Systematic Review and Meta-analysis of Depressive Symptom Severity of Employed and Unemployed Women in Turkey.

Introduction: Depression which is one of the mood disorders, causes a decrease in the work that requires participation during the day, and affects interpersonal relationships. It is known to be a fairly common mental disorder, especially among women. The aim of this systematic review is to investigate the effect of women's employment status on the severity of depressive symptoms in Turkey. Method: We searched the databases of YÖK Thesis Center, ULAKBIM, Web of Science and Scopus to detect those studies aiming to compare the employed women with housewives in terms of the depressive symptoms measured with validated self-report scales in Turkish. Results: Of the 283 studies reported in Turkish or English as an article or dissertation, 10 met the inclusion criteria for meta-analysis. The random effects meta-analysis conducted with R 4.0.1, meta and metafor package revealed a slight and statistically nonsignificant effect of the employment status on women's depressive scores (g=-0.13 95% Confidence Interval [CI] [-0.41, 0.14]). Heterogeneity between studies was estimated at a high level (I2=90.3% 95% CI [84.3%, 94%]). Results of the meta-regression analyses implied that neither the sample size (R2=0.00%) nor the publication year (R2=5.58%) were among the main sources the heterogeneity. The findings suggest that the risk of having depressive symptoms is nearly same in employed women as in housewives. Discussion: Hence, employment status is unlikely to be among the main factors leading to relatively higher prevalence of depression among women.

Validity and Reliability Study of Mental Health Recovery Measure's Turkish Version. / Ruh Sagligi Iyilesme Ölçegi'nin Türkçe Formunun Geçerlik ve Güvenirlik Çalismasi.

OBJECTIVE: The present study aims to translate into Turkish and investigate the validity and reliability of the Mental Health Recovery Measure (MHRM). METHOD: The sample consisted of 343 outpatients - and in-patients under treatment for a variety of psychiatric diagnoses at a state hospital and a university research hospital. The MHRM along with the Subjective Recovery Assessment Scale (SRAS), Psychological Well Being Scale (PWBS), Emotional Eating Scale (EES), and The Internalized Stigma of Mental Illness Scale (ISMI). RESULTS: The mean MHRM total score was estimated at 31.66 (sd=10.02). Exploratory factor analysis revealed one single robust factor explaining 64% of the variance of the total scores. Alpha internal consistency coefficient was calculated as 0.94 and corrected item-total correlation coefficients were entirely above 0.60. The MHRM scores showed positive and strong correlations with the PWBS (r=0.695; p<0.001) and SRAS (r=0.732; p<0.001), negative and strong correlation with the ISMI (r=-0.696; p<0.001) and no correlation with the EES scores (r=-0.021; p=0.703). CONCLUSION: Our data provides initial evidence supporting the validity and reliability of the Turkish MHRM in evaluating the tendency for recovery of mental health consumers for clinical and research purposes. Further studies addressing psychometric properties of the scale are warranted.

Prevalence of Personality Disorder Diagnosed with SCID-II Among Psychiatry Patients in Turkey: Systematic Review and Meta-Analysis. / Türkiye'de Psikiyatri Hastalarinda SCID-II ile Tanilanan Kisilik Bozuklugunun Prevalansi: Sistematik Gözden Geçirme ve Metaanaliz.

OBJECTIVE: To review and summarize data on the prevalence of overall personality disorder extracted from SCID-II (Structured Clinical Interview for DSM-III Axis II Disorders) studies conducted in Turkey with samples consisting of mental health consumers, and also to elaborate on the level and sources of heterogeneity. METHOD: MEDLINE, WOS, PsycINFO, ScienceDirect databases as well as the Turkish Psychiatric Database have been systematically searched. Relevant studies conducted with samples composed of psychiatric inpatients or outpatients receiving psychiatric treatment were included. The diagnostic rate of any personality disorder was regarded as the valid indicator of the overall personality disorder prevalence; therefore, papers presenting data not conducive to this goal were excluded. RESULTS: A total of 311 papers were identified, and 55 studies were included in the qualitative synthesis. Following a critical appraisal of the quality of the data involving point prevalence rates ranging from 20% to 100%, we decided to include 35 studies in the quantitative synthesis. A random-effects meta-analysis followed by a subgroup analysis yielded a summary estimate of 52% [46 - 58%] for the prevalence of overall personality disorder. A high level of overall heterogeneity 84.8 % [80.0 - 88.4] was found to persist in each diagnostic subgroup with a particular primary diagnosis. CONCLUSION: The prevalence estimates derived from the meta-analysis of the SCID-II studies conducted in Turkey support the notion that personality disorder is present in nearly half of the mental health service consumers. That the level of heterogeneity across studies originating from Turkey alone was as high as those observed in previous reviews covering studies originating from various countries suggests that the very source of such heterogeneity might be questionable validity and reliability of SCID-II diagnoses.

