Impact of the first, second and third peak of the COVID-19 pandemic on anxiety, depression and stress symptoms of healthcare workers.

BACKGROUND AND OBJECTIVES: Numerous studies have been conducted on the psychological effects of the COVID-19 pandemic. However, how the mental health of health workers will be affected among the number of peaks during the pandemic has not been evaluated yet. The study aims to investigate the effects of the first, second, and third peaks of COVID-19 on anxiety, depression, and stress symptoms in healthcare workers. METHODS: The current study included 4031 healthcare workers, 1051 during the first peak period, 1409 during the second peak period, and 1571 during the third peak period. The Depression-anxiety-stress scale-21(DASS-21) was used to assess the participants' levels of anxiety, depression, and stress symptoms. RESULTS: The mean age of the participants was 33.74 ± 7.95, and 2634 (66.3 %) were female. 36.9 %(n = 1486) of the participants were physicians, 41.1 % (n = 1655) were nurses and 22.1 % (n = 890) were other healthcare workers. A statistically significant difference was documented in the DASS-21 anxiety (F(2:4028) = 502.893, p 2. Peak > 1. Peak), DASS-21 depression (F(2:4028) = 46.034, p 2. Peak > 1. Peak), DASS-21 stress (F(2:4028) = 65.548, p 1. Peak), and DASS-21 total scores (F(2:4028) = 156.860, p 2. Peak > 1. Peak) of healthcare workers during all three peak periods. CONCLUSIONS: Our findings show that as the peak number rises, so do the levels of anxiety and depression among healthcare workers. As a result, it is possible to assert that prolongation of the COVID-19 pandemic worsens mental problems (Tab. 2, Fig. 3, Ref. 35).

The Validity and Reliability of the Turkish Version of the Meta-Worry Questionnaire.

Introduction: This study aims to investigate the validity and reliability of the Meta-Worry Questionnaire in the Turkish version as a contribution to clinical practice. Method: The research sample consisted of two groups. Cases were people who have General Anxiety Disorder (n=165) and controls were age and sex-matched healthy volunteers (n=158). To evaluate the psychometric properties of the scale, Meta-Worry Questionnaire, Metacognition Questionnaire-30, Beck Depression Inventory, Beck Anxiety Inventory, Penn State Worry Questionnaire and Generalized Anxiety Disorder-7 Questionnaire were used. Results: In this study, Cronbach's alpha coefficient values of frequency and belief components were found 0.92 and 0.94, respectively. At the same time, excluding each item, Cronbach's alpha coefficient values of these two components also remained above 0.90, regardless of which item was chosen. While the frequency component accounted for 69.07% of the total variance, the belief component accounted for 72.95%. The area under the ROC curve is 0.948 for the frequency component and 0.944 for the belief component. The construct validity of the scale was tested with Exploratory and Confirmatory Factor Analysis and the one-dimensional structure of the scale was shown. To evaluate the psychometric properties of the scale, other scales which are related to metacognition were used. Conclusion: All items in the tool displayed a high correlation with the overall questionnaire. High total variance of the scale indicates its high validity. These results suggest high reliability of the tool as well as consistency of every item it includes.

The role of personality traits on mode of delivery.

PURPOSE: The aim of this study is to understand the motives behind CS requests in nulliparous women in their late pregnancy better and to investigate if specific personality traits affect the maternal decision on mode of delivery. MATERIAL AND METHOD: This prospective study was conducted with 70 healthy, nulliparous parturient with singleton pregnancies. Women at their 28-32. weeks of gestation were asked to fill a socio-demographic data form and the questionnaires; Personality Belief Questionnaire - Short Form (PBQ-SF) and The Childbirth Attitudes Questionnaire (CAQ). After delivery, all the results of pre-filled questionnaires and women's mode of delivery were analyzed and compared. RESULTS: There were significant differences in personality types; dependent (p = 0.033), passive-aggressive (p = 0.031), obsessive-compulsive (p = 0.001), antisocial (p = 0.014), narcissistic (p = 0.014) and borderline (p = 0.014) between vaginal delivery and CS groups. The CAQ scores of the mothers who requested CS were significantly higher (p:0.007). Weak but significant positive relation was found between total CAQ scores and avoidant (p = 0.022), dependent (p = 0.034), passive-aggressive (p = 0.040), narcissistic (p = 0,006), schizoid (p = 0.007), paranoid (p = 0.007) and borderline (p = 0.007) personality types. CONCLUSION: This is the first study that investigates the relationship between mode of delivery and personality traits according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and cognitive behavioral perspective in the literature. These personality traits can be carried at a level that is not clinically significant to create an obvious pathology, yet they might play a role as the motives behind the apparent reasons for women who request CS. Understanding women's motives and attitudes for childbirth during their pregnancy may help healthcare providers to tailor women's approach to childbirth to avoid unnecessary CS.

