The effectiveness of psychoanalytic psychotherapy in individuals diagnosed with PTSD due to torture and severe human right violations

Abstract Introduction: Various psychotherapies have been applied to individuals who have been subjected to torture and severe human rights and to patients with PTSD, however, studies assessing the effectiveness of such therapies are limited. Psychoanalytic psychotherapy is said to be used frequently in practice for these patient groups. Yet, there are scarcely any studies assessing its efficacy. In this study, we aim to assess the effectiveness of psychoanalytic psychotherapy in patients with PTSD associated with torture and severe human rights violations. Additionally, the study seeks to monitor the continuity of therapy within the first year and its relationship with overall clinical change. Methods: 70 patients with PTSD related to torture and severe human rights violations who applied to the Human Rights Foundation of Turkey were given psychoanalytic psychotherapy. CGI-S and CGI-I scales were applied to the patients (in Months 1, 3, 6, 9, and 12); and the patients' continuity of therapy and the changes in their recovery during the one-year psychotherapy period were assessed. Results: 38 (54.3%) of the patients were female. Their mean age was 37.7 years (SD = 12.25), while their mean baseline CGI-S score was 4.67. The mean length of treatment was 21.9 sessions (SD = 20.30). As the number of sessions increased, the final CGI-I scores of the patients improved significantly (p <.001) towards recovery. The change towards recovery became more evident particularly in the patients who had continued the therapy for more than 12 sessions. Mean scores for CGI-I scale were 3.46, 2.95, 2.23, 2.00, and 1.54 for months 1, 3, 6, 9 and 12 respectively. In addition, the drop-out rate was 34% (24 patients) for those who dropped out of therapy prematurely without any CGI-I assessment (9 patients) and those who dropped out of therapy with no improvement in their CGI-I scores –i.e. with CGI-I scores of 4-7 (15 patients). Conclusions: Considering the limited literature in the field, this study has provided significant data on the effectiveness of the use of psychoanalytic psychotherapy in individuals diagnosed with PTSD related to torture and severe human rights violations, despite its limitations –including not involving a control group. Furthermore, the findings might offer important clues regarding the relationship between continuity of therapy and clinical change

Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results

PURPOSEThoracic endovascular aortic repair (TEVAR) is a safe and effective treatment method for a variety of thoracic aortic pathologies. We aimed to investigate the mortality and complication outcomes and associated factors of TEVAR treatment in Turkey.METHODSIn this single-centered retrospective study, patients with thoracic aorta pathologies treated with TEVAR at Gazi University School of Medicine, Department of Radiology, between January 2009 and January 2020 were included. Perioperative, early, and late mortality, complications, and technical success were the outcomes.RESULTSThe sample comprised 58 patients with 68 TEVAR interventions. Eleven (16.2%) patients were female, the mean age was 60.1 ± 13.4 years. Emergent TEVAR was required in 20.7% of the patients. The main indications of TEVAR were intact descending aorta aneurysms in 37.9% of the sample, 31.0% Stanford type-B dissection, and 12.1% traumatic transections. The technical success rate of primary and secondary interventions was 98.3% and 100%, respectively. The mortality rate in the first 30 days was 8.6%. Seventeen (29.3%) cases had at least 1 complication related to TEVAR treatment. The most common complication was type-1A endoleak (10.3%). Having acute symptoms, stroke, and acute renal failure were significantly associated with mortality (P=.020, .049, and .009, respectively).CONCLUSIONThis study reported the outcomes of TEVAR treatment from a tertiary medical center in Turkey over a decade. Patients presenting with acute symptoms and who developed stroke and acute renal failure after the procedure should be carefully followed up as these factors were found to be associated with mortality

Toplum ve Psikoloji İlişkisini Kürt Meselesi Üzerinden Okumak (preprint)

Bayad A, Şen E, Alparslan K, Eser Ü. Toplum ve Psikoloji İlişkisini Kürt Meselesi Üzerinden Okumak (preprint). In: Şah U, Gürel Kayaoğlu A, Gürsel B, Eroğlu D, Sandıkçı E, eds. Eleştirel Psikoloji Yaklaşımlar, Gündemler, Tartışmalar. Araştırma-İnceleme Dizisi. Vol 541. İletişim; 2022: 311-335

Expanding the clinical and immunological phenotypes and natural history of MALT1 deficiency

