An adolescent in Istanbul with Munchausen's syndrome

This article presents the treatment period for a 16-year-old girl with Munchausen's syndrome. She was initially referred to the hospital with emphysema of the face, which turned out to be due to self-injection of air. She had an eight-month hospitalization period for the diagnosis of her condition. After the diagnosis was established she was treated by our psychiatric team and followed for 21 months successfully without recurrence

Group psychotherapy with female-to-male transsexuals in Turkey

The change in Turkish law to allow local sex reassignment surgery was passed in May 1988. By law, a candidate for such surgery must obtain a medical certificate attesting that the operation is necessary. However, the law does not specify conditions for granting such a certificate, so any physician can give a certificate based on his own criteria. Sex reassignment surgery can therefore be performed without preoperative psychiatric evaluation and preparation. This is a report of 40 female-to-male transsexuals. They had completed psychiatric assessment and participated in group therapy. These meetings provided a valuable setting for getting to know transsexuals and their families. Participants' long, regular attendance and low dropout rate demonstrate high group cohesion. The aim of the study is to report characteristics of a group of transsexuals living in a different cultural setting from other studies of this patient population in order to identify problems of Turkish transsexuals and advocate changes in current Turkish laws for sex reassignment

When should quality of life be measured after radical cystectomy?

Aim: In this prospective study our aim was to establish the time it takes cystectomized patients' to adapt to their new health status

Obsessive-compulsive disorder after epilepsy surgery

It is a well-known fact that after epilepsy surgery (ES) preexisting psychopathology may deteriorate or de novo psychopathological syndromes, mainly of a depressive and psychotic nature, may appear. Previously, recovery of obsessive-compulsive disorder (OCD) after ES has been reported in patients who had comorbid OCD preoperatively; however, there have been no reports on the appearance of de novo OCD interfering with daily living activities post-ES. This is the first report of OCD after ES in patients with mesial temporal lobe epilepsy (MTLE). Five patients with MTLE were identified with obsessive personality traits before surgery. Within the first 2 months after ES, two of these MTLE patients fulfilled OCD diagnostic criteria. These OCD patients were not any different from the other three patients with respect to age, age of onset of epilepsy, seizure types, and seizure frequency. All patients stopped having seizures postoperatively, but the OCD patients had worse quality of life postoperatively than preoperatively. Our findings show that those patients with obsessive traits preoperatively should be carefully monitored after ES. (C) 2003 Elsevier Inc. All rights reserved

Prevalência e fatores associados à sintomatologia depressiva em idosos residentes no Nordeste do Brasil

OBJETIVO: Analisar a influência de fatores sociodemográficos, de saúde física, capacidade funcional e função cognitiva sobre a sintomatologia depressiva de idosos do município de Santa Cruz, no Rio Grande do Norte. MÉTODOS: Estudo com delineamento transversal de base populacional, incluindo 310 idosos, acima de 60 anos, residentes na zona urbana da cidade, nos quais se aplicou a Escala de Depressão Geriátrica (GDS-15).Aanálise estatística foi realizada com nível de significância p = 0,05, com cálculo da respectiva odds ratio (OR) na regressão logística binária. RESULTADOS: Encontrou-se uma prevalência de 25,5% de sujeitos considerados casos de depressão, nos quais, a partir de análise multivariada, verificou-se associação significativa com idade acima de 75 anos (p = 0,046), analfabetismo (p = 0,037), má percepção de saúde (p < 0,001) e dependência para atividades instrumentais da vida diária (AIVD) (p = 0,001). CONCLUSÕES: As variáveis idade acima de 75 anos, analfabetismo, má percepção de saúde e dependência para AIVD estiveram associadas de forma independente à presença de sintomatologia depressiva nos idosos da nossa população. Os autores discutem que a identificação de fatores que influenciam o surgimento de sintomas depressivos em idosos constitui passo fundamental para o planejamento das ações que visem reduzir os efeitos dessa enfermidade na qualidade de vida dessas pessoas