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ABSTRACT: Our aim is to reveal the interaction of cultural and religious influences with professional equipment by determining the level of knowledge, sexual attitudes, and homophobia of medical students about LGBTI+ individuals. The study included 324 students from our faculty of medicine. The Hudson and Ricketts Homophobia scale, the Attitudes Towards Lesbians and Gay Men scale, and the Hendrick Sexual Attitudes scale were used with the sociodemograpic data form. Data were collected and analyzed using descriptive and inferential statistical tests. The mean score of the students from the Hudson and Ricketts Homophobia scale was 58.50. The findings of our study support that medical students consider that the education they receive in this regard is inadequate. One of the goals of undergraduate medical education is the provision of health services to all segments of society; therefore, it is recommended to make improvements in the curriculum in this regard.
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Educación Médica , Minorías Sexuales y de Género , Estudiantes de Medicina , Masculino , Femenino , Humanos , Atención a la Salud , ActitudRESUMEN
BACKGROUND: Transcranial magnetic stimulation (TMS) is considered an effective and fast option for treating patients with major depressive disorder. With the increase in treatment options, the determination of biomarkers that predict which treatment will benefit patients the most has been a matter of curiosity for researchers. SUBJECTS AND METHODS: In this study, we aimed to determine the changes in serum concentrations of S100B, a neurotrophic factor thought to play a role in psychiatric disorders after repetitive TMS (rTMS) and anti-depressant drugs (AD) therapy in patients with major depressive disorder(MDD).In this cohort study, rTMS was applied to the left dorsolateral prefrontal cortex(DLPFC) of drug-resistant MDD patients, while another group of MDD patients was treated with AD for three weeks. Patients were evaluated by psychometric tests and serum S100B concentration at baseline and following intervention. There was also a healthy control group in which patients' S100B values were compared at baseline. RESULTS: There is a population with a total of 48 participants.(16 healthy controls,16 anti-depressant treatment groups, 16 individuals who received rTMS in addition to anti-depressant ) A total of 48 participants completed the study, and the S100B levels of the rTMS group and the anti-depressant drug group were found to be significantly higher than the healthy control group. S100B values, which were higher in the anti-depressant and rTMS groups compared to healthy controls, showed a significant reduction in group time interaction (start and end of treatment). CONCLUSION: rTMS of DLPFC demonstrated an effective complementary treatment for treatment-resistant patients with MDD, especially for patients with relatively high serum S100B concentrations.
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Trastorno Depresivo Mayor , Trastorno Depresivo Resistente al Tratamiento , Humanos , Trastorno Depresivo Mayor/tratamiento farmacológico , Estimulación Magnética Transcraneal , Estudios de Cohortes , Depresión , Corteza Prefrontal , Resultado del Tratamiento , Trastorno Depresivo Resistente al Tratamiento/tratamiento farmacológico , Proteínas Sanguíneas/uso terapéutico , Subunidad beta de la Proteína de Unión al Calcio S100RESUMEN
BACKGROUND: The objective of this study is to measure the levels of sestrin-2 (SESN2) and hypoxia-inducible factor-1 alpha (HIF-1α), which can be determinants in the relevant physiopathology and etiology, assessment of the clinical severity, and identification of new treatment targets in major depressive disorder (MDD) and its subtypes. METHODS: A total of 230 volunteers, including 153 patients diagnosed with MDD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and 77 healthy controls, were included in the study. Of the MDD patients included in the study, 40 had melancholic features, 40 had anxious distress features, 38 had atypical features, and the remaining 35 had psychotic features. All participants were administered the Beck's Depression Inventory (BDI) and Clinical Global Impressions-Severity (CGI-S) scale. Serum SESN2 and HIF-1α levels of the participants were measured using the enzyme-linked immunosorbent assay (ELISA) method. RESULTS: The HIF-1α and SESN2 values of the patient group were found to be significantly lower than those of the control group (p < 0.05). The HIF-1α and SESN2 values were significantly lower in patients with melancholic, anxious distress, and atypical features compared to the control group (p < 0.05). The HIF-1α and SESN2 levels did not differ significantly between patients with psychotic features and the control group (p > 0.05). CONCLUSION: The findings of the study suggested that knowledge of SESN2 and HIF-1α levels may contribute to the explanation of the etiology of MDD, objective assessment of the severity of the disease, and identification of new treatment targets.
