Biomedical subjects

Erol Göka

Publications and source records attributed to Erol Göka.

8 recordsLinked to original sources

PubMed2006

[Projective identification in human relations].

Melanie Klein, one of the pioneers of Object Relations Theory, first defined "projective identification", which is regarded as one of the most efficacious psychoanalytic concepts after the discovery of the "unconscious". Examination of the literature on "projective identification" shows that there are various perspectives and theories suggesting different uses of this concept. Some clinicians argue that projective identification is a primitive defense mechanism observed in severe psychopathologies like psychotic disorder and borderline personality disorder, where the intra-psychic structure has been damaged severely. Others suggest it to be an indispensable part of the transference and counter-transference between the therapist and the patient during psychotherapy and it can be used as a treatment material in the therapy by a skillful therapist. The latter group expands the use of the concept through normal daily relationships by stating that projective identification is one type of communication and part of the main human relation mechanism operating in all close relationships. Therefore, they suggest that projective identification has benign forms experienced in human relations as well as malign forms seen in psychopathologies. Thus, discussions about the definition of the concept appear complex. In order to clarify and overcome the complexity of the concept, Melanie Klein's and other most important subsequent approaches are discussed in this review article. Thereby, the article aims to explain its important function in understanding the psychopathologies, psychotherapeutic relationships and different areas of normal human relations.

Communication↗

PubMed2005

IL-6 levels decrease with SSRI treatment in patients with major depression.

OBJECTIVE: Some evidence indicates that an immune response with an increased production of proinflammatory cytokines often accompanies major depression. The objective of this study was to examine the serum levels of IL-6 in patients with major depression and the changes occurring in IL-6 levels during treatment with selective serotonin reuptake inhibitors (SSRI). METHOD: Twenty-three patients with a DSM-IV diagnosis of major depressive disorder and 23 healthy matched controls were included in the study. The severity of depression was measured with the Hamilton rating scale for depression. Blood samples for IL-6 levels were obtained at baseline and at week 6 of treatment and IL-6 concentrations were evaluated using a solid phase sandwich enzyme immunoassay. All patients were treated with an SSRI. RESULTS: The IL-6 levels showed no statistically significant difference between the patients and the controls at baseline. However, IL-6 levels after treatment with SSRIs were significantly lower compared with the baseline IL-6 levels of both the patients and the controls. CONCLUSION: The results of this study suggest that proinflammatory cytokines show some changes during the course of treatment of major depression. These findings might also be considered as supporting the hypothesis of a modulatory role of antidepressants on the immune system.

Adult↗

PubMed2005

[Impulsivity and mental disorders].

OBJECTIVE: Although there are several studies revealing the role of impulsivity in mental disorders, debates in the literature about how to define and determine impulsivity continue. Being a measurable feature of behaviour, impulsivity is defined as the failure to resist a drive or stimulus or as a personality dimension as the inability to resist the desire to harm one's self or others. Besides this negative definition, however, impulsivity is also defined as independent dysfunctional and functional concepts having both positive and negative consequences. It can be a psychopathological structural part of many mental disorders, but it can be a characteristic of normal behaviour as well. Although not defined in detail in DSM-IV, it is mentioned as a diagnostic criterion in several mental disorders like impulse control disorders (pathological gambling, intermittent explosive disorder, pyromania, kleptomania and trichotillomania), impulsive aggressive disorders of personality (borderline, antisocial, histrionic and narcissistic), manic episodes of bipolar disorder, attention deficit hyperactivity disorder (ADHD), neurological disorders with behavioural disinhibition and substance abuse. Studies have revealed impulsivity to be more common in subjects with conduct disorders, attention deficit hyperactivity disorder, disorders of personality, substance and alcohol abuse, psychotic disorders, bipolar disorders, eating disorders and dementia compared to healthy subjects in control groups. The aim of the present paper is to define impulsivity as a concept and symptom, to discuss its relation to mental disorders, to show the biological basis of this relationship and to review the literature relating to this issue.

Female↗

PubMed2004

[Validity and reliability of the Turkish form of symptom interpretation questionnaire].

OBJECTIVE: This study was undertaken to investigate the validity and reliability of the Turkish version of Symptom Interpretation Questionnaire (SIQ) that was developed by Robbins and Kirmayer (1991). METHOD: Subjects of the study were: 53 patients with medically unexplained somatic complaints (MUS) that were referred to I. Psychiatry Clinic of Ankara Numune Teaching and Research Hospital, 26 patients who were diagnosed as Major Depressive Disorder (MDD) based on their mental complaints, and 71 healthy individuals (Control). RESULTS: Construct validity of SIQ was studied with factor analysis and the scale is statistically shown to consist of three theoretical styles of symptom attribution; normalizing, psychologizing and somatizing. Criterion related validity of normalizing subscale was shown with the absence of significant correlations between SIQ-normalizing scale and either Toronto Alexythimia Scale-20 or SIQ-number of symptoms. Validity of psychologizing subscale was demonstrated by obtaining higher significant mean psychologizing subscale scores in MDD group when compared with mean scores in MUS and Control groups. Criterion related validity of somatizing subscale was shown with significant correlations between SIQ-somatizing scale and SIQ- number of symptoms, and by demonstrating that mean somatizing subscale scores in patients with history of physical disease was significantly higher from mean scores in patients without such history. Internal reliability of SIQ subscales were, alpha=0.86 for normalizing subscale, alpha=0.87 for psychologizing subscale and alpha=0.87 for somatizing subscale. CONCLUSION: Internal reliability, criterion related validity, discriminating power for specific groups and construct validity of the SIQ Turkish version were demonstrated to be satisfactorily valid and reliable.

