Turk psikiyatri dergisi = Turkish journal of psychiatry最新文献

Neuroleptic Malignant Syndrome (NMS) is an idiosyncratic and potentially life-threatening drug reaction. Although uncommon, NMS cases induced by oral quetiapine have been reported. Most reports have predisposing risk factors such as an organic brain disorder, concomitant use of other antipsychotics or lithium, overdose or rapid titration. NMS with low doses of quetiapine is a much rarer clinical picture. Venlafaxine is commonly associated with withdrawal upon discontinuation sometimes as soon as the next day. In this case report, a 40-year-old man treated with venlafaxine for generalized anxiety disorder with symptoms of full-blown NMS after venlafaxine withdrawal, induced by low-dose quetiapine (50 mg), is presented. In accordance with the previous reports, we speculate that venlafaxine withdrawal was a predisposing factor in our case however we also discussed other possible explanations for NMS. Acknowledging the risk of NMS, even with low doses of quetiapine in patients devoid of known risk factors, is of paramount importance for prompt diagnosis and mitigating morbidity and mortality. To our knowledge, this is the first case of NMS with such a low dose of quetiapine without any other known risk factors or substances. Keywords: Antipsychotics, NMS, Quetiapine, Venlafaxine, Consultation Liaison Psychiatry.

No abstract available.

COVID-19 may affect central nervous system. The symptoms related to the CNS may occur through the direct neuroinvasion of the virus, inflammation, autoimmunity, psychosocial stressors and treatment side effects. COVID-19 can increase the severity of existing mental illnesses and also trigger the onset of a new mental illness. In this case report, we present a 52-year-old male patient with no previous psychiatric history as well as no family history of mental illness. The patient's manic symptoms began while he was hospitalized due to severe COVID-19 pneumonia. The patient, who self-discharged himself from the hospital was brought to the emergency department involuntarily by his relatives 14 days later and was admitted to the psychiatry service. In this case report, possible etiological factors were discussed and the treatment course during the hospitalization and one year follow-up were presented. Our aim is to contribute to the literature by discussing possible etiological factors and management of mania that started during the treatment of COVID-19. COVID-19 can affect the central nervous system and be associated with psychiatric symptoms. Keywords: COVID-19, Mania, Bipolar Disorder, Central Nervous System.

Objective: Healthcare workers are continuously exposed to challenging environments, making them liable for poor mental health. The COVID-19 pandemic exacerbated this problem, however available data in Lebanon is scarce. We conducted this investigation to provide comprehensive evidence on the mental health of Lebanese healthcare workers.

Methods: In this systematic review, we analyzed 3957 workers reported in 15 cross-sectional studies (10 during and five before the pandemic), identified after searching four databases. Examined mental health problems included depression, anxiety, stress, posttraumatic stress disorder (PTSD), and poor sleep quality. STATA software was used to pool the prevalence across studies. Subgroup analyses were performed based on the pandemic status, severity of mental health problems, and healthcare worker type. Gender and marital status were analyzed as potential risk factors. The methodological quality of all included studies was good as per the National Institute of Health risk of bias tool.

Results: Anxiety, depression, stress, PTSD, insomnia, and poor sleep quality were reported in 50%, 52%, 50%, 35%, 45%, and 41% of the population, respectively. Most cases had mild anxiety (40%), mild depression (45%), but severe stress (27%). Depression and anxiety were highest among pharmacists (69% and 56%) and nurses (49% and 45%), respectively. Compared to the pre-pandemic period, depression (36% vs. 62%) and anxiety (30% vs. 56%) rates were higher during the pandemic, while stress levels were lower (62% vs. 45%). Both gender and marital status were insignificant predictors of depression, anxiety, stress, or PTSD.

Conclusions: Depression, anxiety, posttraumatic stress, insomnia, and poor sleep quality are experienced by approximately one in every two Lebanese healthcare workers. The rate of depression and anxiety almost doubled during the pandemic with higher rates among pharmacists and nurses than physicians and residents. Both gender and marital status were deemed insignificant predictors of reported mental health problems.

