FERDANUR Yolcu Çiftlik, Pelin Göksel, Gökçe Çamoğlu
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BACKGROUND AND AIM:Obsessive-Compulsive Disorder (OCD) is a chronic psychiatric disorder that significantly impairs an individual's functioning. rTMS is a non-invasive neuromodulation method. This study aims to examine the effect of repetitive transcranial magnetic stimulation (rTMS) treatment administered to patients with treatment-resistant OCD on Y-BOCS scores and to evaluate the role of basic clinicalsociodemographic variables such as age, gender, and disease duration in treatment response. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):This study was conducted as a retrospective study to examine the effect of rTMS treatment in patients diagnosed with treatment-resistant OCD. The study sample consisted of patients diagnosed with OCD according to DSM-5 and treated with TMS at the Psychiatry Clinic. The patients' basic clinical and sociodemographic characteristics, such as age, gender, and duration of illness, as well as their YaleBrown ObsessiveCompulsive Scale (Y-BOCS) scores before and after TMS, were obtained from patient records. Ethics committee approval no. 2026/33 has been obtained for the study. RESULTS:A total of 19 patients were included in the study, 10 of whom were women and 9 were men. The mean age was 34.95 years, the mean disease duration was 8.6 years, and none had a history of previous TMS. The mean YBOCS Scale scores were 28.37 before treatment and 21.63 at the end of treatment. A mean decrease of 6.74 points in the Yale-Brown scale scores was observed with treatment. The decrease in YBOCS scores with TMS treatment was 6.10 on average in women and 4.78 in men, which was not found to be significant (p > 0.05). No significant relationship was found between the patient's age and illness duration. CONCLUSIONS:In line with numerous studies in the literature, it has been demonstrated that age, gender, or duration of illness are not determining factors in the response to TMS treatment. Keywords: Obsessive-Compulsive Disorder, Transcranial Magnetic Stimulation, Treatment Resistance
BACKGROUND AND AIM: Obsessivecompulsive disorder(OCD) is characterized by recurrent intrusive thoughts, urges, or mental images accompanied by repetitive behaviors, whereas generalized anxiety disorder (GAD) involves persistent and excessive worry related to everyday events and associated physical symptoms. Both disorders may impair sexual functioning, including sexual satisfaction. In individuals with OCD, sexual satisfaction may be influenced by feelings of shame and guilt, as well as by depressive symptoms, medication-related sexual side effects, and cultural factors. The present study aimed to compare patients with OCD and GAD with respect to sexual satisfaction, shame, and guilt, and to examine whether shame and guilt are associated with diagnostic group and sexual satisfaction. METHODS: This study has been approved by the Ankara University Faculty of Medicine Ethics Committee (Approval date and number: 05.05.2025, I04-351-25). This ongoing cross-sectional study includes 10 patients diagnosed with OCD(mean age: 38.00±4.78) and 29 patients diagnosed with GAD(mean age: 35.67±5.30). All participants completed a sociodemographic data form, the The Golombok-Rust Inventory of Sexual Satisfaction (GRISS), Offence-Related Shame and Guilt Scale (ORSGS), and the Hamilton Depression Rating Scale(HAM-D). In addition, to assess illness severity, the Hamilton Anxiety Rating Scale was administered to the GAD group, and the YaleBrown Obsessive Compulsive Scale was administered to the OCD group. RESULTS: In the OCD and GAD groups, GRISS, ORSGS, and HAM-D scores were 45.60±9.03 vs. 40.46±18.96, 36.90±15.96 vs. 39.96±15.20, and 9.10±5.64 vs. 8.82±6.32, respectively. MannWhitney U analyses revealed no significant group differences in GRISS, HAM-D, or ORSGS scores, and no significant correlations were observed between age, ORSGS, and disease severity in either group (all p>0.05). CONCLUSIONS: In this preliminary analysis, no statistically significant associations were observed between guilt, shame, and sexual satisfaction in individuals. However,these findings should be interpreted as preliminary. Future analyses based on a larger
sample may provide clearer insights into these relationships.
