Menstrual psychosis has an acute onset and is characterised by confusion, stupor and mutism, delusions, hallucinations, or a manic syndrome lasting for a brief duration, with full recovery. These symptoms maintain periodicity in rhythm with the menstrual cycle. The symptoms may appear in the premenstrual phase or may begin with the onset of menstrual flow (catamenial psychoses). Usually, menstrual psychosis has a polymorphism of both psychotic and affective symptoms (Brockington I. Menstrual psychosis. World Psychiatry. 2005;4(1):9-17.). In this article we present a case of menstrual psychosis with premenstrual onset.

A 26 years old, nulliparous single female with one mentally ill relative on her mother’s side (her grandmother) presented with an episodic illness characterized by mood swings, irrelevant speech, irritability, suspiciousness and thought disorder related to her menstrual cycles. She had earlier suffered prolonged attacks of mania, developed a recurrent episodic illness which returned every month for five years. Her menses began at 15. She presented with the history of a few episodes of manic illness starting five days before and ending suddenly with the onset of the menses.

On mental status evaluation during the index episode, the patient was agitated, had labile affect, grandiose and referential delusions and erotomania. A detailed physical examination, routine biochemistry, and gonadal hormonal assay were unremarkable.

She was started on olanzapine 10 mg/day, lithium 1200 mg/day and low-dose clonazepam. Although the severity of the psychotic and affective symptoms gradually reduced during the future menstrual cycles, they did not completely resolve.

The pathophysiology of menstrual psychosis is not exactly understood, but it has been postulated that fluctuation of the sex hormones occurring during the menstrual cycle is responsible. Previous studies have reported the association of psychosis with estrogen withdrawal (Mahé V, Dumaine A. Oestrogen withdrawal associated psychoses. Acta Psychiatr Scand. 2001;104(5):323-331.). Treatment strategies for menstrual psychosis include the use of oral contraceptive pills for the regulation of hormones during the menstrual cycle, in our case patient did not want to use oral contraceptive pills.

None Declared

A growing body of evidence has shown the association between autoimmune thyroiditis and mental illness (Rege et al. AUS N J S Psychiatry 2013; 300 141-154). Identifying the neuropsychiatric features associated with thyroid antibody positivity could have significant implications for diagnostic and therapeutic strategies. However, the link between anti-thyroid antibodies and precise underlying pathophysiology requires future research.

The aim of the present study was to conduct a retrospective evolution in patients diagnosed with schizophrenia spectrum disorder and affective disorder who were screened for anti-thyroid antibodies at the time of their hospitalization and to investigate neuropsychiatric features of anti-thyroid antibody-positive patients.

A total of 143  inpatients diagnosed with schizophrenia spectrum disorders and affective disorders between 2021 and 2023 were screened for anti-thyroid antibodies such as thyroid peroxidase (TPO) and thyroglobulin (TG). All patients were women. In order to elucidate the subsequent neuropsychiatric clinical features of individuals with positive anti-thyroid antibodies, the retrospective examination was conducted based on Neuropsychiatric Invetory-Q (NPI-Q) and DSM-V diagnostic criteria utilized at the time of hospitalization.

The main age of the patients was 48.2 (SD 10.4). A total of 143 inpatients with schizophrenia spectrum disorders and affective disorders were screened for anti-thyroid antibodies at the time of their hospitalizations. %23.1 (n=33) tested positive for at least one of the anti-TG or anti-TPO. All patients were euthyroid. The neuropsychiatric diagnoses are shown in Table 1. The most common neuropsychiatric features assessed by NPI-Q are shown in Table 2. 12.1% (n=4) of all patients were treated with IV steroid Pulse therapy.Table 1.

Neuropsychiatric syndrom-level diagnostic patterns according to DSM-V

In particular, in a subset of schizophrenia spectrum disorder or affective disorder patients with positive anti-thyroid antibodies may indicate autoimmunity, especially in cases where catatonic symptoms dominate the clinical presentation.

None Declared

To investigate alterations in middle-ear mechanics after type 1 cartilage tympanoplasty by comparing the ambient pressure absorbance values of the perforated tympanic membrane, normal tympanic membrane and cartilage-grafted tympanic membrane.

Twenty patients diagnosed with non-suppurative chronic otitis media and 20 healthy controls were included. Pure tone audiometry and wideband tympanometry were performed once in the healthy controls and pre-operatively, one month and three months post-operatively in the patients.

Using wideband tympanometry, the patients’ three-month post-operative ambient pressure absorbance values were found to be similar to those of the healthy controls at low frequencies, while lower ambient pressure absorbance values were recorded at middle and high frequencies. Air–bone gap and ambient pressure absorbance values showed significant negative correlations at 1000 and 4000 Hz both pre- and post-operatively.

