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Purpose: Individuals with gender dysphoria (GD) may request hormone therapy and various surgical operations to change their physical characteristics. The present study aimed to investigate the effects of two treatments, mastectomy and gender-affirming hormone therapy (GAHT), on adults with GD who were assigned female at birth (GD AFAB). Methods: In this cross-sectional study, we gathered data from a total of 269 individuals in three groups: (a) untreated group (n = 121), (b) GAHT group (n = 84) who had been receiving treatment for at least 6 months, and (c) GAHT-MAST group (n = 64) who had been using GAHT for at least 6 months and had undergone mastectomy at least 3 months prior. All participants were asked to complete the Symptom Checklist-90-Revised (SCL-90-R), the Body Uneasiness Test (BUT), and the World Health Organization's Quality of Life Questionnaire- Brief Form, Turkish Version (WHOQOL-BREF-Tr). Results: We found that individuals in the untreated group had higher psychopathological symptoms and body uneasiness scores, and lower quality of life scores compared to both GAHT and GAHT-MAST groups. There was no difference in psychopathology between the GAHT-MAST group and the GAHT group, but body uneasiness scores were lower, and quality of life scores were higher in the GAHT-MAST group. Conclusion: Our study suggests that individuals receiving GAHT improved mental health, body satisfaction, and overall quality of life. Combining mastectomy with GAHT may further enhance these benefits. [ABSTRACT FROM AUTHOR]

Objectives: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease, known for its heterogeneous clinical presentation. Although it is rarer in children, a more severe clinical course can be seen than in adults. It is known that sleep has physiological and developmental importance in children, and there are many studies on sleep quality in adult SLE patients. The aims of this study are to evaluate the sleep habits of children and adolescents with SLE and to compare them with their healthy peers. Methods: The study included 48 children and adolescents with SLE and 64 healthy peers as a control group. The Children's Sleep Habits Questionnaire was used to evaluate the sleep characteristics of children. Results: The age and gender of the children were similar across groups. The bedtime resistance and night waking scores of SLE patients were significantly higher than those of the control group. Total sleep score was higher in patients with SLE than in the control group, but there was no significant difference (47.13±7.63 vs 44.61±8.17; p=0.051). Similarly, the rate of sleep disorders in the patient group (75%) was higher than that of the control group (61%), though the differences were not statistically significant (p = 0.156). There was no correlation between disease severity and sleep problems. Conclusion: This research demonstrated that sleep disorders tend to increase in children and adolescents with SLE. Therefore, clinicians should pay attention to sleep disorders during the follow-up sessions of children and adolescents with SLE. Key Points • Sleep disorders tend to increase in children and adolescents with SLE. • Disease severity is not associated with sleep problems. [ABSTRACT FROM AUTHOR]

Introduction: Transgender people are exposed to many health inequality practices while receiving healthcare. In this study, we aimed to investigate the levels of transphobia among physicians who play an active role in the gender-affirming treatment (GAT) in Turkey. Methods: In this cross-sectional study, 530 physicians from the disciplines of psychiatry, endocrinology, gynecology, urology, and plastic surgery were assessed. Respondents completed a web-based survey consisting of sociodemographic data form and Genderism and Transphobia Scale (GTS) from May to June 2020. Results: Among the 530 physicians, 126 were psychiatrists, 107 were endocrinologists, 119 were gynecologists, 111 were urologists, and 67 were plastic surgeons. We concluded that the transphobic attitude was the lowest in psychiatrists and the highest in urologists. In addition, we found that males were more transphobic than females (for GTS, p <.001; morality/shame and teasing, p <.001; for violence, p =.003), married individuals than single ones (for GTS, p =.012; morality/shame, p =.006), and residents than other academic status (for teasing, p =.024). Finally, we showed that transphobic attitudes are higher among the religious and those belonging to a religion people, respectively, and lower among the atheists and the deists. Conclusions: Our findings indicate that transphobia is quite common among physicians in Turkey other than psychiatrists who are more in contact with transgender people. Policy Implications: It can be said that it may be important to establish more relationships with transgender individuals and develop policies regarding this situation in order to reduce the common transphobia among physicians. [ABSTRACT FROM AUTHOR]

