Depression, anxiety, body image scores, and sexual dysfunction in patients with polycystic ovary syndrome according to phenotypes.

Background: Polycystic ovary syndrome (PCOS) has been linked to both mental and metabolic disturbances. The purpose of this research was to investigate psychological features such as anxiety and depression, body image, sexual dysfunction, and associated factors among the PCOS phenotypes and to compare these with healthy controls. Methods: The study involved 167 reproductive-age women with PCOS and 73 healthy controls. Standardized scales assessing depression (the Beck Depression Inventory [BDI]), depression and anxiety (the Hospital Anxiety and Depression Scale [HADS] and the General Health Questionnaire [GHQ]), and body image scale (the Body Cathexis Scale [BCS]) were administered to all participants. Hirsutism scores, serum androgen levels, and metabolic parameters were recorded. Results: Significantly higher BDI, HADS depression, and GHQ scores, and a more negative body image in terms of BCS scores were observed in the women with PCOS than in the healthy controls. BDI scores were significantly higher in phenotypes A, B, and D compared with the healthy controls. No significant difference was observed in BDI and HADS depression scores among the phenotypes. Significant differences were observed only between phenotype A and the control group in terms of HADS depression and GHQ scores. BCS scores were significantly higher in phenotypes A, B, and C than in the healthy controls. No significant difference was determined in Female Sexual Function Index (FSFI) scores between the PCOS phenotypes and the healthy controls. When all participants were divided into three groups based on body mass index (BMI), a statistically significant difference was observed only between the phenotype A lean group (BMI: 18.5-24.9 kg/m2) and the control group in terms of BDI, HADS depression, and BCS scores. Conclusions: BDI, HADS depression scores, and GHQ scores were all higher in patients with PCOS compared with the healthy controls. These features were more pronounced in phenotypes A and B, including hyperandrogenism and oligo-anovulation. Physicians should be aware of the high risk of these disorders in women with PCOS.

Mental health problems of second generation children and adolescents with migration background.

OBJECTIVE: Despite the growing number of young second-generation immigrant (SGI) children and adolescents, studies about their mental health are rare. The objective of this study was to investigate the mental health problems of SGI children and adolescents in Istanbul, Turkey. METHODS: In a clinical sample the mental health of 54 SGIs and 50 native children and adolescents were examined using the Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL) and Children's Global Assessment Scale. The assessments were carried out by a blinded rater. RESULTS: SGI children had higher rates of psychiatric disorders such as depression (p = 0.001), post-traumatic stress disorder (PTSD) (p = 0.011) and anxiety disorders (p = 0.013), more comorbid disorders and lower functionality scores compared to their native counterparts (p = 0.001). CONCLUSIONS: SGI children seem to have higher rates of psychiatric disorders most probably due to migration-induced burdens. The professionals treating SGI children should have more awareness for these problems to be able to approach them in a culture and language sensitive way.

Factors Affecting the Choice of Psychiatry as a Specialty and Satisfaction among Turkish Psychiatry Residents.

OBJECTIVE: This study aimed to investigate the factors affecting the choice of psychiatry among psychiatry residents, identify the fulfillment of expectations, and assess their satisfaction level. METHODS: Anonymous questionnaires were administered to 98 psychiatry residents, and sociodemographic and professional data were collected. RESULTS: Among the reasons for choosing psychiatry, the opportunity to cultivate interest in humanities, importance of social and relational issues, and intellectual challenge were most frequently selected. The opportunity for complete use of medical training, salary, and opportunity to practice psychotherapy were the expectations least met. The largest group of participants was satisfied to have chosen psychiatry (41.5%), decided on psychiatry training after medical school (35.4%), and attached importance to becoming a clinician (70.7%). CONCLUSIONS: Although the satisfaction level was high in this study, addressing the areas in which expectations were not met may increase the satisfaction of psychiatry residents and the selection of psychiatry as a specialty.

Dandy-Walker Malformation Presenting with Affective Symptoms.

Dandy-Walker malformation is defined by enlarged posterior fossa, cystic dilatation of the fourth ventricle, and cerebellar hypoplasia. Although developmental delay and mental retardation are common in Dandy-Walker malformation cases, other comorbid psychiatric conditions have been rarely reported. There are limited numbers of case reports about comorbidity of bipolar disorder with Dandy-Walker malformation in the literature. Herein, a Dandy-Walker malformation case presenting affective symptoms is reported, and psychiatric symptoms which might be seen in this rare malformation are discussed along with diagnosis, treatment, and follow-up processes. A 27-year-old male patient, hospitalized for compulsory treatment, had been diagnosed with Dandy-Walker malformation in childhood. First complaints were attention deficiency, behavioral problems, learning difficulties; and manic and depressive episodes have occurred during follow-ups. He recently complained of decreased need for sleep, irritability, and increased speed of thought, and psychiatric examination was consistent with manic episode. Cranial computed tomography (CT) revealed bilateral ventriculomegaly, enlarged third and fourth ventricles with posterior fossa cyst, and cerebellar hypoplasia. His treatment included 30 mg/day aripiprazole, 1000 mg/day valproic acid, 200 mg/day quetiapine, 4 mg/day biperiden, and 100 mg/month paliperidone palmitate. Beside its traditional role in the regulation of coordination and motor functions, cerebellum is increasingly emphasized for its involvement in the mood regulation. Thus, as seen in Dandy-Walker malformation, cerebellar anomalies are suggested to play a role in the pathophysiology of mood disorders. Further studies are needed to better understand the relationship between mood disorders and cerebellum. Moreover, treatment options should be considered carefully in terms of resistance to treatment and potential side effects, for psychiatric disorders occurring in these cases; and detailed examinations, including cranial imaging, would be beneficial in bipolar cases with early onset, unresponsiveness to treatment, presenting atypical symptoms, mental retardation, and developmental delay as well as neurological symptoms and signs.

