The Chinese emperor Shen-Nung was first to mention (2737 BC) the benefits of cannabis, noting its... more The Chinese emperor Shen-Nung was first to mention (2737 BC) the benefits of cannabis, noting its properties against malaria and rheumatism (1). Following the isolation of Δ9-tetrahydrocannabinoid (Δ9-THC) in 1964 (2) and discovery of cannabinoid receptors (CB1 and CB2) in the 1980s (3), a large number of cannabinoid receptor agonists have been synthesized for therapeutic purposes (3) while, on the other hand cannabis has become the most widely produced and consumed illicit substance worldwide (4). For many decades there have been few additions to the spectrum of drugs abused. However, in recent years, there has been a huge upsurge in novel psychoactive substances, also known as “legal highs”, “designer drugs”, “herbal highs” or “research chemicals”. Since 1997 more than 200 new psychoactive substances have been identified (5). In 1990s, Huffman et al. (6) synthesized naphthoylindoles, naphthoylpyrroles and related compounds with cannabinoid receptor agonist activity, which have bec...
Introduction: Patients with alcohol use disorder (AUD) use immature defense styles, and AUD is re... more Introduction: Patients with alcohol use disorder (AUD) use immature defense styles, and AUD is related with adult attention-deficit hyperactivity disorder (ADHD). Harm avoidance (HA) is related with both AUD and particularly inattentiveness (IN) dimension of ADHD. Aim: The aim of the present study was to evaluate the relationship of defense styles with probable ADHD and severity of ADHD symptoms while controlling the effect of HA among male inpatients with AUD. Settings and Design: The present study with cross-sectional design was conducted at the Alcohol and Drug Research, Treatment and Training Center (AMATEM) of Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery in Istanbul. Statistical Analysis: Chi-square test, independent samples t-test, multiple logistic and linear regression analyses, and multivariate analysis of covariance (MANCOVA) were used. Materials and Methods: Participants (n = 151) were evaluated with the Adult ADHD Self-Report Scale, the Defense Style Questionnaire, and the HA Dimension of the Temperament and Character Inventory. Results: HA (particularly HA-1 [anticipatory worry and pessimism]) and immature defense style (particularly acting out) predicted the presence of probable ADHD. In linear regression analysis, HA (particularly HA-1 and HA-4 [fatigability and asthenia]), high immature (particularly acting out), and low mature defense styles predicted the severity of ADHD symptoms. In MANCOVA, immature defense style predicted both the IN and the hyperactivity/impulsivity (HI) dimensions of ADHD, whereas HA and IN dimension and low mature defense style predicted HI dimension. Conclusions: These findings suggest that immature defense style (i.e., acting out) is related with both the presence of probable ADHD and severity of ADHD symptoms, together with HA, which must be taken into account while treating patients with ADHD among male populations with AUD.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2016
Psychometric properties of the Turkish version of the Adult ADHD Self-Report Scale (ASRS-v1.1) in... more Psychometric properties of the Turkish version of the Adult ADHD Self-Report Scale (ASRS-v1.1) in a sample of Inpatients with alcohol use disorder Objective: The Adult Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) allows dimensional self-rating assessment of ADHD according to DSM-IV. The Turkish version of the scale was validated in university students. The aim of the present study was to evaluate psychometric properties of the Turkish version of the ASRS in a sample of inpatients with alcohol use disorder (AUD). Method: Participants included 190 inpatients with AUD. Participants were evaluated with the ASRS and the Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale (Adult ADHD Scale). Results: The ASRS-18 (18 item version) was found to be a psychometrically sound adult ADHD screening measure with high convergent validity when compared with Adult ADHD Scale (r=0.738; 0.694 for inattentive-IN subscale and 0.690 for hyperactive/impulsive-HI subscale) and to have a Cronbach's α of 0.863 (0.822 for IN subscale and 0.775 for HI subscale). Two components accounted for 31.13% and 9.27% of total variance, respectively, for the ASRS-18. Subscales were highly correlated with total ASRS-18 score (n=190, r=0.887, r=0.886, respectively) and moderately correlated with each other (r=0.571). Test-retest correlation was moderate (n=120, r=0.677) for IN subscale whereas test-retest correlation was high for HI subscale (r=0.774) and for ASRS-18 (r=0.765). The ASRS-18 had sensitivity and specificity scores of 0.81 and 0.75, respectively, when using the optimal cutoff score of 30. Additionally, the ASRS-18 showed good discriminant validity as it significantly differentiated alcohol-dependent inpatients with a risk of ADHD from those without. The ASRS-6 (6 item version) showed psychometric properties similar to those of ASRS-18, although the sensitivity score (0.75) was lower than in ASRS-18, whereas the specificity score (0.79) was similar to ASRS-18, when using the optimal cutoff score of 10 for ASRS-6. Conclusion: These findings confirm the Turkish version of the ASRS (both 18-item and 6-item versions) as a reliable and valid adult ADHD screening instrument that measures a two-dimension construct among inpatients with AUD.
Yatarak tedavi gören erkek alkol ba¤›ml›s› hastalarda Cloninger'in kiflilik boyutlar›n›n alkol af... more Yatarak tedavi gören erkek alkol ba¤›ml›s› hastalarda Cloninger'in kiflilik boyutlar›n›n alkol aflermesi ile iliflkisi Amaç: Alkol aflermesi, alkol kullanmak için güçlü bir subjektif dürtü olarak tan›mlanmaktad›r. Alkol aflermesi ile ilgili ortaya ç›kan bireysel farkl›l›klarda kiflilik yap›s›n›n önemli rol oynayabilece¤i düflünülmektedir. Bu araflt›rman›n ama-c›, yatarak tedavi gören alkol ba¤›ml›lar›nda kiflilik özelliklerinin alkol aflermesi ile iliflkisinin de¤erlendirilmesidir.
