Schizophrenia is a serious psychiatric disorder that affects the thoughts,feelings and behaviours of individuals.While the quality of life of individuals can be significantly improved with effective treatment and regular follow-up,it is known that mortality rates in these patients are higher than in the general population.Understanding the causes of death in schizophrenia patients is critical for developing treatment and care strategies.The aim of this study was to investigate the causes of death in schizophrenia patients with regular follow-up. The study was initiated with the approval of Erenköy Mental and Neurological Diseases Training and Research Hospital's ethics committee meeting dated 20.02.2025 and numbered 18.Since2016,the retrospective causes of death of schizophrenia patients with KadıköyTRSM follow-up who were removed from the records due to death were determined by analysing the hospital records(Kortex, the follow-up system approved by the Ministry of Health). Age factor has a determining effect on the causes of death in schizophrenia patients.Although suicide was reported to be the most common cause of death in psychotic patients in older sources(15%),this rate is lower in follow-up patients(7%) compared to other studies.MI is the most common cause of death in all age groups and in both sexes (58%),cancer (19%) ranks second.Another important point that the study shows us is that the suicide rate decreases significantly in both sexes and in all age groups as the follow-up period increases. Under regular follow-up and treatment, the causes of death in schizophrenia patients are largely due to physical health problems.Therefore, a treatment that includes not only psychiatric treatment but also comprehensive and frequent check-ups to maintain their physical health is needed.Early diagnosis and management of cardiovascular and metabolic diseases,smoking cessation interventions, promotion of physical activity and psychosocial crisis management to reduce the risk of suicide play a critical role in improving the living conditions of these patients.
Beren Özel, Selvi Ceran, Arda Bağcaz, Hakan Öğütlü
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BACKGROUND AND AIM:Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterized by restricted dietary intake without body image concerns. The Nine-Item ARFID Screen (NIAS) is a tool for detecting ARFID symptoms; however, its psychometric properties in Turkish adults remain unexplored. This study assessed the factor structure, reliability, and validity of the Turkish NIAS by examining its associations with anxiety, depression, and disordered eating. METHODS :A total of 212 adults (42.9% male; mean age = 37.24 ± 11.19 years) completed the Turkish NIAS, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Eating Attitudes Test-26 (EAT-26) and provided BMI data. Principal Axis Factoring with Oblimin rotation explored the factor structure, and internal consistency was assessed using Cronbachs alpha. Pearson correlations and t-tests examined associations between NIAS scores and other measures. The study was approved by the Baskent University Ethics Committee (Project no: KA24/301,16.10.2024). RESULTS:The mean NIAS score was 11.42 ± 8.48, with no significant gender differences (p = 0.61). Females scored higher on PHQ-9 (p = 0.002) and GAD-7 (p < 0.001). Exploratory factor analysis revealed a three-factor solution (picky eating, low appetite, fear of aversive consequences), explaining 73% of the variance (KMO = 0.80; Bartletts test, p < 0.001) with strong internal consistency (? = 0.85). BMI inversely correlated with the appetite subscale (r = 0.15, p = 0.04), while NIAS total scores did not significantly correlate with EAT-26 (r = 0.10, p = 0.17), indicating minimal overlap with weight concerns. CONCLUSIONS:The Turkish NIAS demonstrates a robust three-factor structure and strong reliability, confirming its validity for ARFID screening. These findings support its use in clinical and research settings and inform targeted interventions.
BACKGROUND AND AIM:Pupil movements have been assessed in depression in terms of pupil dilation; however, they have not been sufficiently evaluated in terms of overall pupil mobility. Our study aims to determine whether pupil mobility in patients with depression differs from that in healthy individuals, with pupil movement analyzed using MediaPipe on visual data. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):The study was approved by the Zonguldak Bülent Ecevit University Clinical Studies Ethical Committee with approval number 2024/21. A total of 22 participants were included in the depression group and 22 in the healthy control group. In our study, we used MediaPipe (Google,n.d.) to measure pupil movements from images captured by POV glasses, documenting naturalistic interactions. Participants were asked the following question: Could you describe how your day goes from when you wake up in the morning until you go to bed at night? We then measured the total pupil movement by combining the movements of both the right and left pupils. RESULTS:There was no significant difference in age between the groups (mean age for depression group:37.1, mean age for control group:37.3, p = 0.96), nor in gender distribution (depression group:11 males,11 females; control group:11 males,11 females, p = 1). The difference in total pupil movement between the depression and control groups was not statistically significant (p = 0.32), with a mean rank of 24.36 for the depression group and 20.64 for the control group. CONCLUSIONS:In our study, no significant difference was found between the two groups regarding pupil mobility. The absence of any differences and the slightly higher mean rank of the control group in the preliminary results maybe attributed to the fact that the control group established more eye contact and refrained from moving their eyes during the face-to-face interview, or it could be due to the relatively small sample size in our study.
