Fatma Nurbanu Turan Öztaş, Ahmet Öztaş, Burak Kulaksızoğlu, Ali Erdoğan
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BACKGROUND AND AIM:Associations between adult attention-deficit/hyperactivity disorder (ADHD) and methamphetamine use disorder (MUD) have been reported (1). This study aims to investigate the co-occurrence of ADHD and related clinical factors in MUD. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):This is a cross-sectional study. A total of 78 patients with MUD, 78 patients with non-methamphetamine substance use disorder (NMSUD), and 78 healthy controls were included. All participants were evaluated using a sociodemographic data form, the Short Form-36 Health Survey, the Adult ADHD Self-Report Scale, the Hospital Anxiety and Depression Scale, the Barratt Impulsiveness Scale-11, and the Structured Clinical Interview for DSM-5 Disorders, Clinician Version. Ethical approval for the study was obtained on January 25, 2024, with decision number TBAEK-6. RESULTS:The prevalence of ADHD based on SCID-5 was 29.5% in the MUD group, 19.2% in the NMSUD group, and 5.1% in the healthy control group. As a result of logistic regression analysis; Methamphetamine use was found to be 2.844 times more likely (p=0.002) in individuals with ADHD diagnosis according to SCID-5, 3.206 times more likely (p=0.001) in those with a high probability of ADHD according to ASRS scores, 2.671 times more likely (p=0.005) in those with HADS Anxiety scores >10, and 2.010 times more likely (p=0.001) in those with HADS Depression scores >7. Methamphetamine use increased by 1.248 times (p<0.001) with a 1-unit increase in the BIS-11 Non-Planning Impulsivity score, 1.310 times (p<0.001) with a 1-unit increase in the BIS-11 Motor Impulsivity score, 1.234 times (p<0.001) with a 1-unit increase in the BIS-11 Attentional Impulsivity score, and 1.152 times (p=0.013) with a 1-unit increase in the SF-36 Physical Functioning score. CONCLUSIONS:Associations between ADHD, impulsivity, and MUD have been reported in the literature (2, 3). Our study demonstrates that methamphetamine use is significantly predicted by ADHD, impulsivity, depression, and anxiety.
BACKGROUND AND AIM:This study aimed to examine the mediating role of dysfunctional schema coping modes in the relationship between perceived parental favoritism and vulnerable and grandiose narcissism. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):The sample included 506 participants (354 females and 150 males), aged 18-65, all of whom had at least one sibling. Data were collected using a Demographic Information Form, questions on parental favoritism, the Schema Mode Inventory, and the Pathological Narcissism Inventory, following approval from the Research Ethics Committee (E-85646034-604.01-78043). RESULTS:Correlation analysis revealed significant positive relationships among the variables. The differences in vulnerable and grandiose narcissism, schema overcompensation, surrender and avoidance scores according to the presence of parental favoritism in the family were examined with MANOVA tests. Significant group differences were found in terms of vulnerable narcissism (p<.025) and schema avoidance (p<.017). In order to examine the mediating role of schema coping modes in the relationship between parental favoritism and narcissism types, two parallel mediation models were tested. According to the results of the analysis, it was found that parental favoritism in the family was not directly related to grandiose (B =.52, p>.05) and vulnerable (B = 2.67, p>.05) narcissism, but indirectly related to the mediating effect of schema surrender and schema overcompensation (p<.05). CONCLUSIONS:The findings suggest that perceived parental favoritism from at least one parent is associated with increased level of schema surrender and schema overcompensation coping modes. These schema coping modes, in turn, predict increased level of vulnerable and grandiose narcissism. Clinical implications of the present study indicate the importance of addressing perceived parental favoritism, along with schema surrender and overcompensation, when working with narcissistic personality patterns.
BACKGROUND AND AIM:This study aims to evaluate the differences between the groups with and without risky alcohol use (RAU) in terms of sociodemographic characteristics, anxiety level, Adult Attachment Styles (AAS), and Early Maladaptive Schemas (EMS) in individuals diagnosed with anxiety disorder (AD). Furthermore, we aimed to investigate whether risky alcohol use in individuals with anxiety disorders can be explained by early maladaptive schemas or adult attachment styles. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):This is a prospective study that complies with the Declaration of Helsinki. It was approved by the Zonguldak University Clinical Studies Ethical Committee on 11/01/2023, with approval number 2020/23. Written informed consent was obtained prior to the interviews. A total of 128 individuals diagnosed with AD were divided into two groups based on the Michigan Alcoholism Screening Test (MAST) cut-off score (?5). The scores of the Adult Attachment Style Scale, Young Schema Questionnaire, and Beck Anxiety Inventory (BAI) along with sociodemographic and clinical features were compared between the two groups. RESULTS:The group with RAU had higher ratios of having a child, smoking, suicide history, and higher scores on abandonment and unrelenting standards (US) schemas. Abandonment and US schema scores increased RAU while approval-seeking (AS) and self-sacrifice schema scores decreased RAU. MAST scores negatively correlated with the scores of pessimism, AS, and punitiveness schemas in the group without RAU and positively correlated with the scores of emotional deprivation, failure to achieve, pessimism, social isolation, AS, dependence, abandonment, vulnerability schemas, and BAI in those with RAU. Our study indicates that 42% of MAST scores can be explained by AAS and EMS scores. The scores of emotional inhibition, defectiveness, and vulnerability schemas and anxious attachment style significantly explained MAST scores. CONCLUSIONS:Our data supports that RAU in individuals with AD is associated with AAS and EMS. Abandonment, US, defectiveness, vulnerability schemas, and anxious attachment styles should be emphasized specifically.