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Trastorno Depresivo Mayor , Humanos , Sestrinas , Ensayo de Inmunoadsorción Enzimática , HipoxiaRESUMEN
First-line drugs for obsessive-compulsive disorder (OCD) pharmacotherapy are selective serotonin reuptake inhibitors (SSRI). The medication must be continued for at least 12 weeks at an effective dosage to find the most effective SSRI. For treatment, the drug dose should be titrated to the highest tolerated dose. The manufacturer's recommended maximum dose of fluvoxamine is 300 mg per day. We reported remission after about 1 month of 600 mg (high dose) fluvoxamine, which was tolerated by a patient with OCD. The patient continued at this dose for 3 months and remained in remission.
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Fluvoxamina , Trastorno Obsesivo Compulsivo , Humanos , Fluvoxamina/uso terapéutico , Trastorno Obsesivo Compulsivo/tratamiento farmacológico , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Quimioterapia CombinadaRESUMEN
Accumulated evidence has demonstrated abnormal amygdala activation in bipolar disorder (BD). The olfactory bulb (OB) has vigorous connections with the amygdala. Although odor-related functions of the OB decreased during the evolutionary process, we hypothesized that an evolved OB with increased activation in emotion regulation may be one of the main factors affecting amygdala functions in BD. Our aim was to investigate metabolism in the OB and amygdala in patients with BD. Twenty-six patients diagnosed with BD according to DSM-5 diagnostic criteria were included in this cross-sectional study. Metabolism in the OB and amygdala was assessed using fluorodeoxyglucose positron emission tomography/CT in patients with BD. The OB and amygdala metabolism was compared with the patients' Z scores. Both OB and amygdala metabolic activities were significantly higher than in the controls. A positive correlation was detected between right/left amygdala metabolism and right OB metabolism (p < 0.05, r:467 and r:662, respectively). This study increased our understanding of the etiopathogenesis of BD. In BD, the main cause of hypermetabolism in the amygdala may be increased metabolism in the OB. During evolution, the OB may have assumed a dominant role in emotional processing rather than olfactory functions.
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Trastorno Bipolar , Humanos , Trastorno Bipolar/diagnóstico por imagen , Trastorno Bipolar/patología , Bulbo Olfatorio/diagnóstico por imagen , Bulbo Olfatorio/patología , Estudios Transversales , Amígdala del Cerebelo/patología , Emociones/fisiología , Imagen por Resonancia MagnéticaRESUMEN
BACKGROUND: This study firstly described gender differences in traumatic experiences and the symptomatology and posttraumatic stress disorder (PTSD), among Syrian refugees settled in a camp in Turkey. Secondly, we aimed to discuss the reasons for gender differences, by comparing with the studies conducted on these Syrian refugees of the same culture who are the victims of the same war in their new settlement where they had been forced to migrate. SUBJECTS AND METHODS: This cross-sectional study was carried out on 352 refugees, randomly selected from a single settlement. The diagnosis of PTSD was performed using face-to-face psychiatric interviews according to the DSM-IV-TR criteria. The Stressful Life Events Screening Questionnaire and a sociodemographic history form were administered to all participants. We compared our results with other PTSD studies on Syrian Refugees. RESULTS: Men were exposed to traumatic events 1.29 times more frequently than women. However, the prevalence of PTSD was significantly higher in women (44.1%) than in men (18.1%), with a prevalence of 30.7% in the overall sample. While symptoms of intrusion and avoidance/numbing were more prevalent in women with PTSD, there was no difference in symptoms of hypervigilance between genders. However, women reported a higher prevalence of fear response to traumatic events. CONCLUSIONS: Female refugees may be more prone than men to develop PTSD, although both genders shared the same traumatic environment in the early post-traumatic periods. The higher frequency of intrusion and avoidance/numbing may originate from an increased tendency of anxiety structural dissociation among women, alongside possibly higher peritraumatic dissociation, which may be also boosted by the higher ongoing perception of threat among female refugees. The possible role of peritraumatic and ongoing dissociation in PTSD should be taken into consideration for further research, particularly among populations under ongoing threat.
