Sedat Özkan

Psychiatric morbidity and quality of life in patients with chronic idiopathic urticaria

BACKGROUND Chronic idiopathic urticaria (CIU) is a frequently occurring disease that has a great impact on the health-related quality of life (HRQL) of patients and seems to be associated with a number of psychological factors. OBJECTIVES To determine the prevalence of psychiatric morbidity in patients with CIU and to determine HRQL of CIU patients compared with controls. METHODS A semistructured interview form, a generic form of the HRQL questionnaire (Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36]), and the Structured Clinical Interview for DSM-IV Axis Disorders (SCID-I) were administered to CIU patients who presented to the Allergy Department of the University of Istanbul (from January 1 to April 30, 2005). Healthy subjects matched sociodemographically with the study group were used as the control group. RESULTS Eighty-four CIU patients and 75 controls were included in the study. The mean +/- SD age of the study participants was 36.83 +/- 10.26 years, and 84% were women. The mean +/- SD duration of the disease was 6.34 +/- 7.2 years, and symptoms were intermittent in 51%. The SCID-I revealed a psychiatric diagnosis in 60% of the patients. In terms of the distribution of psychiatric diagnoses, the most frequently occurring diagnosis was depressive disorders (40%). Most patients (81%) believed that their illnesses were due to stress. The subdomains on the SF-36 measurements were significantly lower than those of the control subjects (P < or = .005). The physical function, vitality, and mental health subdomains of the SF-36 in the patients with a psychiatric diagnosis were significantly lower (P < .05). CONCLUSION These findings suggested that psychiatric morbidity is high among ICU patients and is detrimental to their quality of life.

Oncology staff: burnout, job satisfaction and coping with stress

The oncology staff is at high risk for developing psychological disorders and burnout. In this study, we aimed to evaluate their burnout levels, job satisfaction, psychological statement and ways of coping with stress and the relationship between these variables and their sociodemographic and occupational characteristics.

A rare case of self-mutilation: self-enucleation of both eyes

Self-enucleation is a very rare self-mutilative behavior deserving attention because of the severity of its results. Self-injurious behavior has been reported to occur in mentally retarded patients, psychotic patients, individuals with personality disorders (primarily borderline personality disorder), malingering, factitious disorder, and in prison populations [l]. Ocular self-mutilation may be associated with chronic schizophrenia, organic disorders such as epilepsy, encephalitis, or LSDinduced psychosis. Other cases of self-inflicted ocular injuries have been associated with major affective disorders, obsessive-compulsive neuroses, and posttraumatic stress disorder (PTSD) [2,3]. In this paper we discuss a psychiatric patient who has been hospitalized in the ophthalmology clinic because of self-enucleation of both of his eyes. This Moslem patient is the first case reported in our country who performed self-enucleation of both eyes with his fingers; his expressed motivation was to not see evil, thereby redeeming sinfulness through his sacrifice and rescuing the people. These statements are very similar to those made in previously reported cases, almost all of whom were Christian.

Temporomandibular dysfunction and risk factors for anxiety and depression

BACKGROUND Anxiety and depression may cause temporomandibular joint (TMJ) complaints or TMJ disorders may trigger some of psychiatric problems. OBJECTIVE The aim of this study was to determine the risk factors and the interactive role of anxiety and depression in patients with TMJ dysfunction. METHOD A total of 273 patients who presented to the multidisciplinary outpatient clinic of TMJ diseases that were followed up for temporomandibular dysfunction (TMD), were included in this trial. Patients were classified in three sub-groups: patients with myofacial pain alone (group-1), patients with TMJ disorder alone (group-2), and patients with TMJ disorder and also myofacial pain (group-3). All patients were examined using the standard TMJ examination and were evaluated with the Hospital Anxiety Depression (HAD) scale in order to determine anxiety and depression. RESULTS According to the univariate analysis, risk factors for patients with confirmed anxiety and/or depression were being female (p= 0.005), existence of myofacial pain (p= 0.01), effects of stress on complaints (p= 0.005) and insufficient social support (p< 0.001). According to regression analysis, presence of psychopathology was increased 3.7 times in those being female, 3.5 times with insufficient social support, and 1.2 times with myofacial pain. CONCLUSIONS Among the patients with TMD, the groups who were considered to have anxiety and depression were female patients, patients with deficient social support system, and patients with myofacial pain alone or patients with myofacial pain accompanying an existing TMJ disorder. The existence of anxiety and depression should be considered in addition to musculoskeletal pathologies during the treatment plan of patients with TMJ who have these risk factors.

Cultural meaning of cancer suffering.

It is not possible to understand the cancer experience independent from the specific culture. The history, culture, related values, and traditions shape the experience of Turkish cancer patients. This article aims to review the current Turkish literature on the psychological and psychosocial effects of cancer and its related burden. The psychological and psychosocial burden of cancer is discussed. The review clearly documents that an interdisciplinary approach that combines oncologic and psychiatric treatments is required for decreasing the emotional, physiological, and social burden of cancer in Turkey.

The development of psychiatric medicine at Istanbul faculty of medicine and evaluation of 889 psychiatric referrals

A clinical analysis of the psychiatric referrals (N = 889) during 1989-1991 is presented. The most prevalent psychiatric syndromes seen in both inpatients and outpatients are compared with reference to those areas of psychopathology that are less frequently identified by nonpsychiatrist physicians. The distribution of psychiatric referrals according to the various clinics in order of frequency was as follows: internal medicine, surgery, dermatology, and neurology. The most frequent reasons for consultation requests were (in order of frequency) the referring physicians difficulty in making a diagnosis; and patient anxiety, depression, adjustment problems, and past psychiatric illness in the history. Depressive illness was the most prevalent psychiatric disorder among both inpatient and outpatient referrals. However, the frequency of alcohol and substance abuse disorder in the inpatient population was only 3.17% and organic brain syndrome was the least frequently recognized psychiatric syndrome by the other clinicians. In this report, the clinical activities of the Liaison Psychiatry Unit of the Psychiatry Department in the Istanbul Medical Faculty are presented. The major problem areas and clinical training objectives of the Consultation-Liaison Psychiatry Unit are discussed.