ÖZET Psikososyal stresin nörobiyolojik etkilerini gözden geçiren bu yaznn ilk bölümünde çocuklu... more ÖZET Psikososyal stresin nörobiyolojik etkilerini gözden geçiren bu yaznn ilk bölümünde çocukluk ça¤ travmalarnn ruh sa¤l¤na etkileri, psikososyal stresin etkilerini açklamak amacyla gelifltirilen nörobiyolojik modeller ve bu amaçla yaplan hayvan çalflmalar tantlmaktadr. Yaplan ...
Background It has been shown that COVID-19 can cause symptoms and diseases such as insomnia, depr... more Background It has been shown that COVID-19 can cause symptoms and diseases such as insomnia, depression, and anxiety. This study aimed to describe prevalence of feeling anxious or depressive among COVID-19 patients in six months of follow-up time and its association with baseline independent factors. Methods This prospective cohort study included patients aged ≥18 years who tested positive for SARS-CoV-2 at Dokuz Eylul University Hospital, Turkey between November 1, 2020 and May 31, 2021. Participants were interviewed by telephone calls on the 1st, 3rd and 6th months after diagnosis. The dependent variable of the study was self-reported moderate or severe anxiety or depression based on EQ-5D-3L general quality of life scale. Generalized estimating equations were used to identify the factors associated with feeling anxious and depressive after SARS-CoV-2 infection. Results In total 5446 patients agreed to participate in the study. Frequency of feeling anxious or depressive at the 1st...
International Journal of Psychology and Psychoanalysis, 2019
Objectives: This study aimed to investigate the association among denial, depression, and other d... more Objectives: This study aimed to investigate the association among denial, depression, and other defense mechanisms in patients with digestive system cancer. Methods: This research was conducted as a case control study. Denial and depression were assessed in 105 patients with digestive system cancer (n = 36; 34.3% were diagnosed with depression). Denial was assessed using the denial of cancer interview, and depression was investigated using SCID-1 and Hospital Anxiety and Depression Scale. Defense mechanisms were assessed using the Defense Mechanism Rating Scale. Results: Patients with depression were less likely to experience denial. Neurotic and immature defense mechanisms were more frequently observed in patients with digestive system cancer who had depression than in those who did not have depression. In addition, a family history of psychiatric disorders, pain, and rectal cancer were related to depression. Mature defense mechanisms, humor, denial, and dissociation have independently protective functions against depression in patients with digestive system cancer. Conclusions: Denial in patients with digestive system cancer can have a protective effect against depression and thus should be considered by clinicians when providing information regarding the illness and its prognosis.
Turkiye Klinikleri Journal of Pediatrics Special Topics, 1999
Somatizasyon terimi ilk kez 1943'te Steckel tarafından "derin yerleşimli bir nevrozun dışavurumu ... more Somatizasyon terimi ilk kez 1943'te Steckel tarafından "derin yerleşimli bir nevrozun dışavurumu olarak ortaya çıkan bir beden rahatsızlığı" anlamında kullanılmıştır (1). Steckel, bu kavramı Freud'un konversiyon kavramının eşanlamlısı olarak kullanmıştı. Başlangıçtaki somatizasyon tanımları bu tanımda olduğu gibi psikolojik durum-larla ortaya çıkan bedensel belirtiler arasında bir neden-sonuç ilişkisi kurmaktaydı. Lipowski 1968'de somatizasyonu "psikolojik durumları bedensel duyumlar, işlev değişiklikleri ve somatik metaforlar biçiminde yaşantılama, kavramsallaştırma ve dışavurma eğilimi" olarak tanımlamıştı (2). Daha sonraki tanımlar somatizasyonun toplumsal boyutuna da yer verir oldular. Katon ve ark. "psikososyal ve duygusal sorunları olan hastaların sıkıntılarını birincil olarak fiziksel belirtilerle ifade etmesi" (3), Kleinman ve Kleinman ise "bireysel ve sosyal sıkıntıların tıbbi yardım arayışına neden olan bedensel yakınmalarla dışavurumu" (4) olarak tanımlamışlardır. Lipowski de 1988'de yaptığı yeni
ÖZET Psikososyal stresin nörobiyolojik etkilerini gözden geçiren bu yaznn ilk bölümünde çocuklu... more ÖZET Psikososyal stresin nörobiyolojik etkilerini gözden geçiren bu yaznn ilk bölümünde çocukluk ça¤ travmalarnn ruh sa¤l¤na etkileri, psikososyal stresin etkilerini açklamak amacyla gelifltirilen nörobiyolojik modeller ve bu amaçla yaplan hayvan çalflmalar tantlmaktadr. Yaplan ...
