Development, implementation and results of Objective Structured Clinical Exam in Psychiatric Association of Turkey Board Exam

WOS: 000440051200001Object: The aim of this study, is to present the process and results of OSCE in Psychiatric Association of Turkey Board Exam-PATBE. Methods: Six stationed OSCE, in which Standardized Patient-SP took role on five stations, were used as an exam method. These stations were planned for assessing the skills of taking history, psychiatric examination, differential diagnosis, making treatment plans and informing the patient. On the sixth station, the examinees are asked to write a forensic psychiatric report. Phases of OSCE were: preparing the blueprint, preparing the SPs' scenario for each station, preparing the examinee's instructions, preparing the observer's instructions and the evaluation guide, SP education, training of observers, pilot implementation, implementation and evaluation of results. The examinees are expected to achieve at least 30% success in each station and 50% success in all stations. Results: 116 examinees participated the exam between 2006-2016 and 91.4% succeeded in the OSCE exam. In feedback forms, examinees stated that the exam is moderately difficult; yet, the content of the exam is in line with the scope of their specialty training and is suitable for evaluating an expert. Discussion: Positive feedbacks from the examinees indicated the efficiency of the exam. The preparation, implementation and evaluation of results of OSCE require considerable time and manpower. OSCE can be used as a valuable test method for psychiatric board certification

Thyroid Function and Ultrasonography Abnormalities in Lithium-Treated Bipolar Patients: A Cross-sectional Study with Healthy Controls

WOS: 000404296300004PubMed ID: 28680307Introduction: Lithium has many effects on thyroid physiology. Although these side effects have been known for a long time, large sample studies of lithium-treated patients using ultrasonography are lacking. The aim of this study is to investigate the detailed thyroid mor-phologies, hormone levels, and antibodies of lithium-treated patients compared with healthy controls. Methods: This cross-sectional study involved 84 lithium-treated patients with bipolar disorder and 65 gender and age similar controls who had never been exposed to lithium. Subjects between 18 and 65 years of age were eligible for the study. Venous blood samples were acquired to determine the levels of free thyroxine (fT4), thyroid stimulating hormone (TSH), and thyroid antibodies; also, ultrasonographic examinations of the patients' thyroid glands were performed. Results: There were no statistically significant differences in smoking habits, known thyroid disease, thyroid medication use, familial thyroid disease, fT4 level, autoimmunity, thyroid nodule presence, or Hashimoto's thyroiditis between the lithium and control groups. The median TSH level and thyroid volume were significantly higher in the lithium group. In the lithium group, 14 cases (16.7%) of hypothyroidism, seven cases (8.3%) of subclinical hypothyroidism, and one case (1.2%) of subclinical hyperthyroidism were defined; in the control group, seven cases (10.8%) of hypothyroidism and two cases (3.1%) of subclinical hyperthyroidism were defined. Thyroid dysfunction, goiter, parenchymal abnormality, ultrasonographically defined thyroid abnormality, and thyroid disorder were found to be more prevalent in the lithium group. 90% of patients with goiter and 74.3% of patients with ultrasonographic pathologies were euthyroid. Conclusion: It is important to note that 90% of the patients with goiter were euthyroid. This indicates that monitoring by blood test alone is insufficient. The prevalence rates of 47.6% for goiter and 83.3% for ultrasonographic pathology demonstrate that ultasonographic follow-up may be useful in lithium-treated patients. To determine whether routine ultrasonographic examination is necessary, large sample prospective studies are necessary due to the limitations of this study.Ege University Scientific Research Project Grant; Psychiatric Association of TurkeyThis study was supported by Ege University Scientific Research Project Grant and Psychiatric Association of Turkey

COVID-19 Pandemisinin Göğüs Hastalıkları Hekimlerinin Uyku Kalitesine ve Ruhsal Durumlarına Etkisi