Generally, the patients’ ambient pressure absorbance values were significantly lower at middle and high frequencies than those of the healthy controls. Post-operative wideband tympanometry is a practical tool for investigating the effects of a repaired tympanic membrane on middle-ear dynamics.

This study aimed to explore the relationship between caffeine use disorder (CUD), caffeine withdrawal symptoms and the prevalence of depression, anxiety and stress (DASS) in adults.

The study utilised a cross-sectional design to assess the relationships between CUD, caffeine withdrawal symptoms and DASS.

Participants’ CUD was evaluated through the Caffeine Use Disorder Questionnaire (CUDQ), while the Depression Anxiety Stress Scale-21 (DASS-21) measured DASS levels. Caffeine withdrawal symptoms and total caffeine intake were calculated based on self-reported consumption of caffeine-rich products.

The study involved 618 participants with an average age of 27·8 (sd 7·8) years.

Participants consumed an average of 461·21 (sd 11·09) mg/d of caffeine, showing a positive correlation between CUD and total caffeine intake. The risk of CUD increased alongside levels of DASS. Individuals with caffeine withdrawal symptoms had higher CUDQ and DASS scores. A multiple linear regression model revealed significant associations between total caffeine intake (P < 0·001) and DASS-21 score (P < 0·001) with CUDQ score.

The study concluded that caffeine, while recognised for its potential health benefits, also exhibits properties that may lead to addiction. The development of caffeine use disorder and cessation of caffeine intake can increase DASS levels in adults, indicating the need for awareness and appropriate interventions in public health nutrition.

After the 2023 Turkey earthquake, thousands of people evacuated to different fields. Earthquake victims still need health care in the evacuation location. This study aims to determine the emergency department (ED) and outpatient clinic utilization characteristics of the evacuated earthquake victims outside the earthquake zone and to provide suggestions for planning the health care facilities in the regions where the evacuated earthquake victims will be placed.

This retrospective, observational study was conducted in a tertiary university hospital from February 7, 2023 through February 20, 2023. All evacuated earthquake victims who presented to the study hospital were included in the study. Non-victim patients were included as the control group. Missing medical records were excluded. Demographic characteristics of the patients, outpatient clinics, International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10) codes, and outcomes were recorded.

A total of 15,128 patients were included in the final analysis. Six-hundred-nine (4.0%) of the patients were evacuated victims. Three-hundred forty-six (56.8%) evacuated victims used the ED. One-hundred fifty-six (25.6%) earthquake victims were in the pediatric age group. Earthquake victims used the ED more than the control group in adult and pediatric age groups (22.5% versus 51.7% and 30.2% versus 71.8%; P <.001, respectively). Earthquake victims frequently presented to the hospital during night shifts in both age groups (P <.05). Pediatric victims were more hospitalized than the control group (4.8% versus 10.9%; P = .001). Diseases of the respiratory system were the most common emergency diagnosis of the victims in both age groups (26.5% and 57.1%, respectively). The most frequently used outpatient clinic was ophthalmology in both age groups (14.6% and 20.5%, respectively).

Evacuated victims, especially pediatric victims, used the ED more than other outpatient clinics. Diseases of the respiratory system were the most common emergency diagnosis of the victims, and the most frequently preferred outpatient clinic was ophthalmology. The most common diseases and frequently preferred clinics should be considered in planning health care for the evacuated earthquake victims.

Recent studies have shown that the distribution of the tryptophan/kynurenine pathway (KP) plays a role in the development of obsessive-compulsive disorder (OCD). We aimed to reveal the relationship between CYP1A1 rs464903 and aryl hydrocarbon receptor (AhR) rs10249788 associated with the KP and interferon gamma (IFN γ) and oxidative stress in OCD.

In our study, the serum and DNAs of 150 samples, including 100 OCD patients and 50 controls, were used. The activity of glutathione peroxidase (GSH-Px), and the levels of IFN γ, thiobarbituric acid reactive substances (TBARS), tryptophan, and kynurenine were determined by biochemical methods. AhR rs10249788 and cytochrome P450 family CYP1A1 rs4646903, which interact directly with the KP, were analysed by polymerase chain reaction followed by restriction fragment length polymorphism. P < 0.05 was considered statistically significant.

There were no significant differences between groups in CYP1A1 rs4646903 and AhR rs10249788 while tryptophan and IFN γ were found to be higher in controls (p < 0.001, for both), and TBARS and indolamine-2,3-dioxygenase were found to be higher in OCD (p < 0.001, for both). There were significant correlations between IFN γ and TBARS and GSH-Px (p = 0.028, p = 0.020, respectively) in the OCD group.

