Assessment of Anxiety, Depression, Self-Esteem, and Quality-of-Life in Patients Undergoing Surgical Removal of an Eye.

Objectives: The objective of this study was to compare anxiety, depression, self-esteem, and quality of life in patients who underwent surgical removal of an eye with those of controls as well as to test the correlations of these variables in both groups. Methods: Beck anxiety inventory (BAI), Beck depression inventory (BDI), 36-item short-form health survey (SF-36), and Rosenberg self-esteem scale were administered to 29 patients with surgical removal of an eye and 30 control subjects. Results: The patient group had significantly lower scores on physical functioning, role limitations due to physical and emotional problems, pain, and general health perception domains of SF-36, as well as significantly higher BDI (p=0.004) scores as compared to controls. The study groups did not differ significantly with respect to BAI scores and energy/vitality, mental health, and social functioning domain scores of SF-36 (p>0.05). Conclusion: This population of monocular patients had similar mental health-related and Beck's Anxiety Inventory scores equivalent to the control group despite the surgical removal of one eye. However, lower scores for some SF-36 domains and higher depression levels in this patient group suggest that psychiatric rehabilitation should be considered after eye removal to improve the psychological outcomes and quality of life in these patients.

The Relationship between Anxiety and Depression Levels with Perceived Stress and Coping Strategies in Health Care Workers during the COVID-19 Pandemic.

OBJECTIVES: Coronavirus disease (COVID-19) has spread rapidly, locally and internationally after it started in Hubei province of China in December 2019. During the spread of this infectious disease in the world, health care workers are taking place as the main people in the screening and treatment of the disease. The present study aims to evaluate the relationship between anxiety and depression levels with perceived stress and coping strategies in health care workers during the COVID-19 pandemic. METHODS: In this study, 200 participants were included. Beck Anxiety Inventory (BDI), Beck Depression Inventory (BDI), Perceived Stress Scale-10 (PSS-10) and COPE (Coping Orientation to Problems Experienced) were applied. RESULTS: Mean scores for BDI and BAI were 9.2±8.9 and 8.2±9.2, respectively. BDI scores of 33 (16.5%) of 200 participants were ≥17. 62% of the participants had minimal depression, 21.5% of the participants had mild depression, 13.5 % of the participants had moderate depression, and 3% of the participants had severe depression according to BDI scores. 60.5% of the participants had minimal anxiety, 25.5% of the participants had mild anxiety, 8.5% of the participants had moderate anxiety and 5.5% of the participants had severe anxiety according to BAI scores. BAI and BDI scores of the female participants were statistically higher than the male participants. A statistically significant positive correlation was found between BAI and BDI scores and PSS-10 scores. A statistically significant difference was found in the averages of BAI and BDI, PSS-10 COPE 3 (Focus on and venting of emotions), 7 (Religious coping) and 13 (Acceptance) subscales levels in occupational groups. A statistically significant difference was found in BDI levels in the clinical units during the pandemic. CONCLUSION: This study indicated that different coping strategies can be used in health care workers regarding anxiety, depression and stress levels during the COVID-19 pandemic. While problem-solving and emotion-focused adaptive coping mechanisms help reduce symptoms, maladaptive and negative coping mechanisms can cause symptoms to exacerbate. Thus, training should be given to developing attitudes of health care workers to cope with stress.

The Relationship Between Anxiety, Depression, Suicidal Ideation and Quality of Life in Patients with Rheumatoid Arthritis.

Rheumatoid arthritis (RA) is a chronic disease and many patients with RA experience lifelong anxiety and depression. The aim of this study is to provide an assessment of anxiety, depression, suicidal ideation, disease activity and quality of life in patients with RA. Fifty patients were included in the study. Hospital Anxiety and Depression Scale (HADS), Short Form Health Survey (SF-36), Beck Scale for Suicide Ideation (BSSI) and Disease Activity Score (DAS-28) were applied. A statistically negative correlation was found between HADS-A and HADS-D scores and all subscales of SF-36. There was a statistically negative correlation between the DAS-28 score and the subscales of the SF-36 except mental health and bodily pain. Suicidal ideation was associated with anxiety and depression and BSSI scores of patients suffering from anxiety and depression are higher than the patients not suffering from anxiety and depression. There was a statistically negative correlation between BSSI and the subscales of SF-36 excepting physical role. This study indicated that anxiety, depression, quality of life, disease activity and suicidal ideation are related to each other in patients with RA. The presence of concomitant anxiety and depression may lead to suicide and poor quality of life and may worsen the prognosis of the RA.

