Decreased Functioning and Contents of Worries Associated with Anxiety or Depression Symptom Levels Within Patients Hospitalized with COVID-19 Infection.

BACKGROUND: High levels of anxiety and depression symptoms have been reported in patients with COVID-19 compared to the general population. These symptoms were related to variables such as gender, age, and education level with anxiety/depression levels. We aimed to determine the relationship between anxiety and depression symptoms and epidemic-related decreased functioning, worry, and quality of life (QoL). SUBJECTS AND METHODS: The study included 238 hospitalized participants due to COVID-19 and 168 participants who were hospitalized for reasons other than COVID-19. The Hospital Anxiety and Depression Scale (HADS), Short Form 36 (SF-36) QoL Scale, and questionnaires prepared by the researchers were applied. The effects of current worries, impairment in QoL, and decreased functioning during quarantine on levels of anxiety and depressive symptoms were investigated by implementing multiple linear regression analyzes. RESULTS: Our study results suggested the anxiety and depression levels of patients with COVID-19 were not higher than those in the internal medicine inpatient unit at the same time. Worries about transmission to others, uncertainty, social media news, and health anxiety increased the psychiatric symptoms of participants with COVID-19. Disruptions in social relationships and health also have an effect on anxiety/depression symptom levels. Conversely, results indicated losses and worries in occupation and finance did not significantly affect mental symptoms. CONCLUSION: Worries about transmission to others, uncertainty and health anxiety are closely related to anxiety and depression among patients with COVID-19. There is a need for research in the mental health field for the later stages of the pandemic in different cultures.

Linguistic Equivalence, Validity and Reliability Study of the Mind Excessively Wandering Scale.

Introduction: The main objective was to study the linguistic equivalence, validity and reliability of the transliterated Turkish version of Mind Excessively Wandering Scale (MEWS) developed by Prof. Philip Asherson in England (2016). Mind excessively wandering defines uncontrolled mental phenomena, which is proposed as the psychological counterpart of Default Mode Network in literature. Method: Mind Excessively Wandering Scale, Adult Attention Deficit Hyperactivity Disorder Self-Report Scale, Barratt Impulsiveness Scale, Difficulties in Emotion Regulation Scale have been used. The sample group consists of 64 patients previously diagnosed as adult Attention Deficit Hyperactivity Disorder for validity, 60 students for transliteral equivalence, and 80 healthy controls for test re-test reliability. Results: Transliteral equivalence study demonstrates that Turkish version of MEWS is highly correlated with the English version and is statistically significant. The sixth item in the scale was removed in order to ensure the consistency model established by LISREL in the validity study according to the confirmatory factor analysis. When the sixth item was excluded, it was concluded that the structure of the scale was compatible. In the reliability study of the MEWS, the Cronbach's alpha value (α) of the scale was found to be 0.826. It is seen that the item with the highest distinctiveness feature is Item-10 (0.618) and the item with the lowest distinctiveness feature is Item-5 (0.318). In the linguistic equivalence study, no statistical difference was found between the English form and the Turkish versions of the scale. Conclusion: As a result of the practical and statistical evaluations, our study demonstrated that the Turkish version of the MEWS is a valid and reliable measurement tool.

Temperament, Character, and Defense Mechanism Changes With Treatment in Depression: A 9-Month Naturalistic Follow-up.

The aim of this study was to evaluate the changes in temperament, character, and defense mechanisms with the treatment and remission in patients with major depressive disorder. The study was designed as a longitudinal observational follow-up study of patients with repeated measures at 0, 12, and 36 weeks. In baseline comparisons, the major depression group showed higher harm avoidance and novelty seeking scores and lower self-directness and mature defense styles scores compared with healthy controls. In the follow-up, temperament dimensions and neurotic defenses remained unchanged, mature defense styles and self-directness revealed significant increase, and immature defense styles revealed significant decrease. Although there was no significant difference in the defense styles, harm avoidance and novelty seeking scores remained higher in MDD patients compare with healthy controls in 36 weeks. Our findings regarding continuation of hierarchically upward improvement in defense mechanism after the remission may support importance of treatment after remission.

Is it possible to determine the level of functional impairment that distinguishes the patients with ADHD from those without ADHD?

