Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633222021Summer32-2 Önyazı: COVID-19 Pandemisinde Psikiyatri Uzmanlık EğitimiA3A4TRRaşitTÜKEL1068

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633222021SummerThe Relationship Between Alexithymia and Impulsiveness in Adult Attention Deficit and Hyperactivity DisorderErişkin Dikkat Eksikliği Hiperaktivite Bozukluğunda Aleksitimi ve Dürtüsellik İlişkisi109117ENTRSedaKİRAZSencanSERTÇELİKSerap ERDOĞANTAYCAN841Objective: It has been emphasised recently that emotion regulation problems may be the core symptoms of attention deficit hyperactivity disorder (ADHD). In this study, we aimed to determine the incidence of alexithymia, the relationship between alexithymia and impulsiveness, the severity of ADHD, depression and anxiety semptoms in adult ADHD. Method: All participants were assessed with the Structured Clinical Interview For DSM IV Axis I Disorders (SCID-I); and completed the Toronto Alexithymia Scale (TAS), the Impulsive Behavior Scale (UPPS), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), Adult Attention Deficit and Hyperactivity Disorder Self Reporting Scale (ASRS) and the Wender Utah Rating Scale (WURS). The ADHD patients were also assessed with the Diagnostic Interview for ADHD (DIVA) for DSM-5 criteria. Results: The study included 101 ADHD patients with a mean age of 23.06 ± 4.24 years with 47.5% females, and 100 healthy control individuals with a mean age of 22.76 ± 5.68 years with 50% female participants. Alexithymia incidence was 41.5% in the ADHD group. The increase in the levels of impulsiveness, depression and anxiety correlated with the severity of ADHD symptoms; and impulsiveness predicted alexithymia in the ADHD group. Conclusion: Alexithymia incidence was higher in the ADHD group. When ADHD and control participants were combined, alexithymic individuals was more associated with impulsivity with frequent display of anxiety symptoms.  

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633222021SummerThe Validity aand Reliability of the Addiction Outcome Assessment Index (AOAI)Bağımlılık Seyir İndeksi (BASİ)’nin Geçerlik ve Güvenilirlik Çalışması129136ENTRMelikeŞİMŞEKMehmetDİNÇKülteginÖGEL842Objective: The objective of this study was to develop a short scale that assesses the progress and recovery in addiction treatment with respect to all relevant areas, and to determine its validity and reliability. Method: After scanning the literature and consulting the experts, a pool of questions was. The pilot form was tested in 10 cases then a final 8-item scale was generated. Clinical sample of the study consisted of 307 alcohol/substance users who applied Turkish Green Crescent Outpatient Counselling Center for psychosocial treatment between March 2016 and March 2017. Non-clinical sample of the study is composed by 102 randomly chosen participants without a history of psychiatric disorder. The reliability of the Addiction Outcome Assessment Index (AOAI) questions was determined by computing the Cronbach’s alpha coefficient, and the factor structure analysis was determined by varimax rotation. Analysis of the reliability of the change between sessions was conducted via Reliable Change Index-(RCI). Results: The Cronbach’s alpha coefficient for the total Outcome Assessment Index (AOAI) was 0.80. Therapists’ total correlation coefficient was 0.75. Explanatory Factor Analysis revealed 2 factors which explains 43.96% of the total variance. The difference between groups’ AOAI-Turkish (BASI) mean score was statistically significant. Cut-off point was determined as 8.63. RCI was 3.5. AOAI’s first session mean score was 14.92±5.63, the mean score decreased at the tenth session to 9.4±4.71. Conclusion: The results showed that AOAI is a valid and reliable questionnaire that can be used to measure the progress of different dimensions of alcohol and substance use.  

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633222021SummerIs Olfactory Reference Syndrome a Diagnostic Entity Under Obsessive-Compulsive and Related Disorders?: A Case ReportOlfaktör Referans Sendromu Obsesif Kompulsif ve İlişkili Bozukluklar Başlığı Altında Değerlendirilebilir mi? Bir Olgu Sunumu142144ENTRDiren BEZEKÖZSOYErhanERTEKİNRaşitTÜKEL843Olfactory reference syndrome (ORS) is a rare psychiatric condition involving embarrassment and distress due to persistent mental preoccupation with the idea of emitting body odours foul and offensive enough to disturb others. This disorder is often accompanied by shame, embarrassment, significant distress, avoidance behavior, social phobia and social isolation. The patients may worry that they spread odours originating from their mouth, sweat, genital areas or the gut. This belief may lead the patients to misinterpret the behaviours of others, they may frequently smell themselves, shower and change clothing during the day. There are differences of opinion whether ORS should be considered as a delusional disorder or appear in under the rubric of obsessive-compulsive related disorders. One of the reasons that create this uncertainty is the variation in the response to different treatments. The treatment strategies generally include the use of antipsychotics, the antidepressants, they are preferentially used in combination. In this report we aimed to discuss the case of a 33-year old male patient whose first complaints had been diagnosed 14 years prior, with a diagnosis of OCD with low insight. Shortly after improvement of the OCD symptoms he developed ORS symptoms. We aimed here to discuss the place of ORS in the diagnostic systems with reference to this case.  