The relationship between impulsivity and panic disorder-agoraphobia: The role of affective temperament.

There are opinions regarding that impulsivity may play a role in the pathogenesis of neuropsychiatric disorders. The aim of this study was to investigate the relationship between impulsivity and panic disorder (PD) in the patient group, to compare impulsivity and affective temperamental traits between patients and healthy controls and to investigate whether there is a relationship between impulsivity and affective temperamental traits. Participants comprised 70 patients with PD and 58 healthy volunteers. The Panic Agoraphobia Scale (PAS), the Barratt Impulsiveness Scale (BIS-11) and the Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire (TEMPS-A) were applied. Patients have significantly higher scores in affective temperament (except hyperthymic) and attentional impulsiveness subscales than the healthy controls. Positive and negative correlations were found between some PAS and BIS-11 scores as well as correlations between especially cyclothymic, hyperthymic, irritable and anxious subscale scores of the TEMPS-A and the BIS-11 scores in the patient group. The results of this study indicate a relationship between impulsivity and PD. The correlations found between affective temperament dimensions and impulsivity suggest how affective temperamental traits may influence different impulsivity dimensions.

Effect on long-term survival of psychiatric disorder, inflammation, malnutrition, and radiotherapy-related toxicity in patients with locally advanced head and neck cancer.

PURPOSE: To evaluate the effects on the long-term survival of psychiatric disorders, inflammation, malnutrition, and radiotherapy (RT)-related toxicity in patients with locally advanced head and neck cancer. METHODS: Included were 47 patients who received RT for non-metastatic locally advanced head and neck cancer. The diagnosis of psychiatric disorder was made by the Diagnostic and Statistical Manual of Mental disorders (4th edn) (DSM-IV) criteria. Malnutrition was defined as weight loss >5% of baseline during RT. Interleukin 1ß (IL-1ß), IL-6, and tumor necrosis factor-alpha (TNF-α) were analyzed by enzyme-linked immunosorbent assay (ELISA). RT-related acute toxicity was evaluated once a week using the National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 2.0. RESULTS: The mean patient age was 57.3±11.4 years (range 33-80); 42 (89.4%) patients were male. Mean disease-free (DFS) and overall survival (OS) were 53 and 55 months, respectively. Mean DFS was significantly lower in patients with psychiatric disorder compared with those without (35 vs 59 months, p=0.013) and the same applied for mean OS (41 vs 61 months, p=0.008). There was no significant difference between patients with and without malnutrition in terms of OS. Similarly, no significant difference was seen between patients with and without RT-related toxicities in terms of OS. Age, psychiatric disorder, T status, and stage differed significantly between these groups (p<0.10) in univariate analysis. The multivariate Cox regression analysis identified that the OS was significantly associated only with psychiatric disorder (odds ratio/OR: 3.22, 95% confidence interval/CI: 1.29-8.41, p=0.013). CONCLUSION: Psychiatric disorders had unfavorable effects on OS in patients with locally advanced head and neck cancer. Inflammation, malnutrition and RT-related toxicity had no significant impact on OS.

The association between depression, weight loss and leptin/ghrelin levels in male patients with head and neck cancer undergoing radiotherapy.

OBJECTIVE: This study investigated the relationship between weight loss, depression and anxiety, and appetite hormones, leptin and ghrelin levels in patients with head and neck cancer (HNC), as well as the effect of radiotherapy and antidepressant treatment on weight and these hormones. METHODS: Forty male patients with HNC and twenty physically and mentally healthy male controls were recruited for the study. Psychiatric status was evaluated with clinical interview and psychometric tests. All patients received radiotherapy and antidepressant treatment with mirtazapine that was given to patients with psychiatric disorders. Serum leptin and ghrelin levels were measured pre- and post-treatment in the patients and once in the controls. RESULTS: There was no significant difference between the serum leptin and ghrelin levels of patients and controls. The leptin levels of the patients were decreased by radiotherapy. Eleven patients were diagnosed with major depressive disorder and adjustment disorder and were classed as depressive patients. Depressive patients were affected more by radiotherapy with respect to weight loss. The basal leptin levels of depressive patients were also lower than non-depressive patients and controls. CONCLUSION: It seems that depression aggravated weight loss and, in addition, decreased leptin levels in cancer patients. Detection and treatment of psychiatric disorders may improve prognosis by preventing weight loss as well as by providing psychiatric treatment in cancer patients.

