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    Awareness of Sexually-Transmitted Diseases and Risky Sexual Behavior in Bipolar Patients: A Comparative Study with Healthy Controls
    (AVES, 2009) Hariri, Aytuel Guersu; Karadag, Figen; Gokalp, Peykan; Aksoy, Umut Mert
    Objective: It is known that patients with bipolar mood disorder have a high risk of acquiring sexually-transmitted diseases (STD). The objective of this study was to evaluate bipolar outpatients regarding their knowledge on STD and possible high risk sexual behaviors, and to compare both sexes in patient group and patients with healthy controls. Method: A total of 129 outpatients with DSM-IV Bipolar Disorder (BP) in remission state and 98 healthy controls were included in the study. Participants were given a demographic questionnaire, an evaluation form about awareness of sexually-transmitted diseases, and a semi-structured form on risky sexual behavior to assess patients' sexual behavior during acute episodes of their illness. Results: In general, level of information about STD was very low. The most known STD was AIDS. 43% (n=55) of bipolar patients reported increased sexual activity during acute episodes. In BP group both sexes displayed high-risk sexual activity, but male patients especially seemed to have more risky behavior. Discussion: It is noteworthy that, although methods of protection from diseases were known to some degree, they were applied properly in neither groups nor sexes. It seems that not only BP patients but general population also need to be informed and educated on risky sexual behavior. (Archives of Neuropsychiatry 2009; 46: 52-60)
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    The Influence of Motherhood on the Emergence of Trauma Symptoms in Two Cases with Childhood Sexual Trauma
    (GALENOS YAYINCILIK, 2010) Yildirim, Ejder Akguen; Gokalp, Peykan; Hacioglu, Muenevver; Kocak, Yunus Emre; Ozer, Seref
    Trauma history is not uncommon in patients with sexual problems. Trauma is experienced as a sexual secret. In this paper, two cases with sexual problems are presented, who are survivors of childhood sexual trauma. Similarity between these cases is that the worries about their children play an important role on the emergence of the symptoms of the childhood trauma. Case A was a 34-year-old mother of two children. She had been sexually abused by her brother when she was 12. She had sexual desire and arousal disorders, which started after her worries about a probable similar situation between her children. Case B was a 30-year-old mother of two children. She was sexually abused by a neighbor from 5 years of age until adolescence. Complaints of lack of sexual desire and aversion started when her daughter was 5. PTSD symptoms were related to their childhood sexual trauma in both cases. The aim of this report is to discuss the influence of motherhood on the appearance of trauma symptoms in women with childhood sexual trauma and to emphasize the presence of sexual trauma and sexual secrets. (Archives of Neuropsychiatry 2010; 47: 174-7)
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    Relationship between defense styles, alexithymia, and personality in alcohol-dependent inpatients
    (W B SAUNDERS CO-ELSEVIER INC, 2012) Evren, Cuneyt; Cagil, Dilara; Ulku, Muge; Ozcetinkaya, Serap; Gokalp, Peykan; Cetin, Turan; Yigiter, Sera
    In the present study, the defense styles were assessed in alcohol-dependent patients to verify whether they used less adaptive defense mechanisms compared with healthy controls and to evaluate if immature defense styles (IDSs) are related with alexithymia, while controlling the effect of age, temperament, and character on this relationship in male alcohol-dependent inpatients. Participants were consecutively admitted 118 male alcohol-dependent inpatients and 60 healthy controls. Patients were investigated with the Defense Style Questionnaire, the Toronto Alexithymia Scale, and the Temperament and Character Inventory. The alcohol-dependent patients were using neurotic defense style, some IDSs (projection, acting out, splitting, and somatization) more, and the mature defense style humor less than the control group. Together with higher age, IDS discriminated alcohol dependents from the control group (higher age, acting out, and splitting and lower humor in the second regression model). Immature defense style was positively correlated with novelty seeking, harm avoidance, self-transcendence, difficulty in identifying feelings (DIF), difficulty in describing feelings, external oriented thinking, and total alexithymia score in the present study, whereas it was negatively correlated with self-directedness and cooperativeness. Mean scores of neurotic and IDS were higher in the alexithymic group than the nonalexithymic group, and alexithymia was correlated with some IDSs. Higher difficulty in describing feelings predicted mature defense style, higher harm avoidance and DIF predicted neurotic defense style, and lower cooperativeness and self-transcendence and higher DIF predicted IDS. These suggest that alcohol dependents are using maladaptive IDS more, which can be taken into account in the development of therapeutic programs for these patients. In addition, IDS seems to be related with alexithymia, particularly DIF factor, whereas low cooperativeness and high self-transcendence are significant covariants. Thus, these results could indicate the use of specific strategies in the clinical and psychotherapeutic management of patients with alexithymic feature and IDS. (C) 2012 Elsevier Inc. All rights reserved.
