The COVID-19 pandemic and its restrictions cause increasing mental health problems in both the general population and psychiatric patients. In this study, it was aimed to compare the number and characteristics of emergency psychiatric consultations in the early-pandemic period and in the same period of 2019, in order to understand how the COVID-19 pandemic affects psychiatric emergencies and the health care seeking behavior of people with psychiatric disorders. A retrospective cross-sectional study was designed in which patients who applied to Emergency Department of Bursa Uludağ University and were consulted to psychiatry between 11 March 2019 – 1 September 2019 and 11 March 2020 - 1 September 2020 were included. Sociodemographic characteristics of the patients, psychiatric diagnoses, hospitalizations, psychotropic drug use and treatment compliance, frequency of admission, indications for hospitalization/referral and suicide attempts were compared. It was observed that the ratio of psychiatric admissions to the emergency department to all emergency department admissions was significantly higher in the early-pandemic period than in the pre-pandemic period. In the early-pandemic period, emergency department admissions due to depression disorders were found to be significantly lower; schizophrenia and other psychotic disorders, and psychotropic drug side effects were found to be significantly higher than in the pre-pandemic period. In this study, it was shown that the COVID-19 pandemic may have a negative impact on psychiatric patients. Prompt implementation of measures to deal with the psychiatric effects of the pandemic, using online health services, developing coping strategies and identifying early signs of psychiatric illness exacerbations can reduce the negative effects of this stressful period on vulnerable individuals.

Primary immunodeficiencies (PIDs) are a group of diseases that develop as a result of primary or congenital malfunction of the immune system and progress with chronic and/or recurrent bacterial, fungal, protozoal and/or viral infections. In this study, we aimed to examine the effects of the COVID-19 pandemic on depression, anxiety levels and psychological resilience in patients with PID and to compare them with those in controls. Seventy patients, aged 18–65 years, who were being followed up with a diagnosis of PID and 69 people as healthy control group, participated in our study. The participants were evaluated cross-sectionally once; sociodemographic data form, Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Resilience Scale for Adults (RSA), and COVID-19 Evaluation form were administered to the participants. HAM-A and HAM-D scores were significantly higher in PID patients compared to controls (HAM-D: 5.5 vs. 3.0, p < 0.001; HAM-A: 6.0 vs. 4.0, p = 0.008). RSA was significantly lower in the patient group (RSA total: 122.5 vs. 136.0, p < 0.001), and pandemic-related risk perception was higher (PRPS: 33.9 vs. 28.3, p < 0.001). Sleep, appetite, and attention-related disturbances were also more common in the patient group. Multivariate regression analyses revealed that PID diagnosis was an independent predictor of increased depression severity (HAM-D), lower psychological resilience (RSA), and greater pandemic-related risk perception. Female sex was independently associated with higher anxiety severity (HAM-A). A personal psychiatric history and greater number of comorbidities were also significant predictors of psychological vulnerability, particularly in relation to depression and anxiety. Given the observed associations between PID and increased levels of depression, anxiety, and reduced psychological resilience during the pandemic, clinicians may consider heightened vigilance for psychological symptoms in this population during times of public health crisis.

This study aims to assess the severity of depressive and anxiety symptoms among medical residents in a university hospital and identify the factors associated with these symptoms. We expected depression and anxiety symptoms to be associated with working conditions, workplace relationships, and social functioning. This cross-sectional study included 283 medical residents at a university hospital who participated on a voluntary basis. Data were collected using the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and a structured sociodemographic data form designed by the researchers. Significantly higher BDI and BAI scores were associated with female gender (p<0.001) and current use of psychiatric medication (p=0.029 and p=0.027, respectively). Key stressors identified included seeing more than 30 patients per day, finding the number of shifts excessive, and perceived inability to participate in social activities. Furthermore, negative workplace experiences -including exposure to threats, lack of peer support, poor relationships with superiors, and feeling unappreciated- were strongly correlated with increased psychological distress. Other contributing factors were overall workplace dissatisfaction, the desire to specialize in a different field, inadequate physical conditions, and a bleak professional outlook for one’s branch. Suicidal ideation during residency was specifically linked to higher depressive symptom severity (p<0.001). Lower professional experience and lower period of residency showed a significant negative correlation with anxiety scores (r=-0.177, p=0.003 and r=-0.146, p=0.014, respectively). In the adjusted regression models, female gender, fewer years of professional experience, current psychiatric medication use, and limited participation in social activities remained independently associated with higher BDI and BAI scores. These results suggest that severity of depressive and anxiety symptoms among resident physicians are closely related to modifiable occupational and environmental factors. Targeted interventions to improve these conditions are essential to support the mental well-being of physicians in training.

Valproik asit ensefalopatisi, ensefalopati etiyolojisinde nadir bir tablo olup VA tedavisi sırasında gelişen bilinç değişikliği, kognitif yavaşlama, fokal nörolojik defisitler ve epileptik hastada paradoksal nöbet artışı ile karakterizedir. Hiperamonyemik(en sık), non-hiperamonyemik ve hepatotoksisite ilişkili olabilir. Serum valproat düzeyleri yüksek veya terapötik aralıkta olabilir. EEG’de zemin aktivitesinde diffüz yavaşlama ve trifazik dalgalar yardımcıdır. Vakamızda, valproat kullanan ve belirgin metabolik veya hepatik predispozan faktörleri olmaksızın nöbet artışı ve ensefalopati geliştiren bir şizofreni hastası yer almaktadır. Serum valproik asit düzeyleri terapötik aralıkta olmasına rağmen, EEG'de zemin aktivitesinde diffüz yavaşlama ile birlikte ağır ensefalopati saptanmış ve yüksek serum amonyak düzeyleri ile tanıya gidilmiştir. Semptomlar valproat kesilmesi ve L-karnitin tedavisi düzelmiştir. Psikiatrik hasta grubunda bulguların ensefalopati ile ayırt edilmesi gerekliliği ve erken tanı tedavi ile geri dönüşümlü olması kritiktir.

Acromegaly is a chronic disease that can cause somatic disfigurement and hormonal changes. The aim of this study was to examine depression and anxiety levels, body image and sexual dysfunctions in patients with acromegaly and to compare them with those of controls. 52 patients with acromegaly who were being followed up at the Endocrinology Outpatient Clinic and 51 non-acromegalic individuals were included. The participants were evaluated cross-sectionally once and evaluated with the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Body Image Scale (BIS) and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). The GRISS total, infrequency, dissatisfaction, impotence and premature ejaculation subdimension scores of the acromegaly patients were found to be significantly higher than those of the controls. Sexual dysfunctions were associated with older age, female sex, unemployment, menopausal status, and the presence of concomitant diabetes mellitus. No meaningful differences were detected in depression or anxiety scores between patients and controls. Body image was significantly more impaired in patients with acromegaly and was associated with higher depression and anxiety scores. There was no difference between scale scores according to disease activity. Although inverse correlations were observed between GRISS total scores and IGF-1 and free T4 levels in univariate analyses, IGF-1 was not independently associated with sexual dysfunction after adjustment for relevant clinical covariates. In conclusion, considering that patients with acromegaly are a risky group in terms of mental disorders and sexual dysfunctions, we recommend that patients should be routinely questioned in terms of psychopathology and sexual functions during their follow-up.