LGBTI Healthcare in Medical Education.

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.

THE EFFECT OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION AND PHARMACOTHERAPY ON SERUM PROTEIN S100B IN TREATMENT-RESISTANT DEPRESSION.

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.

Remission of treatment-resistant obsessive-compulsive disorder with 600 milligrams of fluvoxamine daily: a case report.

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.

Is abnormal metabolism in the olfactory bulb and amygdala associated with bipolar disorder?

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.

Recent Traumatic Episode Protocol EMDR Applied Online for COVID-19-Related Symptoms of Turkish Health Care Workers Diagnosed with COVID-19-Related PTSD: A Pilot Study.

Background: This study investigates the effect of the online Eye Movement Desensitization and Reprocessing Recent Traumatic Episode Protocol on posttraumatic stress disorder, anxiety, depression, and burnout symptoms in healthcare workers diagnosed with pandemic-related post-traumatic stress disorder. Methods: The study included healthcare workers who applied to psychiatry outpatient clinics due to the psychiatric symptoms that developed related to the pandemic and who were diagnosed with post-traumatic stress disorder. The Beck Anxiety Inventory, Impact of Event Scale-Revised to evaluate the symptoms of post-traumatic stress disorder (avoidance, intrusion, and hyperarousal), Maslach Burnout Inventory, and Beck Depression Inventory were used for the assessment. The tests were administered 3 times (pre-treatment, post-treatment, and at 1-month follow-up). Results: This study included 14 healthcare workers diagnosed with post-traumatic stress disorder; 2 (14.3%) physicians, 2 (14.3%) nurses, 4 (28.6%) other-healthcare workers/medical staff, and 6 (42.8%) other healthcare workers/non-medical staff. There was a significant decrease in Impact of Event Scale-Revised total score, the intrusion and hyper-arousal sub-scores between T1 and T2 (P = .018; P = .005; P = .0005, respectively) and between T1 and T3 (P < .001; P < .001; P < .001, respectively), but there was no difference between T2 and T3 (P = .89). A significant difference was found in repeated measurements of both Beck Depression Inventory [P < .001] and Beck Anxiety Inventory [P < .001] scores. There was a significant difference in emotional exhaustion, one of the subscales of Maslach Burnout Inventory (P = .09). However, there was no significant difference in depersonalization (P = .48) and personal accomplishment (P = .66). Conclusions: Recent Traumatic Episode Protocol appears to be capable of reducing symptoms of anxiety, depression, intrusion, and hyperarousal symptoms of post-traumatic stress disorder and emotional exhaustion when symptoms that developed are related to the pandemic in healthcare workers.

Gender Differences in the Symptomatology of Posttraumatic Stress Disorder among Syrian Refugees Settled in a Camp in Turkey.

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.

Substance use profile, treatment compliance, treatment outcomes and related factors in probation: a retrospective file review.

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.

The Effects of Maintenance Electroconvulsive Therapy on Hospitalization Rates.

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.