Psychological Attitudes of Physicians in Seeking Help and Associated Factors

Background

Physician suicides have been increasing in recent years, and this shows that the psychological state of physicians is a subject that needs research and intervention. We think that the factors affecting the behavior of physicians to seek medical help due to their psychiatric disorders should be addressed. Therefore, we conducted a study examining the relationship between the anxiety, depression and stress levels of physicians, their attitudes toward seeking psychological help, and the degree of self-stigma related to seeking help.

Methods

One hundred sixty-six physicians who accessed online platforms were included in the study, and data were collected using self-report forms. The Depression Anxiety Stress Scale, the Attitudes Toward Seeking Professional Psychological Help Scale, and the Self-Stigma in Seeking Help Scale were used as assessment instruments.

Results

A positive correlation was found between negative attitudes toward seeking psychological help and depression, anxiety, and stress, whereas a negative association was found between positive attitudes and depression, anxiety, and stress. A significant association was found between age and depression and anxiety scores.

Conclusion

Physicians with high levels of depression, anxiety, and stress are more likely to exhibit negative attitudes toward seeking psychological help, and interventions are needed to improve attitudes toward seeking help.

Social Cognition in Schizophrenia Patients and Their First-Degree Relatives

INTRODUCTION

Social cognition is a person's ability to configure the designs of relationships between themselves and others and to use these designs to guide social behaviors in a flexible manner. The models that are the most studied and describe social cognition are the theory of mind (ToM) and emotion recognition. This study was aimed to detect ToM and emotion recognition disorders in schizophrenia patients and their first-degree relatives.

METHODS

Thirty schizophrenia patients in remission, the first-degree relatives of schizophrenia patients (n=30), and 30 healthy volunteers who were paired with the patients in terms of age and duration of education were included in the study. The Positive and Negative Symptom Scale (PANSS), Dokuz-Eylül Theory of Mind Scale (DEToMS), Reading the Mind in the Eyes test, Facial Emotion Identification Test (FEIT), and Facial Emotion Discrimination Test (FEDT) were performed by the patients participating in this study.

RESULTS

ToM and emotion recognition were found to be defective in the schizophrenia patients and their relatives. The performances of ToM and emotion recognition were ranked as the schizophrenia group, family group, and control group, from the worst to the best. The schizophrenia group showed poor performance in all sub-components except irony. In the family group, the empathy subcomponent showed similar performance with the control group, whereas the subcomponents of the second-order false belief, metaphor, and faux pas tests showed similar performance with the patient group. There were differences among the three groups in the first-order false belief subscale as well as the total DEToMS. The patient and family groups showed the poorest performances, whereas the control group showed the best performance.

CONCLUSION

The detection of ToM and emotion recognition disorders in the remission period, regardless of the attack period and asymptomatic first-degree relatives, may support the view that the period of schizophrenia is an independent continuous variable.

Adjuvant chemotherapy for superficial transitional cell bladder carcinoma: long-term results of a European Organization for Research and Treatment of Cancer randomized trial comparing doxorubicin, ethoglucid and transurethral resection alone

PURPOSE

We compared the efficacy of transurethral resection alone or transurethral resection followed by bladder instillations of doxorubicin or ethoglucid for 1 year in patients with superficial bladder carcinoma, and followed them long term for the incidence of progression to muscle invasion.

MATERIALS AND METHODS

A total of 443 patients with superficial transitional cell carcinoma of the bladder was randomized. After randomization of 206 patients the control arm was closed to patient entry based on the results of an interim analysis showing a significant difference in favor of those receiving adjuvant chemotherapy.

RESULTS

Final analysis of treatment results for recurrence included 432 patients at a median followup of 3.4 years for time to first recurrence, 5 years for analysis of time to invasion (Category T2 disease or worse) and 10.7 years for duration of survival. Time to first recurrence was significantly prolonged by both drugs compared to transurethral resection alone (doxorubicin versus transurethral resection alone p < 0.001 and ethoglucid versus control p < 0.001). Recurrence rate per year was 0.30 for both adjuvant treatment arms and 0.68 for the resection only group. Progression to muscle invasion was rare (15.1% of cases) and not apparently different in the 3 treatment arms. Of the 423 patients death from any cause in 199 and from malignant disease in 59 was not correlated with treatment. However, there was a strong correlation between death from malignant disease, and T category and tumor grade.

CONCLUSIONS

In regard to time to first recurrence and recurrence rate per year this study indicates that adjuvant chemotherapy with doxorubicin and ethoglucid using the indicated schedule is superior to transurethral resection alone. However, progression in stage or survival was not influenced by the treatment regimen.

Adjuvant chemotherapy of superficial transitional cell bladder carcinoma: preliminary results of a European organization for research on treatment of cancer. Randomized trial comparing doxorubicin hydrochloride, ethoglucid and transurethral resection alone

Patients with superficial transitional cell carcinoma of the bladder were entered in a randomized clinical trial to compare the efficacies of transurethral resection alone or followed by bladder instillation of doxorubicin hydrochloride or ethoglucid (Epodyl) for 1 year. Results showed that adjuvant chemotherapy with the selected drugs prolonged the mean interval between recurrences. Mild systemic toxicity and chemical cystitis were observed in 3 and 3 per cent, respectively, of the patients given ethoglucid, and in 5 and 4 per cent, respectively, of those taking doxorubicin.

[Value of computed tomography and lymphography for the demonstration of pelvic lymph node metastases in prostatic cancer]

Between 1977 and 1982 74 patients with cancer of the prostate underwent a pelvic lymphadenectomy. 17 had a preceding lymphangiography and 25 computerized tomography; the sensitivity of the former was 50%, the specificity 56% and the accuracy 53%, whereas the latter produced rates of 25, 100 and 76%, respectively. These percentages are in keeping with the literature. In addition, 61 of the 74 patients had during the lymphadenectomy a frozen section, which was in 87% accurate, but yielded a false negative ratio of 32%. The efficiency is within the figures given in the literature.