Objective: This study aims to assess the associations of the severity of different symptom dimensions and psychosis risk factors with the overall functioning levels in first-episode psychosis (FEP) patients over a 6-month follow-up period.

Method: Psychosis symptom dimensions (positive, negative, depression, mania, attention and other cognitive), sociodemographic characteristics and environmental risk factors (alcohol-substance use, childhood traumas, current stressful life events) were prospectively assessed in 32 patients who were hospitalized for FEP during the six-month follow-up period. The associations of these variables with the longitudinal Global Assessment of Functioning (GAF) scores of these patients were analyzed using linear regression or repeated measures ANOVA.

Results: The severity of positive, negative, depression and mania dimensions reduced (p<0.001) during the follow-up period, while no significant change was found in Stroop interference effect scores (F=0.4, p=0.53). FEP patients with substance or alcohol use had significantly worse functioning during the follow-up period (F=11.2, p=0.001; F=5.3, p=0.02, respectively), and those patients' functioning improved significantly less (F=10.0, p=0.002; F=4.3; p=0.04, respectively). Stroop test performance detected at the first month of the follow-up period significantly predicted the final general functioning scores of the follow-up [Stroop test word reading time (sec): B=-0.58 (-1.13-0.03); color telling speed (sec): B=-0.35 (-0.59-0.1); interference effect: B=-0.28 (-0.57-0.01)].

Conclusion: The stable course and prognostic value of attention and other types of cognitive functioning in FEP patients is remarkable. Interventions for alcohol-substance use in FEP patients should be a part of routine practice.

Objective: This study was conducted to investigate the role of two candidate polymorphisms to improve the diagnosis of Post-Traumatic StressDisorder (PTSD) in forensic psychiatry settings.

Methods: Individuals who applied to our unit with PTSD symptoms following a traffic accident were included. The control group consisted of people who had experienced a similar accident without any symptoms. Sociodemographic data-form, Hamilton Depression Rating Scale and Anxiety Sensitivity Index-3 (ASI 3) were applied to the patients and controls, and the frequencies of the rs8042149 polymorphic allele of the RORA gene and the rs717947 polymorphic allele (4p15) were investigated.

Results: A total of 103 people were included (54 case, 49 control). The rates of polymorphisms were not different between the groups. Higher education levels were associated with lower PTSD incidence while higher scores in the Social Subscale of ASI strongly predicted the occurrence of PTSD.

Conclusion: The polymorphisms assessed did not help to differentiate the groups in the current sample. The potential of the Social Subscale of ASI-3 in predicting the occurrence of PTSD following a trauma should be evaluated in a longitudinal design.

Objectives: The COVID-19 pandemic may be considered as a shared source of uncertainty. Prolonged engagement with social media regarding this uncertainty could present as a risk factor for anxiety. We sought to investigate the relationship between intolerance of uncertainty, dimensions of resilience, uncertainty source (pandemic)-related social media use, and the risk of anxiety and depression in patients with cancer.

Method: Patients with solid organ cancer (n=113) completed the sociodemographic data form, the Intolerance to Uncertainty Scale-12 (IUS-12), the Resilience Scale for Adults (RSA) and the Hospital Anxiety and Depression Scale (HADS) between May and August 2020.

Results: Depression scores were high at 17.7% of the patients while anxiety scores were high at 49.6%. RSA and its dimensions significantly differ between the Anxiety and Depression groups determined by the HADS. Time spent on social media about the COVID-19 pandemic (SMT) was associated with higher HADS-Anxiety scores (r=0.26, p<0.01), whereas higher resilience was associated with lower HADS-Anxiety (r=-0.42, p<0.01) and HADS-Depression (r=-0.52, p<0.01) scores. In addition to high levels of intolerance of uncertainty, low levels of the social resources were found to be a risk factor for depression, and low levels of self- and future-perception dimensions were found to be a risk factor for anxiety, regardless of the patients' social media use.

Conclusion: As the factors that fuel uncertainty will always have an affect on cancer patients and cancer care, promoting the patients' resilience resources should be one of the main priorities for cancer patients.