Validity and Reliability of the Turkish Version of the Emotional Eater Questionnaire (EEQ-TR). / Duygusal Yeme Ölçegi'nin Türkçe Çevirisinin Geçerlik ve Güvenirlik Çalismasi.

OBJECTIVE: In this study, we aimed to translate the Emotional Eater Questionnaire (EEQ) to Turkish and investigate the reliability and validity of the Turkish version. METHOD: The participants, consisting of 749 undergraduate students majoring at nursing or midwifery, completed on the EEQ and the Oxford Happiness Scale (OHS), the Beck Depression Inventory (BDI), the Orthorexia Nervosa-11 Scale (ORTO-11), the Zarit Caregiver Burden Scale (ZCBS) and the Eating Attitude Test (EAT). RESULTS: An internal consistency coefficient of 0.84 was computed for the entire scale which, similarly to the original scale, demonstrated a three-factor structure, namely, "Disinhibition", "Type of food" and "Guilt". All corrected item-total correlations were above 0.34. The EEQ score showed negative correlations with the OHS score at a low level (r=-0.15, p<0.001), and the EAT score at a moderate level(r=-0.33, p<0.001); and positive correlations with the BDI score (r=0.16, p<0.001) at a low level and the ZCBS score at a moderate level (r=0.36, p<0.01). The variance analysis demonstrated significant differences in the EEQ scores of the normal-weight, overweight and obese students [F(2.712) =11.17, p<0.001, η2 = 0.03]. CONCLUSION: EEQ Turkish version seems to have sufficient internal consistency which supported its reliability as well as the construct validity. Our data provided additional support for the validity of the EEQ for assessing the emotional overeating tendency among the Turkish university students.

Validation of the DSM-5 Alternative Model Personality Disorder Diagnoses in Turkey, Part 1: LEAD Validity and Reliability of the Personality Functioning Ratings.

This study addresses longitudinal, expert, all data (LEAD) validity and reliability of the personality functioning ratings in Turkey, which are essential in assessing Criterion A for the entire DSM-5 alternative model for personality disorders (AMPD) diagnoses. A total of 120 consenting patients recruited at a university psychiatry clinic were rated by individual clinicians with respect to DSM-III-R and AMPD criteria. Subsequently, a LEAD panel consisting of 3 senior clinicians convened to reach a consensus personality disorder diagnosis for each participant. Blind personality functioning ratings of a subgroup of 20 participants by the same set of 4 clinicians were obtained for test-retest reliability investigation. Concordance between the LEAD and AMPD diagnoses was as good as that between the LEAD and DSM-III-R diagnoses (kappas = .68). The personality functioning scores correlated strongly (r > .50) with the sum of specific DSM-III-R diagnoses. Reliability estimates pertaining to the personality functioning scores and resultant AMPD Criterion A decisions were mostly in the good range. In conclusion, DSM-5 alternative model-oriented personality functioning ratings yield total or composite scores that are evidently valid and reliable tools to diagnose general personality disorder and to estimate its global severity.

[Validity and Reliability of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in Turkish Psychiatry Patients and Healthy Controls]. / Dünya Saglik Örgütü Yetiyitimi Degerlendirme Çizelgesi'nin (WHODAS 2.0) Türkçe Çevirisinin Geçerlik ve Güvenirliginin Psikiyatri Hastalari ve Saglikli Kontrollerde Incelenmesi.

