Revolving Door Phenomenon and Related Factors in Schizophrenia, Bipolar Affective Disorder and Other Psychotic Disorders.

BACKGROUND: Patients with chronic mental illness are frequently hospitalized and discharged from psychiatry wards. This situation is referred to as the "revolving door phenomenon" (RDP). In addition to factors related to the patient and the disease, limited number of beds leading to shortened hospital stay are among the reasons associated with frequent hospitalization. This study aims to compare patients with RDP and patients with single hospitalization in terms of clinical, sociodemographic, and treatment-oriented characteristics in order to evaluate the risk factors causing frequent hospitalization. SUBJECTS AND METHODS: In this study, patients who were admitted and hospitalized between May 1, 2011 - May 1, 2016 were retrospectively evaluated from patient records. The RDP group consisted of 74 patients and the single-hospitalization group consisted of 59 patients who met inclusion criteria. RESULTS: The RDP group had significantly higher rates of male gender, ECT history, past suicide attempts, multiple drug treatment, clozapine use, legal incidents, and noncompliance to follow up following discharge compared to the single-hospitalization group (p<0.05). CONCLUSION: This study demonstrates that Turkey also has RDP patients with characteristics and hospitalization patterns similar to patients in countries with different cultural, social, and economic conditions. It is important to identify and correct factors that cause frequent hospitalization as it will reduce the burden of the health system as well as provide benefit to the patient.

Stress levels of healthcare workers in the COVID -19 pandemic in relation to gender roles: Is the problem limited to the work?

Objective: In addition to many medical consequences, COVID-19 pandemic has also caused some social changes especially for healthcare workers working in the front lines of the pandemic. However, this has not affected everyone equally and gender roles became a determinant especially in domestic life. Method: In this cross-sectional study with a sample of 670 healthcare workers in Turkey;a sociodemographic data form, Perceived Stress Scale (PSS), and Gender Roles Attitude Scale (GRAS) were applied to examine stress levels and their relationship with gender roles. Results: Mean PSS scores were significantly higher in women (27.03) healthcare workers than men (23.14) Women who did all or most of the housework on their own were almost three times the men (67.2% vs 22.9%) and this increased stress levels of women. In the GRAS, female participants had higher scores (173.2) than male participants (161.8);which means they were more egalitarian, and academic degree or job did not affect GRAS. Discussion: Besides many challenges related with working in pandemic period;women healthcare workers face additional distress because of the gender roles. Analyzing the effects of the pandemic without gender dimensions may be insufficient to fully understand the public health aspect of the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Turkish) Amac: Covid-19 Pandemisi, ozellikle on safhada gorev alan saglik calisanlari uzerinde bircok tibbi etkinin yaninda, bazi sosyal degisimlere de neden olmustur. Ancak bu durum herkesi esit olarak etkilememekte, toplumsal cinsiyet rolleri ozellikle ev yasaminda etkili olmaktadir. Yontem: Turkiye'den 670 saglik calisani ile yapilan bu kesitsel calismada, sosyodemografik veri formu, Algilanan Stres Olcegi (ASO) ve Toplumsal Cinsiyet Rolleri Tutum Olcegi (TCRTO) uygulanmistir. Bulgular:Ortalama ASO skorlari kadin saglik calisanlarinda (27,03) erkeklere (23,14) oranla anlamli olarak yuksek bulundu. Tum ev isini tek basina yaptigini soyleyen kadinlarin orani erkeklerin uc kati idi (67.2%/ 22.9%) ve bu durum kadinlarin stres duzeyini yukseltiyordu. TCRTO'de kadinlar (173,2), daha esitlikci tutumu gosterecek sekilde erkeklerden (161,8) daha yuksek puan aldilar. Is kolu ya da akademik duzeyin cinsiyet rolleri uzerinde etkili olmadigi bulundu. Sonuc: Pandemi kosullarinda calismanin getirdigi bircok zorlugun yani sira, kadin saglik calisanlari cinsiyet rolleri nedeniyle daha fazla stres duzeyine sahiptir. Pandeminin getirdigi halk sagligi sorunlarini tam olarak anlayabilmek icin cinsiyet rollerinin de hesaba katilmasi gerekmektedir. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Clinical Characteristics of Patients With Delirium Consulted During the First Year of the COVID-19 Pandemic, and the Role of Monocyte to Lymphocyte Ratio in Survival of COVID-19-Positive Patients With Delirium

The development of delirium can lead to severe and significant consequences for the patient. The primary aim of the study was to identify potential differences in clinical characteristics and medical management between elderly hospitalized patients with delirium and with and without coronavirus disease 2019 (COVID-19). A secondary aim was to report the short-term outcomes and possible predictors of outcomes of both patient groups. A retrospective study was conducted. Patients' records were screened for delirium. Clinical and laboratory data were collected, including baseline inflammatory markers. No significant difference was found between the patients with and the patients without COVID-19 regarding clinical characteristics and the dose of antipsychotic medication. COVID-19-positive delirium was not different from COVID-19-negative delirium in terms of length of hospital stay, intensive care, and antipsychotic needs. Monocyte to lymphocyte ratio (MLR) may be a predictor of survival in patients with COVID-19 and delirium. [Psychiatr Ann. 2022;52(8):338–348.]

Psychological outcomes of COVID-19 survivors at sixth months after diagnose: the role of kynurenine pathway metabolites in depression, anxiety, and stress.

Coronavirus disease 2019 (COVID-19) has resulted in long-term psychiatric symptoms because of the immunologic response to the virus itself as well as fundamental life changes related to the pandemic. This immune response leads to altered tryptophan (TRP)-kynurenine (KYN) pathway (TKP) metabolism, which plays an essential role in the pathophysiology of mental illnesses. We aimed to define TKP changes as a potential underlying mechanism of psychiatric disorders in post-COVID-19 patients. We measured plasma levels of several TKP markers, including KYN, TRP, kynurenic acid (KYNA), 3-hydroxykynurenine (3-HK), and quinolinic acid (QUIN), as well as the TRP/KYN, KYNA/3-HK, and KYNA/QUIN ratios, in 90 post-COVID-19 patients (on the first day of hospitalization) and 59 healthy controls (on the first admission to the Check-Up Center). An online questionnaire that included the Depression, Anxiety and Stress Scale-21 (DASS-21) was used 6 months after the initial assessment in both groups. A total of 32.2% of participants with COVID-19 showed depressive symptoms, 21.1% exhibited anxiety, and 33.3% had signs of stress at follow-up, while 6.6% of healthy controls exhibited depressive and anxiety symptoms and 18.6% had signs of stress. TRP and 3-HK were negative predictors of anxiety and stress, but KYN positively predicted anxiety and stress. Moreover, TRP negatively predicted depression, while KYNA/3-HK was a negative predictor of anxiety. The correlation between depression, anxiety, and stress and TKP activation in COVID-19 could provide prospective biomarkers, especially the reduction in TRP and 3HK levels and the increase in KYN. Our results suggest that the alteration of TKP is not only a potential biomarker of viral infection-related long-term psychiatric disorders but also that the therapy targets future viral infections related to depression and anxiety.