... Tüm hastalara sosyode-mografik form ve PAAÖ uygulandı. Zeka geriliği, iletişimi önemli ölçüde... more ... Tüm hastalara sosyode-mografik form ve PAAÖ uygulandı. Zeka geriliği, iletişimi önemli ölçüde etkileyecek düzeyde görme, işitme ve bilişsel yeti kaybı, psikotik bozukluğu, organik mental bozukluğu olan olgu-lar çalışma dışı bırakıldı. Değerlendirme araçları ...
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2015
Psychological symptoms related with violence and its relationship with internalizing and external... more Psychological symptoms related with violence and its relationship with internalizing and externalizing problems among 10 th grade students in Istanbul Objective: Aim of this study was to evaluate the associations of gender, self-destructive behavior (selfharming behaviors-[SHB] and suicidal ideation/attempts-[SI/A]), lifetime substance use (tobacco, alcohol and any drug) and psychological variables (depression, anxiety, anger and impulsivity) with having psychological symptoms after experiencing or witnessing any violence, serious assault or battery event among 10 th grade students in Istanbul/Turkey. Methods: Online self-report survey was conducted based on 4957 10 th grade students selected according to multi-stage sampling in 45 schools from 15 districts of Istanbul. Results: Risks of assault from a peer, physical fight within last year, bearing arms, disciplinary punishment and problems with the law were higher in the group with psychological symptoms (GPS). Together with SHB and SI/A, lifetime tobacco and any drug use, male gender, depression, anxiety, and anger predicted the GPS. Conclusion: The findings suggest that with a single and simple question, high risk group of GPS can be determined, followed and offered proper help for both internalizing problems and externalizing behaviors, whether or not they are consequences of the victimization.
Aggression and Serum Cholesterol Levels in Non-Medicated Schizophrenic Patients: A Controlled Stu... more Aggression and Serum Cholesterol Levels in Non-Medicated Schizophrenic Patients: A Controlled Study Objective: Aggression in schizophrenia is a serious problem. Various studies have shown that there is a significant relationship between low serum cholesterol levels and aggression. In this study, we examined the relationship between aggression and serum cholesterol levels among in-patients with schizophrenia Method: One hundred and five DSM-IV schizophrenic patients and 40 control subjects were studied. The sociodemographic and clinical variables were assessed with a questionnaire developed for this purpose. The degree of psychopathology was rated by the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS). Aggression was rated by the Overt Aggression Scale (OAS). Cholesterol levels were measured by the enzymatic method. Results: Fifty six (53.3%) of the 105 patients with schizophrenia showed aggression according to the OAS. There were no significant differences between aggressive and non-aggressive schizophrenic patients with respect to BPRS, SAPS and SANS scores. Sociodemographic factors showed no differences between the two groups, whereas the aggressive group showed more common previous aggressive behaviour and a history of criminal behaviour and had spent more days in hospital than the non-aggressive group. Serum total cholesterol (TC) and lowdensity lipoprotein (LDL) cholestorel levels in the aggressive group were found to be significantly lower than those in the nonaggressive group and the control subjects. There were no significant differences between the non-aggressive group and the control subjects with respect to cholesterol levels. Conclusions: There is a significant relationship between low serum cholesterol levels and aggression in schizophrenia. Serum cholesterol levels might be a useful tool for predicting aggressiveness; however, more controlled studies are needed to confirm this.
Dusunen Adam:The Journal of Psychiatry and Neurological Sciences, 2021
Objective: The objective of the study is to evaluate the alcohol-and cigarette-use-related behavi... more Objective: The objective of the study is to evaluate the alcohol-and cigarette-use-related behaviors among young adults during the COVID-19 pandemic restrictions in Turkey. The second objective was to evaluate whether the gender, dysfunctional COVID-19 anxiety, and presence of probable attention-deficit/hyperactivity disorder (ADHD) are associated with the increase in alcohol consumption and cigarette smoking while controlling the effects of current age and diagnosis of anxiety disorder before the COVID-19 pandemic. Method: The study was conducted with an online survey among volunteer participants of young adults. The Adult ADHD Self Report Scale (ASRS-v1.1) and the Coronavirus Anxiety Scale (CAS) were used to evaluate a group of university students. Results: A total of 1,042 respondents (mean age 26.9 +/- 10.9 years;61.6% female) filled out the survey. Of these, 17.6% reported an increase and 7.7% reported reduced cigarette smoking, whereas 10.8% reported an increase and 8.5% repor...
De¤iflime Haz›r Olma ve Tedavi ‹ste¤i Ölçe¤i (SOCRATES) Türkçe Versiyonu'nun yatarak tedavi gören... more De¤iflime Haz›r Olma ve Tedavi ‹ste¤i Ölçe¤i (SOCRATES) Türkçe Versiyonu'nun yatarak tedavi gören erkek alkol ba¤›ml›s› hastalarda faktör yap›s›, geçerli¤i ve güvenirli¤i Araflt›rmalar/Researches G‹R‹fi T edaviye haz›r olma ve tedavi için motivasyon, son dönemde ba-¤›ml›l›k tedavisi ile ilgili yap›lan ça-l›flmalar için en ilgi çekici konulardan biri olmufltur (1). Yard›m arama karar› ile yard›m› kabul etmek, yani de¤iflim için haz›r olma ve tedavi iste¤i, birbirinden farkl›d›r (2). Olumsuz tedavi seyrinin bildirilen en s›k nedeni, tedaviyi yar›m b›rakma, tedavide kalma süresinde ve tedaviye kat›l›mda azl›k ve depreflmede artma ile kendini gösteren, tedaviye haz›r olmama ve tedavi için motivasyonda yetersizlik olmas›d›r (3-5). Asl›nda tedaviye haz›r olma ve tedavi için motivasyon kendine özgü dönemleri
Address for Correspondence/Yaz›flma Adresi: Dr. Cuneyt Evren, Bak›rkoy Ruh Sa¤l›¤› ve Sinir Hasta... more Address for Correspondence/Yaz›flma Adresi: Dr. Cuneyt Evren, Bak›rkoy Ruh Sa¤l›¤› ve Sinir Hastal›klar› E¤itim ve Araflt›rma Hastanesi, Alkol ve Madde Ba¤›ml›l›¤› Araflt›rma Tedavi ve E¤itim Merkezi, ‹stanbul, Turkey E-posta: cuneytevren@yahoo.com Gelifl tarihi: 08.08.2008 Kabul tarihi: 18.09.2008 ABSTRACT Objective: The aim of this study was to investigate the determinants of social anxiety symptoms in alcohol dependent inpatients. Method: Participants were 176 consecutively admitted male alcohol dependent inpatients. Patients were investigated with the Liebowitz Social Anxiety Scale (LSAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Toronto Alexithymia Scale (TAS-20) and Temperament and Character Inventory (TCI). Results: Subscales of LSAS (fear or anxiety and avoidance) were correlated with all the scales, particularly highly correlated with BDI, TAS-20 and “difficulty in identifying feelings” (DIF) and “difficulty in describing feelings” (DDF) subscales of T...
