Parental psychological distress associated with COVID-19 outbreak: A large-scale multicenter survey from Turkey

Aims: Pandemics can cause substantial psychological distress; however, we do not know the impact of the COVID-19 related lockdown and mental health burden on the parents of school age children. We aimed to comparatively examine the COVID-19 related the stress and psychological burden of the parents with different occupational, locational, and mental health status related backgrounds. Methods: A large-scale multicenter online survey was completed by the parents (n = 3,278) of children aged 6 to 18 years, parents with different occupational (health care workers—HCW [18.2%] vs. others), geographical (İstanbul [38.2%] vs. others), and psychiatric (child with a mental disorder [37.8%]) backgrounds. Results: Multivariable logistic regression analysis showed that being a HCW parent (odds ratio 1.79, p <.001), a mother (odds ratio 1.67, p <.001), and a younger parent (odds ratio 0.98, p =.012); living with an adult with a chronic physical illness (odds ratio 1.38, p <.001), having an acquaintance diagnosed with COVID-19 (odds ratio 1.22, p =.043), positive psychiatric history (odds ratio 1.29, p <.001), and living with a child with moderate or high emotional distress (odds ratio 1.29, p <.001; vs. odds ratio 2.61, p <.001) were independently associated with significant parental distress. Conclusions: Parents report significant psychological distress associated with COVID-19 pandemic and further research is needed to investigate its wider impact including on the whole family unit. © The Author(s) 2020

Validity and Reliability of Mobility Inventory-Turkish Version

The Mobility Inventory (MI; Chambless et al. 1985) assesses the degree to which respondents avoid 26 typical agoraphobic situations, when alone and when accompanied. The aim of this study is to investigate the validity and reliability of Mobility Inventory-Turkish Version.Method: Mobility Inventory was administered to 92 patients (male33, female59) with agoraphobia or panic disorder with agoraphobia. Analysis were applied to &quot;when alone&quot; and &quot;when accompanied&quot; subscales. Reliability of MI was analyzed by test-retest correlation, split-half technique, Cronbach's alpha coefficient. Construct validity was evaluated by factor analysis performed with principal component analysis and varimax rotation after the Kaiser-Meyer-Olkin (KMO) and Bartlett test had been performed. Results: &quot;when alone&quot; subscale: Cronbach coefficient was found as 0.93. In analysis performed by split-half method reliability coefficients of inventory halves were found as 0.892 and 0.878. Again spearmen-brown coefficient was found as 0.879 by the same analysis. Factor analysis revealed six basic factors. These six factors explained 70.4 %of the total variance. &quot;when accompanied&quot; subscale: Cronbach coefficient was found as 0.906. In analysis performed by split-half method reliability coefficients of inventory halves were found as 0.865 and 0.850. Again Spearmen-Brown coefficient was found as 0.766 by the same analysis. Factor analysis revealed seven basic factors. These seven factors explained 73.4 %of the total variance. Conclusion: Analysis demostrated that ME-Turkish version had a satisfactory level of reliability and validit

