"Just Because I Don't Conform to Societal Norms": A Qualitative Study of Transgender People's Experiences of Domestic Violence and Coping Methods.

Background Transgender people experience violence in various forms, primarily domestic violence. The aim of this study was to examine transgender people's experiences of domestic violence and their coping methods. Materials and methods This study was conducted using the phenomenological method, one of the five basic qualitative research methods, with 20 transgender participants who applied to Ondokuz Mayis University, Samsun, Turkey, to start the gender-affirming treatment process. The participants comprised 19 transgender men and 1 transgender woman. A semi-structured interview form was used for data collection. The average interview duration was 75.7 minutes. Audio recordings were used in the interviews, which were then transcribed. The obtained data set was subjected to content analysis. Results As a result of the content analysis, three themes emerged: being a transgender individual and the family, experiences of domestic violence, and methods of coping. According to the study results, the participants had experienced domestic violence of different dimensions, primarily psychological violence. Defined gender roles and societal expectations were determined to trigger violent behaviors. The most frequently used coping methods were giving a direct reaction, seeking instrumental-social support, and ignoring the incidents. Conclusion Our findings demonstrated that transgender people experience domestic violence at a high rate and that transphobic behaviors are triggered by societal norms. Our results are particularly noteworthy for clinicians regarding the importance of family support and accurate information for transgender people and the coping methods they use most.

The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia.

Background: Suicidal behavior is quite common in schizophrenia and various risk factors for suicide have been reported. The aim of this study was to examine the relationship between suicide attempts and ideation with depression, insight, and internalized stigmatization in patients with schizophrenia. Method: Thirty-six patients with a history of suicide attempts and 52 patients without suicide attempts who were diagnosed as schizophrenia according to DSM-5 diagnostic criteria were included in this study. According to the score which they obtained from the eighth item of the Calgary Depression Scale for Schizophrenia, patients were divided into two groups: not suicidal ideations (zero points) and suicidal ideations (one, two, or three points). Sociodemographic information form, Positive and Negative Syndrome Scale, Calgary Schizophrenia Depression Scale, Schedule for Assessing the Three-Component of Insight, The Internalized Stigma of Mental Illness Scale, and The Suicide Ideation Scale were applied to all of the patients who participated in the study. Results: Patients with suicide attempts were more likely to be single and had higher the Internalized Stigma of Mental Illness Scale scores compared to patients without suicide attempts. Patients with suicidal ideation had higher Positive and Negative Syndrome Scale total scores, higher Calgary Schizophrenia Depression Scale scores, and higher the Internalized Stigma of Mental Illness Scale scores than those without suicidal ideation. There was a strong, positive correlation between the Suicide Ideation Scale and Calgary Schizophrenia Depression Scale, as well as there was a moderate, positive correlation between Positive and Negative Syndrome Scale, the Internalized Stigma of Mental Illness Scale, and the Suicide Ideation Scale in the suicidal ideation group. In regression analysis, depression was found to be a predictor of suicidal ideation. Conclusion: Depression and internalized stigma were risk factors for suicide in schizophrenia. Risk factors need to be carefully assessed to prevent suicide in schizophrenia.

Evaluation of the relationship between death anxiety and clinical features of the disease and functionality in patients with schizophrenia.

Aim: This study aimed to examine the relationship between death anxiety in schizophrenia patients and the clinical characteristics of the disease and its functionality. Method: The study included 52 patients diagnosed with schizophrenia according to the DSM-5 diagnostic criteria and 52 healthy volunteers. Death anxiety scores were compared between the two groups using the Abdel-Khalek Death Anxiety Scale (ADAS). The functionality of the schizophrenia patients was evaluated with the Functional Remission of General Schizophrenia (FROGS) scale. Results: The mean ADAS total scores were statistically significantly higher in the schizophrenia patient group than in the control group. A low-level negative correlation was determined between the ADAS total points and the FROGS total points, the FROGS subscales of daily life skills and health. Conclusion: The results of this study showed higher death anxiety in schizophrenia patients than in the healthy control group. Patients with a higher level of functionality were determined to have a lower level of death anxiety. These results support our idea that interventions and therapeutic approaches to increase functionality in patients with schizophrenia can reduce their death anxiety. In order to reach more evident conclusions on this subject, prospective studies that deal with the causal relationship between death anxiety and functionality are needed.