Dusunen Adam:The Journal of Psychiatry and Neurological Sciences, 2021
Objective: The main aim of the present study was to consider the impact of gaming motivations amo... more Objective: The main aim of the present study was to consider the impact of gaming motivations among young adults when evaluating the relationship between probable attention deficit hyperactivity disorder (ADHD) and massively multiplayer online role-playing games (MMORPGs), with disordered gaming. Method: In the present study, participants were assessed with the Adult ADHD Self-Report Scales (ASRS-v1.1), the Motives for Online Gaming Questionnaire (MOGQ), and the nine-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF). Results: Participants with probable ADHD (n=143, 19.2%) and without probable ADHD (n=602, 80.8%) did not differ according to the current age, gender, presence of romantic relationship, marital status, where and with whom they are living, employment status and time spent on the gaming. Compared to participants without probable ADHD, those with probable ADHD had higher rates of having a game console, purchasing games, gaming more than usual on weekends, having problems related to gaming, probable internet gaming disorder (IGD) according to IGDS9-SF cutoff score and higher scales scores (IGDS9-SF and MOGQ), whereas they had a lower age at first gaming. Among different game types, those with probable ADHD were gaming more with multiplayer online battle arena games, social network games, music games, MMORPGs, sports games/car games, and horror-themed/survival games. Scores of all six types of gaming motives were higher among those with probable ADHD, and among them coping/escape, social, skill development, and fantasy distinguished the presence of probable ADHD. In the ANCOVA analysis, the presence of probable ADHD and the use of MMORPGs (as well as online gaming motives [coping/escape, recreation, fantasy, social and competition]) predicted the severity of IGD symptoms, and also these effects also interacted, involving probable ADHD and using MMORPGs. Conclusion: These findings suggest that those with probable ADHD may have different gaming characteristics than those without probable ADHD. Probable ADHD and using MMORPGs are related to the severity of disordered gaming, along with almost all type of online gaming motivations. Also, the effects of probable ADHD and MMORPGs use interacted with each other.
OBJECTIVES: The first aim of this study was to investigate the relationship of impulsivity with I... more OBJECTIVES: The first aim of this study was to investigate the relationship of impulsivity with Internet addiction symptom severity (IASS), and the second aim was to evaluate the mediator effect of posttraumatic stress disorder (PTSD) symptoms on this relationship among Turkish university students. METHODS: A total of 314 Turkish university students participated in this study. However, 268 students who answered "YES" to the any question concerning various traumatic experiences were included in the study. The students were assessed through sociodemographic questionnaire, the Internet Addiction Scale (IAS), the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) and the Barratt Impulsiveness Scale 11-Short Form (BIS-11-SF). RESULTS: According to Internet addiction risk severity (IARS), the participants were classified into the three groups as high (25.0%, n = 67), mild (33.6%, n = 90), and no risk (41.4%, n = 111) of IA. Total score of BIS-11-SF and subscale scores (non-planning impulsivity [NPI], motor impulsivity [MI], and attention impulsivity [AI]) were higher in the group with high IARS. Scale scores were mildly correlated with each other. Finally, hierarchical regression analysis indicated that severity of MI, AI, and PTSD symptoms, especially hyperarousal symptoms, were the main predictors for IASS. CONCLUSIONS: There was strong relationship between impulsivity and IASS and this relationship persist even after severity of PTSD symptoms was entered in the analysis among Turkish university students. Severity of PTSD symptoms especially hyperarousal symptoms, may partially mediate the relationship between severity of impulsivity (especially MI and AI) and IASS.
The objective of this study is to evaluate the relationship between alcohol use disorder and self... more The objective of this study is to evaluate the relationship between alcohol use disorder and self psychology by comparing inpatients with alcohol use disorder and healthy individuals. A total of 308 individuals were included in this study. The subject group consisted of 206 male inpatients in the Alcohol and Substance Addiction Research Treatment and Education Center (ASAREC) of Bakırköy Mental Health and Neurological Diseases Education and Research Hospital who were diagnosed with alcohol use disorder and a control group composed of 102 randomly selected males with no alcohol use or other psychological disorders. The data collection tools used in the study were Self Psychology Inventory and Socio-demographic Data Form, which was created by the study' s authors for the present study and solicited information regarding participants' age, sex, alcohol use, family income, and marital status in order to homogenize the data. The defensive grandiose self and defensive idealized parental imago scores of participants with alcohol use disorders were significantly higher than those of the control group. The healthy grandiose self and healthy idealized parental imago scores of participants with alcohol use disorders were significantly lower than those of the control group. The results of the present study suggest that one of the reasons of alcohol use disorders may be an inadequate self make up and weak ego defense mechanisms and that alcohol use disorders may be related to pathological narcissism.