BACKGROUND AND AIM:ADHD is a childhood-onset neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, with over 50% of individuals continuing to experience clinically significant symptoms into adulthood. Emotional dysregulation is a common and burdensome feature of ADHD. This study examines the relationship between emotion regulation difficulties and clinical variables by comparing adults with ADHD to healthy controls (HC). METHODS (Ethics Committee Approval must be obtained and the number should be specified.):The study included 168 adults with ADHD from the Adult Neurodevelopmental Disorders Clinic, Selçuk University and 106 HC. Diagnoses were established using the Structured Clinical Interview for DSM-5. Participants completed the Difficulties in Emotion Regulation Scale (DERS), Adult ADHD Self-Report Scale (ASRS), Mind Excessively Wandering Scale (MEWS), Hospital Anxiety and Depression Scale (HADS), and Childhood Trauma Questionnaire (CTQ). Ethical approval was obtained from the Selçuk University Local Ethics Committee (Decision Number: 2022/354). RESULTS:The mean age was 24.28 ± 6.5 years in the ADHD group and 25.55 ± 7.66 years in the HC group, with no significant differences in age or gender. The ADHD group exhibited greater severity in all self-reported symptoms compared to healthy controls. DERS scores correlated positively with ASRS, MEWS, HADS, and CTQ in both groups. A linear regression model explained 49.1% of the variance in emotion dysregulation (F=38.61; p<0.001). Higher CTQ (t=2.17; p=0.03), ASRS (t=2.15; p=0.03), MEWS (t=2.19; p=0.03), and HADS (t=5.72; p<0.001) scores were associated with greater emotion dysregulation, regardless of ADHD diagnosis. CONCLUSIONS:This study confirms significant emotion regulation difficulties in adults with ADHD. The associations between emotion dysregulation and clinical measures underscore the broad impact of emotional dysregulation. Further studies with larger samples are needed to explore underlying mechanisms and inform targeted interventions.
Şeyda Nur İspir Çaltıner, Hacer Reyyan Demirel, Hacer Söylemez, Elif Yıldız, Memduha Aydin
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BACKGROUND AND AIM:Schizophrenia requires long-term antipsychotic treatment, which can lead to metabolic side effects like weight gain, dyslipidemia, and insulin resistance.Long-acting injectable(LAI) antipsychotics improve treatment compliance, and this study examines the prevalence of MetS in patients. METHODS:This study was conducted in the Psychotic Disorders Outpatient Clinic of Selcuk University Faculty of Medicine. Patients aged 18-65 were screened between 2020-2025. Sociodemographic, clinical and body measurement data were collected from hospital medical records. Ethical approval was obtained from the Selcuk University Ethics Committee(2023-434). RESULTS:A total of 113 schizophrenia patients were included in the study, 40 of the patients were female (64.6%) and 73 were male (35.4%); mean age was 41.74 ± 11.50 years. The 11.5% (n = 13) of patients were treated with first-generation (FGA)-LAI: haloperidol (n=9, 8%) and zuclopenthixol (n=4, 3.5%). The remaining 88.5% (n= 100) of the sample was treated with second-generation (SGA)-LAI: paliperidone monthly (n=41, 36.3%), paliperidone 3 monthly (n=30, 26.5%), aripiprazole (n=26, 23%) and risperidone (n=3, 2.7%). 50 patients (44.2%) met the criteria for MetS. Among the different LAI antipsychotics used, paliperidone three-monthly had the highest MetS prevalence (60.0%), followed by aripiprazole (57.7%) and haloperidol (55.6%), paliperidone monthly (26.8%). No statistically significant difference was found between the average long-acting usage times and ages of patients of those with and without MetS (5.10±2.5 and 5.53±2.97, p<0.05; 42.4±10.8 and 41.2±12.3, p<0.05). There was no difference between genders in terms of MetS. FGA-LAI or SGA-LAI didnt differ in terms of MetS. CONCLUSIONS:Studies have shown that patients with schizophrenia have a significantly higher risk of developing MetS compared to the general population. This study further emphasizes the high prevalence of MetS among schizophrenia patients treated with LAI antipsychotics. Given the well-documented complications associated with MetS, routine metabolic screening, early detection, and preventive interventions should be an integral part of schizophrenia treatment.