Introduction: This study aims to determine the sleep quality and its relationship with anxiety and depressive symptoms, working conditions and other factors among the frontline pulmonologists on active duty during the COVID-19 pandemic.Method: An online survey was conducted among pulmonologists in Turkey. The survey link was e-mailed to the members of the professional societies of pulmonologists. The volunteers were asked to fill in questions about their sociodemographics, medical and psychiatric history, working and housing conditions, perceived levels of support during the pandemic, as well as the sleep habits before the pandemic. Also, questions investigating the severity/level of their worries were inquired and they were asked to fill in two scale forms (the Hospital Anxiety Depression Scale and Pittsburgh Sleep Quality Index-PSQI).Results: The sample consisted of 179 pulmonologists who were divided into two groups according to PSQI as good sleepers (PSQI 5). It was observed that 59.2% of the participants had poor sleep quality during the pandemic. Being anxious (p<0.0001, Odds ratio [OR]=0.139, 95% Confidence Interval [CI] [0.052-0.372]), working in intensive care unit (p=0.046, OR=2.363, 95% CI [1.015-5.497]), worry level about excessive increase of the number of patients above the capacity of the institution they worked in (p=0.018, OR=1.755, 95% CI [1.102-2.794]) and being dissatisfied with ones' sleep before the pandemic (p<0.016, OR=0.272, 95% CI [0.094-0.786]) were found to be the main factors that negatively affected the quality of sleep of pulmonologists during the pandemic.Conclusion: More than half of the pulmonologists in our sample group had low sleep quality during the pandemic. For establishing a good sleep regime for clinicians, its crucial to consider certain interventions on the affecting factors

Impact of Direct Acting Antiviral Agents on Psychiatric and Sexual Health of Patients with Hepatitis C Virus

WOS: 000466134600005Objectives: Data about the psychosocial side effects of direct-acting antiviral agents (DAA) used for the treatment of hepatitis C virus (HCV) infection is scarce. In this study, it is aimed to assess the psychiatric and sexual effects of ledipasvir/sofosbuvir (L/S) combination and paritaprevir-ritonavir-ombitasvir-dasabuvir (PROD) combination in patients with HCV infection. Materials and Methods: The sample of this retrospective study consisted of patients who were diagnosed with HCV infection and received PROD or L/S treatment. The patients were assessed by the Hospital Anxiety and Depression (HAD) scale and Arizona Sexual Experiences (ASEX) scale at baseline and first-, third- and sixth-month visits. Besides these, demographic data and data about the liver disease were collected. Results: During the studied period, 42 patients were started DAA treatment. The average age of the sample was 56.64 +/- 12.04 years. Thirty-five (83.3%) patients achieved sustained viral response. Data of the patients who filled HAD or ASEX at baseline and at least in one of the following visits within six months were used. Anxiety, depression and sexual measures did not differ between baseline and following assessments. Conclusion: L/S and PROD do not seem to have a significant effect on anxiety and depression levels and sexual experiences of the patients while they made an improvement in viral load

COVID-19-related anxiety in people living with HIV: an online cross-sectional study

Tasbakan, meltem/0000-0002-4689-720XWOS:000600735500006PubMed: 32777899Background/aim: The emergence of the coronavirus disease 2019 (COVID-19) outbreak has had an enormous emotional impact on sonic vulnerable groups, such as people living with human immunodeficiency virus (HIV) (PLHIV). This study was planned with the aim of assessing the anxiety levels of PLHIV and the sources of their anxiety. Materials and methods: A web-based questionnaire was sent to PLHIV using the virtual snowball sampling method. The questionnaire included questions about sociodemographic status, information about HIV infection, and the Beck Anxiety Inventory (BAI). Additionally, some opinions of the participants about COVID-19 were asked. Results: A total of 307 respondents, with a median age of 33 years, from 32 different cities, participated in the study. More than half of the respondents reported the belief that COVID-19 was not sufficiently well-known by the medical community and nearly 45% believed that they would have snore complications if they contracted COVID-19. One-fourth of the participants had anxiety. Having a preexisting psychiatric disorder, perceiving that they were practicing insufficient preventive measures, not being sure about the presence of any individuals with COVID-19 in their environment, and living with a household member with a chronic disease were found to be the risk factors of PLHIV for having anxiety during this pandemic. The BAI scores were correlated with the patient-reported anxiety levels about the spread of COVID-19 in Turkey, acquiring COVID-19, transmitting COVID-19 to another person, and transmitting HIV to another person. Among the stated conditions, the most common concern was the spread of COVID-19 all over the country, while the least common was transmitting HIV to someone else. Conclusion: The results revealed that a significant proportion of the sample had anxiety, and the findings were essential for developing evidence-based strategies for decreasing the anxiety of PLHIV, especially for those who had risk factors and to provide them with better health care during this pandemic or other pandemic-like crises