OBJECTIVE: The present study aimed to investigate psychometric properties of a series of disability scores obtained from Turkish version of the WHODAS 2.0 interviewer-, self- and proxy-administered forms consisting of either 36 items or 12 items. METHODS: Following the translation, 35 patients with a psychiatric diagnosis and 35 healthy controls between 18 and 65 years of age selfrated their functional impairment on the WHODAS. In addition, each participant was rated by a relative and by one or two clinicians on the pertinent WHODAS forms. In order to collect evidence for validity and reliability of WHODAS general disability and domain scores, we employed a series of Student's t-tests, ROC analyses, logistic regression analyses, intraclass and Pearson's correlation analyses, Cronbach's alpha and item-total statistics. RESULTS: Regarding general disability scores, in both clinical sample and healthy controls, all three types of 36-item WHODAS displayed satisfactory or higher validity and reliability coefficients. On the other hand, for 12-item version, only the interviewer-rated form demonstrated satisfactory results only in the clinical sample. Domain disability scores yielded by the 36-item forms were generally associated with adequate or acceptable coefficients in the clinical sample, while the coefficients were unacceptable in the control group. CONCLUSION: The 36-item WHODAS interviewer-, proxy- and self-rated forms are suitable to assess general disability in Turkish mental health consumers and in healthy subjects. Among the 12-item WHODAS forms, the interviewer-rated form emerges as the sole instrument with comparable validity and reliability for measuring general disability in psychiatric patients. The domain disability scores derived from the long form and general disability scores derived from the short form is suitable for evaluating clinical subjects, but not healthy subjects.

Persistent Depression as a Novel Diagnostic Category: Results from the Menderes Depression Study.

INTRODUCTION: Persistent depressive disorder (PDD) introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 as a novel diagnostic category represents a consolidation of two separate DSM-IV categories, chronic major depressive disorder (MDD) and dysthymic disorder. The present study aims to investigate the frequency and clinical as well as socio-demographic correlates of PDD in comparison with those of episodic MDD among patients seeking treatment for depressive symptoms. METHODS: Participants were 140 depressive out-and in-patients under treatment at the psychiatry clinic of the Adnan Menderes University Research Hospital. Each patient was assessed by means of a structured clinical interview (SCID-I) and relevant psychometric instruments including the Hamilton Depression Inventory and Eskin Suicidal Behavior Inventory. RESULTS: Among the depressive patients, 61% fulfilled the criteria for PDD and 39% for episodic MDD. As compared with patients with episodic MDD, the PDD patients were older (d=.54), lower in educational attainment (d=.55), more likely to have comorbid generalized anxiety disorder (OR=3.7), and more prone to report symptoms of anxiety, hopelessness, pessimism, and somatic complaints. Nevertheless, the PDD patients displayed heterogeneous characteristics with respect to clinical severity and suicidal behavior. CONCLUSION: Our findings suggest that majority of depressive patients, including those fulfilling the criteria for MDD, have been suffering from a persistent ailment rather than an episodic disorder. Clinicians with a cross-sectional perspective are more likely to diagnose MDD, whereas those with a longitudinal perspective are more likely to identify PDD in the majority of depressive patients. The incorporation of both of these perspectives into DSM-5 in a complementary manner will possibly enhance our insight into depressive disorders and improve our treatment results.

Personality disorders in a community sample in Turkey: prevalence, associated risk factors, temperament and character dimensions.

BACKGROUND: Data from Turkey on prevalence of personality disorders (PD) in the normal population are sparse. AIMS: The present study conducted in a community sample aimed to investigate personality disorders in terms of prevalence, associated risk factors and personality dimensions. METHODS: A stratified sampling procedure allowed us to compose a sample consisting of 774 participants residing in Aydin, Turkey. The DSM-IV and ICD-10 Personality Questionnaire (DIP-Q) and the Temperament and Character Inventory (TCI) were used to assess PDs and personality dimensions, respectively. RESULTS: Roughly 20% of the participants received a PD diagnosis. Among the individual PD categories, schizotypal and obsessive-compulsive PDs were the most prevalent diagnoses. Participants with PD were more likely to have lower [corrected] self-directedness and cooperativeness scores. These risk factors and personality dimensions were most strongly associated with the cluster B disorders. CONCLUSION: New versions of the diagnostic systems should include schizotypal, obsessive-compulsive and cluster B PDs as separate diagnostic categories, and impaired self-directedness as well as cooperativeness as a general diagnostic criterion for the sake of backward and forward compatibility of the research in this field.

[Identity confusion and psychopathology in late adolescence]. / Gençlerde Kimlik Bocalamasi ve Psikopatoloji.