For the first time studied in OCD, it has been shown that IFN γ, tryptophan, oxidative stress parameters, and gene variants of CYP1A1 rs4646903 anAhR rs10249788 are shown effective on the KP.

Although common mental health problems have been widely studied with self-stigma, few studies have focused on the mediating effect of self-stigma in the relationship between mental health problems and help-seeking behaviours of refugee adolescents. Therefore, the purpose of the present study was to examine whether self-stigma mitigates the adverse effects of stress, anxiety, and depression symptoms on the help-seeking behaviours of Syrian adolescents living in Turkey.

The participants of this study included 488 Syrian refugee adolescents (boys, 63.73%; girls, 3627%) living in Turkey. Participants completed the Depression Anxiety Stress Scale and General Help-Seeking Scale and Self-Stigma of Seeking Psychology Help Scale.

The findings revealed that stress (β = 0.19, p < 0.01), anxiety (β = 0.12, p < 0.05), and depression (β = 0.17, p < 0.01) had significant and positive predictive effects on self-stigma, but not on help-seeking behaviours. Also, self-stigma (β = −0.12, p < 0.01) had a significant negative predictive effect on help-seeking behaviours. With regard to the indirect effects, the findings showed that self-stigma fully mediated the associations between stress – help-seeking [effect = −0.05, 95% confidence interval (CI) −0.11 to −0.01], anxiety – help-seeking (effect = −0.04, 95% CI −0.09 to −0.01)], and depression – help-seeking (effect = −0.05, 95% CI −0.12 to −0.01).

Our findings highlight the potential negative effects of self-stigma on the help-seeking behaviours of Syrian refugee adolescents, both directly and indirectly. These results can be used to develop and implement effective and efficient interventions to address the unmet mental health needs of refugee adolescents.

Sexual life and sexual satisfaction are associated with psychological well-being. It has already been shown that sexual satisfaction is related to sexual myths or stereotypes, somesociodemographic and sociosultural variables, and gender. However, we have not met any study in which socioeconomic status, sexual myths and gender roles were taken together.

The aim of this study was to investigate whether socioeconomic status predicts sexual satisfaction through sexual myths and gender roles.

The Bem Gender Roles Scale (Ozkan and Lajunen Sex Roles 2005;103-110), the Sexual Myths Scale (Golbasi et al. Sex Disabil 2016; 34 75-87), the New Sexual Satisfaction Scale (Stulhofera et al. J Sex Res 2010;47 257-268), the Socio-Economic Status Measurement Tool (Kalaycioglu et al. J Soc Res 2010; 1 183-220) were applied face-to-face or online to 185 women and 74 men who had heterosexual relationships. Relationships between scale scores were examined with Pearson correlation analysis. Serial multiple mediator analysis was used to test mediator role of either masculinity or sexual myths in the relationship between socioeconomic status and sexual satisfaction.

We found significant correlations between socioeconomic status and sexual myths (r=-.22, p<.001), between socioeconomic status and sexual satisfaction (r=.13, p<.001), sexual myths and sexual satisfaction (r=.20, p>.001) and between masculinity and sexual satisfaction (r=.18, p=.004), The relationship between femininity and sexual satisfaction was not significant (r=.01, p=.845). Sexual myths (b=-.19, t(257)=-3.48, p<.01) and masculinity (b=.40, t(257)=3.26, p<.01) mediated the relationship between socioeconomic status and sexual satisfaction (b=.15, t(257)= 2.04, p<.05).

Interventions on sexual myths will reduce the effect of socioeconomic disadvantage on sexual satisfaction.

None Declared

Successful placement of a peripheral intravenous catheter (PIVC) on the first attempt is an important outcome for difficult vascular access (DVA) patients. This study compared standard technique, ultrasonography (USG), and near-infrared light (NIR) in terms of success in the first attempt in patients with DVA.

This was a prospective, randomized controlled study. The study was conducted in a tertiary care hospital. Emergency department patients who describe DVA history, have no visible or palpable veins, and were assessed by the nurse to have a difficult PIVC were included to study. The PIVC procedure was performed on patients by standard, USG, or NIR device techniques. For all approaches, the success of the first attempt was the primary aim. Total procedure time, the total number of attempts, and the need for rescue intervention were secondary aims.

