Depressive symptoms in higher education students during the COVID-19 pandemic: the role of containment measures.

BACKGROUND: Students are a vulnerable group for the indirect impact of the COVID-19 pandemic, particularly their mental health. This paper examined the cross-national variation in students' depressive symptoms and whether this can be related to the various protective measures implemented in response to the initial stage of the COVID-19 outbreak. METHODS: Student data stem from the COVID-19 International Student Well-being Study, covering 26 countries during the first wave of the COVID-19 pandemic. Country-level data on government responses to the COVID-19 pandemic were retrieved from the Oxford COVID-19 Tracker. Multilevel analyses were performed to estimate the impact of the containment and economic support measures on students' depressive symptoms (n = 78 312). RESULTS: School and workplace closures, and stay-at-home restrictions were positively related to students' depressive symptoms during the COVID-19 pandemic, while none of the economic support measures significantly related to depressive symptoms. Countries' scores on the index of these containment measures explained 1.5% of the cross-national variation in students' depressive symptoms (5.3%). This containment index's effect was stable, even when controlling for the economic support index, students' characteristics, and countries' epidemiological context and economic conditions. CONCLUSIONS: Our findings raise concerns about the potential adverse effects of existing containment measures (especially the closure of schools and workplaces and stay-at-home restrictions) on students' mental health.

Is early marriage practice a problem for women living in Istanbul? A qualitative study.

Early marriages (EM) adversely affect women's physical and mental health, education, and social status. The current study aimed to analyze effects of EM through the thoughts, experiences, and suggestions of women who were married under the age of eighteen in Istanbul, Turkey, and the key informants (e.g., social worker, psychologist, obstetrician) who have encountered EM. In-depth interviews were conducted with fifteen women who were married before age 18, recruited from psychiatry outpatient department and eleven key informants. Thematic analysis was used. Low educated, poor family environment with domestic violence and neglect of children, loss of parents, lack of access to education, and traditional social structure were stated as causes for EM. Families' attitudes about EM were characterized as their daughter's reputation would be tarnished which implied the daughter's premarital relationships would be perceived as immoral by community. All women experienced traditional, aggressive rituals for the first night of marriage, husbands were mostly insensitive, and coercive resulting a traumatic experience. Women were subjected to physical, sexual, psychological, and emotional violence; most of them were socially isolated after marriage with restrictions imposed by their spouses and spouses' family that limited communication with their loved ones. The women generally felt unprepared for adult sexual life and motherhood. In order to prevent EM, raising parents' awareness about EM, supporting girls' education, and enforcing legitimate regulations were recommended. Early marriages violate human rights, cause negative consequences for health both physically and mentally, and deepen social inequality for women. All the participants suggested a better functioning legislative arrangement. The male dominated society that legitimizes child marriages and other harmful traditional practices should be addressed.

Negative Consequences of Substance Use in European University Students: Results from Project SNIPE.

BACKGROUND: University students are a risk group for heavy substance use and the experience of various potentially severe negative substance use consequences which may impact on their health, social, and academic functioning. Whilst the experience of negative consequences of substance use is well understood in North American student samples, there is little data on these experiences in European students. In order to develop effective harm prevention and reduction interventions for students' substance use, there needs to be an understanding of the types of consequences experienced in European student samples. OBJECTIVES: The aim of the study was to investigate the prevalence and predictors of the experience of negative substance use-related consequences amongst university students in 7 European countries. METHODS: University students (n = 4,482) in Belgium, Denmark, Germany, the Slovak Republic, Spain, Turkey, and the UK completed an online survey of their substance use behaviours and the experience of associated negative consequences. RESULTS: European students reported that experiencing a hangover or illness, missing class, being short of money, and experiencing memory loss were the most commonly experienced negative consequences of substance use. Not living with other students and using alcohol, cannabis, sedatives, and cocaine were also associated with higher odds of experiencing these negative consequences. CONCLUSIONS: In contrast to North American data, European university students tended to experience consequences that are associated with lower level health risks rather than more severe consequences (e.g., drink-driving and physical injury). Harm prevention and reduction interventions for students should be targeted towards those consequences that are most salient to the target group to ensure feedback is relevant and potentially more effective in changing students' substance use behaviours.