The aim of this study was to investigate the relationship of attention deficit/hyperactivity symp... more The aim of this study was to investigate the relationship of attention deficit/hyperactivity symptoms (ADHS) with severity of Internet addiction risk (SIAR), while controlling the effects of variables such as depression, anxiety, anger, sensation seeking and lack of assertiveness among university students. Crosssectional online self-report survey was conducted in two universities among a representative sample of 582 Turkish university students. The students were assessed through the Addiction Profile Index Internet Addiction Form Screening Version (BAPINT-SV), the Psychological Screening Test for Adolescents (PSTA) and the Adult Attention deficit/hyperactivity disorder Self-Report Scale (ASRS). The participants were classified into the two groups as those with high risk of Internet addiction (HRIA) (11%) and those with low risk of Internet addiction (IA) (89%). The mean age was lower in the group with HRIA, whereas depression, anxiety, sensation seeking, anger, lack of assertiveness and ADHS scores were higher in this group. Lastly, a hierarchical regression analysis suggested that severity of sensation seeking and ADHS, particularly attention deficiency, predicted SIAR. The severity of sensation seeking and ADHS, particularly attention deficit symptoms, are important for SIAR. Awareness of sensation seeking among those with high ADHS may be important in prevention and management of IA among university students.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2013
Personality dimensions and defense styles that are related with relapse during 12 month follow-up... more Personality dimensions and defense styles that are related with relapse during 12 month follow-up in male alcohol dependents Objective: The aim of this study was to evaluate the defense styles and the personality dimensions that are related with relapse to alcohol use 12 months after inpatient treatment in male alcohol dependents. Methods: Participants were 70 consecutively admitted male alcohol dependents. Among these patients 44 were available to examine after 1 year. Patients were investigated with the Temperament and Character Inventory (TCI) and Defense Styles Q (DSQ) at baseline. Results: Among 44 alcohol dependent inpatients 61.4% (n=27) were considered as relapsed to alcohol use. Current age was lower in relapsed group. Age at regular alcohol use, duration of education, regular income did not differ between groups. Rate of history of self-mutilation and/or suicide attempt at baseline were higher in relapsed group. Rate of changing social environment during 12 months after inpatient treatment was lower in the relapsed group, whereas using drugs and spending time with substance using friends were higher in this group. Mean scores of "acting-out", "devaluation" and "displacement" were higher in the relapsed group. Also same immature defense styles predicted relapse together with self-directedness (SD). When current age was included in the analysis, being younger and high acting-out predicted relapse in alcohol dependents after inpatient treatment. Conclusions: Clinicians must be careful for younger alcohol dependents with lower SD and for those who use immature defense styles (particularly acting-out) since these variables may be related with relapse.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2010
Erkek alkol bağımlılarında depreşme ile ilişkili etkenler: 12 aylık takip çalışması Amaç: Bu çalı... more Erkek alkol bağımlılarında depreşme ile ilişkili etkenler: 12 aylık takip çalışması Amaç: Bu çalışmanın amacı, erkek alkol bağımlılarında yatarak tedavinin ardından, 12 aylık takipte alkol kullanımının depreşmesiyle ilişkili klinik değişkenlerin saptanmasıdır. Yöntem: Çalışmaya, ardışık olarak hastaneye yatırılmış 156 erkek alkol bağımlısı hasta katılmıştır. Yatarak tedaviden 12 ay sonra, bu hastalardan 102'sinin değerlendirilmesi mümkün olmuştur. Hastalar, başlangıçta, Belirti Tarama Listesi (SCL-90) ve Michigan Alkolizm Tarama Testi (MATT), 12 ay sonra ise PENN Alkol Aşerme Ölçeği (PAAÖ) ile değerlendirilmiştir. Bulgular: Yatarak tedavi görmüş 102 alkol bağımlısı hastanın %61.8'i (n=63) alkol kullanımı depreşmiş olarak değerlendirilmiştir. Sosyodemografik değişkenler gruplar arasında fark göstermemiştir. MATT ve SCL-90 genel şiddet puanı gruplar arasında fark göstermemiş iken, aşerme puanı depreşen grupta yüksek bulunmuştur. Depreşen gruptakilerin 12 aylık takip süresince daha az poliklinik kontrolüne geldikleri, Ayaktan Tedavi Programı'na (ATP) daha az katıldıkları, kendilerini korumak amaçlı daha az sosyal çevre değişikliği yaptıkları ve aşerme için daha az ilaç kullandıkları bulunmuştur. Aşerme şiddeti ve takipte ATP'ye katılmama, alkol bağımlılarında depreşmeyi belirlemiştir. Sonuç: Aşerme şiddeti ve ATP'ye katılmama depreşme ile ilişkili temel etkenlerdir. Aşerme giderici ilaç kullanımı ile birlikte ATP'ye düzenli katılımın sağlanması, hastaların alkol aşermesini tanımalarına ve onunla başetmelerine yardımcı olabilir.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2010
Antiepileptik barbeksaklon (maliasin®) bağımlılığı olan iki olgu Barbeksaklon (Maliasin®), antiep... more Antiepileptik barbeksaklon (maliasin®) bağımlılığı olan iki olgu Barbeksaklon (Maliasin®), antiepileptik olarak değerlendirilen ve epilepsi tedavisinde etkinliği kanıtlanmış bir ilaçtır. Bununla beraber, kliniğimize barbeksaklon kötüye kullanımı tanısı ile yatarak tedavi başvurusunda bulunan olguların sayıları da giderek artmaktadır. Bu yazıda, bir bağımlılık merkezinde yatarak tedavi olan ve barbeksaklon bağımlılığı tanısı alan iki olgu sunulmuştur. Ayrıca bu olgular doğrultusunda, reçeteli ilaçların endikasyon dışı kullanımları tartışılmıştır.