Validity and Reliability of the Turkish Version of Mahony Psychological Assessment for Bariatric Surgery.

Background: The aim of this study was to determine the validity and reliability of the Turkish version of Mahony Psychological Assessment for Bariatric Surgery which can be easily administered and used as a guide by health professionals who will be included in the treatment of patients who are potential candidates for bariatric surgery. Methods: A total of 310 patients who were admitted to health institutions for bariatric surgery in 3 different provinces of Turkey answered these questions in the Turkish translation of Mahony Psychological Assessment for Bariatric Surgery. Eating disorder examination questionnaire was also administered to the patients in addition to Mahony Psychological Assessment for Bariatric Surgery. Results: Early life problems due to weight scores of women were significantly higher than men (P = .001). Among the age groups, both the early life problems due to weight scores (P = .008) and dysphoric feelings about weight scores (P < .001) of the 18-44 age group were significantly higher than the participants who are over the age of 45. There is a weak-to-medium and positive correlation between the total Mahony Psychological Assessment for Bariatric Surgery total scores and all the subscale and total scores of the Eating Disorder Examination Questionnaire (P < .05 for all). These correlation results support the co-validity of Mahony Psychological Assessment for Bariatric Surgery and Eating Disorder Examination Questionnaire. Internal consistency of the Mahony Psychological Assessment for Bariatric Surgery was at a high level except for the subscale of positive treatment attitude and supportive environment. Cronbach's ɑ values were calculated to be 0.902 for the subscale of emotional and binge eating, 0.820 for the early life problems due to weight, 0.856 for the dysphoric feelings about weight, 0.539 for the positive treatment attitude and supportive environment, and 0.919 for the whole scale. Conclusion: The analyses have shown that the Turkish version of Mahony Psychological Assessment for Bariatric Surgery may be used in clinical interviews and psychiatric evaluation of bariatric surgery patients in Turkey.

Adaptation and the Psychometric Properties of Turkish version of the Structured Clinical Interview for the DSM-5-Personality Disorders - Clinician Version (SCID-5-PD/CV). / DSM-5 Kisilik Bozukluklari için Yapilandirilmis Klinik Görüsme (SCID-5-PD)'nin Türkçeye Uyarlanmasi ve Psikometrik Özellikleri.

OBJECTIVE: The aim of this study is to demonstrate the validity and reliability of the Categorical and Dimensional Psychometric Properties of the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD) after its translation to the Turkish. METHOD: The study was carried out with 102 volunteers from two university hospitals. The SCID interview was conducted by two experienced psychiatrists who interchanged positions as interviewer and observer; and completed the research forms without discussing the patient. The diagnostic agreement between the interviewers and the Kappa coefficient were calculated. Divergent and convergent validity analyses were carried out for diagnostic validity and the scores obtained from the self-report form as well as the dimensional evaluation scores were used in the statistical analyses. RESULTS: The group mean age for volunteers was 39.6±11.6 years and 66.7% consisted of females. The Kappa values for personality categories were 0.79 for avoidant personality structure, 0.64 for dependent personality structure, 0.81 for obsessive-compulsive personality structure, 0.76 for paranoid personality structure, 0.49 for schizotypal personality structure, 0.90 for histrionic personality structure, 0.66 for narcissistic personality structure, 0.89 for borderline personality structure and 0.71 for antisocial personality structure. Dimensional evaluation showed significant correlation with the diagnostic agreement between the interviewers and also with the scores of the self-report forms completed by the participants. CONCLUSION: The results demosntrated that the Turkish version of the Structured Clinical Interview for DSM-5 Personality Disorders (SCID- 5-PD-CV-TR) is valid and reliable.

The Effect of Vision-Related Quality of Life on Depression and Anxiety in Patients with Behçet Uveitis.

