Reducing Mental Illness Stigma in Mental Health Professionals Using a Web-based Approach

Objective: This study was designed to investigate the efficacy of a web-based mental disorder stigma education program for mental health professionals. Methods: The sample consisted of 205 individuals who were either residents or specialists in psychiatry. Participants were contacted through a national web-based e-mail group that consisted of professionals in psychiatry, who were randomly assigned to experimental and control groups. The experimental group received an informative e-mail which contained a general account of "stigma" before they were asked to respond to an Internet-based questionnaire which was designed to predict their stigmatizing attitudes towards individuals with mental disorders. Control subjects, on the other hand, were asked to respond to the same Internet-based questionnaire without having been given the aforementioned informative e-mail. Results: The experimental group, compared to the control group, demonstrated a lesser stigmatizing attitude towards individuals with mental illness, as measured by the Internet-based survey which utilized the "social distance" concepts of stigma. Conclusions: These data suggest that such "anti-stigma" campaigns using the potential of the Internet might be an effective tool in the fight against the stigmatization of persons with mental illness

Changes in sleep structure and sleep spindles are associated with the neuropsychiatric profile in paradoxical insomnia

Aim: Sleep spindles have an important role in the pathophysiology and perception of sleep. We aimed to investigate the link between sleep spindles and microstructural architecture of sleep in regard to psychiatric characteristics in paradoxical insomnia. Method: A total of 40 participants (20 with paradoxical insomnia, 20 healthy controls) were included in the study. All participants were evaluated by somnologists and undergone a full-night polysomnography at sleep laboratory. In addition, psychiatric interview was made by the same psychiatrist, and questionnaires were performed to assess the dimensions of the personality such as the neuroticism or extroversion (Eysenck Personality Questionnaire, EPQR-A); to evaluate the tendency to exaggerate somatic perceptions (Somatosensory Amplification Scale, SSAS), somatic parts of dissociation (Somatoform Dissociation Questionnaire, SDQ-20), and somatization (Somatization Scale, SS); to measure participants' feelings about their health and disease anxiety (Health Anxiety Inventory, HAI-18), and the level of uncontrollable and persistent anxiety (Penn State Worry Questionnaire, PSWQ); to investigate the tendency to ruminative thinking (Ruminative Thought Style Questionnaire, RTSQ), alexithymia (Toronto Alexithymia Scale, TAS-20); and to define the presence and the severity of depressive symptoms (Beck Depression Inventory, BDI). Results: The duration and frequency of the sleep spindles were similar between two groups, while the density was significantly decreased in paradoxical insomnia. The duration of sleep spindles, on the other hand, showed positive correlations with the extroversion dimension scores of EPQR-A and PSWQ scores. Discussion: Sleep protective mechanisms are disturbed in paradoxical insomnia as shown by the lower density of sleep spindles. In addition, fast spindle activity is associated with the personality traits, characterized by an increase in the expression of feelings and the level of anxiety

ELEKTİF SEZARYEN AMELİYATLARINDA UYGULANAN ANESTEZİ TEKNİKLERİNİN ANNE, BEBEK KONFORU VE EMZİRME ÜZERİNE ETKİLERİ

Amaç:Elektif sezaryen ameliyatında uygulanan genel-anestezi ya da kombine spinal epidural-anestezinin;anne,bebek konforu ve emzirme üzerine etkilerinin belirlenmesidir.Yöntem:Altmış gebe rastgele KSE(Kombine Spinal Epidural n=30) ve GA(Genel Anestezi n=30)olarak ayrılmıştır.24saat boyunca postoperatif analjezi için GA grubuna iv ,KSE grubuna epidural hasta kontrollü analjezi yöntemi kullanılmıştır.Ağrı şiddeti verbal analog skala (VAS 0-10),hemodinamik veriler ve yan etkiler, ek analjezik gereksinimi postoperatif 0,1,2,6,12 ve 24.saatlerde kaydedilmiştir.Gebenin iyilik halinin belirlenmesi ve uygulanan anestezi tekniğinin ona olan etkisini araştırmak üzere sosyademografik veriler,pre/postoperatif Beck Depresyon Ölçeği(BDÖ),STAI(State–Trait Anxiety Inventory–Durumluk Sürekli Kaygı Ölçeği) ve Edinburg Doğum Sonrası Ölçesi(EPDS) uygulanıp aralarındaki ilişki incelenmiştir.Her iki grupta da APGAR 1. ve 5. dakikalar ve ilk emzirme saati, ek mama ihtiyacı kaydedilmiştir.Bulgular:Yaş ortalaması 31.0±5.0 yıldır.1.dk APGAR değerleri KSE grubunda anlamlı olarak yüksektir(p < 0.05).5.dk APGAR değerleri benzerdir.Hemodinamik verilere bakıldığında;GA grubunda 0.saatte DAB ve 6.saatte SAB anlamlı olarak yüksek saptanmıştır(p=0.04).0.ve 6.saatteki diğer hemodinamik veriler ile 1,2,12 ve 24.saatlerdeki tüm değerler gruplarda benzerdir(p > 0.05).1.,6.,12.saat VAS değerleri arasında anlamlı fark bulunmuştur(p=0.03,p=0.02,p=0.02).GA grubunda ek analjezi ihtiyacı anlamlı olarak daha yüksek saptanmıştır(p < 0.05).Postoperatif 0. ve 1.saat VAS değeri ile preoperatif STAI-D arasında anlamlı düzeyde pozitif korelasyon saptanmıştır(p=0.021,p=0.028).Pre/postoperatif Beck, pre/postoperatif STAI-D, pre/postoperatif STAI-S,EPDS, postoperatif emzirmeye başlama zamanı verilerinin sonuçları karşılaştırıldığında anlamlı fark bulunmamıştır(p>0.05).Sonuç-yorum:Postoperatif ek analjezi ihtiyacına bakıldığında KSE grubunda daha etkin analjezi sağlandığı söylenebilir.Ayrıca preoperatif STAI-D ve 0. ve 1.saat VAS arasındaki pozitif korelasyon dikkat çekicidir.Genel anestezi ve kombine-spinal epidural anestezinin hemodinami ve olası yan etkiler açısından da değerlendirildiğinde anne-bebek konforu ve emzirmeye başlama zamanı ile ilgili birbirlerine üstünlükleri olmadığı görülmektedir