Miray Besir, Başak Bağcı, Aslı Tuğba Esen, Büşra Yıldız
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The prevalence of substance use disorders and comorbid psychiatric conditions is increasing both globally and in Turkey In this patient group, compulsory treatment decisions can be made through the court system. The establishment of specialized treatment centers where compulsory treatment decisions can be enforced is currently on the agenda.Understanding the sociodemographic and clinical characteristics of patients admitted for inpatient treatment will contribute to improving the effectiveness of this integrated service model. The sociodemographic data and clinical characteristics of 160 cases admitted to the our unit between July 31, 2023, and December 31, 2024, were retrospectively analyzed using the Hospital Information Management System PROBEL software.(Ethics Committee Approval Number:2025 SAEK-0116) All 160 patients in the study were male and were hospitalized at the treatment center. The mean age of the patients was 32.88 ± 8.82 years,while the mean age at first admission to the AMATEM outpatient clinic was 26.93 ± 7.83 years. Among the 148 cases with substance use,the mean age of substance initiation was 17.44 ± 5.92 years.In the psychiatric evaluations conducted during hospitalization, 56.8% (n=84) exhibited persecutory delusions,and 50% had reference delusions. During post-discharge outpatient visits, 47.3% of the patients no longer exhibited psychotic symptoms. Patients were discharged with diagnoses of bipolar disorder in 7.4% (n=10), psychotic disorder in 29.4%(n=40),first-episode substance-induced psychosis in 14.7% (n=20),recurrent substance-induced psychosis in 39% (n=53),depression in 2.9%(n=4),anxiety disorder in 3.7% (n=5), and obsessive-compulsive disorder in 2.2% (n=3). In this study, the difference between the mean age of substance initiation and the age of first consultation was striking. After discharge, nearly half of the patients showed a regression of psychotic symptoms, which was considered consistent with the literature.Since these findings are comorbid conditions triggered by substance use, it is important to organize treatments in these centers that will keep the person away from the substance
BACKGROUND AND AIM:Clozapine is a gold standard second generation antipsychotic in treatment resistant schizophrenia that has a limited usage due to side effects such as weight gain, dyslipidemia, impaired glucose metabolism, tachycardia, sedation, agranulocytosis and myocarditis. Metabolic side effects, which increase cardiovascular risk and decrease quality of life, increase mortality and morbidity are important in clinical practice. In our study, we aimed to determine the predictors of metabolic side effects such as weight gain and dyslipidemia in the first 4 weeks of treatment in patients started on clozapine. METHODS:In our study, the records of 45 patients who were hospitalized and started on clozapine were evaluated retrospectively. Weight, body mass index, blood lipids, fasting blood sugar, hemogram in the 0th and 4th weeks were compared. The study protocol was approved by the ethics committee (approval number: 2024-TBEK 2024/11-09). RESULTS:The mean age of 45 patients included in our study was 38,13 years(77.7% male, 22.2% female). The mean clozapine dose reached at the end of week 4 was 318,33 mg/day. Statistically significant changes between week 0th and 4th were observed in eosinophils(p<0.001), weight(p<0.001), body mass index(p<0.001), triglycerides(p=0.002), very low density lipoprotein(p=0.002), alanine aminotransferase(p=0.027) and total cholesterol(p=0.004). As a result of ANCOVA analysis, body mass index(p<0.001 ?2=0.95) and white blood cell count(p=0.01 ?2=0.17)on the week 0 are effective on body mass index on week 4. CONCLUSIONS:In our study, weight gain in patients using clozapine was found to be associated with initial WBC and BMI. These markers can be considered as predictors of weight gain in patients starting clozapine. Our study provides enlightening results about the metabolic side effects when starting clozapine treatment. Long-term follow-up studies with larger samples are needed to predict side effects in patients starting clozapine treatment, to determine which patients should be more careful, and thus to better manage side effects.
BACKGROUND AND AIM:One of the serious adverse effects of clozapine use is acute myocarditis. In our study, we aim to compare different systemic inflammatory markers, and CRP and Troponin levels, which are important markers for the risk of acute myocarditis, in patients who started clozapine treatment over a two-year period at a training and research hospital. Based on the comparison, we aim to identify statistically significant markers for risk assessment in clinical practice. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):A retrospective analysis was conducted on 92 patients who started clozapine treatment. Data on CRP (C-reactive protein), troponin, HDL (high-density lipoprotein), albumin, lymphocytes, neutrophils, platelets, monocytes, CALLY(Superiority of CRP Albumin Lymphocyte Index) (Albumin*Lymphocyte/CRP), SIRS(Systemic Inflammatory Response Syndrome) (Platelet*Neutrophil/Lymphocyte), monocyte/lymphocyte ratio, neutrophil/lymphocyte ratio,platelet/lymphocyte ratio and monocyte/HDL ratio (MHR),along with sociodemographic characteristics, were extracted from the hospital system.Inflammatory markers were assessed at weeks 0, 1, 2, and 4 after initiating clozapine treatment,and statistical analyses were performed to determine significant changes.The study was approved by the ethics committee (Protocol Code: 2024-TBEK 2024/09-08). RESULTS:Among the 92 participants,71.7% were male and 28.3% were female, with a mean age of 38.32 (SD = 10.60) years.A history of chronic disease was present in 26.1% of participants while 73.9% had no chronic illness.A significant increase was observed in troponin(p<0.001),platelet(p=0.003) and albumin(p=0.015) levels. However, no statistically significant changes were detected in CRP,HDL,neutrophils,lymphocytes or monocytes.According to Friedman test results, the monocyte/HDL ratio was 0.01(SD=0.01) at baseline and increased to 0.03(SD=0.01) by week 4, with this increase being statistically significant(p=0.024).Other changes, apart from MHR, were not statistically significant. None of the recorded inflammatory indexes was found to be a predictor of troponin increase. CONCLUSIONS:Recent studies suggest that MHR,a non-invasive inflammatory marker,is a novel prognostic factor for cardiovascular diseases.Clozapine use for 12-14 days increases pro-inflammatory cytokines, boosting inflammation.Inflammation and oxidative stress are key in myocarditis development.While MHR may aid in assessing acute myocarditis,the impact of clozapine on the immune system requires further investigation.
