I am Ahmet Gürcan, a psychiatrist at Başkent University, Turkey. My research focuses on mental health innovations, particularly in mood disorders, digital psychiatry, and violence against doctors. I am interested in global collaborations with early career psychiatrists and researchers through impactful studies.
mood disorders anhedonia reward processes digital psychiatry violence against doctors global psychiatry
Suicide is a public health issue, and there are several factors leading to suicide, like mental illness and psychosocial stressors. Actual loneliness (living alone) and subjective loneliness (feeling of being alone) and different suicidal behaviors have been reported to have some link. This scoping review aimed to assess the association between loneliness and suicidal behaviour by exploring the existing literature.A scoping review was conducted implementing the appropriate framework and in accord with the PRISMA-ScR extension. A PubMed database search was made using a combination of terms to find publications in English from 2011 to 2021. Studies were included if they reported quantitative outcomes of the association between loneliness and suicidal experiences, including suicidal thoughts, plans, and/or attempts. Screening and data charting of the published literature was conducted by a panel of authors. The accuracy and clarity of extracted data was checked by three reviewers.Among 421 articles found, 31 full texts were evaluated based on exclusion and inclusion criteria, out of which, 18 papers that reported quantitative outcomes of the association between loneliness and suicidal experiences were included. We found that association between loneliness and suicidal behaviour is determined by individual, social and cultural factors. Co-existing mental illness, substance use disorder and economic hardship play an important role for the completion of suicide.Loneliness is correlated with suicide, and the knowledge about this association could assist in the identification of suicidal individuals or those at elevated risk of suicidal behaviour. Future studies should focus on loneliness and its relation to suicidal ideation in individuals with different mental health disorders and personalities.
The treatment gap for persons with mental disorders averages 50% in all countries of the world and rises to 90% in least-resourced countries1. The mental health care sector is increasingly adopting newer digital health options that may help to significantly reduce this gap. Although telemental health care has a long-standing history and compelling empirical evidence base, its implementation in routine mental health care conditions has remained scant for many years2. However, following the COVID-19 pandemic, it represents now a routine clinical activity, and newer opportunities (as well as challenges) are rapidly emerging3. Digital (mental) health offers several valuable options (ranging from digital therapies to digital phenotyping, augmented reality, social media, artificial intelligence)4, 5 that will contribute significantly to deliver, support and enhance mental health care globally over the coming years6, being particularly appealing for younger generations7-9. However, the adoption of novel digital clinical options is occurring at different paces across countries, often with suboptimal implementation. Many national and international initiatives have been set up to promote digital mental health and care. For example, in Europe, a six-nation project has been implemented with the support of the European Regional Development Fund to increase the dissemination and quality of e-mental health services in Belgium, France, Germany, Ireland, The Netherlands, and the UK (e-Mental Health Innovation and Transnational Implementation Platform North-West Europe project; eMEN)10. The European Psychiatric Association also launched a series of initiatives (e.g., scientific symposia at its annual congresses, a task force on e-mental health, a series of training courses and a training video toolkit) to ensure a more even spread of digital mental health across Europe11. According to recent evidence, digital mental health interventions in lower income countries may represent a valuable option, if adequately implemented and evaluated12. Thus, further action is required to ensure the equitable implementation and impact of digital mental health at a global scale. The WPA Working Group on Digitalization in Mental Health and Care is aiming at the improvement of global mental health and care by introducing digital tools and programs, thereby contributing to transforming health systems for universal health coverage. The Working Group, appointed in 202013 and chaired by W. Gaebel, U. Volpe and R. Ramalho, is working alongside experts in the field of digital psychiatry and WPA early career psychiatrists. Currently, the Working Group is collaborating with WPA Member Societies, drawing a baseline on global digitalization in mental health and care by means of an international survey. The survey covers topics ranging from the grade of digitalization in general and mental health care, to the availability of national policies and regulations, barriers and facilitators for implementation, guidelines for tools and