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Refugiados , Trastornos por Estrés Postraumático , Estudios Transversales , Femenino , Humanos , Masculino , Refugiados/psicología , Factores Sexuales , Trastornos por Estrés Postraumático/psicología , Siria/epidemiología , Turquía/epidemiologíaRESUMEN
BACKGROUND: This study is the second leg of a two-leg project. In the first leg, the effect of the COVID-19 pandemic on healthcare workers (HCWs) was investigated in the period between the first case in Turkey and the arrival of the first case in the hospital. OBJECTIVE: In this second leg, three months after the first evaluation, we aimed to investigate whether psychological effects of COVID-19 such as stress, anxiety, depression, and sleep quality have been changed on HCWs. METHODS: This was a 3-month observational study. 169 hospital staff who participated in the first leg of the study were reached and asked to participate in the second leg evaluation in Gaziantep University Medical Faculty Hospital.110 HCWs accepted to participate. Impact of Event Scale (EIS-R), Depression Anxiety Stress Scale (DASS-21), and Pittsburgh Sleep Quality Index (PSQI) were used to assess in both two legs. Paired Sample T-test was used for comparison of normally distributed variables. Wilcoxon test was used for the comparison of abnormally distributed variables. SPSS 22.0 software was used in the analysis of variables. RESULTS: Of the HCWs with an average age of 33.9±6.6 years, 59% (65) were males. There was no significant difference between the two legs in terms of IES-R, DASS-21, and PSQI scales. CONCLUSION: This study suggests that the psychological effects of the COVID-19 pandemic on HCWs started with the pandemic, before the arrival of the first case in the hospital. Also, these psychological effects continued similarly without significant change after the initiation of direct contact with COVID-19 patients and even after the increase in COVID-19 patients in a hospital which in they work.
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COVID-19 , Pandemias , Adulto , Ansiedad/epidemiología , COVID-19/epidemiología , Depresión/epidemiología , Depresión/etiología , Femenino , Personal de Salud/psicología , Hospitales Universitarios , Humanos , Masculino , SARS-CoV-2RESUMEN
OBJECTIVE: We aimed to compare the electrocardiographic parameters in patients with methamphetamine use to healthy controls. METHODS: The study is a cross-sectional case-control study. Sixty-eight patients diagnosed with methamphetamine use disorder (MUD) according to DSM-5 criteria and 65 subjects in healthy control group who can match the patient group with demographic data were included in the study. Heart rate, P wave dispersion, QT dispersion, QTc and Tp-e/QTc ratios were calculated in the ECGs of all participants. RESULTS: The mean age of the patients was 25.60 ± 5.70 and of the control group was 27.43 ± 6.10 (p = 0.076). There was no statistically significant difference between the blood pressure, body mass index, HDL-LDL-total cholesterol and triglyceride values of the participants (p > 0.05). Although QT dispersion was 13.68 ± 9.12 in patients with methamphetamine use disorder, it was calculated as 9.08 ± 7.85 in the control group (p = 0.002). Finally, the Tp-e/QTc ratio of the patients was higher than the healthy controls (p = 0.014). CONCLUSION: In our study, we found a significant deterioration in QT dispersion and Tp-e/QTc ratio in the MUD group. Therefore, it should be kept in mind that there is a risk of malignant arrhythmia in this patient group and care should be taken in terms of arrhythmic events during follow-up in this patient group.Key pointsPatients with methamphetamine use showed significant deterioration in QTd and Tp-e/QTcMethamphetamine users have prolonged Tp-e/QTc ratio and QTdCaution should be exercised in terms of arrhythmic events in methamphetamine users.
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Metanfetamina , Humanos , Masculino , Estudios de Casos y Controles , Estudios Transversales , Metanfetamina/efectos adversos , Electrocardiografía , Arritmias Cardíacas/inducido químicamente , Arritmias Cardíacas/diagnósticoRESUMEN
BACKGROUND: Few studies have investigated the relationship between electroconvulsive therapy (ECT) and markers of nitrosative stress and oxidative DNA damage. OBJECTIVE: The aim of this study is to examine changes in nitrosative stress and oxidative DNA damage in patients with a depressive episode treated with ECT. METHODS: The current study included 48 patients with a depressive episode treated with ECT and 30 healthy control participants. First, the serum nitrosative stress markers of nitric oxide (NOâ¢), nitric oxide synthase (NOS), and peroxynitrite (ONOO-) and the oxidative DNA damage marker 8-hydroxy-2'-deoxyguanosine (8-OHdG) were compared between the study and control groups. These parameters were also compared pre- and post-treatment for the study group. RESULTS: NOâ¢, NOS, and ONOO- levels were significantly higher in patients with depressive disorder (DD) than in the control group. NO⢠and NOS levels significantly decreased in the ECT group after treatment while 8-OHdG levels significantly increased. CONCLUSIONS: The study findings suggest that ECT may have reduced nitrosative stress levels while increasing oxidative DNA damage. More research is now needed to better understand the issue.KEY POINTSNitrosative stress levels can increase in patients with depressive disorder.Electroconvulsive therapy may reduce nitrosative stress while increasing oxidative DNA damage.These results suggest that nitrosative stress plays an important role in the mechanism of action of electroconvulsive therapy.