Objective: Affective lability, which is an important aspect of mood dysregulation, is seen in many psychiatric conditions. The aim of this study is to examine the psychometric properties of the Affective Lability Scale-18 in the Turkish sample of the non-clinical group.

Method: A total of 615 individuals (312 females and 303 males) who did not have a past or current psychiatric disorder were included in the study. The participants were administered sociodemographic data form, Affective Lability Scale-18, Difficulties in Emotion Regulation Scale, and Beck Depression Inventory. The participants were divided into 4 groups; a pilot group, EFA (exploratory factor analysis) group, CFA (confirmatory factor analysis) group and test-retest group.

Results: The factor analysis conducted for the construct validity of the scale, revealed similar results to that of the original scale. The Cronbach's alpha internal consistency coefficient was 0.92 for the EFA group and 0.92 for the CFA group. The test-retest reliability coefficient was 0.82. Difficulties in Emotion Regulation Scale (DERS) and Beck's Depression Inventory (BDI) were used tp measure validity. The correlation between the total scores of participants on the ALS-18 and their scores on the DERS and BDI was determined to be positive and moderate (r=0.38, r=41).

Conclusion: The Affective Lability Scale-18 in the Turkish sample, three sub-dimensions, anxiety/depression, depression/elevation, anger and the general factor all have sufficient internal consistency and it has been demonstrated that the scale can be applied in our country to evaluate the situations in which affect variability is evaluated.

Objectives: The aim of this study is to examine the prevalence of digital technology tool use in individuals with schizophrenia or schizoaffective disorder in Turkey, as well as evaluating the association between the use and psychosocial functionality and clinical symptoms.

Method: Data were collected from 100 patients who were diagnosed with schizophrenia or schizoaffective disorder based on the DSM-5 criteria. The use of technology was evaluated with a questionnaire developed for this study. The level of psychosocial functioning was assessed using the Personal and Social Performance Scale (PSP), and the positive and negative symptom severity was evaluated using the Positive and Negative Syndrome Scale (PANSS).

Results: The digital technology users were significantly younger than the non-users. The majority of patients own a mobile phone (86%) and a computer (67%). Furthermore, 61% of patients used mobile applications, with Facebook and WhatsApp being the most popular social media platforms (48%). Patients who used digital technology tools had higher PSP scores. Furthermore, patients who used digital technology tools had significantly lower scores in PANSS negative subscale. There was no difference in PANSS positive subscale scores between digital technology tool users and non-users.

Conclusion: Patients diagnosed with schizophrenia may benefit from mobile applications and social media tools that can help them participate in daily activities and improve their overall well-being.

Objective: This study aims to examine the relationship between university students' difficulties regulating emotions and their tendency to gamble.

Method: The population of this cross-sectional and correlational study consisted of 69,000 undergraduate level students studying at three state universities in three different provinces in Turkey between February-September 2022. Based on the calculation using the sampling method of the known population, study data were collected face-to-face from 750 students. The data were collected using three tools: a descriptive information form, the South Oaks Gambling Screening Test (SOGS), and the Difficulties in Emotion Regulation Scale-Brief Form (DERS-16). Descriptive statistics, Pearson correlation and Multiple Linear Regression analysis were used to analyze the relationship among the scales' mean scores.

Results: Of the participating university students, 51.6% were female and 48.4% were male. Of these students, 42% stated that they had gambled at least once in their lives and 25.3% of them were still gambling. The mean DERS score was 38.14±14.37, which indicated a moderate difficulty in emotional regulation, and the mean SOGS score was 5.12±3.18. A positive and significant correlation was found between DERS SOGS (r=0.304, p<0.05). It was determined that university students' tendency to gamble was predicted by the three sub-dimensions of the DERS (Clarity (β=0.258, p=0.001), Purpose (β=0.156, p=0.021) and Non-Acceptance (β=1.768, p=0.001)), being male and gambling status in the family (p<0.05).

Conclusion: Emotional regulation difficulties in university students may play an important role in their gambling tendencies.