Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633412023SpringHealing to Heal – After the Maraş Earthquake1TRYavuzAYHAN132410.5080/u 27306

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633412023SpringHealing to Heal – After the Maraş Earthquakeİyileşmek için İyileştirmek – Maraş Depremi’nin Ardından110.5080/u 27306ENTRYavuzAYHAN132410.5080/u 27306The February 6th earthquakes devastated us. We’re ruined, collapsed. In fact, writing at this moment seems trivial, all I feel like doing is to mourn and relay my condolences to those who survived (actually to all of us). But there are things that must be done. How will we protect our psyche? What should we do as a part of our species, as a member of our community and as an individual? Immediately after the earthquake, The Psychiatric Association of Turkey took action and organized an educational event for mental health professionals. In a flash, they’ve prepared a review paper highlighting the important points in the acute management of these people and the principles of psychological first aid. This expert opinion is now published in the current issue of the Journal, please take a look at that (Yıldız ve ark. 2023). I am not sure whether we will be able to effectively protect these people from future psychiatric problems (it is up for debate in later issues), but I know it’s crucial to be with those who are in need, to show that we are here for them and to firmly maintain our support; hopefully with the guidance of this paper. And to learn. To ease the shock of a later disaster, to still be standing tomorrow, we have to act now. It has a bitter side to it but we learn from people who are in pain. We need to convert our personal experiences into ones that advance ourselves and our profession. As the Turkish Journal of Psychiatry, we’d be honored to share your studies on the earthquake. We can only learn from each other. And we can only heal if we truly know. We hope to heal ourselves by healing others. Keep safe. REFERENCES Yıldız Mİ, Başterzi AD, Yıldırım EA et al. (2023) Preventive and Therapeutic Mental Health Care after the Earthquake-Expert Opinion from the Psychiatric Association of Turkey. Turk Psikiyatri Derg 34: 39-49.

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633412023SpringMassachusetts General Hospital Hairpulling Scale: Validity and Reliability Study of the Turkish FormMassachusetts Genel Hastane Saç/Kıl Yolma Ölçeği: Türkçe Formunun Geçerlik ve Güvenirlik Çalışması21010.5080/u25864ENTREfruz PİRDOĞAN AYDINJulide GÜLER KENARİlknur KIVANÇ ALTUNAYFatma DENİZÖmer Akil ÖZERKayıhan OğuzKARAMUSTAFALIOĞLU132510.5080/u25864Objective: The aim of this study is to analyze the validity and reliability of the Turkish form of Massachusetts General Hospital Hairpulling Scale (MGH-HPS), which is used to measure the severity of Trichotillomania (TTM). Methods: Fifty patients diagnosed with TTM according to the DSM-5 diagnostic criteria and fifty healthy controls participated in the study. The participants were asked to complete a sociodemographic questionnaire, the MGH-HPS-TR, the Clinical Global Impression (CGI), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the Barratt Impulsiveness Scale (BIS-11). The construct validity and the criterion validity of the MGH-HPS-TR were determined by means of exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. The reliability analysis of the MGH-HPS-TR was assessed by calculating the Cronbach’s α coefficient and the item total correlation coefficient. The values for the area under the curve (AUC), sensitivity and specificity were based on the ROC analysis. Results: AFA and CFA results indicated a single factor structure with 7 items explaining 82.5% of the variance. The item/factor loadings were satisfactory with the best fit indeces. Correlations were found between the scores on the MGH-HPS-TR and the other scales used for criterion validity analyses. The internal consistency and the item-total correlation coefficients of the scale were found to be satisfactory. Based on a cut of point of ≥ 9, the scale had high power for discriminating between the patient and the control groups and high sensitivity and specificity. Conclusion: This study showed that the MGH-HPS-TR can be used as a valid and reliable psychometric tool in Turkey. Keywords: Trichotillomania, reliability, validity, scale, hair pulling, body focused repetetive behaviour