Keywords: Generalized Anxiety Disorder, ObsessiveCompulsive Disorder, Sex Guilt,
Sexual Satisfaction, Sexual Shame
Muhammet Sancaktar, Bahadir Demir, Gülçin Elboga, Feridun Bülbül, Abdurrahman Altındağ
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BACKGROUND AND AIM:This study examined how self-stigma and social stigma
influence attitudes toward seeking psychological help among university students and
explored demographic and contextual factors shaping these variables. METHODS (Ethics Committee Approval must be obtained and the number should be
specified.):A cross-sectional design was conducted with 457 students at a large public
university between JanuaryJune 2024. Participants completed the Attitudes Toward
Seeking Psychological Help ScaleShort Form, the Self-Stigma of Seeking Psychological
Help Scale, and the Social Stigma for Receiving Psychological Help Scale. Analyses
included t-tests, ANOVA, correlations, and multiple linear regression (p < 0.05).Ethical
approval was obtained from the Gaziantep University Non-Interventional Research
Ethics Committee (Decision No: 2023/163). RESULTS: Help-seeking attitudes (ASSPH-SF) were significantly higher among female
students (p = 0.001), while males reported greater social stigma (SSRPH) (p = 0.007).
Significant interfaculty differences were found for both attitudes (p = 0.033) and social
stigma (p = 0.008). Higher income correlated with increased social stigma (p = 0.001),
and lower income with reduced self-stigma (p = 0.045). Family history (p = 0.001) and
personal psychiatric diagnosis (p = 0.023) were linked to more positive help-seeking
attitudes. Self-stigma and social stigma were positively correlated (r = 0.38) and
negatively predicted help-seeking attitudes (r = -0.23, r = -0.15). Social stigma declined
with age (r = -0.14). Regression models explained significant variance for ASSPH-SF
(R²=0.292), SSSPH (R²=0.435), and SSRPH (R²=0.419), with key demographic and stigma
variables as significant predictors. CONCLUSIONS:The findings suggest that a positive attitude toward seeking psychological help reduces stigma, whereas self-stigma and social stigma function as key, mutually reinforcing barriers to psychological help-seeking among university students. Targeted stigma-reduction strategies, particularly contact-based and cognitive interventions, should be prioritized. Keywords: psychological help-seeking, self-stigma, public stigma, university students, attitude
BACKGROUND AND AIM:Future physicians' beliefs about psychiatry influence their
clinical approach to mental illness. While medical training shapes these views, preexisting cognitive traits at the start of clinical practice remain under-examined. This
study adopted a transdiagnostic perspective to investigate the associations between
anxiety-related cognitive styles, emotional distress, and beliefs about psychiatry among
medical interns at the onset of their clinical clerkship. METHODS (Ethics Committee Approval must be obtained and the number should be
specified.):This cross-sectional study assessed 110 sixth-year medical students on their
first clinical clerkship day. Participants completed the Beliefs About Mental Illness
Scale, the Anxious Thoughts Inventory (meta, social, and health anxiety subscales), and
the Depression Anxiety Stress Scale21 (DASS-21). Statistical analyses included
Pearson correlations and hierarchical linear regression. Emotional distress was entered
in the first step of the regression, followed by anxiety-related cognitive dimensions in the
second step to identify independent factors associated with beliefs about psychiatry.
The study was approved by the Tokat Gaziosmanpaşa University Faculty of Medicine
Non-Interventional Scientific Research Ethics Committee (Approval No: 24-MOBAEK019; Date: 13.12.2024). RESULTS:Beliefs about psychiatry were moderately associated with baseline metaanxiety (r=?.32, p<.05) and social anxiety (r=.29, p<.05), whereas associations with
depression and general anxiety were weak and not statistically significant. In the
hierarchical regression model, baseline psychological characteristics accounted for a
meaningful proportion of variance in beliefs about psychiatry (R²=.116, p=.044). Higher
levels of meta-anxiety were independently associated with less favorable beliefs
(?=?.42, p=.034), while higher social anxiety was associated with more favorable beliefs
(?=.39, p=.017), after controlling for depression, anxiety, and stress levels. CONCLUSIONS: At the very beginning of clinical training, beliefs about psychiatry
appear to be shaped less by overall emotional distress and more by how individuals
cognitively and metacognitively relate to anxiety. These findings suggest that
transdiagnostic cognitive factorsparticularly meta-anxiety and social anxietymay
play a meaningful role in shaping interns professional attitudes toward psychiatry even
before prolonged clinical exposure begins.