BACKGROUND AND AIM:In the current treatment guidelines, single drug treatment is recommended for the treatment of BD, and combination treatments are frequently used in clinical practice. This study aimed to retrospectively determine psychotropic drug use in the long-term follow-up of BD patients and to investigate its place in daily clinical practice by correlating it with the sociodemographic and disease characteristics of the patients. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):The sociodemographic, disease-related characteristics and medications used by 141 patients followed up with the diagnosis of BD in ALKÜ were retrospectively examined. ALKÜ ethics committee approval was received dated 22.01.2025 and numbered 02-12 RESULTS:82 (58.2%) of the patients were female, mean age was 35.64±11.77 years. 47.5% of the patients were married and 44% were working. The age of onset of BD was 24.99±10.19. 51.8% of the patients had a family history of BD. The first illness period was determined to be mania in 41.1% (n: 58) of the patients and depression in 52.5% (n: 74). The first illness episode of 44.7% (n: 63) of the patients was psychotic. In their first episode, 17% of the patients were treated with a combination of mood stabilizers (MS) and antipsychotics (AP), and 19.9% (n: 28) were treated with only AP monotherapy. In their current treatments, 73% of the patients were treated with a combination of MS and AP. CONCLUSIONS:The recommended treatment for BD is to use MS or AP the disease periods and to continue the treatment with only MS during the remission periods. However, it has been stated that in recent years, the use of AP has increased and the duration of use has been extended, both as AP, AD and MS. In a similar study, it was determined that 95.4% of patients used AP and MS in their treatment.
Background and Aim Rumination, initially defined by Nolen-Hoeksema, refers to repetitive and passive thinking. This study examines the impact of rumination on psychological resilience among physicians, a group frequently exposed to occupational stressors that may affect their mental well-being. Understanding factors that contribute to resilience in this population is crucial for addressing mental health challenges within the medical profession. METHODS: An online survey was conducted with 205 physicians, collecting data through a sociodemographic questionnaire and measures of rumination, perceived stress, and resilience. Correlation and regression analyses were performed to explore the relationships among these variables. Institutional review board approval was obtained from Pamukkale University (E.494675). RESULTS: The sample consisted of 205 physicians (125 women, 61%; 80 men, 39%) with a mean age of 34.92 years (SD = 6.03). Most participants (77.1%, n=158) worked in public institutions. Regarding career intentions, 28.8% never considered leaving the profession, while 30.2% rarely thought about it; smaller proportions reported thinking about it occasionally (22.9%), monthly (11.7%), weekly (3.4%), or almost daily (2.9%). Female physicians reported significantly higher perceived stress (p=0.02) and lower resilience (p=0.02) than males, though no significant gender difference was observed in rumination (p=0.73). Greater work-life satisfaction was associated with lower stress (p=0.002) and rumination (p<0.001), along with higher resilience (p<0.001). Higher perceived stress (r=?0.573, p<0.01) and rumination (r=?0.580, p<0.01) correlated with lower resilience. Regression analysis identified rumination (B = -0.069, p < 0.001, ? = -0.378) and perceived stress (B = -0.180, p < 0.001, ? = -0.366) as significant negative predictors of resilience. CONCLUSIONS: Addressing rumination and reducing perceived stress are key factors in enhancing resilience. Given the higher stress and lower resilience reported by female physicians, targeted interventions to improve workplace satisfaction and manage stress may be particularly beneficial for this group.