OBJECTIVES: To evaluate the effect of vision-related quality of life on depression and anxiety in patients with Behçet uveitis. MATERIALS AND METHODS: The Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI) I-II, and the Visual Functioning Questionnaire (VFQ)-25 were used to evaluate 105 patients being followed for Behçet uveitis. Sociodemographic data and VFQ-25 scores were compared between the groups with and without depression and anxiety. Regression analysis was performed to determine the relationship between the variables. RESULTS: Forty-eight (82.8%) men and 10 (17.2%) women who completed the questionnaires were included in the study. The mean age of the patients was 37.76±11.14 (18-65) years and the mean duration of uveitis was 8.57±7.43 (1-27) years. The mean VFQ-25 composite, BDI, STAI-I, and STAI-II scores were 74.90±18.50 (18.79-97.04), 10.76±8.90 (0-43), 42.52±6.23 (25-55), and 46.53±6.80 (27-58), respectively. Of 58 patients, 31% had depressive symptoms and 58.6% had anxiety symptoms. VFQ-25 composite score was lower in the depressive group than in the group with no depression (p=0.030), while there was no significant difference in this score between the groups with and without anxiety. Regression analysis revealed a negative relationship between total VFQ-25 composite score and depression. CONCLUSION: In our study, high rates of depression and anxiety were detected in patients with Behçet uveitis. Patient-reported visual functioning was associated with depression. In patients with Behçet uveitis, it is important to evaluate vision-related quality of life as well as visual acuity.

The effects of the COVID-19 outbreak on physicians' psychological resilience levels.

BACKGROUND: Health-care workers exposed to coronavirus19 disease could be psychologically stressed. The objective of this study is to assess the anxiety, depression levels, and psychological resilience of physicians working during the Covid-19 outbreak and to evaluate the related factors that are associated with their psychological resilience. METHODS: The sample of this descriptive study was composed of medical doctors and dentists. The data were obtained online between April 13-23, 2020 through a survey prepared by the researchers. In addition, a questionnaire about the participants' sociodemographic characteristics, the Psychological Resilience Scale and Hospital Anxiety Depression Scale (HAD-A/HAD-D) was given. RESULTS: The average age of the 671 participants was 44.0 ± 9.0 years. Psychological resilience scores were significantly higher in those who had children, who had worked for 15 years or more, and who had received training about COVID-19 (p < 0.05). Depression scores were higher among women and in those who reported having a chronic disease, whose workload increased after the outbreak, and who had physical contact with COVID-positive patients. The anxiety scores were also higher among women and in those whose workload had increased and who had contact with COVID-positive patients (p < 0.05). The physicians with scores below the cutoff point on the HAD-D/HAD-A had significantly higher scores on the Psychological Resilience Scale (p < 0.05). DISCUSSION: Depression and anxiety levels were found to be significantly lower in physicians with greater psychological resilience. Psychological and social support of all health-care workers, especially physicians, is important in the struggle with the pandemic. It is thought that determining the variables related to psychological resilience in health-care workers will be a guide for psychosocial services.

The effect of cognitive symptoms in binge eating disorder on depression and self-esteem: a cross-sectional study.

PURPOSE: To compare individuals with class II and III obesity with and without binge eating disorder (BED) in terms of sociodemographic characteristics, depressive symptoms, self-esteem, eating behaviors, and cognitive variables thought to be involved in the pathophysiology of the disease. METHODS: The participants were selected from volunteer patients with body mass index ≥ 35 applying to the Ondokuz Mayis University Medical Faculty, Turkey, for bariatric surgery between 01.07.2016 and 31.05.2019. The Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RSES), and Eating Disorder Examination Questionnaire (EDE-Q) were administered to all participants. RESULTS: Binge eating disorder (BED) was determined in 95 (34%) of the 278 individuals applying for bariatric surgery. The frequency of previous psychiatric diseases was higher in the BED group than in the non-BED group. BDI, RSES, total EDE-Q, weight concern, shape concern, and eating concern EDE-Q subscale scores were also higher in the BED group. Correlation analysis revealed positive low correlation between depression scores and total EDE-Q scores and all subscales scores, with the exception of restraint. Positive low correlation was determined between decreased self-esteem and body weight and shape concern. At multivariate regression analysis, cognitive variables explained 28.6% of variance in depressive symptoms in the BED group, and 21.5% of variance in self-esteem. CONCLUSION: The study results showed elevation in cognitive factors in patients with BED compared to the controls. Among these variables, eating and weight concern were shown to be associated with depressive symptoms, while eating concern was linked to self-esteem. LEVEL OF EVIDENCE: Level III, case-control analytic study.