interventions, and capacity building by education and training. Building on the results, the WPA Working Group is going to transform and support the national digital infrastructures together with the Member Societies and other stakeholders, including patient and family organizations. The collaboration with WPA Member Societies will also contribute to produce evidence-based guidelines for safe and ethical use of digital mental health options at the individual, institutional and country level, including awareness building and improving digital literacy, also fostering implementation research of digital mental health and care. The WPA Working Group is also developing and delivering scientific and training initiatives, including symposia and workshops at national and international levels. It is contributing to World Congresses of Psychiatry, e.g., the one held in Bangkok in 2022, where an in-person course on "Digitalization in Mental Health and Care" was organized from a worldwide perspective. At the same Congress, an online symposium on worldwide digitalization in mental health and care was organized by the WPA Working Group to help define methods of rapid implementation of telepsychiatry, explore the need for standardized training curricula for global digital psychiatry, and identify facilitators and barriers for cultural safety in e-mental health. The WPA Working Group will also deliver a course on digitalization in daily clinical work at the upcoming WPA Congress of Psychiatry to be held in Vienna, Austria. Considering the fast evolving pace of digital technologies, as per WPA request, the Working Group is currently finalizing a new WPA Position Statement on Digitalization in Mental Health and Care, also to update the previous WPA Position Statement on e-Mental Health. To this aim, an exhaustive review of the current evidence on the global level of digitalization in mental health and care has been carried out. This new Position Statement will provide the WPA and its Member Societies with a roadmap on high priority and targeted interventions to support implementation and upscaling of digital mental health and care in global mental health systems.
Climate change poses significant challenges to global mental health, with potential consequences including increased rates of suicide and mental health disorders. Early Career Psychiatrists (ECPs) play a crucial role in addressing these challenges. The Climate Psychiatry Alliance, a group of psychiatrists dedicated to improving mental health amidst climate change, recognizes the importance of cultivating climate-aware ECPs. Training ECPs to become confident climate-aware clinicians enables them to effectively treat patients experiencing anxiety, depression, and PTSD in the context of climate-related distress. Together with other mental health professionals, ECPs can contribute to efforts by implementing strategies for monitoring and treating mental health problems arising from climate events. Additionally, they can raise awareness about the psychological consequences and risks of suicide associated with climate change. Collaboration among ECPs from various regions is essential in developing community-based approaches and reducing vulnerabilities. ECPs must prioritize supporting vulnerable populations by advocating for increased funding for mental health support and research in affected areas. Long-term solutions to address the mental health impacts of climate change and global warming should be pursued to mitigate future suicidality. Integrating climate considerations into local mental health programs and expanding psychological support services is crucial. By promoting emotional resilience and self-awareness, ECPs can contribute to building a more climate-resilient and mentally healthy society.
Violence against psychiatry trainees is an important issue to the medical profession. However, this matter has been under researched, especially in Asian countries.We aimed to explore the rates and factors associated with violence against psychiatric trainees in Asian countries.An online, 15 item cross sectional pilot survey was designed and disseminated among psychiatric trainees in Asia through the World Network of Psychiatric Trainees, national and local networks of trainees, and social media. The questionnaire sought to enquire about the experience of physical, verbal, and sexual assaults and its impact. Data were analyzed using Statistical Package for the Social Sciences (SPSS) V20.0.A total of 467 responses were obtained from psychiatric trainees in 16 countries in Asia. More than two thirds of participants (n = 325, 69.59%) reported a history of assault. Psychiatry inpatient units were the most common setting (n = 239, 73.54%). A relatively lower proportion of participants from the East Asian countries reported an assault, compared to other countries (χ2 = 13.41, P = 0.001). Sexual assault was more common among women compared to men (χ2 = 0.94, P = 0.002).Violence against psychiatric trainees seems common across Asian countries. Our findings call for further systematic investigation of the phenomenon and suggest the need to develop programs to protect psychiatric trainees against the threat of violence and its subsequent psychological complications.