INTRODUCTION: Functional impairment in attention deficit hyperactivity disorder (ADHD) can occur in many areas such as in family, social activities, and problems related to school and may also persist during adulthood. The Weiss Functional Impairment Rating Scale-Parent Form (WFIRS-P) is designed to measure the functional impairment related to ADHD symptoms. The aim of this study was to determine the level of functional impairment that distinguishes the patients with ADHD who were diagnosed through semi-structured interviews from those without ADHD. METHOD: This study consists of ADHD patients who were diagnosed through semi-structured interview aged 5-18 years (n = 250) and same age gender-matched healthy controls (n = 250). A receiver operating characteristic (ROC) curve was constructed by calculating the sensitivity and specificity of the scale cut-off values. RESULTS: An area under the curve (AUC) of 0.974 (95% CI 0.956-0.986) was found in this study. For WFIRS-P subdomains, AUC curves, which range from 0.76 to 0.95, were also having strong power for differentiation between groups. The optimal cut-off value for WFIRS-P using Youden's J Index is 0.32. There is no significant gender and age group differences in AUC for either the total or subdomain scores. CONCLUSION: Our findings provide that Turkish version of WFIRS-P could be a reliable way of distinguishing the level of functional impairment in ADHD from controls.

Evaluation of the Relationship Between Attention Deficit Hyperactivity Disorder Symptoms and Chronotype.

INTRODUCTION: The aim of the study is to investigate the relationship between circadian characteristics and behavioral problems in children with Attention Deficit Hyperactivity Disorder (ADHD) (n=53), and to compare this group with healthy controls (n=38). METHOD: Fifty-three medication-free children with ADHD, aged 6-12 years, and 38 healthy children, age and sex matched, participated. Parents completed the Conners' Parent Rating Scale-Revised, the Children's Chronotype Questionnaire (CCTQ), and the Children's Sleep Habits Questionnaire (CSHQ) to assess sleep variables. RESULTS: ADHD children had more sleep-onset problems and parasomnias (in CSHQ) compared to healthy controls. However, circadian preferences did not differ between the groups in CCTQ scores. Another important finding was a mild correlation between parasomnia, bedtime on schooldays, and ADHD symptoms. CONCLUSION: Our study showed that children with ADHD showed more resistance to going to bed than did controls on school days. However, in contrast to our hypothesis, morningness/eveningness preference did not differ from controls in ADHD children.

Attention-Deficit/Hyperactivity Disorder and Nicotine Dependence in Adults.

INTRODUCTION: The aim of this study is to assess clinical characteristics and smoking profiles of individuals diagnosed with attention-deficit/hyperactivity disorder (ADHD) and compare their nicotine dependence status with healthy controls for better understanding the mutual and complex relationship between ADHD and smoking. METHODS: We included the following participants in the study: 40 adults with the diagnosis of ADHD, 40 participants who visited the smoking cessation polyclinic without any psychiatric disorders, and 40 healthy controls. A sociodemographic data form, Wender Utah Rating Scale (WURS), Adult ADD/ADHD Diagnosis and Evaluation Inventory, and Fagerstrom Nicotine Dependence Test (FNDT) were administered to the participants. RESULTS: Mean age of the ADHD, nicotine dependence, and control groups was 28.68±7.22, 34.17±8.60, 33.70±7.45 years, respectively. Percentages of females and males were 27.5% and 72.5% in the ADHD group, 50% and 50% in the nicotine dependence group, 47.5% and 52.5% in the control group. The attention-deficit scores in the ADHD, nicotine dependence, and control groups were 21.18±5.05, 7.23±3.96, 4.75±2.65, respectively (p=0.001), whereas the hyperactivity scores were.73±5.84, 6.43±4.2, and 3.58±2.27, respectively (p=0.001). The related features scores were 56.53±12.96, 24.30±13.93, and 13.13±6.11, respectively (p=0.001), whereas the WURS scores were 61.88±12.69, 23.03±16.07, 11.90±8.15, respectively (p=0.001). FNDT scores in ADHD and nicotine dependence groups were 5.83±2.11 and 6.20±2.74, respectively (p=0.495). CONCLUSION: Considering the argument of ADHD being an independent risk factor for nicotine dependence, we think the co-occurrence of the smoking addiction and ADHD symptoms in the context of dopamine dysregulation is important in the clinical setting. Treatment modalities and of preventive strategies should be considered while keeping this in mind.

Hyperfocusing as a dimension of adult attention deficit hyperactivity disorder.

Patients with Attention Deficit Hyperactivity Disorder (ADHD) suffer not only from inability to focus but also from inability to shift attention for events that trigger their interests. This phenomenon is called "hyperfocusing". Previous literature about hyperfocusing is scarce and relies mainly on case reports. The study aimed to investigate and compare the severity of hyperfocusing in adult ADHD with and without psycho-stimulant use. ADHD (DSM-IV-TR) patients either psycho-stimulant naive (n=53) or on psycho-stimulants (n=79) from two ADHD clinics were recruited. The control group (n=65) consisted of healthy university students. A socio-demographic form, the Beck Depression Inventory, the Wender-Utah Rating Scale, the Adult ADHD Self- Report Scale and the Hyperfocusing Scale were applied to the participants. There was no difference between total Hyperfocusing Scale and Adult ADHD Self- Report Scale scores of two patient groups, but both have higher scores than controls (p<0.001). Hyperfocusing is higher in adult ADHD and there was no difference between stimulant-naive patients or patients on stimulants. Hyperfocusing can be defined as a separate dimension of adult ADHD.

