İlhan Çetin

Self-harm, suicidal ideation and suicide attempts among college students

Self-harm, suicidal ideation, and suicide attempts are well represented behaviours in the general population of both developed and developing countries. These behaviours are indicative of underlying risk factors that show a strong interdependent correlation. In this study we attempted to define correlates for and prevalence of self-harm, suicidal ideation, and suicide attempts among Turkish college students. This 2006 study included 636 students from two Turkish state universities. Our results showed that the lifetime prevalence of self-harm was 15.4%, the prevalence of suicidal ideation was 11.4%, and the prevalence of suicide attempts was 7.1%. We uncovered correlates for self-harm, including low income, unsatisfying familial relationships, smoking, and alcohol, inhalant, and tranquilizer abuse. Tranquilizer abuse shared a dual role as a correlate for suicide ideation and as a means to attempt suicide. Additionally, we found that drug abusers and adolescents who practise self-harm presented the highest suicide risk.

Spatiotemporal change and ecological modelling of malaria in Turkey by means of geographic information systems.

We described the spatiotemporal change of malaria (Plasmodium vivax) in Turkey over 34 years (1975-2008), and assessed the role of environmental variables in this change. We developed seven 5-year-period raster maps by using geo-referenced malaria case data from the centres of 81 provinces and the kriging method with a spherical variogram model in a geographic information systems (GIS) model. We also modelled malaria incidence in GIS by using our average malaria incidence raster map, and complementary spatial database including the raster map layers of 14 environmental variables. We chose linear regression analysis with backward method to investigate relationships among variables and develop a model. The model was run in GIS to obtain a model incidence raster map. We tested the reliability of the model map by residual statistics, and found the model map dependable. Five-year-period maps revealed that the distribution of malaria cases moved from the East Mediterranean region to the Southeast Anatolia region due to changing human activities. The latitude, minimum temperature, distance to seas and elevation variables were found to have significant impacts on malaria. Consequently, the model incidence map established a good background for early warning systems to predict epidemics of malaria following environmental changes.

A tularemia outbreak in an extended family in Tokat Province, Turkey: observing the attack rate of tularemia

OBJECTIVE We report the first tularemia epidemic occurring in Tokat Province, located in the Middle Black Sea Region of Turkey, and some features of the cases. This epidemic has allowed the calculation of the attack rate of this disease because of its appearance in a single large family. METHODS The clinical and laboratory features of patients were examined. For serological diagnosis, microagglutination assays were done on serum samples from patients and other members of the family. RESULTS Seven members of the family developed overt clinical disease (one ulceroglandular, six oropharyngeal). Three patients had conjunctivitis in addition to oropharyngeal involvement. All patients had a microagglutination titer above 1/160. As eight out of 16 members of the extended family were found to be positive for tularemia serology, the attack rate was calculated to be 50%. CONCLUSIONS Tularemia is highly infectious and different clinical forms can occur in a single epidemic.

Factors associated with illicit drug abuse among Turkish college students.

Objectives:Illicit drug use peaks during late adolescence and young adulthood. Turkey has a young population, and, as an historical opium producing country, it has experienced a continual illicit drug abuse problem. This study aimed to estimate the prevalence of substance abuse, to determine the risk factors associated with drug abuse, and to compare the drug abuse between a metropolitan and a rural area. Methods:This was a cross-sectional study performed between March 2007 and May 2008 at 2 universities; 1 from a rural area (Gaziosmanpasa University) and 1 from a metropolitan area (Istanbul University). Results:We found that the most common drugs were minor tranquilizers (5.7%), followed by inhalants (4.9%), and cannabis (3.6%). Cannabis and inhalant abuse were especially common among males. The major risk factors were contact with a person, such as a family member or a peer, who practiced substance abuse, a low level of success at school, being arrested or in trouble with the police, and burglary or theft. Conclusions:These risk factors were similar those identified in developed countries. Similar risk factors were shared between different substances. Hence, preventive measures should target substance abuse in general, rather than focusing on controlling the abuse of individual substances.