The Quality of Life in the Patients with Diabetic Foot Ulcers

Introduction: Diabetic foot ulcer (DFU), one of the complications of Diabetes Mellitus (DM), is the most common reason for the hospitalization of diabetic patients and leads to extremity amputations and increase in mortality. DFU brings an additional physical and emotional burden to the patients and affects their quality of life (QoL) negatively. This study was organized with the aim of comparing the anxiety, depression and QoL levels of DFU patients with diabetic patients without DFU due to the limited number of the studies investigating the QoL and mental health of DFU patients. Materials and Methods: One hundred and thirty-three patients followed up in the X University Faculty of Medicine Infectious Diseases and Clinical Microbiology Department and volunteered to participate in this cross-sectional study. Besides sociodemographic information, anxiety and depression levels were assessed by Hospital Anxiety Depression (HAD) Scale and QoL was measured by Short Form 36 (SF-36). Results: Among the 133 DM patients with a median age of 60 years, 83 patients were in the DFU group. Mean age (p= 0.006, t=-2.813) and male prevalence (p= 0.0002, chi(2)= 13.824) were higher in the DFU group. Only physical functioning scores were lower in the DFU group (p= 0.002, Z=-3.04) while comparing SF-36 and HAD scores between the two groups. All SF-36 subscale scores of both diabetic groups were lower than the Turkish normative values (p< 0.0001). Conclusion: Finding worse QoL in the aspect of physical functioning among DFU patients reveals the necessity of interventions that will improve the DFU patients' QoL by increasing their physical functioning, besides medical and surgical treatments for foot ulcers. In our study, it was found that all diabetic patients had lower QoL than the normal population. This finding emphasizes the need for taking steps to improve the QoL of patients with DM and especially DFU

Impact of lipodystrophy on health-related quality of life: the QuaLip study

Background: Lipodystrophy is a rare disease characterized by loss of adipose tissue. Natural history studies have demonstrated significant burden of disease; however, there is limited data on the impact of lipodystrophy on quality of life (QoL) and psychoemotional well-being. The QuaLip study is a prospective observational real-world study that aims to determine the impact of lipodystrophy on QoL and psychoemotional well-being and explore subjective burden of the disease. Sixty-seven adult patients and eight pediatric patients with lipodystrophy were included. Patients were followed up for 24 months and assessments were repeated every three months. Patients were examined by licensed psychiatrists at baseline, and at year 1 and year 2 visits. Results: Eighteen (27.69%) of 65 adult patients (two subjects refused psychiatric assessment) were diagnosed with a psychiatric disorder (e.g., depressive episodes, mixed anxiety and depressive disorder, anxiety disorder, adjustment disorder, recurrent depression, panic disorder, generalized anxiety disorder, unspecified mood disorder, nonorganic sleep disorder, post-traumatic stress disorder, depressive episode comorbidity, social phobia and obsessive–compulsive disorder comorbidity). Lipodystrophy disease and QoL questionnaires revealed a significant disease burden over the study period. More than one-third of patients reported depression symptoms on the Beck Depression Inventory and more than one-fourth of the patients reported significant hunger throughout the study period. Physical appearance, fatigue, and pain contributed to the disease burden. QoL scores were lower in patients with psychiatric disease and in those with poor metabolic control. Attention deficit hyperactivity disorder, depressive disorder, sub-threshold depressive symptoms, obsessive–compulsive disorder, appetite problems, and issues with physical appearance were identified in selected pediatric subjects. Conclusions: Lipodystrophy has a significant impact on QoL and psychoemotional well-being. Psychiatric disorders seem to be underdiagnosed among patients with lipodystrophy