INTRODUCTION: In addition to many medical consequences, Covid- 19 pandemic has also caused some social changes especially for healthcare workers working in the front lines of the pandemic. However, this has not affected everyone equally and gender roles became a determinant especially in domestic life.

METHODS: In this cross-sectional study with a sample of 670 healthcare workers in Turkey; a sociodemographic data form, Perceived Stress Scale (PSS) and Gender Roles Attitude Scale (GRAS) were applied to examine stress levels and its relationship with gender roles.
RESULTS: Mean PSS scores were significantly higher in women (27.03) healthcare workers than men (23.14) Women who did all or most of the housework on their own were almost three times the men (67.2% vs 22.9%) and this increased stress levels of women. In the GRAS, female participants had higher scores (173.2) than male participants (161.8); which means they were more egalitarian, and academic degree or job did not affect GRAS.

DISCUSSION AND CONCLUSION: Besides many challenges related with working in pandemic period; women healthcare workers face additional distress because of the gender roles. Analyzing the effects of the pandemic without gender dimensions may be insufficient to fully understand public health aspect of the pandemic.

INTRODUCTION: The number of studies investigating oxidative stress levels in OCD subtypes is limited. This study aimed to compared total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index values between OCD subtypes and to determine relationship between oxidative stress and neurocognitive function.

METHODS: 19 autogenous type OCD, 21 reactive type OCD and 42 healthy controls were taken to this study.All patients were rated using the Yale-Brown Obsessive Compulsive Scale, the Metacognition Questionnaire, the Beck Depression Inventory and Beck Anxiety Inventory, the Wisconsin Card Sorting Test, and the Stroop test. Serum TOS and TAS levels were determined.
RESULTS: TAS levels were significantly higher in patients with OCD (p=0.018) than in the healthy controls. TAS levels were also significantly higher in patients with RT type OCD than in the healthy controls (p=0.003). In RT OCD, TAS was correlated with the Wisconsin Card Sorting Test – trials to complete the first category (p=0.02) and the Metacognition Questionnaire - need to control thoughts (p=0.02) subscales.
DISCUSSION AND CONCLUSION: The study findings indicated an overall oxidative imbalance shift toward the antioxidant side in patients with OCD and RT type OCD. This may be a way of coping with the disease. The correlation between TAS and the Wisconsin Card Sorting Test – trials to complete the first category subscale suggests that the change in serum TAS level may be a condition that for overcoming mental inflexibility. These results should be confirmed by prospective studies.

INTRODUCTION: Social media usage is increasing gradually and the websites that enable social interaction may influence people’s loneliness and depression levels. The aim of the present research was to examine the multiple mediating roles of self-esteem and happiness in the relationship between loneliness and depression.
METHODS: The study sample was composed of 409 Facebook and Instagram users. Data were collected by using personal information form, Beck Depression Inventory, Oxford Happiness Scale-Short Form, Rosenberg Self-Esteem Scale and UCLA Loneliness Scale. Correlation analysis was carried out to determine the relationship between variables. Multiple mediation analysis was conducted to determine the mediating roles of self-esteem and happiness in the relationship between loneliness and depression.
RESULTS: The results suggest that self-esteem and happiness, indeed, have mediating roles in the relationship between loneliness and depression, and multiple mediation models were found to be statistically significant. The frequency of accessing Instagram was positively associated with depression and loneliness. Facebook users had higher self-esteem levels compared to Instagram users.
DISCUSSION AND CONCLUSION: In conclusion, the relationship between loneliness and depression was found to be significantly mediated by self-esteem and happiness. Increased frequency of access to Instagram every day was found to increases the level of depression and loneliness. Additionally, Instagram users were found to have lower self-esteem compared to Facebook users.

