STRESS AND BURNOUT IN PSYCHIATRISTS IN TURKEY DURING COVID-19 PANDEMIC

Background: Clinicians working in mental health (MH) services seem to be at increased risk of burnout. This study aimed to investigate the stress and burnout levels of psychiatrists working in MH services in Turkey and determine the relationship between stress, workload, and support during the COVID-19 pandemic. Subjects and methods: An online questionnaire was sent to child and adult psychiatrists registered with Turkish professional mail groups. 217 psychiatrists replied, with equal numbers from child (n=108) and adult (n=109) MH services. The Copenhagen Burnout Inventory and study-specific questionnaire were used. Results: 60.8% of psychiatrists (n=132) experienced medium-or high-intensity work-related burnout, 49.8% (n=108) experienced patient-related burnout, and 31.8% (n=69) experienced medium-or high-intensity personal burnout. Patient-related burnout scores were significantly higher in the child psychiatry group than in the adult psychiatry group. The majority (n=126, 58.1%) reported either moderate or higher stress levels linked to the COVID-19 pandemic. Turnover intention, reluctance to retrain in psychiatry and sense of lack of value in the job are all associated with higher levels of burnout. Conclusions: The current COVID-19 pandemic is likely to bring additional stressors to psychiatrists. This study shows that psychiatrists in Turkey already exhibit high levels of work-related stress. Organizational interventions to ameliorate psychiatrists’ wellbeing and work conditions are required

MITOCHONDRIAL DNA COPY NUMBER IS ASSOCIATED WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER

Background: Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder in children. Several hypotheses have been proposed to explain its etiology. Mitochondrial dysfunction (MD) is suggested to be one of the causes of Attention Deficit Hyperactivity Disorder. The objective of the study was to evaluate the relationship between MD and ADHD by investigating mitochondrial DNA (mtDNA) levels from peripheral blood leukocytes, one of the best biomarkers of mitochondrial dysfunction. Subjects and methods: This study included 56 children aged 6-16 years who were diagnosed with ADHD for the first time and 56 age- and sex matched children without ADHD. Real-time PCR was performed to determine the relative mtDNA copy number in each study participant. Results: The mean mtDNA copy number of the case group was 57.623±24.827 and that of the control group was 44.204±18.926 (p=0.002). The mtDNA copy number of the case group was higher than that of the control group. Results of ROC curve analysis provided a mtDNA cutoff value of 45. Conclusion: Significantly higher mtDNA copy number in ADHD group may suggest mitochondrial dysfunction in the etiopathogenesis of ADHD

Mitochondrial Dysfunction in Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder is a neurodevelopmental disorder with primary symptoms of inattention, hyperactivity, and impulsivity, beginning in early childhood. Attention deficit hyperactivity disorder has a complex etiology based on neurobiological foundations, involving genetic, environmental, and biological factors in the early development process. The etiology of attention deficit hyperactivity disorder has not been completely clarified yet, but it has been suggested that increased oxidative stress is one of the possible common etiologies in attention deficit hyperactivity disorder. Oxidative stress can cause cellular damage, DNA repair system malfunction, and mitochondrial dysfunction. Mitochondrial dysfunction is thought to be a susceptibility factor in the development of psychiatric diseases. This article aims to review the research conducted to evaluate the possible relationship between attention deficit hyperactivity disorder and mitochondrial dysfunction and systematically examine the data obtained from these studies. Although studies considering the relationship between attention deficit hyperactivity disorder and mitochondrial dysfunction are less than those of autism spectrum disorder, schizophrenia, and mood disorders, studies on attention deficit hyperactivity disorder are increasing. A compensating system against mitochondrial dysfunction caused by hereditary and environmental factors may be generated by an increase in mitochondrial DNA copy number. Mitochondrial DNA copies may decrease with the reduction of attention deficit hyperactivity disorder severity and attention deficit in patients receiving treatment and may positively affect mitochondrial functions. The literature data of this review show that mitochondrial dysfunction could be a crucial factor in the pathophysiology of attention deficit hyperactivity disorder. Understanding mitochondrial contributions in the pathogenesis of attention deficit hyperactivity disorder may result in new diagnostic tools and the development of new therapeutic strategies for attention deficit hyperactivity disorder treatment

Psychometric properties of the nine-item avoidant/restrictive food intake disorder screen (NIAS) in Turkish adolescents

Abstract Background This study evaluates the psychometric properties of the Turkish version of the Nine-Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS) in a population of Turkish adolescents. Method The NIAS, designed to screen for ARFID symptoms, including picky eating, fear-related eating behaviors, and low appetite, was administered to secondary school students between 13 and 18 ages in Muğla, Turkiye. Results Based on a sample of 268 adolescents, the NIAS’s reliability and validity in this demographic are supported. The research utilized confirmatory factor analysis to verify its three-factor structure and various reliability tests, including Cronbach’s alpha and test-retest reliability, confirming the scale’s internal consistency and temporal stability. The descriptive analysis highlighted significant differences in NIAS scores across BMI categories, with underweight adolescents scoring higher, suggesting a potential link between ARFID symptoms and lower body weight. Criterion validity was supported by significant correlations between NIAS subscales and measures of anxiety, depression, and eating behaviors, indicating the scale’s effectiveness in reflecting relevant psychopathological features. Conclusion Overall, the study establishes the Turkish NIAS as a useful tool for identifying ARFID in Turkish adolescents, aiding early detection and intervention in this at-risk age group. Further research is recommended to explore the scale’s utility across different clinical settings and refine its diagnostic accuracy, enhancing our understanding of ARFID’s impact on youth mental health and nutritional status