The Chinese emperor Shen-Nung was first to mention (2737 BC) the benefits of cannabis, noting its... more The Chinese emperor Shen-Nung was first to mention (2737 BC) the benefits of cannabis, noting its properties against malaria and rheumatism (1). Following the isolation of Δ9-tetrahydrocannabinoid (Δ9-THC) in 1964 (2) and discovery of cannabinoid receptors (CB1 and CB2) in the 1980s (3), a large number of cannabinoid receptor agonists have been synthesized for therapeutic purposes (3) while, on the other hand cannabis has become the most widely produced and consumed illicit substance worldwide (4). For many decades there have been few additions to the spectrum of drugs abused. However, in recent years, there has been a huge upsurge in novel psychoactive substances, also known as “legal highs”, “designer drugs”, “herbal highs” or “research chemicals”. Since 1997 more than 200 new psychoactive substances have been identified (5). In 1990s, Huffman et al. (6) synthesized naphthoylindoles, naphthoylpyrroles and related compounds with cannabinoid receptor agonist activity, which have bec...
Introduction: Patients with alcohol use disorder (AUD) use immature defense styles, and AUD is re... more Introduction: Patients with alcohol use disorder (AUD) use immature defense styles, and AUD is related with adult attention-deficit hyperactivity disorder (ADHD). Harm avoidance (HA) is related with both AUD and particularly inattentiveness (IN) dimension of ADHD. Aim: The aim of the present study was to evaluate the relationship of defense styles with probable ADHD and severity of ADHD symptoms while controlling the effect of HA among male inpatients with AUD. Settings and Design: The present study with cross-sectional design was conducted at the Alcohol and Drug Research, Treatment and Training Center (AMATEM) of Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery in Istanbul. Statistical Analysis: Chi-square test, independent samples t-test, multiple logistic and linear regression analyses, and multivariate analysis of covariance (MANCOVA) were used. Materials and Methods: Participants (n = 151) were evaluated with the Adult ADHD Self-Report Scale, the Defense Style Questionnaire, and the HA Dimension of the Temperament and Character Inventory. Results: HA (particularly HA-1 [anticipatory worry and pessimism]) and immature defense style (particularly acting out) predicted the presence of probable ADHD. In linear regression analysis, HA (particularly HA-1 and HA-4 [fatigability and asthenia]), high immature (particularly acting out), and low mature defense styles predicted the severity of ADHD symptoms. In MANCOVA, immature defense style predicted both the IN and the hyperactivity/impulsivity (HI) dimensions of ADHD, whereas HA and IN dimension and low mature defense style predicted HI dimension. Conclusions: These findings suggest that immature defense style (i.e., acting out) is related with both the presence of probable ADHD and severity of ADHD symptoms, together with HA, which must be taken into account while treating patients with ADHD among male populations with AUD.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2016
Psychometric properties of the Turkish version of the Adult ADHD Self-Report Scale (ASRS-v1.1) in... more Psychometric properties of the Turkish version of the Adult ADHD Self-Report Scale (ASRS-v1.1) in a sample of Inpatients with alcohol use disorder Objective: The Adult Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) allows dimensional self-rating assessment of ADHD according to DSM-IV. The Turkish version of the scale was validated in university students. The aim of the present study was to evaluate psychometric properties of the Turkish version of the ASRS in a sample of inpatients with alcohol use disorder (AUD). Method: Participants included 190 inpatients with AUD. Participants were evaluated with the ASRS and the Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale (Adult ADHD Scale). Results: The ASRS-18 (18 item version) was found to be a psychometrically sound adult ADHD screening measure with high convergent validity when compared with Adult ADHD Scale (r=0.738; 0.694 for inattentive-IN subscale and 0.690 for hyperactive/impulsive-HI subscale) and to have a Cronbach's α of 0.863 (0.822 for IN subscale and 0.775 for HI subscale). Two components accounted for 31.13% and 9.27% of total variance, respectively, for the ASRS-18. Subscales were highly correlated with total ASRS-18 score (n=190, r=0.887, r=0.886, respectively) and moderately correlated with each other (r=0.571). Test-retest correlation was moderate (n=120, r=0.677) for IN subscale whereas test-retest correlation was high for HI subscale (r=0.774) and for ASRS-18 (r=0.765). The ASRS-18 had sensitivity and specificity scores of 0.81 and 0.75, respectively, when using the optimal cutoff score of 30. Additionally, the ASRS-18 showed good discriminant validity as it significantly differentiated alcohol-dependent inpatients with a risk of ADHD from those without. The ASRS-6 (6 item version) showed psychometric properties similar to those of ASRS-18, although the sensitivity score (0.75) was lower than in ASRS-18, whereas the specificity score (0.79) was similar to ASRS-18, when using the optimal cutoff score of 10 for ASRS-6. Conclusion: These findings confirm the Turkish version of the ASRS (both 18-item and 6-item versions) as a reliable and valid adult ADHD screening instrument that measures a two-dimension construct among inpatients with AUD.
Yatarak tedavi gören erkek alkol ba¤›ml›s› hastalarda Cloninger'in kiflilik boyutlar›n›n alkol af... more Yatarak tedavi gören erkek alkol ba¤›ml›s› hastalarda Cloninger'in kiflilik boyutlar›n›n alkol aflermesi ile iliflkisi Amaç: Alkol aflermesi, alkol kullanmak için güçlü bir subjektif dürtü olarak tan›mlanmaktad›r. Alkol aflermesi ile ilgili ortaya ç›kan bireysel farkl›l›klarda kiflilik yap›s›n›n önemli rol oynayabilece¤i düflünülmektedir. Bu araflt›rman›n ama-c›, yatarak tedavi gören alkol ba¤›ml›lar›nda kiflilik özelliklerinin alkol aflermesi ile iliflkisinin de¤erlendirilmesidir.
