someone with schizophrenia and 45.9% (n=78) said that they could marry someone with schizophrenia. The presence of psychiatric diagnoses in a close friend (social acceptance of patients) was found to be an influential variable. Conclusions: The resident physicians had high-level knowledge of schizophrenia as a psychiatric disorder, but their knowledge on the effects and adverse effects of the medication was insufficient or incorrect. The sample's social acceptance of patients was generally good, despite putting social distance in situations requiring more personal intimacy. Based on these results, to treat schizophrenia more successfully, we need to either revise psychiatry curriculum in medical education or provide targeted skill training for non-psychiatric physicians in order to adopt more positive attitudes towards patients with schizophrenia and refer them appropriately to psychiatrists when needed.
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    Risk factors for delaying treatment seeking in obsessive-compulsive disorder
    Demet, MM; Deveci, A; Taskin, EO; Dündar, PE; Ermertcan, AT; Demet, SM; Bayraktar, D; Öztürkcan, S
    Background: Despite the multiple alternatives of treatment, it is well known that patients with obsessive-compulsive disorder (OCD) delay seeking treatment. In this study, the aim was to determine the risk factors for delaying treatment seeking in OCD patients. Methods: The sample consisted of 132 OCD who completed the Yale-Brown Obsessive-Compulsive Scale, Yale-Brown Obsessive-Compulsive Scale Symptom Checklist, and Beck Depression Inventory. Results: In univariate analyses with risk evaluation, income level, being single or divorced, having a history of psychiatric treatment, poor insight for the symptoms, and obsessions of hoarding were the variables that were found to be significant. In the regression model, history of psychiatric treatment and duration of OCD were the 2 variables that remained statistically significant. Conclusion: This was the first study wherein the sample included patients who were recruited from a nonpsychiatric department: the dermatology clinic. Application to dermatology has not been determined as a risk factor for delaying treatment seeking in OCD patients. (c) 2010 Elsevier Inc. All rights reserved.

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