Catatonia Due to Lithium Neurotoxicity: A Case Report. / Lityum Nörotoksisitesine Ikincil Gelisen Katatoni Vakasi: Bir Olgu Sunumu.

Lithium may cause toxicity as it has a narrow therapeutic range. Lithium intoxication may manifest in the form of acute, acute on chronic and chronic intoxication. Neurotoxicity is a common component of chronic lithium intoxication and the symptoms include tremor, ataxia, dysarthria, extrapyramidal symptoms, hyperreflexia, seizures and status epilepticus. Although rare, catatonia could as a manifestation of lithium neurotoxicity. In this report, we present a patient with bipolar disorder presenting with catatonic symptoms secondary to lithium intoxication. We will discuss the risk factors, differential diagnosis and the treatment of catatonic symptoms. Lithium neurotoxicity may present with various clinical symptoms including catatonia, and differential diagnosis should be made well in such cases. If lithium neurotoxicity is suspected, rapid and appropriate intervention is required to prevent permanent neurological damage. Keywords: Lithium, Neurotoxicity, Catatonia.

Recurrent Psychotic Depression Associated with Chronic Subdural Haematoma: A Case Report.

Chronic subdural hematomas (CSDH) with isolated psychiatric presentation are rare. In this paper, we report a case of 77-year-old-female patient who had psychotic depression after repetitive head trauma without any neurological symptoms. The brain magnetic resonance imaging revealed an 20 mm subdural hematoma in the right frontoparietal region and a 7 mm subdural hematoma in the left frontal region. The psychiatric symptoms improved within the first week after evacuation but relapsed with the occurrence of right sided pneumocephalus. In the follow up, with the disappearance of the pneumocephalus, the psychiatric symptoms improved. It should be kept in mind that isolated psychiatric symptoms can be seen due to subdural hematoma and evacuation of the hematoma has an important role in improving the psychiatric symptoms.

c.4168G>A(p.Ala 1390Thr) Variation in KMT2D Gene Detected in an Ultra-treatment-resistant Schizophrenia Patient: A Case Report and Literature Review.

Schizophrenia has a multifactorial etiology with a significant genetic component. Genome-wide association studies have identified common variants in candidate genes. However, the common variant can only account for a portion of the genetic variation underlying the disorder. Therefore, researchers suggest that rare variants may be one source of missing heritability in schizophrenia. We report the case of a 20-year-old male patient diagnosed with early-onset and ultra-treatment-resistant schizophrenia and mild intellectual disability and discuss certain rare genetic variants that may be involved in the etiology. He was hospitalized for the initiation of clozapine treatment and was referred to the department of genetics because he had macrocephaly, high arched palate, a prominent forehead, hearing impairment, and hyperpigmented skin lesions. The whole exome sequencing analysis revealed a heterozygous 4168G>A(p.Ala1390Thr) variant in exon 15 of KMT2D (Lysine N-Methyltransferase 2D) (NM_003482.4) gene, which is associated with Kabuki Syndrome. The variants in KMT2D have been reported to be associated with brain development and may play a role in schizophrenia. We discussed the relationship between schizophrenia and genetic variants detected in this case in light of the literature.

Psychological well-being of healthcare workers during COVID-19: Relationship with risk perception and fear in the context of health belief model.

This study aimed to evaluate the extent of fear and risk perception related to COVID-19 and their impact on the psychological well-being of healthcare workers. Data were gathered through an online survey, incorporating questions about risk perception utilizing the health belief model, the Fear of COVID-19 Scale, and the General Health Questionnaire-12. A total of 364 HCWs participated in the survey, with 94% of participants identified as being in the high-risk category for mental disorders based on their General Health Questionnaire scores. The assessment of COVID-19-related risk perception within the Health Belief Model demonstrated significant correlations between perceived susceptibility, perceived severity, perceived barriers, and self-efficacy with both the fear scale and General Health Questionnaire scores. Linear regression was employed to identify factors influencing General Health Questionnaire scores, revealing that risk perception, Fear of COVID-19 scores, marital status, and perceived health were significantly associated with General Health Questionnaire scores. These findings underscore the importance of monitoring the psychological well-being of healthcare workers throughout all stages of pandemic preparedness and response.