INTRODUCTION: To investigate the association between suicidal behavior, perceived gender equality, and childhood traumas among depressive adolescent girls who have attempted suicide in the last 1 year.
METHODS: 84 adolescent girls aged between 12-18 (Eastern Provinces n=34, Western Provinces n=50) were assessed via Columbia Suicide Severity Scale by clinicians to determine the severity of their suicidal behavior. Participants and their mothers filled the Perception of Gender Scale (PGS); participants completed Childhood Trauma Questionnaire (CTQ), and Beck Depression Inventory (BDI).
RESULTS: Participants from the eastern provinces had significantly lower PGS scores (t=-2.369, p=0.02) and higher BDE (t=-2.081, p=0.04), and CTQ-Emotional Neglect (U=537.500, p=0.03) scores than those from the western provinces. Participants from the eastern provinces more frequently classified into high-severity suicide cluster than those from the western provinces (X2(1)=6.215, p=0.01). PGS score was significantly correlated with both CTQ-emotional neglect score (rho=-0.240, p=0.03), maternal education level (rho=0.282, p=0.001), and maternal-PGS score (rho=0.430, p<0.001). Adolescents in high-severity suicide cluster had lower PGS (t=-2.369, p=0.02) and maternal-PGS scores (t=-2.138, p=0.03) and higher CTQ scores (t=2.195, p=0.03) than those in low-severity suicide cluster. In the logistic regression analysis, the only significant variable that predicted being in the high-severity suicide cluster was maternal-PGS score (B=-0.051, p=0.02).
DISCUSSION AND CONCLUSION: The current study showed that more traditional gender role perception in mothers and adolescents was associated with more severe suicide attempts among depressive adolescent girls. Having been raised in families with more traditional social roles may have caused these adolescents to experience more emotional neglect, higher depression severity, thus more severe suicidal behavior.

INTRODUCTION: In recent years, the Wechsler Intelligence Scale for Children-IV (WISC-IV) has been used to evaluate attention, learning, and memory for the diagnosis of Attention Deficit and Hyperactivity Disorder (ADHD). In the diagnosis of ADHD, WISC-IV has been standardized and started to be used in our country in recent years. The aim of this study, it is to examine which sub-scores of WISC-IV differ from the group with ADHD and healthy sample.
METHODS: The sample of this study consists of 100 children and adolescents between the ages of 6-16 diagnosed with ADHD in the child and adolescent psychiatry outpatient clinic of a foundation hospital in Istanbul, and 88 healthy children and adolescents who were followed up in the pediatric health and diseases department of the same hospital.
RESULTS: In our study, when the scores of the Verbal Comprehension Test, Perceptual Reasoning, Processing Speed and Whole scale scores, which are sub-scores of the WISC-IV Intelligence Test, were compared, it was found that the scores of children with ADHD were significantly lower than the scores of healthy children. However, when the working memory scores of the WISC-IV Intelligence Test sub-scores of ADHD and normal children were compared, no significant difference was found between the scores of children with ADHD and those of healthy children.
DISCUSSION AND CONCLUSION: In this study, it was determined that the Verbal Comprehension Test, Perceptual Reasoning, Processing speed and All scale scores were significantly lower in children with ADHD.

INTRODUCTION: In this study, we aimed to determine the effects of the early phase of the COVID-19 pandemic on the services in Community Mental Health Centers (CMHCs) and on the patients followed up by the CMHC. In this direction, the clinical data of the patients and CMHC services were compared with the same period of the previous year.
METHODS: Three CMHCs’ data within the first three months following the first COVID-19 case report in Turkey (11.03.2020-11.06.2020) were compared with the same period of the previous year retrospectively. Sociodemographic data, the number of admissions to the emergency psychiatry outpatient clinic, and the number of admissions to the psychiatry service of 2008 patients followed-up by CMHC were recorded as well as clinical parameters of inpatients and the quantitative values of the services provided by CMHCs.
RESULTS: The number of patients presenting to the emergency psychiatry outpatient clinic and admission to the inpatient psychiatry unit significantly decreased in the initial phase of the COVID-19 pandemic (p <0.001). While a narrowing was observed in psychiatric hospitalization indications, face-to-face CMHC services decreased.
DISCUSSION AND CONCLUSION: The COVID-19 outbreak has created difficulties in preventing and treating COVID-19 infection in individuals with severe mental illness, as well as difficulties in safely handling patients' existing mental illnesses. Considering the experiences from the early period of the pandemic, for current and future needs, the continuity of CMHCs should be supported and efforts should be made to provide digital services such as telepsychiatry applications when necessary.

