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Dusunen Adam. 2010; 23(4): -

From The Editor

Cüneyt Evren.


First of all, we would like to thank everyone who contributed to the fourth issue of 2010 of ?Düşünen Adam? Journal of Psychiatry and Neurological Sciences. This preface is the second one I wrote for this issue. This is due to an important incident which put the issue I would like to emphasize into agenda just after the first preface I have written. First, I would like to revise the recent review articles about this. It has already been reported that schizophrenia and other psychoses are related with violence mainly like homicide and the main reason for this relationship is the comorbid substance abuse. Moreover, in these patients with comorbidity, risk of violent action is the same as non-psychotic substance abusers. Actually, these findings show that prevention programs focused on substance abuse can be effective to reduce violent acts in these cases (1). Another meta-analysis showed that 38.5% of homicides occur at the first psychotic episode and just before treatment started. Because homicide risk in this period is 15.5 times higher than post-treatment period, it was proposed that early treatment of the first episode can prevent some of the homicide attempts (2). Last of all, after evaluating the 39 cases whom were psychotic at the time of homicide, 10.2% of the actions were found to be due to mistakes of the therapist or legal authorities and 15.4% could be prevented by the communication of the therapist and patients? relatives. In this study, it was concluded that all of the family members should get involved in the treatment of patient and threats of psychotic patients should be taken as serious (3). ?Violence towards physician? has always been a fact but also far away from me. This did not change when this topic was turned to ?violence towards psychiatrist? until it happened to people whom I know closer and loved to. I have always expected the threat from patients? relatives rather than from them who try to hospitalize them by force. Haven?t I ever faced with danger? Yes, I did but I related my being rescued by perceiving this as a part of the disease and my growing anger causing increased tension. I think this the main reason why I have always expected danger from patients? relatives or people I encountered in the street. After assaulted by a schizophrenic patient, my wife who is also a psychiatrist had cervical disc hernia and had to wear collar for several days. Many incidents happened in the meantime. During the last year, one of our specialist friends was taken hostage and one of our residents had to be operated after the assault of a patient and these incidents thought me ?Nothing important happened in any case?. When I got the news from psychiatry mail-group that our dear Hüseyin (Soysal) who served our hospital for many years was assaulted, I also learned that his condition was well. Hüseyin also sent an e-mail to the same mail group on December 9, 2010 thinking he recovered

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