Ecem Aydın, Batuhan Gülırmak, Özge Şahmelikoğlu Onur
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BACKGROUND AND AIM:Bipolar disorder (BD) is a chronic mood disorder characterized by manic/hypomanic and depressive episodes. A diagnosis of Bipolar I Disorder (BD-I) requires at least one manic episode. Unipolar mania (UM) is defined by the presence of only manic episodes. Studies in the literature suggest that patients classified as UM should be considered a separate diagnostic group from classical BD patients. Impulsivity is defined as a tendency to react quickly and without planning. Obsessive beliefs involve misinterpretation of intrusive, unwanted thoughts. This study aims to compare UM and BD-I patients on obsessive beliefs, impulsivity, and their clinical features. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Our study received ethical approval (No.24/157) from UHS Hamidiye Scientific Research Ethics Committee on February, 2024. The study included 31 patients with euthymic BD-I and 20 patients with UM. Patients were assessed using sociodemographic data forms,Young Mania Rating Scale, Beck Depression Inventory, Positive and Negative Syndrome Scale, Barratt Impulsiveness Scale, and Obsessive Beliefs Questionnaire. RESULTS:Suicide attempts were significantly more common in BD-I group (46.7%) than in UM group (0%) (p<0.05). No significant differences were found in impulsivity and obsessive belief scores, except for perfectionism and intolerance of uncertainty subscale, which were higher in BD-I (p<0.05). Patients with a history of suicide attempts had higher planning subscale scores (p<0.05), but other impulsivity subscale scores showed no significant differences (p>0.05). CONCLUSIONS:Despite small sample size, our findings suggest that while UM and BD-I patients share similar levels of impulsivity and obsessive beliefs overall, BD-I patients exhibit significantly higher levels of perfectionism and intolerance of uncertainty. Additionally, a history of suicide attempts was markedly more common in BD-I patients. Furthermore, patients with a history of suicide attempts demonstrated higher impulsivity in the planning subscale.
Şuheda Tapan Çelikkaleli, Mustafa Akın, Pinar Guzel Ozdemir
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BACKGROUND AND AIM:Increased care burden, lack of social support, social isolation and economic difficulties are common in mothers caring for children with intellectual disability (ID). This study aimed to examine the effects of socio-demographic factors, cognitive abilities and perceived social support on mental health in mothers of children with ID. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Mothers of children with intellectual disability participated in our study. Sociodemographic Data Form, Multidimensional Scale of Perceived Social Support (MSPSS) and Symptom Checklist-90-Revised (SCL-90-R) scales were given to all participants, and Benton Visual Memory Test (BVRT) was also administered. (Ethics committee approval number 2023/05-05 was obtained). RESULTS:Sixty-four mothers participated in our study. Income level showed a significant relationship with the mean MSPSS score (p=0.005). BVRT score was significantly associated with history of chronic disease (p=0.013), income level (p=0.043), education level (p=0.000) and maternal age (p=0.039). BVRT score was negatively correlated with somatization (p=0.001) and anxiety (p=0.030). MSPSS total scores were moderately negatively correlated with SCL-90 overall mean (p=0.009), somatization (p=0.003), interpersonal relationships (p=0.000), anxiety (p=0.000) and depression (p=0.005). Multiple regression analyses showed that MSPSS and BVRT scores were significant predictors of somatization level ( p<0.01). MSPSS mean score was a significant predictor of anxiety level ( p<0.01). CONCLUSIONS:In our study, it was found that low income level negatively affected the perception of social support, and history of chronic disease and low education level were associated with a decrease in cognitive functions. The negative correlation of BVRT scores with somatization and anxiety suggests that cognitive functions may be related to psychological symptoms. The negative correlation of social support with depression, anxiety and somatization suggests that it may be a protective factor for mental health. In this context, it is important to strengthen social support systems and increase psychosocial interventions to support psychological well-being in mothers of children with intellectual disabilities.
BACKGROUND AND AIM:This study aims to focus on risk factors, besides protective factors associated with burn-out in hospital staff in the period of coronavirus outbreak since these factors are considered to be important for possible epidemics ahead. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Brief Symptom Scale-25 (BSS-25), COVID-19 Fear Scale, Gratitude Scale, Meaning in Life Scale, Brief Psychological Resilience Scale, Maslach Burnout Scale were used in the study. The study was conducted with 105 participants. Multiple Regression Analysis was performed to examine which factors predict the burnout patterns of hospital employees. Ethics committee approval (GO 21/1019) was obtained from Hacettepe University Health Sciences Research Ethics Committee. RESULTS:According to the results of the analyses, higher psychiatric symptomatology was associated with higher levels of emotional exhaustion subdimension of burnout (B =.11; p <.001). Psychological resilience has been found to be associated with emotional exhaustion (B = -.35; p <.05) and personal accomplishment subdimensions of burn out (B = -.21; p <.05), but not with depersonalizastion subdimension of burnout. Higher levels of presence of meaning in life were found to be associated with higher levels of personal accomplishment (B = -.21; p <.05). CONCLUSIONS:Psychiatric symptomatology was found to be a possible risk factor for emotional exhaustion. It can also be suggested that psychological resilience may be protective against emotional exhaustion and lack of personal accomplishment. Besides, meaning in life may be protective against the lack of personal accomplishment. Since no risk or protective factor was identified for the depersonalisation subdimension, it was thought that this dimension required to be handled differently from the other dimensions of burnout. The oral presentation will focus on the development of an intervention plan that addresses the occupational burnout experienced by hospital employees during possible future crisis periods, integrating the factors from both psychiatric symptomatology and positive psychology.