Turkiye Klinikleri Pharmacology - Special Topics, 2003
İntihar ve Depresif Bozukluklar Antidepresan ilaçlarla zehirlenmeler büyük oranda intihar amacıyl... more İntihar ve Depresif Bozukluklar Antidepresan ilaçlarla zehirlenmeler büyük oranda intihar amacıyla yüksek doz ilaç alımı sonucunda oluşmaktadır. İntihar girişimi, toplumlarda ve sosyodemografik gruplarda farklı oranlarda görülen önemli bir mortalite nedenidir. Sağlık sorunlarının ...
Dokuz Eylül Üniversitesi Tıp Fakültesi dergisi, Apr 1, 2007
Her yıl dünyada birçok insan kardiyovasküler cerrahi geçirmektedir. Koroner arter bypass grafting... more Her yıl dünyada birçok insan kardiyovasküler cerrahi geçirmektedir. Koroner arter bypass grafting ameliyatında cerrahi tekniklerdeki ilerleme sonucunda yüksek risk grubundaki hastalar da (hipertansiyon ve diyabet gibi) ameliyata alınabilmektedir. Yüksek risk grubundaki ve ileri yaştaki hastalara CABG uygulanması beraberinde nörolojik komplikasyonları da getirmiştir. Ortaya çıkan nörolojik sorunlar inme, ameliyat sonrası deliryum, bilişsel bozukluklar ve depresyondur. Bu nedenle ilgi son yıllarda kalbin ameliyat sonrası durumu yerine CABG'nin beyin üzerine de olan etkilerine kaymıştır. Gereç ve yöntem: Çalışmamıza CABG ve valf replasmanı geçiren 24 olgu alındı. Bu olgularda serebral hasarı göstermek amacı ile gliadan salınan S-100B protein, nöronlardan salınan nöron spesifik enolaz ve iskemi patofizyolojisinde birçok fonksiyonu olan nitrik oksid düzeyleri ölçüldü. Ayrıca hastaların bilişsel fonksiyonlarını ölçen nöropsikolojik testler uygulandı. Bu amaçla CABG ve VR ameliyatı geçiren 24 olgudan ameliyat öncesi ve ameliyattan sonra 1., 6. ve 24. saatler ve 3. ve 7. günlerde venöz kan alınarak S-100B protein, NSE ve NO düzeyleri ölçüldü. Nöropsikolojik testler ameliyattan önce ve ameliyat sonrası 3. ve 7. günlerde uygulandı. Bulgular: Nöropsikolojik testler sonucunda 8 olguda bilişsel fonksiyon kaybı saptandı. Bu olgularda ameliyat sonrası 1. ve 6. saatteki S-100B protein düzeyleri, perfüzyon zamanı ve olguların yaş ortalaması bilişsel kayıp saptanmayan grupla karşılaştırıldığında anlamlı yüksek bulundu. NSE, VR grubunda ameliyattan sonra 7.gün ameliyat öncesi değerlere göre anlamlı yüksek bulundu ancak bunun bilişsel fonksiyon kaybıyla bir bağlantısı saptanmadı. Ameliyat öncesi ve ameliyat sonrası NO düzeylerinde ise anlamlı fark bulunmadı. Sonuç: CABG hastaları içinde yaş ortalaması yüksek ve perfüzyon zamanı uzun olanlarda bilişsel fonksiyon kaybı daha fazla görülmektedir. Artan serum S-100B protein düzeyleri serebral etkilenme ve buna bağlı bilişsel fonksiyon kaybı ile koreledir. Anahtar sözcükler: S-100B Protein, nöron spesifik enolaz, nitrik oksit, kardiyovasküler cerrahi SUMMARY Objective: Every year, many people undergo cardiovasculary surgery in the world. Due to improvements in coronary artery bypass surgery (CABG) tecniques, patients in high risk
This article reviews the neurobiological effects of psychosocial stress. In the first part, the r... more This article reviews the neurobiological effects of psychosocial stress. In the first part, the results of childhood traumas, neurobiological models which explain the effects of psychosocial stress and animal studies on this subject are introduced. In a number of studies, an increase in the adulthood prevalence of depression, anxiety disorders and other psychiatric disorders was shown in children who were exposed to early life stress. Pre-clinical and clinical studies have shown that early life stressors cause endocrine, autonomous and behavioral stress responses as a result of permanent sensitivity in corticotropin releasing factor and other neurotransmitter systems in the central nervous system. As a result of this sensitivity, repeating stressors may play an important role in the pathogenesis of depression, anxiety disorders and psychophysiologic disorders. In contrast with the numerous studies investigating the long term effects of early life stressors on the brain, there are very few studies investigating the acute effects of these stressors. In spite of these limitations, it is known that psychosocial stressors may cause different neurobiological results in adults and children. After reviewing the relationship between psychosocial stressors and the neurobiology of affective disorders, it is explained how psychosocial stresses cause sensitivities in the central nervous system and how these sensitivities cause illness. These interactions have implications for treatment in the light of the explained mechanisms. In the last part of the article, new treatment strategies developed for correcting the effects of stress on the central nervous system are introduced.