Anhedonia, which is defined as diminished capacity of having pleasure, is a common symptom in many mental disorders. It has been aimed in this study to adapt to the Turkish language the Snaith- Hamilton Pleasure Scale Clinician Administered Form (SHAPS-C) and examining reliability and validity of Snaith-Hamilton Pleasure Scale Clinician Administered Turkish Form (SHAPS-C-TR) which measures anhedonia in clinical and healthy samples.Two groups consisting of 63 participants consulting the psychiatry clinic and 67 non-clinical participants were included in the study. Data were collected with the Turkish version of the SHAPS-C (the SHAPS-C-TR), the Beck Depression Inventory (BDI), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Positive Negative Affect Scale (PANAS).The Kuder-Richardson internal consistency coefficient for the entire participants, the clinical and the non-clinical group were, 0.765, 0.813 and 0.657 respectively. The intra-class coefficient for test-retest reliability was 0.732. The total score on the SHAPS-C-TR significantly correlated with the scores on the anhedonia items of the BDI and the MADRS but not the scores on anxiety items. The PANAS positive symptoms scores were negatively correlated with the SHAPSC- TR total score. In the clinical group, the participants followed up with depression had significantly higher SHAPS-C-TR score than the rest of the participants. A similar difference was not demonstrated by the scores of the clinical group participants followed up with anxiety disorder. Scores on the SHAPS-C-TR did not vary with respect to the demographic characteristics of the participants.The SHAPS-C-TR is a valid and reliable measurement tool to assess anhedonia in both clinical and non-clinical individuals irrespective of differences in demographic features.
Neuroleptic malignant syndrome (NMS) is a rare but life-threatening condition caused by dopamine modulating medications, particularly antipsychotics. First-line treatments of neuroleptic malignant syndrome are supportive care, discontinuation of the offending agent and pharmacotherapy. In drug-resistant and severe situations, electroconvulsive therapy (ECT) is recommended as well. In this paper we present a 23-year old male with bipolar disorder who was treated with multiple injections of zuclopenthixol long acting and depot forms for a recent manic episode and developed NMS. The patient was transferred to an intensive care unit, medical management was initiated including benzodiazepines, bromocriptine and dantrolene. Due to the inadequate response after several days, ECT (bitemporal electrode placement, briefpulse, on a daily basis) was initiated. After 17 sessions, NMS relieved and there was no need for maintenance ECT. The patient is under follow-up care for 3 years with no cognitive and physical sequela. Keywords: Electroconvulsive therapy, neuroleptic malignant syndrome, bipolar disorder.
Objective: In this study, it was aimed to discuss the problems and working conditions of Early Career Psychiatrist (ECP) in the light of the literature Method: ECPs (in the first five years of their residency or under forty years of age) were included in the study via e-mail.An online questionnaire structured by the researchers was applied to all participants.The first 7 of the questionnaire questions are related to socio-demographic characteristics, and they were asked about age, gender, city of residence, year of profession, state service obligation, the hospital where he worked, the institution he specialized in.In the continuation of the questionnaire, a total of 24 questions were asked about the clinical and practical applications of psychiatry, education, career and working environment.Results: A total of 245 ECPs, 69.8% female and 30.2% male, aged between 27 and 41 years were included in the study.The average age of the participants in the study was 33.59 ± 2.80 years.As a city, the most frequent (17.1%) attendance was from Istanbul.71% of them had completed their compulsory service.The institution worked with was reported as the most frequently (39.2%) state hospital affiliated to the Ministry of Health.In our study, it was found that 65.7% of ECPs were subjected to violence in the working environment and 83.9% of those exposed to violence were exposed to verbal violence.Discussion: Both legal and institutional arrangements need to be made in order to improve the working conditions of ECPs, to prevent violence, to feel safe in the working environment and to increase the level of satisfaction.In addition, there is a need to increase the educational opportunities of ECPs after their specialization and to encourage scientific research
