Türkiye Sinir ve Ruh Sağlığı Derneği Turk Psikiyatri Derg 1300-2163 37 2026 Investigation of Peripheral Inflammatory Biomarkers in Trichotillomania Trikotillomani’de Periferik İnflamatuar Biyobelirteçlerin Araştırılması 1 8 10.5080/u27726 EN TR Serkan YAZICI Ezgi Sıla AHİ ÜSTÜN Rıfat Serav İLHAN Meram Can SAKA Journal Article 1449 10.5080/u27726 Objective: Immunological factors may play a role in the etiology of trichotillomania (TTM). Peripheral inflammatory markers such as Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), Monocyte-Lymphocyte Ratio (MLR), monocyte to high-density lipoprotein (HDL) ratio (MHR), Systemic Immune-Inflammation Index (SII) have not yet been investigated in TTM. This study aimed to compare TTM with healthy control (HC) in terms of various inflammatory markers such as NLR, PLR, MLR, MHR, SII. Method: The electronic records were examined of patients who were diagnosed with TTM who attended to the outpatient psychiatry clinic between January 2022 and December 2023. 46 TTM and 44 HC were included in the study. Blood samples for 90 participants were examined from electronic records, and NLR, PLR, MLR, and SII values were calculated. Participants with TTM were scored according to disease severity using the Clinical Global Impression–Severity (CGI-S) scale. Results: NLR, PLR, MLR, MHR, and SII were significantly higher in TTM. No significant correlation was found between CGI-S scores and NLR, PLR, MLR, MHR, and SII values in TTM. According to binary logistic regression analysis, a significant relationship was found between NLR and TTM. Conclusion: TTM group have elevated peripheral inflammatory markers compared with HC group. Findings of the study support the potential inflammatory process in TTM. Keywords: Trichotillomania, Inflammation, Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), Monocyte -Lymphocyte Ratio (MLR), Monocyte to HDL ratio (MHR), Systemic Immune-Inflammation Index (SII)

Türkiye Sinir ve Ruh Sağlığı Derneği Turk Psikiyatri Derg 1300-2163 37 2026 A Psychiatric Perspective on Bariatric Surgery and Obesity: What Do Psychiatrists Think and Do? A Cross-Sectional Survey Study Obezite ve Bariyatrik Cerrahiye Psikiyatri Penceresinden Bakış: Psikiyatristler Ne Düşünüyor ve Ne Yapıyor? Kesitsel Bir Anket Çalışması 9 19 10.5080/u27725 EN TR Yasemin KOÇYİĞİT Duygu ÇAP Şule BIÇAKCI AY Journal Article 1450 10.5080/u27725 Objective: This study aimed to evaluate the knowledge levels, attitudes, and referral practices of psychiatrists regarding obesity and bariatric surgery. Method: In this descriptive, cross-sectional study, a questionnaire was administered to 169 psychiatrists and 75 psychiatry residents across Turkiye. The questionnaire included sections on demographic characteristics, clinical approaches to obesity, sources of information about bariatric surgery, referral tendencies, psychiatric contraindications, and knowledge regarding the postoperative period. Data were collected through a structured questionnaire created by the researchers and administered online via Google Forms. Results: Most participants were able to define obesity (82.8%) correctly, but a large proportion reported that they do not routinely record patients’ height and weight in clinical practice (71.3%). It was reported by 78.7% of the participants that they had conducted at least one psychiatric evaluation prior to bariatric surgery, and 69.7% stated that they would refer patients for surgery when appropriate indications were present. Psychotic disorders, substance use disorders, and eating disorders were most frequently considered as contraindications, while anxiety and personality disorders were generally not regarded as contraindications. The level of knowledge regarding the conditions that need to be considered after surgery varied, with predominant lack of knowledge regarding nutritional management. Approximately one-third of the participants reported that they do not have sufficient knowledge about obesity treatment. Conclusion: Although the general attitudes towards bariatric surgery are positive, there were differences in levels of knowledge and some barriers affecting referral to surgery were evident. These findings highlight the need to develop educational programs aimed at enhancing psychiatrists’ knowledge and skills related to bariatric surgery. Keywords: Attitudes, bariatric surgery, obesity, psychiatrist