The 35% CO2 challenge test has been shown to reproduce panic symptomatology in panic patients wit... more The 35% CO2 challenge test has been shown to reproduce panic symptomatology in panic patients with a good sensitivity (Perna et al 1994) while specificity has been investigated only for some anxiety disorders (Perna et al 1995, Caldirola et al in press). To date there is a single study investigating 35% CO2 in a small sample of patients with Generalized Anxiety Disorder (GAD). Since severe anxiety is common in both in panic and generalized anxiety disorders, in the present study have investigated the relationships between these two disorders comparing the reactivities to one vital capacity inhalations of 35% CO2 in patients with PD alone, with GAD alone and with both disorders. Included in the study were 14 patients with PD 14 patients with GAD (mean age: 40.4 5: 9.7, 4 women and 1 l men), 14 patients with both GAD and PD (mean age: 40.6 ± 11.4, 7 women and 7 men) and 14 patients with PD (mean age: 32.3 ± 11.2, 7 women and 7 men). Patients were consecutively recruited at San Raffaele Hospital in Milan. Diagnoses were made according to DSM IV criteria and patients were free from Axis I disorders other than PD and GAD. Each subject underwent one vital capacity inhalation of 35% CO2 and air-placebo in a double blind, random, cross-over design. Anxiety was evaluated immediately before and after CO2 inhalation by a visual analogue scale for anxiety (VAS-A) and a self-administered scale evaluating the 13 DSM 1V panic symptoms. The responses were calculated as percentage of the maximum increment possible on the VAS-A (A%VAS-A) and as rates of positive responses were compared, according to previously validated criteria (Perna et al 1994). ANOVA show a significantly different responses among the three groups (F = 9.7; p < 0.001) with higher responses in PD and PD/GAD groups compared to those reported in the GAD group both for A%VAS-A
The goal of our ongoing study ist to estimate the efficacy of mirtazapine in old age patients sho... more The goal of our ongoing study ist to estimate the efficacy of mirtazapine in old age patients showing depressive disorders. Up tc now 52 patients aged between 60 and 89 years have been treated in our hospital with mirtazapine, because of severe depressive syndromes. The dosage varied
Family-focused therapy (FFT) is a 9-month, 21-session structured psychoeducational treatment for ... more Family-focused therapy (FFT) is a 9-month, 21-session structured psychoeducational treatment for bipolar disorder. Several US-based studies have documented its efficacy as adjunctive to medication for depression stabilization and relapse prevention. However, FFT has never been applied outside of the United States. The objective of this case series is to explore the applicability of FFT in a non-Western culture. Ten patients with bipolar disorder and their family members attended the 9-month FFT as adjunctive to pharmacotherapy in an outpatient specialty clinic in Izmir, Turkey. Patients improved in Global Assessment of Functioning Scores and Clinical Global Impression Scores from pre-to posttreatment. Case studies are given, which illustrate the differences between Western and non-Western families coping with bipolar disorder. FFT was easily applied to a Turkish sample with few changes in format or focus. Adaptations included substitution of oral for written therapeutic tasks or homework assignments. Randomized controlled trials are needed to test the clinical effectiveness of FFT and other psychosocial interventions in non-Western cultures.
