Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633522024SummerThe Principles and Rules of Professional Ethics in Psychiatry8586TRGoncaAŞUT10.5080/u27521

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633522024SummerThe Principles and Rules of Professional Ethics in PsychiatryPsikiyatri Meslek Etiği İlke ve Kuralları858610.5080/u27521ENTRGoncaAŞUT10.5080/u27521

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633522024SummerBarriers To Accessing Mental Health Services Among Syrian Refugees: A Mixed-Method StudySuriye Kökenli Sığınmacıların Ruh Sağlığı Hizmetlerine Ulaşmasını Engelleyen Etmenler: Karma Yöntemli Bir Çalışma879410.5080/u27044ENTRCengizKILIÇEdipKAYAÖzgeKARADAĞSarpÜNER10.5080/u27044Objective: Although Syrian refugees have high rates of mental health problems due to war trauma, little is known on their degree of need for and contact with mental health services. Using a population sample of Syrian refugees living in Ankara, we assessed the perceived need for and contact with mental health services, as well as the barriers to access these services. Method: This was a cross-sectional mixed-method study of 420 Syrian refugees living in Ankara city center, using face to face interviews administered at the respondents’ home by trained, Arabic-speaking interviewers. PTSD and depression were assessed using Harvard Trauma Questionnaire and Beck Depression Inventory, respectively. Results: Of all the refugees in our sample, 14,8% (N=62) stated that they felt the need for mental healthcare since arriving in Turkey. The actual number contacting any mental health service was very low (1,4%, N=6). The most important barriers to accessing mental health services were reported by the respondents to be language problems and lack of information on available mental health services. Service providers and policymakers also reported similar topics as the most important barriers: low awareness about mental health problems, daily living difficulties, and language and cultural barriers. Multivariate analyses revealed that presence of medical or mental disorders and female gender predicted the perceived need for contacting services. Conclusion: Our results show that, although refugees report high rates of mental health problems, the perceived need for and actual contact with services are very low. To address this treatment gap, and to provide adequate care for refugees with mental health problems, common barriers (language and awareness) should be identified and dealt with. Keywords: Refugee, Mental Health, Healthcare Utilization, Syria

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633522024SummerReferral Network Pathways of Care for Psychiatric Disorders in Kashmir – A Study from IndiaKeşmir’de Psikiyatrik Bozuklukların Tedavisine Yönelik Sevk Yolları - Hindistan’dan Bir Çalışma9510110.5080/u26915ENTRShoibSHEIKHMohd SaleemSHEIKHMohammed Shaiful IslamSHEIKH10.5080/u26915Objective: Access to psychiatry services in Kashmir is challenging because of active enduring conflict, insecurity and a fundamental role played by the traditional health workers. We aimed to assess the main pathways to mental health services in Kashmir, India. Methods: This cross-sectional hospital-based study was performed from March 2012 to June 2017 in the outpatient psychiatry department at a psychiatric disease hospital in Kashmir. A convenience sampling method was used to select newly referred patients to the services. A survey was developed to collect information on demographic data and the main pathways for patients when seeking care for mental disorders. Results: A total of 518 patients were interviewed. About half of the respondents (48.8 %) attended clinical consultation from a general pathway like a physician or a neurologist, while 31.8% were visiting a psychiatrist for a significant psychiatric disorder. For some patients (17.8%), their initial pathway to mental health services is traditional healers. Conclusion: The current study revealed different pathways to seeking psychiatric care in Kashmir India. Further studies are needed to address the treatment gap and ways to improve access to mental health services for the Kashmir population. Keywords: Psychiatric Disorders, Referral, Pathway, Conflict

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633522024SummerThe Effects of Art Therapy and Psychosocial Skills Training on Symptoms and Social Functioning in Patients with Schizophrenia and Their RelativesŞizofreni Hasta ve Yakınlarıyla Yapılan Sanatla Terapi ve Ruhsal Toplumsal Beceri Eğitiminin Hastalık Belirtileri ve Sosyal İşlevsellik Üzerine Etkileri10211510.5080/u26773ENTRAslıSARANDÖLRümeysa AyşeGÜLLÜLÜİlknur KİRAZAVCIEralpTÜRKSalih SaygınEKER10.5080/u26773Objective: The effects of antipsychotics on negative symptoms are limited. The most appropriate approach in the treatment of schizophrenia is the integration of drug therapy with psychological and social interventions. The purpose of this study was to evaluate and compare the effects of art therapy and psychosocial skills training (PSST) in the treatment of schizophrenia. Methods: A total of 15 patients diagnosed with schizophrenia according to the criteria in DSM-5 and 12 patient relatives were included in the study. The patients were randomly divided into 2 groups, 7 were included in the art therapy program and 8 were included in the PSST program for schizophrenia. 90-minute sessions of art therapy and PSST were carried out once a week for 17 weeks. Participants with schizophrenia were evaluated with the Positive and Negative Syndrome Scale (PANSS), Social Functioning Scale (SFS) and the Calgary Depression Scale for Schizophrenia and the relatives were given Beck Depression Inventory, Beck Anxiety Inventory and Zarit Burden Interview. Results: There was a significant decrease in the PANSS negative symptoms, PANSS general psychopathology, SFS pro-social activities and SFS recreation scores in both groups, while the SFS social withdrawal scores decreased significantly only in the art therapy group. In the PANSS negative symptoms subscale, passive social withdrawal, difficulty in abstract thinking, lack of spontaneity and flow of conversation and stereotyped thinking scores were significantly lower in the art therapy group. In the PSST group only the score for difficulty in abstract thinking declined significantly. Conclusion: The findings of the present study suggest that art therapy and PSST have positive effects on the improvement of negative symptoms as well as improvements in social and cognitive functionality in schizophrenia. Keywords: Schizophrenia, Art Therapy, Psychotherapy Group, Psychosocial Skills Training, Social Functioning

