Background: Posttraumatic stress disorder (PTSD) and depression are common among populations displaced due to large-scale political conflicts and war. Objective: The aim of this study is to investigate the prevalence and gender-based differences in symptoms of PTSD and depression among Iraqi Yazidis displaced into Turkey. Method: The study was conducted on 238 individuals who were evaluated using the Structured Clinical Interview for DSM-IV (SCID-I) and the Stressful Life Events Screening Questionnaire. Results: Of the participants, 42.9% met the DSM-IV diagnostic criteria for PTSD, 39.5% for major depression, and 26.4% for both disorders. More women than men suffered from PTSD and major depression. More women than men with PTSD or depression reported having experienced or witnessed the death of a spouse or child. Women with PTSD reported flashbacks, hypervigilance, and intense psychological distress due to reminders of trauma more frequently than men. Men with PTSD reported feelings of detachment or estrangement from others more frequently than women. More depressive women than men reported feelings of guilt or worthlessness. Conclusions: PTSD and major depression affected women more frequently than men. While women tended to respond to traumatic stress by undermodulation of emotions and low self-esteem, men tended to respond by overmodulation of emotions. Rather than being a derivative of sex differences, this complementary diversity in response types between genders seems to be shaped by social factors in consideration of survival under extreme threat.
Merve Tekin, Atilla TekinÖzet Dissosiyasyon, belirli koşullar altında herkeste ortaya çıkabilecek uyumsal bir mekanizmadır. Başlangıçta travmatik yaşantıların üstesinden gelme amacıyla kullanılırken zamanla patolojik bir sürece dönüştüğü ve bir bozukluk olarak nitelendirildiği düşünülmektedir. Başta derealizasyon ve depersonalizasyon olmak üzere, çeşitli dissosiyatif belirtiler anksiyete bozuklukları arasında görülen yaygın belirtilerdendir. Bu çalışma anksiyete bozukluklarında eşlik eden dissosiyatif belirtilerin ele alınmasını, dissosiyasyonun anksiyete bozukluklarında klinik seyri nasıl etkilediğini, dolayısıyla da tedaviye yönelik kuramsal bilgileri ve bu alanda yapılan çalışmaların sonuçlarını içermektedir. AbstractDissociation is an adaptive mechanism that may arise in everyone under certain conditions. It was first thought to be used to overcome traumatic experiences initially but over time it was thought that it turned into a pathological process and was interpreted as a disorder. There are several dissociative symptoms that are commonly seen in anxiety disorders and the most common ones are depersonalization and derealization. The aim of this study is to see how dissociative symptoms associate with anxiety disorders and how they affect the clinical course in anxiety disorders. Therefore, the study includes the theoretical knowledge for the treatment and the results of the studies that were established in this area.
Ocular manifestations in antineutrophil cytoplasmic antibody-associated vasculitis can be associated with the general or limited form of disease and can even occur in the absence of systemic disease. Ocular manifestations of associated vasculitis can be the first symptom of previously not manifested or undiagnosed systemic disease, allowing ophthalmologists to contribute to the diagnosis. Although its ocular findings are variable and nonspecific, the presence of necrotizing changes and peripheral corneal involvement accompanying scleral inflammation are important clues suggesting systemic vasculitis, especially associated vasculitis. The disease may affect all layers of the eye; scleritis and orbital involvement being the most common. Conjunctivitis, episcleritis, peripheral ulcerative keratitis, uveitis and retinal vasculitis are other ocular findings that may be observed during the disease course. Ocular involvement is most commonly seen in granulomatosis with polyangiitis followed by eosinophilic granulomatosis with polyangiitis and microscopic polyangiitis. Due to the high morbidity and mortality of associated vasculitis, it is very important to recognize the ocular manifestations of vasculitis as a sign of the underlying systemic disease and an indicator for the disease activity. Treatment varies depending on the location and severity of the ocular involvement. Although localized medical and surgical treatments can help to manage associated ocular disease, systemic immunosuppressive medications are often required to control the underlying disease. With the increasing availability and use of biological agents, prognosis has improved in patients with severe ocular complications. Rituximab appears to be useful in inducing remission and controlling relapses in patients with ocular involvement of associated vasculitis, particularly in cyclophosphamide resistant cases. A multidisciplinary approach in the diagnosis, treatment and follow-up of patients with associated vasculitis is required in order to achieve successful results.
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