Student estimations of peer alcohol consumption: links between the Social Norms Approach and the Health Promoting University concept.

BACKGROUND: The Social Norms Approach, with its focus on positive behaviour and its consensus orientation, is a health promotion intervention of relevance to the context of a Health Promoting University. In particular, the approach could assist with addressing excessive alcohol consumption. AIM: This article aims to discuss the link between the Social Norms Approach and the Health Promoting University, and analyse estimations of peer alcohol consumption among European university students. METHODS: A total of 4392 students from universities in six European countries and Turkey were asked to report their own typical alcohol consumption per day and to estimate the same for their peers of same sex. Students were classified as accurate or inaccurate estimators of peer alcohol consumption. Socio-demographic factors and personal alcohol consumption were examined as predictors for an accurate estimation. RESULTS: 72% of male and 51% of female students were identified as having accurate estimations about the amount of alcoholic drinks consumed per day by their peers. Male students, older students, those studying year 3 and above, and Turkish and Danish students were more likely to accurately estimate their peers' alcohol consumption. Independent from these factors, students' accurate estimation of peers' drinking decreased significantly with increasing personal consumption. CONCLUSIONS: As accurate estimates of peer alcohol consumption appear to affect personal drinking behaviour positively, social norms interventions targeted at correcting possible misperceptions about peer alcohol use among students may be a useful health promotion tool in the context of a health promoting university.

Containment Measures and Alcohol Consumption Among Drinking Higher Education Students Before and During the COVID-19 Pandemic: A Multilevel Analysis in 25 Countries.

Hazardous alcohol use tends to be more prominent among higher education students. The COVID-19 pandemic severely altered student life, raising questions on its impact on students' alcohol use patterns. The current study examined cross-country variations in drinking behaviors (weekly drinking and binge drinking), and the extent to which these variations were associated with containment measures implemented during the first wave of the COVID-19 pandemic. Data were obtained from the COVID-19 International Student Well-being Study, covering students in 25 middle- and upper-high income countries. Data on government responses were retrieved from the Oxford COVID-19 Government Response Tracker. Multilevel multinomial logistic regression analyses were performed on weekly drinking (n = 44,212) and binge drinking (n = 32,785). Considerable cross-country variation existed for weekly drinking and binge drinking. In the majority of countries, a self-reported decrease in weekly drinking and a substantial self-reported decrease in binge drinking were observed. Closings of schools were associated with decreases in weekly drinking, while limitations on social gatherings were associated with increases in weekly drinking. The stringency index was associated with reporting decreased binge drinking. The study findings demonstrate a number of small yet significant associations between containment measures and changes in student drinking behaviors. Future studies are required to uncover why some students increased their alcohol consumption, particularly in countries with stricter limitations on social gatherings.

A feasibility trial to examine the social norms approach for the prevention and reduction of licit and illicit drug use in European University and college students.

BACKGROUND: Incorrect perceptions of high rates of peer alcohol and tobacco use are predictive of increased personal use in student populations. Correcting misperceptions by providing feedback has been shown to be an effective intervention for reducing licit drug use. It is currently unknown if social norms interventions are effective in preventing and reducing illicit drug use in European students. The purpose of this paper is to describe the design of a multi-site cluster controlled trial of a web-based social norms intervention aimed at reducing licit and preventing illicit drug use in European university students. METHODS/DESIGN: An online questionnaire to assess rates of drug use will be developed and translated based on existing social norms surveys. Students from sixteen universities in seven participating European countries will be invited to complete the questionnaire. Both intervention and control sites will be chosen by convenience. In each country, the intervention site will be the university that the local principal investigator is affiliated with. We aim to recruit 1000 students per site (baseline assessment). All participants will complete the online questionnaire at baseline. Baseline data will be used to develop social norms messages that will be included in a web-based intervention. The intervention group will receive individualized social norms feedback. The website will remain online during the following 5 months. After five months, a second survey will be conducted and effects of the intervention on social norms and drug use will be measured in comparison to the control site. DISCUSSION: This project is the first cross-national European collaboration to investigate the feasibility of a social norms intervention to reduce licit and prevent illicit drug use among European university students. FINAL TRIAL REGISTRATION NUMBER: DRKS00004375 on the 'German Clinical Trials Register'.