Validity and Reliability of the Turkish Version of Generalized Anxiety Disorder Scale-Revised.

OBJECTIVE: This study aims to assess the psychometric values of the Generalized Anxiety Disorder Scale-Revised (GADS-R) which measures the intensity and duration of worry, various coping and avoidance strategies to cope with worrying, and positive and negative metacognitive beliefs about worrying. METHODS: 114 patients with generalized anxiety disorder and 198 healthy controls were included in the study. These patients were diagnosed according to DSM-IV TR, and the primary diagnosis of the patients was generalized anxiety disorder which was confirmed via SCID I and II, subsequently. Sociodemographic form, GADS-R total and subscale scores, and Meta-Cognitions Questionnaire-30 (MCQ-30), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Generalized Anxiety Disorder-7 Scale (GAD-7), and Penn State Worry Questionnaire (PSWQ) were used to assess validity, reliability and cut-off point. RESULTS: GADS-R total and subscale scores and MCQ-30, BDI, BAI, GAD-7, and PSWQ were found to be statistically higher in the patients with GAD compared to a healthy control group. GADS-R has five factors and showed relatively acceptable sensitivity and specificity for detecting anxiety disorders at a cut-off point of 1188. CONCLUSION: The GADS-R is a valid and reliable scale that can be used in the Turkish population as an assessment tool.

The impact of COVID-19-related mental health issues on menstrual cycle characteristics of female healthcare providers.

AIM: To investigate the association between menstrual cycle regularity in healthcare providers and COVID-19 pandemic-related anxiety, depression, stress. METHODS: A cross-sectional study was conducted by administrating online questionnaires to female healthcare workers in Turkey. Women aged 18-40 years with regular menstrual cycles for more than 1 year before the beginning of the pandemic were included in the study and they were divided into two groups according to menstrual cycle regularity during the pandemic. The questionnaires included sociodemographic characteristics, medical and reproductive history, lifestyle information of participants, COVID-19 Stress Scales (CSS), and a short version of the Depression Anxiety Stress Scale (DASS-21). RESULTS: A total of 952 women were included in the study, 679 had regular menstrual cycles, and 273 had irregular menstrual cycles. The prevalence of irregular menses among Turkish women healthcare workers aged 18-40 years was 28.7%. The CSS subdimensions and total scores were significantly higher in the irregular menstruation group than in women with regular menstruation (p < 0.001). The DASS-21 depression, anxiety, and stress subdimensions were likewise significantly higher in women with irregular menstruation (p < 0.001). Besides, both the univariable and the multivariable logistic regression results showed the relationship between irregular menstruation and CSS total score. CONCLUSION: The current study showed the association between the COVID-19 pandemic-induced anxiety, perceived stress, depressive symptoms, and increased prevalence of menstrual cycle irregularity among healthcare providers.

The comparison of anxiety, depression and stress symptoms levels of healthcare workers between the first and second COVID-19 peaks.

BACKGROUNDS: Although the psychological effects of the COVID-19 pandemic have been investigated, there is no study comparing the effects between the peaks. This study aims to compare the levels of anxiety, depression, and stress of healthcare workers struggling with pandemic between the first and second peaks. METHODS: A total of 2460 healthcare workers, 1051 from the first peak period and 1409 from the second peak period, were included in the study. The first peak measurements of the participants were made between 07.04.2020 and 05.05.2020 and the second peak measurements were made between 22.11.2020 and 20.12.2020 according to the peak period in Turkey. Depression-Anxiety-Stress-21(DASS-21) scale was applied to the participants online by the purpose of the study. RESULTS: The mean age of the participants was 32.63 ± 7.70, and 66.5% of them were female. A statistically significant difference was found between the income status (p < 0.001), lifestyle (p < 0.001) and COVID-19 test result (p < 0.001), DASS-21 Depression (p < 0.001, t = -5.311), Anxiety (p < 0.001, t = -8.244), Stress (p < 0.001, -10.056) and total(p < 0.001, t = -8.719) scores of the two groups. CONCLUSION: The present study results showed that healthcare workers meticulously struggling with the pandemic had increased anxiety, depression, and stress levels at the second peak of the pandemic compared to the first peak.