Psikiyatri Polikliniği: Şizofreni Tedavisi Bağlamında Kesitsel Bir Çalışma

Amaç: Bu çalışmanın amacı; Eğitim ve Araştırma Hastanesi Psikiatri Polikliniğinebaşvuran hastaların sosyodemografik özelliklerini araştırmak ve Şizofreni tanısı alanhastaların tedavi ve takip sonuçlarını değerlendirmektir.Gereç ve Yöntem: Psikiyatri polikliniğine yapılan 2707 başvuru değerlendirildi. Ayrıca şizofreni hastalarına poliklinik şartlarında uygulanan tedaviler incelendi.Bulgular: Araştırma süresince psikiyatri polikliniğine toplam 2707 başvuruyapılmıştır. Çalışmaya alınan hastaların 649’u (%24) şizofreni ve diğer psikotik bozukluklar,506’sı (%18,7) depresif bozukluklar, 389’u (%14,4) anksiyete bozuklukları,117’si (%4,3) bipolar bozukluklar tanısı almıştı. Şizofreni hastalarının 347’si (%62) tekilaç kullanıyordu. Bu hastaların 287’si (%51,3) atipik antipsikotik, 60’ı (%10,7)ise tipikantipsikotik almaktaydı. Hastaların 205’i (%36,6) kombine antipsikotik kullanmaktaydı. Çalışmamızda şizofreni hastalarının %77,5’ine, tek başına veya kombinasyonşeklinde atipik antipsikotik reçetelendiğini saptadık.Sonuç: Psikiyatri poliklinikleri, psikiyatrik tedavinin en önemli çalışma alanlarıdır. Belirgin yeti yıkımına yol açan kronik hastalıkların, hastalığa özelleşmiş rehabilitasyonalanlarında değerlendirilmesi, psikiyatri polikliniklerinin hem hizmet hem de araştırmaalanlarında daha etkin kullanımını sağlayacaktır. Şizofreni tedavisinde, literatüre uygun ancak tedavi protokollerine uymayan sonuçlar saptadık. Şizofreni tedavisinde,ilaç dışı tedavileri de içeren bütüncül tedavi yaklaşımına daha fazla dikkat çekilmelidir.Aim: The aim of this study was to investigate the sociodemographic characteristics of patients who applied to the Psychiatry Outpatient Clinic of Education and Research Hospital and to evaluate the treatment and follow-up results of patients diagnosed with schizophrenia. Material and Methods: 2707 applications whiche were received to the psychiatric outpatient clinic were evaluated . Also the treatments of schizopherina patients in polyclinic were analysed. Results: During the study period, 2707 applications were made to the psychiatry polyclinic. 649 (24%) of the patients were diagnosed with schizophrenia and other psychotic disorders. 506 (18.7%) of the patiens were diagnosed with depressive disorders. 389 (14.4%) of the patients were diagnosed with anxiety disorders and 117 (4.3%) of the patients were diagnosed with bipolar. 347 (62%) of the schizophrenic patients were on a single medication. 287 (51.3%) of these patients were taking atypical antipsychotics and 60 (10.7%) of them were taking typical antipsychotics. 205 (36.6%) of all patients were taking combined antipsychotic medication. We found that 77.5% of patients with schizophrenia were prescribed atypical antipsychotics alone or in combination. Conclusion: Psychiatric polyclinics are the most important fields of study for psychiatric treatment. Evaluation of chronic diseases which cause significant loss of competence in disease specialized rehabilitation units will provide more effective use of psychiatric polyclinics in both service and research areas. For schizophrenia treatment, we found results that were in accordance with the literature but not with the treatment protocols. Holistic treatment approach, including non-pharmacological treatments for schizophrenia should be pushed forward

A Technique: Examining the Evidence

Introduction: Cognitive therapy is based on the realistic epistemology which exerts that there is an objective reality beyond human experience. Cognitive models of psychopathology stipulate that the processing of external event or internal stimuli is biased and therefore systematically distorts the individual’s construction of his or her experiences, leading to a variety of cognitive errors. These distorted cognitions predispose or perpetuates mental disorders. If this bias that is also manifested in the automatic thoughts during specific instances can be attenuated by weakening the belief in these thoughts, it may lead into change in the accompanying emotion and dysfunctional behaviour. Objective: The aim of this review is to describe the basic technique of cognitive therapy namely “examining the evidence” and also present the clinical application of this technique. In order to perform this technique, first situation must be detailed. Then assessed emotion is graded according to its severity. After that, key automatic thought must be identified and phrased accordingly. After grading belief in the thought, evidence for and against the thought can be generated using appropriate questioning. In the end by using this evidence, the belief in the automatic thought and the emotion must be reviewed. Examining the evidence can also be used as a homework assignment to be done between sessions. In this text, steps of examining the evidence, which questions to be asked, and the points that must be attendant is reviewed and a sample interview is included. Conclusion: By its empirical nature “examining the evidence” is the most valuable technique of cognitive therapy and when it is applied properly long lasting change can occur in client

Adaptation, Validity and Reliability of the Body Sensations Questionnaire Turkish Version