The coronavirus disease (COVID-19) pandemic has posed numerous challenges to the world. Patients who suffer from a mental health condition are more likely to become infected with COVID-19 because they may have difficulties in following precautionary measures, needing regular contact with a health facility for psychological monitoring and a reduction in health care support during the pandemic.1 The risk of infection is also increased because of comorbidities and/or psychotropic medication side effects.1 In a recent systematic review of sixteen studies conducted in seven nations, higher COVID-19 mortality was seen in people with mental disorders.2 Therefore, individuals with psychiatric disorders should be considered as high-risk for severe COVID-19 complications and encourage to take substantive preventive strategies. Clozapine is an important medicine in the treatment of resistant schizophrenia.3 Although effective, clozapine has a wide range of significant side effects that some of them are irritating such as sedation, dizziness, gastrointestinal symptoms, sialorrhea, benign fever etc. Some of them are life threatening such as seizures, heart adverse effects, pneumonia, hepatic failure, pancreatitis, respiratory failure, agranulocytosis, and sudden death.4 Many side effects overlap with COVID-19 symptoms such as fever, flu-like symptoms, and myalgia that is seen with neutropenic sepsis (Table 1).5, 6 Further, in a study conducted in the United Kingdom among 6309 persons with schizophrenia, it was found that individuals on clozapine had an increased risk of COVID-19 infection compared with those who were on other antipsychotics.7 It is consistent with previous studies showing clozapine is associated with higher rates of infection and pneumonia than those on other antipsychotics.8, 9 It is thought that the higher incidence of pneumonia is likely due to sialorrhea. As a result, it raises the risk of pneumonia with COVID-19 infection.10 Persons on clozapine are at risk for cardiovascular events and death due to the presence of comorbid medical disorders.11 Diabetes and cardiovascular disease are common comorbidities that enhance the risk. Myocarditis, pericarditis, and cardiomyopathy could be consequence of both COVID-19 and clozapine. These adverse cardiac events appear with highly variable symptoms from a flu-like initiation to chest pain, shortness of breath, fever, tachypnea, and sudden death. Serial MB isoenzyme of creatine phosphokinase (CPK-MB), C-reactive protein (CRP), troponin test, and ECG is advised in order to determine any sign which refers to a cardiac event.12, 13 Clozapine-induced cardiac complications may be missed and delayed presenting to services due to the similarity with the symptomatology of the COVID-19. A delay could lead to serious consequences such as clozapine-induced myocarditis has an estimated mortality of more than 20%.14 Fever in patients who take clozapine is related to varied causes from a benign fever to serious condition such as neutropenic sepsis.3 To reduce the risks of concealing COVID-19 symptoms, it is advisable to avoid paracetamol treatment for clozapine fever. To avoid neutropenic sepsis, a white blood cells (WBC) count with absolute neutrophil count monitoring is required. It will help to distinguish between neutropenic sepsis and COVID-19 infection if symptoms appear. Vitamin D supplementation is necessary to reduce the risk of pneumonia, and smoking cessation should be promoted.15 Diabetes is a common side effect, and it raises the risk of COVID-19 infection and related complications. Blood glucose monitoring is particularly crucial.3 A cumulative 10% risk of seizures after 3.8 years of clozapine treatment has been recognised.16 COVID-19 infection has been linked to a variety of neurological symptoms, including headache, dizziness, myalgia and anosmia, encephalopathy, encephalitis, necrotizing hemorrhagic encephalopathy, stroke, epileptic seizures, rhabdomyolysis, and Guillain-Barre syndrome.17 COVID-19 infection increases the risk of thromboembolism and raises the risk of deep venous thrombosis and pulmonary embolism.18 Venous thromboembolism is a rare clozapine adverse effect, although smoking, weight gain, and cardiovascular disease all enhance the risk.19 When a person on clozapine contracts COVID-19, it is likely that neurological and vascular complications become more likely than the general population. Many medicines are used off-label for the treatment of COVID-19. Chloroquine, hydroxychloroquine, azithromycin, lopinavir/ritonavir, ribavirin, remdesivir, and tocilizumab are the most used medications. Each of these substances distinctly interacts with psychotropic drugs. With clozapine, atazanavir, lopinavir/ritonavir, and QT prolongation can occur, necessitating strict monitoring.20 Azithromycin causes neutropenia, which is also a common clozapine side effect.21 Clozapine has been reported to increase ribavirin blood levels due to pharmacokinetic interactions, which increases the risk of bone marrow suppression and necessitates comprehensive blood count monitoring.15 Ribavirin produces serious adverse effects, including