INTRODUCTION: Although early marriage is a serious and profound problem in Turkey, its effects on mental health were not comprehensively studied. This study aims to understand mental burden of the early marriage and the factors mediating this.
METHODS: This study includes 72 participants. 41 women who married at the age of 17 or younger were selected as the study group and, 31 women who married at the age of 20 or later were selected as the control group. Psychiatric disorders were screened by a psychiatric interview and participants filled in Symptom Checklist-90R, Golombok-Rust Inventory of Sexual Satisfaction and Childhood Trauma Questionnaire- 28.
RESULTS: 53.7% of the women married early had at least one psychiatric disorder with major depression being the most common. The frequency of suicide attempt and nicotine use were also higher in the early married group. The early married women were more frequently exposed to domestic physical violence in marriage and emotional abuse, neglect, and physical abuse in childhood. Moreover, sexual functioning were found to be more impaired in women who married at an early age and this relationship was still significant when other psychiatric symptoms were controlled.
DISCUSSION AND CONCLUSION: Early marriage seems to be associated with an increased mental health burden including sexual dysfunction. Therefore, to protect women's mental and sexual health social policies should be developed.

INTRODUCTION: It was aimed to investigate the relationship between remission time and quality of life, functionality and craving in patients with opiate use disorder (OUD).
METHODS: 150 patients who were diagnosed with OUD according to DSM-5 diagnostic criteria were included in the study. The patients were divided into 3 groups as 50 patients who were in remission for less than 1 month, 50 patients who were in remission for 1 to 6 months, and 50 patients who were in remission for more than 6 months. World Health Organization Quality of Life Scale Short Form (SF-36), World Health Organization Disability Assessment Scale (WHODAS 2.0) and Substance Craving Scale (SCS) were administered to all participants together with the Sociodemographic Data Form.
RESULTS: From SF-36 subscales; physical role difficulties, emotional role difficulties, energy vitality, mental health, social functionality, pain, and general health perception scores increased between 1-6 months, while physical function scores increased significantly after the sixth month. WHODAS 2.0 total score and subscales of comprehension and communication, movement, self-care, activities of daily living, participation in social life decreased between 1-6 months, and communication with people scores significantly decreased after the sixth month. SCS scores decreased significantly as the duration of remission increased. As the disability decreased, the quality of life increased significantly, with the decrease of craving, disability decreased and the quality of life increased.
DISCUSSION AND CONCLUSION: We can say that the quality of life increases and disability decreases in OUD patients in a short time with being in remission and a decrease in craving. Our study emphasizes the importance of treatment in this patient group.

INTRODUCTION: It is now well accepted that inflammatory processes play a role in the etiopathogenesis of psychiatric disorders. NLRP3 inflammasome, which is formed by the combination of NLRP3, ASC and Caspase-1 proteins, and its activator NEK7, takes part in these processes. In this study, we aimed to investigate the relationship between inflammatory markers (i.e. IL-1β, IL-18, NLRP3 inflammasome protein levels) and cognitive functions in patients with obsessive compulsive disorder (OCD).
METHODS: Forty-two patients between the ages of 18-45 who were diagnosed with OCD were included in the study. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and Hamilton Depression Scale (HAM-D) were used for clinical evaluations. In order to evaluate cognitive functions, Trail Making Test (TMT), Berg Card Sorting Test and Category Fluency Test were applied. IL-1β and IL-18 cytokine levels were determined by the ELISA method; measurement of the protein amounts of NLRP3, Caspase-1, ASC and NEK7 were performed by Western blotting.
RESULTS: Serum IL-1β was negatively correlated with TMT (B-A) (rs=-.36, p= 0.019). Similarly, ASC was negatively correlated with TMT-B and TMT (B-A) (rs=-.38, p= 0.03; rs=-0.36, p = 0.04, respectively). However, no statistically significant relationship was found between other inflammatory parameters (NLRP3, Caspase-1, and IL-18) and neurocognitive tests.
DISCUSSION AND CONCLUSION: Our results indicate that some aspects of neurocognitive impairment in patients with OCD might be related to neuroinflammatory processes, with implications for our understanding of the pathogenesis of OCD.