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Terapia Electroconvulsiva , Estrés Nitrosativo , Humanos , Estrés Nitrosativo/genética , Óxido Nítrico/farmacología , 8-Hidroxi-2'-Desoxicoguanosina , Ácido Peroxinitroso/farmacología , Estrés Oxidativo/genética , Óxido Nítrico Sintasa/metabolismo , Óxido Nítrico Sintasa/farmacología , BiomarcadoresRESUMEN
We investigated the psychological impact of the COVID-19 outbreak in terms of stress, anxiety, depression, sleep quality and affecting factors on healthcare workers (HWs) without secondary trauma thus far in the period between the first cases in Turkey and the arrival of the first case in ahospital. This descriptive cross-sectional study included 169 HWs. We used Impact of Event Scale (IES-R), Depression Anxiety Stress Scale and Pittsburgh Sleep Quality Index (PSQI) for assessment. The mean age of HWs was 33.9±6.9 years and 56.2% were males. Of the HWs; 20.7% were nurses, 33.7% doctors and 45.6% staff members. IES-R classified the HWs as follows: 15.4% of them were affected mildly, 4.7% moderately and 9.5% of them were affected severely. 42.6% of HWs had apoor sleep quality. This study shows that how HWs were affected when the outbreak had not yet reached the hospital in which they work. In total, 29.6% of the HWs were psychologically affected by mild to severe levels from the outbreak in this period. The most prevalent psychological impact was poor sleep quality. Psychological impact on HWs may have begun before the outbreak reached the hospitals; therefore, necessary measures should be taken as early as possible.
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COVID-19 , Adulto , Ansiedad , Estudios Transversales , Depresión , Brotes de Enfermedades , Personal de Salud , Hospitales Universitarios , Humanos , Masculino , SARS-CoV-2 , Calidad del Sueño , Turquía/epidemiologíaRESUMEN
OBJECTIVE: In our study, we aimed to examine Optical Coherence Tomography (OCT) findings in patients diagnosed with methamphetamine use disorder (MUD) by comparing them with healthy controls. METHODS: Sixty-five people were included in our study and 130 eyes were evaluated; 33 cases were included in the patient group with MUD according to DSM-5 diagnostic criteria and 32 as the healthy control group. Detailed biomicroscopic examinations and then both eyes were evaluated through OCT by the same ophthalmologist. RESULTS: There was no statistically significant difference between the patient and control groups in terms of gender and age (p > 0.05). When the OCT findings were evaluated, the measurements of the patients in any quadrant for retinal nerve fiber layer (RNFL) were not statistically different from the control group (p > 0.05). Macula and choroidal layer thickness did not differ between the groups (p > 0.05). Only right intraocular pressure was found to be decreased in the patient group (p = 0.026). CONCLUSIONS: There are a limited number of studies examining OCT findings in patients with MUD. Visual symptoms and intraocular pressure should be considered when evaluating patients with MUD and planning their treatment. In addition; in order for OCT findings to gain importance, which can be used as an effective method to show the possible neurodegeneration that may occur in substance use disorder, it should be supported with further research.
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Metanfetamina , Tomografía de Coherencia Óptica , Coroides , Humanos , Metanfetamina/efectos adversos , Retina/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodosRESUMEN
OBJECTIVE: A case of lithium-induced akathisia is presented, a side effect that has only rarely been reported in the literature. CASE: A 49-year-old married woman was hospitalized 4 weeks before her presentation to our outpatient clinic due to a manic episode with psychotic features. Lithium carbonate (600 mg/d) was started for mood stabilization and soon, thereafter, she developed akathisia, which did not respond to reducing the dose of risperidone and addition of propranolol and lorazepam. The akathisia resolved when lithium was discontinued and replaced with valproic acid for mood stabilization. DISCUSSION: Akathisia is commonly overlooked or misdiagnosed by physicians. This case report is presented to alert physicians to the possible emergence of akathisia when the lithium ion is prescribed for mood stabilization.