Impact of COVID-19 on the Life of Higher-Education Students in Istanbul: Relationship Between Social Support, Health-Risk Behaviors, and Mental/Academic Well-Being.

Objective: This study aimed to draw a general picture of the impact of the coronavirus disease 2019 (COVID-19) -pandemic on the life of higher-education students in Istanbul, with specific emphasis on the relationship between students' social support systems, health-risk behaviors, and mental/academic well-being. Methods: A total of 2583 higher-education students from different fields of study participated in an online survey gathering information from several domains, including available social networks, support-seeking attitudes, substance use patterns, physical activity levels, academic stress, academic satisfaction, and psychological well-being during the pandemic. Results: Our findings pointed to major changes in students' life circumstances and daily routines during COVID-19, including a significant decrease in contact with friends, overall substance use, and physical activity as well as high levels of depression, academic stress, and academic dissatisfaction. Depressive symptoms were significantly predicted by the loneliness score (OR = 2.08, 95% CI = 1.88-2.29), female gender (OR = 1.65, 95% CI = 1.21-2.24), frequency of binge drinking (OR = 1.4, 95% CI = 1.06-1.86), and level of academic stress (OR = 1.15, 95% CI = 1.1-1.19), whereas the number of people to easily borrow money from was found to be a protective factor against depression (OR = 0.95, 95% CI = 0.92-0.99). Conclusion: Our results highlight the need for higher-education institutions to take the appropriate social and mental health interventions, tailored to fit the specific requirements of the COVID-19-related measures.

An Analysis of the Psychosocial Challenges Faced by the University Students During COVID-19 Pandemic, and the Students' Knowledge, Attitudes, and Practices Toward the Disease.

INTRODUCTION: The aims of the present study were 1) to identify the major psychosocial challenges faced by students of a university in Istanbul, during the initial period of the COVID-19 outbreak, 2) to assess how these interacted with their level of knowledge, attitudes, and practices toward COVID-19 and the related health measures in place. METHODS: As part of an international research, a total of 2583 university students from Istanbul participated in an online survey, which included questions in several domains including their studies and daily life before and after the outbreak, their concerns and worries about the pandemic, their level of knowledge on COVID-19, their views on the policies implemented by the government and their institution, their attitude and practices toward the protective measures. RESULTS: Majority of the students reported to suffer from financial adversities due to the outbreak. The closure of residential facilities and the cancellation of face-to-face lectures resulted in the vast majority of the students moving back to their family home. Their daily routines were largely replaced by individual home activities, and social interactions shifted almost totally to digital platforms. They also reported high levels of anxiety and worries concerning a wide range of the possible detrimental outcomes of COVID-19, which were in close association with their knowledge, attitudes, and practices towards the disease, as well as their adherence to the policy measures and their satisfaction with the policies of the government. CONCLUSION: These results may help policymakers in better understanding the psychosocial impacts of COVID-19 on the life of university students, and to develop more comprehensive strategies to address their multifaceted struggles, as well as to improve their compliance with the health measures in the future.

The Relationship of Food Addiction With Other Eating Pathologies and Impulsivity: A Case-Control Study.

The concept of food addiction (FA) has become central in recent years in understanding the psychological etiology of obesity. In this matched case-control study from Turkey, it was aimed to examine the prevalence of FA and related risk factors in four consecutive body mass index (BMI) categories. The case group consisted of pre-operative bariatric surgery patients with BMI over 35.0 kg/m2 (n = 40) and the control group was composed of age- and gender- matching individuals from the other categories, namely obese (n = 35), overweight (n = 40), and normal weight (n = 40). The Yale Food Addiction Scale (YFAS) and a standardized clinical interview using the DSM-5 substance use disorders criteria adopted for FA, the Eating Disorder Examination Questionnaire (EDEQ) and the Barratt Impulsivity Scale (BIS-11) were used as assessment instruments. It was found that FA was significantly associated with more serious eating pathologies, more frequent weight-cycling and earlier onset of dieting, higher impulsivity, and higher BMI. Motor and total impulsivity scores showed a positive albeit week correlation with the severity of FA but no significant correlation with BMI, indicating a relationship between impulsivity and weight gain in some but not all individuals. The severity of FA predicted the increase in BMI. Our findings suggest that FA is associated with weight gain in a group of individuals, plausibly through impulsive overeating. Emphasis on FA and its clinical implications such as addiction-based treatments may improve outcomes in obesity and facilitate health promotion.