Türkiye Sinir ve Ruh Sağlığı Derneği Turk Psikiyatri Derg 1300-2163 37 2026 A Comparison of Misophonia and Autistic Traits in Parents of Children with and without Autism Spectrum Disorder Otizm Spektrum Bozukluğu Olan ve Olmayan Çocukların Ebeveynlerinde Mizofoni ve Otistik Özelliklerin Karşılaştırılması 20 29 10.5080/u27720 EN TR Fatma SUBAŞI TURGUT Masum ÖZTÜRK Zehra AKAN Engin Deniz YILMAZ Journal Article 1451 10.5080/u27720 Objective: This study aims to compare misophonia levels and autistic traits between parents of children diagnosed with autism spectrum disorder (ASD) and parents of typically developing children. Methods: Parents of children diagnosed with ASD who presented to the Child and Adolescent Psychiatry outpatient clinic (n=56) and parents of typically developing children (n=56) were included in the study. The Childhood Autism Rating Scale (CARS) was administered to the children with ASD. All participating parents completed the Autism Spectrum Quotient (AQ) and the Amsterdam Misophonia Scale– Revised (AMISOS-R). Results: The rate of reporting throat sounds as a misophonic trigger was higher among parents of children with ASD (p=0.004). Weak but significant positive correlations were found across all participants between the AMISOS-R total score and the AQ total score, the attention switching subscale score, and the communication subscale score (r=0.275, p=0.003; r=0.266, p=0.005; r=0.35, p<0.001, respectively). Among parents of children with ASD, the AMISOS-R total score was positively correlated with items 3, 5, and 9 of the CARS (p<0.05). Conclusion: Our findings support potential associations between misophonia and ASD, and suggest that misophonia in parents may be related to certain characteristics in the child, such as sensory processing and emotional regulation. Keywords: Amsterdam Misophonia Scale, autism spectrum disorder, misophonia, sensory processing

Türkiye Sinir ve Ruh Sağlığı Derneği Turk Psikiyatri Derg 1300-2163 37 2026 Relationship Between Visual Integration, Social Cognition, and Symptoms in Schizophrenia: An Eye-Tracking Study Şizofrenide Görsel Entegrasyon, Sosyal Biliş ve Semptomlar Arasındaki İlişki: Bir Göz Hareketleri İzleme Çalışması 30 37 10.5080/u27715 EN TR Emine Nur CORUM Muammer CORUM Cumhur TAS Journal Article 1452 10.5080/u27715 Objective: This study investigates the associations between eye movement patterns, visual contour integration, social cognitive abilities, and symptom severity in individuals diagnosed with schizophrenia. Method: The study included 40 clinically stable patients with schizophrenia. Eye movements were recorded using an eye-tracking system during a free-viewing paradigm. Visual integration was evaluated with the Jittered Orientation Visual Integration (JOVI) task, while social cognition was assessed using the Reading the Mind in the Eyes Test and the Hinting Task. Symptom severity was measured with the PANSS. Data were analyzed using Pearson correlation coefficients and repeated measures analysis of variance. Results: Positive symptom severity was positively correlated with increased fixation counts and faster path velocity in social contexts. Conversely, social cognition was negatively correlated with fixation duration and saccadic velocity during face exploration. Participants exhibited significantly lower fixation counts when viewing socially relevant images. Additionally, shorter saccade length and slower path velocity were observed during face viewing. However, no significant relationship was found between eye movements and contour integration. Conclusion: This study demonstrates that eye movement characteristics in schizophrenia may be significantly associated with social cognition and symptom severity. Although causal inferences cannot be drawn due to the cross-sectional design, the findings help clarify inconsistencies in the literature and partially address gaps regarding eye movement research. Furthermore, the study provides valuable insights for the development of eye movement–based assessment and intervention approaches in clinical practice. Keywords: Eye tracking, schizophrenia, social cognition, visual integration