Objective: In this study, it is aimed to evaluate the validity and reliability of Body Sensations Questionnaire (BSQ). Method: BSQ was administered to 122 patients with panic disorder. BSQ Turkish version completed by translation, back-translation and pilot assessment. Socio-demographic Data Form and BSQ Turkish version were administered to participants. Construct validity was assesed by factor analysis after Kaiser-Meyer-Olkin (KMO) and Bartlett tests applied. Principal component analysis and varimax rotation used for factor analysis. Results: 66% (n=80) of the participants were female and 34% (n=42) were male. The mean age of participants was 31,7±10,8 years and age range was 18-58 years. Internal consistency of the questionnaire was calculated 0,921 by Cronbach alpha. In analysis performed by split-half method reliability coefficients of half questionnaire were found as 0,889 and 0,850. Again spearmen-brown coefficient was found as 0,849 by the same analysis. Factor analysis revealed five basic factors. 75,2% of the total variance was explained with these five factors. Conclusion: The results of this study show that the Turkish version of BSQ is a reliable and valid scale for measuring the fear of the bodily sensations associated with panic

Psychiatric Polyclinic: A Cross Sectional Study in the Context of Schizophrenia Treatment

Amaç: Bu çalışmanın amacı; Eğitim ve Araştırma Hastanesi Psikiatri Polikliniğinebaşvuran hastaların sosyodemografik özelliklerini araştırmak ve Şizofreni tanısı alanhastaların tedavi ve takip sonuçlarını değerlendirmektir.Gereç ve Yöntem: Psikiyatri polikliniğine yapılan 2707 başvuru değerlendirildi. Ayrıca şizofreni hastalarına poliklinik şartlarında uygulanan tedaviler incelendi.Bulgular: Araştırma süresince psikiyatri polikliniğine toplam 2707 başvuruyapılmıştır. Çalışmaya alınan hastaların 649’u (%24) şizofreni ve diğer psikotik bozukluklar,506’sı (%18,7) depresif bozukluklar, 389’u (%14,4) anksiyete bozuklukları,117’si (%4,3) bipolar bozukluklar tanısı almıştı. Şizofreni hastalarının 347’si (%62) tekilaç kullanıyordu. Bu hastaların 287’si (%51,3) atipik antipsikotik, 60’ı (%10,7)ise tipikantipsikotik almaktaydı. Hastaların 205’i (%36,6) kombine antipsikotik kullanmaktaydı. Çalışmamızda şizofreni hastalarının %77,5’ine, tek başına veya kombinasyonşeklinde atipik antipsikotik reçetelendiğini saptadık.Sonuç: Psikiyatri poliklinikleri, psikiyatrik tedavinin en önemli çalışma alanlarıdır. Belirgin yeti yıkımına yol açan kronik hastalıkların, hastalığa özelleşmiş rehabilitasyonalanlarında değerlendirilmesi, psikiyatri polikliniklerinin hem hizmet hem de araştırmaalanlarında daha etkin kullanımını sağlayacaktır. Şizofreni tedavisinde, literatüre uygun ancak tedavi protokollerine uymayan sonuçlar saptadık. Şizofreni tedavisinde,ilaç dışı tedavileri de içeren bütüncül tedavi yaklaşımına daha fazla dikkat çekilmelidir.Aim: The aim of this study was to investigate the sociodemographic characteristics of patients who applied to the Psychiatry Outpatient Clinic of Education and Research Hospital and to evaluate the treatment and follow-up results of patients diagnosed with schizophrenia. Material and Methods: 2707 applications whiche were received to the psychiatric outpatient clinic were evaluated . Also the treatments of schizopherina patients in polyclinic were analysed. Results: During the study period, 2707 applications were made to the psychiatry polyclinic. 649 (24%) of the patients were diagnosed with schizophrenia and other psychotic disorders. 506 (18.7%) of the patiens were diagnosed with depressive disorders. 389 (14.4%) of the patients were diagnosed with anxiety disorders and 117 (4.3%) of the patients were diagnosed with bipolar. 347 (62%) of the schizophrenic patients were on a single medication. 287 (51.3%) of these patients were taking atypical antipsychotics and 60 (10.7%) of them were taking typical antipsychotics. 205 (36.6%) of all patients were taking combined antipsychotic medication. We found that 77.5% of patients with schizophrenia were prescribed atypical antipsychotics alone or in combination. Conclusion: Psychiatric polyclinics are the most important fields of study for psychiatric treatment. Evaluation of chronic diseases which cause significant loss of competence in disease specialized rehabilitation units will provide more effective use of psychiatric polyclinics in both service and research areas. For schizophrenia treatment, we found results that were in accordance with the literature but not with the treatment protocols. Holistic treatment approach, including non-pharmacological treatments for schizophrenia should be pushed forward