... Tüm hastalara sosyode-mografik form ve PAAÖ uygulandı. Zeka geriliği, iletişimi önemli ölçüde... more ... Tüm hastalara sosyode-mografik form ve PAAÖ uygulandı. Zeka geriliği, iletişimi önemli ölçüde etkileyecek düzeyde görme, işitme ve bilişsel yeti kaybı, psikotik bozukluğu, organik mental bozukluğu olan olgu-lar çalışma dışı bırakıldı. Değerlendirme araçları ...
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2015
Psychological symptoms related with violence and its relationship with internalizing and external... more Psychological symptoms related with violence and its relationship with internalizing and externalizing problems among 10 th grade students in Istanbul Objective: Aim of this study was to evaluate the associations of gender, self-destructive behavior (selfharming behaviors-[SHB] and suicidal ideation/attempts-[SI/A]), lifetime substance use (tobacco, alcohol and any drug) and psychological variables (depression, anxiety, anger and impulsivity) with having psychological symptoms after experiencing or witnessing any violence, serious assault or battery event among 10 th grade students in Istanbul/Turkey. Methods: Online self-report survey was conducted based on 4957 10 th grade students selected according to multi-stage sampling in 45 schools from 15 districts of Istanbul. Results: Risks of assault from a peer, physical fight within last year, bearing arms, disciplinary punishment and problems with the law were higher in the group with psychological symptoms (GPS). Together with SHB and SI/A, lifetime tobacco and any drug use, male gender, depression, anxiety, and anger predicted the GPS. Conclusion: The findings suggest that with a single and simple question, high risk group of GPS can be determined, followed and offered proper help for both internalizing problems and externalizing behaviors, whether or not they are consequences of the victimization.
Aggression and Serum Cholesterol Levels in Non-Medicated Schizophrenic Patients: A Controlled Stu... more Aggression and Serum Cholesterol Levels in Non-Medicated Schizophrenic Patients: A Controlled Study Objective: Aggression in schizophrenia is a serious problem. Various studies have shown that there is a significant relationship between low serum cholesterol levels and aggression. In this study, we examined the relationship between aggression and serum cholesterol levels among in-patients with schizophrenia Method: One hundred and five DSM-IV schizophrenic patients and 40 control subjects were studied. The sociodemographic and clinical variables were assessed with a questionnaire developed for this purpose. The degree of psychopathology was rated by the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS). Aggression was rated by the Overt Aggression Scale (OAS). Cholesterol levels were measured by the enzymatic method. Results: Fifty six (53.3%) of the 105 patients with schizophrenia showed aggression according to the OAS. There were no significant differences between aggressive and non-aggressive schizophrenic patients with respect to BPRS, SAPS and SANS scores. Sociodemographic factors showed no differences between the two groups, whereas the aggressive group showed more common previous aggressive behaviour and a history of criminal behaviour and had spent more days in hospital than the non-aggressive group. Serum total cholesterol (TC) and lowdensity lipoprotein (LDL) cholestorel levels in the aggressive group were found to be significantly lower than those in the nonaggressive group and the control subjects. There were no significant differences between the non-aggressive group and the control subjects with respect to cholesterol levels. Conclusions: There is a significant relationship between low serum cholesterol levels and aggression in schizophrenia. Serum cholesterol levels might be a useful tool for predicting aggressiveness; however, more controlled studies are needed to confirm this.
Dusunen Adam:The Journal of Psychiatry and Neurological Sciences, 2021
Objective: The objective of the study is to evaluate the alcohol-and cigarette-use-related behavi... more Objective: The objective of the study is to evaluate the alcohol-and cigarette-use-related behaviors among young adults during the COVID-19 pandemic restrictions in Turkey. The second objective was to evaluate whether the gender, dysfunctional COVID-19 anxiety, and presence of probable attention-deficit/hyperactivity disorder (ADHD) are associated with the increase in alcohol consumption and cigarette smoking while controlling the effects of current age and diagnosis of anxiety disorder before the COVID-19 pandemic. Method: The study was conducted with an online survey among volunteer participants of young adults. The Adult ADHD Self Report Scale (ASRS-v1.1) and the Coronavirus Anxiety Scale (CAS) were used to evaluate a group of university students. Results: A total of 1,042 respondents (mean age 26.9 +/- 10.9 years;61.6% female) filled out the survey. Of these, 17.6% reported an increase and 7.7% reported reduced cigarette smoking, whereas 10.8% reported an increase and 8.5% repor...
De¤iflime Haz›r Olma ve Tedavi ‹ste¤i Ölçe¤i (SOCRATES) Türkçe Versiyonu'nun yatarak tedavi gören... more De¤iflime Haz›r Olma ve Tedavi ‹ste¤i Ölçe¤i (SOCRATES) Türkçe Versiyonu'nun yatarak tedavi gören erkek alkol ba¤›ml›s› hastalarda faktör yap›s›, geçerli¤i ve güvenirli¤i Araflt›rmalar/Researches G‹R‹fi T edaviye haz›r olma ve tedavi için motivasyon, son dönemde ba-¤›ml›l›k tedavisi ile ilgili yap›lan ça-l›flmalar için en ilgi çekici konulardan biri olmufltur (1). Yard›m arama karar› ile yard›m› kabul etmek, yani de¤iflim için haz›r olma ve tedavi iste¤i, birbirinden farkl›d›r (2). Olumsuz tedavi seyrinin bildirilen en s›k nedeni, tedaviyi yar›m b›rakma, tedavide kalma süresinde ve tedaviye kat›l›mda azl›k ve depreflmede artma ile kendini gösteren, tedaviye haz›r olmama ve tedavi için motivasyonda yetersizlik olmas›d›r (3-5). Asl›nda tedaviye haz›r olma ve tedavi için motivasyon kendine özgü dönemleri
Address for Correspondence/Yaz›flma Adresi: Dr. Cuneyt Evren, Bak›rkoy Ruh Sa¤l›¤› ve Sinir Hasta... more Address for Correspondence/Yaz›flma Adresi: Dr. Cuneyt Evren, Bak›rkoy Ruh Sa¤l›¤› ve Sinir Hastal›klar› E¤itim ve Araflt›rma Hastanesi, Alkol ve Madde Ba¤›ml›l›¤› Araflt›rma Tedavi ve E¤itim Merkezi, ‹stanbul, Turkey E-posta: cuneytevren@yahoo.com Gelifl tarihi: 08.08.2008 Kabul tarihi: 18.09.2008 ABSTRACT Objective: The aim of this study was to investigate the determinants of social anxiety symptoms in alcohol dependent inpatients. Method: Participants were 176 consecutively admitted male alcohol dependent inpatients. Patients were investigated with the Liebowitz Social Anxiety Scale (LSAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Toronto Alexithymia Scale (TAS-20) and Temperament and Character Inventory (TCI). Results: Subscales of LSAS (fear or anxiety and avoidance) were correlated with all the scales, particularly highly correlated with BDI, TAS-20 and “difficulty in identifying feelings” (DIF) and “difficulty in describing feelings” (DDF) subscales of T...
