Impact of lipodystrophy on health-related quality of life: the QuaLip study.

BACKGROUND: Lipodystrophy is a rare disease characterized by loss of adipose tissue. Natural history studies have demonstrated significant burden of disease; however, there is limited data on the impact of lipodystrophy on quality of life (QoL) and psychoemotional well-being. The QuaLip study is a prospective observational real-world study that aims to determine the impact of lipodystrophy on QoL and psychoemotional well-being and explore subjective burden of the disease. Sixty-seven adult patients and eight pediatric patients with lipodystrophy were included. Patients were followed up for 24 months and assessments were repeated every three months. Patients were examined by licensed psychiatrists at baseline, and at year 1 and year 2 visits. RESULTS: Eighteen (27.69%) of 65 adult patients (two subjects refused psychiatric assessment) were diagnosed with a psychiatric disorder (e.g., depressive episodes, mixed anxiety and depressive disorder, anxiety disorder, adjustment disorder, recurrent depression, panic disorder, generalized anxiety disorder, unspecified mood disorder, nonorganic sleep disorder, post-traumatic stress disorder, depressive episode comorbidity, social phobia and obsessive-compulsive disorder comorbidity). Lipodystrophy disease and QoL questionnaires revealed a significant disease burden over the study period. More than one-third of patients reported depression symptoms on the Beck Depression Inventory and more than one-fourth of the patients reported significant hunger throughout the study period. Physical appearance, fatigue, and pain contributed to the disease burden. QoL scores were lower in patients with psychiatric disease and in those with poor metabolic control. Attention deficit hyperactivity disorder, depressive disorder, sub-threshold depressive symptoms, obsessive-compulsive disorder, appetite problems, and issues with physical appearance were identified in selected pediatric subjects. CONCLUSIONS: Lipodystrophy has a significant impact on QoL and psychoemotional well-being. Psychiatric disorders seem to be underdiagnosed among patients with lipodystrophy.

Clinical Effects of Cannabis Use in First-Episode Acute Psychotic Patients.

Introduction: Cannabis is the most widely used illegal psychoactive substance worldwide. Although there are clinical studies examining the differences between psychotic symptoms emerging after cannabis use and non-cannabis-related psychotic symptoms, data are limited in the scientific literature. We aimed to investigate the effects of cannabis use on psychotic symptoms and compare the cognitive function differences between the cannabis-user and non-user groups. Methods: First-episode psychotic patients were included in the study and divided into two groups based on cannabis use. Participants with cannabis use and without cannabis use were compared in terms of socio-demographic factors, psychotic symptoms, cognitive functions, and childhood trauma. All patients were assessed twice, during recruitment and after treatment for psychotic symptoms. Results: A total of 38 patients comprising of 18 patients with a history of cannabis use and 20 patients without a history of cannabis use were included. There were significant correlations between cannabis use, and living apart from family and family history of substance abuse. Negative psychotic symptoms were higher in the non-user group. The negative psychotic symptoms improved more significantly after treatment in the non-user group. There was a significant correlation between cannabis use and Stroop Color-Word Test scores. Conclusion: Our results give us a chance to argue that psychosis has different features in people with and without a history of cannabis use. These two phenomena could differ in many ways, so different prevention strategies and treatment options should be considered.

Effect of COVID-19 Pandemic on Sleep Quality and Mental State of Frontline Pulmonologists.

Introduction: This study aims to determine the sleep quality and its relationship with anxiety and depressive symptoms, working conditions and other factors among the frontline pulmonologists on active duty during the COVID-19 pandemic. Method: An online survey was conducted among pulmonologists in Turkey. The survey link was e-mailed to the members of the professional societies of pulmonologists. The volunteers were asked to fill in questions about their sociodemographics, medical and psychiatric history, working and housing conditions, perceived levels of support during the pandemic, as well as the sleep habits before the pandemic. Also, questions investigating the severity/level of their worries were inquired and they were asked to fill in two scale forms (the Hospital Anxiety Depression Scale and Pittsburgh Sleep Quality Index-PSQI). Results: The sample consisted of 179 pulmonologists who were divided into two groups according to PSQI as good sleepers (PSQI ≤5) and poor sleepers (PSQI >5). It was observed that 59.2% of the participants had poor sleep quality during the pandemic. Being anxious (p<0.0001, Odds ratio [OR]=0.139, 95% Confidence Interval [CI] [0.052-0.372]), working in intensive care unit (p=0.046, OR=2.363, 95% CI [1.015-5.497]), worry level about excessive increase of the number of patients above the capacity of the institution they worked in (p=0.018, OR=1.755, 95% CI [1.102-2.794]) and being dissatisfied with ones' sleep before the pandemic (p<0.016, OR=0.272, 95% CI [0.094-0.786]) were found to be the main factors that negatively affected the quality of sleep of pulmonologists during the pandemic. Conclusion: More than half of the pulmonologists in our sample group had low sleep quality during the pandemic. For establishing a good sleep regime for clinicians, its crucial to consider certain interventions on the affecting factors.