Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633342022WinterRetrospectionA5A6TRAygünERTUĞRUL131310.5080/u27273

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633342022WinterComparison of Formal Thought Disorder in the Acute Episode of Schizophrenia and Manic Episode of Bipolar Affective DisorderŞizofreni ve İkiuçlu Duygudurum Bozukluğunun Akut Hastalık Döneminde Düşünce Süreci Bozukluklarının Karşılaştırılması22323210.5080/u25886ENTREmreMUTLUŞahinGÜRKANErolGÖKAA. Elif ANILYAĞCIOĞLU131410.5080/u25886Objective: The aim of this study was to compare the formal thought disorder (FTD) in the acute episode of schizophrenia (SCHZ) and bipolar affective disorder (BPAD), and to determine the FTD dimensions associated with BPAD. Method: The study included a total of 34 SCHZ patients not meeting the standardized remission criteria and 20 patients in BPAD manic episode. The patients completed the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impression Scale (CGI), the Young Mania Rating Scale (YMRS), the Hamilton Depression Rating Scale (HAM-D) and the Thought and Language Disorder Scale (TALD) in order to assess FTD. The association of FTD with the diagnoses was analyzed by a logistic regression model including the TALD factors and the SCHZ and BPAD groups. Results: Statistically significant differences were not determined between the demographic features, the CGI scores and the TALD objective positive factor scores of the SCHZ and BPAD groups. The objective negative and subjective negative factors (p<0.001 for all) were higher in SCHZ group and the subjective positive factor were significantly higher in BPAD group (p=0.028). In the logistic regression model, the TALD subjective positive factor was associated with BPAD diagnosis, and the objective negative factor was associated with SCHZ diagnosis. In the BPAD group, the TALD total score correlated positively with the manic episode severity, and the scores on the subjective negative and subjective positive factors correlated negatively with disease duration. Conclusion: The study results show that FTD is common to the acute episodes of both SCHZ and BPAD and that assessment of the subjective positive FTD symptoms and objective negative FTD symptoms may be useful to differentiate the acute episode of SCHZ from the BPAD manic episode. Keywords: Formal thought disorder, schizophrenia, bipolar affective disorder manic episode

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633342022WinterHow Do Cannabis and Synthetic Cannabinoids Affect Neurocognitive Functions?Esrar ve Sentetik Kannabinoidler Nörobilişsel İşlevleri Nasıl Etkiler?23324710.5080/u26956ENTRHande ÇELİKAYSÖYLERAyşe EnderALTINTOPRAKEbru ÖZTÜRKALDEMİR131510.5080/u26956Objective: In this study, the losses of neurocognitive function caused by the use of cannabis and synthetic cannabinoid were studied on specific cognitive areas (attention and working memory, executive functions, visuospatial perception, learning and memory, planning and problem solving, word naming) and were described in comparision with healthy controls (control group). Method: In this study, while 52 participants who applied to Ege University Faculty of Medicine Department of Mental Health and Mental Disorders Drug Addiction Treatment Center Clinic between March 2015 – February 2017 and used cannabis at least for one year in the past and 51 participants who used synthetic cannabinoids for at least one year in the past were participant groups with a history of substance use; 57 staff/student of Ege University with no history of any substance use were participants of the control group. The research sample consisted of 160 participants. The sample group consisted of 160 men aged 18-35, and also 16 participants aged 36-54 were involved in the study in order to observe neuropsychological functions that changed with age. Stroop Test for attention area, Raven Standart Progressive Matrices Test for executive functions area, Line Orientation Test and Cancellation Test for visuospatial perception area, Serial Digit Learning Test and Öktem Verbal Memory Progresses Scale for learning and memory area, The Tower of London Test for planning and problem solving skill, Boston Naming Test for word naming area were used. Results: In this study, while the lowest perfomance on the ability of focused attention, visuospatial cognition, visual scanning, orientation, sustained attention, general ability, short-term memory, learning, long-term memory, word naming was shown by the participants with a history of synthetic cannabis use, the participants with a history of cannabis use had the lowest performance on the ability of response rate, perseveration, conceptualizing, abstract thinking, changing sets, recognition. Participants’ history of substance use did not affect the ability of planning and problem solving. Conclusion: In conclusion, this study suggests that the addition of cognitive rehabilitation programs to medical and psychosocial improvement studies carried out in the field of addiction will increase the success. Keywords: Neurocognitive function; cannabis; synthetic cannabinoid