Dusunen Adam:The Journal of Psychiatry and Neurological Sciences, 2021
Objective: The main aim of the present study was to consider the impact of gaming motivations amo... more Objective: The main aim of the present study was to consider the impact of gaming motivations among young adults when evaluating the relationship between probable attention deficit hyperactivity disorder (ADHD) and massively multiplayer online role-playing games (MMORPGs), with disordered gaming. Method: In the present study, participants were assessed with the Adult ADHD Self-Report Scales (ASRS-v1.1), the Motives for Online Gaming Questionnaire (MOGQ), and the nine-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF). Results: Participants with probable ADHD (n=143, 19.2%) and without probable ADHD (n=602, 80.8%) did not differ according to the current age, gender, presence of romantic relationship, marital status, where and with whom they are living, employment status and time spent on the gaming. Compared to participants without probable ADHD, those with probable ADHD had higher rates of having a game console, purchasing games, gaming more than usual on weekends, having problems related to gaming, probable internet gaming disorder (IGD) according to IGDS9-SF cutoff score and higher scales scores (IGDS9-SF and MOGQ), whereas they had a lower age at first gaming. Among different game types, those with probable ADHD were gaming more with multiplayer online battle arena games, social network games, music games, MMORPGs, sports games/car games, and horror-themed/survival games. Scores of all six types of gaming motives were higher among those with probable ADHD, and among them coping/escape, social, skill development, and fantasy distinguished the presence of probable ADHD. In the ANCOVA analysis, the presence of probable ADHD and the use of MMORPGs (as well as online gaming motives [coping/escape, recreation, fantasy, social and competition]) predicted the severity of IGD symptoms, and also these effects also interacted, involving probable ADHD and using MMORPGs. Conclusion: These findings suggest that those with probable ADHD may have different gaming characteristics than those without probable ADHD. Probable ADHD and using MMORPGs are related to the severity of disordered gaming, along with almost all type of online gaming motivations. Also, the effects of probable ADHD and MMORPGs use interacted with each other.
OBJECTIVES: The first aim of this study was to investigate the relationship of impulsivity with I... more OBJECTIVES: The first aim of this study was to investigate the relationship of impulsivity with Internet addiction symptom severity (IASS), and the second aim was to evaluate the mediator effect of posttraumatic stress disorder (PTSD) symptoms on this relationship among Turkish university students. METHODS: A total of 314 Turkish university students participated in this study. However, 268 students who answered "YES" to the any question concerning various traumatic experiences were included in the study. The students were assessed through sociodemographic questionnaire, the Internet Addiction Scale (IAS), the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) and the Barratt Impulsiveness Scale 11-Short Form (BIS-11-SF). RESULTS: According to Internet addiction risk severity (IARS), the participants were classified into the three groups as high (25.0%, n = 67), mild (33.6%, n = 90), and no risk (41.4%, n = 111) of IA. Total score of BIS-11-SF and subscale scores (non-planning impulsivity [NPI], motor impulsivity [MI], and attention impulsivity [AI]) were higher in the group with high IARS. Scale scores were mildly correlated with each other. Finally, hierarchical regression analysis indicated that severity of MI, AI, and PTSD symptoms, especially hyperarousal symptoms, were the main predictors for IASS. CONCLUSIONS: There was strong relationship between impulsivity and IASS and this relationship persist even after severity of PTSD symptoms was entered in the analysis among Turkish university students. Severity of PTSD symptoms especially hyperarousal symptoms, may partially mediate the relationship between severity of impulsivity (especially MI and AI) and IASS.
The objective of this study is to evaluate the relationship between alcohol use disorder and self... more The objective of this study is to evaluate the relationship between alcohol use disorder and self psychology by comparing inpatients with alcohol use disorder and healthy individuals. A total of 308 individuals were included in this study. The subject group consisted of 206 male inpatients in the Alcohol and Substance Addiction Research Treatment and Education Center (ASAREC) of Bakırköy Mental Health and Neurological Diseases Education and Research Hospital who were diagnosed with alcohol use disorder and a control group composed of 102 randomly selected males with no alcohol use or other psychological disorders. The data collection tools used in the study were Self Psychology Inventory and Socio-demographic Data Form, which was created by the study' s authors for the present study and solicited information regarding participants' age, sex, alcohol use, family income, and marital status in order to homogenize the data. The defensive grandiose self and defensive idealized parental imago scores of participants with alcohol use disorders were significantly higher than those of the control group. The healthy grandiose self and healthy idealized parental imago scores of participants with alcohol use disorders were significantly lower than those of the control group. The results of the present study suggest that one of the reasons of alcohol use disorders may be an inadequate self make up and weak ego defense mechanisms and that alcohol use disorders may be related to pathological narcissism.