Background: Objective: Having a child diagnosed with cancer is stressful for the whole family and may cause significant psychological impact on parents and siblings. Chronic, life-altering diseases may also have similar effects in siblings due to the daily life changes in the family to accommodate the child with chronic disease. We investigated the impact of having a sibling with cancer or type 1 diabetes mellitus (T1DM) on the psychological features of adolescents, with particular focus on self-conscious emotions such as guilt and shame—which are associated with the development of psychopathologies. Method: Sixty-four children who were siblings of patients diagnosed with cancer (CS group), 54 children who were siblings of patients diagnosed with T1DM (DMS group), and 200 adolescents with siblings who did not have any chronic disease (control group) were included in the study. The CS group was also divided into two subgroups with respect to cancer type (leukemia and non-leukemia). Feelings of guilt and shame were evaluated via the Test of Self-Consciousness Affect for Adolescents (TOSCA-A). The Children's Depression Inventory (CDI) and the State-Trait Anxiety Inventory (STAI) were used to determine the levels of depression and anxiety symptoms. Comparisons between groups were performed and within-group directional relationships between scores were analyzed. Results: Guilt scores were significantly higher in CSs than controls (p = 0.009), and the guilt scores of CSs and DMSs were similar (p = 0.508). Other subdimension scores obtained from the TOSCA-A and the CDI and STAI scores were similar in all three groups. In the CS group, externalization scores of siblings with leukemia were significantly higher than that of siblings with non-leukemia cancer. Although shame scores were similar in the CS, DMS, and control groups, shame scores were found to be positively correlated with CDI and STAI total scores in each group (p < 0.05 for all), whereas guilt scores did not demonstrate any significant correlations. Conclusion: Our results support prior studies in showing that CSs feel a greater level of guilt compared to adolescents without disease-stricken siblings, whereas, interestingly, CSs and DMSs were found to experience similar levels of guilt. Despite lack of significant increase in the CS and DMS groups, shame levels were positively correlated with depression and anxiety scores in all groups, but the lower correlation coefficients for the CS group indicate the presence of other factors influencing this relationship. We believe our results warrant the need for future studies evaluating the needs of the siblings of children with other chronic diseases, preferably with longitudinal follow-up to determine situations associated with need for psychosocial support. [ABSTRACT FROM AUTHOR]

Objective: Having a child with a chronic illness is a source of stress for the whole family, especially the primary caregiver. The aim of this study was to evaluate the associations between caregiver burden and both the caregiver's and child's psychological symptoms in a cohort of children with systemic lupus erythematosus (SLE). Methods: Thirty-four patients (aged 9–18 years) with childhood-onset SLE and their caregivers participated in this study. The control group was composed of healthy children and their caregivers. Questionnaires were used to evaluate caregiver burden and the psychological status of parents and children and adolescents with and without SLE. Results: No significant difference was found between the study and control groups for caregiver burden, anxiety and depression in parents, and psychological status in children. Caregiver burden was positively correlated with parent's depression, anxiety, and behavioral and peer problems of the children, and it was negatively correlated with the children's prosocial behaviors. According to regression analyses, the parents' depression and children's peer relationship had a positive effect on caregiver burden scores. Conclusion: Physicians should be aware of the presence of psychological symptoms in patients with childhood-onset SLE and their caregivers because it can affect caregiver burden and the caregiver's psychological state. Key points •Caregiver burden was positively correlated with parent's depression and anxiety. •Caregiver burden was positively correlated with children's behavioral and peer problems. •Caregiver burden was negatively correlated with child's prosocial behaviors. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the psychological symptoms of children and adolescents with rheumatological diseases (RD) and their parents during the outbreak. A web-based questionnaire survey was conducted in a cross-sectional design in RD patients and healthy controls. The Hospital Anxiety and Depression Scale was used to evaluate parental psychiatric status; while the State-Trait Anxiety Inventory for Child was used for children. Four hundred and fifty-nine patients with RD and their parents completed the present study, as well as 336 healthy peers. The age and gender of the children were similar across groups. Under 12 years of age, the trait anxiety of the children and the psychological symptoms of parents were similar across groups; while over 13 years of age, anxiety and depression scores of the parents, as well as trait anxiety of the children were higher than the control groups' (7.3 ± 3.4 vs 6.3 ± 3.8, p = 0.006 for parental anxiety; 6.6 ± 3.8 vs. 5.3 ± 3.9, p < 0.001 for parental depression; 36.1 ± 8.7 vs. 33.3 ± 7.9, p = 0.002 for child trait anxiety). In patient group, there were no differences in scale scores according to variables such as rheumatological disease diagnosis, the consulting of doctor for treatment, thinking that RD increases the risk of COVID-19, the history of rheumatic disease attack during the pandemic process, and the use of biological agents. The children's trait anxiety was positively correlated with their parents' anxiety (r = 0.414, p < 0.001) and depression (r = 0.300, p < 0.001) scores. These findings suggest that clinicians should pay attention to the psychiatric symptoms of both children with RD and their parents during the pandemic. [ABSTRACT FROM AUTHOR]

There is no documentation about the association between peer victimization, psychological status, and quality of life (QOL) in children and adolescents with systemic lupus erythematosus (SLE). The aim of this study was to evaluate the association between peer victimization, psychological symptoms, and QOL in a cohort of children and adolescents with SLE. Forty-one patients (aged 9-18 years) participated in this study. The control group ( n = 49) was composed of healthy children and adolescents from local community. Questionnaires were used to evaluate the peer victimization, psychological status, and QOL of children and adolescents with and without SLE. No significant difference was found between the study and control groups for peer victimization, depression, state and trait anxiety, and QOL scores. The peer victimization, depression, anxiety, and self-esteem scores were negatively correlated with psychosocial and total subscale scores of QOL in the study group. According to regression analyses, trait anxiety had a negative predictive effect on the physical health domain scores of QOL, whereas trait anxiety and peer victimization had a negative effect on the psychosocial domain and total scores of QOL in the SLE patients. This study suggests that trait anxiety and peer victimization are risk factors for poor QOL in adolescents with SLE. [ABSTRACT FROM AUTHOR]