[Do general practitioners diagnose and treat patients with alcohol use problems?]. / Pratisyen Hekimler Alkol Kullanim Sorunlari Olan Hastalari Taniyor ve Tedavi Ediyorlar Mi?

AIM: To determine the primary health care working general practitioners' knowledge, attitude and behavior towards alcohol use disorders. METHOD: In this descriptive and cross-sectional study 135 general practitioners (GPs) completed the questionnaire. RESULTS: Pre and post graduate education on alcohol use disorders is low (25.4 % and 11.7% respectively). Most of the GPs do not know the levels of risky alcohol use, screening tests, and biochemical markers. The mean knowledge score is 6.67+/-1.70. Most GPs think that alcohol use disorders are not an important issue in primary health care (57%), they do not have time to deal with patients' alcohol problems (74.1%), it is difficult to diagnose risky alcohol users without clear symptoms (91.1%), patients do not follow advice on alcohol use (85.2%), and physicians themselves are tolerant towards alcohol (71.1%). Half of the GPs reported that they find it difficult to talk about alcohol use with patients and think that patients may be angered by alcohol consumption questions. Mean attitude score is 4.44+/-2.15. Most of the GPs reported that they would ask questions about alcohol use to their patients (91.7%) and declare that the patients' problems were related to alcohol (90.2%). More than half of them reported that they would refer the patient to a specialist or an alcohol treatment center (58.5%). The mean behavior score is 5.96+/-1.46. CONCLUSION: In our country it is clear that more education and support for GPs is needed due to their important role in intervention for alcohol use problems.

Prevalence and risk factors of psychotic symptoms: in the city of Izmir, Turkey.

BACKGROUND: Psychotic symptoms, psychotic-like experiences and schizotypal signs can emerge in different socio-cultural circumstances and cause clinical or non-clinical pictures. Transient or self-limiting psychotic-like experiences are more prevalent than clinical psychotic disorders. The aim of this study is to determine the prevalence and sociodemographic correlates of psychotic symptoms in an urban area. METHODS: A cross-sectional study was conducted among the residents of two districts in the urban area of Izmir, Turkey. Among the systematically selected 1,500 residents of 85,212-study population, a total of 1,268 individuals (response rate: 84.5%) were screened for any lifetime psychotic symptoms. RESULTS: Composite International Diagnostic Interview (CIDI) was used to assess psychotic symptoms. CIDI (+) psychotic symptoms were found in 3.6% of the screened sample. Logistic regression analysis showed that being a female (OR=2.4, 95% CI=1.2-5.1), having a first degree family history of any mental disorders (OR=13.9, 95% CI=5.7-34.3), lack of social support (OR=4.5, 95% CI=2.3-8.6) and alcohol use (OR=4.9, 95% CI=2.3-10.6) were all related to psychotic symptoms. CONCLUSION: Prevalence of any psychotic symptom is lower compared to European studies. Alcohol might be considered as a risk factor for developing psychotic symptoms in the Turkish cultural setting.

Domestic Violence Among Women Attending to Psychiatric Outpatient Clinic.

OBJECTIVE: Domestic violence (DV) is defined as all kinds of abusive behaviors between spouses or relatives living in the same house. Domestic violence is most commonly directed towards women and children. This study aims to review the extent of domestic violence among women consulting to psychiatric outpatient clinic, and to identify its relation with sociodemographic risk factors and psychological symptoms. METHOD: Self-reported Domestic Violence Questionnaire and Symptom Checklist-90-R (SCL-90-R) information was collected from women who admitted to psychiatric outpatient clinic at Marmara University Research and Educational Hospital, and accepted to participate in the study. RESULTS: 300 women participated in the study. Mean age of participants was 36.24±10.88, 75.7% of them were married, and mostly live within nuclear families. 70.1% of the participants reported verbal violence, and 49.0% reported physical violence. 65.3% of those who have experienced verbal violence have also experienced physical violence. 26.1% of them reported as not having experienced domestic violence before. The nature and extent of domestic violence, women's attitudes towards it, and its relation with experience of domestic violence during childhood have been explored. Participants' educational levels, current age and age of marriage, style of marriage, educational level and age of spouse were not found to be associated with experiencing of domestic violence. Both verbal and physical domestic violence were significantly associated with the economic status of women (p<0.05). The mean SCL-90-R score was 1.40±0.68 with the highest mean subgroup score under depressive symptoms category (1.80±0.79). Mean SCL-90-R score showed significant association with the experience of domestic violence (p≤0.001). CONCLUSION: Most of the women participated in the study have experienced domestic violence. Both verbal and physical violence increased with lower economic status. Psychiatric symptoms increased with the experience of domestic violence. Considering its high prevalence and detrimental psychological effects, domestic violence should be inquired by clinicians as part of the psychiatric interview.