Emergency departments frequently encounter individuals attempting suicide, with %40 of suicide deaths preceded by an emergency department visit within a year. This study analyzes patient characteristics following suicide attempts at our hospital's emergency department, aiming to identify risk factors and contribute to suicide prevention efforts. Ethics committee approval has been obtained. The number is 2024-SAEK-0048. A retrospective analysis was conducted on the sociodemographic and clinical data of patients who visited the emergency department, between July 1, 2023, and July 1, 2024, due to a suicide attempt and were referred to the psychiatry department. Data was collected from the hospital's software system, and statistical analysis was performed using SPSS 20.0, with the chi-square test applied to assess relationships between sociodemographic and clinical variables. Among the 228 patients aged 18 and over who presented to our emergency department and were consulted by psychiatry, the mean age was 34.13 years, with 109 (%47,8) females and 119 (%52,2) males. Previous suicide attempts were reported in %55.7 of cases. Males were more likely to use sharp objects, firearms, or hanging, while females tended to use drugs or toxins (p<0.005). Male suicide attempts were also more planned than impulsive (p<0.05). When our study results are compared with general literature information, it is consistent that suicide attempts are more frequent in single individuals, those with a history of psychiatric diagnosis, and those with alcohol and substance use. It also aligns with findings that women more often attempt suicide using drugs and toxic substances, as well as self-harm with sharp objects, while men more often attempt suicide by hanging and firearm injuries. This study investigates the relationship between the psychiatric status, sociodemographic characteristics, and clinical presentation of individuals who have attempted suicide, providing revealing data for developing effective suicide prevention strategies.
BACKGROUND AND AIM:Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition with varying symptoms across time, where autistic individuals face greater challenges transitioning to adulthood (Howlin & Magiati, 2017) and maintaining social functioning compared to those with other psychiatric disorders (Barneveld et al., 2014). This study aims to examine how the long-term psychiatric and psychosocial outcomes of individuals with ASD initially evaluated in childhood for baseline autistic behaviors between 2004 and 2006 (T1) relate to current autistic behaviors (T2) and social functioning outcomes while considering the influence of age at diagnosis and psychiatric comorbidities. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Participants diagnosed with ASD and assessed using the Autism Behavior Checklist (ABC) during 20042006 (T1) were recontacted and invited for reassessment (T2). A total of 28 individuals (85.7% male, mean age: 25.54 ± 2.66) agreed to participate. Sociodemographic data, psychiatric diagnoses according to DSM-5 criteria, and updated ABC scores were recorded. Social functioning was measured using the Social Functioning Scale (SFS), completed by participants' parents. Statistical analyses were conducted using Wilcoxon signed-rank tests to assess changes in ABC scores, Spearmans rank-order correlations to examine relationships between key variables. For mediation analysis, the R software environment (Version 2023.12.1) was utilized. Specifically, mediation models were constructed to examine whether current autistic behaviors (ABC T2) mediated the relationship between baseline autistic behaviors (ABC T1) and social functioning (SFS Total). Models accounted for covariates, including age at autism diagnosis and comorbid psychiatric conditions, which were categorized based on the literature into "mild" (e.g., anxiety disorders, OCD) and "severe" (e.g., schizophrenia, bipolar disorder). Indirect, direct, and total effects were estimated using bootstrapped confidence intervals to assess the mediation effect, with statistical significance determined at p <.05.This study received ethics committee approval(23-7.1T/30). RESULTS:The mean duration between initial and current assessments was 18 years. Educational attainment varied, with 50% completing middle school and 32.1% completing high school. All participants resided in family-owned homes (100%), and while all were single, 42.9% had reported previous romantic relationships. Psychiatric comorbidities were present in 57.1% of participants, with anxiety disorders (28.6%) being the most common, followed by schizophrenia (10.7%), bipolar disorder (7.1%), and obsessive-compulsive disorder (3.6%). Family psychiatric histories were prevalent, with 89.3% reporting a diagnosed psychiatric condition in a family member. All participants (100%) had attended special education programs, with a majority (85.7%) currently holding an official disability report. Longitudinal analysis of ABC scores revealed a significant increase in the Sensory subscale rising from 9.54 (SD=4.87) at T1 to 15.25 (SD=6.01) at T2 (W = 36.5,p<.001). No significant changes were observed in other subscales or the total ABC score (W = 155.5,p =.428).
Correlation analyses demonstrated that increased autistic behaviors at T1 negatively correlated with key social functioning domains, Social Engagement (r = -.484,p<.01), Independence-Competence (r = -.657,p<.001), and Independence-Performance (r = -.657,p<.001). Stronger negative correlations were observed at T2 across all SFS subscales, indicating that current autistic behaviors had a stronger impact on social outcomes than baseline behaviors. Age at starting special education showed a positive correlation with SFS Total (r=.429,p<.05), suggesting higher social functioning with later starts, while duration of special education was not correlated with SFS or ABC T1 or T2 scores. Age at autism diagnosis was positively correlated with SFS Total (r=.537,p<.01) and negatively with ABC Total (T2) (r=?.469,p<.05), showing better social functioning and fewer maladaptive behaviors with later diagnoses. Finally, age at first words correlated negatively with SFS Total (r=?.523,p<.01), indicating lower social functioning with delayed speech milestones, and positively with ABC Total (T2) (r=.409,p<.05), reflecting higher maladaptive behaviors associated with delayed first words. Correlation analyses are summarized in Table 1. A mediation analysis examined the relationship between baseline autistic behaviors (ABC Total at T1) and social functioning (SFS Total) through current autistic behaviors (ABC Total at T2). Age at autism diagnosis was included due to its correlation with SFS Total, while comorbidities were categorized as mild (e.g., anxiety, OCD) or severe (e.g., schizophrenia, bipolar disorder) based on prior literature. Baseline autistic behaviors significantly predicted current autistic behaviors (B = 0.58, SE = 0.22, p =.015), indicating that an increase in autistic behaviors at T1 was associated with higher maladaptive autistic behaviors at T2. However, age at autism diagnosis was not a significant predictor of ABC T2. In the outcome model, maladaptive autistic behaviors at T2 strongly and negatively affected social functioning (B = -1.93, SE = 0.38, p <.001). Neither mild (B = -30.7, SE = 28.26, p =.29) nor severe (B = -138.33, SE = 101.1, p =.186) comorbidities independently impacted