MENTAL HEALTH SUPPORT PROGRAM FOR HEALTHCARE PROFESSIONALS IN A PANDEMIC HOSPITAL IN TURKEY AND ITS RESULTS ON ANXIETY, DEPRESSION, INSOMNIA AND SEXUAL DISORDERS

Background: The COVID-19 pandemic has put enormous stress on the health care workers, threatening not only their physical health but also their mental well-being. No mental health support program (MHSP) addressing depression and anxiety in healthcare workers (HCWs), has been shown to be effective in Turkey previously. We aimed to measure the effect of our MHSP among healthcare workers who applied for psychological help associated with the COVID-19 pandemic. Subjects and methods: An MHSP has been created for healthcare professionals working in a pandemic hospital during the COVID-19 period. Health workers were recruited between July and September 2020. Anxiety, depression, and insomnia levels were evaluated with HAM-A (Hamilton Anxiety Scale), HDRS (Hamilton Depression Scale), and Insomnia Severity Index (ISI) before and after the intervention. Sexual complaints were questioned by a consultant psychiatrist. MHSP (n=31), and treatment as usual (TAU, n=27) groups were compared using repeated-measures ANOVA. Results: Sociodemographic data, medical history of COVID-19, and psychiatric diagnoses were similar between the groups. There was no difference in baseline HAM-A, HDRS, and ISI scores (p>0.05). At the end of the study, there was a significant difference between study groups regarding anxiety scores (For post-treatment, MHSP=8.0±2.6 vs. TAU=17.9±3.1, p<0.001) and depression symptoms (For post-treatment, MHSP=8.8±2.7 vs. TAU=20.0±2.4, p<0.001) but not in insomnia levels (For post-treatment, MHSP=6.5±2.4 vs. TAU=7.3±2.4, p=0.499). Likewise, both groups reported similar levels of improvement in reduced sexual drive. Conclusions: Our study results suggest that the MHSP effectively alleviates the psychiatric complaints of healthcare professionals. It is recommended to have mental support teams for healthcare professionals in hospitals

A case of immune-mediated type 1 diabetes mellitus due to congenital rubella infection

Congenital rubella infection is a transplacental infection that can cause intrauterine growth retardation, cataracts, patent ductus arteriosus, hearing loss, microcephaly, thrombocytopenia, and severe fetal injury. It has been shown that type 1 diabetes mellitus develops in 12%-20% of patients with congenital rubella infection, and disorders in the oral glucose tolerance test is observed in 40% of patients. No biochemical or serological markers exist which could indicate that type 1 diabetes was caused by a congenital rubella infection. We report a 13-year-old male patient who was admitted to our hospital with complaints of new-onset polyuria, polydipsia, urination, and weight loss. In addition, he was found to have neurosensory hearing loss, patent ductus arteriosus, and microcephaly. Immune-mediated type 1 diabetes mellitus was considered due to the fact that the autoantibodies of diabetes mellitus were positive

Investigating Predictors of Clozapine Response in Adolescents with Schizophrenia and Schizoaffective Disorder

Objectives: We aimed to determine the clinical predictors of clozapine response in patients with early-onset schizophrenia (EOS)/schizoaffective disorder and the effect of substance use disorder (SUD) on treatment outcomes. Methods: Medical records of patients with treatment-resistant EOS receiving clozapine were identified for data analysis dated between January 2015 and April 2020. Patients on clozapine were followed in an inpatient unit of a tertiary care mental health hospital. Using the Positive and Negative Symptom Scale (PANSS), >= 30% reduction was defined as the response criteria after clozapine treatment. Results: Of 50 subjects (age: 16.3 +/- 1.3 years, 36.0% female), 22 subjects (44.0%) met the defined response criteria. Clozapine responder (CLZ-R) and clozapine nonresponder (CLZ-NR) groups were similar regarding age at illness onset, sex, and duration of untreated psychosis. The CLZ-R group had higher baseline positive PANSS scores (24.8 +/- 8.1 vs. 17.1 +/- 6.6, p = 0.001, d = 1.0) and total PANSS scores (94.8 +/- 17.2 vs. 80.1 +/- 19.8, p = 0.008, d = 0.8) compared with the CLZ-NR counterparts. The duration of hospital stay was longer in the CLZ-NR group (122.3 +/- 48.2 vs. 87.3 +/- 36.2 days, p = 0.007). Among 32 male patients, the presence of SUD (n = 9, 28.1%) was associated with a less reduction in total PANSS scores (F = 7.5, p = 0.010) and higher levels of positive symptoms at the end of the treatment (12.8 +/- 4.1 vs. 18.8 +/- 7.4, p = 0.006, d = 1.0). Synthetic cannabinoids were the most common substance type used among males with treatment-refractory EOS (25.0%). Conclusions: Our results did not support the role of sociodemographic variables in clozapine response. Positive symptoms and SUD yielded a prognostic value in patients receiving clozapine

ADHD and Risk of Childhood Adiposity: a Review of Recent Research

Purpose of Review Attention deficit/hyperactivity disorder (ADHD) is considered as a risk factor for childhood adiposity and obesity. Studies on ADHD have provided limited data concerning the connections between eating habits, body mass index, and obesity. The purpose of this review was to examine the current literature regarding recent cohort and cross-sectional studies to determine the links between ADHD and childhood adiposity. Recent Findings Studies in this review were classified into dietary features, nutritional status, neuroimaging findings, genetic overlapping, behavioral, cognitive, and neurocognitive aspects that play a role in mediating and moderating the relationship between ADHD and obesity. While ADHD, childhood adiposity, and overweight/obesity co-occur in children and adolescents, this relationship is largely explained by a variety of multidirectional factors