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633222021SummerBurnout in Healthcare Professionals During the Covid-19 Pandemic in a Tertiary Care University Hospital: Evaluation of the Need for Psychological SupportÜçüncü Basamak Bir Üniversite Hastanesinde Covid-19 Pandemisinde Sağlık Çalışanlarında Tükenmişlik: Psikolojik Destek İhtiyacının Değerlendirilmesi7586ENTRÖzen ÖNENSERTÖZÖzlem KUMANTUNÇELNezihSERTÖZCenanHEPDURGUNDamla İŞMANHAZNEDAROĞLUCananBOR870Objective: Anxiety, stress and burnout are observed in healthcare workers during the Covid-19 pandemic. This study aimed to determine the levels of anxiety and burnout and related risk factors in the healthcare workers and assistant personnel at a tertiary referral university hospital. Method: Hospital Anxiety Depression Scale (HADS), Maslach Burnout Inventory (MBI) and a sociodemographic questionnaire were delivered on-line to all employees of our hospital. 683 individuals were to the study who completed and returned the forms between April 15-30, 2020. Results: Stress, depression and anxiety levels were significantly higher in nurses. Emotional burnout and depersonalization symptoms were higher and personal accomplishment scores were lower in resident physicians and nurses in comparison to the other groups. Being single, having a child and living away from home were factors underlying the burnout severity. Frontline work in the Covid-19 clinics did not affect the levels of anxiety, stress and depression. On the basis of the cut off points of the HADS scores; anxiety disorder (OR: 7.19) and depression (OR 3.43) were the most relevant risk factors for emotional exhaustion. Anxiety disorder was also the main risk factor for depersonalization. Depersonalization was 2.7-fold more among the nurses complaining of being overworked. Social support from the work environment and the family was protective against depersonalization. Conclusion: Covid-19 pandemic has adversely affected the wellbeing of healthcare workers. The presence of depression and anxiety increased the risk of burnout. Social support can be expected to protect against burnout. It is, therefore, of great importance to implement urgently effective psychosocial and organizational interventions in order to protect the mental health of healthcare workers and to prevent burnout.  

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633222021SummerLetter to the Editor: Tele-Psychiatry Implementation In A University Hospital During The Covid-19 PandemicEditöre Mektup: Küresel Salgın Döneminde Bir Üniversite Hastanesinde Tele-Psikiyatri Uygulaması148150ENTRMustafaYıldızMehmet BuğrahanGürcanDuyguEsenHilmiYaşar871

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633222021SummerClinical Characteristics and Comorbidities of Patients with Trichotillomania and Skin Picking Disorder Who Admitted to a Psychodermatology Outpatient Clinic: A Comparative StudyPsikodermatoloji Polikliniğine Başvuran Trikotillomani ve Deri Yolma Bozukluğu Tanılı Hastaların Klinik Özellikleri ve Eş Tanıları: Bir Karşılaştırma Çalışması100108ENTREfruz PİRDOĞANAYDINJülide GÜLERKENARİlknur KIVANÇALTUNAYAzra GÖKOVALIBEĞENENYiğitKIVILCIMÖmer AkilÖZERKayıhan OğuzKARAMUSTAFALIOĞLU1067Objective: Trichotillomania (TTM) and Skin Picking Disorder (SPD) are psychiatric disorders characterized by chronic and compulsive pulling and picking to remove hair and skin. There are very few studies on the clinical and phenomenological differences of TTM and SPD. In this study we aimed to compare the clinical characteristics and comorbidities of patients diagnosed with TTM and SPD. Method: We enrolled 56 TTM and 113 SPD patients who were assessed with SCID-I for DSM-IV. In addition, we evaluated the DSM- 5 criteria for Obsessive and Compulsive Disorder spectrum. We also utilized sociodemographic form, the Clinical Global Impression Scale, the Beck Anxiety Inventory and the Beck Depression Inventory. Results: Although patients with TTM and SPD had many common clinical features and comorbidities, statistically significant differences were determined in the number of the pulling/picking sites (Z=- 7.084; p<0.001), the type of the outpatient clinics which they initially consulted (χ2=19.451; p<0.001), reasons for pulling/picking behavior (p<0.05) and comorbidities of depression (χ2=3.878; p=0.049) and onychophagia (χ2=7.173; p=0.007). Disease severity and depression and anxiety scores of patients with TTM and SPD who had comorbid diseases were statistically significantly higher compared to the patients without comorbidities (p<0.005). Conclusion: TTM and SPD often present with common clinical characteristics and a high incidence of psychiatric comorbidities. Finding out the clinical characteristics, the triggering factors and determining the comorbidities are important to gain an understanding of the course and determine the appropriate treatment for these disorders. Hence, phenomenological studies on large patient populations are needed.  

