Early maladaptive schemas in female patients with migraine and tension-type headache.

Chronic headache is a serious clinical problem in women which psychological factors play major role and requires an approach with bio-psycho-social integrity. Psychiatric comorbidities such as anxiety disorder and major depression are frequent. Young described Early Maladaptive Schemas (EMS) as maladaptive and dysfunctional patterns that appear due to unpleasant situations occurred between patient and people who were important to him. EMS affect perception, emotions, thoughts and behaviors that makes a basis for many disorders. EMS are found to be related with depression, anxiety and somatization within recent literature. In literature, chronic pain and migraine's relationship with EMS were studied before in a few separate articles. However, there is a lack of data that compares the relationship between EMS and clearly distinguished headache types: migraine (MH) and tension-type headache (TTH) especially in female patients who are more prone to somatic complaints/findings. Our study directly compared three groups, migraine and tension type headache and healthy controls. 150 female patients with chronic headache were enrolled for study in consecutive fashion. Exclusion criteria were as follows: age < 18 or > 60 years, male gender, existence of comorbidity affecting central nervous system, headache due to drug/substance abuse, previous diagnosis of migraine with aura, previous diagnosis of psychotic disease, mental retardation, cognitive disorders, being in delirium state. Patients were grouped into two categories according to type of headache and a third control group. All patients were evaluated with Young Schema Questionnaire (YSQ) and their scores were noted and categorized in related schema domains. Sociodemographic data were comparable among groups. However, there were significant differences in terms of previous psychiatric diagnosis and psychiatric drug usage. When we compared YSQ scores, groups differed in many schema categories. MH group showed significantly higher scores in dependency/incompetency, unrelenting standards and punitiveness schemas when compared to remaining two groups. TTH group had significantly more points in emotional deprivation, vulnerability to harm or illness schemas among all groups. On the other hand, control group had significantly higher scores in insufficient self-discipline and entitlement/grandiosity schemas when compared to both MH and TTH groups. Presence of EMS in female patients with headache significantly differed from control group. Types of EMS were also significantly different between patients with MH and TTH among this whole headache group. We suggest that a comprehensive psychotherapeutic approach that targets to improve coping methods for distinct EMS in distinct headache types would provide critical aid to general treatment of headaches especially in resistant cases.

Assessment of Anxiety, Depression and Work-Related Strain Levels of Healthcare Professionals Working in Operating Rooms and Intensive Care Units During the COVID-19 Outbreak.

OBJECTIVE: The purpose of the study was to determine the levels of work-related strain, anxiety, and depression in health professionals working in operating rooms and intensive care units who deal with the diagnosis, treatment, and care of coronavirus disease 19 patients. METHODS: The population of the study consisted of 320 healthcare professionals working in the operating room and intensive care units. After providing detailed information about the study to the participants, a questionnaire consisting of 21 questions including sociodemographic infor- mation and working life characteristics, 14 questions from the Hospital Anxiety and Depression Scale, and 18 questions from the Work-Related Strain Inventory (WRSI) were administered under supervision. RESULTS: In total, 58.8% of the participants were working in intensive care units, and 41.2% of the participants were in the operating room. The scores obtained from Work-Related Strain Inventory were found to be statistically significantly high in those who wanted to choose a differ- ent profession, those who were on duty during the coronavirus disease 19 pandemic process, those whose spouses followed coronavirus disease 19 patients during the pandemic, those who encountered a suspicious situation and had a coronavirus disease 19 test, those who had difficulty in accessing personal protective equipment, and those who thought that their lives were in danger during the pandemic process. Participants with anxiety risk according to Hospital Anxiety and Depression Scale-Anxiety subscale and depression risk according to Hospital Anxiety and Depression Scale-Depression subscale were found to be 153 (47.8%) and 300 (93.8%), respectively. CONCLUSIONS: It was found that Work-Related Strain Inventory and anxiety-depression rates were significantly high in both the operating room and intensive care unit workers who actively provided healthcare services to patients diagnosed with coronavirus disease 19.

[The prevalence of eating disorders and comorbid psychiatric disorders in the Sivas Province]. / Sivas Il Merkezinde Yeme Bozukluklarinin Yayginligi ve Eslik Eden Psikiyatrik Tanilar.

OBJECTIVE: The purpose of this study was to determine the prevalence of eating disorders (EDs) in the Sivas province, and to identify the sociodemographic characteristics and co-morbid axis-I and axis-II diagnoses in EDs. METHOD: 1122 people between 18-44 years of age were enrolled in the study after completing the eating attitude test (EAT), and people who had points around the cut-off score had clinical interviews. The control group included subjects that were age- and sex-matched with the ED group, were not diagnosed with an ED, and had an EAT score <30. In order to determine the following as axis I or axis II, SCID-I (Structured Clinical Interview for DSM-IV Axis-I Disorders) and SCID-II (Structured Clinical Interview for DSM-III-R Personality Disorders) were performed on both the eating disorder and control groups. RESULTS: As a result of the scanning done with EAT, we observed that 5.25% of this population might have an eating behavior disorder. The prevalence of the eating disorders was found to be 1.52% by the structured clinical interview in the second step of the study. While the prevalence of bulimia nervosa was determined to be 0.63%, that of binge eating disorder was 0.81%. The diagnosis of ED is common and statistically significant among women (88.2%). According to the study, persons diagnosed with ED were more likely to have a moderate income as compared with those who were not diagnosed with an ED. Also, people with ED had been exposed to more traumas, and it was more likely that someone in their family had a psychiatric diagnosis. Among the patient group, the axis I and axis II co-morbidity rates were significantly higher than those of the control group. 47% (8/17) of the patients were determined to have a co-morbid axis I diagnosis. The most frequently diagnosed co-morbidity was major depressive disorder. 41% of the patients were determined to have an axis II diagnosis. The most common rate of diagnosis was 11.8% for both obsessive-compulsive personality disorder and avoidant personality disorder. CONCLUSION: The results of this study show that the point prevalence rate for EDs among all the participants was 1.52%, with binge eating disorder being the most prevalent ED. Psychiatric co-morbidity is common in patients with eating disorders. An ED is a disease that can be seen in different age groups and socioeconomic levels. Studies with larger samples, including different regions of the country and different age groups, and with diagnoses that have been confirmed by clinical interviews, are required.