INTRODUCTION: In this study, it was aimed to investigate the effect of melatonin level, which is thought to have a role in the etiology of autism spectrum disorder (ASD), on the clinical severity of ASD and accompanying sleep disorder.
METHODS: A total of 30 children who were 4- to 10-year-old and diagnosed with ASD and 20 healthy children were included. Melatonin metabolite 6-hydroxymelatonin sulfate levels measured in 12-hour night urine were compared between the two groups. Childhood Autism Rating Scale was used to determine the clinical severity of autism, Children's Sleep Questionnaire was used to screen current sleep problems, besides sleep problems were evaluated subjectively
RESULTS: There was no statistically significant difference in 6-hydroxymelatonin sulfate levels measured in 12-hour night urine between the two groups (p=0.566). The relationship between Childhood Autism Rating Scale scores and 6-hydroxymelatonin sulfate levels of children with ASD was evaluated, no statistically significant difference was found (p=0.548, r: -,114). There was no significant relationship between the Children's Sleep Questionnaire scores and 6-hydroxymelatonin sulfate levels in the ASD group (p=0.790).
DISCUSSION AND CONCLUSION: Our study is one of the few studies in this field; there was no statistically significant difference between the melatonin metabolite values in both groups. There was no relationship between clinical severity and sleep habits of ASD and melatonin metabolite in urine. There is a need for future studies to be conducted with more sample groups of children diagnosed with ASD who have obvious sleep disorders.

INTRODUCTION: The aim of this study is to examine the relationship between the levels of hope- hopelessness and stress coping among dependent patients on probation and these two variables.
METHODS: Descriptive research was conducted between August and December 2019. One hundred seventy-six (176) individuals who were in a University Hospital probation unit for treatment and control purposes participated in the study. In this research, the introductory information form of the Beck Hope-Hopelessness Scale and Stress Coping Scale were used. The relationships among percentage mean, standard deviation, and variables were evaluated using correlation analysis.
RESULTS: The mean age of 176 individuals participating in the study was 31.18 ± 0.64. Respondents of most were male (92%) and their marital status mostly was single (56.3%). The majority of individuals were found to have graduated from primary education (63.1%) and to have worked in a job (48.3%). A moderately strong positive correlation was found with the sensory sub-dimension in individuals using the effective coping style between the Stress Coping Styles Scale and the Beck Hope-Despair Scale subscales, whereas there was a negative correlation in the lower dimension of motivation loss and expectations for the future in individuals who used ineffective coping styles.
DISCUSSION AND CONCLUSION: Individuals treated on probation have moderate levels of hopelessness and have been found to use the desperate approach style as a way of coping with stress.

