ANXIETY AND DEPRESSION AMONG PEOPLE LIVING WITH HIV DURING THE COVID-19 PANDEMIC: A FACE-TO-FACE SURVEY FROM TURKEY

Background: During the COVID-19 pandemic, there have been some difficulties in the routine care of people living with HIV (PLWH). Subjects and methods: We aimed to evaluate the impact of COVID-19 on mental health of PLWH and their use of health services. This study was conducted using the face-to-face interview method in the outpatient clinic of a university hospital, between 01.09.2020 and 30.11.2020. Hospital Anxiety and Depression Scale and survey instrument designed by the researchers investigating socio-demographic data and access to health services were used. Results: The study included 217 patients, 91.7% (n=199) of whom were male. All of the patients were postponed their hospital appointments, 60.8% were concerned about not being able to contact their physician and 53% had concerned about being stigmatized if they went to the hospital. Of the participants, 27.6% had depression, 12.9% had anxiety and 8.3% had both depression and anxiety. Low income, job loss, and fear of being stigmatized were associated with depression and anxiety. Lower level of education, discontinuation of medications and lack of opportunity to work remotely were associated with depression, while history of psychiatric illness, worry about not being able to contact their physician and cessation of antiretroviral therapy were associated with higher anxiety levels. Conclusion: It is important to develop strategies ensuring the continuity of care for PWLH and identify and support those with a higher mental health impact

Parental psychological distress associated with COVID-19 outbreak: A large-scale multicenter survey from Turkey

Aims: Pandemics can cause substantial psychological distress; however, we do not know the impact of the COVID-19 related lockdown and mental health burden on the parents of school age children. We aimed to comparatively examine the COVID-19 related the stress and psychological burden of the parents with different occupational, locational, and mental health status related backgrounds. Methods: A large-scale multicenter online survey was completed by the parents (n = 3,278) of children aged 6 to 18 years, parents with different occupational (health care workers—HCW [18.2%] vs. others), geographical (İstanbul [38.2%] vs. others), and psychiatric (child with a mental disorder [37.8%]) backgrounds. Results: Multivariable logistic regression analysis showed that being a HCW parent (odds ratio 1.79, p <.001), a mother (odds ratio 1.67, p <.001), and a younger parent (odds ratio 0.98, p =.012); living with an adult with a chronic physical illness (odds ratio 1.38, p <.001), having an acquaintance diagnosed with COVID-19 (odds ratio 1.22, p =.043), positive psychiatric history (odds ratio 1.29, p <.001), and living with a child with moderate or high emotional distress (odds ratio 1.29, p <.001; vs. odds ratio 2.61, p <.001) were independently associated with significant parental distress. Conclusions: Parents report significant psychological distress associated with COVID-19 pandemic and further research is needed to investigate its wider impact including on the whole family unit. © The Author(s) 2020

The psychiatric assessment schedule for adults with developmental disability checklist: reliability and validity of Turkish version

Aim/background: There is a lack of psychometric instruments to measure psychopathology in people with intellectual disabilities (ID). This may lead to underdiagnosis of treatable psychiatric comorbidities in this population. Psychiatric assessment schedule for adults with developmental disabilities (PAS-ADD) Checklist was developed as a screening tool designed for lay people. The PAS-ADD Checklist was created in English and was later on validated for other languages, including French and German. There is no psychometric measure available in Turkish to screen for or detect psychiatric symptoms in adults with ID. The aim of the present study was to present a psychometric evidence of the Turkish language version of the PAS-ADD Checklist. This is the first study aiming to present and validate a psychiatric screening instrument for adults with ID in Turkey. Methods: The Turkish version was developed by translation and back translation. The checklist and a structured purpose-designed socio-demographic form were administered to 151 adult individuals with ID of whom 71 were living in care homes, 80 at family home. They all underwent face-to-face psychiatric assessment through clinical examination. The Turkish version of the Checklist was compared with the original English and other language versions, and the psychometric properties were presented. Internal consistency, test–retest reliability, inter-rater reliability, factorial analysis and sensitivity/specificity were calculated. Results: The validity and reliability of the Turkish version seem acceptable with good psychometric properties. The item analysis of the total scale showed strong consistency with Cronbach’s alpha of 0.75. Test–retest reliability for different items (rs: between 0.50 and 0.69) was better than inter-rater reliability (rs: between −0.15 and 0.75) which could be expected given that raters are non-specialist people. Sensitivity and specificity were calculated for the number of participants who did and did not cross threshold and for whom a psychiatric disorder was or was not present. The sensitivity was 78.7% and specificity was 78.8%. An explanatory principal component factor analysis was conducted on the Turkish version of the Checklist revealed six factors. This six-factor solution explained 54% of variance. The likely reasons for the findings are discussed. Conclusion: Overall, the Turkish version of the PAS-ADD Checklist is an acceptable generic screening tool considering the difficulty of detecting mental health problems in people with ID and the lack of Turkish screening instrument. The Turkish version of the PAS-ADD Checklist can be recommended as a general screening tool for psychiatric disorders in adults with ID. It will contribute to early diagnosis and management of mental health problems and therefore improve the quality of life of those with ID and their family/care givers