SFS Total. The indirect effect of ABC T1 on SFS Total via ABC T2 was significant (B = -0.81, 95% CI [-1.65, -0.15], p =.014), while the direct (B = 0.17, 95% CI [-0.50, 0.85], p =.62) and total (B = -0.64, 95% CI [-1.52, 0.31], p =.174) effects were not. This suggests that current maladaptive autistic behaviors fully mediate the relationship between baseline autistic behaviors and social functioning. Mediation analyses are summarized in Table 2. CONCLUSIONS:Transitioning from adolescence to adulthood is particularly challenging for autistic individuals and is often associated with insufficient planning and lack of appropriate support (Friedman & Parish, 2013). Anxiety, mood, and schizophrenia spectrum disorders are common co-occurring conditions that significantly affect adult outcomes (Lugo-Marín et al., 2019). Our sample also reported high rates of psychiatric comorbidities, including bipolar disorder, schizophrenia, anxiety, and OCD, although they were not significantly associated with social functioning in adult life in our study. While early social engagement and less severe autism symptoms in childhood are known to predict better adult outcomes (Woodman et al., 2015), our findings offer a different perspective. Specifically, childhood maladaptive autistic behaviors do not directly predict social functioning in adulthood; rather, their effects are mediated by the maladaptive autistic behaviors. This study underscores the persistent influence of maladaptive autistic behaviors on adult social functioning, emphasizing the necessity for sustained, individualized interventions beyond childhood. REFERENCES:Barneveld, P., Swaab, H., Fagel, S., Engeland, H. van, & Sonneville, L. D. de. (2014). Quality of life: A case-controlled long-term follow-up study, comparing young high-functioning adults with autism spectrum disorders with adults with other psychiatric disorders diagnosed in childhood. Comprehensive Psychiatry, 55 2, 302310. https://doi.org/10.1016/j.comppsych.2013.08.001
Friedman, N., & Parish, M. E. W. S. L. (2013). Transition to adulthood for individuals with autism spectrum disorder: Current issues and future perspectives. 3, 181192. https://doi.org/10.2217/NPY.13.13 Howlin, P., & Magiati, I. (2017). Autism spectrum disorder: Outcomes in adulthood. Current Opinion in Psychiatry, 30. https://doi.org/10.1097/YCO.0000000000000308 Lugo-Marín, J., Magán-Maganto, M., Rivero-Santana, A., Cuellar-Pompa, L., Alviani, M., Jenaro-Rio, C., Díez, E., & Canal-Bedia, R. (2019). Prevalence of psychiatric disorders in adults with autism spectrum disorder: A systematic review and meta-analysis. Research in Autism Spectrum Disorders, 59, 2233. https://doi.org/10.1016/j.rasd.2018.12.004 Woodman, A. C., Smith, L. E., Greenberg, J., & Mailick, M. R. (2015). Change in Autism Symptoms and Maladaptive Behaviors in Adolescence and Adulthood: The Role of Positive Family Processes. Journal of Autism and Developmental Disorders, 45, 111 126. https://doi.org/10.1007/s10803-014-2199-2
BACKGROUND AND AIM:Medical faculty residents work under intense stress and pressure in addition to their professional responsibilities.These conditions emphasize the importance of psychological skills impacting individual well-being and professional performance.Mentalization is a critical competency for effective interpersonal interactions,enhancing professional and personal quality of life.Research has shown that mindfulness and self-compassion positively contribute to mentalization capacity.The aim of this study was to investigate the relationships among these three concepts in medical faculty residents. METHODS:Residents from Ataturk University Faculty of Medicine were invited to participate via institutional email lists.Participants then completed an online survey consisting of the Freiburg Mindfulness Inventory (FMI),the Short Form of the Self-Compassion Questionnaire (SCQ-SF),the Mentalization Scale (MentS),and a sociodemographic data form.Ethical approval was obtained on 27.12.2024/B.30.2.ATA.0.01.00/725. RESULTS:Out of the 100 participants,65 were female and 35 were male.The mean age was 29.76±3.75 years.Positive correlation was observed between MentS score and FMI score (r=0.416,p<0.001),MentS score and SCQ-SF score (r=0.405,p<0.001) and SCQ-SF score and FMI score (r=0.723,p<0.001).In the regression analyses,FMI score was significantly associated with MentS score (b=0.674,p=0.004).Further subgroup analysis comparing surgical and medical
specialties showed no statistically significant differences in MentS, FMI,or SCQ-SF scores between these groups (p>0.05).According to the mediation analysis,no direct relationship was identified between the SCQ-SF score and MentS score (b=0.001,p>0.005).However, the SCQ-SF score was found to have a positive indirect effect on the MentS score through increased FMI score (b=0.454,p=0.001). CONCLUSIONS:This study found that mentalization capacity in medical faculty residents is associated with mindfulness and self-compassion.Mediation analysis revealed that the effect of self-compassion on mentalization occurs indirectly through mindfulness.This finding underscores the need to support self-compassion with mindfulness-enhancing strategies to improve individuals' mentalization capacity.The literature highlights the critical role of mentalization capacity in enhancing both professional and personal quality of life.In conclusion, a holistic approach is needed to support mentalization as a key factor in coping with professional stress.
Diğdem Göverti, Elif Poyraz, Beste Nur Güvendi Melenkiş, Duygu Nur Tutam, Serdar Dursun
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BACKGROUND AND AIM: Catatonia is a complex neurobehavioral syndrome related with several psychiatric and medical conditions. Dysfunction of cortical-subcortical motor regulation systems, including GABA, dopamine, and glutamate, or increased and sympathetic freezing response may be some of the mechanisms. Neuropsychiatric symptoms due to SARS-CoV-2 (COVID-19) develop as complications, such as anosmia, thrombotic events, cognitive and attention disorders, depression and psychosis. Catatonic conditions occurring secondary to COVID-19 are found in the literature when there is no underlying psychiatric etiology. In this study, we aimed to investigate catatonia retrospectively in the period of 2 years before and after the pandemic. METHODS (Ethics Committee Approval must be obtained and the number should be specified.) The study has been designed as a restrospective chart review. The data was investigated by three psychiatrists for the period of 2 years before and after the released first COVID-19 case as two groups in 2022. Individuals diagnosed with 'Catatonia'
according to DSM-5-TR who applied to the emergency department, outpatient and inpatient clinics of Erenköy Mental Health Hospital Ethics approval was taken by the committee with the number of 186700 in 10/05/2022. RESULTS: Forty patients were included in the study, consisting of 20 females (50.00%) and 20 males (50.00%). There was no significant difference in pre-(n:21) and post-COVID 19 (n:19) cases according to age, gender, underlying cause, treatment applied in two groups (p<0.05). In addition, symptom diversity of catatonia was not statistically significant in both groups (p<0.05). The difference in severity of catatonia cases in the two periods was not statistically significant according to the Bush-Francis Catatonia scale (p<0.05).
