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Öğe Co-Morbidity between major depression and schizophrenia: Prevalence and clinical characteristics(Medicinska Naklada, 2020) Bener, Abdulbari; Dafeeah, Elnour Elnaem; Abou-Saleh, Mohammed T.; Bhugra, Dinesh; Ventriglio, AntonioBackround: The aim of this study was to explore the co-morbidity between Major Depressive Disorder (MDD) and Schizophrenia (SZ) among a large number of patients describing their clinical characteristics and rate of prevalence.Subjects and methods: A cohort-study was carried out on 396 patients affected by MDD and SZ who consecutively attended the Department of Psychiatry, Rumeilah Hospital in Qatar. We employed the World Health Organization - Composite International Diagnostic Interview (WHO-CIDI) and the Structured Clinical Interview for DSM-5 (SCID-5) for diagnoses. Patients were also grouped in MDD patients with and without co-morbid SZ (MDD vs MDD/SZ) for comparisons.Results: A total of 396 subjects were interviewed. MDD patients with comorbid SZ (146(36.8%)) were 42.69 +/- 14.33 years old whereas MDD without SZ patients (250 (63.2%)) aged 41.59113.59. Statistically significant differences between MDD with SZ patients and MDD without SZ patients were: higher BMI (Body Mass Index) (p=0.025), lower family income (p=0.004), higher rate of cigarette smoking (p<0.001), and higher level of consanguinity (p=0.023). Also, statistically significant differences were found in General Health Score (p=0.017), Clinical Global Impression-BD Score (p=0.042), duration of illnesses (p=0.003), and Global Assessment of Functioning (p=0.012). Rates of anxiety dimensions (e.g.: general anxiety, agoraphobia, somatisation, etc.), mood dimensions (e.g.: major depression, mania, oppositional defiant behaviour, Bipolar disorder), Attention Deficit Hyperactivity Disorder, psychotic and personality dimensions were higher among MDD with SZ patients than MDD without SZ.Conclusion: This study confirms that MDD with SZ is a common comorbidity especially among patients reporting higher level of consanguinity. MDD/SZ comorbidity presents unfavourable clinical characteristics and higher levels of morbidity at rating scales.Öğe COVID-19 pandemic and psychological fatigue in Turkey(SAGE Publications Ltd, 2021) Morgül, Ebru; Bener, Abdulbari; Atak, Muhammed; Akyel, Salih; Aktaş, Selman; Bhugra, Dinesh; Ventriglio, Antonio; Jordan, Timothy R.Aim: The aim of this study was to investigate the association between the COVID-19 pandemic and psychological fatigue as a mental health issue among the population of Istanbul, Turkey. Participants and methods: This is a cross-sectional study conducted in Istanbul, Turkey, between March and June 2020, where a total of 4,700 persons were approached and 3,672 (78%) of participants (64.4% males and 35.6% females ) completed the Knowledge Attitude Practices (KAP) and Fatigue Assessment Scale (FAS) questionnaires. Results: In this study, 64.1% of participants were categorized as psychologically fatigued and 35.9% as normal. There was a significant difference between fatigued and normal participants with respect to age, educational level, occupational status, place of residence and number of family members (p < .001). Other differences related to knowledge of COVID-19 were symptoms, treatment, ways of spreading (p < .001), prevention by avoiding crowded places (p =.008) and isolation (p =.002). For attitudinal items, normal participants generally showed more positive attitudes than the fatigued in believing that COVID-19 will finally be controlled, satisfaction with preventive measures taken by the authorities, reporting suspected cases with symptoms and trusting that Turkey can overcome the COVID-19 pandemic (p < .001). Multivariate stepwise regression analysis indicated that level of education, avoiding going to crowded places, eye, nose and mouth organs are sensitive organs to the virus, keeping physical distance due to epidemic affect by COVID-19 virus, isolation and treatment of people reduce the spread of COVID-19 virus and 14-days period of time, COVID-19 is mainly transmitted through contact with the respiratory droplets of an infected person, occupational status, health education programme needed and antibody treatment variables were significantly associated with fatigue after adjusting for age, gender and income variables. Conclusion: The current study provides valuable information for policymakers and mental health professionals worldwide regarding associations between the mental health of individuals and the ongoing outbreak, COVID-19.Öğe Determinants of brain drain among physicians in Turkey: Findings from a national exploratory study(2025) Bener, Abdulbari; Ventriglio, Antonio; Almas, Furkan; Bhugra, DineshBackground: The shortage of physicians in Turkey is a highly critical emergency. In fact, physicians’ migration to developing or high-income countries, defined as brain drain, threatens the sustainability of the national healthcare system. Aims: This study explored the driving factors associated with Turkish Physicians’ brain drain, including high-economic inflation, social-politics, poor-living, equity, violence, and the desire to practice medical activity abroad. Methods: A cross-sectional survey of 1,861 Turkish physicians aged 25 to 65 years old was conducted employing the Brain Drain questionnaire, the Depression Anxiety Stress Scale (DASS-21), the Patient Health Questionnaire 9 (PHQ-9), and the