Psychiatric symptoms and disorders among Yazidi children and adolescents immediately after forced migration following ISIS attacks.

BACKGROUND: The aim of the present study was to evaluate psychiatric problems and disorders among Yazidi Kurd refugee children and adolescents, who were assessed immediately after their forced migration following life-threatening attacks by ISIS terrorists. METHODS: We retrospectively analyzed the psychiatric assessments of 38 Yazidi children and adolescents (age 2-18, mean 12 years, m:f = 16:22), which were performed upon their arrival at the refugee camp. RESULTS: All children and adolescents exhibited psychiatric problems and disorders, 50 % had one, and 50 % had more than one. The most relevant problems were disturbed sleeping (71 % of children), followed by depression (36.8 %), conversion disorders (28.9 %), adjustment (21.8 %), acute (18.4 %) and posttraumatic stress (PTSD, 10.5 %) disorders, and non-organic enuresis (18.4 %). CONCLUSION: Our study confirms the results of previous studies, asserting that refugee children and adolescents do not just suffer from PTSD but from various other problems that are already present in the first days of resettlement. Children and adolescents living in refugee camps urgently need psychosocial support.

Relationship of Suicidal Ideation and Behavior to Attachment Style in Patients with Major Depression.

INTRODUCTION: The attachment theory aims to understand close relationships in adulthood based on the relationship of a child with the caregiver. Attachment styles are classified as secure, preoccupied, fearful and dismissing, which are the subtypes of insecure attachment style. Insecure attachment is suggested to be related to depression and suicide. In this study, the relationship of suicidal ideation and behavior to attachment style is investigated in patients diagnosed with major depression. METHODS: Sixty-two patients diagnosed with major depressive disorder according to the DSM-IV-TR criteria were taken and divided into two groups, 31 patients with and 31 patients without a past suicide attempt. Sixty healthy volunteers matched with the patients for age, gender and education and comprised the control group. Sociodemographic and clinical data form, Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Hamilton Depression Rating Scale (HDRS), Experiences in Close Relationships Scale (ECR), Scale of Suicidal Ideation and Suicidal Behavior Scale were applied to the groups. RESULTS: In the patients with depression, ECR anxiety and avoidance scores were found to be higher compared with those in the control group. There were no differences in the anxiety and avoidance scores between the patients with and without suicide attempt. The rate of participants who showed secure attachment style in the control group was higher than that of those with depression. In the patients with fearful attachment style, the suicide attempt rate was found to be higher than the other groups. A positively significant relationship was detected between ECR anxiety score and scores of HDRS suicide item, Scale of Suicidal Ideation and Suicidal Behavior Scale. CONCLUSION: Patients with depression were more anxious and more avoidant and showed more insecure attachment. In patients with depression with fearful attachment style, suicide attempts were more common.

[Idiopathic bilateral basal ganglia calcification (Fahr's disease) presenting with psychotic depression and criminal violence: a case report with forensic aspect]. / Psikotik depresyon ve siddet davranisi ile basvuran idiyopatik bilateral bazal ganglion kalsifikasyonu (Fahr hastaligi): adli yönü dolayisiyla bir olgu sunumu.

Fahr's disease is a rare neuropsychiatric disease characterized by bilateral intracranial calcification, primarily in the basal ganglia. The more general term, Fahr's syndrome, is used for primary and secondary basal ganglia calcification, regardless of the etiology, but the term Fahr's disease is used to describe primary, idiopathic cases. Fahr's disease may present with neurological symptoms, such as parkinsonism and extrapyramidal symptoms, dysarthria, paresis, convulsion, and syncope. Psychiatric disorders, including behavioral disorders, psychosis, and mood disorders, as well as cognitive disorders can occur. CT is useful for the diagnosis of Fahr's disease. Herein we present a patient diagnosed as Fahr's disease that presented with symptoms of depression, delusions, and auditory hallucinations. The 47-year-old male patient was hospitalized in a forensic psychiatry inpatient clinic due to aggressive behavior and was subsequently diagnosed with major depressive disorder with psychotic features. While hospitalized he was treated with antidepressant and antipsychotic drugs, as well as electroconvulsive therapy, resulting in significant improvement in his symptoms. As bilateral basal ganglia calcification was observed via CT, the patient was diagnosed as Fahr's disease. This case report emphasizes the importance of cranial imaging and detailed laboratory examination when evaluating patients with psychosis and affective symptoms. Pathologies such as Fahr's disease must be included in the differential diagnosis, especially in cases with neurological symptoms and cranial imaging findings.