DISCUSSION: While cases of catatonic syndrome developing during COVID-19 infection are reported in the literature, there are also patients with 'delayed' or 'excited-induced' catatonia after infection and a patient presenting with catatonia clinic 6 weeks after COVID-19 infection.
BACKGROUND AND AIM: Suicide attempt is not only a personal mental health issue but also an action influenced by sociocultural and socioeconomic factors. This study aims to retrospectively evaluate the clinical data of individuals who presented after a suicide attempt, focusing on their sociodemographic characteristics, preferred methods of suicide, and underlying etiological factors. METHODS: In the study, 78 cases who presented to our polyclinic for suicide attempts between 01.01.2017-01.09.2021 and for whom forensic reports were prepared were examined retrospectively. The sociodemographic characteristics and suicide-related data of the cases were retrieved from forensic reports and medical records in the hospital's electronic system. Based on the characteristics of the study sample, suicide methods have been classified into drug ingestion and other methods. The study was approved by the Adıyaman University Non-Interventional Clinical Research Ethics Committee (Decision number: 2021/07-27, dated 21.09.2021). RESULTS: Of these, 33.3% (n=26) are men, and 66.7% (n=52) are women. The primary method of attempt is drug intake, with 60 cases (76.9%). When suicide methods were categorized into drug intake and other methods, it was determined that the distribution of attempt methods was similar between sex (?²(1) = 0.325, p = 0.569). Among the cases in which the reasons for suicide were identified (n=42), the most common reasons were partner-related in 15 cases (35.7%) and
family-related in 13 cases (31.0%). A history of suicide attempt was found in 21 cases (26.9%). It was noticed that in 35.9% of the cases (n=28), psychiatric consultation was not requested during their admissions. CONCLUSIONS: It was observed that the cases were mostly female, young adults, and preferred taking medication as a method. Having a history of suicide attempts and a history of psychiatric illness are predisposing factors. Individuals who suicide attempt must undergo detailed psychiatric examinations and be included in a clinical follow-up process.
Burnout Syndrome is defined as a chronic response to stress.Compared to other professions,healthcare workers report a higher incidence of burnout due to working hours,working conditions etc. based on this, our study aimed to investigate the relationship between burnout and specific psychiatric symptoms in nurses,who represent most healthcare workers in our country,who face excessive workloads due to a lack of sufficient staff and are exposed to a higher workload per person.With this study,we believe that we can contribute to the literature,which has long examined the effects of burnout on nurses,by exploring both the relationship between psychiatric symptoms and burnout,as well as the impact of workload on burnout. The study included nurses from University Hospital.Participants were administered the Demographic Data Form,Depression Anxiety Stress Scale-Short Form(DASS21),Work Overload Scale(WOS),Maslach Burnout Inventory(MBI).The research was approved by the Tokat Gaziosmanpaşa University Faculty of Medicine Clinical Research Ethics Committee(registration number24KAEK194). A total of 74 participants were included.The clinics where the participants worked were surgery(31),intensive care(11),emergency(6),internal medicine(26).None had a diagnosed psychiatric illness.The MBI scale results showed:emotional exhaustion(19.47±3.89),desensitization(6.70±4.82), personal accomplishment (20.32±3.79),and total score(46.48±7.55).Although there is no cutoff score for this scale,moderate levels of emotional exhaustion and depersonalization were observed in the subscales,high levels of burnout were seen in personal achievement. It was found that as
individuals workloads increased,their burnout rates, as well as depression,anxiety,stress levels also increased.A negative correlation was also observed between the personal achievement/failure subscale of the MBI and the workload scale scores. Based on the emergence of excessive workload, burnout and accompanying psychiatric symptoms,it is thought that determining the burnout levels of nurses and their relationship with psychiatric symptoms would be beneficial in taking individual and institutional measures to reduce existing burnout and enable early intervention.Protecting the mental health of healthcare workers will help prevent the increasing number of resignations,psychiatric treatment admissions,self-medication,suicide attempts in recent years.
BACKGROUND AND AIM: Orthorexia nervosa (ON) is an obsession with healthy eating, which can lead to physical, psychological, and social difficulties. Pregnancy involves changes that may influence eating behaviors. This study evaluates the prevalence of ON and associated factors among pregnant women at Selçuk University Faculty of Medicine. METHODS: This cross-sectional study was conducted between August 2 and August 16, 2024, with 99 pregnant women from the obstetrics outpatient clinic. Participants completed a 14-item sociodemographic questionnaire and the 24-item Orthorexia Nervosa Inventory (ONE). Assessed variables included age, education, employment status, family income, pregnancy count, gestational age, pre-pregnancy weight, height, smoking status, daily meal frequency, folic acid use in the first trimester, and iron, vitamin D, and multivitamin supplementation in the second trimester. Ethical approval was obtained from the Selçuk University Local Ethics Committee (Approval number: 2024/426). Statistical analyses included correlation and group comparisons. RESULTS: Participants were aged 1744 years, with a mean ONI score of 41 ± 8.3. Those in the second trimester who did not use iron had higher ONI disturbance subscale scores (p = 0.024). Pregnant women who did not use vitamin D had higher total ON scores (p = 0.047) and higher ONE disorder subscale scores (p = 0.036). A positive correlation was observed between age and ONI total scores (r = 0.202, p = 0.045), as well as between pre-pregnancy body weight and emotional stress (p = 0.048, r = 0.202) and disturbance subscale scores(p = 0.023, r = 0.232). CONCLUSIONS: The findings suggest that ON risk in pregnant women is influenced by sociodemographic and psychological factors. The increased ON tendencies in those not using
vitamin D and iron suggest a potential link between nutrition and ON risk. Nutritional and psychological counseling during pregnancy may help mitigate these risks.