Prevalence of Depression, Anxiety, Distress and Insomnia and Related Factors in Healthcare Workers During COVID-19 Pandemic in Turkey.

The purpose of this study was to evaluate the prevalence of depression, anxiety, distress, and insomnia and related factors in healthcare workers during the COVID-19 pandemic in Turkey. We applied the study survey online to HCWs during the pandemic in Turkey between 23 April and 23 May 2020. We used the sociodemographic data form, Patient Health Questionnaire-9, General Anxiety Disorder-7, Insomnia Severity Index, and Impact of Event Scale-Revised. Six hundred twenty (66.0%) of the 939 HCWs taking part in the study were female, 580 (61.8%) were physicians, 569 (60.6%) were working on the front line. Seven hundred twenty-nine (77.6%) participants exhibited depression, 565 (60.2%) anxiety, 473 (50.4%) insomnia, and 717 (76.4%) distress symptoms. Depression, anxiety, insomnia, and distress symptoms were significantly greater among females, individuals with a history of psychiatric illness, and individuals receiving psychiatric support during the COVID-19 pandemic. HCWs serving in Turkey during the COVID-19 pandemic experienced high levels of depression, anxiety, insomnia, and distress symptoms. Female gender, being a nurse, working on the front line, history of psychiatric illness, and being tested for COVID-19 were identified as risk factors for mental health problems.

Predictors of depression and anxiety among caregivers of hospitalised advanced cancer patients.

INTRODUCTION: Cancer is a chronic disease that requires long-term treatment and care. Caregivers of cancer patients are at greater risk of developing depression than the general population. The effect of caregivers' cognitive flexibility on depression and anxiety has not been well studied. We aimed to investigate the social characteristics, burden levels and cognitive flexibility of caregivers of advanced cancer patients, and determine the relationship between these factors and depression and anxiety. We hypothesised that factors such as cognitive flexibility and caregiver burden level significantly predict anxiety and depression. METHODS: The study included 69 primary informal caregivers of patients with Stage 4 cancer. Methods utilised included diagnostic semi-structured interviews, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Zarit Caregiver Burden Inventory and cognitive flexibility inventory. RESULTS: BDI scores were found to be significantly higher in caregivers who cared for men compared to those who cared for women (20.44 ± 2.06 vs. 13.29 ± 1.81; t = 2.60; p = 0.01). BDI mean scores were statistically lower in caregivers who received help with caregiving compared to those who did not (t = 2.62; p = 0.01). Cognitive flexibility level, burden level and lack of social support were found to be predictors of caregiver depression. CONCLUSION: The study showed that individuals with low cognitive flexibility levels are more likely to have depressive and anxiety symptoms. Based on our findings, we opine that evaluations of caregivers' cognitive strategies and social support are needed to determine the risk of depression in caregivers of cancer patients.

Early maladaptive schemas in patients with bipolar and unipolar disorder.