Hacer Reyyan Demirel, Şeyda Nur İspir Çaltıner, Fatih Ekici
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BACKGROUND AND AIM:.Interest in the role of the inflammatory response in mood disorders is increasing. Considering that depressed patients with BD show higher subclinical inflammation than MDD patients, the use of inflammatory parameters in differential diagnosis becomes importance.The aim of this study was to evaluate the relationship between Neutrophil/Lymphocyte,Platelet/Lymphocyte and Monocyte/Lymphocyte ratios measured during the depressive period in patients with unipolar depression and mania/hypomania that may develop during the follow-up period. METHODS:The data of individuals over the age of 18 diagnosed with depressive disorders and followed up at the Psychiatry Outpatient Clinic of Selçuk University Faculty of Medicine Hospital between 01/01/2019 and 01/01/2025 were retrospectively analyzed.NLR, PLR and MLR were calculated retrospectively from complete blood count tests. Ethics committee approval was obtained (2025/138). RESULTS:Our sample of 40 people consisted of 62.5% women, with a mean age of 46.3 ± 16.1 years and a mean age of depression onset of 35.2 ± 13.7 years.The mean HDRS-17 during the first depressive episode was 21.0 ± 6.2.The average follow-up duration was 4.4 ± 3.1 years.During follow-up 17.5% of the patients experienced a manic/hypomanic episode.There was no significant relationship between the presence of a manic episode during follow-up and the inflammatory markers measured during the first depressive episode including NLR1(p=0.33), PLR1(p=0.84), MLR1(p=0.86), SII(platelet × neutrophil/lymphocyte)(p=0.63) and SIRI (neutrophil × monocyte/lymphocyte)(p=0.88). When the ratios of inflammatory blood parameters between the last depressive/manic episode and the first episode were examined, no significant relationship was found between NLR2/1(p=0.10), PLR2/1 (p=0.52), MLR2/1(p=0.19) and SIRI2/1(p=0.49) and diagnostic conversion.However a significant relationship was observed with SII2/1(p=0.045). CONCLUSIONS:Although we are still far from identifying a molecular biomarker to distinguish unipolar and bipolar depression, the rate of change in inflammatory blood parameters may provide insights into the position of the disease within the mood disorder spectrum. Beyond this study larger and longitudinal studies are needed.
BACKGROUND AND AIM: Forensic psychiatry has developed since the 1990s to examine the legal aspects of mental illnesses, especially their effects on legal proceedings. PTSD, a psychiatric disorder that arises after traumatic events, is a major focus. The disability rate and the causal relationship between trauma and legal issues in PTSD cases are frequently discussed in forensic psychiatry. This study aims to analyze Supreme Court decisions regarding PTSD-diagnosed cases from the second half of 2024 from a psychiatrist's perspective. METHODS: On January 31, 2025, a detailed search was conducted on the Supreme Court's decision database (https://karararama.yargitay.gov.tr/) using the terms "post-traumatic stress disorder" and "trauma-related disorder," filtering for decisions from the last six months of 2024. The obtained cases were analyzed. As the data is publicly available, ethical approval was not required. RESULTS: The study analyzed 19 cases, including 11 related to sexual abuse, 7 to incapacity, and 1 to intentional injury. In 10 cases, PTSD diagnoses were rejected due to insufficient information, such as the lack of a psychiatric expert report, unclear links between the trauma and PTSD, no evidence of whether the condition would persist or could improve with treatment, and no specified disability rate. In 9 cases, the health report with a PTSD diagnosis was accepted as valid. Of these, 4 cases considered PTSD as evidence of the event and influenced the courts decision, while in 5 cases, the report had no impact. No common feature was found in the preparation of the accepted reports. CONCLUSIONS: The study highlights the importance of a precise diagnosis and thorough documentation of trauma-related psychiatric disorders for the healthy progression of legal proceedings. Health reports should include details on the victims mental state, the possibility of improvement with treatment, and a clear connection to the traumatic event, as these factors can help prevent potential future legal issues for psychiatrists.
