Expressing emotions, rejection sensitivity, and attachment in patients with fibromyalgia.

Objectives: This study aimed to examine emotional awareness, control of emotions, and the childhood attachment process in fibromyalgia patients. Patients and methods: The observational study was conducted with 117 participants (14 males, 103 females; mean age: 43.9±9.0 years; range, 22 to 64 years) between February 20, 2022, and May 20, 2022. Sixty-one patients and 56 healthy control subjects filled out a form including sociodemographic data, such as age, sex, occupation, and educational status. In addition, the participants answered the Expressing Emotions Scale, Rejection Sensitivity Scale, and Experiences in Close Relationships Scale. Results: In our study, Expressing Emotions Scale scores are significantly higher in the healthy control group than in the patient group (p<0.05). Rejection Sensitivity Scale scores are significantly higher in the patient group than in the healthy control group (p<0.05). In the Experiences in Close Relationships Scale, a significant difference was determined between the patient and control groups in the avoidant attachment subdimension (p<0.05). Similarly, a significant difference was observed between both groups in terms of the anxiety attachment subdimension (p<0.05). Conclusion: The ability to express emotions is lower and avoidant and anxious attachment rates are higher in fibromyalgia patients.

Oxytocin in the Treatment of Psychiatric Disorders.

Oxytocin is a peptide hormone that is most known for its role in reproduction. However, many effects other than reproduction have been defined. The lifetime prevalence of mental disorders is approximately 20%, and they have a significant ratio among the diseases that lead to disability. Treatment resistance may cause the mental disorder to become chronic and increase disability. With the examination of the oxytocinergic system, both the elucidation of the etiology of the diseases and their evaluation as a new treatment option have come to the fore. In various studies, it has been desired to create a more effective treatment model by measuring the level of oxytocin in psychiatric disorders, examining its receptor, and applying exogenous oxytocin in the treatment. In this review, an overview of oxytocin's efficacy in treatment is presented by considering the relationship between psychiatric disorders and the oxytocinergic system.

Manganese Intoxication Presenting with Depressive Symptoms: A Case Report.

Manganese regulates many enzymes in the human body and is essential for normal development and bodily function. Chronic manganese poisoning has an insidious and progressive course and usually begins with nonspecific complaints such as headache, fatigue, sleep disturbances, irritability and emotional instability. In the following process, neurological symptoms like parkinsonism are added. A severe clinical condition that is irreversible may occur. In this case report, a female patient who applied to the psychiatry outpatient clinic with depressive symptoms and was diagnosed with manganese intoxication in the following period will be presented.

The "Non-Treated" Versus "LT3-Treated" Protocols of Short-Term Hypothyroidism Induction in Differentiated Thyroid Cancer: An Analysis of Hypothyroid Complications, Mood Disorders, and Quality of Life.

This study aimed to compare "non-treated" versus "levotriiodothyronine (LT3)-treated" protocols of short-term hypothyroidism induction prior to radioactive iodine (RAI) ablation therapy in differentiated thyroid cancer (DTC). A total of 120 DTC patients who had thyroxine withdrawal either via 4-week hypothyroidism induction (non-treated group, n=60) or 2-week administration and then 2-week withdrawal of LT3 (LT3-treated group, n=60) to induce hypothyroid state prior to RAI ablation after initial surgery were included. Complications related to hypothyroidism-induction, Beck Depression Inventory (BDI), Hospital Anxiety-Depression Scale (HADS), and SF-36 health-related quality of life (HRQoL) scores were recorded. In the non-treated group, transition from euthyroid to hypothyroid state was associated with significant increase in the likelihood of moderate-to-severe depression on BDI (p<0.001), presence of depression on HADS-D (p<0.001), presence of anxiety on HADS-A (6.7% during euthyroid state vs. 33.3% during hypothyroid state, p<0.001), and major syndrome on BPRS (0.0 vs. 10.0%, p=0.001) as well as significant decrease in all SF-36 HRQoL domain scores (p<0.001 for each). In conclusion, our findings indicate the likelihood of L3-treatment to enable a more favorable transition period from euthyroid to hypothyroid state without experiencing a deterioration in depression, anxiety, or HRQoL.

Examination of eating and nutritional habits in health care workers during the COVID-19 pandemic.