depression, aggressiveness, and suicide ideation. Due to a reduction in metabolism in response to inflammatory reactions, COVID-19 infection enhances the probability of clozapine toxicity.22 Clozapine produces constipation, nausea, vomiting, bloating, and stomach pain due to its anticholinergic impact on the gastrointestinal system.3, 23 The medications used to treat COVID-19 also have gastrointestinal adverse effects that include nausea, vomiting, and diarrhoea that may add to the suffering in the affected patient. Access to the vaccination may be difficult for persons with mental disorders, and antipsychotics, which is known to cause immune dysfunction may impact the vaccination efficacy.24 There is also a report of elevated clozapine levels following administration of an mRNA vaccine.25 Long-term clozapine use can result in secondary antibody deficiency and low class-switched memory B cells.26 Substantive information on COVID-19 vaccination and the immune response while on clozapine therapy is not available at present. Mental health care delivery, access to clozapine tablets, and availability of monitoring investigations are arduous during the pandemic. Clozapine dispensation can be stopped if absolute neutrophils are not done and reported during an infective wave or a lockdown. Patients may not have access to current lab work due to a lack of transportation, inability to leave the house due to the danger of infection, or lab closures in resource-limited locations.27, 28 If testing is difficult to come by, the neutrophil count can be done every 3 months, and drug dispensation can be done every 90 days if the patient has been on medication for more than a year, and there has been no history of neutropenia below 2000/μL.29 Telehealth, caregiver training, online resource education, and the activation of warm lines are all essential in this situation.27, 28 Continuing clozapine is related to better occupational activity, independent living, and low rate of hospitalization and relapse, as well as good outcome in suicidal individuals.30, 31 According to several side effects that are confusing in time of pandemic and increasing risk of COVID-19, the prescription and discontinuation of clozapine is a dilemma. Before beginning treatment of clozapine, the risk and benefit should be carefully examined, considering the drug's potential side effects and the need for constant monitoring.3 The patients must be closely monitored. Tachycardia, hypotension, fever, and sedation are frequent side effects of clozapine medication that do not always require medication termination. In this situation, frequent vital sign monitoring is required, which may be difficult owing to contact confines. In certain situations, clozapine could be sustained even combined with immunosuppression treatment with a precise assessment and close monitoring.32 The early diagnosis of rare but life-threatening side effects and clozapine suspension is essential. None. The authors declare that there is no conflict of interest. Conceptualization and writing original draft: Sheikh Shoib. Writing - review and editing: All the authors worked equally. Authors confirm that manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.
Introduction The European Psychiatric Association (EPA) Summer School allows psychiatric trainees and early career psychiatrists (ECPs) from all over Europe to meet, network, and learn together. After the 2020 edition being cancelled due to COVID-19, the 10th edition in 2021 focused for the first time on research and was conducted remotely. Objectives To provide an overview and feedback about the first Virtual EPA Research Summer School as a new way to encourage international networking during COVID-19. Methods The School was organized by the EPA Secretary for Education, and 4 Faculty members. It started with a “breaking the ice session” one week before and then a two-days meeting on 23-24 September 2021 using an online video-platform. This was preceded by all the 21 participants (from 18 different countries) recording a short 4-minute video presentation, which was uploaded and shared with other participants and Faculty. Results Participants were divided on a voluntary basis into three working groups: 1) “Drug repurposing: overcoming challenges in pharmacoepidemiology” 2) “Psychopathological research in psychiatry”; 3) “How to conduct a cross-sectional survey?”. The Summer School program was composed of plenary sessions with lectures by the Faculty members, discussion sessions, and working groups time. At the end, each group presented a summary of the work done to the rest of the participants. Conclusions Although the remote format limits social interactions during the Summer School, overall participants’ high satisfaction and productivity indicate that not only online formats, but also the topic of research might be covered in future editions. Disclosure No significant relationships.