Psychological factors responsible for low adherence to mask-wearing measures during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has led to >6 million deaths. Anti-mask movements may decrease the effects of preventive measures. Psychological factors that may be related to anti-mask behaviour are not well researched. AIMS: This study aims to determine the psychological correlates of anti-mask attitudes and behaviour in an online general population sample, focusing on the possible role of claustrophobia. METHOD: Data on attitudes and behaviour toward mask-wearing were collected from an online sample of 3709 people. Predictors of both anti-mask attitudes and behaviour were assessed with linear and logistic regression analyses. RESULTS: Few people (3.3%) were overtly opposed to mask-wearing; mask opposition was more common in men than women. Predictors of negative attitude toward mask-wearing and low adherence to mask-related measures were similar and included male gender, lower education, lower income, being employed, having had COVID-19 and lower COVID-19-related anxiety. Psychopathology measures did not show a prediction, whereas claustrophobia had a significant prediction that was over and above those of other predictors. Avoidance behaviour had similar predictors, except for higher COVID-19-related anxiety. CONCLUSIONS: Although low adherence to mask-wearing during the pandemic was not related to having a mental disorder, it may partly be caused by psychological factors. Those who had a negative attitude also reported lower adherence behaviour, and were characterised by being male, having lower education, being employed and having lower COVID-19-related anxiety; claustrophobia was a strong predictor of attitude. Understanding psychological factors responsible for low adherence may help to decrease morbidity and mortality in future pandemics.

High/severe fear of childbirth and related risk factors among pregnant women: is vaginismus a risk factor?

This study aimed to investigate the prevalence of fear of childbirth (FOC) and associated factors including vaginismus in pregnant women with high/severe FOC. In the study, 407 women who were at 24-40 weeks of gestation were included. The Wijma Delivery Expectancy/Experience Questionnaire Version A (WDEQA), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and vaginismus sub-scale of the Golombok Rust inventory of sexual satisfaction (GRISS) were used. 186 (46%) participants had high/severe FOC. Pregnant women with high/severe FOC had a significantly higher fear of pain during sexual intercourse, higher scores in the WDEQA, BDI, BAI, and vaginismus sub-scale of GRISS. Depression and anxiety level, educational level, access to information on delivery during pregnancy, presence of medical disease, and expression of FOC were predictors of high/severe FOC. Assessment of FOC and associated risk factors, including vaginismus, during pregnancy, will enable the identification of risk groups and the creation of support programmes.Impact StatementWhat is already known on this subject? The range of fear of childbirth (FOC) changes from mild anxiety to severe fear. The prevalence and severity of FOC and related risk factors vary in the studies due to cultural factors, differences in the definition of FOC and measurement tools. The relationship between FOC and vaginismus has not been sufficiently investigated.What do the results of this study add? This study aimed to investigate the prevalence of fear of childbirth (FOC) and associated factors including vaginismus in pregnant women with high/severe FOC.What are the implications of these findings for clinical practice and/or further research? This is the first study that evaluates vaginismus as a risk factor for FOC. Assessment of FOC and associated risk factors, including vaginismus, in pregnant women, will enable the identification of risk groups and the creation of support programs for risk reduction.

Relationship of depression, impulsivity, distress intolerance and coping styles with maladaptive eating patterns in bariatric candidates.

PURPOSE: The study aimed to investigate the problematic eating patterns and understand their relationship to psychological constructs, including stress intolerance, coping mechanisms and impulsivity, and psychiatric symptoms among bariatric surgery candidates. METHODS: The bariatric candidates were evaluated by psychiatric interview and standard scales assessing maladaptive eating behaviors (Eating Attitudes Test (EAT), Bulimia Investigatory Test-Edinburgh (BITE), Dutch Eating Behavior Questionnaire (DEBQ)), depression (Beck Depression Inventory (BDI)), psychiatric symptoms (Brief Symptom Inventory (BSI)), and psychological constructs (Distress Intolerance Index (DSI), Coping Styles Scale (CSS), UPPS Impulsive Behavior Scale(UPPS)). RESULTS: More than half (57.8%) had maladaptive eating behaviors, and 23.6% had binge-eating behavior. Depression and anxiety predicted EAT, BITE, and DEBQ emotional and external eating sub-scale scores; distress intolerance, helpless coping style, and impulsivity predicted maladaptive eating behaviors in bariatric candidates. CONCLUSION: Maladaptive eating patterns play an essential role in the failure to lose weight and regain weight and are predicted by depression, anxiety, and psychological constructs in this study. Evaluation of pathological trait characteristics besides discrete psychiatric syndromes should be recommended in the pre-operation process to plan relevant interventions in the long-term management of weight. LEVEL OF EVIDENCE: Level III, evidence obtained from well-designed cohort analytic studies.

Atypical Neuroleptic Malignant Syndrome Induced by Low Dose Quetiapine in a Patient Treated with Donepezil.

Neuroleptic malignant syndrome is a rare idiosyncratic drug reaction that causes morbidity and mortality. Although muscle rigidity and fever are accepted as major symptoms, there is no consensus on the diagnostic criteria. This flexibility in diagnostic criteria allows for the diagnosis of atypical cases. Keeping in mind that neuroleptic malignant syndrome may also occur with the use of low doses of atypical antipsychotics is important for making the diagnosis quickly and reducing the risk of morbidity and mortality. In this report, we aim to present a case with atypical neuroleptic malignant syndrome associated with the use of very low dose quetiapine and discuss the risk factors that facilitate its emergence.