Türkiye Sinir ve Ruh Sağlığı Derneği Turk Psikiyatri Derg 1300-2163 37 2026 Psychotherapy Experiences within Multidisciplinary Care for Functional Neurological Symptom Disorder: A Qualitative Study Fonksiyonel Nörolojik Belirti Bozukluğunda Multidisipliner Tedavi Çerçevesinde Uygulanan Psikoterapiyle İlgili Deneyimler: Nitel Bir Çalışma 38 48 10.5080/u27815 EN TR Talat DEMİRSÖZ Journal Article 1453 10.5080/u27815 Objective: Functional Neurological Symptom Disorder (FNSD) is a complex neuropsychiatric condition associated with significant disability and shaped by the interaction of biological, psychological, and social processes. Although clinical recognition of FNSD has increased, patients’ subjective experiences of psychotherapy within multidisciplinary treatment remain insufficiently examined. This study aimed to qualitatively explore psychotherapy experiences of individuals diagnosed with FNSD who received short-term cognitive behavioral therapy (CBT) as part of a multidisciplinary treatment program. Method: Semi-structured online interviews were conducted with 12 patients diagnosed with functional movement disorders who had completed a multidisciplinary inpatient treatment program. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis to identify recurrent patterns across the narratives. Results: Patients described therapeutic change across four domains: reduced symptom burden, improved emotional regulation, shifts in illness-related perspectives, and increased behavioral engagement in daily functioning. Change was primarily attributed to three domains: (i) the therapeutic relationship and the psychologically safe treatment environment, (ii) individual readiness and active participation in therapy, and (iii) structured cognitive, behavioral, and experiential techniques. Nevertheless, variability in outcomes was evident, as some patients reported persistent symptoms and ongoing emotional challenges. Conclusion: Psychotherapy experiences in FNSD are not limited to symptom reduction. Alongside improvement, multidimensional experiences such as increased self-awareness, changes in how they understand and interpret their experiences, and re-engagement in daily life were also reported. These findings provide clinically meaningful insights into how therapeutic change is experienced within psychotherapy for FNSD and the factors to which this change is attributed by patients. Keywords: Cognitive behavioral therapy; functional neurological symptom disorder; multidisciplinary treatment; qualitative research.

Türkiye Sinir ve Ruh Sağlığı Derneği Turk Psikiyatri Derg 1300-2163 37 2026 Clozapine-Induced Myocarditis in Huntington’s Disease: Case Report Huntington Hastalığında Klozapin Kullanımına Bağlı Gelişen Miyokardit Olgusu 49 53 10.5080/u27742 EN TR Nur ÖZGEDİK TURHAN Journal Article Case Reports 1454 10.5080/u27742 Huntington’s disease (HD) is an autosomal dominant neurodegenerative disease. Its clinical presentation is primarily characterized by motor dysfunction, cognitive decline, and a broad spectrum of neuropsychiatric symptoms. Common psychiatric manifestations of HD include mood and anxiety disorders as well as behavioral and personality changes. Psychosis is relatively rare. Clozapine may be used for HD with psychosis because of its low extrapyramidal side effect profile. However, clozapine administration has been associated with rare but potentially fatal adverse effects, such as agranulocytosis and myocarditis. Clozapine-induced myocarditis is a severe complication that typically emerges within the first weeks of treatment and can lead to cardiovascular collapse if not recognized early. Although cardiac autonomic dysregulation and basal cardiac stress induced by mutant huntingtin (mHTT) protein accumulation are recognized in patients with Huntington’s disease (HD), data regarding clozapine toxicity within this specific context remain limited. This case report presents a 51-year-old male patient who developed acute myocarditis during clozapine treatment initiated for psychotic symptoms arising in the context of HD. Following the discontinuation of clozapine, the patient was referred for cardiological monitoring. Throughout this paper, we will discuss the diagnostic process of myocarditis—a rare but potentially life-threatening complication of clozapine—and potential contributing factors. This case highlights the vital importance of early cardiac monitoring during clozapine use, particularly in psychiatric conditions accompanied by neurodegenerative processes. Keywords: Case report, chorea, clozapine, Huntington’s disease, myocarditis, psychosis