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633412023SpringEvaluation of Simple Markers of Inflammation and Systemic Immune Inflammation Index in Schizophrenia, Bipolar Disorder Patients and Healthy ControlsŞizofreni Hastalarında, Bipolar ve Sağlıklı Kontrol Grubunda Basit İnflamasyon Belirteçlerinin ve Sistemik İmmün İnflamasyon İndeksinin Değerlendirilmesi111510.5080/u26248ENTRAli İNALTEKİNİbrahimYAĞCI132610.5080/u26248Objective: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), mean platelet volume (MPV), and systemic immune inflammation index (SII) are recently used as indicators of inflammation. NLR, PLR, MLR, and MPV have been evaluated in many studies in patients with schizophrenia and bipolar disorder. However, there are no studies investigating SII. This study aims to evaluate NLR, PLR, MLR, MPV and SII values and complete blood count elements in patients hospitalized with diagnoses of the schizophrenia with psychotic episode and bipolar disorder with manic episode by comparing them with the control group. Method: A total of 149 patients who were hospitalized with the diagnoses of the schizophrenia with psychotic episode and bipolar disorder with manic episode and who met the inclusion criteria were included in our study where the control group was composed of 66 healthy individuals. White blood cell (WBC), neutrophil, lymphocyte, platelet, and monocyte counts were obtained retrospectively from complete blood counts at the time of admission, based on which NLR, PLR, MLR, and SII were calculated. Results: In this study, higher NLR, PLR, and SII values and lower MPV and lymphocyte counts were observed in schizophrenia patients compared to the control group. NLR, PLR, and SII values and neutrophil counts were higher in patients with bipolar disorder compared to the control group. Lower MPV values were found in patients with schizophrenia compared to patients with bipolar disorder. Conclusion: Simple inflammatory and SII values in our study indicate the presence of low-grade systemic inflammation in schizophrenia and bipolar disorder. Keywords: Bipolar disorder, schizophrenia, inflammation, biomarkers, laboratory

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633412023SpringInvestigation of Adolescents Who Have Internet Addiction Accompanied By Attention Deficit and Hyperactivity Disorder in Terms of Emotion Regulation and Social Cognitionİnternet Bağımlılığı ve Eşlik Eden Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Ergenlerin Duygu Düzenleme ve Sosyal Biliş Açısından İncelenmesi162310.5080/u26072ENTRHozan SAATÇIOĞLUBetül AKYEL GÖVENÖmer KARDAŞZekiYÜNCÜ132710.5080/u26072Objective: The aim of this study is to evaluate social cognition and emotion regulation skills in individuals with Internet Addiction (IA) and Internet addiction with comorbid Attention Deficit/Hyperactivity Disorder (IA + ADHD). Method: The sample of the study consist of 30 IA, 30 IA + ADHD patients, 30 healthy controls between the ages of 12-17 who applied to the Child and Adolescent Psychiatry Department, Technology Outpatient Clinic. K-SADS-PL, WISC-R, sociodemographic data form, Internet Addiction Scale (IAS), Addiction Profile Index Internet Addiction Form (APIINT), Beck Depression Inventory, Global Assessment of Functioning Scale, and Difficulties in Emotion Regulation Scale were applied to all participants. Social cognition was evaluated using Faces Test, Reading the Mind in the Eyes Test, The Unexpected Outcomes Test, Faux Paus, Hinting Test and Comprehension Test. Results: In social cognition tests, IA and IA + ADHD groups failed significantly compared to the control group. Emotion regulation difficulties were significantly higher in IA and IA + ADHD groups compared to the control group (p<0.001). Use of the internet for doing homeworks (p<0.001) was found to be higher in the control group than in the IA and IA + ADHD groups Conclusion: It has been found that individuals diagnosed with internet addiction have difficulties in both social cognition and emotion regulation, which is more severe in the presence of comorbid ADHD. Keywords: Internet addiction; social cognition; emotion regulation difficulties; Attention Deficit/Hyperactivity Disorder; DSM-5

