Gökçe Cömert

Inappropriate sexual behaviour due to frontal dementia

Three years ago, a 55-year-old man, a teacher, was involuntarily brought to our outpatient psychiatry clinic by his wife. He had agreed to be examined because of his wifes divorce request. He had no symptoms and no insight about his condition during the examination. According to his wife, he had started to spend more time on the computer using social media (Facebook, etc) to chat with women whom he did not know before and was staying up all night. He had an increased demand for sexual intercourse from his wife and had started to watch pornography. Their frequency …

Yellow smoke stain on fingers in patient with schizophrenia

Smoking rates in patients with schizophrenia has been reported as 74-92%.2 It is assumed that smoking reduces negative symptoms and it is kind of self-medication for the patients with schizophrenia.3 It was observed that patients with schizophrenia smoke cigarettes which have higher nicotine and tar content and they used to smoke until the end of the cigarettes.3,4 Typically, this is linked to cognitive impairment and dementia. Also it has been suggested that the reason of it might be the presence of high level of nicotine at the end of the cigarette.4 It might say that the medical treatment of patients with smoke stains on their fingers is inadequate.

Early Onset Progressive Nonfluent Aphasia

A 33-year-old male patient was admitted to the clinic with depressive symptoms. He divorced for years ago. He was treated with antidepressants for 2 years. It had been an increase in his depressive symptoms for the last one year. He also complained about forgetfulness, difficulty understanding, unwillingness, sadness and suicidal thoughts. His speech was hypophonic, slow and includes phonemic paraphasias. He occasionally stammered. He was apathic. In the neurological examination, could not be found a problem. His Hamilton Depression Rating Scale point was 18. His mother was diagnosed with dementia when she was 55 years old. Left hemispheric cortical atrophy and lateral ventricular asymmetry were detected in his cranial magnetic resonance imaging (MRI) (Figure 1, Figure 2, and Figure 3). Increase in theta-delta and alpha frequency was detected in his quantitative electroencephalography (QEEG) without any

MULTIPLE SELF-MUTILATIONS IN ADULT ATTENTION DEFICIT HYPERACTIVITY DISORDER

1 Uskudar University, NPIstanbul Hospital, Department of Psychiatry, Uskudar University *Address for Correspondance: Assist. Prof. Dr.Alper Evrensel, Department of Psychology, Uskudar University, Altunizade Mh. Haluk Turksoy Sk. No:14 Istanbul, Turkiye 34662. Tel: +902164002222 Fax: +902164741256 E-mail: alper.evrensel@uskudar.edu.tr MULTIPLE SELF-MUTILATIONS IN ADULT ATTENTION DEFICIT HYPERACTIVITY DISORDER

Benlik Gelişiminin Nöropsikolojik Temelleri

Yuz tanima, sosyal iliski ve benlik gelisimi arasinda bir baglanti vardir. Insanin yuz tanimayi dil islevinde oldugu gibi onemli ve karmasik bir dizge uzerinden gerceklestirmesinin bir nedeni olmalidir. Insanlarin birbirilerini yuzlerinden tanimalari, dostu dusmani yuz uzerinden ayirmalari, butun dostluklarini yuz uzerinden kurmalari onun dis dunyada insan icin ne kadar temel bir rol oynadigini ortaya koyar. Ortak benligin ic dunyada kurdugu butunlugun benzeri dis dunyada yuz uzerinden kurulmaktadir. Prosopagnozi gibi norolojik bozukluklardan yola cikarak benligin beyindeki merkezine iliskin arastirmalar ve yorumlar yapilmaktadir. Ozellikle uyarilmis potansiyellerle yapilmis calismalar bu konuda onemli bir altyapi saglayacak gibi durmaktadir. Bu yazida yuz tanima ile benlik gelisimi arasindaki iliskiye noropsikolojik acidan deginmek amaclanmistir.

Lithium-induced cortical atrophy and cognitive dysfunction.

A 50-year-old woman presented to the psychiatry clinic with symptoms of forgetfulness, distractibility and difficulty in absorbing information. She was started on lithium after a manic episode 10 years earlier and had been on lithium 900 mg/day for the past 10 years. During this period her mood had remained stable and she was euthymic. However, her occupational and social functioning was impaired significantly in the past year. She had no family history of bipolar disorder or dementia. No medical condition was detected as an explanation …

Premature Birth and Autism

There is a relationship between premature birth and autism (1-4). We had two cases, in which the patients had premature birth and were also supported during their neonatal period. Although the patients did not fully show the symptoms of autism, they showed cognitive immaturity and cognitive defects, close to the structure of autistic mind. Features such as swinging and decline in social integration indicate autistic structure. EK, 28 years old man, single, computer engineer, has worked in a software company for two years. He was confusing about the reality and dreams. Also he was perceiving others speech as disconnected. He complained about his nonsense and continuous thoughts during the day. He was disturbed by noises and crowds. His speech was disconnected; he was jumping from one topic to another. He was usually doubtful about everything. He was able to write on a computer but was speaking slowly face to face. He had lack of attention since his childhood. He had only two friends and no girlfriends up to his present age. He described his mother as quiet. He was born premature when he was seven months and received neonatal care, stayed in an incubator for two months. He was diagnosed with “adult type mild autism”. Clomipramin (37.5 mg/day) and pimozod (1 mg/day) were prescribed, but he started to suffer from hipersomnia. So, he started to take fluoxetine (20 mg/day). DK was a 37 years old, single woman. She was a university graduate and worked in finance sector. She was rigid in social relations. She was unbalanced and was showing extreme hate or love. She was always doubtful about everything. She was impulsive and reactive. She had the fear of being abused by others. She did not accept any compliments from others and wanted the things in her way. She had no friends and no long term intimate relationship. She left her boyfriend because she thought he was going to leave. However, she regretted what she did and made it up with her boyfriend. She described her mother as introverted, alone and hardworking. She was born premature when she was seven months and received neonatal care, stayed in an incubator for two months. She was diagnosed with “adult type mild autism” and haloperidol (15 mg/day) was prescribed to her. Her doubts and impulsive behaviors were diminished afterwards. Even though families of both patients had autistic features, this does not show exactly that there is a relationship between premature birth and autism (1,2). However, it does show that autism might cause premature birth. In addition, the aborted babies could also be autistic (3). If these babies were born, the incidence rate of autism might have increased; if so, autism is not only cerebral but also an undefined systematic disorder and it might cause premature birth (4). Address reprint requests to: Assoc. Prof. Dr. M. Emin Ceylan Uskudar University, Department of Molecular Biology and Genetics, Istanbul Turkey