BACKGROUND AND AIM: Autism Spectrum Disorder(ASD) has devastating effects on parental mental health(MH). While effects of this chronic disorder on parental MH during childhood have been studied, there is limited information regarding the parental MH of increasing adult ASD population. Therefore, we aim to determine the psychiatric symptoms levels(PSL) of parents of adult with ASD, to compare the PSL between mothers and fathers, to investigate the predictors of parental PSL. METHODS: Mothers(aged:39-62) and fathers(aged:42-69) of 77 adult ASD patients(aged:18-39) were included. Parental PSL was assessed with the Brief Symptom Inventory, behavioral problems of patients was assessed with the Aberrant Behavior Checklist, independence level of patients(IL) was measured with the Lawton Instrumental Activities of Daily Living Scale, and social functioning level of patients(SFL) was evaluated with the Social Functioning Scale. Variables related to patients(age/gender/independent toileting and self-care skills/functional speech ability/literacy learning status/intellectual disability(ID)/medical and psychiatric comorbidity/psychotropic use/behavioral problems/autism severity) and parents(age/education/working status/medical diagnosis) included in the regression models. Approval was obtained from Kocaeli University(No:2022/20.21). RESULTS: Mothers were the most frequent caregiver. Mothers' labor force participation rate was significantly lower, somatization and depression were significantly higher than fathers'. As IL increased, paternal depression and negative self-concept(NSC) significantly decreased. When SFL increased, maternal anxiety, depression, somatization and paternal NSC significantly decreased. Parents of patients with psychiatric comorbidity and ID, who was dependent on self-care and toileting skills, and illiterate had significantly higher PSL. In regression analysis; increased patient's irritability was associated with increased maternal anxiety, NSC and paternal anxiety, depression, somatization, hostility; increased hyperactivity was associated with increased maternal depression and hostility; increased irritability and presence of medical disease in the mother and patient, increased maternal somatization; increased irritability and social withdrawal were associated with increased paternal NSC. CONCLUSIONS: This study contributes to better understanding of the protective and risk factors of adult ASD cases parents' psychopathology.
BACKGROUND AND AIM:Autism spectrum disorder (ASD) is a lifelong disorder that core symptoms continue into adulthood with partial changes. Prognosis is mostly poor, but there are also cases who lose the diagnosis. There are a limited number of studies evaluating the ASD in adulthood; results are inconsistent, and datas are often shared from western. We aimed to evaluate the outcome of ASD in adulthood, taking into account the opportunities of our country, and to investigate the predictors of the outcome of ASD and loss of diagnosis(LD). METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Approval was received from Kocaeli University(GOKAEK-2022/20.21). 87 cases who were diagnosed with ASD in childhood and who were over 18 years old included. Outcome evaluated with Rutter/Howlin criteria. RESULTS:49.4% of the cases were diagnosed with Autistic Disorder(AD), 20.7% with Atypical Autism(AA), 24.7% with Asperger Syndrome(AS) and 5.7% with LD. First sentence formation age in AS was lower than AD and AA(p=0.005). None of AD case could speak fluently, two-thirds of AA cases could talk albeit disjointedly, two-thirds of AS and all LD cases could speak fluently. LD's age at starting special education was lower than others'(p=0.001) and their IQ were above 70(p<0.001). In 9/10 of the cases, autism core symptoms were persisted. Outcome was very good/good in 14.9%, fair in 24.2%, and poor/very poor in 60.9%. In regression analysis; absence of intellectual disability predicted LD and poor/very poor outcome associated with presence of intellectual disability. CONCLUSIONS:Our article is the first study to comparatively evaluate autism subtypes in adulthood, shows autism subtype is an important predictor of outcome, and there are cases that lose the diagnosis. IQ is the most important prognostic factor; age of development of language skills and age of starting special education are also important. There is a need for longitudinal studies evaluating adult ASD cases that clinicians will encounter frequently in coming years.
Birce Lal Yalçın, Ibrahim Sungur, Kaan Keskin, Elif Özge Aktaş, Efsa Ediz, Yiğit Erdoğan, Ali Saffet Gonul
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BACKGROUND AND AIM:Schizophrenia is linked to widespread structural brain abnormalities, but individual variability complicates their characterization. Traditional case-control studies show group-level differences but miss personalized deviations. Normative modeling refines this by establishing a reference brain structure distribution in healthy individuals and identifying patient-specific deviations. This approach helps detect neuroanatomical abnormalities at the individual level and reveals schizophrenia subtypes based on structural variation. By comparing patient data to a normative model, we can assess significant changes in volume, cortical thickness, or surface area, offering insights into schizophrenia's pathophysiology. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Structural MRI data from 92 schizophrenia patients(mean age:38.3 ± 9.5 years;69.6%male) were analyzed using a centile brain-based normative model. MRI preprocessing was performed using FreeSurferv7.4.1, following standard ENIGMA pipeline recommendations. Deviations were classified as either supranormal(increased volume or thickness) or infranormal(reduced volume or thickness), with thresholds set at Z-scores of 1.96(supranormal) and -1.96(infranormal). The frequency and distribution of these deviations were assessed across multiple brain regions. We utilized the open-access ENIGMA Centile Brain Groups normative model for comparison. The study was approved by Ege University Ethics Committee(approval number:19-12T/42,approval date:11.12.2019;additional ethics committee clarification approval:24-3T/89,approval date:13.03.2024) RESULTS:The most pronounced deviations were observed in the pallidum(right), accumbens(left), and frontal pole(left). Specifically, the right pallidum(Rpal) exhibited the highest rate of supranormal deviations(32.6%), indicating increased volume compared to the normative model. Conversely, the left accumbens(Laccumb) showed the highest rate of infranormal deviations(31.5%), reflecting reduced volume. Additionally, the left pallidum(Lpal) and left frontal pole exhibited significant supranormal deviations(25%),while the right thalamus(Rthal) also showed notable supranormal deviations(14.1%). CONCLUSIONS:These findings highlight distinct neuroanatomical deviations in schizophrenia,particularly in subcortical structures associated with motor and cognitive processing. The observed supranormal increases in the pallidum and thalamus,alongside infranormal reductions in the accumbens,suggest potential alterations in basal ganglia and limbic system function. Further research is needed to explore the clinical implications of these structural changes in schizophrenia.