BACKGROUND AND AIM Maladaptive Daydreaming (MD) is an excessive and immersive form of daydreaming that can interfere with daily life and mental well-being. Academic procrastination, another common issue among students, negatively affects academic performance and psychological health. However, the relationship between MD and procrastination remains unclear. This study examines the associations between MD, academic procrastination, and psychological distress in medical students. METHODS: This cross-sectional study was conducted among medical students from Çanakkale Onsekiz Mart University and Karamanoglu Mehmetbey University during the 2023-2024 academic year. Data were collected via Google Forms. Participants completed the sociodemographic data form, Maladaptive Daydreaming Scale (MDS-16), Tuckman Academic Procrastination Scale (TPS), and Depression Anxiety Stress Scale (DASS-21). Axis I psychiatric diagnoses were determined based on self-reports rather than structured clinical assessments. Ethical approval was obtained from the Karamanoglu Mehmetbey University Ethics Committee (19.12.2023, IRB no: 12-2023/03). Statistical analyses were performed using SPSS v27. RESULTS: The study included 201 students (42.8% male, 57.2% female). MDS-16 scores correlated positively with depression (r = 0.245, p < 0.01), anxiety (r = 0.222, p < 0.01), stress (r = 0.216, p < 0.01), and academic procrastination (r = 0.181, p < 0.05). Maladaptive daydreamers (MDers) had significantly higher depression (p = 0.002), anxiety (p = 0.003), stress (p = 0.018), and procrastination (p = 0.034) scores but did not differ in grade point average (GPA) (p = 0.319). Academic procrastination negatively correlated with GPA (r = -0.216, p < 0.01). CONCLUSIONS: MD is associated with greater procrastination and psychological distress, suggesting that excessive daydreaming may serve as an emotional escape. Increased procrastination in MDers may result from difficulties managing time and responsibilities, reinforcing stress and avoidance behaviors. Although MD did not impact GPA, its link to distress highlights the need for interventions. Future research should explore coping mechanisms to help students manage MDs academic consequences.
BACKGROUND AND AIM:Adverse childhood experiences (ACEs) are defined as a set of experiences,including sexual, physical and emotional abuse or neglect,that occur before the age of 18. Studies indicate that approximately one-third of patients with psychosis and 3050% of those with bipolar disorder have experienced childhood trauma.This study aims to investigate the relationship between ACEs and MetS in patients with schizophrenia (Sch) and bipolar disorder (Bp) METHODS The study included patients aged 1865 who had been diagnosed with Bp or Sch followed for at least six months, and visited our outpatient clinic between July and August
2024.Participants completed a sociodemographic questionnaire and the Turkish version of the Adverse Childhood Experiences Scale (ACE-TR). MetS was assessed using the NCEP-ATP III criteria.(MetS will be diagnosed based on the presence of three or more of the following: abdominal obesity, hypertriglyceridemia, low HDL, high blood pressure, and fasting hyperglycemia)The study was approved by our university's ethics committee (2024/6177) RESULTS ]The study included 27 female (39.71%) and 41 male (22.06%) patients,with a mean age of 43.16±10.78 years. Among them,26 (38.24%) had Sch, and 42 (61.46%) had Bp.MetS was present in 57.1% of Bp and 30.7% of Sch patients.The ACE-TR total scores were significantly higher in patients diagnosed with MetS (p < 0.001). MetS prevalence was also higher in unmarried individuals (p = 0.043) those with a greater number of hospitalizations (p = 0.030) and those with more suicide attempts (p = 0.012)(p < 0.05) CONCLUSIONS:Our study demonstrated a significant association between ACEs and MetS in Bp and Sch patients.The increasing treatment costs associated with MetS will create a significant burden on the country's economy, leading to a serious deterioration in the quality of life for patients.Therefore, paying attention to patients who experience adverse childhood experiences,providing treatment support,taking measures to reduce risks,will offer significant benefits both individually and socially
BACKGROUND AND AIM:Major depressive disorder (MDD) is a prevalent psychiatric disorder and accompanying mental complaints are known to influence the prognosis and treatment approach of MDD. Climate change anxiety (CCA) encompasses the negative emotions arising from climate change, warranting detailed examination both within the holistic evaluation of depressive patients and as a distinct mental health concern. This study aims to assess the level of CCA in patients with MDD, examine how demographic variables, tolerance to uncertainty, and coping attitudes relate to CCA, and contribute to the literature on this emerging topic. METHODS:The study included 82 patients diagnosed with MDD and 80 healthy controls. Written informed consent was obtained from all participants, and the research was conducted with the approval of the local ethics committee with the number of 2022/465. Data were collected using the Sociodemographic and Clinical Data Form, Beck Depression Scale, Climate Change Worry Scale, Climate Change Hope Scale, Intolerance of Uncertainty Scale, and Coping Orientation to Problems Experienced Scale. Statistical analyses were performed using SPSS software version 22.0. RESULTS:The study found that CCA increased with higher levels of education, and age and intolerance of uncertainty were positively correlated to CCA (p<0.05). There was no statistically significant difference in CCA levels between patients with MDD and the control group (p>0.05). It was observed that individuals with greater concern about climate change also had more hope that this phenomenon could be mitigated (p<0.05). Additionally, CCA was not related to gender(p>0.05); however, variations in anxiety levels were associated with different preferred coping attitudes (p<0.05). CONCLUSIONS:To our knowledge, this is the first study to define CCA by comparing it with a patient group and healthy controls. Our findings suggest that demographic factors and intolerance of uncertainty play a role in CCA, but the presence of MDD does not significantly alter CCA levels.