OBJECTIVES: Health care workers are in the high-risk group in terms of contracting infection because of their role in providing care to patients with COVID-19. We aim to examine the relationship between perceived stress, emotional eating, and nutritional habits in health care workers during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted through an online survey in Turkey between July 1, 2021 and August 15, 2021. Overall, 405 participants age 19 to 67 y completed an online survey incorporating the Emotional Eating Scale (Cronbach's α = 0.84), Perceived Stress Scale (Cronbach's α = 0.84), and Nutrition Change Process Scale (Cronbach's α = 0.90). We gathered data on weight, height, and changes in eating habits during the pandemic to analyze how the pandemic affected dietary and nutritional practices. RESULTS: The majority of respondents were female (67.7%). Most respondents (58%) reported changing their eating and nutritional habits during the pandemic. Economic concern and concern about finding food and water due to COVID-19 were found to affect changes in eating and dietary habits (odds ratio [OR]: 2.55; 95% confidence interval [CI], 1.69-3.84; P < 0.001 and OR: 2.1; 95% CI, 1.39-3.18; P < 0.001, respectively). Losing a loved one because of COVID-19 was determined as an independent risk factor for eating and dietary habits (OR: 29.5; 95% CI, 2.23-38.9; P = 0.010). CONCLUSIONS: Perceived stress and emotional eating are related to changes in eating/dietary habits among health care workers during the pandemic. We recommend healthy food choices and increased physical activity to reduce emotional eating and mitigate stress.

The Relationship between COVID-19 Protection Behaviors and Pandemic-Related Knowledge, Perceptions, Worry Content, and Public Trust in a Turkish Sample.

Background: This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Methods: Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective behaviors (hand cleaning, wearing a face mask, and physical distancing) to prevent COVID-19 were examined. The impacts of the following variables on protective behaviors were investigated using logistic regression analysis: knowledge, cognitive and affective risk perception, pandemic-related worry content, public trust, conspiracy thinking, and COVID-19 vaccine willingness. Results: Out of a total of 4210 adult respondents, 13.8% reported nonadherence to protection behavior, and 86.2% reported full adherence. Males and young (aged 18−30 years) people tend to show less adherence. Perceived self-efficacy, susceptibility, and correct knowledge were positively related to more adherence to protective behavior. Perceptual and emotional factors explaining protective behavior were perceived proximity, stress level, and worrying about the relatives who depended on them. Trust in health professionals and vaccine willingness were positive predictors, while conspiracy thinking and acquiring less information (<2, daily) were negative predictors. Unexpectedly, trust in the Ministry of Health showed a weak but negative association with protection behavior. Conclusions: Perceived stress, altruistic worries, and public trust seem to shape protection behaviors in addition to individuals' knowledge and cognitive risk perception in respondents. Males and young people may have a greater risk for nonadherence. Reliable, transparent, and culture-specific health communication that considers these issues is required.

Retinal nerve fiber layer decrease and choroidal layer increase after four weeks of buprenorphine/naloxone maintenance treatment in opioid use disorder

Background and Objectives: Spectral-domain optical coherence tomography (SD-OCT) findings in substance use disorders have been investigated in recent years. In this study, we compared the retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL), the inner plexiform layer (IPL), and the choroid thickness (CT) of OUD and control groups before and after buprenorphine/naloxone maintenance treatment (BN-MT).MethodsThe OUD group consisted of 46 male subjects and the control group consisted of 49 male subjects. Patients with chronic opioid use and opioid positivity in their urine during the initial SD-OCT application were included in the study. At the end of the fourth week of BN-MT, SD-OCT was repeated and BN positivity was detected in the urine of the patients at this time.ResultsThere was a significant difference between OUD and control groups in terms of nasal superior and CT values of both eyes (p<0.05) before BN use. The values of RNFL sectors and CT of both eyes before and after BN-MT differed significantly (p<0.05); CT increased and RNFL sectors decreased. After BN-MT, psychometric scales differed significantly in favor of the patients (p<0.05). The SD-OCT values of the OUD group after BN-MT were compared with the control group: the right IPL (p=0.003), the left IPL (p=0.023), the right N (p=0.001) and the left N (p<0.001) values were significantly lower in the OUD group.ConclusionThis is the first study to show the SD-OCT findings of patients with OUD before and after BN-MT. The findings of this study may indicate possible effects of chronic opioid use in patients and/or possible effects of exogenous opioid or BN present in the body during SD-OCT applications. However, based on our findings, it is not possible to distinguish between the two possible outcomes. The fact that the use of BN acting through opioid receptors has different effects from exogenous opioids may be due to different receptor profiles. (AU)

'COVID-Somnia' in healthcare workers during the pandemic.