BACKGROUND AND AIM:Smartphone addiction is a behavioral addiction characterized by excessive smartphone use that negatively affects daily life. Procrastination is defined as the unnecessary delay of priority activities. Mind-wandering refers to a shift in attention away from the external environment toward thoughts that are stimulus-independent and unrelated to the task at hand. Smartphone addiction, procrastination, and mind-wandering behaviours in medical students might be related. These behaviours can cause negative psychiatric processes. This study examines the relationship between psychological well-being and smartphone addiction, mind-wandering, and procrastination in medical students. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):A cross-sectional online survey was conducted, collecting data from medical students enrolled at Atatürk University. The study utilized a socio-demographic data form, the Smartphone Addiction Scale-Short Form (SAS-SF), the Adult Procrastination Inventory (API), the Mind Excessively Wandering Scale (MEWS), and the Psychological Well-Being Scale (PWBS). Ethical approval was obtained from the Atatürk University Ethics Committee (Decision date: 31.01.2025, Decision No:11). RESULTS:The study included 325 participants(202 women, 123 men). Significant negative correlation was found between SAS-SF and PWB scores (p < 0.001, r = -0.351). API score indicated significant negative correlation with PİOÖ score (p < 0.001, r = -0.313). Similarly, significant negative correlation was shown between MEWS and PWB scores (p < 0.001, r = -0.352). Additionally, positive correlations were noted between MEWS and SAS-SF scores (p < 0.001, r = 0.568), SAS-SF and API scores (p < 0.001, r = 0.408), and MEWS and API scores (p < 0.001, r = 0.412). CONCLUSIONS:The correlation analysis suggests that increased procrastination, mind-wandering, and smartphone addiction may be associated with a decline in psychological well-being. Interventions targeting procrastination, mind-wandering, and smartphone addiction could be effective in improving the psychological well-being of medical students.
BACKGROUND AND AIM: This study aimed to investigate the levels of general psychopathology, perceived stress,self-esteem,alexithymia and post-traumatic stress disorder(PTSD) in patients with psoriasis and neurodermatitis, and to determine how these psychosocial factors affect the course of chronic dermatological diseases.Chronic skin disorders,characterized by periods of remission and exacerbation,adversely affect not only the physical health of patients but also their social,emotional and psychological well-being. METHODS: The study was conducted with 32 psoriasis,32 neurodermatitis patients and 32 healthy controls who presented at the Dermatology Outpatient Clinic of Cumhuriyet University Faculty of Medicine.Ethical approval was obtained on 18.11.2020 with decision number 2020-11/06.Each participant was informed about the study and provided with an informed consent form.Participants first completed a socio-demographic data form, followed by the administration of the SCL-90-R, the Perceived Stress Scale, the Rosenberg Self-Esteem Scale(RSES), the Toronto Alexithymia Scale(TAS-20), and the PTSD Checklist for DSM-5(PCL-5). RESULTS: When the SCL-90-R subscales were compared,the prevalence of psychopathology was found to be statistically significantly higher in psoriasis and neurodermatitis patients compared to the control group(p<0.05).Among psoriasis patients, 65.6% had the highest scores on the interpersonal sensitivity subscale,followed by OCD and depression.Among neurodermatitis patients, 78.1% had the highest scores on depression and OCD subscales,followed by somatization and anger.When examining perceived stress test scores,psoriasis patients(17.96±8.09) had scores similar to the control group(14.53±6.56),but a significant difference was observed between neurodermatitis patients(21.06±7.37) and the control group(p=0.002). When analyzing RSES test scores, psoriasis patients(1.84±1.13) and the control group(1.25±1.27) showed similar scores, but the neurodermatitis group(2.9±2.08) had significantly higher scores compared to the other groups(p=0.001). When comparing TAS-20 and PCL-5 test scores,the difference was due to the control group participants, whose test scores were significantly lower than those in the other groups(TAS-20: p=0.001,PCL-5: p<0.001). CONCLUSIONS: These findings emphasize the necessity of considering not only the physical symptoms but also the psychosocial aspects in the treatment of chronic dermatological diseases.
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