The European Psychiatric Association (EPA) Summer School is an intensive program which has been organised for 10 years now by the EPA Committee on Education and allows selected psychiatric trainees and early career psychiatrists (ECPs) from all over Europe to meet, network, and learn together.After the 2020 edition being cancelled due to COVID-19 pandemic, the 2021 edition was held online and continued the EPA educational mission in an innovative and up-to-date approach.Twenty one participants from 16 different countries were selected to attend by the EPA Committee on Education.During the two full days of training, participants were engaged in fundamental educational activities by renowned faculty members such as
The COVID-19 pandemic and its impact on mental health has remained immense and global in all senses. Various types of induced psychiatric disorders, both new episodes and exacerbation of the preexisiting ones has been reported - starting from adjustment disorder to full psychotic illnesses.
 Various clinical symptoms, including systematized delusions, affective symptoms and self harm ideas has been mentioned needing upto prolonged admission and in patient care. Various etiopathogenetic models, incluing direct neural infection to cytokine storms or unmasking of the hidden vulnerabilities has been proposed however this needs further research. Traditional antipsychotic pharmacological agents has been proven to work well though special attention to pharmacological interactions is needed with caution for co morbid conditions and chance of side effects.
 We collaborated in worldwide Task Force of early career psychiatrists and prepared the definition of our point of view.
Bupropiona bağlı gelişen lökopeni: Bir olgu sunumu
COVID-19, caused by SARS-CoV-2 infection, has affected the whole world since the end of 2019.It is known that the disease affects multiple organs and systems in different ways.Among these effects, it is possible to count both direct and indirect effects on mental health too.Among the indirect effects, the effects of the pandemic on daily life and its consequences, and the direct effects on individuals who have been infected can be counted.All these effects do not manifest uniformly and cause deterioration in different aspects of mental health.Examples of these disorders are mood disorders, sleep disorders, anxiety disorders and psychotic disorders.Unfortunately, the mechanisms and basis of the effects of the infection have not been clarified yet.However, research on ways of protection and possible clinical manifestations has been carried out and published since the beginning of the pandemic.In this review, the effects of the COVID-19 pandemic on mental health was summarized in light of current research.
Introduction The interest for academic background and investigational activities are essential in psychiatry. Several European-wide, early career psychiatrists-driven studies have been carried out completely independently, leading to high quality publications, where all the co-authors are junior researchers. Objectives To further elaborate the European federation of psychiatric trainees (EFPT) platform of promoting the experience of collaborative work and research lead by psychiatric trainees in different countries all over Europe. Methods A review of EFPT collaborative trainee-led research initiatives since the beginning with the focus on published articles and their impact on psychiatric community in Europe. Results Main topics of trainee research are related to postgraduate psychiatric training schemes in Europe raising awareness on enhancing and harmonizing standards of psychiatric education and training across Europe. Other research topics are related to treatment strategies while being a psychiatric in Europe, to migration and “brain drain” phenomenon of psychiatric trainees in Europe, to access to information in psychiatric training. Conclusions International cooperation's in research should be promoted since the training. Joining professional associations provides opportunities for participating in research activities and establishing networks with other colleagues. Collaboration between psychiatric trainees ensures a more effective use of individual talents and a quick way of accessing and transferring new knowledge and research expertise. Moreover it provides a supportive framework for multi-center research. Disclosure of interest The authors have not supplied their declaration of competing interest.