Türkiye Sinir ve Ruh Sağlığı Derneği Turk Psikiyatri Derg 1300-2163 37 2026 Treatment of Comorbid Schizophrenia in an Adolescent with Osteogenesis Imperfecta: A Case Report Osteogenezis İmperfekta Tanılı Bir Ergende Şizofreni Komorbiditesinin Tedavisi: Olgu Sunumu 54 58 10.5080/u27751 EN TR Ayşe Eylül ÖZEL GÜMÜŞ Merve ONAT Journal Article Case Reports 1455 10.5080/u27751 Osteogenesis imperfecta (OI) is a rare connective tissue disorder characterized by bone fragility, growth retardation, hearing loss, and short stature. Literature on the comorbidity of OI and psychotic disorders is limited. Antipsychotic side effects such as hyperprolactinemia, sedation, and orthostatic hypotension may increase fracture risk, presenting challenges in comorbid cases. Here, we describe a 14-year-old male with OI and schizophrenia. The patient presented with a three-month history of irritability, self-harm, auditory hallucinations, and referential delusions. His history included multiple fractures, leading to OI diagnosis at age 8. He was admitted with acute psychotic disorder and treated with aripiprazole 20 mg/day, resulting in significant symptom improvement. No new bone fractures were observed during one year of follow-up. This case highlights the management of comorbid OI and schizophrenia. Fracture risk is a critical concern in OI patients. Clinicians should carefully select antipsychotics in the presence of psychosis and closely monitor patients to minimize adverse effects. Keywords: Adolescent, antipsychotics, osteogenesis imperfecta, schizophrenia, side effects

Türkiye Sinir ve Ruh Sağlığı Derneği Turk Psikiyatri Derg 1300-2163 37 2026 Turkish Adaptation of the Clinical Perfectionism Questionnaire: A Psychometric Evaluation in Clinical and Non-Clinical Samples Klinik Mükemmeliyetçilik Ölçeği’nin Türkçe Uyarlaması: Klinik ve Klinik Olmayan Örneklemlerde Psikometrik Değerlendirme 59 66 10.5080/u27873 EN TR Yağmur Sever FİDAN Arda KIZILSERT Nazmiye İlayda DIŞPINAR USTA Nisa PARLAYICI KOÇAK Sümeyye Yasemin ÇALLI Cansu ÖZÇERİ Selin USLU ALİHANOĞLU Enes OKAN Mihriban ALBAYRAK Ömer AYDEMİR Journal Article 1456 10.5080/u27873 Objective: The aim of this study was to evaluate the validity and reliability of the Turkish version of the Clinical Perfectionism Questionnaire (CPQ-TR) in clinical and non-clinical samples. Method: This cross-sectional study included 63 clinical participants (Obsessive–Compulsive Disorder and Major Depressive Disorder) and 148 non-clinical participants. The scale adaptation was conducted using a translation–back translation procedure. Confirmatory factor analysis and internal consistency analyses were performed. Convergent and concurrent validity were examined through correlations with the Frost Multidimensional Perfectionism Scale (FMPS), Depression Anxiety Stress Scales–21 (DASS–21), and the Yale–Brown Obsessive Compulsive Scale (Y-BOCS). Results: The internal consistency of the original 12-item CPQ-TR was found to be at a borderline level (Cronbach’s α=0.677); following the removal of Items 2 and 8, the Cronbach’s alpha coefficient of the resulting 10-item form increased to 0.76. Confirmatory factor analysis indicated limited support for a unidimensional factor structure. The CPQ-TR showed strong correlations with the FMPS (r=0.593) and moderate correlations with the Y-BOCS and DASS-21 (r=0.30–0.35). Participants with Obsessive–Compulsive Disorder had significantly higher CPQ scores compared to those with Major Depressive Disorder (p=0.018) and healthy controls (p <0.001). Conclusion: The findings indicate that the 12-item CPQ-TR demonstrates borderline internal consistency but remains a valid instrument for assessing clinical perfectionism. The 10-item version appears to be a more psychometrically robust option for use in both research and clinical settings. Keywords: Clinical perfectionism, Clinical Perfectionism Questionnaire, confirmatory factor analysis, clinical and non-clinical samples, psychometrics, Turkish adaptation, validity and reliability