, intensive care unit admission (OR: 2.58 (1.70-3.90)) were associated with self-reported anxiety... more , intensive care unit admission (OR: 2.58 (1.70-3.90)) were associated with self-reported anxiety and depression. Conclusions: Feelings of anxiety and depression are common in COVID-19 patients and may persist in the long term. Anxiety and depression were associated with gender, economic status and disease severity. Determination of vulnerable groups for anxiety and depression after COVID-19 can be helpful for early diagnosis and initiation of mental care services. Key messages: As a consequence of Covid-19, anxiety and depression in Covid-19 survivors are common generally. It shouldn't be overlooked or underestimated for the public mental well-being. Covid-19 mental effects on the population have a correlation with social determinants of health. Therefore, determining vulnerable groups is a key to planning mental care services.
ÖZET Psikososyal stresin nörobiyolojik etkilerini gözden geçiren bu yaznn ilk bölümünde çocuklu... more ÖZET Psikososyal stresin nörobiyolojik etkilerini gözden geçiren bu yaznn ilk bölümünde çocukluk ça¤ travmalarnn ruh sa¤l¤na etkileri, psikososyal stresin etkilerini açklamak amacyla gelifltirilen nörobiyolojik modeller ve bu amaçla yaplan hayvan çalflmalar tantlmaktadr. Yaplan ...
Background It has been shown that COVID-19 can cause symptoms and diseases such as insomnia, depr... more Background It has been shown that COVID-19 can cause symptoms and diseases such as insomnia, depression, and anxiety. This study aimed to describe prevalence of feeling anxious or depressive among COVID-19 patients in six months of follow-up time and its association with baseline independent factors. Methods This prospective cohort study included patients aged ≥18 years who tested positive for SARS-CoV-2 at Dokuz Eylul University Hospital, Turkey between November 1, 2020 and May 31, 2021. Participants were interviewed by telephone calls on the 1st, 3rd and 6th months after diagnosis. The dependent variable of the study was self-reported moderate or severe anxiety or depression based on EQ-5D-3L general quality of life scale. Generalized estimating equations were used to identify the factors associated with feeling anxious and depressive after SARS-CoV-2 infection. Results In total 5446 patients agreed to participate in the study. Frequency of feeling anxious or depressive at the 1st...