Personal and perceived peer use and attitudes towards use of non-prescribed prescription sedatives and sleeping pills among university students in seven European countries.

INTRODUCTION: The use of non-prescribed prescription sedatives and sleeping pills (NPPSSP) among university students has been described as an important public health issue. However, the impact of perceived social norms on students' use and attitudes towards use of NPPSSP is still unclear. Our aim was to investigate whether perceptions of peer use and approval of use are associated with students' personal use and approval of NPPSSP use. METHODS: Cross-sectional data from the Social Norms Intervention for the prevention of Polydrug Use (SNIPE) project containing 4482 university students from seven European countries were analyzed to investigate self-other discrepancies regarding personal use and attitudes towards NPPSSP use. Associations between personal and perceived peer use and between personal and perceived approval of use were examined using multivariable logistic regression. RESULTS: The majority (51.0%) of students perceived their peers' NPPSSP use to be higher than their personal use. 92.6% of students perceived their peers' approval of NPPSSP use to be identical or higher than their personal approval. Students perceiving that the majority of peers had used NPPSSP at least once displayed higher odds for personal lifetime use (OR: 1.95, 95% CI: 1.49-2.55). Perceived peer approval of NPPSSP use was associated with higher odds for personal approval (OR: 5.49, 95% CI: 4.63-6.51). CONCLUSIONS: Among European university students, perceiving NPPSSP use and approval of use to be the norm was positively associated with students' personal NPPSSP use and approval of use, respectively. Interventions addressing perceived social norms may prevent or reduce NPPSSP use among university students. Final trial registration number: DRKS00004375 on the 'German Clinical Trials Register'.

Cognitive dysfunctions in patients with obsessive-compulsive disorder compared to the patients with schizophrenia patients: relation to overvalued ideas.

OBJECTIVE: The clinical overlaps between schizophrenia and obsessive-compulsive disorder (OCD) seem to be related to thought disorders involving obsessions, overvalued ideas, and delusions. Overvalued ideas are beliefs falling in between obsessions and delusions and are stronger than obsessions but weaker than delusions. The goal of the present study was to compare patients with OCD to those with schizophrenia in terms of cognitive functions and to relate cognition and overvalued ideas in OCD. METHODS: Twenty three patients with OCD (free of depression), 24 patients with schizophrenia, and 22 healthy subjects matched to patients in age, gender, education, and hand dominance were included in the study. All subjects were administered neurocognitive tests assessing verbal learning-memory, executive functions, verbal fluency, attention and verbal working memory. RESULTS: Patients with schizophrenia showed worse performance on cognitive tests than the OCD and control groups. The severity of overvalued ideas was significantly correlated to cognitive functions in the OCD group. There were no significant differences in cognitive functions between schizophrenia group and the OCD patients who had higher scores on the Overvalued Ideas Scale (OVIS). CONCLUSION: Overvalued ideas in OCD may be related to cognitive dysfunctions in OCD and this subtype of OCD may have similar characteristics to schizophrenia in terms of cognition.

Normative data and discriminative properties of short form 36 (SF-36) in Turkish urban population.