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633522024SummerThe Relationship Between Childhood Trauma and Body Image, Self-Esteem and Eating Attitudes in Patients undergoing Bariatric SurgeryBariatrik Cerrahi Aday Hastalarının Çocukluk Çağı Travmaları ile Beden Algısı, Benlik Saygısı ve Yeme Tutumları Arasındaki İlişki11612610.5080/u26831ENTRZiyaBERBEROĞLUÇiçekHOCAOĞLU10.5080/u26831Objective: Psychiatric evaluation of candidate patients before bariatric surgery (BS) has an important place in the success of the treatment. In this study, it was aimed to examine the relationship between childhood trauma (CT) and body image, self-esteem and eating attitudes of individuals who applied for BS. Method: A total of 87 BS candidate patients with morbid obesity, 57 women and 30 men, were included in the study. Sociodemographic Information Form, Childhood Trauma Questionnaire (CTQ), Body Perception Scale (BPS), Rosenberg Self-Esteem Scale (RSES), and Eating Attitude Test (EAT-40) were used as data collection tools in the study. Results: CT was detected in 47.1% of the cases. RSES (t=3.296; p<0.01) and BPS (t=3.267; p<0.01) scores were found to be significantly higher in those with a history of CT. A positive and significant relationship was found between EAT-40 and CTQ -sexual abuse (SA) sub-dimension (r=0.570; p<0.01). A significant relationship was found between all subdimensions of CTQ and RSES. A significant relationship was found between CTQ physical neglect (PN), emotional neglect (EN), and emotional abuse (EA) sub-dimensions and BPS. In addition, CTQ total score was found to significantly and negatively predict self-esteem (β=- 4.432; p<0.001) and body image (β=-3.700; p<0.001). Conclusion: In our study, it was found that those with CT were dissatisfied with their bodies and had lower self-esteem. Questioning CT in the psychological evaluation of pre-BS cases may contribute to the understanding of the etiology of obesity and may play an important role in planning the follow-up after BS. Keywords: Bariatric Surgery, Body İmage, Self-esteem

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633522024SummerThe Adaptation, Validity and Reliability Study of Turkish Metacognitive Beliefs about Health Anxiety Questionnaire (MCQ-HA)Sağlık Kaygısı Hakkında Üstbilişsel İnanışlar Anketi (ÜBA-SK) Türkçe Formunun Uyarlama, Geçerlik ve Güvenirlik Çalışması12713610.5080/u26770ENTRSidarKIRANAdviye EsinYILMAZ10.5080/u26770Objective: The aim of the present study was to adapt the Metacognitive Beliefs about Health Anxiety Questionnaire (MCQ-HA) to Turkish, and to evaluate its psychometric properties. Method: The study consisted of 631 participants, 146 of whom were diagnosed with a physical illness, while 485 of whom did not have any physical illness. Results: As similar to its original form, factor analysis results confirmed a three-factor structure in samples with and without physical illness, as well as in the total sample. Results of composite reliability, itemtotal correlation and test-retest analyses revealed acceptable reliability coefficients for the MCQ-HA. Convergent validity of the MCQHA was supported with significant correlations with health anxiety symptoms and somatosensory amplification both in physical illness and healthy samples. Result of discriminant validity analysis revealed that the MCQ-HA was able to differentiate individuals with high and low levels of health anxiety. Incremental validity examinations showed that the MCQ-HA accounted for additional variance in health anxiety after controlling for neuroticism. Conclusion: The Turkish form of the MCQ-HA has similar psychometric properties to its original form, and a valid and reliable assessment device to be used in studies focusing on health anxiety. Keywords: Health Anxiety, Metacognition, Metacognitive Beliefs About Health Anxiety Questionnaire, Validity, Reliability