International Journal of Psychology and Psychoanalysis, 2019
Objectives: This study aimed to investigate the association among denial, depression, and other d... more Objectives: This study aimed to investigate the association among denial, depression, and other defense mechanisms in patients with digestive system cancer. Methods: This research was conducted as a case control study. Denial and depression were assessed in 105 patients with digestive system cancer (n = 36; 34.3% were diagnosed with depression). Denial was assessed using the denial of cancer interview, and depression was investigated using SCID-1 and Hospital Anxiety and Depression Scale. Defense mechanisms were assessed using the Defense Mechanism Rating Scale. Results: Patients with depression were less likely to experience denial. Neurotic and immature defense mechanisms were more frequently observed in patients with digestive system cancer who had depression than in those who did not have depression. In addition, a family history of psychiatric disorders, pain, and rectal cancer were related to depression. Mature defense mechanisms, humor, denial, and dissociation have independently protective functions against depression in patients with digestive system cancer. Conclusions: Denial in patients with digestive system cancer can have a protective effect against depression and thus should be considered by clinicians when providing information regarding the illness and its prognosis.
Turkiye Klinikleri Journal of Pediatrics Special Topics, 1999
Somatizasyon terimi ilk kez 1943'te Steckel tarafından "derin yerleşimli bir nevrozun dışavurumu ... more Somatizasyon terimi ilk kez 1943'te Steckel tarafından "derin yerleşimli bir nevrozun dışavurumu olarak ortaya çıkan bir beden rahatsızlığı" anlamında kullanılmıştır (1). Steckel, bu kavramı Freud'un konversiyon kavramının eşanlamlısı olarak kullanmıştı. Başlangıçtaki somatizasyon tanımları bu tanımda olduğu gibi psikolojik durum-larla ortaya çıkan bedensel belirtiler arasında bir neden-sonuç ilişkisi kurmaktaydı. Lipowski 1968'de somatizasyonu "psikolojik durumları bedensel duyumlar, işlev değişiklikleri ve somatik metaforlar biçiminde yaşantılama, kavramsallaştırma ve dışavurma eğilimi" olarak tanımlamıştı (2). Daha sonraki tanımlar somatizasyonun toplumsal boyutuna da yer verir oldular. Katon ve ark. "psikososyal ve duygusal sorunları olan hastaların sıkıntılarını birincil olarak fiziksel belirtilerle ifade etmesi" (3), Kleinman ve Kleinman ise "bireysel ve sosyal sıkıntıların tıbbi yardım arayışına neden olan bedensel yakınmalarla dışavurumu" (4) olarak tanımlamışlardır. Lipowski de 1988'de yaptığı yeni
ÖZET Psikososyal stresin nörobiyolojik etkilerini gözden geçiren bu yaznn ilk bölümünde çocuklu... more ÖZET Psikososyal stresin nörobiyolojik etkilerini gözden geçiren bu yaznn ilk bölümünde çocukluk ça¤ travmalarnn ruh sa¤l¤na etkileri, psikososyal stresin etkilerini açklamak amacyla gelifltirilen nörobiyolojik modeller ve bu amaçla yaplan hayvan çalflmalar tantlmaktadr. Yaplan ...
Turkiye Klinikleri Pharmacology - Special Topics, 2003
İntihar ve Depresif Bozukluklar Antidepresan ilaçlarla zehirlenmeler büyük oranda intihar amacıyl... more İntihar ve Depresif Bozukluklar Antidepresan ilaçlarla zehirlenmeler büyük oranda intihar amacıyla yüksek doz ilaç alımı sonucunda oluşmaktadır. İntihar girişimi, toplumlarda ve sosyodemografik gruplarda farklı oranlarda görülen önemli bir mortalite nedenidir. Sağlık sorunlarının ...