The association between temperament features and childhood traumas in patients with juvenile myoclonic epilepsy

Background/aim: Epilepsy is a common chronic neurological problem that impairs daily activities, functionality, and quality of life. Childhood traumas (CTs) are known to be critical factors in the onset or development of many psychiatric and medical disorders. They also play a critical role in the development of temperament and personality. This study aimed to investigate the association between CTs and common temperament patterns and features seen in epilepsy patients. Materials and methods: The study included 38 patients who were diagnosed with juvenile myoclonic epilepsy (JME) and volunteered to participate in the study. In addition to the sociodemographic form and questions on disease features, Structured Clinical Interview for DSM-IV Axis I Disorders, Temperament Evaluation of Memphis, Pisa, Paris and San Diego Questionnaire (TEMPS-A), Childhood Trauma Questionnaire (CTQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were administered to all participants. In the present study, a cut-off value of 35 was used for the CTQ scale. The patients with CTQ scores lower than 35 (50%, n = 19, Group 1) and the patients with CTQ scores above 35 (50%, n = 19, Group 2) were compared. Results: The comparison of TEMPS-A and its subscale scores in the JME patients in the groups with CTQ scores above or below a cut-off value detected significant differences between the groups in depressive and irritable temperament scores. The mean BDI scores were also different between the two groups. Furthermore, a significant positive correlation was detected between the disease duration, anxiety, and depression scores in the JME patients. A significant relationship was detected between the emotional neglect subscale score of the JME patients and the BDI scores. A significant positive correlation was found between the total disease duration, BDI, and BAI. Significant moderate-level relationships were found between the BDI score and irritable, depressive, cyclothymic, and anxious temperaments and between the BAI score and irritable, depressive, cyclothymic, and anxious temperaments. Conclusion: Several temperamental features of JME patients are related to CTs. More depressive symptoms are seen in JME patients with higher disease durations.

Significant Effects of Body Image on Sexual Functions and Satisfaction in Psoriasis Patients.

Negative body image appraisals may effect the sexual functions, avoidance, and level of finding oneself sexually attractive. The aim of the study is to assess the levels of sexual dysfunction and sexual satisfaction in patients with psoriasis and the effect of the body image appraisal on sexual functions and satisfaction. In all, 216 individuals were included in the study, and 112 of them had psoriasis; 104 individuals who never experienced any skin problems participated in the study and answered questions that assess depression and anxiety levels, sexual problems and satisfaction, as well as body image appraisal. Psoriasis patients showed significantly higher levels of sexual impairments and less satisfaction with sexual life compared to controls. The psoriasis group had lower body image satisfaction compared to the controls. Depression and anxiety levels in the psoriasis group were higher than in the control group. The cognitive meaning of skin involvement as body image satisfaction was found to be the most significant risk factor that affected sexual functions in psoriasis patients. It also predicted sexual satisfaction in the patient group. However, the objective measure of the severity of the disease as Psoriasis Area and Severity Index (PASI) was not a determinant of sexual dysfunctions and satisfaction.

Validity and Reliability of Cognitive Attentional Syndrome-1 Questionnaire.

OBJECTIVE: This study aimed to evaluate the reliability and validity of the Turkish version of Cognitive Attentional Syndrome-1 (CAS-1) questionnaire. METHODS: 221 participants were included in the study who do not meet any psychiatric diagnosis. Participants were applied SCID I and II and filled CAS-1 scale, Meta-Cognitions Questionnaire-30 (MCQ-30), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Generalized Anxiety Disorder-7 (GAD-7) Scale, and Penn State Worry Questionnaire (PSWQ). Testing the reliability Cronbach's alpha, item analysis and Item and total score correlation coefficients were applied. For testing structural validity, Confirmatory Factor Analysis was used, and for testing the content validity, the relationship between each item of CAS-1 and MCQ-30, BDI, BAI, GAD-7, PSWQ was examined. RESULTS: The correlation reliability coefficients were statistically significant except for using alcohol/drugs as a coping mechanism. Cronbach Alpha reliability coefficient of 16 items was 0.771 whereas, this ratio was 0.772 for the first eight items (CAS) and 0.685 for the last eight items (Metacognitive Beliefs) which showed that the internal consistency of CAS-1 was high. Structural and Content Validity of the scale was significant. CONCLUSION: The Turkish version of the CAS-1 was a reliable and valid measure to evaluate CAS in a Turkish population.

