OBJECTIVE: This study aims to examine how internalized stigma differs in opioid use disorder (OUD) based on sociodemographic and clinical variables, and to what extent internalized stigma is related to treatment motivation, perceived social support, depression, and anxiety levels. METHODS: One hundred forty-five individuals with OUD included. Sociodemographic and clinical data form, the Internalized Stigma of Mental Illness Scale (ISMI), Treatment Motivation Questionnaire (TMQ), Multidimensional Scale of Perceived Social Support, the Beck Depression Inventory, and the Beck Anxiety Inventory were utilized in the study to collect data. Bivariate and partial correlation coefficients between variables were computed. ISMI and TMQ scores were compared between patients with depressive symptoms and patients without depressive symptoms by using t-test and Mann Whitney U test. RESULTS: Internalized stigma was high among male patients with heroin use disorder. There was a positive correlation between internalized stigma score and treatment motivation, depression, and anxiety levels. On the other hand, there was a negative correlation between internalized stigma score and multidimensional perceived social support. CONCLUSION: Internalized stigma occupies an important place in the treatment of OUD, which occurs with frequent relapses and which is hard to treat. Not only application for treatment but also adherence to treatment and treatment motivation at maintenance phase bestow a complicated relationship with depression and anxiety. In the struggle against internalized stigma, it plays a vital role to mobilize people's social support systems, to educate families on the issue and to get in touch with support units exclusive to heroin users.
Objective: Mood stabilizers and antipsychotic drugs are known to have adverse effects on sexual function. However, patients often refrain from speaking about sexual complaints that may cause dose reduction and discontinuation of the drug without medical supervision. In this study we aimed to evaluate sexual functions of patients with bipolar disorder in remission period, considering prolactin levels and medications. Method: We recruited 52 patients with bipolar disorder in remission according to DSM-IV diagnostic criteria. Prolactin levels were measured in all patients. The Golombok Rust Inventory of Sexual Satisfaction (GRISS) was used to assess sexual dysfunction. Results: Mean prolactin levels were 24.71 ± 4.25 and 19.96 ± 5.52 ng/ml respectively for females and males. Patients taking mood stabilizer (MS) and mood stabilizer plus antipsychotic (AP) treatment had different prolactin levels (p<0.001). Total GRISS scores were not different for MS and MS+AP treatment groups. We didn't find a correlation between Total GRISS scores and prolactin levels. There was a significant deterioration in female non-sensuality, female dissatisfaction and anorgasmia subscales of female patients and significant deterioration in premature ejaculation, impotence and male dissatisfaction subscales of male patients. Discussion: In our sample, both men and women patients with bipolar disorder in remission have sexual dysfunctions. Our results suggest that prolactin levels are not sufficient to demonstrate the sexual dysfunction. To enhance patient compliance it is necessary to focus more on sexual symptoms of patients receiving MS and AP treatment. ÖZETAmaç: Duygudurum dengeleyici ve antipsikotik ilaçlarýn cinsel iþlevlerle ilgili yan etkileri olduðu bilinmektedir. Bununla birlikte hastalar genellikle bu yakýnmalarý hakkýnda konuþmaktan kaçýnýrlar ve cinsel iþlev bozukluklarý, hastalarýn kendi kendilerine doz azaltmalarýna ya da tedaviyi býrakmalarýna sebep olabilir. Bu çalýþmada, remisyon dönemindeki bipolar bozukluk hastalarýnýn ilaç tedavileri ve prolaktin düzeylerini dikkate alarak cinsel iþlevlerini deðerlendirmeyi amaçladýk. Yöntem: Çalýþmaya DSM-IV kriterlerine göre bipolar bozukluk tanýsý alan 52 hasta dâhil edildi. Hastalarýn prolaktin düzeyleri ölçüldü. Cinsel disfonksiyonu deðerlendirmek için, Golombok Rust Cinsel Doyum Ölçeði (GRCDÖ) kullanýldý. Bulgular: Prolaktin düzeyleri ortalamasý kadýn ve erkekler için sýrasýyla 24.71 ± 4.25 ve 19.96 ± 5.52 ng/ml idi. Duygudurum dengeleyici (DD) ve duygudurum dengeleyiciye ek antipsikotik (AP) alanlar arasýnda prolaktin seviyeleri farklýydý (p<0.001). Toplam GRCDÖ puanlarý DD ve DD+AP tedavi grubunda farklý deðildi. Toplam GRCDÖ ile prolaktin seviyeleri arasýnda korelasyon yoktu. Kadýnlarda dokunma, doyum, anorgazmi, erkeklerde prematür ejakülasyon, empotans ve doyum alt ölçeklerinde bozulma mevcuttu. Sonuç: Çalýþmamýzda, remisyondaki kadýn ve erkek bipolar bozukluk hastalarýnda cinsel disfonksiyonlar mevcuttu. Prolaktin seviyeleri cinsel disfonksiyonu yansýtmakta yeterli bulunmadý. ...
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