Transient Fever Response After ECT in a Patient with Catatonic Schizophrenia: A Case Report. / Katatonik Sizofreni Hastasinda EKT Sonrasi Ortaya Çikan Geçici Ates Yaniti: Olgu Sunumu.

Electroconvulsive therapy (ECT) is an effective and safe treatment method for many psychiatric disorders. In general medical practice, ECT may cause side effects as most other treatment methods do. Headache, myalgia, nausea, vomiting, confusion, anterograde amnesia are common side effects of electroconvulsive therapy. Fever; in addition to general medical conditions such as infection, malignancy, connective tissue diseases, drug treatments, malignant hyperthermia, convulsions, it can also occur due to conditions such as neuroleptic malignant syndrome (NMS), serotonin syndrome, catatonia, malignant catatonia, which are frequently encountered in psychiatry clinics. In the literature, transient fever response due to electroconvulsive therapy application have been described, albeit rarely. Although there are many proposed mechanisms for the emergence of a fever response, regardless of its cause, it is still not understood why some fever responses occur. In this article, we present the differential diagnosis of the fever response, possible causes, and the mechanisms that may reveal the secondary fever response to electroconvulsive therapy in a case with a diagnosis of catatonic schizophrenia, who developed a fever response during electroconvulsive therapy sessions and no fever response was observed at times other than electroconvulsive therapy sessions. In this case, postictal benign fever response associated with electroconvulsive therapy was considered after excluding other medical conditions that may cause a fever response after electroconvulsive therapy. Keywords: ECT, Fever, Catatonia, NMS.

Preventive and Therapeutic Mental Health Care after the Earthquake- Expert Opinion from the Psychiatric Association of Turkey. / Deprem Sonrasi Erken Dönemde Koruyucu ve Tedavi Edici Ruh Sagligi Hizmeti-Türkiye Psikiyatri Dernegi Uzman Görüsü.

Two major earthquakes hit Turkey at the Kahramanmaras region on February 6th 2023. The earthquakes affected almost 15 million individuals, resulting in more than forty thousand deaths, thousands of wounded and the destruction of ancient cities of humankind. Immediately after the earthquakes, the Psychiatric Association of Turkey organized an educational event to address the needs for a guidance on how to approach a trauma of such a big scale. The experts in this educational event summarized their presentations and prepared this review to guide the mental health professionals serving victims of this disaster. The review summarizes the early symptoms of trauma, and puts a framework on the principles of psychological first aid, the approach at the initial stages of the disaster, principles of planning, triage, and psychosocial support systems and the proper use of medications. The text covers the evaluation of the impact of trauma, aligning psychiatric practice with psychosocial interventions, the improvement of counseling skills and methods to better understand the mind during the acute post trauma phase. A set of presentations highlight the challenges in child psychiatry, brings a systematic overview to the earthquake and discuss the symptomatology, first aid and intervention principles in children and adolescents. Last, the forensic psychiatric perspective is presented, followed by a piece on the essentials of delivering bad news and the review is concluded with the emphasis on burnout, a syndrome to avoid particularly for field professionals, and possible preventive measures. Keywords: Disaster, trauma, psychosocial support, psychological first aid, acute stress disorder, post traumatic stress disorder.

A Comprehensive Assessment of Psychosocial Well-being Among Growing Rod Graduates: A Preliminary Investigation.

BACKGROUND: Traditional growing rods (TGR) encompass a long process, in which patients experience physical and psychosocial difficulties. However, the effect of repeating surgeries on the overall psychological functioning of graduated patients has not been thoroughly investigated in the literature. The aim of this study is to evaluate the psychological well-being of graduated idiopathic early-onset scoliosis patients in terms of psychopathology, neurocognition, and psychosocial functioning, and determine the accuracy of scoliosis outcome questionnaires in these regards. METHODS: TGR graduates with idiopathic early-onset scoliosis without known intellectual disabilities or neuromuscular impairments were included. Patients were thoroughly evaluated using psychological instruments [Wechsler Adult Intelligence Scale, Auditory Consonant Trigram Test, Verbal Fluency Test, Beck Depression Inventory, Beck Anxiety Inventory, Rosenberg Self-Esteem Scale, Symptom Checklist-90, Post-Traumatic Growth Inventory, Strengths and Difficulties Questionnaire, Spinal Appearance Questionnaire, Scoliosis Research Society 22-item questionnaire (SRS-22)]. Results were compared with normative data when available. Spearman correlations were performed between the results of these tests, the total treatment duration, and the number of spinal surgeries. RESULTS: Of the 15 patients included in the study, 9 were females, and the mean age was 18.73 (16 to 23). The mean age at index surgery was 6.38 (3 to 10) whereas that of graduation was 14.00 (12 to 16). The average number of spinal surgeries was 14.28 (7 to 20). Two patients performed below the range of adult intellectual functioning. Auditory Consonant Trigram Test showed normal verbal working memory and attention control. Six patients had abnormal Verbal Fluency Test performance. Eight patients had abnormal ratings on at least one of the assessment scales of psychopathology (Symptom Checklist-90, Beck Depression Inventory, and Beck Anxiety Inventory). Eight patients had low-to-moderate self-esteem (Rosenberg self-esteem scale). The median spinal appearance questionnaire and SRS-22 scores were 34 and 4.18, respectively. Pain and function subdomains of SRS-22 scored higher than self-image and mental health. No correlation was found between the treatment duration and number of surgeries and test scores. SRS-22 showed correlations with multiple psychological tests. CONCLUSION: Completed TGR treatment yields acceptable correction of deformities and surgical outcomes, however, may fail to improve psychological well-being. This is the first study to find various psychosocial abnormalities in two-thirds of cases. LEVEL OF EVIDENCE: Level IV; cross-sectional study.