Keywords: Beliefs About Psychiatry, Medical-Intorns, Meta-Anxiety
OBJECTIVE: This study aims to evaluate the clinical efficacy of Electroconvulsive
Therapy (ECT) in inpatients diagnosed with unipolar or bipolar depressive episodes and
to identify the demographic and clinical factors influencing treatment response. METHODS: Data from 35 patients treated at the Ondokuz Mayıs University Psychiatry
Clinic between 2020 and 2025 were retrospectively analyzed. Ethical approval was
obtained from the Ondokuz Mayıs University Clinical Research Ethics Committee
(Project No: 2026/8, 2026000008). Treatment efficacy was assessed using the 17-item
Hamilton Depression Rating Scale (HAM-D) administered before and after the ECT
course. Statistical analyses included bivariate correlations followed by a multiple
regression model adjusted for baseline HAM-D scores, gender, and the number of
depressive episodes. RESULTS: The mean age of the participants was 53.7 ±13.2 years, with 62.9% being
female. A statistically significant mean improvement of 9.6 ±5.4 in HAM-D scores was
observed following treatment (p < 0.001). Multiple regression analysis (R2 = 0.395, p =
0.020) revealed that age was the only significant independent predictor of clinical
improvement (B = 0.209, t = 3.15, p = 0.004). Baseline depression severity, gender,
number of episodes, and length of hospital stay did not significantly impact the
treatment response (p > 0.05).
DISCUSSION: Our findings align with the literature suggesting that older age is
associated with superior ECT response. The persistence of age as an independent
predictor, even when controlling for baseline HAM-D scores, suggests that biological
factors or clinical characteristics unique to older populations may enhance ECTs
therapeutic effects.
CONCLUSION: ECT is a highly effective intervention for reducing symptom severity in
hospitalized depressive patients. The finding that older age predicts better clinical
outcomes, regardless of baseline severity, underscores ECT's role as a potent and
primary therapeutic option for the elderly population.
Keywords: depressive episode, electroconvulsive therapy, treatment response
BACKGROUND AND AIM:A remarkable portion of the human genome is transcribed into
non-coding RNAs including long non-coding RNAs (lncRNAs), microRNAs (miRNAs) and
pseudogene-products, which interact in cluster networks to regulate cellular processes,
such as gene expression. Through DNA-chip analysis, we previously showed that the
expression of GUSBP2, a member of the glucuronidase-beta pseudogene family, was
significantly downregulated in generalized-anxiety disorder (GAD). Our aim in this study
is to generate a GUSBP2-centered pseudogene-RNA interaction network to identify coregulated gene clusters and associated pathways, which may contribute to the
pathogenesis of GAD. METHODS (Ethics Committee Approval must be obtained and the number should be
specified.):Candidates for the network were predicted using the ENCORI/starbase
database. Alignment scores (AS) of the putative binding sites were calculated by the
Smith-Waterman algorithm. Network maps of the pseudogene-mRNA interactome were
constructed and cluster analysis was performed using the STRING database. Nestedhubs within the primary clusters were identified using the built-in DBSCAN algorithm.
Gene ontology (GO) enrichment analysis was performed using the STRING database.
Raw data was obtained from web-based open-source applications, therefore no ethics
commitee approval was required. RESULTS:A total of 13 lncRNAs and 36 mRNAs were identified as candidates for the
GUSBP2-centered network. Among the lncRNAs, the top scoring pairings were of
GUSBP1 (AS=23,5), GUSBP16 (AS=18), MALAT1 (AS=17,5) and miRNA-host gene
MIR31HG (AS=16). Furthermore, the network map of the pseudogene-mRNA
interactome covering all candidate mRNAs (moderate-to-high confidence cut-off
value=0,67; p-value<10-16) was significantly enriched in functional GO terms such as
sensory_perception_of_chemical_stimulus (FDR=1,02x10-8) and
olfactory_receptor_activity (FDR=4,55x10-7). Cluster analysis predicted the presence of a nested-hub of 8 novel genes within the olfactory_transduction cluster, which was
significantly enriched in the category of morphine_addiction (FDR=1,53x10-6). CONCLUSIONS:Our findings suggest that molecular pathways contributing to the
pathogenesis GAD and opioid abuse might be interlinked via GUSBP2-co-regulated
gene-hubs. This is the first computational study in literature to describe a novel
GUSBP2-mediated network bridging the two aforementioned psychiatric disorders.