Background: The coronavirus disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has detrimental effects on physical and mental health. Patients with severe mental illness are at higher risk of contracting the virus due to social determinants of health. Vulnerable populations include the elderly, people with pre-existing conditions, and those exposed to SARS-CoV-2. Unfortunately, only a few countries have updated vaccination strategies to prioritize patients with mental illnesses. Therefore, we aimed to explore whether individuals with mental disorders are prioritized in vaccine allocation strategies in different world regions. They are often neglected in policymaking but are highly vulnerable to the threatening complications of COVID-19. Methods: A questionnaire was developed to record details regarding COVID-19 vaccination and prioritizations for groups of persons with non-communicable diseases (NCDs), mental disorders, and substance use disorders (SUDs). NCDs were defined according to the WHO as chronic diseases that are the result of a combination of genetic, physiological, environmental, and behavioral factors such as cardiovascular diseases, cancer, respiratory diseases, and diabetes. Results: Most countries surveyed (80%) reported healthcare delivery via a nationalized health service. It was found that 82% of the countries had set up advisory groups, but only 26% included a mental health professional. Most frequently, malignancy (68%) was prioritized followed by diabetes type 2 (62%) and type 1 (59%). Only nine countries (26%) prioritized mental health conditions. Conclusion: The spread of the coronavirus has exposed both the strengths and flaws of our healthcare systems. The most vulnerable groups suffered the most and were hit first and faced most challenges. These findings raise awareness that patients with mental illnesses have been overlooked in immunization campaigns. The range of their mortality, morbidity, and quality of life could have widened due to this delay.
Abstract Background: The Broadman Area 17 (V1) has a good representation of retinotopic map. Similarity between visual input and the representation of it in V1 would be affected from both an intrinsic noise and the saccadic eye movements. GABA’s role in increasing signal to noise ratio is known but, how GABAergic activity helps to control noise, based on input and saccades, has not been modelled. Methods: A computational model of V1 was designed by using the MATLAB 2021a platform, and different six images, each containing a circle, triangle, and square, were used to test the model. The developed V1 was constituted of six different orientation columns (OCs). Each OC contains GABAergic and glutamatergic connections. Thus, OCs were activated not only based on afferent image inputs but also on the interaction among fired columns via the sum of glutamate and GABAergic neuron weights. V1 representation states for twelve, twenty and thirty saccades were summed and visualized. Finally, the original and representational forms of the image were compared. In the model, GABA activity levels have been tuned and the results of each level analysed. Results: It has been shown that level of GABA activity in the orientation columns during saccades is a critical factor for an ideal image representation. Decreased levels of GABA activity can be associated with inadequacy of noise elimination which could impair correct contour perception. Conclusion: Orientation columns can be conceptualized as microprocessors of V1. In this region, images are represented with high similarity. This similarity seems to need efficient GABAergic activity.
