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.
OBJECTIVES: Social anxiety disorder (SAD) can be described as a clear and constant fear of the individual for being judged by others in the social milieu and being mocked by others. Although SAD is a treatable disorder, there is a diagnostic confusion due to many factors such as the difficulty in recognizing the symptoms of the disease. There are several scales currently available for SAD symptom measurement; however, some of them are long scales and should be answered by the patient and do not include physiologic manifestations. The Brief Social Phobia Scale (BSPS), which is a scoring system scored by the clinician, has an important place among these scales. There are three different subscales, which are fear, avoidance, and physiological symptoms on the BSPS. The aim of this study is to test the validity and reliability of the Turkish version of the BSPS. METHODS: The BSPS, sociodemographic data form, Liebowitz Social Anxiety Scale (LSAS), Spielberger State-Trait Anxiety Inventory (STAI I-II), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Global Assessment of Functioning (GAF) Scale were applied to 55 patients with social phobia (31 males, 24 females) who met the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria. Internal consistency of the scale was measured and the factor analysis was performed after applying Kaiser Meyer Olkin and Bartlett tests to assess the construct validity. To test the concurrent validity of the scale, Pearson correlation coefficient was computed between the BSPS and the LSAS. Its correlation with STAI I-II, BDI, BAI, and GAF was also investigated. RESULTS: The Turkish version of the BSPS showed sufficient internal consistency. As a result of the factor analysis, a five-factor structure that accounts for 71.4% of the total variance was obtained and the loading of factors differs from the original study. Moderately strong correlation was found between the BSPS and the LSAS scores. There was a mild correlation between the total score of the BSPS and the STAI-I and BDI. There was a moderate correlation between the total scale score of the BSPS and the STAI-II and BAI scores. CONCLUSIONS: As a result of the validity and reliability studies, it has been determined that the Turkish version of the BSPS can be used as a valid and reliable measurement tool in detecting SAD. It was found that there were unique anxiety findings that distinguish SAD from the other anxiety disorders. It is thought that the inclusion of such important symptoms within the applied scale will also benefit clinical practice. ARTICLE HISTORY
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