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633342022WinterThe Use of Pesticides in Suicide Attempts in the Eastern Mediterranean Region of TurkeyTürkiye Doğu Akdeniz Bölgesinde İntihar Girişimlerinde Pestisit Kullanma Durumu24825410.5080/u26347ENTRErsinNAZLICANBurakMETENezihat RanaDİŞELLutTAMAM131610.5080/u26347Objective: In parallel with common usage areas, pesticide poisonings are encountered in the community due to reasons such as no wearing of protective clothing and masks during use, unintentional consumption and suicide-intended intake. In this study was aimed to examine the cases who applied to the emergency department with pesticide poisoning and share of suicide cases. Method: This study is a retrospective record study based on the files of 234 patients who reported to the emergency department for pesticide and rodenticide poisoning between 2014 and 2018. The patients were compared in terms of sociodemographic, substance type, prognosis, and accident/suicide status. Chi-square test, Binary logistic regression analysis were used in the analysis of the data. Results: Organophosphates was the most common substance recorded as a cause of poisoning, while rat poison placed second. 38% of the acute poisoning cases were suicide attempts. Poisoning among men was found to be prominently due to accident whiles among women suicidal poisoning was more prominent. While the mortality rate is 4.7% in all acute intoxication cases, the mortality rate in poisonings with suicidal purposes is 5.6%. Patients with psychiatric diseases have a 28-fold higher risk of intoxication of attempting suicide. The most common comorbid psychiatric disorders in acute pesticide poisoning are anxiety and depression. Conclusion: A major proportion of pesticide poisoning cases is suicide attempts. Suicide attempt is at the forefront in women and death rates are higher in people with psychiatric illness. It may be advisable to avoid the easy accessibility of pesticides. Keywords: Pesticides, rodenticides, suicide

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633342022WinterPsiNorm: A fast, efficient and free open-source software for interpreting, reporting and archiving neuropsychological test resultsPsiNorm: Nöropsikolojik Test Verilerinin Değerlendirilmesi, Rapor Hazırlanması ve Arşivlenmesi için Hızlı ve Etkin Bir Açık Yazılım25526210.5080/u26267ENTRYavuzAYHANBilal BahadırAKBULUTAybüke HandanŞİŞMANBergeVELİBAŞOĞLU131710.5080/u26267Objective: In many clinics, calculation and interpretation of neuropsychological test results, along with reporting, data organization and archiving of the data are done manually. In this era where most of the similar processes are automated, manual application may result in excessive time consumption, unnecessary use of qualified work-force, and is also open to error. A software that automates these processes for neuropsychological tests used for dementia assessment may overcome these issues. Method: We aimed to develop a free, open source software not requiring specialized training, which would optimise the calculation, preparation of personal reports and archiving processes of neuropsychological tests, hence would easily be incorporated in to the daily work of psychologists. We’ve used Python 3.6 as the programming language, and JSON was used as the data interchange format to allow for personal alterations in the content. The tests were selected among those which are in common use for neuropsychological evaluation of adults in Turkey, with available norm values. (Funding: TUBITAK 214S048). Results: PsiNorm was developed, comprising widely used standardized tests for cognitive evaluation of adults in Turkey. The software is lightweight, compatible with most common operating systems, and easy-to-use. We’ve shown that Psinorm significantly reduced the time required for calculation of percentiles and norms as well as for producing a draft report. The reports are prepared in .txt format and the databases are prepared in MS Excel ve CSV formats. PsiNorm is available freely at psinorm.org. Conclusion: PsiNorm is a free, open-source software which is available for researchers and clinicians who perform neuropsychological tests. PsiNorm provides significant time and labor-force benefits, is easy-touse and can be customized by the user. Keywords: Neuropsychological tests, software, dementia, psychometrics, cognitive dysfunction