OBJECTIVES: Sleep disorders associated with COVID-19 pandemic are termed as 'COVID-somnia.' In this study, we sought to assess the prevalence of COVID-somnia in healthcare workers, establish the factors that trigger this condition, and to investigate its relationship with anxiety and depression symptoms. METHODS: This cross-sectional study was conducted between April 2021 and June 2021, and it included healthcare workers who served during the pandemic. Participants' demographic data, Beck Depression and Anxiety Inventories, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index (ISI) were used, and the results were statistically analyzed. Multiple analyses of factors affecting ESS and ISI scores were evaluated using binary logistic regression model and PSQI score were analyzed using a multiple linear regression model. RESULTS: A total of 1,111 healthcare workers who served during the pandemic voluntarily enrolled to the study. The mean age was 37.3 ± 8.48 years, and 63.5% were females. Our study showed that the healthcare workers, evaluated with the PSQI, experienced a deterioration of sleep quality. Primary factors affecting this are working on the front line, the presence of chronic diseases, depression, and anxiety. Regression analyses identified depression and anxiety as the common factors affecting ESS, ISI, and PSQI scores. CONCLUSION: Raising awareness regarding COVID-somnia among healthcare workers, who play a leading role in curbing the pandemic, would reduce sleep disturbances, depression, and anxiety. It would also contribute to the planning and implementation of preventive and therapeutic mental health programs with a multidisciplinary approach.

COVID-19 Survivors' Intensive Care Unit Experiences and Their Possible Effects on Mental Health: A Qualitative Study.

ABSTRACT: It is known that being hospitalized in the intensive care unit (ICU) for any reason is a risk factor for future psychiatric problems. This qualitative study aims to identify the experiences of coronavirus disease 2019 (COVID-19) ICU survivors and provide insights for relevant mental health problems after being discharged. Participants were COVID-19 patients discharged from ICUs of a secondary care hospital. The experiences of 21 ICU survivors were evaluated using Colaizzi's 7-step approach, which were determined by the purposeful sampling method. There were three themes generated from the interviews as "emotions on COVID-19 diagnosis," "feelings about ICU stay and health care providers," and "life in the shadow of COVID-19." Two subthemes for every single theme were generated, and a total of 19 codes were extracted. It is essential to understand the individual's unique experiences in designing preventive interventions and apply individual preventive mental health interventions during ICU stay.

Implications of Childhood Trauma on Suicidal Behavior and Deliberate Self-Harm in Patients with Major Depressive Disorder.

BACKGROUND: Traumatic experiences in the first years of life have an important role in the occurrence of major depression as well as many psychiatric diseases. The aim of this study is to investigate the relationship between childhood trauma (CT), suicidal behavior and deliberate self-harm (DSH) behavior in patients who are diagnosed with major depressive disorder (MDD). SUBJECTS AND METHODS: 106 patients who were admitted with depressive complaints to the psychiatry outpatient clinic of Recep Tayyip Erdogan University Training and Research Hospital in Turkey were included in the study. Sociodemographic and clinical features data form, Hamilton Depression Rating Scale (HAD-D), Childhood Trauma Questionnaire (CTQ-28) and Intentional Self-harm Questionnaire (DSHI) were applied to all of the cases. RESULTS: 86 (81.1%) of the cases were female and 20 (18.9%) were male. It was determined that 68.9% of the patients had CT, 49.1% had a history of DSH, and 52.1% had a suicide attempt history. It was determined that 75% of those with DSH behavior had a history of suicide attempt. There was a significant difference between the groups (p˂0.001). When the subtypes of CT, suicide ideation, suicide attempt and DSH behavior, were compared to each other, a significant relationship was found for all of the subtypes. A significant correlation was found between the number of CT and suicide attempts and DSH (p˂0.001). CONCLUSIONS: In this study, high levels of CT and its subtypes were found in patients with MDD. In the presence of CT and all of its subtypes, suicide attempt and DSH were significantly higher. In the follow-up of cases diagnosed with MDD, questioning CT is important in terms of suicide attempt and prevention of DSH.

Relationships between childhood trauma and dissociative, psychotic symptoms in patients with schizophrenia: a case-control study.

