Vesile Altınyazar

A cross-cultural investigation of suicidal behavior and attitudes in Austrian and Turkish medical students

PurposeThis cross-cultural study investigated the prevalence of suicidal behavior and attitudes towards suicide and reactions to suicidal individuals in 320 Austrian and 326 Turkish medical students.MethodsData were collected using a self-report questionnaire consisting of sections on demographic information, suicidal behavior, current mood, religiosity, attitudes towards suicide, and reactions to suicidal individuals.ResultsMore Austrian (37.8%) than Turkish (27.3%) students reported life-time, past 12-month, or current suicidal ideation, while more Turkish (6.4%) than Austrian (2.2%) students reported life-time or past 12-month suicide attempts. Austrian students had more permissive and liberal attitudes towards suicide, while those of Turkish students were more rejecting. Conversely, attitudes of Turkish medical students towards an imagined suicidal close friend were more accepting than those of Austrian medical students. Comparisons of suicidal versus nonsuicidal students showed that those reporting suicidal ideation or suicide attempts generally were more accepting of suicide and viewed suicide as a solution to a greater extent than the nonsuicidal group.ConclusionThe findings suggest that cultural factors play a role in observed country differences in suicidal ideation and behavior and in attitudes towards suicide and reactions to suicidality among Austrian and Turkish medical students.

Anorexia nervosa and Wernicke Korsakoff's syndrome: Atypical presentation by acute psychosis

A 16-year-old girl was admitted to the emergency department because of acute changes in mental state such as paranoid and nihilistic delusions, confabulations, and distortions of body schema perception. Her history was compatible with anorexia nervosa in that she had lost more than 17 kg in weight over one and a half years. Her body mass index was 14. She was diagnosed with Wernicke Korsakoffs syndrome and was given intravenous thiamine at 250 mg/day. Response was dramatic for nystagmus and gait incoordination but not for other symptoms. After dosage was increased to 750 mg/day all symptoms including psychosis improved. With her increase in food consumption, secondary deterioration was observed and diagnosed as refeeding syndrome. After proper replacements she was completely normal in the 9th month, and her weight was 55 kg. This patient was interesting for the presenting symptoms (psychosis), and improvement by high doses of thiamine replacement, and also for refeeding syndrome during this period.

Facets of Self in Schizophrenia The Reliability and Accuracy of Trait Self-Knowledge

Disturbance of self is a core feature of schizophrenia. In this article, we argue that a nuanced appreciation of self is necessary to understand the relation between the self and its disruption. After discussing evidence for the fractionation of self into several functionally independent yet normally interacting systems of knowledge, we focus on a specific self-system: trait self-knowledge. This system has proven robust in the presence of a host of cognitive and neural impairments rendering other systems of self dysfunctional. Little, however, is known about how this system is affected by schizophrenia. Our findings indicate that, in accord with previous investigations demonstrating the resilience of trait self-knowledge, schizophrenic patients maintain both highly reliable and moderately accurate trait self-knowledge.

Insomnia and dementia: is agomelatine treatment helpful? Case report and review of the literature

The treatment of sleep disorders in Alzheimer’s disease (AD) may be quite challenging in elderly patients because of drug side effects or interactions and comorbid local or systemic diseases. Here, we report a patient with AD, who was suffering from severe insomnia and depression. We ordered agomelatine for the treatment of insomnia in this patient, and it was quite helpful not only for insomnia but also for depression and for the cognitive symptoms related with dementia. Our aim was to share these observations for similar patients.

The temperament and character personality profile of the glaucoma patient

BackgroundTo determine the temperament and character profile of glaucoma patients.MethodsA total of 234 patients (104 with primary open angle glaucoma, and 130 control subjects without any ocular disease) were selected for this prospective, cross-sectional study. All the participants underwent a comprehensive ophthalmological examination, including the best corrected visual acuity, intraocular pressure measurement, gonioscopy, and visual field analysis. All the participants were given the Turkish version of the Temperament and Character Inventory (TCI). The TCI is a self-reported evaluate, with 240 true/false items measuring four domains of temperament; harm avoidance (HA), persistence (PS), novelty seeking (NS), reward dependence (RD), and three domains of character; self-transcendence (ST), cooperativeness (C), self-directedness (SD).ResultsThe glaucoma patients achieved the higher scores than the controls for the HA and SD dimensions (p < 0.001 and p = 0.033). The glaucoma patients scored lower than the controls for the NS, P and ST dimensions (p < 0.001, p < 0.001 and p = 0.002). There were no differences in the RD and C scores between the patients and the controls (p = 0.944 and p = 0.343). There was no correlation between the duration of illness and the TCI dimensions. Disease severity was positively associated with HA (r = 0,220, p = 0,025) and the anticipatory worry (r = 0.227, p = 0.021) dimension.ConclusionsGlaucoma patients had a different personality profile to healthy individuals. This may affect treatment compliance and is also important when coping with maladaptive patient attitudes.