OBJECTIVE: The aim of our study is to determine the difference between the bipolar disorder, unipolar disorder and control groups in terms of maladaptive schemes and childhood trauma. METHODS: Two groups of patients under monitoring with a diagnosis of bipolar or unipolar disorder and one group of healthy controls were enrolled in this study. Each group consisted of 60 subjects. The Young Mania Rating Scale and Beck Depression Inventory were used to confirm that patients were in remission. The Childhood Trauma Questionnaire and Young Schema Questionnaire-Short Form 3 were used to identify childhood traumas and early maladaptive schemas. RESULTS: In bipolar disorder, a positive, low power correlation was observed between the vulnerability to threats schema and emotional, physical and sexual abuse. In the unipolar disorder group, there was a positive, low power correlation between the emotional inhibition, failure, approval seeking, dependence, abandonment and defectiveness schemas and social isolation, and a positive, moderate correlation between social isolation and emotional abuse. CONCLUSIONS: Individuals with bipolar disorder suffered greater childhood trauma compared to subjects with unipolar disorder and healthy individuals. Greater maladaptive schema activation were present in individuals with bipolar disorder compared to those with unipolar disorder and healthy individuals.

Associations with violent and homicidal behaviour among men with schizophrenia.

Objective We aimed to assess the risk factors associated with homicidal behaviour in male patients diagnosed with schizophrenia. Methods In a period of 1 year, male schizophrenia cases between 18-65 years of age (n = 210) were included. The clinical evaluation included the Positive and Negative Syndrome Scale (PANSS) and Overt Aggression Scale (OAS). The patients were divided into three groups in terms of violent behaviour history: (1) homicide group (n = 30), (2) a violent act resulting in serious injury (n = 71), (3) control group (patients without a history of a violent act) (n = 109). Results Lower level of education, rural residence, being unemployed and living alone were found to be significantly more common in patients who had committed a violent act compared to the schizophrenia patients in the control group. In order to explore the predictive value of several factors associated with violent behaviour, a logistic regression model was used, and variables (shorter duration of education, living alone, and lack of insight) significantly predicted the presence of violent behaviour (murder and/or injury) (χ(2)=31.78, df = 12, p = 0.001). Conclusions In order to be able to determine causality of homicidal acts in schizophrenia patients, our significant findings between homicidal violence, non-homicidal violence and the control group would merit further attention and exploration in further studies.

[Relationship between the Psychiatric Symptoms in Expecting Parents and Postpartum Depression and Infantile Colic: A Multicenter Follow up Study]. / Anne ve Baba Adaylarinda Psikiyatrik Belirtiler ile Dogum Sonrasi Depresyon ve Infantil Kolik Arasi Iliski: Çok Merkezli Bir Takip Çalismasi.

OBJECTIVE: The aim of this study is to evaluate the relationship between postpartum depression (PPD), infantile colic (IC) and different psychosocial variables, psychiatric symptoms, attachment style and perceived social support in expecting parents. METHOD: Two hundred forty five expecting mothers and 150 expecting fathers were first interviewed between the 22-34 weeks of pregnancy. Sociodemografic data form, Adult Attachment Style Scale (AASS), State Anxiety Inventory (SAI), Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS) and Brief Symptom Inventory (BSI) were filled out by each expecting parent. Second interview was conducted between the postpartum 4-24 weeks. Data form consisting health, nutrition, sleep and crying problems of the infant and EPDS and SAI were filled out by mothers and SAI by fathers. RESULTS: One in every four mothers had PPD symptoms above the threshold on EPDS. Maternal and paternal insecure attachment style, maternal psychiatric symptoms and postpartum anxiety level were found to be the predictors of PPD. One in every five infants had IC and maternal education level, hostility score and PPD symptoms along with paternal insecure attachment style and psychiatric symptoms were the main predictors of IC. CONCLUSION: Results about PPD and IC regarding maternal variables are consistent with the literature. In addition, paternal insecure attachment style is found to be an important risk factor for both PPD and IC. Fathers should also be included in further studies exploring PPD or IC.

Mother-Child Interactions of Preterm Toddlers.