Separation anxiety disorder among outpatients with major depressive disorder: Prevalence and clinical correlates

Prior studies have reported that separation anxiety disorder (SEPAD) can continue into or may begin in adulthood. Association of SEPAD with other psychiatric disorders has been frequently examined, and high rates of co-morbidities have been found. The aim of this study was to investigate the prevalence and clinical correlation of SEPAD in adult patients undergoing treatment for major depressive disorder (MDD). The study sample was comprised of 100 outpatients. Participants underwent a DSM-5-based comprehensive assessment. Purposefully-designed semi-structured sociodemographic information and illness history forms were filled out by the researchers, and diagnoses of SEPAD were made using the Structured Clinical Interview for Separation Anxiety Symptoms, Separation Anxiety Symptom Inventory and Adult Separation Anxiety Survey. The frequency of SEPAD was 41% in patients with MDD, three-quarters of whom were adult onset. The use of new-generation antidepressants, adjunctive medications and comorbidity of other anxiety disorders were higher in patients with SEPAD (p < 0.05). SEPAD was highly prevalent, with a majority of cases starting in adulthood among patients with MDD, while SEPAD comorbidity was associated with high levels of anxiety and an increased likelihood of suboptimal response to usual depression treatment. Further studies are required to define the relevance and pathological basis for the comorbidity of SEPAD in people with MDD

Prescribing trends in treatment-resistant schizophrenia

Objectives: Schizophrenia is a common mental health condition associated with significant morbidity and excess early mortality. Treatment-resistant schizophrenia (TRS) occurs in about one in three patients diagnosed with schizophrenia. The aim of this study was to identify attitudes of a nationally representative sample of psychiatrists towards pharmacotherapy of patients with TRS, the potential factors related to their choice of various regimens, and to investigate the clinical outcomes of different methods employed. Methods: Psychiatrists were contacted through national e-groups and various psychiatry conventions. They provided information about their professional and demographic characteristics. They were asked to describe clinical and demographic characteristics of an adult patient with TRS under their care for at least 3 months. They reported on the medication change they made and the effect of this intervention on the positive symptoms and functioning of the patient. Results: Among the 207 patients reported on, only 28.7% were on monotherapy for TRS immediately before the change in medication. With the change made in treatment regime, 40.1% were switched to a different antipsychotic agent as monotherapy, 40.6% received combination therapy with two or more antipsychotic agents, 1.4% received high-dose antipsychotics, and 4.8% had augmentation with antidepressants or mood stabilizers. 13.1% psychiatrists employed more than one method. Of the whole sample, 48.3% were put on clozapine either as monotherapy or with other medications. The monotherapy and combination groups were compared in terms of characteristics of patients and prescribers, which revealed no significant difference (p > .05). There was also no difference found on the outcome variables of two groups (p > .05). Conclusions: Although polypharmacy was found to be a common practice, there seemed to be a comparably good ratio of clozapine utilization and of attempts of switching to monotherapy among the prescribers. There were no significant patient- or prescriber-related factors in relation to preference of treatment regimens, which need further investigation on larger samples

Internalized stigma in obsessive compulsive disorder: Correlates and associations with quality of life

In the present study we aimed to measure IS among outpatients with OCD, and to assess its relationship with clinical and sociodemographic variables, and quality of life. Out of 100 patients assessed, 79 patients with OCD were included in the study. Each patient was assessed using the SCID-5 CV, Y-BOCS, ISMI Scale, and WHOQOL-BREF. There was a strong correlation of IS with lower QoL and severity of OCD symptoms. Avoidance behavior, psychological health and social relationship domains emerged as independent factors related to IS in the regression analysis. There is a need for further studies on a larger samples to identify the specifics of the development and impact of IS in people with OCD