BACKGROUND: SF-36 has been both translated into different languages and adapted to different cultures to obtain comparable data on health status internationally. However there have been only a limited number of studies focused on the discriminative ability of SF-36 regarding social and disease status in developing countries. The aim of this study was to obtain population norms of the short form 36 (SF-36) health survey and the association of SF-36 domains with demographic and socioeconomic variables in an urban population in Turkey. METHODS: A cross-sectional study. Face to face interviews were carried out with a sample of households. The sample was systematically selected from two urban Health Districts in Izmir, Turkey. The study group consisted of 1,279 people selected from a study population of 46,290 people aged 18 and over. RESULTS: Internal consistencies of the scales were high, with the exception of mental health and vitality. Physical health scales were associated with both age and gender. On the other hand, mental health scales were less strongly associated with age and gender. Women reported poorer health compared to men in general. Social risk factors (employment status, lower education and economic strain) were associated with worse health profiles. The SF-36 was found to be capable of discriminating disease status. CONCLUSION: Our findings, cautiously generalisable to urban population, suggest that the SF-36 can be a valuable tool for studies on health outcomes in Turkish population. SF-36 may also be a promising measure for research on health inequalities in Turkey and other developing countries.

Normative Perceptions of Cannabis Use Among European University Students: Associations of Perceived Peer Use and Peer Attitudes With Personal Use and Attitudes.

OBJECTIVE: Perceptions of peer behavior and attitudes exert considerable social pressure on young adults to use substances. This study investigated whether European students perceive their peers' cannabis use and approval of cannabis use to be higher than their own personal behaviors and attitudes, and whether estimations of peer use and attitudes are associated with personal use and attitudes. METHOD: University students (n = 4,131) from Belgium, Denmark, Germany, the Slovak Republic, Spain, Turkey, and the United Kingdom completed an online survey as part of the Social Norms Intervention for Polysubstance usE in students (SNIPE) Project, a feasibility study of a web-based normative feedback intervention for substance use. The survey assessed students' (a) personal substance use and attitudes and (b) perceptions of their peers' cannabis use (descriptive norms) and attitudes (injunctive norms). RESULTS: Although most respondents (92%) did not personally use cannabis in the past 2 months, the majority of students thought that the majority of their peers were using cannabis and that their peers had more permissive attitudes toward cannabis than they did. When we controlled for students' age, sex, study year, and religious beliefs, perceived peer descriptive norms were associated with personal cannabis use (odds ratio [OR] = 1.42; 95% CI [1.22, 1.64]) and perceived injunctive norms were associated with personal attitudes toward cannabis use (OR = 1.46; 95% CI [1.09, 1.94]). CONCLUSIONS: European students appear to possess similar discrepancies between personal and perceived peer norms for cannabis use and attitudes as found in North American students. Interventions that address such discrepancies may be effective in reducing cannabis use.

Effects of quetiapine on cognitive functions in schizophrenia.

OBJECTIVE: All atypical antipsychotic drugs with complex pharmacology have been shown to improve some, but not all, domains of cognitive function, including quetiapine, i.e., the agent with the most rapid dissociation from dopamine receptors and a relatively weak serotonin antagonism. The present study was to evaluate which, if any, areas of cognition improve in patients with schizophrenia, following a brief treatment with quetiapine. METHODS: Effects of quetiapine on cognition were investigated in a group of patients with schizophrenia (n=14). Neuropsychological tests in cognitive areas previously shown as impaired in schizophrenia were administered at baseline and after 8 weeks of treatment with quetiapine. Administered at these two times were also the Positive and Negative Syndrome Scale, Hamilton Depression Rating Scale, and scales to assess motor side effects (Abnormal Involuntary Movement Scale, Simpson-Angus Scale, and Barnes Akathisia Scale). RESULTS: Wilcoxon Signed Ranks Test indicated a statistically significant improvement in scores on Digit Span Test, Trail Making Test, Stroop Test, Finger Tapping Test, and on the Positive and Negative Syndrome Scale. No significant change was noted in motor side effects. CONCLUSION: The patients improved in their attentional, motor, and visuo-motor skills, and in executive functions as well as with respect to psychopathology, without an increase in motor side effects.

Is quality of life associated with cognitive impairment in schizophrenia?