Keywords: GAD, bioinformatics, lncRNA, RNA-RNA interaction network, enrichment,
cluster analysis
BACKGROUND AND AIM:Neurological findings and investigations in patients hospitalized in psychiatry services are important for differential diagnosis and treatment. This study aims to examine the demographic characteristics, psychiatric and neurological diagnoses, neurological investigations, and their results in psychiatric inpatients. METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Sociodemographic and medical information of patients hospitalized in the Psychiatry Service of Pamukkale University between October 1, 2024 and September 30, 2025 were retrospectively reviewed. Approval for the study was obtained from the university ethics committee (E-60116787-020-767207). RESULTS:Of the 211 patients included in the study, 97 (46%) were female, with a mean age of 38.5 ± 16.96 years. Known neurological comorbidity was present in 18 patients (8.5%), most commonly epilepsy (5.2%). Neurology consultation was requested for 17.5% of the patients. Neurological investigations were requested for 19.4% of all patients,with pathological findings in 48.8% of investigated patients. The mean age of patients referred for organic exclusion was 58.6 ± 14.55 years, while the mean age of those referred for treatment regulation was 41.8 ± 14.15 years. A statistically significant difference was found between the two groups (Z = 3.35; p = 0.001). Psychotic disorder was the most common diagnosis among patients who required neurology consultation (19.4%). Neurology consultation for organic exclusion was more common among patients with psychotic and bipolar disorders. CONCLUSIONS:Neurology consultations and investigations were common among psychiatric inpatients. The higher mean age and increased rate of imaging abnormalities in patients consulted for organic exclusion are consistent with neurological disorders being more common in advanced age. Although abnormalities were detected in approximately half of the patients, most findings were chronic or nonspecific. Consultation indications differed according to psychiatric diagnosis. The findings highlight the importance of integrating neurological and psychiatric approaches in the
clinical evaluation of psychiatric patients. Collaboration between psychiatry and
neurology supports differential diagnosis and clinical decision-making.
Keywords: Neurology consultation, Psychiatric inpatients, Neurological investigations
BACKGROUND AND AIM:Orthorexia Nervosa (ON) is a relatively new concept introduced
by Steven Bratman, characterized by an excessive and rigid preoccupation with healthy
eating. Although it is not formally classified within current diagnostic systems,
increasing evidence suggests that ON shares important cognitive and behavioral
features with ObsessiveCompulsive Disorder (OCD). Intrusive thoughts related to food
purity, strict dietary rules, and ritualized food preparation and consumption resemble
compulsive patterns observed in OCD and often result in significant time consumption,
emotional distress, and functional impairment. The present study aimed to examine the
prevalence of orthorexia among university students and to investigate its relationship
with clinical characteristics and obsessive beliefs. METHODS (Ethics Committee Approval must be obtained and the number should be
specified.):This cross-sectional, descriptive study was approved by the Ethics
Committee of Tekirdağ Namık Kemal University (December 31, 2024; protocol no:
2024.319.12.03). Initially, 124 students were assessed; 28 were excluded due to a
history of psychiatric disorders. The final sample consisted of 96 students aged 1865
years. Participants completed a Sociodemographic Data Form, the Beck Depression
Inventory, Beck Anxiety Inventory, Eating Disorder Examination Questionnaire, Eating
Attitudes Test, Obsessive Beliefs Questionnaire (OBQ-44), and ORTO-15. RESULTS:According to the ORTO-15 (cutoff ?40), 66 participants (68.8%) were classified
as orthorexic, while 32 (31.2%) were non-orthorexic. Orthorexic participants
demonstrated significantly higher obsessive beliefs. Scores on the OBQ-44 subscales
responsibility/threat estimation (54.6±17.7), perfectionism/certainty (65.2±18.9), and
importance/control of thoughts
(34.0±11.5)were all significantly higher in the orthorexic group compared with the nonorthorexic group (43.7±15.2; 52.2±17.3; 26.3±10.7)(p = 0.004, p = 0.001, and p = 0.003,
respectively). The OBQ-44 total score was also significantly elevated among orthorexic
individuals (154.0±41.3;122.3±39.2) (p = 0.001). CONCLUSIONS:These findings support a strong association between orthorexia and
obsessive beliefs, reinforcing the conceptualization of ON within the obsessive
compulsive spectrum disorders.