Determination of Ni and Cd accumulation properties of some Brassicaceae species

Karagöz, Alptekin ( Aksaray, Yazar )Toprakta ağır metal kirliliğinin hiper toplayıcı bitkilerle önlenmesi (fitoremidasyon) olanaklarını araştırmak amacıyla, arazi, iklim odası ve sera çalışmaları yürütülmüştür. Serpantin toprakları üzerinde yetişen nikele dirençli veya nikel biriktirici bitki türleri ile çinko kurşun madenleri çevresindeki topraklarda kadmiyuma dayanıklı bitkiler, topraklarıyla birlikte değerlendirilmiştir. Bu amaçla, Batı Anadolu’da 192 serpantin ve 52 çinko-kurşun madeni çevresi yüzey toprağı analiz edilmiş, üzerindeki otsu ve çalı türü bitkilerden örnekler alınmış ve tohum toplanmıştır. DTPA ile ekstrakte edilebilir en yüksek nikel ve kadmiyum içeriğine sahip üçer toprakta, çalışılan metalleri toplama ve çimlenme yeteneği yüksek bitkilerle bir dizi kültür denemesi yürütülmüştür. Bu topraklarda ayrıca mikrobiyel biyokütle ile, mikrobiyel toplulukların yetişme süreci boyunca gösterdikleri değişim izlenmiştir. Toprakların bitkilerce alınabilir nikel içeriğinin, toplamın % 2,9-5,8 kadarını oluşturduğu ve genellikle artan sıcaklık ve yağış değerleriyle arttığı belirlenmiştir. Bu oran kadmiyumda % 15-17 aralığına yükselmekte olup, söz konusu metalin yüksek çözünürlüğünü ve tehlikesini göstermiştir. Toplanan dört yüzden fazla bitki örneğinde Brassicaceae familyası üyeleri dışında nikel hiper toplayıcısına rastlanmamıştır. Kadmiyum hiper toplayıcısı bitki bulunamamış, ancak tehlikeli düzeylerde kadmiyum biriktiren bitkiler örneklenmiş veya yetiştirilmiştir. Poa bulbosa, Hymenocarpus circinnatus ve Plantago lanceolata, yüksek oranda kadmiyum toplayan bitkiler arasında öncelikli türler olarak belirlenmiştir. DTPA ile ekstrakte edilebilen nikel ve kadmiyum miktarları ile aynı türün bireylerinin bünyesindeki miktarlar arasında yakın ilişki bulunmuştur. Mikrobiyel biyokütlenin ve ortam koşullarına uyum sağladığı belirlenen çok sayıda mikrobiyel topluluğun, bitki gelişim dönemlerine göre önemli değişiklikler gösterdiği saptanmıştır.Nickel hyperaccumulating plants grown in serpentine soils and cadmium resistant species collected from zinc and lead mine and smelting areas were tested under growth chamber and greenhouse conditions in order to test their phytoremediation abilities. In Western Asia Minor, 192 serpentine and 52 surface soils around zinc lead mine lands were sampled together with their apparent herbaceous and arbuscular flora. Plants to be grown in the highest 3 of DTPA extractable Ni and 3 of Cd containing soils were selected after their high emergence, and hyperaccumulating performances of nickel and cadmium uptake. Microbial biomass and microbial populations in those soils were also monitored through the growing seasons. Bioavailable nickel content was determined changing 2.9-5.8% of the total, and increasing with the regional precipitation and mean temperature. Bioavailable cadmium contents were in the range of 15-17% of the total, indicating higher solubility and more threatening properties of that heavy metal. Only some of the Brassicaceae species hyperaccumulated nickel among more than four hundred plant species sampled. No cadmium hyperaccumulating species were found in situ or in the culture media in spite of presence of several highly cadmium accumulating plants. Poa bulbosa, Hymenocarpus circinnatus ve Plantago lanceolata had the potential of further study due to their high cadmium uptake ability. DTPA extractable nickel and cadmium contents were closely correlated with the different individuals of any species. Microbial biomass and adapted microbial populations were seasonally changed to an extent