BACKGROUND AND AIM:Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that typically manifests in childhood and can persist into adulthood. A short attention span, hyperactivity, and impulsivity characterize ADHD. It can cause significant functional impairments in various domains of life, including psychological, social, academic, and occupational functioning. Recent studies have shown a growing interest in exploring not only the behavioral symptoms but also the cognitive symptoms and internal experiences of individuals with ADHD. One of the frequently reported internal experiences of ADHD patients is continuous mental activity and constantly shifting thoughts, their thoughts are often uncontrollable, and multiple thoughts may co-occur. This condition, referred to as mind wandering, manifests as difficulty in focusing on ones targeted tasks, with thoughts involuntarily and extensively scattered across different topics. Understanding this condition is crucial for gaining insights into the mental functioning of individuals with ADHD. Studies have also indicated that 43% to 80% of adults with ADHD experience symptoms of insomnia, a common sleep disorder that makes it difficult to fall or stay asleep or causes early awakening accompanied by an inability to return to sleep. In dividuals with sleep problems may also exhibit ADHD symptoms. Evidently, insomnia may play a crucial role in the management
and treatment of ADHD. Chronotype, or circadian preference, refers to the time of day when an individual is most efficient in performing daily activities. Individuals with ADHD, research indicates, tend to exhibit a later chronotype, leaning more toward the evening type compared to the general population. The studies that investigated the relationship between ADHD and chronotype found that the evening chronotype is mainly associated with inattention, hyperactivity, impulsive behaviors, and sleep problems. Chronotype is thus also an important factor in understanding and treating ADHD. The theory of mind (ToM) concept refers to the ability to understand the mental and emotional states of others. Crucial for successful social interactions, it involves recognizing that others may hold beliefs different from ones own and may act according to those beliefs. According to a meta-analysis conducted by Bora and Pantelis, while individuals with ADHD perform better on ToM tests than individuals with autism, they perform worse than healthy controls. Research indicates that a lack of ToM skills can produce difficulties in various areas, such as attention, learning, social interaction, and communication. For neurodevelopmental disorders such as ADHD, training programs aimed at improving ones ToM skills can positively impact ones social functioning. Based on our literature review, we identified that chronotype and ToM association and mind-wanderings associations with the ToM, chronotype, and insomnia have not been explored in adult ADHD patients. Additionally, we aimed to assess which of the mainly explored factors in our study (mind wandering, ToM, and chronotype) would mediate the association between ones severity of ADHD symptoms and insomnia. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):The study included 125 patients diagnosed with ADHD without comorbid psychiatric disorders. They were assessed using the structured clinical interview for DSM-5 (SCID-5), a sociodemographic and clinical data form, the adult ADHD self-report scale (ASRS), the mind excessively wandering scale (MEWS), the insomnia severity index (ISI), the morningness-eveningness questionnaire (MEQ), the Dokuz Eylul theory of mind scale (DEToMS), and the reading the mind in the eyes test (RMET). Ethical approval was obtained from the Ataturk University Faculty of Medicine Clinical Research Ethics Committee (decision number 40, dated May 2, 2023, and numbered B.30.2.ATA.0.01.00/307). The Ataturk University Scientific Research Projects Commission supported the study (project ID number: 13784). All the participants' informed consent was obtained before the study commenced. RESULTS:Out of the 125 participants, 49.6% (n=62) were female. The median age was 24 years (interquartile range: 2229; range:1846). According to the MEQ classification, 44.8% of the participants (n=56) were identified as having an evening chronotype, 44.0% (n=55) as having an intermediate chronotype, and 11.2% (n=14) as having a morning chronotype. While 55.2% of the participants (n=69) had a history of a psychiatric diagnosis before being diagnosed with ADHD, 46.4% of the participants (n=58) had a history of self-mutilation. Additionally, 37.6% of the participants (n=47) were using medication for ADHD. According to the results of the correlation analysis, the ASRS total score was positively correlated with the MEWS score (r=0.702; p<0.001 ), ISI score (r=0.386; p<0.001), and DEToMS total score (r=-0.193; p=0.031), while it was negatively correlated with the MEQ score (r=-0.284; p=0.001). The MEWS score was positively correlated with the ISI score (r=0.477; p<0.001) but negatively correlated with the MEQ score (r=-0.267; p=0.003) and the DEToMS total score (r=-0.217; p=0.015). The ISI score was negatively correlated with both the MEQ score (r=-0.320; p<0.001) and the DEToMS total score (r=-0.203; p=0.023). The DEToMS total score was positively correlated with the RMET score (r=0.257; p=0.004). According to the mediation analysis results, no direct relationship was identified
between the total ASRS and ISI scores (?=0.106; p=0.356). However, the total ASRS score indirectly affected the ISI score through increased MEWS scores (?=0.386; p<0.001). CONCLUSIONS:Our results revealed the factors associated with mind wandering, insomnia, chronotype, and ToM in individuals with ADHD. Mind wandering was found to be positively correlated with ADHD symptom severity and insomnia; in contrast, it was negatively correlated with the ToM skills and morning chronotype characteristics. The full mediating role of mind wandering in the relationship between ADHD symptoms and insomnia levels is a noteworthy finding that should be considered in adult ADHD patients with insomnia symptoms. Addressing mind wandering in adult ADHD patients could thus be a crucial target for improving insomnia. Overall, our findings emphasize the need for a multidimensional approach when evaluating and treating ADHD, considering not only its core symptoms but also its associated cognitive and sleep-related impairments. Further longitudinal and interventional studies are needed to validate these relationships and to explore potential treatment strategies for adult ADHD. Our results may serve as a valuable reference for interventions targeting areas such as mind wandering, insomnia, chronotype, and the ToM in adult ADHD patients. REFERENCES:Faraone SV, Bellgrove MA, Brikell et al. (2024) Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers 10: 1-21. Coogan AN, McGowan NM. (2017) A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder. Atten Def Hyp Disord 9: 129-47. Franklin MS, Mrazek MD, Anderson CL et al. (2017) Tracking distraction: The Relationship Between Mind-Wandering, Meta-Awareness, and ADHD Symptomatology. J Atten Disord 21: 475-86. Wynchank D, Ten Have M, Bijlenga D et al. (2018) The Association Between Insomnia and Sleep Duration in Adults With Attention-Deficit Hyperactivity Disorder: Results From a General Population Study. J Clin Sleep Med 14: 349-57. Bora E, Pantelis C. (2016) Meta-analysis of social cognition in attention-deficit/hyperactivity disorder (ADHD): comparison with healthy controls and autistic spectrum disorder. Psychol Med 46: 699-716.