This study evaluated 270 patients. The first attempt success rates for USG, standard, and NIR methods were 78.9%, 62.2%, and 58.9%, respectively. The rate of first attempt success was higher in patients who underwent USG (USG versus standard, P = .014; USG versus NIR, P = .004; standard versus NIR, P = .648). The total median (IQR) procedure time for USG, standard, and NIR methods was 107 (69-228), 72 (47-134), and 82 (61-163) seconds, respectively. The total procedure time was longer in patients undergoing USG (standard versus USG, P <.001; NIR versus USG, P = .035; standard versus NIR, P = .055). The total median (IQR) number of attempts of USG, standard, and NIR methods were 1 (1-1), 1 (1-2), and 1 (1-2), respectively. A difference was found among the groups regarding the total number of attempts (USG versus NIR, P = .015; USG versus standard P = .108; standard versus NIR, P = .307). No difference was found among groups in terms of the need for rescue methods.

It was found that USG increases the success of the first attempt compared with the standard method and NIR in patients with DVA.

Dikmen Valley is a slum district where the Municipality of Ankara intended to start an urban transformation project. Dikmen neighborhood includes nearly 1000 houses which the Municipiality attempted to pull down suddenly at night in the winter of 2007.

Residents of Dikmen Valley resisted and managed to stop this attempt. Whole event was experienced as an acute trauma as well as a continuous experience of anxiety because of ongoing risk of another attack.

The aim of the present study was to investigate the psychological consequences of the whole process.

The study sample consisted of 201 individuals from 106 households, and a total of 178 individuals from 102 households was taken as comparison group from another slum neighborhood where residents did not experience any threat to their houses. The Beck Depression Inventory, the Spielberger Trait Anxiety Scale, and the General Self-Efficacy Scale were used for assessment.

Dikmen sample was found to have a statistically significant higher mean score of anxiety and depression compared to the comparison group. Dikmen had a higher level of general self-efficacy belief than the comparison group after controlling for depression and anxiety scores.

Although the traumatic process after an attack of pulling down and the threat of losing one's house resulted with a depressive state and anxiety in Dikmen residents, unexpectedly they had a high level of general self-efficacy. To the researchers’ observations, a social transformational process has been realized resulting with an overall high general self-efficacy level in Dikmen neighborhood.

Attention deficit and hyperactivity disorder (ADHD) is one of the most frequently seen neurobehavioral disorder in school-aged children. Although the main cause of ADHD is unknown, it's thought that numerous biopsychosocial factors have part in etiology of ADHD together.

This study aims to compare autonomic nervous system functions by measuring pupil diameters in 6–11 aged boys diagnosed ADHD with age and sex matched healthy controls.

Thirty-two boys with ADHD and 24 healthy controls were participated into this study. We studied with a more homogeneous group by exclusion of any other psychiatric disorders except oppositional defiant disorder (ODD). the participants were evaluated autonomic nervous system functions by measuring pupil diameter changes in photopic and mesopic conditions.

There were no statistical differences on photopic and mesopic pupil diameters between ADHD and healthy control groups (p>0.05). Moreover, there were no significant differences on same parameters between pure ADHD and ADHD+ODD groups (p>0.05).

These findings suggest that boys with ADHD don’t show difference in pupil diameters from typically children. This might indicate no difference in autonomic nervous system functions.

To identify the relationship between marital adjustment and, sex roles and burnout rather than dependence features of the patient in wives of the patients with AUD.

The study sample consisted of 33 wives of AUD patients (according to DSM-IV-TR criteria) who were applied to a University Hospital Alcohol Dependence Clinic to leave alcohol use. Sociodemographic questionnaire, Marital Adjustment Scale (MAS), Maslach Burnout Inventory (MBI), Bem Sex Role Inventory-Short Form (BSRI) and, Beck Depression Inventory (BDI) were applied to the wives of ADD patients.

Mean MAS score was under cut-off score (29.63 ± 10.33) and it shows that marital adjustment is lower in wives of ADD patients. It was shown that marriages longer than ten years, and higher emotional exhaustion scores were associated with lower marital adjustment in our study. Masculinity scores were higher in wives who perceived their income status higher. In contrast to previous studies, which examined marital adjustment, masculinity role was found to be associated with higher marital adjustment in our study.

Emotional exhaustion and depression are common in spouses of the patients with ADD in our study. There may be a distortion in expected roles of the spouses which cause a disequilibrium on the family relationship. Lower income status, having increased number of children was associated with severe depression in wives which found to reduce marital adjustment scores. Finally, most of the wives of ADD patients will need psychotherapeutic treatments during addiction period. So incorporating spouses into treatment of ADD patients is a necessity to improve marital adjustment and burnout.

The authors have not supplied their declaration of competing interest.