Keywords: Disordered eating, Obsessive Beliefs, Obsessive Compulsive Disorder,
Orthorexia Nervosa,
Özge Arıkan, , Ejder Akgün Yıldırım, , Sevilay UMUT KILINC
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BACKGROUND AND AIM:
Recent research suggests that fear of positive evaluation (FPE), in addition to fear of
negative evaluation (FNE), plays a significant role in social anxiety. This study examined
the relationships among FPE, FNE, and social anxiety, and investigated whether
perfectionism, self-esteem, and perceived parental attitudes were associated with and
predictive of FPE in a non-clinical sample. METHODS: The sample consisted of 161 volunteer undergraduate and associate degree
students in Istanbul (20232024). Participants completed the Liebowitz Social Anxiety
Scale (LSAS), Fear of Positive Evaluation Scale (FPES), Fear of Negative Evaluation
ScaleBrief Form (FNES-BF), Frost Multidimensional Perfectionism Scale (FMPS),
Rosenberg Self-Esteem Scale (RSES), and the Perceived Parental Attitudes Scale
(EMBU). Pearson correlation analyses examined associations among variables. Multiple
regression analyses were conducted to identify predictors of FPE (dependent variable).
Mediation analysis tested whether FNE mediated the relationship between FPE
(independent variable) and social anxiety (dependent variable). Ethical approval was
obtained (Approval No: 2024-03-13). RESULTS: The mean LSAS score was 42.35 (SD = 26.95). FPE was strongly correlated
with social anxiety and showed a stronger association than FNE. Maladaptive
perfectionism and low self-esteem significantly predicted higher FPE, whereas adaptive
perfectionism negatively predicted FPE. Rejection and overprotective parental attitudes
were positively associated with FPE, while emotional warmth showed a negative
association. Mediation analysis indicated that FNE mediated the relationship between
FPE and social anxiety. CONCLUSIONS:
Consistent with emerging literature suggesting that fear of positive evaluation
represents a distinct but related construct within social anxiety, our findings highlight its
clinical relevance. Addressing fear of positive evaluation, alongside fear of negative
evaluation, may enhance assessment and intervention strategies in social anxiety.
Keywords: Fear of Positive Evaluation, Parental Attitudes, Perfectionism, Self-Esteem,
Social Anxiety
BACKGROUND AND AIM:Medical faculty residents are at higher risk for somatization
symptoms due to heavy workloads and academic stress. Personality traits are believed
to significantly influence this process. This study aims to examine the relationship
between obsessivecompulsive personality traits, neuroticism, and somatization
symptoms among medical faculty residents. METHODS (Ethics Committee Approval must be obtained and the number should be
specified.):In this study, residents at Atatürk University Faculty of Medicine were
evaluated using the ObsessiveCompulsive Personality subscale of the Short Form of
the Personality Belief Questionnaire (PBQ-SF-OCP), the Neuroticism subscale of the
Revised Short Form of the Eysenck Personality Questionnaire (EPQ-RS-N), the
Somatization subscale of the Symptom Checklist-90-Revised (SCL-90-R-S), and a
sociodemographic data form. Ethical approval was obtained (approval no.
B.30.2.ATA.0.01.00/455). RESULTS:Of the 146 participants, 63.7% were female (n = 93) and 36.3% were male (n =
53), with a mean age of 32.54 ± 3.83 years. According to the SCL-90-R-S cutoff score
(>1), somatization was identified in 30.82% of the participants (n = 45). Significant
positive correlations were found between SCL-90-R-S scores and both the PBQ-SF-OCP
subscale (r = 0.298, p = 0.017) and the EPQ-RS-N subscale (r = 0.351, p < 0.001). In
linear regression analysis, EPQ-RS-N scores were independently and positively
associated with SCL-90-R-S scores (b = 0.994, 95% CI: 0.4921.495, p < 0.001). CONCLUSIONS:In this study, somatization symptoms among medical faculty residents
were shown to be independently associated particularly with the level of neuroticism.
