The effectiveness of suicide risk assessment tools in predicting the need for hospitalization

Objective: In this study, adults presenting to the emergency room after a suicide attempt were evaluated by means of some suicide risk assessment tools, and the effectiveness of these tools in identifying those who needed to be hospitalized was investigated. Method: A total of 60 participants were included in the study. The clinical risk assessment of a psychiatrist was considered to be the gold standard for evaluation, and the consistency of the scores obtained by the tools used in the study (Modified “SAD PERSONS” Scale, California Suicide Risk Estimator, Suicide Risk Assessment Tool) were compared with this gold standard by receiver operating curves (ROC). For each tool, the optimal cut-off score, and its sensitivity and specificity at this value, which identified those who needed to be hospitalized were calculated. Independent samples’ t test was used to demonstrate whether the clinical assessment and the cut-off scores of the tools were able to differentiate the groups who needed to be hospitalized or not. The relationship between the clinical assessment and the tools was investigated by Pearson correlation analyses. Results: The sensitivity of the assessment tools for the need for hospitalization ranged from 44.4% to 72.2%, and their specificity ranged from 81.0% to 95.2%. No differences were found between the ROCs of the assessment tools when they were compared with each other. The cut-off scores of the assessment tools managed to differentiate those who needed to be hospitalized. Discussion: Although the assessment tools may not replace the clinical risk assessment of a psychiatrist, some of them may be helpful for the emergency room healthcare staff in identifying the adults who need to be hospitalized after an attempted suicide

Neuroleptic malignant syndrome developed in a case with ınvasive ductal carcinoma of the breast diagnosed with schizophrenia

Bu çalışma, 5-8 Kasım 2022 tarihlerinde [K.K.T.C.]’düzenlenen 7.Psikiyatri Zirvesi 14.Anksiyete Kongresi‘nde bildiri olarak sunulmuştur.Nöroleptik malign sendrom (NMS) hipertermi, müsküler rijidite, bilinç değişikliği, otonomik disfonksiyon, serum kreatin fosfokinaz (CPK) düzeyinde yükselme ve lökositoz ile karakterize olan, nadir görülen ancak mortal seyreden bir sendromdur. Yorgunluk, dehidrasyon ve yetersiz beslenme NMS için risk faktörleri olarak kabul edilir ve kanser hastaları NMS için yüksek risk grubunu temsil etmektedir. Bu yazıda yetmiş üç yaşında şizofreni tanısıyla takipli bir hastada psikotik ajitasyonu kontrol altına almak amacıyla haloperidol 5 mg/gün intramüsküler olarak uygulanmasından iki gün sonra gelişen yüksek ateş, müsküler rijidite, otonomik instabilite gelişmesi, CPK ve C-reaktif protein (CRP) düzeyinde yükselme, lökositoz saptanması NMS düşündürmüştür. Takip sırasında istenen beyin bilgisayarlı tomografisinde (BT) metastatik kanamadan şüphelenilen hastanın, biyopsi sonucu memenin invaziv duktal karsinomu olarak raporlanmıştır. Literatür incelendiğinde olgumuz, meme kanseri olan şizofreni hastasında antipsikotik kullanımı sonucu gelişen ilk NMS olgusudur.Neuroleptic malignant syndrome (NMS) is a rare but mortal syndrome characterized by hyperthermia, muscular rigidity, altered consciousness, autonomic dysfunction, elevated serum creatine phosphokinase (CPK) level and leukocytosis. Fatigue, dehydration, and malnutrition are considered risk factors for NMS, and cancer patients represent a high-risk group for NMS. In this article, the detection of high fever, muscular rigidity, autonomic instability, high CPK and C-reactive protein (CRP) levels, and leukocytosis two days after haloperidol 5 mg/day intramuscular administration to control psychotic agitation in a 73-year-old patient with schizophrenia suggested NMS. The biopsy result of the patient with suspected metastatic hemorrhage in the brain computed tomography (CT) during follow-up was reported as invasive ductal carcinoma of the breast. When the literature is examined, our case is the first case of NMS developed as a result of antipsychotic use in a schizophrenic patient with breast cancer

Effects of Coronavirus (COVID-19) Pandemic on Health Anxiety Levels of Healthcare Professionals

ABSTRACT Objective: We aimed to determine the effects of the COVID-19 outbreak on health workers' health concerns and life. Methods: The study included 293 healthcare professionals reached via e-mail. A questionnaire created by researchers and health anxiety inventory were applied online to all participants. The questionnaire questions investigated the sociodemographic characteristics of the participant, whether he received psychological support during the COVID-19 outbreak, whether he had a chronic disease, whether he had problems with the care of his children, whether he was actively involved in the COVID clinic / service, and how his social and work life was affected. Results: Participants consisted of 73 doctors, 145 nurses and 75 other healthcare professionals (OHP). It was determined that the COVID-19 test was performed to the healthcare personnel in the risk group at a very low rate (1.4%). The number of people receiving psychiatric support during the COVID-19 outbreak was 59 (20.1%). It was determined that the COVID-19 outbreak affected business life and social life of healthcare professionals very much and significantly (

How are experiential avoidance and cognitive fusion associated with alexithymia?

A transdiagnostic approach to psychiatric disorders presents an opportunity to evaluate the relationship between alexithymia and the concepts of psychopathology according to the psychological flexibility model. This study aimed to investigate the relationship between alexithymia, cognitive fusion and experiential avoidance. A total of 133 outpatient participants were included in this cross-sectional study. Sociodemographic Data Form, Toronto Alexithymia Scale-20, Acceptance and Action Questionnaire-II, Cognitive Fusion Questionnaire, Hospital Anxiety and Depression Scale, and Ten-Item Personality Inventory were used. The non-alexithymic group consisted of 37 participants while the alexithymic group of 26. The alexithymic group had higher scores in terms of depression, anxiety, experiential avoidance, and cognitive fusion. Difficulty in identifying and differentiating feelings and total alexithymia scores had positive correlations with anxiety, experiential avoidance, and cognitive fusion. In hierarchical regression analysis, the only difficulty in identifying feelings was predicted by both experiential avoidance and cognitive fusion. These results revealed that alexithymia might also be conceptualized adopting the psychological flexibility point of view