INTRODUCTION: We aimed to investigate the mother-toddler relationship in preterm toddlers. METHODS: The sample consisted of 18 mothers and their preterm toddlers (group 1) and 20 mothers and their fullterm toddlers (group 2). Anxiety and depressive symptom levels, attachment pattern, and parental attitudes of mothers and social-emotional problems and developmental level of the toddlers were explored to assess possible confounding factors in the mother-toddler relationship. Two researchers rated the Parent Infant Relationship Global Assessment Scales (PIRGAS). RESULTS: Both the mothers in group 1 and group 2 had similar Beck Depression Inventory (BDI) and State and Trait Anxiety Inventory (STAI) scores. However, the mothers who gave birth before 32 weeks of gestation had higher trait anxiety scores than others (46±2.4 vs. 42.3±5.4, p=0.01). The groups had similar Brief Infant Toddler Social Emotional Assessment Scale (BITSEA) problem and competency scores. The parenting style of group 1 revealed that they had higher scores on the Parenting Attitude Research Instrument (PARI) subscale 5 (excessive discipline) (39.6 vs. 32.1; p=0.02). CONCLUSION: Mother-toddler interaction and attachment security were found to be similar in fullterm and moderately preterm healthy toddlers. Our findings suggest that not the preterm birth itself but the medical, developmental, and/or neurological consequences of prematurity may affect the mother-toddler interaction. To explore the independent effect of prematurity in mother-toddler dyadic relationship, longitudinally designed studies are warranted.

Effects of Dimensional and Categorical Classification on the Clinical Manifestation of Major Depressive Disorder.

INTRODUCTION: The aim of this study was to combine the dimensional concept with the categorical system in major depressive disorder (MDD) to reduce the complexity of the diagnosis. Furthermore, it was aimed to match categorical and dimensional approaches in a clear and simple manner. METHOD: The study included a patient group of 131 consecutive outpatients diagnosed with MDD according to the DSM-IV diagnosis criteria, and a control group of 99 people that is matched with the patient group by gender, age and education level. All subjects completed the Beck Depression Inventory, the Beck Anxiety Inventory and the Toronto Alexithymia Scale (TAS). RESULTS: Cronbach's alpha values for the analysis of the internal consistency of the scale for the patients group, control group and the total participants were determined as .94-.97, .87-.92 and .93-.96, respectively. Nine factors were obtained from the results of exploratory factor analysis. According to the Scree-plot, it was decided that the two-factor structure represents best. Although depression and anxiety are two distinct dimensions, the relationship between them was found to be significantly significant. This was valid for both patient and control groups. When the relationship between the DSM-IV diagnosis criteria and all variables (depression and its sub-dimensions, anxiety and its sub-dimensions and the number of symptoms) was evaluated, the number of symptoms was found to be significantly related with all of the criteria. CONCLUSION: The number of symptoms and the severity of illness are found to be important in the clinical manifestation of MDD. The relationship of the severity of the illness with sleep and appetite seems weaker. While loss of interest was mainly predicting the disorder, weight changes, psychomotor changes, difficulty in concentration, fatigue, and worthlessness were determined not to be predictors of the manifestations. According to dimensional approach, somatic anxiety and deterioration in performance predict the presence of the disorder. According to categorical and dimensional approaches, some of the DSM-IV criteria (#2, #1, #9, #4, number of symptoms, severity of symptoms, somatic anxiety, performance deterioration) are seen to contribute to the matchability between the approaches.

[Executive function differences between first episode and recurrent major depression patients]. / Ilk Epizod Major Depresyon ve Yineleyici Major Depresyon Gruplari Arasinda Yönetici Islev Farkliliklari

OBJECTIVES: The differences between recurrent episodes and first episode depression among depressive patients in terms of executive functions had not previously been investigated. In this study, we aimed to explore executive function differences between patient groups with depression and healthy control subjects. METHOD: 19 first episode sufferers of depression, 14 sufferers of recurrent major depression and 33 healthy subjects, selected as suitable with regard to gender and educational level, were enrolled in this study. In the first session, we applied the SCID-I, State-Trait Anxiety Inventory (STAI), Mini Mental Test (MMT) and the Beck Depression Inventory (BDI). In the second session we applied neuropsychological tests including the Wisconsin Card Sorting Test (WCST), Verbal Fluency Test (VFT) and Stroop Tests to all participants. RESULTS: Patients with depression exhibited worse performance in all tests compared to control subjects. While there were no differences between first episode and recurrent depression patients in terms of depression severity and anxiety levels, recurrent depression patients had significantly more perseveration tendency in WCST and significantly worse performance in word production. Among patients in the recurrent depression group, 63,5% had second, 22,2% third, 14,2% had had a fourth episode. There is a significant correlation between the number of depressive episode and the perseveration tendency in WCST. DISCUSSION: The results indicate that, compared to first episode depression, the patients with recurrent depression have worse executive function performance and perseveration tendencies. Episode quantity and perseveration tendency were associated.