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633342022WinterValidity and Reliability Study of Turkish Forms of the Quality of Relationships Inventory-Bereavement Version and the Bereavement Guilt Scaleİlişki Niteliği Ölçeği–Yas Versiyonu ile Yas ve Suçluluk Ölçeği Türkçe Formu’nun Geçerlik ve Güvenirlik Çalışmaları26327310.5080/u26027ENTREmrahKESERYağmur ARKARCIIlgın GÖKLERDANIŞMAN131810.5080/u26027Objective: The aim of this study was to investigate the psychometric properties of the Turkish forms (TR) of the Quality of Relationships Inventory-Bereavement Version (QRI-B) and the Bereavement Guilt Scale (BGS). Method: The sample consisted of 447 bereaved adults who lost a loved one due to death at least 6 months ago and within the past 5 years. Participants completed the QRI-B, BGS, Beck Depression Inventory (BDI), Prolonged Grief Inventory (PG-13), The Grief and Meaning Reconstruction Inventory (GMRI), Rosenberg Self-Esteem Scale (RSS) ve Life Satisfaction Scale (LSS). Results: Results of the explanatory factor analysis showed a good fit between the BGS-TR and the original form of BGS consisting of a 5-factor and 14 items. Besides, the QRI-B-TR showed a similar fit with the original QRI-B consisting of a 2-factor and 13 items, except for item 1. The QRI-B-TR and BGS-TR had positive correlations with the PGI and BDI, and negative correlations with the RSS, LSS, and GMRI-growth subscale. These correlations supported the convergent validity. After controlling for demographic variables, the subscales of the QRI-B-TR and BGS-TR explained 49% of the variance in prolonged grief symptoms. Internal consistency values of the total scale and the subscales for both instruments ranged between 0.70 and 0.94. Conclusion: The findings of the study demonstrated that the Turkish versions of the QRI-B-TR and BGS-TR were reliable and valid psychometric tools. Additionally, it was shown that quality of pre-death relation and grief related guilt were strong predictors of prolonged grief symptoms. Keywords: Prolonged grief, guilt, quality of pre-death relationship

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633342022WinterValidity and Reliability of the Turkish Version of the Munich Chronotype QuestionnaireMünih Kronotip Anketi Türkçe Formu’nun Geçerlik ve Güvenilirlik Çalışması27427910.5080/u26079ENTRŞengülERDOĞANHabibe K.ÜÇPUNARBanu CANGÖZTAVAT131910.5080/u26079Objective: The Morningness-Eveningness Questionnaire (MEQ) has been widely used to determine chronotype. The Munich Chronotype Questionnaire (MCTQ) was developed as an alternative measurement tool to the MEQ, focusing on different sleep behaviors on work and free days. The aim of this study was to adapt the MCTQ to the Turkish language and to validate the questionnaire on young and healthy adult members of the Turkish population. Method: This study was conducted with total of 214 (161 Female, 53 Male) healthy young adult volunteers between the ages of 18-30 (M=20.72, SD=2.33) from Hacettepe University. After adaptation to the Turkish language to form the MCTQ-TR, the psychometric properties were compared with the MEQ-TR. The test retest reliability of the MCTQ-TR was investigated on 25 participants (19 Female, 6 Male), 4 months after the first application. Results: The test-retest reliability coefficient of the MCTQ-TR was calculated as r=0.643 (p<0.05). The validity and reliability results indicated a negative and statistically significant correlation between the MEQ-TR and MCTQ-TR scores (r=-0.627; p<0.001). Conclusion: The MCTQ-TR is a valid and reliable measurement tool that can be used to determine chronotype in healthy Turkish young adult population. Keywords: Munich Chronotype Questionnaire, chronotype, validation, reliability, sleep