INTRODUCTION: In this study, we aimed to adapt the 17-item Insomnia Catastrophizing Scale (ICS) into Turkish and to examine its psychometric properties.
METHODS: 240 healthy volunteers and 75 patients with major depressive disorder participated in the study. The construct validity of the scale was carried out by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) methods. For reliability analysis, Cronbach alpha coefficient, test-retest correlation and item-total correlation methods were used. ICS and subscale scores were compared between groups for discriminant validity. For assessing the criterion related validity, the Pittsburg Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were used.
RESULTS: The mean age of the healthy volunteers and depression group were respectively 21.29 ± 2.88, 33.98 ± 10.14. ICS was found to have a two-factor structure as revealed by principal component factor analysis with Varimax rotation. In the EFA, the 4th and the 11th items were included in both factors and the difference between the factor loads was less than 0.1, and the 3rd, 5th and 14th items were excluded from the scale due to the correlated errors with other factors in the CFA. The fit indices of the 12-item final version of the ICS were CMIN=135.270, df=51, p<0.001, χ2/df=2.652, RMSEA=0.073, CFI=0.978, GFI=0.929. The Cronbach alpha coefficients of the ICS final version, night and, daytime subscales were 0.958, 0.941 and, 0.955 respectively. Test–retest reliability analysis at two weeks also showed good temporal stability (depression group r=0.592, healthy volunteers group r=0.857). In the discrimanant validity, ICS scores were found to be significantly higher in the depression and clinical insomnia groups. Significant positive correlations were found between ICS and the PSQI and ISI.
DISCUSSION AND CONCLUSION: The ICS is valid and reliable for Turkish languge and culture with revised model as two subscale and 12 items.

Joubert Syndrome is a rare genetic and clinical disorder that affects many different parts of the body, especially the central nervous system, musculoskeletal system, kidneys, eyes, respiratory system, endocrine system and liver. In addition to all these affected organ systems, dysmorphic facial features can also be observed in people with Joubert Syndrome. Symptoms and clinical signs in individuals with Joubert Syndrome vary greatly in several ways, to the extent where afflicted individuals even from the same family might have completely different clinical presentations, when compared to one another. Although the clinical features of Joubert Syndrome appear in the neonatal period, the diagnosis can usually take years after the symptoms appear. A prevalence of between 1 per 80 000 and 1 per 100 000 live births has been reported by many investigators. Despite its heterogenous symptom cluster, poor outcome in cases of Joubert Syndrome presenting predominantly with hypotonia and global developmental delay has been reported. Although mental retardation has been reported as the primarily anticipated psychiatric condition in cases with Joubert Syndrome, some other clinical sources within relevant literature identify autism spectrum disorders as another possible psychiatric diagnosis observed in affected individuals. It is known that there are a limited number of cases with Joubert Syndrome, it is a rare condition and the main psychiatric finding expected in the course of the syndrome is mental retardation. With this case report, we have aimed to discuss a case of Joubert Syndrome who had presented with symptoms of major depressive disorder that mimicked mental retardation.

Hikikomori is a psychopathological and social syndrome characterized by a complete withdrawal from society for at least six months, lack of interest or willingness to attend school/work, and lack of interest in personal relationships. The Hikikomori phenomenon has often been considered a condition specific to the Japanese context, namely, cultural-bound syndrome. Recently, there are also been very few case reports of HS from other countries. In this case, a 15-year-old male adolescent, who has not been in school for about a year, does not leave his room except for physical needs, and cuts off social communication with everyone, including his family, is presented. As a result of clinical examination and applied scales, the patient's social isolation was associated with Hikikomori syndrome, and then the patient underwent psychosocial training to prevent social isolation. Hikikomori syndrome harms individuals' mental health, social participation, and educational and workforce stability, making it an important global issue. This case is the first report of hikikomori in Turkey and it is important to support hikikomori as an intercultural syndrome.

It has been highlighted that comorbidity of Traumatic Brain Injury (TBI) and PTSD leads a more complicated treatment process. Hence, it might be useful and practical to provide more trauma-focused therapy method such as eye movement desensitization and reprocessing (EMDR) therapy. This article illustrates a clinical case by describing the positive outcome of the concentrated EMDR therapy with a treatment frequency increased more than one session in a week of a 25 years old woman with TBI and PTSD. EMDR treatment has been provided for ten days and seven sessions in total for 90 min in each session. The results of the treatment have been measured with CAPS, SUD & VOC score. Results show the effectiveness of concentrated EMDR even after the 16 months follow up.