BACKGROUND: This study aimed to investigate the prevalence of psychiatric disorders among earthquake survivors who sought psychiatric consultation at outpatient clinics in the aftermath of the Kahramanmaras Twin Earthqua...BACKGROUND: This study aimed to investigate the prevalence of psychiatric disorders among earthquake survivors who sought psychiatric consultation at outpatient clinics in the aftermath of the Kahramanmaras Twin Earthquakes (Mw 7.8 and Mw 7.5). SUBJECTS AND METHODS: This observational study targeted a demographic impacted by seismic events within the first month, specifically all patients who self-presented at our outpatient clinic. The primary outcome variable was the diagnosis at the time of consultation according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Additional outcome variables explored included the frequency of re-experiencing the traumatic event, avoidance of internal and external reminders, experiencing phantom earthquake syndrome, hyper-vigilance, negative affectivity, hallucinations, and delusions. RESULTS: The study involved 331 individuals, predominantly female (67.4%), with a mean age of 41.2 years. Most had 10.9 years of education and lived with families. A small proportion (1.8%) reported physical injuries from the earthquake, while 58.7% reported housing problems. The majority experienced no loss or injuries of acquaintances, friends, or relatives (80.4% and 81%, respectively). Co-morbid medical conditions were present in 14% (hypertension) and 7% (diabetes mellitus) of participants. At the consultation, 53% were diagnosed with a psychiatric disorder, primarily trauma and stress related, depressive, and anxiety disorders. CONCLUSION: The findings underscore the significant mental health impact of earthquakes and highlight the need for immediate and targeted mental health interventions in the aftermath of such events. The study also emphasises the importance of recognising and addressing the mental health needs of vulnerable groups in post-disaster settings.
BACKGROUND: A post-hoc analysis was planned to create and compare machine learning algorithms to predict treatment responses to sleep disturbances in patients with schizophrenia. SUBJECTS AND METHODS: This post-hoc analy...BACKGROUND: A post-hoc analysis was planned to create and compare machine learning algorithms to predict treatment responses to sleep disturbances in patients with schizophrenia. SUBJECTS AND METHODS: This post-hoc analysis was done on a randomized controlled trial (NCT03075657), studying the effect of add-on ramelteon on sleep and circadian rhythm disturbances in 120 patients with schizophrenia. We created models using random forest, k-nearest neighbors, extreme gradient boosting machine, R part Classification and regression trees and logistic regression algorithms. R language with mlbench, caret, MASS, rPART packages were used. Box plot and dot plot were plotted to visualize comparisons among the models. RESULTS: The logistic regression algorithm was found to be the best-fit model with a specificity of 0.93 and sensitivity of 0.45, and ROC 0.78. Predominant symptom domain (positive or negative), urinary melatonin and global PSQI score at baseline were the most important variables when plotted in terms of mean decrease accuracy. These variables contributed significantly to the final model in the logistic regression algorithm, and the accuracy of this algorithm was found to be 90% for prediction. CONCLUSIONS: Machine learning models are an emerging trend in clinical research and should be translated into clinical practice. The logistic regression model predicted responders with 90% accuracy.
BACKGROUND: This study aimed to compare the retinal nerve fiber layer (RNFL), the inner plexiform layer (IPL), the ganglion cell layer (GCL), and the choroid thickness (CT) of patients diagnosed with panic disorder (PD)...BACKGROUND: This study aimed to compare the retinal nerve fiber layer (RNFL), the inner plexiform layer (IPL), the ganglion cell layer (GCL), and the choroid thickness (CT) of patients diagnosed with panic disorder (PD) before and after four-weeks of the treatment and to compare the findings with the healthy subjects. SUBJECTS AND METHODS: The PD group consisted of 32 subjects and the control group consisted of 64 subjects. All patients were managed by paroxetine plus alprazolam after PD diagnosis. The spectral-domain optical coherence tomography (SD-OCT) was applied twice to the PD group, before and after treatment, and once to the control group. RESULTS: Age (p=0.916) and smoking status (p=0.850) of PD (23 females, 9 males) and control (46 females, 18 males) groups were similar. Pre-treatment PD's RNFL sub-sectors, GCL, and IPL values were lower than the control group. Pre-treatment PD's CT value was higher than the control group. Four-weeks of PD treatment caused an increase in RNFL sub-sectors in the pre-treatment SD-OCT parameters of PD group, significantly in left mean and left TI. The sensitivity of mean CT (p<0.001) related to the diagnosis of pre-treatment PD was 71.9 percent and the specificity was 93.8 percent (Nagelkerke R2=0.636). The area under the ROC curve of mean CT was 0.915 (p<0.001; 95% CI [0.845-0.985]). The optimal cut-off value for mean CT was 321.75, and its sensitivity and specificity for the diagnosis of OUD were 68.8% and 98.4%, respectively. CONCLUSION: This is the first study to examine the effect of PD treatment on SD-OCT parameters in patients diagnosed with PD. We suggest that acute exacerbation of PD is characterized by an increase in CT and a decrease in RNFL sub-sectors, GCL, and IPL. PD treatment causes an increase in RNFL sub-sectors.