Psychometric properties of the nine-item avoidant/restrictive food intake disorder screen (NIAS) in Turkish children

Abstract Background The nine item avoidant/restrictive food intake disorder screen (NIAS) is a short and practical assessment tool specific to ARFID with three ARFID phenotypes such as “Picky eating,” “Fear,” and “Appetite”. This study aimed to evaluate the psychometric properties of the Turkish translation of the NIAS parent form and to investigate the relationship between ARFID symptoms and anxiety, depression symptoms, and eating behaviors in a sample of Turkish children. Method Parents were asked to provide their children's sociodemographic data and to complete the NIAS, Eating Disorder Examination Questionnaire-Short (EDE-QS), Children's Eating Behavior Questionnaire (CEBQ), and Revised Child Anxiety and Depression Scale (RCADS) scales. Results The sample included 440 participants between 6 and 12 ages. Turkish NIAS demonstrated good internal consistency. The three-factor model of the Turkish NIAS was in an acceptable structure. The Turkish NIAS scale was shown to be valid and reliable. NIAS scores were shown to be higher in underweight participants. The NIAS-parent version subscales showed expected convergent and divergent validity with the CEBQ, EDEQ-S, and RCADS scales in children, except CEBQ emotional overeating and desire to drink subscales were correlated with NIAS. Conclusion The Turkish version of the NIAS is valid and reliable in evaluating ARFID symptoms in children

Viral etiology in adult influenza-like illness/acute respiratory infection and predictivity of C-reactive protein

Conclusions: Influenza virus is the most likely pathogen in ILI/ARI when CRP = 5 mg/L. This might be explained by tissue destruction. Myalgia is rare with rhinovirus probably due to absence of viremia. Negative bacteria by PCR and culture suggest unnecessary antibiotic use in ILI/ARI

Heyet Raporu Değerlendirme Sürecinde Çocuk ve Ergen Psikiyatristlerin Yaşadıkları Zorluklar

This study aimed to identify the challenges facedby child and adolescent psychiatrists on reportingIntellectual & Developmental Disability during thedisability evaluation process in Turkey, One hundredfive child and adolescent psychiatrists agreed toparticipate in the study. We asked them to complete anonline questionnaire that was prepared for this study.The major challenge of the process was determiningwhether the disability is severe or not. On the otherhand, the age range that the participants had the mostdifficulty in the process was preschool. As a result,child and adolescent psychiatrist had essentialdifficulties while evaluating children with Intellectual& Developmental Disabilities. As a solution, medicaldiagnosis and functionality should be evaluatedtogether in order to determine the disability level andwhether disability is severe or not.Bu çalışma, çocuk ve ergen psikiyatrlarının Türkiye'de özel gereksinimi değerlendirme sürecinde Entellektüel Yeti Yitimi ve Bilişsel Gelişim Geriliği’ni raporlamada karşılaştıkları zorlukları tespit etmeyi amaçlamıştır. Yüz beş çocuk ve ergen psikiyatrist çalışmaya katılmayı kabul etti. Katılımcılardan, bu çalışma için hazırlanan çevrimiçi bir anketi doldurmaları istendi. Katılımcılar, sürecin kendileri için en büyük zorluğunun gereksinimin ciddi olup olmadığının belirlenmesi olduğunu belirttiler. Öte yandan, katılımcıların bu süreçte en fazla zorluk yaşadığı yaş aralığı okulöncesi idi. Sonuç olarak, çocuk ve ergen psikiyatristleri Entellektüel Yeti Yitimi ve Bilişsel Gelişim Geriliği tanılı çocukları değerlendirirken önemli zorluklarla karşılaşmıştır. Çözüm olarak, gereksinim düzeyini ve gereksinimin şiddetli olup olmadığını belirlemek için tıbbi tanı ve işlevsellik birlikte değerlendirilmesi gereklidir

MITOCHONDRIAL DNA COPY NUMBER IS ASSOCIATED WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER

Background: Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder in children. Several hypotheses have been proposed to explain its etiology. Mitochondrial dysfunction (MD) is suggested to be one of the causes of Attention Deficit Hyperactivity Disorder. The objective of the study was to evaluate the relationship between MD and ADHD by investigating mitochondrial DNA (mtDNA) levels from peripheral blood leukocytes, one of the best biomarkers of mitochondrial dysfunction. Subjects and methods: This study included 56 children aged 6-16 years who were diagnosed with ADHD for the first time and 56 age- and sex-matched children without ADHD. Real-time PCR was performed to determine the relative mtDNA copy number in each study participant. Results: The mean mtDNA copy number of the case group was 57.623±24.827 and that of the control group was 44.204±18.926 (p=0.002). The mtDNA copy number of the case group was higher than that of the control group. Results of ROC curve analysis provided a mtDNA cutoff value of 45. Conclusion: Significantly higher mtDNA copy number in ADHD group may suggest mitochondrial dysfunction in the etiopathogenesis of ADHD