BACKGROUND: Childhood trauma (CT) is an important risk factor in the emergence and clinical course of psychiatric disorders. In the latest literature, an association exists between CT and patients with schizophrenia. There is also a strong relationship between the dissociative symptoms of schizophrenia and the presence of CT. AIMS: The aim of this study is to examine the relationship between CT and dissociative, positive and negative symptoms in patients with schizophrenia. METHODS: One hundred patients with schizophrenia and 100 healthy volunteers were included in the study. The Sociodemographic Data Form, Dissociative Experiences Scale (DES), Positive and Negative Syndrome Scale (PANSS), and Childhood Trauma Questionnaire (CTQ) were administered to all participants. RESULTS: The CTQ and DES scores of the schizophrenia group were significantly higher than those of the control group. In patients with schizophrenia, a positive association was found between positive symptoms and DES scores. In terms of negative symptoms, a positive association was found between apathetic social withdrawal and CTQ-emotional neglect (EN), CTQ-physical neglect (PN) and CTQ total scores. There was a significant positive correlation between CTQ-EN scores and negative symptoms and PANSS scores. No significant relationship was found between negative symptoms and DES scores. CONCLUSIONS: High rates of CT and dissociative symptoms are seen in patients with schizophrenia. In addition, the findings of the relationship between CT and dissociative, positive and negative symptoms are also noteworthy. Therefore, it may be important for clinicians to assess trauma history during the psychiatric evaluation of patients with schizophrenia.

The Occurrence of Funeral Mania After Bereavement: A Case Report.

Stressful or traumatic life events can lead to emergence of mood episodes. Events such as migration, relocation, job loss, bankruptcy, economic loss, divorce, natural disasters, accidental injury, or the loss of a loved one can trigger the first episode of bipolar disorder. After such life events, symptoms of depressive episodes often appear. Funeral mania, on the other hand, is defined as the emergence of manic episodes following the death of a close family member. Information on funeral mania, which occurs shortly after the loss of a loved one, is limited with a few case reports. In this study, a 26-year-old female patient who presented with the symptoms of a manic episode for the first time after her father's death and who had no previous psychiatric disease or treatment history was presented in the light of findings in the literature. It is noteworthy that the patient, who was followed up with the diagnosis of bipolar disorder (mania period) according to DSM-5 diagnostic criteria, had a temporal closeness between her mood symptoms and her father's death, and had not developed such a reaction to previous traumatic life events. Therefore, the diagnosis was evaluated as funeral mania. It should be kept in mind that, although rare, symptoms of mania can be seen among possible grief reactions.

Effects of Chronic Suppression or Oversuppression of Thyroid-Stimulating Hormone on Psychological Symptoms and Sleep Quality in Patients with Differentiated Thyroid Cancer.

In differentiated thyroid cancer (DTC), the standard treatment includes total thyroidectomy and lifetime levothyroxine (LT4) replacement. However, long-term exogenous LT4 has become controversial due to the adverse effects of oversuppression. The study included 191 patients (aged 18-76 years) with a prospective diagnosis of non-metastatic DTC and 79 healthy individuals. The patients with DTC were stratified into three groups according to their TSH levels: suppressed thyrotropin if TSH was below 0.1 µIU/ml, mildly suppressed thyrotropin if TSH was between 0.11 and 0.49 µIU/ml, and low-normal thyrotropin if THS was between 0.5 and 2 µIU/ml. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Anxiety Sensitivity Index (ASI), Short Symptom Inventory (SSI), and Pittsburgh Sleep Quality Index (PSQI) were administered to all participants. It was found that the BDI, BAI, SSI and PSQI scores were worse in patients with DTC (p=0.024, p=0.014, p=0.012, and p=0.001, respectively). According to theTSH levels, the mean ASI was found to be higher in the suppressed and mildly suppressed thyrotropin groups (19±14.4 vs. 10.6±11.1; 16.4±14.9 vs. 10.6±11.1, p=0.024, respectively), the mean SSI was found higher in the suppressed group (61.0±55.5 vs. 35.1±37.0, p=0.046), and the mean PSQI was higher in all three groups (7.94±3.97 vs. 5.35±4.13; 7.21±4.59 vs. 5.35±4.13; 7.13±4.62 vs. 5.35±4.13, p=0.006) when compared with the controls. No significant difference was found between the groups. A positive correlation was detected in the duration of LT4 use and BDI and SSI, and a weak, negative correlation was detected between TSH levels and ASI and PSQI. Based on our study, it was found that depression, anxiety disorders, and sleep problems were more prevalent in patients with DTC, being more prominent in the suppressed TSH group. These results were inversely correlated with TSH values and positively correlated with the duration of LT4 use. Unnecessary LT4 oversuppression should be avoided in patients with DTC.