Social norms regarding alcohol use and associated factors among university students in Turkey

Abstract Background Misperceptions on the higher rates of peer alcohol use are predictive of increased personal use among university students. Objectives This study aims to assess the prevalence, perceived peers' social norms and other predictors of alcohol use in a sample of Turkish university students. Methods This study is established upon the baseline Turkish data on alcohol use of the project Social Norms Intervention for the prevention of Polydrug usE (SNIPE). The data was obtained by a self-reported, online questionnaire from 858 students of Marmara University who were registered to the study web page. Results Alcohol use and drunkenness rates were 62.6%, and 40.9%, respectively. Twenty point two percent of students reported drinking alcohol at least once a week in the last two months. Majority of students (70.4%) reported that religion has an important or very important role in their lives. Perceived higher frequency of peer alcohol use (p<0.000) and drunkenness (p<0.000) were significantly associated with personal alcohol use frequency. Tobacco use rate was 60.2% and positively associated with alcohol use frequency (p<0.000). In all participants, male gender (OR: 1.56; 95% CI: 1.07-2.28), giving less importance to religion (OR: 20.91; 95% CI: 10.95-39.95), tobacco use everyday/almost everyday (OR: 17.88; 95% CI: 9.33-34.29), perceived positive peer attitude towards alcohol use (OR: 2.192; 95% CI: 1.25-3.82) and perceived higher frequency of peer alcohol use (OR: 3.487; 95% CI: 1.66-7.31) were found to be associated risk factors for alcohol use. Age (OR: 1.186, CI 95%: 1.03-1.36) and perceived positive peer attitude towards alcohol use (OR: 3.86, CI 95%: 1.84-8.09) were the additional risk factors among female student whereas perceived positive peer alcohol use frequency (OR: 8.08, CI 95%: 2.40-27.10) among male students. Discussion As the first study conducted in Turkey applying social norms theory, our results indicate the noticeable misperceptions of students regarding their peers' alcohol use. Based on our results, targeting both tobacco and alcohol use, and a gender-sensitive approach employing social norms interventions may enhance the preventive strategies for risky alcohol use among university students.

A comparison of DSM-IV-TR and DSM-5 definitions for sexual dysfunctions: critiques and challenges.

INTRODUCTION: The diagnostic criteria of sexual dysfunctions (SDs) are paramount for the development of sexual medicine as reliable diagnoses are essential to guide treatment plans. Prior Diagnostic and Statistical Manual of Mental Disorders (DSM) classifications based definitions of SD mostly on expert opinions and included imprecise terms. The validity of diagnoses of SD has only recently been challenged, and efforts are made to make more operational definitions. AIM: This paper aims to compare and contrast the recently released Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) diagnostic criteria of SD with that of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition Text Revision (DSM-IV-TR) and explains the rationale for making changes in the new DSM-5. It also aims to address some issues to be considered further for the future. METHODS: Online proposed American Psychiatric Association website DSM-5, the new released DSM-5, and DSM-IV-TR diagnostic criteria for SD were thoroughly inspected, and an extensive literature search was performed for comparative reasons. MAIN OUTCOME MEASURES: Changes in diagnostic criteria of DSM-5 were detected, and DSM-IV-TR and DSM-5 diagnostic criteria for SD were compared and contrasted. RESULTS: Diagnostic criteria were more operationalized, and explicit duration and frequency criteria were set up in DSM-5 for purposes of good clinical research. Classifications based on simple linear sexual response were abandoned, and diagnostic classifications were separately made for males and females. Desire and arousal disorders in women were merged. CONCLUSIONS: Drifting apart from linear sexual response cycle may be an advancement in establishing specific diagnostic criteria for different genders. However, it is still a question of debate whether there is enough evidence to lump sexual interest and arousal disorders in females. Making more precise definitions is important to differentiate disorders from other transient conditions. However, there is still room to improve our definitions and find a way to include gay and lesbian individuals. Further discussions and debates are expected to be continued in the future.