Reduced Cortical Thicknesses of Adolescents with Bipolar Disorder and Relationship with Brain-derived Neurotrophic Factor

Background: Cortical thickness (CT) and brain-derived neurotrophic factor (BDNF) were widely investigated in bipolar disorder (BD). Previous studies focused on the association between the volume of subcortical regions and neurotrophic factor levels.Objective: In this study, we aimed to evaluate the association of the CT in youth with early-onset BD with BDNF levels as a potential peripheral marker of neuronal integrity.Method: Twenty-three euthymic patients having a clinical diagnosis of BD and 17 healthy subjects as an age-matched control group with neuroimaging and blood BDNF levels were found eligible for CT measurement. A structural magnetic resonance scan (MRI) and timely blood samples were drawn.Results: Youth with BD exhibited lower cortical thickness in caudal part of left (L) middle frontal gyrus, right (R) paracentral gyrus, triangular part of R inferior frontal gyrus, R pericalcarine region, R precentral gyrus, L precentral gyrus, R superior frontal gyrus and L superior frontal gyrus when compared to healthy controls. The effect sizes of these differences were moderate to large (d=0.67-0.98) There was a significant correlation between BDNF levels with caudal part of the R anterior cingulate gyrus (CPRACG) in adolescents with BD (r=0.49, p=0.023).Conclusion: As a special region for mood regulation, the CT of the caudal part of the R anterior cingulate gyrus had a positive correlation with BDNF. Regarding the key role of CPRACG for affective regulation skills, our results should be replicated in future follow-up studies, investigating a predictive neuroimaging biomarker for the early-onset BD

Selective serotonin reuptake inhibitors and manic switch: A pharmacovigilance and pharmacodynamical study

Background: There is still no approved mechanism of manic switch in bipolar disorder, yet many selective serotonin reuptake inhibitors were accused for this important adverse event. Therefore, we aimed to investigate to estimate SSRI' s risk for reporting mania and elevated mood using FEARS database and investigate receptor mechanisms involved

Depression and cognitive distortions in hemodialysis patients with end stage renal disease: A case-control study

© 2021 Asociación Universitaria de Zaragoza para el Progreso de la Psiquiatría y la Salud MentalBackground and objectives: Identifying cognitive distortions is essential for Cognitive Behavioral Therapy (CBT) that plays a key role in the treatment of depression. Depression seen in patients with End-Stage Renal Disease (ESRD) has not been sufficiently diagnosed and treated. This study aimed to examine the cognitive distortions and schemas of patients diagnosed with ESRD. Methods: Fifty-six patients undergoing hemodialysis and forty-seven controls were enrolled in the study. A sociodemographic and clinic data form, Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Hospital Anxiety and Depression Scale (HADS), Dysfunctional Attitudes Scale (DAS), Automatic Thoughts Questionnaire (ATQ) were applied to all participants. Results: The prevalence of the psychiatric disorder in the case group was significantly higher than the prevalence of the psychiatric disorder in the control group. Compared with the control group, the HADS depression subscale was significantly high in the patient group. There was a positive correlation between the duration of hemodialysis and total scores of DAS as well as the “dependency attitudes” factor among the case group. The “helplessness” subscale scores of the ATQ were significantly higher in the case group compared to the control group. Conclusions: The duration of hemodialysis was related to dependency attitudes of cognitive distortions among patients with ESRD. Studies investigating cognitive modalities are needed to treat depression more successfully in this population. It will contribute to the Cognitive Behaviour Therapy of ESRD patients when these factors are taken into consideration

Social Information Processing and Executive Functions in Male Children and Adolescents with Internet Gaming Disorder

In recent years, in addition to its clinical importance, interest in the social-cognitive aspect of internet gaming disorder (IGD) has increased. This study aimed to investigate autistic traits, executive functions, and self-regulation abilities of patients with IGD. Eighty-seven male patients with IGD and eighty-three male healthy controls (HC) were included in the study. All patients were diagnosed with IGD as per the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders-5. Healthy controls without any comorbid psychiatric diagnosis were recruited from the community. The Brief Rating Inventory of Executive Function (BRIEF) and the Social Responsiveness Scale (SRS) were implemented to evaluate autistic traits, executive functions, and self-regulation skills. The Beck Depression Inventory (BDI), Screen for Child Anxiety and Related Disorders and Internet Gaming Disorder Scale-Short-Form were used to evaluate psychopathology. The effect size of the impairments in executive functions and self-regulation skills was large (Cohen's d = 1.0-2.0). IGD groups had higher levels of autistic traits compared to healthy controls (d = 1.0-1.4). The differences in BDI and BRIEF scores remained significant in logistic regression analysis. Age at illness-onset, total severity of anxiety, and autistic traits were found as significant correlates of deficits in executive functions among patients with IGD. The results of this study supported the higher autistic traits and poorer executive function skills of patients with IGD. Deficits in executive functions were associated with autistic traits and younger age-onset of the illness