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633342022WinterMild Behavioral Impairment: A New Prodromal Syndrome for DementiaHafif Davranışsal Bozulma: Demans Öncülü Yeni Bir Sendrom28028910.5080/u26980ENTRAslıAYTULUNŞahinde Özlem ERDENAKİ132010.5080/u26980In this review, it is aimed to discuss neuropsychiatric symptoms as prodromal symptoms of dementia syndromes, to define the concept of ‘Mild Behavioral Impairment’, and to introduce the ‘Mild Behavioral Impairment Checklist’. Neuropsychiatric symptoms (NPS) represent non-cognitive symptoms and behaviors in dementia patients. The frequency of NPS accompanying dementia increases as the disease progresses. Studies reveal that NPS are seen in patients with dementia as well as in the elderly without cognitive complaints, individuals with subjective cognitive complaints, and individuals diagnosed with mild cognitive impairment. Based on these findings, identifying and detecting these symptoms were thought to be useful in predicting the development of dementia in cases where cognitive symptoms have not yet appeared. ‘Mild Behavioral Impairment’ was first defined by Taragano and Allegri, and it was introduced as a concept that includes neurobehavioral symptoms seen in elderly people for at least 6 months and that do not meet the diagnostic criteria of any other psychiatric syndrome. Mild Behavioral Impairment Checklist (MBI-C) has been developed recently which consists of 34 questions including apathy, mood, impulse dyscontrol, social inappropriateness, abnormal thinking, and perception. Studies on the neurobiological basis of these sub-domains and their relationship with biomarkers gained momentum with the definition of the concept and the development of MBI-C. However, the concept is still very new and it is possible for people to be over-diagnosed and to face the risk of stigmatization during the evaluation. Therefore, studies with large samples are needed. Demonstrating the validity of this concept will also serve the purpose of identifying the subjects with a neurodegenerative disease without any cognitive complaints yet at a very early stage in clinical studies. Keywords: Mild behavioral impairment, neuropsychiatric symptoms, prodromal dementia

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633342022WinterRevisiting Jerusalem Syndrome: A Case Displaying Similar Symptoms to Jerusalem Syndrome During Mecca VisitKudüs Sendromuna Tekrar Bakış: Mekke Ziyareti Sırasında Kudüs Sendromuna Benzer Belirtilerle Başvuran Bir Olgu29029210.5080/u26966ENTRFeritŞAHİNSelçukCANDANSAYARBahadırGENİŞ132110.5080/u26966Jerusalem syndrome is a mental illness rarely seen in people who visit Jerusalem, manifests itself with obsessive religious thoughts, delusions, psychotic symptoms, and some characteristic features. In clinical practice, it’s uncommon to encounter patients displaying symptoms of the Jerusalem syndrome. In this paper, we report a case of a middle-aged woman who manifested psychiatric symptoms similar to the Jerusalem syndrome after a Mecca visit without any previous psychiatric history. After careful examination, religious delusions, auditory and visual hallucinations, racing thoughts, disorganized speech, and confusion were denoted, therefore the patient was hospitalized. Brain imaging and laboratory examination was unremarkable. After nine days of antipsychotic treatment, the patient’s symptoms completely dissolved, and she was discharged. Antipsychotic treatment was ceased entirely after two months. The patient and her family members reported that the patient was symptom-free for the following two years. Keywords: Brief reactive psychosis, religion, travel, differential diagnosis

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633342022WinterA COLLABORATIVE, INTEGRATIVE MENTAL HEALTH APPROACH: “THE STEPPED CARE MODELİŞBİRLİĞİNE DAYALI, ENTEGRE BİR RUH SAĞLIĞI YAKLAŞIMI: “KADEMELİ BAKIM MODELİ”29329410.5080/u27236ENTRSalihaHALLAÇBurhanettinKAYA132210.5080/u27236Dear Editor, In this paper, it is aimed to raise awareness about the stepped care model as an approach in the organization of mental health services related to the protection, development, care and treatment of mental health. Concerning mental health, World Health Organization emphasizes that “Mental Health is more than mental disorders. It is a state of well-being that includes using one’s own abilities, self-realization, coping with the stresses in the natural flow of life, learning to be well and trying to heal, working efficiently and contributing to the society in which they live.” (World Health Organization 2022a). It has been reported that the disease burden of common mental disorders (depression, anxiety, post-traumatic stress disorder, psychoactive substance use disorders, suicide, etc.) is gradually increasing (World Health Organization 2021). Especially in the last century, the importance and seriousness of endemic and pandemic events (HIV, SARS virus, and still continuing Covid-19, etc.) or non-communicable diseases (cancer, heart diseases, diabetes, etc.), climate changes, economic, socio-political dynamics and wars are noteworthy as a predisposition and/or precipitating factors in terms of mental health (World Health Organization 2022a, World Health Organization 2022b). Protection and improvement of mental health, together with individual, social, and structural mental health determinants, predict interventions that reduce risks, increase resilience, and create a supportive environment for mental health. These interventions are recommended to be designed individually, in a way to be disseminated to special groups across the community. Globally, one person dies by suicide every 40 seconds, and more than 18 million health workers are needed in terms of human resources