OBJECTIVE: The aim of this study was to investigate the relationship of identity confusion with clinical diagnoses and personality pathology. METHOD: Participants in the first part of the study were 950 high school students or graduates. The participants were 484 males and 466 females ranging in age between 16 and 25 years of age (X = 18.3, sd = 0.8). We first administered the Instrument for Assessing Identity Confusion (IFAIC), and following a random sampling procedure we selected 30 participants with an IFAIC score > or = 1 standard deviation above the mean score to constitute the identity confusion group, and 30 participants with an IFAIC score < or = 1 standard deviation below the mean score to constitute the non-confusion group. The 60 participants included in the second part of the study were clinically assessed by means of SCID-I and SCID-II interviews. FINDINGS: The percentage of the participants receiving at least one axis I diagnoses was 73.3 % in the identity confusion group as opposed to 6.6 % in the non-confusion group. Likewise, participants in the identity confusion group fulfilled more personality disorder criteria than those in the non-confusion group. When the groups were compared for each personality disorder criteria, significant differences were observed in terms of avoidant, dependent, obsessive-compulsive, self-defeating, borderline and schizotypal personality disorders. CONCLUSION: Findings of the present study do not support the view that identity confusion is a condition emerging exclusively in adolescents with borderline or psychotic personality organization.

[Validation of the Turkish versions of the short-form Conners' teacher and parent rating scales]. / Conners Kisa Form Ogretmen ve Ana Baba Derecelendirme Olçeklerinin Geçerligi.

OBJECTIVES: To investigate factorial and criterion validity as well as reliability of the Turkish translations of the 28-item Conners' Teacher Rating Scale (CTRS) and 48-item Conners' Parent Rating Scale (CPRS), which both measure attention deficit, hyperactivity, and conduct problems in children, through a series of studies conducted with either normal or clinical samples. METHOD: Normal sample data for the teacher and parent rating scales were collected at several elementary schools in Ankara through 2 different studies. The teacher rating scale sample consisted of 1539 pupils rated by their teachers, and the parent scale sample consisted of 954 pupils rated by their parents. The clinical sample consisted of 270 children diagnosed with attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ADD), and/or conduct disorder (CD), who were rated by a child psychiatrist on a DSM-IV criteria form, as well as by their parents and teachers on the respective Conners' rating scales (CRS). The patients' clinical criteria scores related to these diagnostic categories were used to evaluate, and if necessary, to modify item content of the corresponding subscales. RESULTS: Turkish versions of the CTRS and CPRS demonstrated good internal consistency as indicated by Cronbach's alpha coefficients of .95 and .90, respectively. Factor analytical data from the normal sample studies supported the construct validity of both Turkish CRS despite non-differentiation of the conduct factor from the hyperactivity factor on the teacher scale. The clinical criteria scores suggested the necessity of adapting the item content of all the subscales, except the hyperactivity subscale. CONCLUSION: The adapted and original subscales of the CRS Turkish forms demonstrated such psychometric properties that they could be employed in assessing attention deficit and disruptive behavior disorders in Turkish children.

Androgenetic alopecia: does its presence change our perceptions?

BACKGROUND: The aim of this study was to evaluate the effects of androgenetic alopecia on males with and without hair loss and to delineate the level of stress gained by this type of alopecia. METHODS: Two hundred and 52 males (175 with hair loss, 77 without hair loss), between 16 and 72 years of age, participated in the study. A hair loss form (five questions for sociodemographical features, eight questions for dermatological features, eight questions for psychological evaluation) and a list of stressful life events were used. RESULTS: Desire for treatment was significantly different between the participants with and without androgenetic alopesia (AGA; chi(2) = 5.877, d.f. = 1, P = 0.015). Regardless of the presence of AGA, 61.4% accepted AGA as a natural condition with a solution that should be sought, 38.5% as a cause for increased attention, and 56.2% thought that the psychological effects of AGA would mostly be negative. The negative effects of their AGA on other family members, relationships with the opposite sex and occupation/academic life were considered by 37.1%, 43.0% and 36.3% of the participants, respectively. None of the psychological parameters differed significantly between the participants with and without AGA. A small portion (5%) of the variance in perception of stress (0.22(2) = 0.048) might be explained by the degree of alopecia. CONCLUSION: Social and cultural differences might alter perceptions concerning AGA regardless of its presence in an individual.