Turk psikiyatri dergisi = Turkish journal of psychiatry最新文献

Objective: Although Syrian refugees have high rates of mental health problems due to war trauma, little is known on their degree of need for and contact with mental health services. Using a population sample of Syrian refugees living in Ankara, we assessed the perceived need for and contact with mental health services, as well as the barriers to access these services.

Method: This was a cross-sectional mixed-method study of 420 Syrian refugees living in Ankara city center, using face to face interviews administered at the respondents' home by trained, Arabic-speaking interviewers. PTSD and depression were assessed using Harvard Trauma Questionnaire and Beck Depression Inventory, respectively.

Results: Of all the refugees in our sample, 14,8% (N=62) stated that they felt the need for mental healthcare since arriving in Turkey. The actual number contacting any mental health service was very low (1,4%, N=6). The most important barriers to accessing mental health services were reported by the respondents to be language problems and lack of information on available mental health services. Service providers and policymakers also reported similar topics as the most important barriers: low awareness about mental health problems, daily living difficulties, and language and cultural barriers. Multivariate analyses revealed that presence of medical or mental disorders and female gender predicted the perceived need for contacting services.

Conclusion: Our results show that, although refugees report high rates of mental health problems, the perceived need for and actual contact with services are very low. To address this treatment gap, and to provide adequate care for refugees with mental health problems, common barriers (language and awareness) should be identified and dealt with.

Objective: Catatonia is a syndrome that can be missed in clinical settings. Diagnosis of catatonia is important because the condition can be reversible and is associated with severe complications. This study aims to screen patients with catatonia admitted to a university hospital's psychiatry and neurology services, examine their characteristics, and compare the coverage of different catatonia scales.

Method: During a consecutive 20 months study period, the Turkish adaptations of the Bush-Francis Catatonia Rating and the KANNER scales were administered in psychiatry and neurology inpatient units and patients on the waiting list for psychiatric hospitalization. The participants were also evaluated with DSM-5 criteria. In addition, the sociodemographic and clinical characteristics of the patients in the psychiatric group were compared.

Results: A total of 214 patients were evaluated. Twenty-eight (13.1%) screened positive for catatonia, and 23 (82.1%) were diagnosed with catatonia according to DSM-5 criteria. KANNER and Bush- Francis identified the same patients as having catatonia. In addition to schizophrenia and mood disorders; neurodevelopmental disorder, encephalitis, postpartum psychosis, obsessive-compulsive disorder, delirium, cerebrovascular disease, functional neurological symptom disorder have also been found to be associated with catatonia. The most common complication was urinary tract infection. Life-threatening complications were also observed.

Conclusion: Overlooking catatonia may have dire consequences. Adhering solely to the DSM-5 criteria may miss some patients with catatonia. Widely and efficiently using standardized catatonia scales can improve detection capacity and enhance the management of morbidity and mortality.

Objective: Whether selective serotonin reuptake inhibitors (SSRI) increase suicide risk, especially in young adults, is still a controversial issue. This study aimed to examine the change in impulsivity characteristics and to evaluate the relationship between impulsivity and suicidality in young adults with major depression who were started on SSRIs.

Method: The study included 50 patients between the ages of 18-24 years with a diagnosis of major depression who were planned to start SSRIs. Participants were evaluated with the Beck Depression Scale, Beck Anxiety Scale, Young Mania Rating Scale, Columbia Suicide Severity Rating Scale, Barratt Impulsivity Scale, Daily Impulsivity Scale (DIS), and Go/ No-Go Task (GNG) before and at the end of the first week of treatment.

Results: Seventy percent of the patients (n: 35) completed the assessments at baseline and at the end of the first week. At the end of one-week there was a statistically significant decrease in the DIS (t=2.283, p=0.029) and commission errors in GNG (t=3.19, p=0.003). In addition, 7 out of 11 patients who had suicidal ideation at the first evaluation did not continue to have suicidal ideation at the end of the first week and there was a significant decrease in the severity of suicidal ideation at the end of the follow-up (W:132.0, p<0.001).

Conclusion: One-week SSRI use in young adults resulted in a decrease in impulsivity in self-report scales assessing state impulsivity and in the GNG. It was observed that the severity of suicidal ideation decreased at the end of the one-week treatment period.

Objective: This study aims to asess alexithymia, anger and its expression, sensitivity to bodily sensations, personality, and their relationship with the severity of the disease in patients with Restless Legs Syndrome.

Method: The study included 63 patients diagnosed with Restless Legs Syndrome and 63 age, gender and education matched controls. All participants were given, Toronto Alexithymia Scale, Somatosensory Amplification Scale, The State Trait Anger Scale and Temperament and Character Inventory. The severity of Restless Legs Syndrome was evaluated using the Restless Legs Syndrome Severity Rating Scale.

Results: The trait anger score (p=0,001), sensitivity to bodily sensations (p<0,001), and the total score of alexithymia (p<0,001) were significantly higher in the patient group Reward dependence in patient group was significantly higher (p=0,008). Restless Legs Syndrome severity positively correlated with trait anger level (r=0,360; p=0,015) and alexithymia total score (r=0,373; p=0,003). Restless Legs Syndrome severity negatively correlated with self-directedness (r=-0,323; p=0,010).