Levels of TNF-α, soluble TNF receptors (sTNFR1, sTNFR2), and cognition in bipolar disorder.

OBJECTIVE: Tumor necrosis factor-alpha (TNF-α) may play an important role in bipolar disorder (BD) pathogenesis. There is only one study about a relationship between TNF-α levels and cognitive impairments in BD. The aim of the present study was to see whether TNF-α, soluble P55 TNF receptor (sTNFR1), and soluble P75 TNF receptor (sTNFR2) levels in BD patients are different from controls and to investigate the relationships between the levels of TNF-α, sTNFR1, and sTNFR2 and the cognitive functions in euthymic BD patients and controls. METHODS: We assessed 54 BD type I patients and 18 controls by using a battery of neuropsychological tests. Serum TNF-α levels were measured using a commercially available enzyme-linked immunosorbent assay, whereas serum sTNFR1 and sTNFR2 levels were measured using a commercially enzyme-amplified sensitivity immunoassay kit. RESULTS: We found that levels of sTNFR1 and sTNFR2 in BD patients were different from controls. No difference was detected between the BD group and the control group for levels of TNF-α. TNF-α level was found to have a negative correlation with the delayed recall in RAVLT. CONCLUSIONS: High levels of sTNFR1 and sTNFR2 in euthymic patients showed that it may support that proinflammatory process continues in euthymic period. This is the first study which showed increased sTNFR2 levels in euthymic period, which could be interpreted as a compensatory mechanism and again the first which deals with verbal memory.

Sexual dysfunction in obsessive compulsive disorder and panic disorder.

BACKGROUND: Clinical research has provided conflicting evidence regarding sexual dysfunction in patients with OCD and PD. This study was undertaken to assess and compare certain parameters of sexual functioning in OCD and PD patients. SUBJECTS AND METHODS: The study population consisted of 80 patients between 20 and 60 years of age with a diagnosis of OCD or PD who were followed and treated at the anxiety outpatient unit of Bakirkoy Research and Training Hospital for Psychiatric and Neurological Disorders between 2005 and 2006. The total study population comprised of 40 patients with OCD, 40 patients with PD, and 40 healthy volunteers as the control group. Of the two questionnaires used for study purposes, the first provided information on demographic data and certain parameters of sexual functioning, while the second was the validated Turkish translation of the Golombok-Rust Sexual Satisfaction Inventory with transliteral equivalence. RESULTS: Male subjects with OCD had a lower age of first masturbation and first nocturnal ejaculation. Infrequency problem among female and male patients with OCD occurred in 63.6% and 57.1%, respectively. Corresponding figures for PD patients were 36% and 38%. Thus, infrequency problem was more frequent among OCD patients. Sexual avoidance was found in 60.6% of female OCD patients and in 64% of female PD patients. Anorgasmia was detected in 24.2% of the female subjects with OCD. CONCLUSION: Sexual dysfunction unrelated to pharmacotherapy has been found to occur in OCD and PD. Assessment of sexual functioning in these individuals before treatment may help prevent deterioration of sexual function that may occur upon introduction of psychotropic medications.

Sexual problems in a sample of the Turkish psychiatric population.

INTRODUCTION: Sexual functioning has received little attention as an important aspect of patient care for those who have severe mental disorders. AIM: The aim of this study is to compare sexual difficulties seen in Turkish psychiatric patients and healthy control subjects. METHODS: Study group consisted of outpatients in remission with schizophrenia (n = 84), bipolar affective disorders (n = 90), heroin addiction (n = 88), and healthy control group (n = 98). A sociodemographical data form and the Golombok Rust Inventory of Sexual Satisfaction were applied to all groups (N = 360). RESULTS: Half of the patient groups and 72.8% of control subjects reported that they had regular sexual life. The patients with heroin addiction complained about more problems in their sexual life than in the other groups. Controls (86.2%) felt more satisfied with their sexual life. Female patients with heroin addiction had statistically significant higher scores in nonsensuality subscale of Golombok Rust Inventory of Sexual Satisfaction. Female patients with schizophrenia and bipolar disorder had statistically significant higher scores in vaginismus subscale than in control group. Between the groups, male patients with bipolar disorder had higher score in most of the items except noncommunication and erectile dysfunction and also had higher total score than in the controls. More men (especially with heroin addiction) thought that their illness and drugs were responsible for their sexual problems, knew the effect of the illness and drugs on their sexual life, and asked questions to their psychiatrists about the problems more than women. CONCLUSION: Patients with bipolar disorders and schizophrenia were unaware of effects of their medication on their sexual life. Finally, it was also found that clinicians in our country do not pay sufficient attention to the sexual problems of psychiatric patients.