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Antipsicóticos , Litio , Antipsicóticos/efectos adversos , Femenino , Humanos , Persona de Mediana Edad , Agitación Psicomotora , Risperidona , Ácido Valproico/efectos adversosRESUMEN
OBJECTIVE: In this study, we aimed to investigate the sociodemographic characteristics of the individuals who mandated to the probation unit as the substances they use, their compliance with the programs, treatment outcomes and the relationships between these parameters. Secondly we aimed to determine the predictive factors that guide in taking protective measures. METHODS: The files of the individuals who applied to probation clinic of Gaziantep 25 Aralik State Hospital between 01.01.2019-31.12.2019 were examined retrospectively. SPSS 22.0 program was used to statistical analysis. RESULTS: Totally 1024 cases were included in the study. Most of the cases were between the ages of 16-35 (84.1%) and 68.3% of individuals were primary school graduates. Most (n: 607, 59.3%) were single in terms of marital status. Substance was detected in the urine of 30.3% of the applicants (n: 311). Among the substances detected in urine, amphetamine-methamphetamine was in the first place with 13.6%. In terms of treatment compliance levels of probation, it was seen that 593 (57.9%) reports were prepared as "no treatment required", 117 (11.4%) were "compliant to treatment" and 303 (29.6%) were "noncompliant to treatment". A statistically significant difference was found between working status and treatment outcomes (p = 0.001). When the first urine result of the patients were grouped as negative and positive; A statistically significant difference was found between the first urine test and the treatment outcomes and criminal score (for both p = 0.001).There was a statistically significant difference between the status of being a probation measure previously and the outcome of treatment (p = 0.019). CONCLUSION: In our study, the most used substance type was found to be amphetamine-methamphetamine (13.6%). Prevalence in substance use appears to be changing. This is an important finding about the prevalence of use of amphetamine-methamphetamine in Turkey. We suggest that those who have irregular jobs in the probation process, those with substance metabolites detected in the first urine, and those who have previously had probation precautions may have a poor prognosis and that it may be more effective to apply to those profiles in a general program that includes social and occupational fields.
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Criminales , Trastornos Relacionados con Sustancias , Adolescente , Adulto , Humanos , Cooperación del Paciente , Estudios Retrospectivos , Trastornos Relacionados con Sustancias/terapia , Resultado del Tratamiento , Adulto JovenRESUMEN
ABSTRACT: This study aimed to study the effect of maintenance electroconvulsive therapy (mECT) on hospitalization rates in patients who had been readmitted after acute courses of electroconvulsive therapy (ECT), and determine the most frequently used treatment schedules in mECT. Patients who had undergone mECT treatment for the last 5 years were retrospectively reviewed. Seventy patients were included in the study. The control group of 70 patients was selected from patients who received only acute ECT. Of the patients in the mECT group, 55.8% (39) were female, and 41.4% (29) were diagnosed with major depressive disorder. The mean number of patients hospitalized who received mECT after acute ECT was 0.55 ± 0.87, whereas it was 1.13 ± 1.31 in patients who received only pharmacotherapy after ECT in a covariant analysis adjusted for age and diagnosis. The most commonly used initial treatment protocol of mECT was weekly × 4, biweekly × 2, and monthly × 6. mECT is more effective in reducing hospitalization after acute ECT treatments than using psychotropic drugs alone for maintenance therapy.
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Terapia Electroconvulsiva/métodos , Hospitalización/estadística & datos numéricos , Adulto , Factores de Edad , Trastorno Bipolar/terapia , Estudios de Casos y Controles , Trastorno Depresivo Mayor/terapia , Terapia Electroconvulsiva/estadística & datos numéricos , Femenino , Humanos , Masculino , Estudios Retrospectivos , Esquizofrenia/terapia , Resultado del TratamientoRESUMEN
OBJECTIVE: We aimed to examine the electrocardiographic arrhythmia risk predictors in patients with opioid use disorder by P wave dispersion, QT dispersion, and by comparing Tp-e/QTc ratio with healthy controls. METHODS: One hundred seventeen patients who were diagnosed with opioid use disorder according to DSM-5 criteria and who were hospitalized in 25 Aralik Gaziantep State Hospital AMATEM (Alcohol and substance addiction treatment center) service and a healthy control group consisting of 168 subjects were included in the study. Electrocardiography (ECG) scans of all participants were performed in the supine position and at rest. P wave dispersion, QT dispersion, and Tp-e/QTc ratio were calculated. RESULTS: Of all the participants, 12 were women (4.21%), 273 (95.78%) were men. The mean age of all participants was 30.42 ± 9.36 years. No difference was found between the gender, mean age, marital status, educational level, and smoking status of the participants (p > 0.05). The entire patient group was using heroin. Heart rate of the patient group was calculated as 68.14 ± 13.26 beats per minute, being lower than healthy controls (p < 0.05). Although QT dispersion value was lower than healthy controls (p < 0.05); P wave dispersion did not differ between groups (p > 0.05). CONCLUSION: It is thought that the patients with opioid use disorder are at risk for cardiac arrhythmia based on our findings. Therefore, physicians should be careful about cardiac rhythm and conduction problems while organizing any treatment of these patients.