Adult↗

PubMed2004

[Mental disorders in the parents of bipolar patients].

OBJECTIVE: It is well known that bipolar disorder has familial transmission. Studies indicate that first-degree relatives of bipolar patients also have higher incidences of other mental disorders than the general population. The aim of this study is to determine the prevalence of mental disorders in the parents of bipolar patients. METHOD: Parents of 35 probands who were treated for their bipolar disorders and 35 age and gender matched healthy subjects' parents were assessed by means of the Structured Clinical Interview for DSM IV (SCID-I), and a questionnaire for the parents. RESULTS: Past and current mental disorders were present in 27.1% of the parents of bipolar patients but in 14.2% of the parents of normal controls; the difference between the groups is statistically significant. The most prevalent mental disorder in both groups is major depressive disorder. The parents of bipolar patients were more likely to have a family history of mental disorder (44.2%) than the control group (12.8%). Parents who had a current or past mental disorder were more likely to have a family history of mental disease. Offspring of in-bred families had more bipolar siblings. Bipolar children of parents who had a family history of mental disorder tended to have an earlier age of onset. CONCLUSION: The findings of this study indicate that there is an increased prevalence of bipolar disorders and other mental disorders in the parents of bipolar patients when compared to the parents of healthy controls.

Adult↗

PubMed2003

The psychiatric view of patients of aesthetic surgery: self-esteem, body image, and eating attitude.

The patient who presents for aesthetic surgery possesses various demands depending on the characteristic properties of the individual. Evaluation of self-esteem, body image and eating habits in patients of aesthetic surgery could help in understanding patients and their demands. We performed Rosenberg Scale Test for evaluation of self-esteem on 98 patients who presented for any kind of aesthetic surgery. Seventy-five patients who required no operation for body fat tissue were give body imaging scale and eating attitude scale tests. The results of the tests revealed an increase in the self-esteem of the patients, but it was not statistically significant. There was a minor disturbance in the body imaging scale without any statistical significance ( p > 0.05). The eating attitude of the patients indicated a disturbance with a ratio of 10% ( p < 0.01), and these patients were referred to psychiatrists. Even if patients of aesthetic surgery have no disorder in the perception of their body images, they reflect their aesthetic problems in their eating attitude; however they have no problem in the fat tissue distribution of their body. The aesthetic imperfection could impede the normal daily life of a patient and adaptation to the social life, and this defect is a health problem that should be solved as soon as possible.

Adult↗

PubMed2002

[Cognitive and emotional factors in major depression and suicide].

OBJECTIVE: Suicide is defined as ending ones life with his own will. It is the most frequent reason of death in psychiatry and accepted as tragic since it can be the cause of young peoples deaths. In this study patients with recent suicide attempt were compared with major depression patients without suicide history and the control group by means of emotional and cognitive variables since suicide is an important complication of major depression and both have similar cognitive processes. METHOD: Thirty patients from each group were assessed by means of demographic variables, Beck depression inventory, UCLA loneliness scale, automatic thoughts scale, and suicide probability scale. Results were analyzed by SPSS for Windows. RESULTS: Three groups were not statistically different by means of demographic variables except age and sex. Women were high risk group for major depression and suicide. The mean age of suicide group was significantly lower than major depression group. When analyzed by means of emotional and cognitive variables; the suicide group had high depressive symptomatology. Automatic thoughts scale scores were higher in the suicide group than the major depression group. Three groups did not differ by means of UCLA loneliness scores. When groups were compared by suicide probability scale; the major depression group and the suicide group did not differ in sub scales except hostility. CONCLUSION: Major depression groups high scores in hostility scale which may be the explanation of suicide; is one of the most important findings in this study

English Abstract↗

PubMed2002

[The concept of placebo and the effect of placebo].

The discussions about what placebo means and how its effect occurs go far back in the history of medicine. In general medicinal understanding, placebo means the subjective feeling of a positive effect in response to something that is used for curative intentions. In spite of difficulties in its definition and unknown content, its existence is generally accepted. What is discussed is its level of effectiveness in any disorder and medication. The placebo effect varies not only among diseases but also among regions and countries. Even the physicians' belief in a placebo increases its effect. Another interesting point about the placebo is its side effects. In many placebo controlled studies, the side effects of the placebo are found to be greater than those of real drugs. Different from other diseases, psychiatric disorders have strong connections with the placebo effect. The results of many studies support this idea. The increasing importance of placebos in psychiatry is really an interesting subject. For some people, the reason for this is hidden in the nature of psychiatric diseases. However, nonpharmacologic placebos such as "inspiration", "convincing", "confidence", and "belief" are believed to play a central role in psychiatry. In this article, placebo (the placebo effect) is defined, the implications of placebo in general medicine or psychiatry are discussed, and specific or nonspecific treatment methods are explained. The effects of a placebo on both the patient and the physician are emphasized. The significance of the placebo effect in psychiatry is also mentioned; and a new point of view, based upon the importance of symbolization and satisfaction is introduced in treatment and related action mechanisms.

English Abstract↗