The prevalence and characteristics of misophonia in Ankara, Turkey: population-based study.

BACKGROUND: Misophonia is defined as significant distress (anger, distress or disgust) when exposed to certain sounds that would not affect most people, such as lip smacking or gum chewing. Although misophonia is common, the aetiology, prevalence and effective treatments are largely unknown. AIMS: Based on our proposed diagnostic criteria, we examined the prevalence of misophonia and its relationship with clinical and demographic variables in a large representative population sample. METHOD: We used a household sample (N = 541) of all residents aged >15 years, living in 300 homes randomly selected in Ankara city centre, Turkey. All participants were assessed at their homes by trained interviewers, for sociodemographic variables, misophonic sounds and related factors, using a semi-structured interview (the Misophonia Interview Schedule) developed for the current research. RESULTS: The current misophonia diagnosis prevalence was 12.8% (n = 69 of 541), although 427 (78.9%) participants reported at least one sound that was distressing. The mean number of misophonic sounds was 8.6 (s.d. 8.9, range 0-44); the figure was 17.6 in those with misophonia compared with 7.3 in those without misophonia. Of those with misophonia, only 5.8% contacted services for their condition. Predictors of misophonia diagnosis included younger age, family history of misophonia and previous contact with mental health services. CONCLUSIONS: Our study showed that misophonia is common in the general population, may cause significant disruption in daily life and is undertreated. Although more evidence is needed to classify misophonia as a psychiatric disorder, our findings support others who claim that the condition belongs to the group of mental disorders.

Perceived Discrimination, Social Support, and Quality of Life in Gender Dysphoria.

INTRODUCTION: Transgender individuals experience discrimination in all domains of their personal and social life. Discrimination is believed to be associated with worse quality of life (QoL). AIM: To investigate the relation between QoL and perceived levels of discrimination and social support in individuals with gender dysphoria (GD). METHODS: Individuals with GD who attended a psychiatry clinic from January 2012 through December 2014 were recruited. Demographic, social, and medical transition features were collected with standardized forms. MAIN OUTCOME MEASURES: Self-report measurements of QoL (Turkish version of the World Health Organization's Quality of Life-BREF) that included physical, psychological, social, and environmental domains, perceived discrimination with personal and group subscales (Perceived Discrimination Scale [PDS]), and social support (Multidimensional Scale of Perceived Social Support) were completed. RESULTS: Ninety-four participants (76.6% trans men) adequately completed the study measurements. Regression models with each QoL domain score as a dependent variable indicated a significant predictor value of personal PDS in social and environmental QoL. Social support from family was associated with better QoL in psychological QoL, whereas perceived support from friends significantly predicted all other domains of QoL. There was a tendency for group PDS to be rated higher than personal PDS, suggesting personal vs group discrimination discrepancy. However, group PDS was not found to be a predictor of QoL in the multivariate model. CONCLUSION: Perceived personal discrimination and social support from different sources predicted domains of QoL with a non-uniform pattern in individuals with GD. Social support and discrimination were found to have opposing contributions to QoL in GD. The present findings emphasize the necessity of addressing discrimination and social support in clinical work with GD. Moreover, strategies to improve and strengthen friend and family support for individuals with GD should be explored by clinicians. Further research with larger and community-based samples is required.

[Resilience in Individuals with Gender Dysphoria: Association with Perceived Social Support and Discrimination]. / Cinsiyetinden Hosnutsuzlugu Olan Bireylerde Psikolojik Dayaniklilik: Algilanan Sosyal Destek ve Ayrimcilik ile Iliskisi.

OBJECTIVE: Psychological distress associated with discrimination is proposed to have an indirect effect on the development of mental disorders, through its negative influence on individual's cognitive, affective and social coping strategies. The aim of this study was to investigate the association between resilience, perceived social support, and perceived discrimination in individuals with gender dysphoria. METHOD: Individuals with gender dysphoria were assessed with Turkish validated forms of Resilience Scale for Adults (RSA), Multidimensional Scale of Perceived Social Support (MSPSS), Perceived Discrimination Scale (PDS), and Beck Depression Inventory (BDI). Diagnoses of mental disorders, history of suicide attempt and non-suicidal self injury were assessed with clinical interviews. Self-report forms were used to obtain demographic information and gender transition related features. RESULTS: Participants' (n=116, 88 trans men) median age was 25. Significantly low RSA scores, indicating poor resilience, were obtained in participants with lifetime (59.5 %) and present (27.6 %) diagnosis of any mental disorder, history of suicide attempt (23.3 %). There was significant direct correlation between RSA and MSPSS scores, inverse correlation with BDI and personal PDS scores, but not with group PDS. Regression analysis revealed that only friends domain score in MSPSS predicted better resilience, whereas personal perceived discrimination score predicted poor resilience. CONCLUSION: Findings support the association between poor resilience and vulnerability to mental and behavioral problems in individuals with gender dysphoria. The associations reveal the significance of addressing discrimination and assisting individuals with gender dysphoria in developing strategies to obtain peer support in providing mental health services.

Etomidate is associated with longer seizure duration, lower stimulus intensity, and lower number of failed trials in electroconvulsive therapy compared with thiopental.

OBJECTIVE: Induction agents used for electroconvulsive therapy (ECT) may alter seizure parameters. In this study, we aimed to investigate the effects of etomidate and thiopental on seizure-related variables. METHODS: Registries of patients who received ECT between 2010 and 2013 in a tertiary psychiatry clinic were evaluated retrospectively. The information of patients who were on the same induction agent and muscle relaxant during the whole treatment course was assessed. Primary outcome measures were total number of ECT sessions, mean peripheral and central seizure duration, cumulative stimulus intensity, and the number of adequate seizures per total number of stimuli. Secondary measures were maximum systolic-diastolic and mean blood pressure, peak heart rate, and the frequency of antihypertensive drug use during the sessions. RESULTS: Although the total number of ECT sessions is similar between the etomidate (n = 43) and thiopenthal (n = 31) groups, the mean seizure duration per stimuli was significantly longer whereas the cumulative stimulus intensity was lower in the etomidate group. The number of adequate seizures obtained in relation with the number of stimuli was also significantly higher, indicating increased probability of eliciting an adequate seizure with etomidate. During threshold determination, the number of stimuli needed to provide an adequate seizure was marginally less with etomidate. No group difference was observed in hemodynamic changes and the frequency of antihypertensive use. CONCLUSIONS: Etomidate use, compared with thiopental as an induction agent, is associated with longer seizure duration with less cumulative intensity. The use of etomidate reduces the number of failed trials and may prevent the application of unnecessary electrical stimuli with a possibly safe hemodynamic profile.