Fatigue Assessment Scale (FAS). Results: Significant differences were observed among physicians staying in Turkey versus considering migration to Western countries, regarding their age, gender, marital status, educational level, occupational status, work years, hospital night shifts, income, and cigarette/nargileh smoking habits (all p ⩽.018). The main reasons for brain drain included transport problems, harassment, low salary, malpractice, bad environment, job insecurity, workload, burnout, treating difficult patients, inadequate postgraduate systems, peer-pressure, health safety concerns, and favoritism in the workplace, as well as stress and depression caused by work overload. In fact, depression, anxiety, stress, fatigue, and burnout varied significantly among the different groups of physicians (all p ⩽.013). Additionally, key predictors of brain drain were better job opportunities, poor hospital management (in Turkey), job-related stress, dealing with difficult patients, research deficiencies, workload, burnout, transportation issues, short consultation time, low salary, and fatigue. Among the general factors contributing to the brain drain in the Turkish Health System, we identified significant issues related to research deficiencies, compulsory working duties, poor quality of postgraduate, inadequate medical-schools, poor hospital management, and shortage of consultants. Conclusion: Physicians’ migration is a major global public health concern, leading to substantial risks for healthcare services, especially in Turkey. Many physicians decide to migrate to work in Western countries.Öğe Mental health of ethnic minorities: The role of racism(Taylor and Francis Ltd., 2023) Ricci, Fabiana; Torales, Julio; Bener, Abdulbari; Castaldelli-Maia, João Mauricio; Chumakov, Egor; Bellomo, Antonello; Ventriglio, AntonioRacism and racial discrimination heavily impact on health and mental health of ethnic minorities. In this conceptual paper and narrative review, we aim to report on relevant evidence from the international literature describing the prevalence and the qualitative aspects of mental illness due to racism and ethnic- discrimination in different settings and populations. Some variables related to racism, such as cultural, institutional, interpersonal factors, as well as the concepts of perceived and internalised racism will be described and discussed. These are relevant characteristics in the explanatory model of the relationship between racism and mental health. Epidemiological data on the prevalence of depressive and psychotic symptoms as well as substance abuse/misuse among ethnic minorities in large catchment areas, such as United States and United Kingdom, will be represented. We conclude that anti-racism policies are essential in order to address racism and racial discrimination around the world. Pluralistic societies should be promoted in order to understand mental illnesses among ethnic and cultural minorities. Also, anti-racism programs should be delivered in the educational and health-care settings and their impact evaluated.Öğe Navigating a world in conflict: the mental health implications of contemporary geopolitical crises(2024) Ventriglio, Antonio; Ricci, Fabiana; Torales, Julio; Castaldelli Maia, João Mauricio; Bener, Abdulbari; Smith, Alexander; Liebrenz, MichaelThroughout history, armed conflicts have profoundly affected individuals and societies, with recent events in Ukraine, the Middle East, and beyond bringing into sharp focus the severe mental health and humanitarian consequences of geopolitical crises. Such situations often result in mass fatalities, destruction, displacement, forced migration, and other critical life events. Amid these scenarios, the adverse outcomes for mental health and well-being in both the short and long term must be emphasized. As a conceivable example of the latter, the proposed concept of intergenerational trauma could have far-reaching implications. In particular, in certain regions, civilians have repeatedly experienced instances of violence and may have continually been exposed to critical life events and traumatic stress. In this context, the consequences of these events for individual well-being and global mental health will likely be registered for years to come. Accordingly, urgent help and actions to address the mental health burdens within contemporary conflicts should be accentuated in humanitarian, political, and diplomatic interventions. Equally, health policies must adopt a long-term approach to support initiatives under the purview of global and public mental health objectives.Öğe Physical and mental health characteristics of hospitalized covid-19 patients with and without type 2 diabetes mellitus in Turkey(2024) Bener, Abdulbari; Atmaca, Murat; Al-Hamaq, Abdulla O. A. A.; Ventriglio, AntonioThe aim of this study was to assess the rates of depression, anxiety, and stress and quality of sleeping among COVID-19 patients with and without type 2 diabetes mellitus (T2DM). A case and control design has been employed, involving patients affected by COVID-19 infection (884 with T2DM vs. 884 controls without T2DM) and hospitalized in Istanbul (Turkey) from January to December 2021. A multivariate stepwise regression approach was used to test the associations between sociodemographic, metabolic, serum markers, mental health scores, and T2DM/COVID-19 patients’ clinical presentation. A statistically significant difference between T2DM and non-T2DM was found with respect to age, gender, BMI (body mass index), smoking, physical exercise, and physical comorbidities as well as levels of depression, anxiety, stress, and sleeping disorders (0.0003 ? all p = 0.025). With regard to serum biomarkers, vitamin D and ferritin were identified as useful parameters of reduction of glycated hemoglobin as well as COVID-19 infection among T2DM patients. This study detected that 25% of patients with COVID-19 and T2DM experienced mental distress, with sleeping disturbances and lifestyle changes markedly impacting their clinical outcome alongside metabolic and serum parameters.