Purpose MALT1 deficiency is a combined immune deficiency characterized by recurrent infections, eczema, chronic diarrhea, and failure to thrive. Clinical and immunological characterizations of the disease have not been previously reported in large cohorts. We sought to determine the clinical, immunological, genetic features, and the natural history of MALT-1 deficiency. Methods The clinical findings and treatment outcomes were evaluated in nine new MALT1-deficient patients. Peripheral lymphocyte subset analyses, cytokine secretion, and proliferation assays were performed. We also analyzed ten previously reported patients to comprehensively evaluate genotype/phenotype correlation. Results The mean age of patients and disease onset were 33 +/- 17 and 1.6 +/- 0.7 months, respectively. The main clinical findings of the disease were recurrent infections (100%), skin involvement (100%), failure to thrive (100%), oral lesions (67%), chronic diarrhea (56%), and autoimmunity (44%). Eosinophilia and high IgE were observed in six (67%) and two (22%) patients, respectively. The majority of patients had normal T and NK cells, while eight (89%) exhibited reduced B cells. Immunoglobulin replacement and antibiotics prophylaxis were mostly ineffective in reducing the frequency of infections and other complications. One patient received hematopoietic stem cell transplantation (HSCT) and five patients died as a complication of life-threatening infections. Analyzing this cohort with reported patients revealed overall survival in 58% (11/19), which was higher in patients who underwent HSCT (P = 0.03). Conclusion This cohort provides the largest analysis for clinical and immunological features of MALT1 deficiency. HSCT should be offered as a curative therapeutic option for all patients at the early stage of life

Expanding the Clinical and Immunological Phenotypes and Natural History of MALT1 Deficiency

Purpose MALT1 deficiency is a combined immune deficiency characterized by recurrent infections, eczema, chronic diarrhea, and failure to thrive. Clinical and immunological characterizations of the disease have not been previously reported in large cohorts. We sought to determine the clinical, immunological, genetic features, and the natural history of MALT-1 deficiency. Methods The clinical findings and treatment outcomes were evaluated in nine new MALT1-deficient patients. Peripheral lymphocyte subset analyses, cytokine secretion, and proliferation assays were performed. We also analyzed ten previously reported patients to comprehensively evaluate genotype/phenotype correlation. Results The mean age of patients and disease onset were 33 +/- 17 and 1.6 +/- 0.7 months, respectively. The main clinical findings of the disease were recurrent infections (100%), skin involvement (100%), failure to thrive (100%), oral lesions (67%), chronic diarrhea (56%), and autoimmunity (44%). Eosinophilia and high IgE were observed in six (67%) and two (22%) patients, respectively. The majority of patients had normal T and NK cells, while eight (89%) exhibited reduced B cells. Immunoglobulin replacement and antibiotics prophylaxis were mostly ineffective in reducing the frequency of infections and other complications. One patient received hematopoietic stem cell transplantation (HSCT) and five patients died as a complication of life-threatening infections. Analyzing this cohort with reported patients revealed overall survival in 58% (11/19), which was higher in patients who underwent HSCT (P = 0.03). Conclusion This cohort provides the largest analysis for clinical and immunological features of MALT1 deficiency. HSCT should be offered as a curative therapeutic option for all patients at the early stage of life

Expanding the Clinical and Immunological Phenotypes and Natural History of MALT1 Deficiency

Purpose MALT1 deficiency is a combined immune deficiency characterized by recurrent infections, eczema, chronic diarrhea, and failure to thrive. Clinical and immunological characterizations of the disease have not been previously reported in large cohorts. We sought to determine the clinical, immunological, genetic features, and the natural history of MALT-1 deficiency. Methods The clinical findings and treatment outcomes were evaluated in nine new MALT1-deficient patients. Peripheral lymphocyte subset analyses, cytokine secretion, and proliferation assays were performed. We also analyzed ten previously reported patients to comprehensively evaluate genotype/phenotype correlation. Results The mean age of patients and disease onset were 33 +/- 17 and 1.6 +/- 0.7 months, respectively. The main clinical findings of the disease were recurrent infections (100%), skin involvement (100%), failure to thrive (100%), oral lesions (67%), chronic diarrhea (56%), and autoimmunity (44%). Eosinophilia and high IgE were observed in six (67%) and two (22%) patients, respectively. The majority of patients had normal T and NK cells, while eight (89%) exhibited reduced B cells. Immunoglobulin replacement and antibiotics prophylaxis were mostly ineffective in reducing the frequency of infections and other complications. One patient received hematopoietic stem cell transplantation (HSCT) and five patients died as a complication of life-threatening infections. Analyzing this cohort with reported patients revealed overall survival in 58% (11/19), which was higher in patients who underwent HSCT (P = 0.03). Conclusion This cohort provides the largest analysis for clinical and immunological features of MALT1 deficiency. HSCT should be offered as a curative therapeutic option for all patients at the early stage of life