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633222021SummerAdaptation of the Measures of Criminal Attitudes and Associates to the Turkish Language: Validity and Reliability StudySuça Yönelik Tutumlar ve İlişkiler Ölçeği Türkçe Formu’nun Geçerlik ve Güvenirlik Çalışması118128ENTRHüseyinNERGİZSedatIŞIKLI1089Objective: There are many biopsychosocial determinants among factors that trigger criminal behavior. Social variables such as the number of friends involved in criminal activity and the amount of time spent with them, as well as psychological processes such as sentiments of entitlement, antisocial attitudes of the individual can influence the possibility of getting involved in acts of crime. The purpose of this study was to adapt the Measures of Criminal Attitudes and Associates (MCAA) to Turkish language and to test its reliability and validity of the Measurement of Criminal Attitudes and Associates (MCAA), adapted to the Turkish language (MCAA-TR). Method: The Turkish version of the scale was tested on 202 adult convicts and 208 undergraduate university students. In order to assess the concurrent validity of the MCAA-TR, the UPPS Impulsive Behavior Scale and Criminal Thinking Scale (MCAA) were given to participants. Results: Principal component analysis showed that the factor structure of the MCAA-TR was highly consistent with the original version of the scale. The Cronbach’s Alpha internal consistency was 0.86 for the total scale and ranged from 0.68 to 0.82 for subscales. Results of discriminant function analysis showed a classification efficiency of 77.6%. Also, the total sub-dimension scores of the MCAA-TR showed significant correlation with the scores on the relevant sub-dimensions of the scales used to evaluate concurrent validity. Conclusion: The MCAA-TR was found to be a valid and reliable tool for assessing crime related cognitions and attitudes  

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633222021SummerCommon Side Effects and Metabolic Syndrome due to Clozapine: Relationship with the Clinical Variables and DisabilityKlozapine Bağlı Sık Görülen Yan Etkiler ve Metabolik Sendrom: Klinik Değişkenlerle ve Yetiyitimiyle İlişkisi8799ENTRGamzeGÜRCANŞevin HUNŞENOLA. Elif ANILYAĞCIOĞLUSevilayKARAHANAygünERTUĞRUL1153Objective: Common side effects of clozapine may affect the treatment process negatively. In this study, we aimed to assess the common side effects and the prevalence of metabolic syndrome in schizophrenia patients treated with clozapine, and to study their relationship with clinical variables and disability. Method: One hundred and twenty two patients who met DSM-IV criteria for schizophrenia, and were on clozapine treatment were included in the study. Clinical status was evaluated through a clinical interview and review of the medical records, and physical measures and laboratory tests were recorded. Patients were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders, UKU (Udvalg for Kliniske Undersogelser) Side Effect Rating Scale, World Health Organization (WHO)-Disability Assessment Schedule II, Positive and Negative Syndrome Scale, Global Assessment Scale, Clinical Global Impression Scale. Results: Common side effects of clozapine were hypersalivation, fatigue, sedation and constipation. The relationship between constipation and clozapine dose, and dizziness and norclozapine plasma levels were significant. The prevalence of metabolic syndrome was 50%, and patients with metabolic syndrome had higher means of age and lifetime cigarette consumption. Disability was positively correlated with the severity of psychopathology and the number of side effects, and negatively correlated with the age at onset of illness. Severity of the psychopathology and the number of side effects predicted the severity of the disability. Conclusion: Clozapine was associated with various side effects and half of the patients had metabolic syndrome. Assessment of common side effects due to clozapine is important for reducing disability  

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633222021SummerCould Weight Loss During Clozapine Therapy be an Indicator of Poor Response?: A Case ReportKlozapin Tedavisi ile Kilo Kaybı Tedaviye Zayıf Yanıtın Göstergesi Olabilir mi?: Olgu Sunumu137141ENTRBurcu KÖKKENDİRLİOĞLUAytül GÜRSUHARİRİ1154Even though effectiveness of clozapine on treatment resistant schizophrenia has been repeatedly demonstrated, it is also associated with many adverse effects including weight gain. Curiously, significant weight loss may occur in some patients. In this case report we discussed whether the observed weight loss could be a negative prognostic factor. The 56 year-old male patient, followed up with the diagnosis of schizophrenia for 20 years, had persistent positive and negative symptoms despite concurrent use of different antiypsychotics. He was diagnosed with treatment-resistant schizophrenia and started on clozapine with dose titration to 500 mg/day over 3 months. He was observed to have lost 17.6% of his initial body weight after 7 months of therapy. The Positive and Negative Syndrome Scale (PANSS) score of the patient did not change significantly. There are a few case reports in the literature on weight loss during clozapine therapy. Some proposed that the weight loss could be a sign of weak response to treatment which is based on the observation that the clinical response might be poor when there is a weight loss and no change in blood triglyceride levels is observed with the treatment. There is a need for more case-control and preclinical studies to explain the mechanisms underlying weight loss and weak response to clozapine therapy in schizophrenia.  

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633222021SummerLetter to the Editor: Sertraline-Induced Acute Urinary Retention In A Patient With Adjustment DisorderEditöre Mektup: Uyum Bozukluğu Olan Hastada Sertralin Kaynaklı Akut Üriner Retansiyon145147ENTRAdemSancıUtkuBaklacıTuğba MenteşeBabayiğitÖmerGülpınar1155