BACKGROUND: The subjectively assessed quality of life of schizophrenia patients is mostly lower than healthy subjects, and cognitive impairment is an integral feature of schizophrenia. The aims of the present study were to compare the quality of life and neurocognitive functioning between the patients with schizophrenia and the healthy subjects, and to examine the relationships between quality of life and neurocognitive functions among the patients with schizophrenia. METHODS: Thirty-eight patients with schizophrenia (15 women and 23 men) and 31 healthy individuals (18 women and 13 men) were included in the study. All participants were administered World Health Organization Quality of Life-Brief Form (WHOQOL-BREF) to assess their quality of life, and Digit Span Test (DST) and Controlled Oral Word Association Test (COWAT) for cognitive functions. RESULTS: The patients with schizophrenia demonstrated lower scores in physical (F=25.6, p=0.0001), psychological (F=15.85, p=0.0001) and social (F=37.7, p=0.0001) domains compared to control group. The patients with schizophrenia showed significantly lower scores on COWAT compared to healthy subjects (F=4.22, p=0.04). The social domain scores of WHOQOL correlated to DST total scores (r=0.45, p=0.007), DST forwards scores (r=0.54, p=0.001) and COWAT total scores (r=0.40, p=0.04) in patients with schizophrenia but not in the control group. The patients with lower level of cognitive functioning had lower scores on social domain of WHOQOL-BREF (z=-2.01, p=0.04). CONCLUSION: Our results confirm that the cognitive deficits in executive function and working memory appear to have direct impact on the patients' perceived quality of life especially in social domain which can either be a cause or a consequence of social isolation of patients with schizophrenia.

[The diagnostic validity of screening tests and laboratory markers in alcohol use disorders]. / Alkol Kullanim Bozukluklarinda Tarama Testleri ve Laboratuvar Belirteçlerinin Tanisal Etkinligi.

OBJECTIVE: To determine the validity of screening tests and markers suggested in the early detection of alcohol use disorders. METHOD: Male patients aged 20-65 were recruited from a psychiatry clinic. They had been consuming alcohol at least once a week. They were not drug users and had no other diseases that affected the markers mentioned in this study. According to the DSM-IV diagnostic criteria, the diagnostic validity of screening tests [Michigan Alcoholism Screening Test (MAST), CAGE (Cut down, Annoyed, Guilty, Eye-opener), Alcohol Use Disorders Identification Test (AUDIT)] and markers [Mean corpuscular volume (MCV), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), carbohydrate-deficient transferrin (CDT)] was investigated in alcohol dependent patients (n=29), alcohol abusers (n=28) and social drinkers (n=28). RESULTS: For the diagnosis of dependence, the sensitivity and specificity of the tests were respectively 69% and 100% for GGT, 41% and 93% for CDT, 100% and 57% for MAST, 97% and 86% for CAGE, and 100% and 75% for AUDIT. For the diagnosis of abuse, the sensitivity and specificity of the tests were respectively 32% and 100% for GGT, 32% and 93% for CDT, 86% and 57% for MAST, 75% and 85.7% for CAGE, and 89% and 75% for AUDIT. The widest area under the ROC curve belonged to GGT as a marker and AUDIT as a screening test. CONCLUSION: According to the results of this study, the marker that has the highest validity is GGT, while AUDIT and CAGE are the best screening tests.

[Quality of life in patients with obsessive-compulsive disorder: relations with cognitive functions and clinical symptoms]. / Obsesif Kompulsif Bozuklukta Yasam Kalitesi: Bilissel Islevler ve Klinik Bulgular ile Iliskisi.

OBJECTIVE: To compare quality of life in patients with obsessive-compulsive disorder with that in healthy subjects and to relate quality of life to cognitive functions and the severity of clinical symptoms. METHODS: Twenty-three patients who met DSM-IV criteria for obsessive compulsive disorder and 22 healthy subjects were included in the study. Quality of life (Turkish Quality of Life Scale-Brief Form) and cognitive functions were investigated in all subjects. In the patient group the relation of quality of life to the cognitive functions and to the severity of clinical symptoms and in the control group the relation of quality of life to the cognitive functions was investigated. RESULTS: The comparison of quality of life between the patient and control groups showed a significant difference (F= 2.60, p= 0.04). The significant differences between the two groups in psychological and social scores were responsible for the overall significant difference. The scores of quality of life were correlated with the scores of the cognitive tests (Trail Making Test, Auditory Consonant Trigram Test and Digit Span Test) and the severity of obsessive-compulsive symptoms. CONCLUSION: The present study revealed that quality of life is lower in patients with obsessive-compulsive disorder than in healthy subjects and is related to cognitive functions and the severity of obsessive-compulsive symptoms.