Conclusion: We demonstrated that alexithymia, sensitivity to body sensations, and anger was high in restless leg syndrome in Restless Legs Syndrome. Restless Legs Syndrome is linked to physical and mental symptoms and certain personality traits.

Mental disorders are a critical global public health problem due to their increasing prevalence, rising costs, and significant economic burden. Despite efforts to increase the mental health workforce in Türkiye, there is a significant shortage of psychiatrists, limiting the quality and accessibility of mental health services. This review examines the potential of artificial intelligence (AI), especially large language models, to transform psychiatric care in the world and in Türkiye. AI technologies, including machine learning and deep learning, offer innovative solutions for the diagnosis, personalization of treatment, and monitoring of mental disorders using a variety of data sources, such as speech patterns, neuroimaging, and behavioral measures. Although AI has shown promising capabilities in improving diagnostic accuracy and access to mental health services, challenges such as algorithmic biases, data privacy concerns, ethical implications, and the confabulation phenomenon of large language models prevent the full implementation of AI in practice. The review highlights the need for interdisciplinary collaboration to develop culturally and linguistically adapted AI tools, particularly in the Turkish context, and suggests strategies such as fine-tuning, retrieval-augmented generation, and reinforcement learning from human feedback to increase AI reliability. Advances suggest that AI can improve mental health care by increasing diagnostic accuracy and accessibility while preserving the essential human elements of medical care. Current limitations need to be addressed through rigorous research and ethical frameworks for effective and equitable integration of AI into mental health care. Keywords: Artificial İntelligence, Health, Large Language Model, Machine Learning, Psychiatry.

Objective: We aimed to evaluate the frequency of Post Traumatic Stress Disorder (PTSD), to determine the risk factors, and to monitor the change of symptoms after 6 months among individuals who survived the avalanche disaster in Van.

Method: Face-to-face interviews were conducted with 35 people who were rescued from two consecutive avalanche disasters in Van 2 months and 6 months after the avalanche disaster. The socio-demographic and clinical data of the cases were evaluated. The Post Traumatic Stress Disorder Symptom Scale-Self Report version (PSS-SR) and clinical interviews were used for PTSD diagnosis. The level of trauma was assessed by using the Impact of Event Scale (IES).

Results: All participants were rescuers who went to the avalanche site for rescue mission. Of the cases, 16 were volunteers from the local community and 19 were professional rescuers. The frequency of PTSD was 71.4% in the early assessment, and 57.1% in the long term. Staying in avalanche for more than 30 minutes, the absence of a history of disaster exposure and being in the group of volunteers were found to increase the risk for PTSD development.

Conclusion: There is a high risk of developing PTSD as a result of an avalanche. People who will intervene with the disasters should be educated and prepared in terms of preventing negative psychological consequences of the disaster. The relationship between the severity of trauma and PTSD was replicated in our study.

Naltrexone is an μ opioid receptor antagonist that is used in alcohol and opiate use disorder. Naltrexone does not constitute tolerance and dependence, and cessation of the drug does not cause withdrawal symptoms. Sustained release form of naltrexone has been developed due to patient compliance issues. There is currently only one sustainedrelease form available in Turkey, which is inserted subcutaneously. In this case report, we present, a probable serious side effect of sustained release naltrexone implant. A 36 years old male with alcohol use disorder, developed a sudden clouding of consciousness one hour after the naltrexone implant application followed by anterograde amnesia in the next 8-10 hours. We were not able to detect any medical or neurological reasons for the altered mental status but after the removal of the naltrexone implant, the symptoms improved. To the best of our knowledge, this is the first case to report clouding of consciousness and anterograde amnesia after naltrexone implantation. Keywords: Naltrexone Implant, Side Effect, Alcohol Use Disorder, Lethargy, Consciousness.

Objective: People with Behçet's Disease, as many individuals with chronic diseases, often face depression, anxiety, poor quality of life and sexual problems. In this study, it was aimed to evaluate depression, anxiety, and sexual dysfuntions in people with Behcet's Disease.

Method: A total of 100 participants, 50 patients (29 female) and 50 healthy volunteers (28 female), participated in the study. Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Female Sexual Function Index (FSFI), and International Index of Erectile Function (IIEF) were administered to the participants.

Results: Depression and sexual dysfunctions were significantly related with Behçet's Disease. In our study, all female participants with Behçet's Disease had problems in sexual functions. Erectile dysfunction was more frequent in participants with Behcet's. The results also showed that there is a significant relationship between depression and orgasmic function (p=0.004), sexual desire (p=0.028), sexual satisfaction (p=0.023), and general satisfaction (p=0.028). There was a significant difference between people with Behçet's Disease (10.54±6.45) and healthy group (7.36 ±6.13) in depression scores (p=0.009). Patients with systemic involvement and those with mucocutaneous involvement were found to be similar in terms of BDI and BAI scores (p>0.05).

Conclusion: Behçet's Disease was found to be a risk factor for depression and sexual dysfunctions.