The Reliability and Validity of The Turkish Form of Berger HIV Stigma Scale.

OBJECTIVE: HIV-related stigma towards people living with HIV/AIDS (PLWHA) creates a barrier in access to quality health care, affects mental health and leads to poor treatment adherence. Assessment of different components of HIV-related stigma is needed to develop appropriate strategies for prevention and intervention. The aim of this study was to translate and adapt Berger HIV Stigma Scale to Turkish and assess its reliability and validity. METHOD: The Turkish version of the 40 item, 4-point Likert-type self-report HIV Stigma Scale, as well as Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RSES) and sociodemographic data form were administered to 95 PLWHA. RESULTS: The items of the scale whose face validity was found to be sufficient, were loaded on four factors in the explanatory factor analysis: Internalised Stigmatization (16 items); Concerns with Public Attitudes (12 items); Negative Self Image (9 items); and Disclosure Concerns (8 items). This structure explained 46.71% of the variance after an item was removed based on the analysis. All subscales had acceptable internal consistency with Cronbach's alpha coefficients .802-.934. BDE scores had moderate positive correlations with Internalized Stigmatization; Concerns with Public Attitudes; Disclosure Concerns subscale scores (rs=0.214, p=0.047; rs=0.295, p=0.006; rs=0.353, p=0.001), and strong positive correlations with Negative Self Image score (rs=0.617, p<0.001). A moderate positive correlation was found between RSES and Negative Self Image subscale score (rs=0.434; p<0.001). CONCLUSION: Our findings showed that the Turkish form of Berger HIV Stigma Scale is a reliable and valid tool for measuring HIV-related stigma in PLWHA.

[The Validity and the Reliability of Turkish Version of the Self-Stigma of Depression Scale]. / Depresyonda Kendini Damgalama Ölçegi: Türkçe Formu, Geçerlilik ve Güvenilirlik Çalismasi.

OBJECTIVE: In this study, we aimed to the Self-Stigma of Depression Scale (SSDS), which evaluates self-stigmatization that can prevent both treatment consultation and compliance by depressed patients run Turkish adaptation, validity and reliability study of. METHOD: The study included a total of 173 subjects consisting of 131 outpatients of the Psychiatry Polyclinic with past or recent major depression disorder (MDD) diagnosis and 42 non-depressed outpatients consulting the Geriatrics Polyclinics for other medical complaints. Each participant was evaluated with the Structured Clinical Interview for DSM IV Axis I Disorders (SCID-I), the Standardized Mini Mental State Examination (MMSE), the Turkish Self-Stigma of Depression Scale (SSDS-TR) and the Beck Depression Inventory (BDI). The MDD patients were further evaluated with the Internalized Stigma of Mental Illness (ISMI) scale. Test-retest reliability of the SSDS-TR was assessed with 27 participants 8-12 weeks after the first test. All analyses were carried out using the IBM-SPSS Statistics version 25 and the IBM SPSS AMOS version 25. RESULTS: In the exploratory factor analysis, the factor structure of SSDS TR differed from the original form. The structural validity of the 4-factor model formed after excluding one problematic item was tested by confirmatory factor analysis and proven to meet the goodness of fit criteria. The Cronbach's α coefficient of the SSDS-TR was 0.847, and a moderate correlation (r=0.436 p=0.023) was obtained by the test-retest analysis. The SSDS-TR scores moderately correlated with the ISMI scores (r=0.485, p<0.001) and weakly correlated with the BDI scores (r=0.246, p<0.001). CONCLUSION: The SSDS-TR formed by excluding one item from the original scale was demonstrated to be a valid and reliable psychometric tool and is expected to fill a gap in the assessment of self stigmatization of MDD patients in Turkey.

[The Relationship of the Change in Symptoms and Cognitive Functions With the Change in Cortical Inhibition Parameters Measured by Transcranial Magnetic Stimulation: An Eight-Week Follow-Up Study]. / Sizofreni Hastalarinda Belirtilerde ve Bilissel Islevlerdeki Degisimin Transkraniyal Manyetik Uyarim ile Ölçülen Kortikal Inhibisyon Parametrelerindeki Degisimle Iliskisi: Sekiz Haftalik Bir Izlem Çalismasi.

OBJECTIVE: Transcranial magnetic stimulation (TMS) studies show cortical inhibition (CI) abnormalities in patients with schizophrenia. However, the relationship between the changes in CI and the changes in psychopathology and cognition caused by antipsychotic treatment is not known. This is an 8 week follow up study which aims to evaluate the relationship of the change in the symptoms and cognitive functions with the change in the CI of the patients, who are switched to new  atypical antipsychotic treatment, and to compare the TMS measures of patients with those of controls. METHOD: Thirteen patients and age, sex, education matched 13 controls were included in the study. Patients were assessed with TMS, Positive and Negative Syndrome Scale (PANSS) and neurocognitive battery at baseline and 8th week, while the control group was evaluated once, with neurocognitive battery and TMS. The CI parameters studied by TMS were resting motor threshold, cortical silent period, ipsilateral silent period (ISP), short interval-intracortical inhibition (SICI) and intracortical facilitation. RESULTS: Intracortical facilitation (ICF) was weaker, ISP was longer in patients than the controls both at the baseline and at the end of the eight weeks. Intracortical facilitation decreased with 8 weeks of antipsychotic treatment indicating an increase in CI. The decrease in PANSS general psychopathology score was related positively with the decrease in ICF.  SICI was related positively with cognitive test performances cross-sectionally and longitudinally. CONCLUSION: Our findings suggest that increase in CI is associated with the improvement in the symptoms and the action of the atypical antipsychotics.