BACKGROUND AND AIM:Inappropriate eating behaviors such as emotional eating, restrictive eating, and external eating have been shown in previous studies to be risk factors for both obesity and eating disorders. These eating behaviors can be measured reliably and validly using
self-report scales such as the Dutch Eating Behavior Questionnaire (DEBQ). This study aimed to examine the relationship between eating behaviors and clinical and demographic characteristics of individuals diagnosed with obesity. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):This study was conducted with 220 volunteers with a body mass index (BMI) ?30 kg/m2 who applied to the obesity center of Etlik City Hospital. SCID 1, sociodemographic data form and Dutch Eating Behavior Questionnaire (DEBQ) were applied to the participants.The study's ethics committee approval was obtained from the Etlik City Hospital scientific and research ethics committee (Ethics committee no: 2024-871) and P value <0.05 was considered statistically significant. RESULTS:The average age of the participants was 42 and 86.4% were female. A positive significant relationship was found between the participants' ages and restrictive eating, and a negative significant relationship was found between emotional eating and age. In addition, a positive significant relationship was found between the duration of obesity and restrictive eating. The female mean was found to be higher than the male mean in restrictive eating and emotional eating scores. In addition, regression analyzes were conducted to determine the effect of participant characteristics on emotional eating and restrictive eating scores. CONCLUSIONS: In this study, it was aimed to determine the correlation of eating behaviors with clinical and demographic characteristics using DEBQ subscales. Increasing similar research will enable the identification of risk groups for the development of obesity and thus the possibility of early intervention before the disease develops.
BACKGROUND AND AIM:Autistic traits are frequently observed in obsessive-compulsive disorder (OCD) and are associated with disorder severity. This study aims to assess autistic traits in OCD using the Autism Spectrum Quotient (AQ) and examine their relationship with retrospective OCD severity and its reduction following treatment. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Individuals diagnosed with OCD at the Dinar State Hospital Psychiatry Clinic were assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) at their initial visit and follow-ups. Thirty-seven participants (Age: 42.20; Male: 14/37) who continued regular follow-ups and met the inclusion criteria were administered AQ and Y-BOCS at the sixth-month visit. Exclusion criteria included psychotic disorders, bipolar disorder, alcohol/substance use disorder, and significant cognitive impairment. Data were analyzed using repeated measures ANOVA (IBM SPSS v.25). Ethical approval: AFSÜ, 13.12.2024, T-2024/11. RESULTS:Y-BOCS total scores showed a significant linear reduction over time (p <.001). This reduction correlated with AQ total (p =.005) and Social Skill (p =.019), Attention Switching (p =.010), and Communication (p =.024) subscales. The reduction in the obsession subscale correlated with AQ total (p =.018) and Attention Switching (p =.040), while the reduction in the compulsion subscale correlated with AQ total (p =.002), Communication (p =.012), Social Skill (p =.036), and Attention Switching (p =.003). CONCLUSIONS:Findings suggest that autistic trait severity in OCD is significantly linked to a less reduction in disorder severity after treatment, with a more pronounced impact on compulsion severity. These findings imply that severe autistic traits may influence treatment response in individuals with OCD. Additionally, the well-established link between OCD treatment resistance and factors such as subtle neurological symptoms, biological factors, and neurodevelopmental disorders suggests that a similar connection may exist between treatment resistance and severe autistic traits.
Engin Ergül, Tuğçe Toker Uğurlu, Merve Aktaş Terzioğlu
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BACKGROUND AND AIM:Childhood traumas negatively impact later life, contributing to psychological, interpersonal, and social difficulties. These adverse experiences may also affect romantic relationships, leading to emotional and social challenges between partners. This study aims to determine the prevalence of romantic relationship dependency among medical students and examine its relationship with childhood traumas. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):The study was conducted during the 20222023 academic year with 366 medical
students. Data were collected online using a sociodemographic questionnaire, the Romantic Relationship Dependency Scale (RRDS), and the Childhood Trauma Questionnaire (CTQ). Ethical approval was obtained from PAÜ (E-60116787-020-374157, 31.05.2023). RESULTS:Among the 366 participants, 63.1% were female, and 36.9% were male. The most common maternal and paternal education levels were university or higher (41.3% and 57.7%, respectively). Most participants (83.6%) came from nuclear families, while 6% had extended families, and 10.4% had divorced parents. A total of 49.7% were in a romantic relationship, with an average duration of 21.9±20.7 months (range: 1100 months). Psychiatric and chronic illness histories were reported by 23.5% and 14.2% of students, respectively. RRDS scores were significantly higher in males (26.8±7.4) than females (24.6±7.3) (p=0.006). However, CTQ total and subscale scores showed no significant gender differences (p>0.05). Participants without relationships had significantly higher CTQ total, emotional abuse, and physical abuse scores (p=0.024, p=0.044, p=0.049). Students with psychiatric histories also had significantly higher CTQ total, emotional neglect, and abuse scores (p=0.009, p=0.005, p=0.002). A weak but positive correlation was found between RRDS and CTQ scores (p>0.05), indicating that higher trauma scores were associated with greater dependency in romantic relationships. CONCLUSIONS:Males had higher relationship dependency scores, a finding consistent with some studies but contradictory to others. Childhood traumas increase susceptibility to dependent romantic relationships and may contribute to psychiatric vulnerabilities in adulthood.