BACKGROUND: Major depressive disorder (MDD) is known as risk factor for developing cardiovascular disease. This study aimed to evaluate the risk of cardiovascular disease in drug-naive patients diagnosed with MDD by eval...BACKGROUND: Major depressive disorder (MDD) is known as risk factor for developing cardiovascular disease. This study aimed to evaluate the risk of cardiovascular disease in drug-naive patients diagnosed with MDD by evaluating frontal QRS-T angle (fQRS-T) and laboratory parameters. SUBJECTS AND METHODS: Fifty-nine MDD patients (28 females, 31 males) and 61 healthy controls (HC) (39 females, 22 males) were included in the study. Electrocardiography (ECG), lipid parameters, hemogram, and biochemistry values of the participants were taken. Hamilton Depression Rating Scale (HDRS) was used to determine the severity of MDD. Monocyte lymphocyte ratio (MLR), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), monocyte high density cholesterol (HDL-C) ratio (MHR), and C-reactive protein albumin ratio (CAR) were calculated. RESULTS: The mean age was 34.54±7.10 years in the MDD group and 32.80±6.78 years in the HC group. The fQRS-T value (p<0.001) was significantly higher in the MDD group than in the HC group. MLR (p<0.001), NLR (p<0.001), and PLR values (p<0.001) were significantly higher in the MDD group than in the HC group. A significant positive correlation was found between MLR, NLR, PLR, HDRS and fQRS-T angle in the MDD group. According to the linear regression analysis for fQRS-T, NLR positively and significantly predict fQRS-T [F=34.700, p<0.001, adjusted R square=0.635]. CONCLUSION: This current study is the first to show that there is a significant positive relationship between NLR, MLR, PLR levels and depression severity and fQRS-T angle in patients diagnosed with MDD.
BACKGROUND: This study aimed to study the genetic variant in the MIF -173 G/C in bipolar disorder (BD) by comparing genotype distributions of the MIF -173 G/C variant between patients and healthy controls, considering cl...BACKGROUND: This study aimed to study the genetic variant in the MIF -173 G/C in bipolar disorder (BD) by comparing genotype distributions of the MIF -173 G/C variant between patients and healthy controls, considering clinical parameters. SUBJECTS AND METHODS: A total of 104 patients with BD and 100 healthy volunteers were included in the study. The participants were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and sociodemographic and clinical data forms. The Young Mania Rating Scale (YMRS), the Hamilton Depression Rating Scale (HAM-D), and The Clinical Global Impression Scale (CGI) were administered to patients with BD. Blood samples were collected from participants to isolate their deoxyribonucleic acid material (DNA). The MIF -173 G/C variant was determined using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis. RESULTS: The genotype distribution (GG, GC, CC) and allele frequencies (G, C) in the BD group significantly differed from those in the control group. The percentages of the GG genotype (p=.040) and G allele (p=.049) were significantly higher in the BD group compared to the control group. When comparing scale scores and clinical parameters (number of manic episodes, depressive episodes, total episodes, duration of disease, age of onset, and number of hospitalizations) based on MIF genotype distributions in patients with BD, the CGI-I score was significantly higher in the group with the GG genotype compared to the GC/CC group (p = .029). CONCLUSION: The MIF -173 G/C variant might be associated with BD and treatment response. Additionally, possessing the GG genotype and G allele appears to be disadvantageous in terms of BD diagnosis and treatment resistance in the Turkish population.
Restless legs syndrome is a neurological disease from the spectrum of movement disorders, with psychiatric comorbid symptoms and manifestations. Women are affected twice as often as men, and the frequency in the populati...Restless legs syndrome is a neurological disease from the spectrum of movement disorders, with psychiatric comorbid symptoms and manifestations. Women are affected twice as often as men, and the frequency in the population is 4-10%, while during pregnancy the prevalence triples. This research was conducted as a result of a search and selection of studies on the prevalence of RLS in pregnancy, which include works published in domestic and foreign journals and searches of PubMed, PubMed Central, Web of Science, Scopus and Embase. A primary search of medical databases found 316 publications. In this secondary process, due to the lack of access to the abstract or full text, and due to the poor quality of the articles, 11 relevant publications were finally found and included in this systematic review. The total number of respondents included in this research is 7033, aged 19-45. The lowest prevalence was 4.9% in Japan, and the highest prevalence was 54.7% in Saudi Arabia. In this review, the overall mean frequency of restless legs syndrome during pregnancy was 24.69%. Furthermore, in our ongoing research conducted in 2022 on restless legs syndrome, we recorded a frequency of 26.5% in a population of 266 pregnant women in the third trimester of pregnancy. The frequency of restless legs syndrome is high among the population of pregnant women, and according to its etiology, clinical manifestations and comorbid manifestation, this disorder represents a close link between psychiatry, neurology and gynecology. For this reason, pregnant women should pay extra attention to the early detection of this disorder, which can significantly affect a pregnant woman's daily energy level, poor sleep and daytime sleepiness, and more frequent symptoms of anxiety and depression.
Electroconvulsive therapy (ECT) is one of the oldest biological treatments in psychiatry. ECT appeared in Europe in the 1930s. During the past century, it underwent several advances, setbacks, and successive adaptations....Electroconvulsive therapy (ECT) is one of the oldest biological treatments in psychiatry. ECT appeared in Europe in the 1930s. During the past century, it underwent several advances, setbacks, and successive adaptations. Despite its stigmatizing media coverage, it maintains its usefulness in current psychiatric clinical practice. This paper aims to provide a summary of the history of ECT, its present state, and its future. It covers the long history of ECT, the requirements for informed consent, most accepted techniques, clinical indications, and required staff training. Additionally, we discuss the uncertain future of ECT in the face of new therapeutic options in modern psychiatry.