The aim of this study was to investigate the relationship of attention deficit/hyperactivity symp... more The aim of this study was to investigate the relationship of attention deficit/hyperactivity symptoms (ADHS) with severity of Internet addiction risk (SIAR), while controlling the effects of variables such as depression, anxiety, anger, sensation seeking and lack of assertiveness among university students. Crosssectional online self-report survey was conducted in two universities among a representative sample of 582 Turkish university students. The students were assessed through the Addiction Profile Index Internet Addiction Form Screening Version (BAPINT-SV), the Psychological Screening Test for Adolescents (PSTA) and the Adult Attention deficit/hyperactivity disorder Self-Report Scale (ASRS). The participants were classified into the two groups as those with high risk of Internet addiction (HRIA) (11%) and those with low risk of Internet addiction (IA) (89%). The mean age was lower in the group with HRIA, whereas depression, anxiety, sensation seeking, anger, lack of assertiveness and ADHS scores were higher in this group. Lastly, a hierarchical regression analysis suggested that severity of sensation seeking and ADHS, particularly attention deficiency, predicted SIAR. The severity of sensation seeking and ADHS, particularly attention deficit symptoms, are important for SIAR. Awareness of sensation seeking among those with high ADHS may be important in prevention and management of IA among university students.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2013
Personality dimensions and defense styles that are related with relapse during 12 month follow-up... more Personality dimensions and defense styles that are related with relapse during 12 month follow-up in male alcohol dependents Objective: The aim of this study was to evaluate the defense styles and the personality dimensions that are related with relapse to alcohol use 12 months after inpatient treatment in male alcohol dependents. Methods: Participants were 70 consecutively admitted male alcohol dependents. Among these patients 44 were available to examine after 1 year. Patients were investigated with the Temperament and Character Inventory (TCI) and Defense Styles Q (DSQ) at baseline. Results: Among 44 alcohol dependent inpatients 61.4% (n=27) were considered as relapsed to alcohol use. Current age was lower in relapsed group. Age at regular alcohol use, duration of education, regular income did not differ between groups. Rate of history of self-mutilation and/or suicide attempt at baseline were higher in relapsed group. Rate of changing social environment during 12 months after inpatient treatment was lower in the relapsed group, whereas using drugs and spending time with substance using friends were higher in this group. Mean scores of "acting-out", "devaluation" and "displacement" were higher in the relapsed group. Also same immature defense styles predicted relapse together with self-directedness (SD). When current age was included in the analysis, being younger and high acting-out predicted relapse in alcohol dependents after inpatient treatment. Conclusions: Clinicians must be careful for younger alcohol dependents with lower SD and for those who use immature defense styles (particularly acting-out) since these variables may be related with relapse.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2010
Erkek alkol bağımlılarında depreşme ile ilişkili etkenler: 12 aylık takip çalışması Amaç: Bu çalı... more Erkek alkol bağımlılarında depreşme ile ilişkili etkenler: 12 aylık takip çalışması Amaç: Bu çalışmanın amacı, erkek alkol bağımlılarında yatarak tedavinin ardından, 12 aylık takipte alkol kullanımının depreşmesiyle ilişkili klinik değişkenlerin saptanmasıdır. Yöntem: Çalışmaya, ardışık olarak hastaneye yatırılmış 156 erkek alkol bağımlısı hasta katılmıştır. Yatarak tedaviden 12 ay sonra, bu hastalardan 102'sinin değerlendirilmesi mümkün olmuştur. Hastalar, başlangıçta, Belirti Tarama Listesi (SCL-90) ve Michigan Alkolizm Tarama Testi (MATT), 12 ay sonra ise PENN Alkol Aşerme Ölçeği (PAAÖ) ile değerlendirilmiştir. Bulgular: Yatarak tedavi görmüş 102 alkol bağımlısı hastanın %61.8'i (n=63) alkol kullanımı depreşmiş olarak değerlendirilmiştir. Sosyodemografik değişkenler gruplar arasında fark göstermemiştir. MATT ve SCL-90 genel şiddet puanı gruplar arasında fark göstermemiş iken, aşerme puanı depreşen grupta yüksek bulunmuştur. Depreşen gruptakilerin 12 aylık takip süresince daha az poliklinik kontrolüne geldikleri, Ayaktan Tedavi Programı'na (ATP) daha az katıldıkları, kendilerini korumak amaçlı daha az sosyal çevre değişikliği yaptıkları ve aşerme için daha az ilaç kullandıkları bulunmuştur. Aşerme şiddeti ve takipte ATP'ye katılmama, alkol bağımlılarında depreşmeyi belirlemiştir. Sonuç: Aşerme şiddeti ve ATP'ye katılmama depreşme ile ilişkili temel etkenlerdir. Aşerme giderici ilaç kullanımı ile birlikte ATP'ye düzenli katılımın sağlanması, hastaların alkol aşermesini tanımalarına ve onunla başetmelerine yardımcı olabilir.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2010
Antiepileptik barbeksaklon (maliasin®) bağımlılığı olan iki olgu Barbeksaklon (Maliasin®), antiep... more Antiepileptik barbeksaklon (maliasin®) bağımlılığı olan iki olgu Barbeksaklon (Maliasin®), antiepileptik olarak değerlendirilen ve epilepsi tedavisinde etkinliği kanıtlanmış bir ilaçtır. Bununla beraber, kliniğimize barbeksaklon kötüye kullanımı tanısı ile yatarak tedavi başvurusunda bulunan olguların sayıları da giderek artmaktadır. Bu yazıda, bir bağımlılık merkezinde yatarak tedavi olan ve barbeksaklon bağımlılığı tanısı alan iki olgu sunulmuştur. Ayrıca bu olgular doğrultusunda, reçeteli ilaçların endikasyon dışı kullanımları tartışılmıştır.
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