Our findings suggest that individual personality traits may play a determining role in the
emergence of psychosomatic responses. Based on the results obtained in this specific
sample, our study may provide a foundation for future longitudinal and interventionbased research and contribute to the development of preventive mental health
programs that take personality traits into account. Additionally, the detection of
somatization in nearly one-third of the participants (30.82%) represents a noteworthy
finding that warrants attention.
Keywords: neuroticism, obsessive compulsive personality traits, somatization
BACKGROUND AND AIM: Delirium is a frequent and clinically challenging condition in
hospitalized older adults, often placing a substantial burden on caregivers. While
caregiver burden and emotional distress are common in this context, their associations
with delirium severity remain insufficiently clarified. This study aimed to examine the
relationships between caregiver burden, emotional distress (depression, anxiety, and
stress), and delirium severity, and to determine whether emotional factors linked to
delirium severity beyond the effect of caregiver burden. METHODS: This cross-sectional study, involving 108 patient-caregiver pairs diagnosed
with delirium according to DSM-5 criteria, assessed delirium severity using the Delirium
Severity Scale, caregiver burden using the Zarit Burden Interview, and caregiver
emotional distress using the Depression, Anxiety, and Stress Scale-21(DASS-21). The
scales were administered simultaneously to patients and caregivers. Inclusion criteria
for caregivers included providing primary care throughout the illness and hospital stay.
Pearson correlation analyses were used to examine bivariate associations. Hierarchical
linear regression analysis was conducted to identify independent correlates of delirium
severity. The study was approved by the Tokat Gaziosmanpaşa University Faculty of
Medicine Ethics Committee (decision date: May 2, 2024; decision number: 83116987). RESULTS: Delirium severity showed significant positive correlations with caregiver
burden and all emotional distress measures. In the hierarchical regression analysis,
caregiver burden significantly predicted delirium severity (R² = 0.10). The addition of
depression, anxiety, and stress scores significantly improved the model (?R² = 0.07). In
the final model, perceived stress emerged as the only emotional variable that
independently predicted delirium severity, whereas caregiver burden and other
emotional factors were no longer significant. CONCLUSIONS: These findings suggest that delirium severity is associated not only with
caregiving burden but also with the caregivers emotional context, particularly perceived
stress. Addressing caregiver stress may be considered as a potential supportive
component of comprehensive delirium management.
Keywords: Caregiver burden, Delirium severity, Emotional distress
Mehmed Ediz Çelik, , Hasan Ali Güler, , Ali Kandeger
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BACKGROUND AND AIM:This study examined whether adults with ADHD show a more
spiky WAIS-R subtest profile than controls and whether this is reflected in the Verbal
Range (SA) and Performance Range (PA). METHODS (Ethics Committee Approval must be obtained and the number should be
specified.):Adults with ADHD (n=55) presenting to the Selçuk University Faculty of
Medicine, Department of Psychiatry, Neurodevelopmental Disorders Outpatient Clinic
and diagnosed via the Structured Clinical Interview for DSM-5 DisordersClinician
Version (SCID-5-CV), and healthy controls (n=42) were included. Participants completed
the Adult ADHD Self-Report Scale (ASRS), the Wender Utah Rating Scale (WURS),
WAIS-R, and a neurocognitive battery (e.g., Stroop, Wisconsin Card Sorting Test). In
WAIS-R, SA was defined as the difference between the highest and lowest scores across
verbal subtests, and PA as the corresponding difference across performance subtests.
The protocol was approved by the Selçuk University Local Ethics Committee (Decision
No: 2025/53). Written informed consent was obtained from all participants prior to study
inclusion. RESULTS:The ADHD group was younger (24.65±6.56; 1843) than controls (32.57±9.18;
2155) (t=4.741, p<0.001). No between-group differences were found in WAIS-R total
score or educational level. Compared with controls, the ADHD group had higher ADHD
symptom severity in childhood (t=6.315, p<0.05) and adulthood (t=11.55, p<0.05) and
performed worse on neurocognitive tests. In the overall sample, SA and PA did not differ
between groups. In sex-stratified analyses, SA was higher in males with ADHD than in
male controls (t=1.77, p<0.05), whereas PA did not differ; females showed no group
differences in SA or PA. CONCLUSIONS:Increased SA in males indicates cognitive-profile heterogeneity in
ADHD and suggests that considering SA in WAIS-R reports may facilitate clinical
planning. The lack of differences in females may relate to possible
masking/compensatory strategies; age mismatch is the main limitation. Further studies
are needed to determine whether SA differences index the neurodevelopmental
spectrum.