Levels of anxiety sensitivity, somatosensory amplification and alexithymia in patients with unexplained infertility.

OBJECTIVE: In this study, we aimed to focus on the psychological aspect of unexplained infertility by comparing their psychological features to those of infertile patients with a known causes and fertile patients. PATIENTS AND METHODS: Sixty unexplained infertility patients, 50 infertile patients with a known cause and 56 fertile patients were included in the study. Patients were evaluated using socio-demographic data form, Toronto Alexithymia Scale (TAS-20), Somatosensory Amplification Scale (SAS) and Anxiety Sensitivity Index (ASI-3). RESULTS: No significant differences in the levels of alexithymia, somatosensory amplification and anxiety sensitivity were detected between the groups (P > .05). When the correlation of clinical scale scores with each other was analysed in the whole group of infertile patients regardless of the cause, a weak positive correlation was found between anxiety sensitivity and difficulty in identifying feelings. CONCLUSION: In our study, it has been found out that; regardless of the knowledge of the aetiology of infertility, the levels of alexithymia, somatosensory amplification and anxiety sensitivity of infertile cases did not differ from those of fertile women. However, it has been shown that as the difficulty in identifying emotions increases in infertile cases, anxiety sensitivity, which may cause psychological infertility, also increases.

The level of depression, anxiety, and sleep quality in pregnancy during coronavirus disease 2019 pandemic.

AIM: We aimed to evaluate the mental health and sleep quality of pregnant women in different trimesters during coronavirus disease 2019 (COVID-19) pandemic and investigate the effect of quarantine and new lifestyle changes that come into our lives with pandemic with on this subject. METHODS: It was conducted on pregnant women (n = 149) who attended routine pregnancy prenatal visit during their pregnancy weeks. The data were collected using sociodemographic and clinical data form, Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) to evaluate maternal depression and anxiety. RESULTS: A significant correlation was observed between the week of gestation and depression, anxiety, and defective sleep scores (p < 0.001). A moderate positive correlation was found between the week of gestation and depression (r: 0.628). A high level of positive correlation was found between the week of gestation and defective sleep quality and anxiety scores (r: 0.858, r: 0.754). A statistically significant increase in depression, anxiety, and defective sleep quality was found in the group staying in home quarantine (p = 0.002). CONCLUSION: This study showed that the COVID-19 pandemic can cause depression, anxiety, and serious sleep disorders in pregnant women. The depression and anxiety scores of pregnant women in home quarantine were also found to be higher than the group not in quarantine. As the week of gestation progresses, mental health symptoms worsen and sleep quality deteriorates.

Relationship between disease and disease severity and semaphorin 5A and hemogram level in obsessive-compulsive disorder.

OBJECTIVE: Semaphorin 5A (SEMA 5A) is a neuroprotein that regulates the formation of excitatory synapses between neurons, important in autoimmunity, inflammatory processes and behaviors. This study aimed to investigate the SEMA 5A levels in patients with obsessive-compulsive disorder (OCD) diagnosed for the first time and evaluate the relationship of disease and disease severity with the blood SEMA 5A level and hemogram. METHODS: More than 41,465 patients who applied to the psychiatry clinic from January 2018 to December 2020 were evaluated according to the DSM-5 criteria; 57 patients diagnosed with OCD for the first time, who met the inclusion criteria, were included in the study. Disease severity was investigated administering the Yale Brown Obsessive Compulsion Scale. The peripheral blood SEMA 5A level and hemogram were measured and evaluated in relation to platelet (PLT) activity, neutrophil-lymphocyte ratio (NLR), PLT-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), C-reactive protein (CRP), and compared with control group of 26 people. RESULTS: The comparison of the groups revealed a significant difference in SEMA 5A and CRP level, neutrophil count and percentage, lymphocyte count, PLT activity. A significant correlation was found between disease and SEMA 5A level, NLR, PLR, and PLT parameters in diagnosis of OCD. As the severity of OCD increased, the SEMA 5A level and PLT count decreased, while the PDW and MLR values increased. CONCLUSION: In patients with OCD, a relationship was found between plasma SEMA 5A, PLT activity, NLR, PLR, and MLR activity levels with disease and the disease severity.