Dokuz Eylül Üniversitesi Tıp Fakültesi dergisi, Apr 1, 2007
Her yıl dünyada birçok insan kardiyovasküler cerrahi geçirmektedir. Koroner arter bypass grafting... more Her yıl dünyada birçok insan kardiyovasküler cerrahi geçirmektedir. Koroner arter bypass grafting ameliyatında cerrahi tekniklerdeki ilerleme sonucunda yüksek risk grubundaki hastalar da (hipertansiyon ve diyabet gibi) ameliyata alınabilmektedir. Yüksek risk grubundaki ve ileri yaştaki hastalara CABG uygulanması beraberinde nörolojik komplikasyonları da getirmiştir. Ortaya çıkan nörolojik sorunlar inme, ameliyat sonrası deliryum, bilişsel bozukluklar ve depresyondur. Bu nedenle ilgi son yıllarda kalbin ameliyat sonrası durumu yerine CABG'nin beyin üzerine de olan etkilerine kaymıştır. Gereç ve yöntem: Çalışmamıza CABG ve valf replasmanı geçiren 24 olgu alındı. Bu olgularda serebral hasarı göstermek amacı ile gliadan salınan S-100B protein, nöronlardan salınan nöron spesifik enolaz ve iskemi patofizyolojisinde birçok fonksiyonu olan nitrik oksid düzeyleri ölçüldü. Ayrıca hastaların bilişsel fonksiyonlarını ölçen nöropsikolojik testler uygulandı. Bu amaçla CABG ve VR ameliyatı geçiren 24 olgudan ameliyat öncesi ve ameliyattan sonra 1., 6. ve 24. saatler ve 3. ve 7. günlerde venöz kan alınarak S-100B protein, NSE ve NO düzeyleri ölçüldü. Nöropsikolojik testler ameliyattan önce ve ameliyat sonrası 3. ve 7. günlerde uygulandı. Bulgular: Nöropsikolojik testler sonucunda 8 olguda bilişsel fonksiyon kaybı saptandı. Bu olgularda ameliyat sonrası 1. ve 6. saatteki S-100B protein düzeyleri, perfüzyon zamanı ve olguların yaş ortalaması bilişsel kayıp saptanmayan grupla karşılaştırıldığında anlamlı yüksek bulundu. NSE, VR grubunda ameliyattan sonra 7.gün ameliyat öncesi değerlere göre anlamlı yüksek bulundu ancak bunun bilişsel fonksiyon kaybıyla bir bağlantısı saptanmadı. Ameliyat öncesi ve ameliyat sonrası NO düzeylerinde ise anlamlı fark bulunmadı. Sonuç: CABG hastaları içinde yaş ortalaması yüksek ve perfüzyon zamanı uzun olanlarda bilişsel fonksiyon kaybı daha fazla görülmektedir. Artan serum S-100B protein düzeyleri serebral etkilenme ve buna bağlı bilişsel fonksiyon kaybı ile koreledir. Anahtar sözcükler: S-100B Protein, nöron spesifik enolaz, nitrik oksit, kardiyovasküler cerrahi SUMMARY Objective: Every year, many people undergo cardiovasculary surgery in the world. Due to improvements in coronary artery bypass surgery (CABG) tecniques, patients in high risk
This article reviews the neurobiological effects of psychosocial stress. In the first part, the r... more This article reviews the neurobiological effects of psychosocial stress. In the first part, the results of childhood traumas, neurobiological models which explain the effects of psychosocial stress and animal studies on this subject are introduced. In a number of studies, an increase in the adulthood prevalence of depression, anxiety disorders and other psychiatric disorders was shown in children who were exposed to early life stress. Pre-clinical and clinical studies have shown that early life stressors cause endocrine, autonomous and behavioral stress responses as a result of permanent sensitivity in corticotropin releasing factor and other neurotransmitter systems in the central nervous system. As a result of this sensitivity, repeating stressors may play an important role in the pathogenesis of depression, anxiety disorders and psychophysiologic disorders. In contrast with the numerous studies investigating the long term effects of early life stressors on the brain, there are very few studies investigating the acute effects of these stressors. In spite of these limitations, it is known that psychosocial stressors may cause different neurobiological results in adults and children. After reviewing the relationship between psychosocial stressors and the neurobiology of affective disorders, it is explained how psychosocial stresses cause sensitivities in the central nervous system and how these sensitivities cause illness. These interactions have implications for treatment in the light of the explained mechanisms. In the last part of the article, new treatment strategies developed for correcting the effects of stress on the central nervous system are introduced.