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633522024SummerEtiopathogenesis in the Development of Borderline Personality Characteristics in Children and AdolescentsÇocuk ve Ergenlerde Borderline Kişilik Özelliklerinin Gelişiminde Etyopatogenez13714910.5080/u26852ENTROnatYETİMÖzhanYALÇIN10.5080/u26852The validity and clinical significance of the characteristics of borderline personality disorder (BPD) in adolescents are increasingly being recognized. The persistence of BPD characteristics in adolescence is high and is associated with negative interpersonal, academic, professional, and financial outcomes. In the literature, BPD characteristics observed in children and adolescents are explained with psychodynamic theories, developmental models, and evolutionary approaches. Emotional dysregulation, interpersonal dysfunction, impulsivity, and self-harming behavior, negative life events, temperament characteristics, neuropsychological dysfunctions, neuroanatomical, genetic, hormonal, and immunological factors may play a role in BPD etiopathogenesis. This review aims to address different approaches and relevant factors for the development of BPD. The articles published between 1968-2021 in the PubMed database were reviewed, and prominent studies were selected for evaluation. The importance of invalidating environment, epistemic freezing and hypermentalization, complex or attachment trauma is emphasized in psychodynamic and developmental literature. In the evolutionary approach, on the other hand, romantic relationships and the onset of reproduction are emphasized as the reason for the emergence of symptoms during adolescence, and it is argued that BPD is related to the rapid life history strategy. It is stated that a decrease in volume in the orbitofrontal cortex and anterior cingulate cortex, which are involved in top-down emotional processing, and an increase in the activity of thalamus and hippocampus regions, which are involved in bottom-up emotional processing are observed in adolescents with BPD characteristics when compared to healthy controls. It is thought that the increase in activation in the superior temporal gyrus and precuneus observed in adolescents with BPD features is a neural indicator of hypermentalization, and the increase in activation in the insula is a neural indicator of social pain. It has been reported that the decrease in resting heart rate and the increase in heart rate variability observed in adolescents with BPD symptoms are associated with the activation of the parasympathetic system. BPD in adolescents is a disorder that challenges clinicians in terms of diagnosis, differential diagnosis, and treatment. It is crucial to evaluate the factors related to etiopathogenesis in BPD in a multifaceted and detailed manner. Keywords: Borderline Personality Disorder, Difficulty in Emotion Regulation, Mentalization, Trauma, Self-harming Behavior, Temperamental Characteristics

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633522024SummerCatatonia Due to Lithium Neurotoxicity: A Case ReportLityum Nörotoksisitesine İkincil Gelişen Katatoni Vakası: Bir Olgu Sunumu15015510.5080/u27074ENTRAnılALPTahsinROLLASElçin ÖZÇELİKEROĞLUM. İremYILDIZA. Elif ANILYAĞCIOĞLUBerna DiclenurULUĞ10.5080/u27074Lithium may cause toxicity as it has a narrow therapeutic range. Lithium intoxication may manifest in the form of acute, acute on chronic and chronic intoxication. Neurotoxicity is a common component of chronic lithium intoxication and the symptoms include tremor, ataxia, dysarthria, extrapyramidal symptoms, hyperreflexia, seizures and status epilepticus. Although rare, catatonia could as a manifestation of lithium neurotoxicity. In this report, we present a patient with bipolar disorder presenting with catatonic symptoms secondary to lithium intoxication. We will discuss the risk factors, differential diagnosis and the treatment of catatonic symptoms. Lithium neurotoxicity may present with various clinical symptoms including catatonia, and differential diagnosis should be made well in such cases. If lithium neurotoxicity is suspected, rapid and appropriate intervention is required to prevent permanent neurological damage. Keywords: Lithium, Neurotoxicity, Catatonia

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633522024SummerCase Report: Second-order Contrast Sensitivity in Tourette SyndromeOlgu Sunumu: Tourette Sendromunda İkinci Düzey Kontrast Duyarlılığı15616110.5080/u26835ENTROtávio CorrêaPİNHOMarcelo Fernandes daCOSTAGivago da SilvaSOUZA10.5080/u26835disease, characterized by motor and vocal tics with no changes in the ocular structures in the ophthalmological evaluations. The visual field evaluations suggest a reduction in central visual field sensitivity. The studies on visual function in this population is scarce. In this case report we present a patient with GTS who has significant alterations in the measure of contrast sensitivity for second order vision without any vision complaints. This reduction occurred in the measure of contrast sensitivity with a white noise carrier for practically all tested space frequencies. The mean contrast sensitivity for first and second-order stimuli with a pink-noise carrier was normal. The second order contrast sensitivity with a white noise carrier is dependent on local and lateral inhibition since it includes many local luminance components. The existence of this sensitivity suggests that specific visual processing mechanisms are affected. Keywords: Tourette Syndrome, Contrast Sensitivity, Contrast Psychophysical Channels, Second-Order Perception

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633522024SummerThe Hidden Toll Of Earthquakes: Addressing The Mental Health Needs Of SurvivorsDepremin Görünmeyen Etkisi: Afetzedelerin Ruh Sağlığına İlişkin Destek16216410.5080/u27334ENTRSaimAMIRMomina JavaidAWANMuhammadEHSANZainabMEHDIHaseebaJAVEDMuhammadAYYANMuhammad YoushayJAWAD10.5080/u27334