Serum ghrelin and leptin levels in patients with depression and the effects of treatment.

OBJECTIVE: Ghrelin and leptin, appetite-regulating hormones, play a role in mood regulation. Current data about the relation between leptin/ghrelin and depression are still controversial. This study aimed to investigate serum leptin and ghrelin levels in patients with depression and the effects of treatment on these levels. METHODS: Serum ghrelin and leptin levels were measured before and after treatment with antidepressant drugs and/or electroconvulsive therapy in 28 patients with depression and once in 21 healthy controls. RESULTS: Serum ghrelin levels of the patients were high in the pre-treatment. After the treatment, ghrelin levels were not different from those of the controls. We found no difference in serum levels of leptin between the patients and controls and no change with treatment. body mass index of the patients increased after the treatment especially in the drug-treated group. CONCLUSION: The present study found increased serum ghrelin levels in depressive patients and normalization with improving of depression but no alteration in leptin levels.

Manic episode associated with mega cisterna magna.

Mega cisterna magna is a part of "Dandy-Walker Complex" and it is characterized by the enlargement of the cisterna magna, morphologically intact vermis and cerebellar hemispheres. We report a case of manic attack in a 23-year-old man with mega cisterna magna. The patient was treated with quetiapine 1,000 mg/day and sodium valproate 1,500 mg/day and the symptoms were ameliorated within 2.5 months. In this case, mega cisterna magna and manic symptoms may be found together coincidentally or any cerebellar dysfunction due to mega cisterna magna may cause or contribute to the appearance of affective symptoms. To our knowledge, this is the first case reporting manic attack with psychotic symptoms associated with mega cisterna magna. This report suggests that any lesion in the cerebellum might contribute to the occurrences of some affective and psychotic symptoms seen in bipolar disorder.

The effects of galantamine hydrobromide treatment on dehydroepiandrosterone sulfate and cortisol levels in patients with chronic fatigue syndrome.

OBJECTIVE: Mental fatigue, cognitive disorders, and sleep disturbances seen in chronic fatigue syndrome (CFS) may be attributed to cholinergic deficit. A functional deficiency of cholinergic neurotransmission may cause the hypothalamic-pituitary-adrenal axis hypoactivity seen in CFS. Therefore, we investigated the alterations in stress hormones such as cortisol and dehydroepiandrosterone sulfate (DHEAS) in CFS patients before and after 4-week administration of galantamine hydrobromide, a selective acetylcholinesterase inhibitor, and aimed to investigate whether there are any relationships between the probable hormonal changes and cholinergic treatment. METHODS: Basal levels of cortisol and DHEAS were measured in 29 untreated CFS patients who were diagnosed according to Centers for Disease Control (CDC) criteria and in 20 healthy controls. In the patient group, four weeks after 8 mg/d galantamine hydrobromide treatment, cortisol and DHEAS levels were measured again. After the treatment 22 patients who stayed in study were divided into two subgroups as responders and nonresponders according to the reduction in their Newcastle Research Group ME/CFS Score Card (NRG) scores. RESULTS: Important findings of this study are lower pre-and post-treatment cortisol levels and in all CFS patients compared to controls (F=4.129, p=0.049; F=4.803, p=0.035, respectively); higher basal DHEAS values and higher DHEAS/cortisol molar ratios which were normalized following four weeks' treatment with 8 mg/d galantamine hydrobromide in the treatment-respondent group (F=5.382, p=0.029; F=5.722, p=0.025, respectively). CONCLUSION: The findings of the decrease in basal DHEAS levels and DHEAS/cortisol molar ratios normalizing with galantamine treatment may give some support to the cholinergic deficit hypothesis in CFS.