Keywords: Cognitive Heterogeneity, ADHD, Performance Range, Verbal Range, WAIS-R
BACKGROUND AND AIM:Misophonia is increasingly understood as a condition
characterized by heightened emotional reactivity rather than a purely auditory
sensitivity.Difficulties in emotion regulation are a core feature of bipolar disorder and
may persist even during remission.The role of misophonia and obsessivecompulsive
personality traits in emotion regulation among individuals with bipolar disorder remains
insufficiently explored.This study aimed to compare misophonia symptoms,obsessive
compulsive personality traits,and mood dysregulation between individuals with bipolar
disorder in remission and healthy controls,and to examine their associations within the
bipolar group. METHODS (Ethics Committee Approval must be obtained and the number should be
specified.):The sample consisted of 42 individuals diagnosed with bipolar affective
disorder in remission and 46 healthy control participants.Gender data were complete for
both groups;overall, 51 participants(58.0%) were male.Participants completed the
Misophonia Symptom List,an ObsessiveCompulsive Personality Disorder screening
scale,the Mood Dysregulation Scale,and the Beck Depression Inventory.Group
comparisons were conducted using independent samples t-tests.Pearson correlation
and multiple linear regression analyses were performed within the bipolar group.The
study was approved by the Tokat Gaziosmanpaşa University Faculty of Medicine Ethics
Committee(Approval Number:25MOBAEK163). RESULTS:The bipolar group was significantly older than the control group (48.52±12.27
vs.25.20±6.12 years,p<.001).Misophonia scores were higher in the bipolar group
compared to controls (0.74 ± 0.66vs.0.57±0.31),although this difference did not reach
statistical significance (p=.132).No significant group differences were observed in
obsessivecompulsive personality traits(p=.358).Mood dysregulation scores were
significantly higher in the control group(2.62±0.87vs.2.05±1.00,p=.006).Despite being in
remission,individuals with bipolar disorder showed higher depressive symptom levels
than controls(p=.004).Within the bipolar group,misophonia was not significantly
associated with mood dysregulation (r=?.12, p=.44),and regression analysis indicated
that misophonia,obsessivecompulsive traits,and depressive symptoms did not
significantly predict mood dysregulation(R²=.12,p=.196). CONCLUSIONS:These findings suggest that misophonia may not represent a stable or
disorder-specific characteristic in bipolar disorder during remission.İts relationship with
emotion regulation appears to be indirect and influenced by multiple clinical
factors.Further studies with age-matched samples and longitudinal designs are needed
to clarify the transdiagnostic relevance of misophonia in affective disorders.
Keywords: Bipolar disorder, emotion regulation, misophonia
BACKGROUND AND AIM:Major Depressive Disorder (MDD) is frequently accompanied
by dissociative symptoms, anxiety, and maladaptive cognitive processes such as
rumination. Childhood trauma and adulthood traumatic experiences have been
suggested as contributors to dissociation and depressive severity. This study aimed to
investigate the relationships between dissociative experiences, childhood trauma,
rumination, and clinical characteristics in individuals diagnosed with MDD. METHODS (Ethics Committee Approval must be obtained and the number should be
specified.):The study included 157 patients diagnosed with MDD and 79 healthy
controls. Patients with MDD were grouped according to their Dissociative Experiences
ScaleTaxon (DES-T) scores. All participants completed a Case Report Form, Beck
Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Dissociative Experiences Scale
(DES), Ruminative Thought Style Questionnaire (RTSQ), and Childhood Trauma
Questionnaire (CTQ-28). Group comparisons, correlation analyses, and multiple
regression analyses were performed. This study was approved by the Zonguldak Bülent
Ecevit University Ethics Committee on April 9, 2025 (2025/07). RESULTS:The dissociative MDD group had significantly lower income levels, younger
age, earlier age at onset of MDD, and a higher frequency of adulthood trauma. This group
also showed significantly higher BDI, BAI, RTSQ, DES, and CTQ-28 scores. BDI scores
were positively correlated with dissociation across all groups. CTQ-28 scores were
positively associated with dissociation but were not significantly related to BDI or RTSQ
scores. BAI scores were positively correlated with all other clinical scales. Predictors of
DES total scores were BAI, BDI, younger age, male sex, and family history of psychiatric
illness. Predictors of RTSQ were BAI and BDI, whereas age and the presence of chronic
medical illness were negative predictors. Predictors of BDI scores included DES total,
CTQ-28, RTSQ, and age. CONCLUSIONS:Findings indicate the importance of assessing dissociative symptoms in
patients presenting with severe depressive symptoms. In this group, anxiety and
rumination levels, as well as childhood and adulthood trauma, age, and family
psychiatric history, should be evaluated together.
