Quality of life and depression in schizophrenia patients living in a nursing homeObjective: Nursing homes are seen as alternative housing for patients with schizophrenia. However, it has not yet been established how suitable this accommodation is for schizophrenia patients. First aim of this study is to assess the quality of life and depression level in schizophrenic patients and compare this data with that of patients living with their families. Second aim is to assess factors related to the quality of living and depression state in all participants of this study. Method: This is a cross-sectional study conducted with patients presenting to the Psychotic Disorders Policlinic of the Beyhekim Psychiatric Clinic of Konya Training and Research Hospital consecutively between December 2012 and May 2013 who had received a diagnosis of schizophrenia according to DSM IV-TR. All participants were administered a sociodemographic data form, Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Quality of Life Scale for Schizophrenia Patients (QLSSP). Results: CDSS scores were found to be significantly increased in schizophrenic patients living in nursing homes. Their QLSSP scores, including interpersonal relations, occupational role, mental symptoms, personal belongings/activity scores, and total scores were statistically significantly low. A significant negative correlation was observed between negative symptom levels and occupational area, mental findings, and the personal belongings/activity areas of quality of life. Between positive symptom levels and quality of life, only scores in the occupational area showed a significant negative correlation. A significant negative correlation between CSDS and QLS was observed in all areas. Conclusion: Quality of life and depression need to be evaluated in all schizophrenia patients, as they are conditions that significantly affect treatment and prognosis. Keywords: Depression, quality of life, schizophrenia ÖZET Bakımevinde kalan şizofreni hastalarında yaşam kalitesi ve depresyonAmaç: Bakımevleri şizofreni hastaları için alternatif yaşam alanları olarak görülmektedir. Ancak bu tür yerlerin şizofreni hastaları için ne kadar uygun olduğu sorusu henüz cevaplandırılmamıştır. Bu çalışmanın birinci amacı bakımevlerinde yaşayan şizofreni hastalarının yaşam kalitesini ve depresyon düzeylerini değerlendirmek ve ailesiyle yaşayan hastalarla karşılaştırmaktı. İkinci amacı ise çalışmaya alınan tüm hastaların yaşam kalitesi ve depresyon durumlarıyla ilişkili faktörlerin değerlendirilmesiydi. Yöntem: Bu çalışma Aralık 2012-Mayıs 2013 tarihleri arasında Konya Eğitim ve Araştırma Hastanesi, Beyhekim Psikiyatri Kliniği, Psikotik Bozukluklar Polikliniğine ardışık olarak başvuran DSM-IV-TR'ye göre şizofreni tanısı alan hastaların katıldığı kesitsel bir çalışmadır. Tüm katılımcılara sosyodemografik veri formu, Kısa Psikiyatrik Değerlendirme Olçeği (KPDÖ), Pozitif ve Negatif Sendrom Ölçeği (PNSÖ), Calgary Şi...

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Objectives: Schizophrenia is a disorder with different clinical features. Schizophrenia may start insidiously and slow and go on for many years. But the negative symptoms and deficiency symptoms leading to social deterioration may come to the forefront. All these factors are taken into consideration, our aim in this study was to examine the demographic and clinical effects of symptoms on schizophrenic patients who have not yet been treated. Methods: Eighty patients who were admitted to the Ankara Numune Training and Research Hospital Psychiatry Outpatient Clinic, who did not have any previous antipsychotic medications and who did not use medications at the time of admission and who met the criteria for schizophrenia according to the DSM-5. Sociodemografic Data Form and the PANSS scale were used to assess the clinical status of the patients. Results: When the demographic characteristics of the participants were examined, 33 (41.2%) were female and 47 (58.8%) were male. The mean age of the patients was 31.08±9.37; mean education year was 8.76±3.53. When the patients participating in the study were evaluated in terms of gender, marital status, working status, smoking status, and family history, no statistical differences were found between the groups in terms of their PANSS scores (p>0.05). However, the PANSS Negative subscale scores (p<.001), general psychopathology scores (p=0.006), and total PANSS scores (p=0.003) were statistically significantly different between the three groups when the patients were untreated for 0-1 years, 1-5 years, and 5 years. Conclusions: In this study none of the sociodemographic factors we assessed had any effect on symptom severity. However, there are different results in the literature regarding gender, age, marital status and working status. Besides, it has been determined that the most important clinical manifestation in our study is the period without treatment. Further studies should identify demographic and clinical features that affect schizophrenic symptom changes.