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633412023SpringIs There a Difference in Parental Attitudes and Attachment for ADHD-Social Phobia Comorbidity?Dikkat Eksikliği Hiperaktivite Bozukluğu-Sosyal Fobi Komorbiditesinde Ebeveyn Tutumları ve Bağlanma Biçimleri Açısından Farklılık Var mıdır?243010.5080/u26580ENTRDilek ÜNALFahriÇELEBİ132810.5080/u26580Objective: Social phobia (SP) is one the commonest of comorbid anxiety disorders seen with ADHD. It is also known that Social phobia and ADHD patients have some differences in parental attitudes and attachment styles. We aimed to investigate the effects attachment status and parental attitudes in ADHD-social phobia comorbidity. Method: 66 children and adolescents with ADHD were included for the study. the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, DSM-5 November 2016-Turkish Adaptation (KSADS-PL-DSM5-T) was used for evaluating diagnosis. Socioeconomic status (SES) was scored with Hollingshead Redlich Scale. Sosyodemografic and clinical data were recorded. Adult Attachment Scale (AAS) and Parental Attitudes Research Instrument (PARI) were completed by the parents. The patients filled Kerns Security Scale (KSS). We compared the ADHD patients with and without SAD comorbidity in terms of scales used and sociodemographic-clinical variables. Results: There were no differences between ADHD + SP group and ADHD without SP group in terms of age, gender, SES, family structure and family history of diagnosed psychiatric disease (p>0.05). Rate of inattentive subtype of ADHD (p=0.05) and comorbid psychiatric disease frequency (p=0.00) was higher in ADHD+SP group compared to ADHD without social phobia group. However, the groups did not differ according to their attachment styles, their parent’s attachment styles and parental attitudes (p>0.05). Conclusion: Parental attitudes and attachment styles may not play a role in the development of SP comorbidity in children and adolescents with ADHD. Other biological and environmental factors should be kept in mind when evaluating and treating children with ADHD who have SP. Biological treatments and individualized interventions such as CBT may be chosen as a first line treatment rather than psychotherapies targeting attachment and parenting styles in those children. Keywords: ADHD, social anxiety, attachment, parental attitudes

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633412023SpringEating Disorder‐15: Factor Structure, Psychometric Properties, Validity, and Reliability of the Turkish Version for Clinical and Non-Clinical SamplesYeme Bozukluğu-15: Klinik ve Klinik Olmayan Örneklemler için Türkçe Versiyonun Faktör Yapısı, Psikometrik Özellikleri, Geçerliği ve Güvenilirliği313810.5080/u27103ENTRHande ÖNGÜN YILMAZAslıhan POLATGizem KÖSESibel BALCIAhmet MuratGÜNAL132910.5080/u27103Objective: Eating Disorder-15 (ED-15) is a self-report scale recommended for use to evaluate weekly progress and treatment results in eating disorders. This research aims to examine the factor structure, psychometric properties, validity, and reliability of the Turkish version of ED-15 (ED-15-TR) for clinical and non-clinical samples. Method: Translation-back translation method was used for language equivalence of ED-15-TR. The research was conducted with a total of 1049 volunteers, with two sample groups as non-clinical (n=978) and clinical (n=71). The participants completed an information form, ED-15-TR, Eating Disorder Examination Scale (EDE-Q), and Beck Depression Inventory (BDI). Three hundred fifty-two participants from the non-clinical group and 18 from the clinical group completed ED-15-TR again within a week. Results: Factor analysis confirmed the two-factor structure of ED-15- TR. Cronbach’s alpha value was 0.911 (0.773, and 0.904 for the two subscales respectively), the intraclass correlation coefficient for testretest reliability was 0.943 in the clinical group (0.906, and 0.942 for the two subscales respectively); 0.777 (0.699, and 0.776 for the two subscales respectively) in the non-clinical group (for all p<0.001). The high level of a positive correlation between ED-15-TR and EDE-Q supported concurrent validity. Conclusion: This research indicates that ED-15-TR is an acceptable, valid, and reliable self-report scale for Turkish society. Keywords: Eating disorders, factor analysis, validity, reliability, scale

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633412023SpringPreventive and Therapeutic Mental Health Care after the Earthquake- Expert Opinion from the Psychiatric Association of TurkeyDeprem Sonrası Erken Dönemde Koruyucu ve Tedavi Edici Ruh Sağlığı Hizmeti-Türkiye Psikiyatri Derneği Uzman Görüşü394910.5080/u27305ENTRMevhibe İrem YILDIZAyşe Devrim BAŞTERZİEjder Akgün YILDIRIMŞahika YÜKSELAhmet Tamer AKERBengi SEMERCİSüleyman ÇAKIROĞLUYankı YAZGANMustafa SERCANBurcu RahşanERİMİlker KÜÇÜKPARLAKMünevver HACIOĞLUYILDIRIM133010.5080/u27305Two major earthquakes hit Turkey at the Kahramanmaraş region on February 6th 2023. The earthquakes affected almost 15 million individuals, resulting in more than forty thousand deaths, thousands of wounded and the destruction of ancient cities of humankind. Immediately after the earthquakes, the Psychiatric Association of Turkey organized an educational event to address the needs for a guidance on how to approach a trauma of such a big scale. The experts in this educational event summarized their presentations and prepared this review to guide the mental health professionals serving victims of this disaster. The review summarizes the early symptoms of trauma, and puts a framework on the principles of psychological first aid, the approach at the initial stages of the disaster, principles of planning, triage, and psychosocial support systems and the proper use of medications. The text covers the evaluation of the impact of trauma, aligning psychiatric practice with psychosocial interventions, the improvement of counseling skills and methods to better understand the mind during the acute post trauma phase. A set of presentations highlight the challenges in child psychiatry, brings a systematic overview to the earthquake and discuss the symptomatology, first aid and intervention principles in children and adolescents. Last, the forensic psychiatric perspective is presented, followed by a piece on the essentials of delivering bad news and the review is concluded with the emphasis on burnout, a syndrome to avoid particularly for field professionals, and possible preventive measures. Keywords: Disaster, trauma, psychosocial support, psychological first aid, acute stress disorder, post traumatic stress disorder