The 35% CO2 challenge test has been shown to reproduce panic symptomatology in panic patients wit... more The 35% CO2 challenge test has been shown to reproduce panic symptomatology in panic patients with a good sensitivity (Perna et al 1994) while specificity has been investigated only for some anxiety disorders (Perna et al 1995, Caldirola et al in press). To date there is a single study investigating 35% CO2 in a small sample of patients with Generalized Anxiety Disorder (GAD). Since severe anxiety is common in both in panic and generalized anxiety disorders, in the present study have investigated the relationships between these two disorders comparing the reactivities to one vital capacity inhalations of 35% CO2 in patients with PD alone, with GAD alone and with both disorders. Included in the study were 14 patients with PD 14 patients with GAD (mean age: 40.4 5: 9.7, 4 women and 1 l men), 14 patients with both GAD and PD (mean age: 40.6 ± 11.4, 7 women and 7 men) and 14 patients with PD (mean age: 32.3 ± 11.2, 7 women and 7 men). Patients were consecutively recruited at San Raffaele Hospital in Milan. Diagnoses were made according to DSM IV criteria and patients were free from Axis I disorders other than PD and GAD. Each subject underwent one vital capacity inhalation of 35% CO2 and air-placebo in a double blind, random, cross-over design. Anxiety was evaluated immediately before and after CO2 inhalation by a visual analogue scale for anxiety (VAS-A) and a self-administered scale evaluating the 13 DSM 1V panic symptoms. The responses were calculated as percentage of the maximum increment possible on the VAS-A (A%VAS-A) and as rates of positive responses were compared, according to previously validated criteria (Perna et al 1994). ANOVA show a significantly different responses among the three groups (F = 9.7; p < 0.001) with higher responses in PD and PD/GAD groups compared to those reported in the GAD group both for A%VAS-A
The goal of our ongoing study ist to estimate the efficacy of mirtazapine in old age patients sho... more The goal of our ongoing study ist to estimate the efficacy of mirtazapine in old age patients showing depressive disorders. Up tc now 52 patients aged between 60 and 89 years have been treated in our hospital with mirtazapine, because of severe depressive syndromes. The dosage varied
Family-focused therapy (FFT) is a 9-month, 21-session structured psychoeducational treatment for ... more Family-focused therapy (FFT) is a 9-month, 21-session structured psychoeducational treatment for bipolar disorder. Several US-based studies have documented its efficacy as adjunctive to medication for depression stabilization and relapse prevention. However, FFT has never been applied outside of the United States. The objective of this case series is to explore the applicability of FFT in a non-Western culture. Ten patients with bipolar disorder and their family members attended the 9-month FFT as adjunctive to pharmacotherapy in an outpatient specialty clinic in Izmir, Turkey. Patients improved in Global Assessment of Functioning Scores and Clinical Global Impression Scores from pre-to posttreatment. Case studies are given, which illustrate the differences between Western and non-Western families coping with bipolar disorder. FFT was easily applied to a Turkish sample with few changes in format or focus. Adaptations included substitution of oral for written therapeutic tasks or homework assignments. Randomized controlled trials are needed to test the clinical effectiveness of FFT and other psychosocial interventions in non-Western cultures.
, intensive care unit admission (OR: 2.58 (1.70-3.90)) were associated with self-reported anxiety... more , intensive care unit admission (OR: 2.58 (1.70-3.90)) were associated with self-reported anxiety and depression. Conclusions: Feelings of anxiety and depression are common in COVID-19 patients and may persist in the long term. Anxiety and depression were associated with gender, economic status and disease severity. Determination of vulnerable groups for anxiety and depression after COVID-19 can be helpful for early diagnosis and initiation of mental care services. Key messages: As a consequence of Covid-19, anxiety and depression in Covid-19 survivors are common generally. It shouldn't be overlooked or underestimated for the public mental well-being. Covid-19 mental effects on the population have a correlation with social determinants of health. Therefore, determining vulnerable groups is a key to planning mental care services.
Uploads
Papers by Can Cimilli