IntroductionTreatment adherence is important to enable the effectiveness of maintenance treatment for bipolar disease, which is an episodic disorder.ObjectiveTo determine clinical and sociodemographic factors related to the treatment adherence.MethodsFirstly, 117 patients and their relatives were interviewed via telephone. Morisky Medication Adherence Scale-4 and McEvoy Treatment Observation Form were applied after 12 months from the discharge. Secondly, a face to face interview was conducted with 86 of 117 patients and Medication Adherence Rating Scale (MARS), Mood Stabilizer Compliance Questionnaire (MSCQ), Drug Attitude Inventory-10 (DAI-10), Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), Beliefs Toward Mental Illness Scale (BMI), The Schedule for the Assessment of Insight (SAI), Bipolar Disorder Functioning Questionnare (BDFQ) and UKU Side Effect Rating Scale (UKU) were applied. Patients were divided into low, medium, and high compliant groups.ResultsIn the group with low adherence, it was found that BDFQ, SAI and DAI-10 scores were lower and existence of psychiatric comorbidity, living alone, preserved autonomy in dosing of mood stabilizers dimension of MSCQ, YMRS score, galactorrhea and ejaculatory dysfunction, number of hospitalization, longer duration of illness were higher. Female gender, lower scores at incurability subscale of BMI, cognitive dimension of BDFQ and SAI score, existence of psychiatric comorbidity, higher scores at preserved autonomy in dosing of mood stabilizers dimension of MSCQ’s, were found as risk factors in prediction model of non-adherence performed with regression analysis.ConclusionsTreatment adherence is associated with many factors that should be considered carefully during a treatment management.

Grief mania that is evaluated as psychogenic mania in the literature is related to manic episode that emerges after the loss of a loved one. There are not many cases that associate causality of beginning of mania and mourning in the literature. It is known that mania is induced by traumatic events but the cases that do not suit stages of development of grief process are evaluated as pathological grief. In this case, the woman who experienced manic episode after her son's death is presented. This case is prepared because mania should be considered as possible grief reaction. Case presentation: A patient who is 40 years old, married, mother of 4 children is brought by relatives because of aggressiveness, tension, insomnia for 4 days, fast and talk a lot and nonsense laughing attacks. She was presented to hospital for stressful life events 2 years ago and started to be on medication (escitalopram 10 mg) because of depression and fibromiyaliji diagnosis. She used medication for 1.5 years and she did not use any medication for the last 6months. There is no history for mental disorder in her family. Psychological examination: her interest for the environment was increased, self-care ability got better, her temperament was cheerful, her sociability was respectful, amount of talking and tone of voice increased, mimic and gesture was appropriate for her temperament, sleeping decreased, thought flow increased and achieved goal of conversation late. Moreover, there were grandiose delusions and hypervigilance, affect was close to euphoria, her psychomotor behaviours increased and social functioning decreased. According to biochemical and radiological workup, there was no pathological situation. The client started to use Lithium 900 mg/day and Olanzapin 10 mg/day because of the bipolar disorder diagnosis. The patient's blood lithium level was 0.8mEq/L and lithium was used 1200 mg/day and then 10 days later the patient's blood lithium level was 0.72 mEq/L. According to clinical observations, the patient's manic symptoms remained. Furthermore, the patient started to cry occasionally after 1 month and her grandiosity disappeared. The patient was discharged from the hospital after 45 days. The patient met the criteria for manic episode in DSM 5. The patient did not take any medication for last 6 months. Thus, it is considered that this situation was not induced by medication. It puts the patient into risk group because she was treated for depression before but it is not considered as bipolar depression because there were psychiatric history in the family and depression that experienced 2 years ago was related to stressful life events. It is considered that this case experienced grief/funeral mania because there was contiguity between loss of her son and manic episode, the patient did not react this way to previous challenging life events and the patient was outside of the ordinary 5 stages of grief process.