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633412023SpringBody Focused Repetitive Behavior Disorders: Behavioral Models and Neurobiological MechanismsBeden Odaklı Tekrarlayıcı Davranış Bozuklukları: Davranış Modelleri ve Nörobiyolojik Mekanizmalar505910.5080/u26213ENTRHande GÜNAL OKUMUŞDevrimAKDEMİR133110.5080/u26213Objective: Body Focused Repetitive Behaviors (BFRB) is an umbrella term for undesirable, repetitive motor activities such as Trichotillomania (TTM), Skin Picking Disorder (SPD), nail biting, cheek chewing, lip biting, finger sucking, finger cracking and teeth grinding. Such behaviors are engaged in to eliminate a part of the body and may result in impaired functionality. The frequency of presentation to clinicians is low since BFRB are defined as harmless, although the number of studies on this condition has increased rapidly recently, including those making a clear determination of epidemiological data, those investigating the etiopathogenesis and those providing treatment guidelines, although they remain inadequate. The present study provides a review of studies investigating the etiology of BFRB to date. Method: Articles published between 1992 and 2021 stored in the Pubmed, Medline, Scopus and Web of Science databases were reviewed, and the prominent research studies of the condition identified were included in the evaluation. Results: Studies investigating the etiopathogenesis of BFRB were found in most cases to investigate adult populations, and were hampered by such confounding factors as clinical heterogeneity, high rates of comorbid psychiatric diseases and small sample sizes. The identified studies reveal that attempts have been made to explain BFRB based on behavioral models, and that the condition is inherited at a high rate. Treatment planning is mostly associated with monoamine systems (especially glutamate and dopamine) and interventions were directed to addiction elements. Furthermore, cognitive flexibility and motor inhibition defects in neurocognitive area and cortico-striato-thalamocortical cycle abnormalities in neuroimaging studies have been reported. Conclusion: Studies investigating the clinical features, incidence, etiopathogenesis and treatment of BFRB, which holds a controversial place in psychiatric classification systems, would contribute to a better understanding of the disease and a more appropriate definition of the condition. Keywords: Body focused repetitive behavior disorders, trichotillomania, skin picking disorder, behavior models, neurobiology, neuroimaging

Türkiye Sinir ve Ruh Sağlığı DerneğiTurk Psikiyatri Derg1300-21633412023SpringClozapine-Induced Obsessive-Compulsive Symptoms and Augmentation with Clonazepam: Risks and RationalesKlozapine Bağlı Gelişen Obsesif-Kompulsif Semptomlar ve Klonazepam ile Güçlendirme Tedavisi: Riskler ve Gerekçeler606410.5080/u27025ENTRMehmet ÜNLERSultan Efsun TAMDEMİRİrem EKMEKÇİ ERTEKZehraARIKAN133210.5080/u27025Obsessive-compulsive symptoms induced by clozapine negatively affect treatment compliance. In some studies, clonazepam was shown to be beneficial in obsessive-compulsive disorder. However, in literature there are case reports of life-threatening complications associated with the combined use of clozapine and benzodiazepines. In this article, the efficacy and safety of the clonazepam augmentation were discussed in two patients who had obsessive-compulsive symptoms induced by clozapine. No life-threatening complications were detected during the follow-up period of more than two years, and the patients benefited dramatically from the addition of clonazepam. In treatment-resistant patients, clonazepam can be used with close monitoring for obsessivecompulsive symptoms associated with atypical antipsychotics. Keywords: Atypical antipsychotics, clonazepam, clozapine, obsessivecompulsive symptoms