BACKGROUND AND AIM:Major depressive disorder (MDD) is associated with cognitive deficits in attention, memory, and executive functions, persisting even in remission and contributing to functional impairment. This study aimed to compare the effects of duloxetine and vortioxetine on cognitive functions in MDD patients. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):In this 8-week study, 103 participants were included: 35 MDD patients treated with vortioxetine (10-20 mg), 34 with duloxetine (60-90 mg), and 34 healthy controls. Assessments included the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale, Clinical Global Impression Scale, Stroop TBAG form, Trail Making Test, and Auditory Verbal Learning Test
(AVLT). Patients with comorbid anxiety disorders were excluded. Statistical analyses included Kruskal-Wallis variance analysis, Mann-Whitney U test, and Wilcoxon test. The study was approved by the Clinical Research Ethics Committee (Decision 115/21, July 21, 2021). RESULTS:No significant differences were found between groups regarding age, education, depression onset age, or episode count (p>0.05). At baseline, HDRS scores were similar (duloxetine: 20.44±4.93, vortioxetine: 21.43±5.04, p=0.354), and both treatments significantly reduced scores by week 8 (p<0.05). At baseline, MDD patients performed worse than controls on cognitive tests. By week 8, vortioxetine improved all cognitive domains, reducing Trail Making Test A and B times, Stroop Test 1-5 times, and increasing AVLT recall. Duloxetine reducing Trail Making Test A times, Stroop Test 1 and 4 times, and increasing AVLT recall. Cognitive scores in both treatment groups remained lower than in controls, possibly due to residual symptoms or the endophenotypic nature of depression. Limitations include unknown pre-illness cognitive capacities, an 8-week study period, and a small sample size. CONCLUSIONS:Both drugs improved cognitive function, although not to the same level as healthy controls, but vortioxetine had a greater effect on attention and executive function than duloxetine.
BACKGORUND AND AIM Treatment-resistant depression (TRD) is defined by inadequate response to antidepressants (AD), yet its criteria vary, requiring standardized staging models for treatment planning. This study investigates the predictive validity of five TRD staging methods in determining initial treatment response and length of hospital stay (LOS) in psychiatric inpatients. METHODS A retrospective analysis was conducted on psychiatric inpatients diagnosed with major depression at Hacettepe University (2012-2014). TRD status before admission and response to initial inpatient treatment were determined through chart review and researchers consensus. Patients were staged using five models: Thase & Rush (T&R) (five levels based on AD failure,
including tricyclics, MAOIs, and ECT), European Staging Method (ESM) (staging by number of AD trials, duration, and augmentation), Maudsley Staging Method (MSM) (severity scoring based on AD failures, augmentation, ECT/TMS, symptom severity, and illness duration), MGH-S (cumulative points for failed AD trials, augmentation, optimization, and ECT), and Conway Staging Method (STAR-D-based staging by failed AD/psychotherapy trials). The Institutional Review Board approved the study (GO 20/771, 01.09.2020). RESULTS Among 49 patients, 77.6% (n=38) responded to treatment, with a mean LOS of 48.95(±21.10) days. Patients were classified as treatment-resistant by 18.8% based on ESM, 14.6% based on MGH-S, 98% on MSM, 65.3% on T&R, and 22.9% on Conway. Logistic regression showed no staging method predicted treatment response when age and gender were included. However, ECT as the initial AD trial was significantly associated with response (p <0.05). Linear regression showed T&R explained 18.7% of LOS (p=0.002), with higher scores linked to longer hospitalization (B = 10.59). Similar patterns were observed for MGH-S, ESM, and Conway, where higher scores predicted longer hospitalization (p <0.05).
CONCLUSION While none of the staging models predicted treatment response, T&R, MGH-S, ESM, and Conway significantly predicted hospital LOS, suggesting their relevance in clinical decision-making.
Ömer Bayırlı, Furkan Çınar, Zehra Eratıcı, Memduha Aydin
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BACKGROUND AND AIM:Night eating behavior (NEB) is considered a contributing factor to the etiology of obesity and may negatively impact sleep quality. However, the relationship between NEB and sleep quality in obese individuals has not been fully explored. This study aims to investigate the relation between NEB and sleep quality. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Sixty-five participants with obesity, bariatric surgery candidates, were evaluated retrospectively at Selçuk University Faculty of Medicine Consultation-Liaison Psychiatry Clinic between January 1, 2024, and January 1, 2025. As part of the routine assessment battery used to evaluate bariatric surgery candidates, participants completed the Sociodemographic Data Form, Night Eating Questionnaire (NEQ), and Pittsburgh Sleep Quality Index. Forty-seven participants who fully completed the scales were included in the analysis. This study presents preliminary findings from an ongoing research project. Statistical analysis was performed using
SPSS. The study was approved by the Ethics Committee (Approval number: 2025/57). RESULTS:The sample was 74.5% female (n = 35), with a mean age of 32.9 ± 10.37 years and a mean BMI of 42.25 ± 7.27. Among the participants, 59.6% (n = 28) were morbidly obese, and 38.3% (n = 18) had a psychiatric history. Participants were divided into two groups based on NEQ scores: below 25 and 25 or higher (high night eating behavior group). In the high-score group (n = 9), impaired sleep quality was significantly higher (U = 68, p = 0.005). The high-score group also had significantly higher scores on the sleep disturbances subscale (U = 101.5, p = 0.039). CONCLUSIONS:A relationship exists between night eating behavior and impaired sleep quality in obese individuals. Focusing on both night eating behavior and sleep disturbances in the treatment of obesity could be a valuable clinical approach.
About this publication
Turkish Journal of Psychiatry
Turkish Journal of Psychiatry (Turk Psikiyatri Derg) is the scientific journal of Turkish Association of Nervous and Mental Health. The journal has been published on a subscription basis four issues annually in March, June, September and December since 1990. Turkish Journal of Psychiatry is indexed in PubMed, Index Medicus, TUBITAK Tıp, Psych-Info, Türkiye Atıf Dizini and has been ranked in Social Science Citation Index (SSCI) since 2005.
27th National Clinical Education Symposium Presentation Abstracts