A Technique Socratic Questioning-Guided Discovery

“Socratic Method” is a way of teaching philosophical thinking and knowledge by asking questions which was used by antique period greek philosopher Socrates. Socrates was teaching knowledge to his followers by asking questions and the conversation between them was named “Socratic Dialogues”. In this meaning, no novel knowledge is taught to the individual but only what is formerly known is reminded and rediscovered. The form of socratic questioning which is used during the process of cognitive behavioral therapy is known as Guided Discovery. In this method it is aimed to make the client notice the piece of knowledge which he could notice but is not aware with a series of questions. Socratic method or guided discovery consists of several steps which are: Identifying the problem by listening to the client and making reflections, finding alternatives by examining and evaluating, reidentification by using the newly found information and questioning the old distorted belief and reaching to a conclusion and applying it. Question types used during these procedures are, questions for gaining information, questions revealing the meanings, questions revealing the beliefs, questions about behaviours during the similar past experiences, analyse questions and analytic synthesis questions. In order to make the patient feel understood it is important to be empathetic and summarising the problem during the interview. In this text, steps of Socratic Questioning-Guided Discovery will be reviewed with sample dialogues after each ste

Premature Ejaculation and Utilization of Cognitive Techniques

Introduction: Premature ejaculation is the most common male sexual dysfunction leading to distress in many couples. Master and Johnson emphasized the concept of early learned experiences and Kaplan emphasized lack of sensory awareness. For treatment sex therapists mainly utilize start-stop and squeeze techniques as homework. Couples enter sex therapy with some cognitive distortions and beliefs about sex and sexuality. These beliefs are also named sexual myths. For some couples using techniques to challenge cognitive distortions and maladaptive beliefs about sex and sexuality can be used. In this paper by presenting a case we discussed how cognitive techniques can be used along with behaviour techniques with couples. Case: Presenting clients are five years married couple who are thirty and twenty nine years old respectively. They attended to the outpatient clinic with the request of the female client. Their main complaint was premature ejaculation. They were diagnosed premature ejaculation using clinical interview. In treatment besides start and stop technique, cognitive techniques were utilized to address dysfunctional beliefs about sexuality. Discussion: Premature ejaculation is a male sexual dysfunction that causes distress and intimacy problems between couples. Stop start and squeeze techniques were accepted as the choice of treatment but their effectiveness is questioned recently. Also cognitive distortions and maladaptive beliefs may hamper therapy progress. Besides that, behavioral techniques utilizing cognitive techniques to lessen the degree of dysfunctional beliefs about sex and sexuality may help the couple to overcome premature ejaculation and enhance sexual satisfaction and intimacy

Early Maladaptive Schemas in Depressed Women and Its Relationship with Depression

Objective: Objective: Schemas are deep enduring cognitive structures that are the source of dysfunctional cognitions, emotions and behaviors, activate after critical incidents in depression. A subset of schemas called Early Maladaptive Schemas (EMS) which are hyphotised to arise from early traumatic and adverse life events are also claimed to be related with not only personality disorders but also mood disorders. In this study we aimed to investigate the relationship between early maladaptive schemas and depression and relationship between schema scores and depression severity in depressed women and compare it with non-depressed controls.Methods: 40 women attending to an outpatient psychiatry clinic and 30 healthy controls participated. All participants were assessed with SCID-1. Data were obtained by using a Sociodemographic Questionnaires, Young Schema Questionnaire-Short Form 3 (YSQ) and Beck Depression Inventory (BDI).Results: All except one (enmeshment/undeveloped self) maladaptive schema scores of depressed women were higher than controls. BDI was correlated to some schema and schema domain scores in both depressed and control groups but the correlations were stronger in control group. Mean emotional deprivation, negativism, abandonment and instability, failure EMS scores showed the highest difference between two groups. The schema domains most related to depression symptom severity were disconnection and rejection, impaired autonomy and performance.Conclusions: Almost all early maladaptive schemas are related to depression, and some schemas are related to depression symptom severity but these correlations are weaker in control group. This may mean that EMS are stable and mood independent structures. Although other schemas are related to depression, mostly related EMS in women might be emotional deprivation schema. These schemas may also overlap with Beck’s unlovability core belief or sociotropy dimensio