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    Relationship of defense styles with history of childhood trauma and personality in heroin dependent inpatients
    (ELSEVIER IRELAND LTD, 2012) Evren, Cuneyt; Ozcetinkaya, Serap; Ulku, Muge; Cagil, Dilara; Gokalp, Peykan; Cetin, Turan; Yigiter, Sera
    In the present study the defense styles were assessed in heroin dependent inpatients to verify whether they used less adaptive defense mechanisms compared to healthy controls and to evaluate if immature defense styles are related with childhood traumas, while controlling the effect of age, temperament and character on this relationship in male heroin dependent inpatients. Participants were consecutively admitted 109 male heroin dependent inpatients and 60 healthy controls. Patients were investigated with the Defense Style Questionnaire, the Childhood Trauma Questionnaire, and Temperament and Character Inventory. Heroin dependent patients were using immature defense style more, particularly acting-out and splitting, than the control group. Together with lower age, immature defense style discriminated heroin dependents from control group (lower age, and higher devaluation and splitting in second regression model). Lower physical neglect score was related with a mature defense style, whereas higher cooperativeness (C) and self-transcendence (ST) were related with a neurotic defense style and lower reward dependence (RD), self-directedness (SD) and higher ST and emotional abuse were related with immature defense style. These suggest that heroin dependents are using maladaptive immature defense styles more, which can be taken into account in the development of therapeutic programs for these patients. Also, immature defense style may mediate the relationship between childhood emotional abuse and some personality dimensions (lower RD, SD and higher ST) in heroin dependent inpatients. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
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    Risky Sexual Behavior among Patients in Turkey with Bipolar Disorder, Schizophrenia, and Heroin Addiction
    (WILEY, 2011) Hariri, Aytul Gursu; Karadag, Figen; Gokalp, Peykan; Essizoglu, Altan
    Aim. Risky sexual behavior associated with such sexually transmitted infections (STIs) as hepatitis B and C, herpes, Treponema pallidum, and Neisseria gonorrhoeae, is more frequent among psychiatric patients and parenteral drug abusers than the general population. The aim of this study was to investigate risky sexual behavior in psychiatric outpatients diagnosed with schizophrenia (SCH), bipolar disorder, and heroin addiction (HA), and to compare them with those observed in healthy controls. Methods. The study group (N = 485; 234 females and 251 males) consisted of patients that consecutively presented to Bakirkoy State and Training Hospital for Psychiatric and Neurological Diseases in Istanbul and normal healthy controls. Main Outcome Measures. The chi-squared test was used for comparisons between groups and categorical variables. One-way analysis of variance (post-hoc Bonferroni test) was used for demographic data. A 22-item questionnaire for collecting demographic, illness history, and sexual activity data, and a structured 23-item form for collecting data on risky sexually behavior were administered to the participants. Results. In all, 10% of the participants had a positive history for STIs. The majority of risky sexual behaviors was observed among the HA patients. The frequency of being sexually assaulted and having homosexual acts among the SCH group were higher. None of the patients had a positive human immunodeficiency virus (HIV) test result. The frequency of positivity for hepatitis B and C markers was highest among the HA patients. Conclusions. The provision of information and training about all STIs and risky sexual behavior should become routine in the treatment of mentally ill patients, especially those that abuse drugs. Hariri AG, Karadag F, Gokalp P, and Essizoglu A. Risky sexual behavior among patients in Turkey with bipolar disorder, schizophrenia, and heroin addiction. J Sex Med 2011;8:2284-2291.
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    SEXUAL DYSFUNCTION IN OBSESSIVE COMPULSIVE DISORDER AND PANIC DISORDER
    (MEDICINSKA NAKLADA, 2012) Aksoy, Umut Mert; Aksoy, Sennur G.; Maner, Fulya; Gokalp, Peykan; Yanik, Medaim
    Background: Clinical research has provided conflicting evidence regarding sexual dysfunction in patients with OCD and PD. This study was undertaken to assess and compare certain parameters of sexual functioning in OCD and PD patients. Subjects and methods: The study population consisted of 80 patients between 20 and 60 years of age with a diagnosis of OCD or PD who were followed and treated at the anxiety outpatient unit of Bakirkoy Research and Training Hospital for Psychiatric and Neurological Disorders between 2005 and 2006. The total study population comprised of 40 patients with OCD, 40 patients with PD, and 40 healthy volunteers as the control group. Of the two questionnaires used for study purposes, the first provided information on demographic data and certain parameters of sexual functioning, while the second was the validated Turkish translation of the Golombok-Rust Sexual Satisfaction Inventory with transliteral equivalence. Results: Male subjects with OCD had a lower age of first masturbation and first nocturnal ejaculation. Infrequency problem among female and male patients with OCD occurred in 63.6% and 57.1%, respectively. Corresponding figures for PD patients were 36% and 38%. Thus, infrequency problem was more frequent among OCD patients. Sexual avoidance was found in 60.6% of female OCD patients and in 64% of female PD patients. Anorgasmia was detected in 24.2% of the female subjects with OCD. Conclusion: Sexual dysfunction unrelated to pharmacotherapy has been found to occur in OCD and PD. Assessment of sexual functioning in these individuals before treatment may help prevent deterioration of sexual function that may occur upon introduction of psychotropic medications.