Bu kitap psikiyatrik bilgilerin kullanılabileceği tüm hekim görüşmelerinde faydalı olacak kimi önemli bilgileri kısa kısa tüm hekimler için tek bir kitapta toparlamak amacı ile hazırlandı. Bu kitapta hastalarla görüşmede karşılıklı ilişkideki zorlukları yönetmekten, bazı önemli psikiyatrik hastalıkları tanımaya; gerekli yönlendirme yapabilecek kadar psikoterapileri tanımaktan, bazı küçük teropotik teknikleri klinik görüşmelerde kullanabilmek için temel bazı bilgilere sahip olmaya kadar geniş bir alanda ruh sağlığı bilgisini toparlamaya çalıştık. Tüm Tıbbi Görüşmeler için Psikiyatriden Gelen Kavramlar: Aktarım, Karşı Aktarım ve Koruyucu Sınırlar Arda Kazım DEMİRKAN Travma Duyarlı Görüşme Pelin BOZKURT GÜNENDI Stigma ve Damgalama Fatma Akyüz KARACAN Ruh Sağlığını Güçlendirme için Bilimsel Öneriler Ebru ŞAHAN Cinsel İşlev Bozukluklarının Tanınması ve Cinsel Danışmanlık Rümeysa TAŞDELEN Poliklinikte Akut Ruhsal Travma Belirtileri Gösteren Başvurulara Yaklaşım Emine Merve AKDAĞ Travma Sonrası Stres Bozukluğu ve Karmaşık Travma Sonrası Stres Bozukluğunu Tanımak İbrahim GÜNDOĞMUŞ Sık ve Önemli Bazı Özel Sendromlar-Görünce Kaçırma Uygun Yönlendir (Bipolar Bozukluk Manik ve Depresif Dönemi Tanımak) Ahmet GÜRCAN Hastalık Kaygısı Bozukluğu ve Yönetimi Burcu BAKAR KAHRAMAN Obsesıf Kompulsıf Bozukluk Hastaları ile Yaşanabılecek Zorluklar ve Aşım Yolları Sevda BAĞ Yapay Bozukluk Seda ŞÜKÜROĞLU İntiharın Değerlendirilmesi ve Yönetimi Seda KİRAZ Psikotik Atakta Uygun Dil ve Uygun Yönlendirme Gamze GÜRCAN Otizm Spektrum Bozukluğu Olgularının Yönetimi Alper ALNAK Multidisipliner Yaklaşım ve Psikiyatri Aybike TELKÖK ŞEN Geriatrik Özen: Eşlik Eden Psikiyatrik Hastalıklar ve Diğerleri Abdullah Burak UYGUR Poliklinikte İyi ve Kötü Haber Verme Fikret Ferzan GIYNAŞ Poliklinikte Aile ile Tedavi Planlamak Betül KURTSES GÜRSOY Ayşe Zeynep AKKOYUN Poliklinikte Panik Atak ile Gelen Hastanın Yönetimi Didem Şule ERDEM Kanser Hastalarında Olası Ruhsal Süreçler: Kabul ve Yas Süreçleri, Yas Danışmanlığı Nilifer GÜRBÜZER Sertaç ZENGİL Poliklinikte Tedavi Reddine Yaklaşım Batuhan AYIK Poliklinikte Konversiyon Atağına Yaklaşım Hatice KAYA Poliklinikte İstismar Tespitinde Ruhsal Duyarlı Adli Süreç Organizasyonu Ayşe Nur İNCİ KENAR Poliklinikte Medikal Probleme Neden Olan Bağımlılıklarda Motivasyonel Yaklaşım Sercan KARABULUT Psikiyatride Sık Kullanılan İlaçlar ve Sık Görülen İlaç Etkileşimleri Nazife Gamze USTA SAĞLAM Sık Poliklinik Başvurularında Süreci Yönetmek: Neler Yapılabilir? Çisem ERDAŞ Şükrü Alperen KORKMAZ Poliklinikte Çocuk Duyarlı Yaklaşım ve Muayene Eda FERAHKAYA Polikliniğe Adli Makamlarca Zorunlu Getirilen Bireye Yaklaşım Cengiz CENGİSİZ Poliklinik Koşullarında Uykusuzluğa Yaklaşım ve Pratik Öneriler Ömer Faruk UYGUR Poliklinikte Kullanılabilecek Bazı Metakognitif Terapi Teknikleri Esengül EKİCİ Poliklinikte Kullanılabilecek Bazı Psikodrama Teknikleri Nafiye Selcan YILDIRIM Çeşitli Terapilerin Kimi Bazı Taktikleri ve Vurguları (Poliklinikte Kullanılabilecek Bazı Polıvagal Teknikler) Ezgi SELÇUK ÖZMEN Poliklinikte Kullanılabilecek Bazı BDT Teknikleri Elif ÖZCAN TOZOĞLU Poliklinikte Kullanılabilecek Bazı ACT Terapi Teknikleri Kübra DURAN Sistemik Terapi Yaklaşımı Pınar KIZILAY ÇANKAYA Poliklinikte Kullanılabilecek Bazı Çözüm Odaklı Terapi Teknikleri Hafize Gülnur ŞEN Poliklinikte Kullanılabilecek Bazı Hipnotik Telkin Yöntemleri Gözde YONTAR Çeşitli Terapilerin Kimi Bazı Stratejileri ve Vurguları (Poliklinikte Kullanılabilecek Bazı Aile Terapisi ve Teknikleri) Meltem OKTAY Polikilinikte Kullanılabilecek Bazı Motivasyonel Görüşme Teknikleri Furkan Bahadır ALPTEKİN