Kadınlarda Erken Dönem Uyumsuz Şemalar ve Depresyon ile İlişkisi

Amaç: Şemalar işlevsel olmayan, bilişlerin, duyguların ve davranışların kaynağı olan derin bilişsel yapılardır. Depresyonda tetikleyici bir olay sonrasında aktive olurlar. Bu şemaların bir kısmına erken dönem uyumsuz şemalar denmektedir ki bunların erken travmatik ve olumsuz yaşam olayları sebebiyle geliştiği öne sürülmektedir. Ayrıca sadece kişilik bozuklukları ile ilgili olmayıp aynı zamanda duygudurum bozukluklarıyla da bağlantılı oldukları iddia edilmektedir. Bu çalışmada erken dönem uyumsuz şemalar ve kadınlardaki depresyon arasındaki ve erken dönem uyumsuz şema puanları ile depresyon şiddeti arasındaki ilişkiyi incelemeyi ve bunu depresyonu olmayan kontrol grubu ile karşılaştırmayı amaçladık. Yöntem: Psikiyatri polikliniğine başvuran 40 kadın ve 30 sağlıklı kontrol çalışmaya dahil edildi. Tüm hastalara SCID-I uygulanarak tanıları kondu. Sosyodemografik verileri içeren bir form ile beraber Young Şema Ölçeği (YSQ) ve Beck Depresyon Envanteri (BDE) kullanılarak veriler elde edildi. Bulgular: Depresyondaki kadınların bir erken dönem uyumsuz şema skoru dışında (iç içe geçmişlik/gelişmemiş benlik) tüm şema skorları kontrollerden yüksek olarak bulundu. BDE skorları hem şemalar hem de şema alanları ile korele bulundu ama bu korelasyon kontrol grubunda daha güçlü idi. İki grup arasındaki şema skorları ortalamalarındaki en büyük fark duygusal yosunluk, karamsarlık, terk edilme ve kararsızlık ve de başarısızlık şemaları arasında bulunmuştur. Sonuç: Tüm erken dönem uyumsuz şemalar kesitsel olarak depresyonla ve bazıları da depresyon şiddeti ile ilişkilidir fakat şiddet için olan bu ilişki kontrollerde daha güçlüdür. Bu EMS'lerin kararlı ve duygudurum değişikliklerinden bağımsız yapılar olduğuna işaret ediyor olabilir. Her ne kadar kadınlarda tüm şemalar depresyon ile ilişkili olsa en güçlü ilişki duygusal yoksunluk ile olabilir. Bu şema Beck'in sevilmeme temel inancı ya da sosyotropi kişilik boyutları ile bir oranda örtüşme gösteriyor olabilirObjective: Objective: Schemas are deep enduring cognitive structures that are the source of dysfunctional cognitions, emotions and behaviors, activate after critical incidents in depression. A subset of schemas called Early Maladaptive Schemas (EMS) which are hyphotised to arise from early traumatic and adverse life events are also claimed to be related with not only personality disorders but also mood disorders. In this study we aimed to investigate the relationship between early maladaptive schemas and depression and relationship between schema scores and depression severity in depressed women and compare it with non-depressed controls. Methods: 40 women attending to an outpatient psychiatry clinic and 30 healthy controls participated. All participants were assessed with SCID-1. Data were obtained by using a Sociodemographic Questionnaires, Young Schema Questionnaire-Short Form 3 (YSQ) and Beck Depression Inventory (BDI). Results: All except one (enmeshment/undeveloped self) maladaptive schema scores of depressed women were higher than controls. BDI was correlated to some schema and schema domain scores in both depressed and control groups but the correlations were stronger in control group. Mean emotional deprivation, negativism, abandonment and instability, failure EMS scores showed the highest difference between two groups. The schema domains most related to depression symptom severity were disconnection and rejection, impaired autonomy and performance. Conclusions: Almost all early maladaptive schemas are related to depression, and some schemas are related to depression symptom severity but these correlations are weaker in control group. This may mean that EMS are stable and mood independent structures. Although other schemas are related to depression, mostly related EMS in women might be emotional deprivation schema. These schemas may also overlap with Beck’s unlovability core belief or sociotropy dimension (Journal of Cognitive Behavioral Psychotherapy and Research 2013, 2: 98-105)