Maternal psychological problems associated with neonatal intensive care admission.

Background. Mothers of infants admitted to a neonatal intensive care unit (NICU) are believed to have heightened distress. The purpose of this paper was to determine depression and anxiety symptoms and attachment style in NICU mothers. Methods. The NICU group consisted of mothers whose infants were admitted to the NICU and the control group consisted of mothers of healthy term infants. The psychosocial assessments were done at the first month. Results. The mean Edinburgh Postpartum Depression (EPDS) score of NICU mothers was significantly higher than that of the control group mothers (9.6 +/- 5.6 versus 7.3 +/- 4.9, P = .005). NICU mothers who had high EPDS (>/=13) scores had significantly higher anxiety scores and insecure attachment style in comparison to the subgroup of NICU mothers who had low EPDS scores. Conclusion. Mothers of NICU babies had higher EPDS scores. Mothers who had higher EPDS scores had higher anxiety scores as well. These NICU mothers should receive appropriate counseling during the hospitalization of their babies.

Breastfeeding duration and postpartum psychological adjustment: role of maternal attachment styles.

AIM: Depressive and anxiety symptoms are common in new mothers. The aim of this study is to explore the link between postpartum psychological adjustment and feeding preferences of the mothers. METHODS: Sixty mothers and newborns were enrolled in this prospective, longitudinal study. Maternal depressive symptoms were screened by the Edinburgh Postpartum Depression Scale (EPDS), and maternal anxiety level was assessed by the State-Trait Anxiety Inventory at 1 month postpartum. The Multidimensional Scale of Perceived Social Support was used for the assessment of maternal social support. The Adult Attachment Scale was used to determine the attachment style of the mother. Infants were examined and evaluated at 1 and 4 months of life. RESULTS: All mothers started breastfeeding their infants postpartum; 91% and 68.1% continued exclusive breastfeeding at 1 and 4 months, respectively. The first-month median EPDS score of mothers who breastfeed at the fourth month was statistically significantly lower than those who were not breastfeeding (6 and 12, respectively) (P = 0001). The first-month median EPDS score of mothers with secure attachment was lower than the median score of mothers with insecure attachment (5 and 9, respectively) (P < 0001). Exclusive breastfeeding rate was not statistically different among mothers with secure and insecure attachment styles. The median state and trait anxiety scores and social support scores of mothers were not different between groups according to breastfeeding status. CONCLUSIONS: This study has shown an association between higher EPDS scores and breastfeeding cessation by 4 months after delivery.

Right basal ganglion hypoperfusion in obsessive compulsive disorder patients demonstrated by Tc-99m-HMPAO brain perfusion spect: a controlled study.

The aim of this study is to demonstrate the regional cerebral blood flows (rCBF) of obsessive-compulsive disorder (OCD) patients compared to controls by using Tc-99m-HMPAO SPECT. Sixteen OCD and seven control subjects were admitted into the study. Yale-Brown Obsessive Compulsive Rating Scale (Y-BOCS), Hamilton Depression Rating Scale (HDRS), and Hamilton Anxiety Rating Scale (HARS) were applied to the patients. The rCBF was found to be decreased in right basal ganglion in OCD patients. The right basal ganglion rCBF was negatively correlated with Y-BOCS total and compulsion scores. The left thalamus rCBF was negatively correlated with Y-BOCS obsession score. Right and left cingulate rCBF were negatively correlated with HDRS score. The results indicating hypoperfusion in right basal ganglion in OCD patients support previous findings about dysfunction of frontal-subcortical circuits in this disorder.