Predictors of Sexual Dysfunction in Women Seeking Treatment for Opioid Use Disorder: A Comparative Cross-Sectional Study from a Tertiary Center

Aim: There is a critical need for scientific evidence on the sexual and reproductive health of women with opioid use disorder (OUD). The main objective of this study was to evaluate sexual dysfunction (SD) and depression in women with OUD and compare them with healthy controls, in addition to exploring possible predictors of SD. Methods: This cross-sectional study was conducted between January and July 2023. Thirty-four women with OUD, according to the DSM-5, and 30 healthy controls were included. The Female Sexual Function Index (FSFI), Patient Health Questionnaire-9 (PHQ-9), and sociodemographic questionnaire were used to evaluate SD, depression, and characteristics related to substance use and sexual/reproductive history. Logistic regression analysis was performed to determine the predictors of SD in women with OUD. Results: Twenty-nine percent (n=10) of the participants with OUD had SD. The scores of the FSFI desire, arousal, lubrication, orgasm (p=0.001 for all), satisfaction (p=0.001) subscales, and the total score (p<0.001) were lower in women with OUD than in the controls. Daily dosage of buprenorphine/naloxone [Odds ratio (OR)=1,956, p=0.027, 95% confidence interval (CI)=1,079-3,545] and PHQ-9 score (OR=1,403, p=0.012, 95% CI=1,076-1,829) were significantly associated with SD in women with OUD. Conclusion: The high prevalence of SDs highlights the unmet sexual health needs of women with OUD. Screening and addressing depressive symptoms should be one of the first steps when caring for SDs in women with OUD

Rehabilitation for Addicted Patients: Erenköy BAHAR Model

Rehabilitation is any action taken on an individual who has lost their physical or mental capabilities due to a disease or accident to recover their health or improve their capabilities in physical, mental, psychological, social and economic terms within their limitations. Rehabilitation application is divided into medical, social, occupational and psychiatric rehabilitation categories. Main purpose of rehabilitation application for addicted patients is the cessation of drug use in order to begin dealing with the psychological, legal, economic, social and physical damages done of the patients. The purpose of this study is to share several rehabilitation models applied on addicted patients of several countries, and to provide up-to-date knowledge on the development of rehabilitation models applied on addicted patients in our country with a relatively topical application example. In the practice of rehabilitation for addicted patients, we share the capacity and procedural operations, two years of research data and the experiences of what we believe is an important model for our country, the Erenköy Bağımlı Hastalar İçin Rehabilitasyon (BAHAR) Center’s model, for their individualized and integrated approach in recovery. The Center’s rehabilitation programs are cascaded into adaptation program, 0 to 3, 3 to 6, and 6 to 12 months long programs. In Erenköy BAHAR Center, patients’ recoveries in medical and spiritual sense were observed; and positive developments in social standing, family relations and occupational and social roles were recorded. It is seen that this center’s treatment methods for addiction are crucial for individual’s general wellbeing and functionality recovery, thus giving rise to the thought of establishing similar centers in our country. In conclusion, rehabilitation for addicted patients in our country is an emerging field and it requires more effort

World Addiction Medicine Reports : formation of the International Society of Addiction Medicine (ISAM) Global Expert Network (ISAM-GEN) and Its global surveys

Funding: All the infrastructure funding of this initiative is supported by the International Society of Addiction Medicine (ISAM). We will be open to fundraising for specific projects within the platform and future collaboration with external partners.Addiction medicine is a dynamic field that encompasses clinical practice and research in the context of societal, economic, and cultural factors at the local, national, regional, and global levels. This field has evolved profoundly during the past decades in terms of scopes and activities with the contribution of addiction medicine scientists and professionals globally. The dynamic nature of drug addiction at the global level has resulted in a crucial need for developing an international collaborative network of addiction societies, treatment programs and experts to monitor emerging national, regional, and global concerns. This protocol paper presents methodological details of running longitudinal surveys at national, regional, and global levels through the Global Expert Network of the International Society of Addiction Medicine (ISAM-GEN). The initial formation of the network with a recruitment phase and a round of snowball sampling provided 354 experts from 78 countries across the globe. In addition, 43 national/regional addiction societies/associations are also included in the database. The surveys will be developed by global experts in addiction medicine on treatment services, service coverage, co-occurring disorders, treatment standards and barriers, emerging addictions and/or dynamic changes in treatment needs worldwide. Survey participants in categories of (1) addiction societies/associations, (2) addiction treatment programs, (3) addiction experts/clinicians and (4) related stakeholders will respond to these global longitudinal surveys. The results will be analyzed and cross-examined with available data and peer-reviewed for publication.Peer reviewe

Levels of the Staff's Exposure to Violence at Locked Psychiatric Clinics: A Comparison by Occupational Groups

WOS: 000380900800008PubMed ID: 27104294This study explored the rates of exposure to violence among physicians, nurses, and other health care staff members working at the locked psychiatric clinics, to examine the quantity and types of violence exposed, and to compare occupational groups by the level of exposure to violence. In parallel with the existing literature, the present study supports the proposition that physicians and nurses working at psychiatric units represent a risky group in terms of exposure to violence. The survey found that 87.6% of staff members viewed security measures insufficient. It is considered by the authors that preventive actions should be taken to reduce the risk of exposure to violence against the staff members working at the locked psychiatric clinics

Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report

Abstract Vitamin B12 is one of the essential vitamins affecting various systems of the body. Reports of psychiatric disorders due to its deficiency mostly focus on middle aged and elderly patients. Here we report a case of vitamin B 12 deficiency in a 16-year old, male adolescent who presented with mixed mood disorder symptoms with psychotic features. Chief complaints were “irritability, regressive behavior, apathy, crying and truancy” which lasted for a year. Premorbid personality was unremarkable with no substance use/exposure or infections. No stressors were present. The patient was not vegetarian. Past medical history and family history was normal. Neurological examination revealed glossitis, ataxia, rigidity in both shoulders, cog-wheel rigidity in the left elbow, bilateral problems of coordination in cerebellar examination, reduced swinging of the arms and masked face. Romberg’s sign was present. Laboratory evaluations were normal. Endoscopy and biopsy revealed atrophy of the gastric mucosa with Helicobacter Pylori colonization. Schilling test was suggestive of malabsorbtion. He was diagnosed with Mood disorder with Mixed, Psychotic Features due to Vitamin B12 Deficiency and risperidone 0.5 mg/day and intramuscular vitamin B12 500 mcg/day were started along with referral for treatment of Helicobacter pylori. A visit on the second week revealed no psychotic features. Romberg’s sign was negative and cerebellar tests were normal. Extrapyramidal symptoms were reduced while Vitamin B12 levels were elevated. Risperidone was stopped and parenteral Vitamin B12 treatment was continued with monthly injections for 3 months. Follow-up endoscopy and biopsy at the first month demonstrated eradication of H. pylori. He was followed monthly for another 6 months and psychiatric symptoms did not recur at the time of last evaluation. Despite limitations, this case may underline the observation that mood disorders with psychotic features especially with accompanying extrapyramidal symptoms lacking a clear etiology may be rare manifestation of vitamin B12 and/or folate deficiency in children and adolescents and be potentially amenable to treatment.</p

The Pathway to Care of Patients With SUD Who Presented at Addiction Treatment Centers (AMATEM) in Turkey

TARAMAPUBMEDTARAMASCOPUSTARAMAWOSAim: Recent studies have shown that alcohol and drug use in Turkey is rising year on year. In order to prevent and treat substance use disorder (SUD), many Alcohol and Drug Research, Treatment and Training Centres (AMATEM) have been established in Turkey. The purpose of this study was to investigate the pathway to care of patients who presented at AMATEM. Method: A total 235 patients with SUD between16-69 age groups who presented at AMATEMs in 2017 were included in this study. A sociodemographic form and a structured selfreport questionnaire consisting of 36 items assessing the pathways of care were given to all the patients. Data were analysed with descriptive statistics using SPSS software. Results: The majority of the patients included in the study were single (55%) and male (96%). Patients mostly had a secondary school level of education (51%) and social security (65%). The majority of the patients stated that they used more than one substance (44%), opiates (20%) or alcohol (18%). Conclusion: This is the first study evaluating the pathway of care in patients with SUD in Turkey. It was observed that a significant majority of patients with SUD presented to AMATEMs and patients who applied to different health institutions stated that they were mostly informed about SUD and AMATEM. There were also patients with negative attitudes towards AMATEMs and non-medical treatment seeking behavior other than AMATEM. Families, relatives and friends of patients with SUD have an important place in reaching the treatment

Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report

Vitamin B12 is one of the essential vitamins affecting various systems of the body. Reports of psychiatric disorders due to its deficiency mostly focus on middle aged and elderly patients. Here we report a case of vitamin B 12 deficiency in a 16-year old, male adolescent who presented with mixed mood disorder symptoms with psychotic features. Chief complaints were “irritability, regressive behavior, apathy, crying and truancy” which lasted for a year. Premorbid personality was unremarkable with no substance use/exposure or infections. No stressors were present. The patient was not vegetarian. Past medical history and family history was normal. Neurological examination revealed glossitis, ataxia, rigidity in both shoulders, cog-wheel rigidity in the left elbow, bilateral problems of coordination in cerebellar examination, reduced swinging of the arms and masked face. Romberg’s sign was present. Laboratory evaluations were normal. Endoscopy and biopsy revealed atrophy of the gastric mucosa with Helicobacter Pylori colonization. Schilling test was suggestive of malabsorbtion. He was diagnosed with Mood disorder with Mixed, Psychotic Features due to Vitamin B12 Deficiency and risperidone 0.5 mg/day and intramuscular vitamin B12 500 mcg/day were started along with referral for treatment of Helicobacter pylori. A visit on the second week revealed no psychotic features. Romberg’s sign was negative and cerebellar tests were normal. Extrapyramidal symptoms were reduced while Vitamin B12 levels were elevated. Risperidone was stopped and parenteral Vitamin B12 treatment was continued with monthly injections for 3 months. Follow-up endoscopy and biopsy at the first month demonstrated eradication of H. pylori. He was followed monthly for another 6 months and psychiatric symptoms did not recur at the time of last evaluation. Despite limitations, this case may underline the observation that mood disorders with psychotic features especially with accompanying extrapyramidal symptoms lacking a clear etiology may be rare manifestation of vitamin B12 and/or folate deficiency in children and adolescents and be potentially amenable to treatment