Öğe Sleep quality, quality of life, fatigue, and mental health in COVID-19 post-pandemic Türkiye: a cross-sectional study(Frontiers Media SA, 2024) Bener, Abdulbari; Morgül, Ebru; Tokaç, Mahmut; Ventriglio, AntonioAim: This study explores the predictors and associated risk factors of sleep quality, quality of life, fatigue, and mental health among the Turkish population during the COVID-19 post-pandemic period. Materials and methods: A cross-sectional survey using multi-stage, stratified random sampling was employed. In total, 3,200 persons were approached. Of these, 2,624 (82%) completed the questionnaire package consisting of socio-demographic information, Pittsburgh Sleep Quality Index (PSQI), the WHO Quality of Life Brief Version (WHOQOL-BREF), Fatigue Assessment Scale (FAS), Patients Health Questionnaire (PHQ-15), GAD-7 anxiety scale, and the 21-item Depression, Anxiety, Stress Scale (DASS-21). Results: Significant differences between genders were found regarding socio-demographic characteristics (p < 0.01). Using PHQ-15 for depressive disorders, significant differences were found between normal and high severity scores (? 10), regarding age group (p < 0.001), gender (p = 0.049), educational level (p < 0.001), occupational status (p = 0.019), cigarette smoking (p = 0.002), waterpipe-narghile smoking (p = 0.039), and co-morbidity (p = 0.003). The WHOQOL-BREF indicated strong correlations between public health, physical health, psychological status, social relationships, environmental conditions, and sleep disorders (p < 0.01). Furthermore, comparisons of the prevalence of mental health symptoms and sleeping with PHQ-15 scores ? 10 (p = 0.039), fatigue (p = 0.012), depression (p = 0.009), anxiety (p = 0.032), stress (p = 0.045), and GAD-7 (p < 0.001), were significantly higher among the mental health condition according to sleeping disorder status. Multiple regression analysis revealed that DASS21 stress (p < 0.001), DASS21 depression (p < 0.001), DASS21 anxiety (p = 0.002), physical health (WHOQOL-BREF) (p = 0.007), patient health depression-PHQ-15 (p = 0.011), psychological health (WHOQOL-BREF) (p = 0.012), fatigue (p = 0.017), and environmental factors (WHOQOL-BREF) (p = 0.041) were the main predictor risk factors associated with sleep when adjusted for gender and age. Conclusion: The current study has shown that sleep quality was associated with the mental health symptoms of depression, anxiety, stress, and fatigue. In addition, insufficient sleep duration and unsatisfactory sleep quality seemed to affect physical and mental health functioning.Öğe The impact of COVID-19 pandemic on mental health of health care workers(Edizioni Minerva Medica, 2022) Bener, Abdulbari; Atak, Muhammed; Kurtuluş, Dilara; Koyuncu, Oğuzhan; Barışık, Cem Cahit; Bhugra, Dinesh; Ventriglio, AntonioBackground: this study investigated the impact of cOViD-19 on professional (hcWs) health care workers’ mental health and the prevalence of depression, anxiety, fear and stress related to their workload. METHODS: This is a cross-sectional survey including 1,554 male and female participants aged 20-65 years in Turkey who completed the 21-item Depression, anxiety, stress scale (Dass-21), Burnout and Fear of cOViD-19 scale (FcV-19s). Bivariate and multivariate regression analyses were performed. RESULTS: Significant differences were found between two groups defined as HCWs-frontline and non-frontline, in the following characteristics: (P=0.013), gender (P<0.001), education (P<0.001), occupational status (P<.001), income (P=0.003), working-years experience (P<0.001), number hospital rooms assigned (P=0.024), number of persons living with (P=0.024), and smoking habits (P=0.018). The findings showed that the prevalence of depression anxiety and stress was significantly higher among the frontline workers when compared to non-frontline ones (all P?0.018). They also reported significantly higher scores of fear of COVID-19 for all items (P<0.001). The mean scores of burnout items were significantly higher among frontline-HCWs as well as all items regarding the COVID-19 (P<0.001). The multivariate stepwise regression analysis confirmed Predictors for depression were: feeling the burnout (physical / mental exhaustion), feeling emotionally exhausted from work, clammy hand, number of years of work experience, fear of family members catching infection, can’t sleep because the risk of getting cOViD-19. Meanwhile, hardworking, number of years at work, feeling depressed and burnout (physical / mental exhaustion) form current COVID-19 work, were all considered main risk factors for anxiety. CONCLUSIONS: The findings of this study determined that fear and burnout related COVID-19 were significantly associated with high scores of depression, anxiety, and stress among frontline-hcWs, which requires immediate action and support.