Assessment of Cases of Suicide in Turkey Based on Turkish Statistical Institute Data

‹ntiharlar tüm dünyada sosyo-ekonomik fark gözetmeksizin önemli bir halk ve ruh sa¤l›¤› sorunu olarak de¤erlendirilmektedir. Birçok ülkede özellikle gençlerde trafik kazalar›ndan sonra önde gelen ölüm nedenleri aras›ndad›r. Bu çal›flmada; Türkiye’de 2002-2009 y›llar› aras›nda meydana gelen intihar vakalar›n›n yafl, cinsiyet, e¤itim düzeyi, intihar nedeni ve y›llar içerisindeki de¤iflimini de¤erlendirmek ve dünyadaki genel intihar e¤ilimi ile karfl›laflt›rmak amaçlanm›flt›r. Çal›flmam›zda Türkiye ‹statistik Kurumunun (TU‹K) ‹ntihar ile ilgili 2002-2009 y›llar› aras›ndaki intihar istatistikleri de¤erlendirilmifltir. Elde edilen verilerin analizinde Windows SPSS 15.0 istatistiksel program› kullan›lm›flt›r. Olgular›n %64,4‘ünün erkek oldu¤u ve %35,6’s›n›n kad›n oldu¤u saptanm›flt›r. Erkek intihar olgular›nda tüm yafl gruplar›nda 2002-2009 y›llar› aras›nda sürekli bir art›fl oldu¤u dikkati çekmektedir. Kad›n intihar olgular›nda 0-19 ve 20-39 yafl grubunun 2002-2009 y›llar› içerisinde azalma gösterdi¤i ancak 40-59 ve 60 ve üzeri yafl grubunda ise art›fl oldu¤u görülmektedir. ‹ntihar eden olgular›n %62,9’unun ilkokul-ilkö¤retim-ortaokul düzeyinde, %16,3’ünün lise düzeyinde, %5,1’inin yüksek ö¤retim düzeyinde e¤itim durumu oldu¤u saptanm›flt›r. 2002-2009 y›llar› aras›ndan intihar eden olgular›n %47’sinin as›, %23,5’inin ateflli silah, %14,2’sinin kimyevi madde, %9’unun yüksekten atlama yöntemini kulland›¤› gözlenmifltir. 20022009 y›llar› aras›nda intihar eden olgular›n %34,3’ünün bilinmeyen bir sebep, %23,8’sinin hastal›k, %15,1’inin aile geçimsizli¤i, %10,2’sinin geçim zorlu¤u, %6,7’sinin hissi iliflki nedeniyle intihar etti¤i gözlenmifltir. Dünya Sa¤l›k Örgütünün verilerine göre intihar nedeniyle küresel mortalite oran› yüz binde 16 olarak bildirilmifltir. 2009 y›l›nda Türkiye’nin toplam nüfusunun 72.561.312 oldu¤u dikkate al›nd›¤›nda, Türkiye’de 2009 y›l›nda intihar oran›n›n yüz binde 4 oldu¤u gözlenmektedir. Amerika Birleflik Devletleri’nin (ABD) 2005 y›l› istatistikleri incelendi¤inde intihar eden olgular›n %52,1’inin ateflli silah yöntemi kulland›¤›, %22,2’sinin asma-bo¤ulma yöntemini kulland›¤›, %17,6’s›n›n ise zehir yöntemi kulland›¤› bildirilmifltir. Türkiye’deki intihar olgular›nda as› yönteminin ABD’ye göre 2,1 kat daha fazla oldu¤u, ABD’de ise ateflli silah yönteminin Türkiye’ye göre 2,2 kat daha fazla oldu¤u gözlenmektedir. Anahtar kelimeler: ‹ntihar, intihar yöntemleri, intihar nedenleri, adli t›p

The relationship between terrorist activities and cases of malaria in the eastern and south-eastern regions of Turkey, 1984-1998.

The objective of this study was to determine whether cases of malaria are related to terrorist activities that have occurred in the eastern and south-eastern regions of Turkey. Some of the determinants related to malaria have been investigated using a national dataset for 11 provinces located in these regions of Turkey. In these regions, both terrorist activity and cases of malaria were common from 1984 to 1998. A multiple regression technique was used to identify the variables that are significantly associated with cases of malaria. Annual incidence of malaria was chosen as the dependent variable along with three independent (explanatory) variables: annual number of terrorist incidences, people per healthcare technician and number of thick blood films per 100,000 people. Based on this analysis, it is determined that the annual number of terrorist incidences has been associated with the annual number of malaria cases in these regions of Turkey since the beginning of terrorist activity in 1984.