Keywords: Adult Trauma, Childhood Trauma, Dissociative Experiences, Major
Depressive Disorder, Rumination
Sare Aydın, Esma Akpınar Aslan, Soner Akar, Cansu Bak
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OBJECTIVE: Recently, the role of inflammation in the etiology and pathophysiology of
mental disorders has become a major focus of research. This study aimed to examine
whether basic inflammatory biomarkers and the Inflammatory Burden Index (IBI) differ
across diagnostic groups among psychiatric inpatients and to investigate the
relationship between these biomarkers, symptom severity, and length of hospitalization.
METHOD: The study included 184 patients hospitalized in the psychiatry clinic (Major
Depression:51, Bipolar Disorder:43, Anxiety:41, Schizophrenia:38). On the first day of
hospitalization, laboratory values for leukocytes, neutrophils (NEU), lymphocytes (LYM),
and C-reactive protein (CRP) were obtained. The Inflammatory Burden Index was
calculated as CRP*(NEU/LYM). Symptom severity was assessed using the Beck
Depression Inventory, Beck Anxiety Inventory, MontgomeryÅsberg Depression Rating
Scale, Young Mania Rating Scale, and the Positive and Negative Syndrome Scale.
Comparisons of inflammatory parameters among diagnostic groups were performed
using the KruskalWallis test, while correlations between clinical variables were
analyzed using Pearson or Spearman correlation analyses. A significance level of p<0.05
was considered for all analyses. Research necessary permissions were obtained from
the local ethics committee(IRB Date/Number:2025/197). RESULTS: No significant differences were found among diagnostic groups in terms of
inflammatory parameters ( p>0.05). There were no significant correlations between CRP,
LYM, or IBI values and clinical variables. However, WBC and NEU levels showed a
significant positive correlation with both length of hospitalization (r=0.214 and r=0.209,
respectively) and MADRS scores (r=0.220 and r=0.223, respectively).CONCLUSION: The findings suggest that inflammation may represent a transdiagnostic
biological process rather than a marker specific to a single psychiatric disorder.
Responsive inflammatory markers such as WBC and NEU appear to be associated with
both the duration of hospitalization and the severity of depression. Studies with
repeated measurements are needed to clarify the longitudinal changes in inflammatory
biomarkers and their relationship with symptom dynamics across psychiatric
diagnoses.
Keywords: Burden, Index, Inflammatory, IBI
BACKGROUND AND AIM: Suicidal behavior is a complex behavioral pattern affecting the
individual, their environment, and society, involving a combination of biological,
psychological, and social factors. Evaluating mental disorders and sociodemographic
data in individuals exhibiting suicidal behavior is crucial for understanding and
preventing it. Our study aimed to determine the rates of admissions to Karabük Training
and Research Hospital due to suicidal ideation or attempts, and to identify clinical and
sociodemographic variables in suicidal ideation or behavior.. METHODS (Karabük University Non-interventional Clinical Trials Ethics Committee
Approval No: 2026/2712)
Consultation requests of 222 individuals, 126 of whom (56.8%) were male, between
January 1, 2025 and January 1, 2026 were retrospectively examined through the patient
record system. In the study, sociodemographic data, stressful life events, history of selfharm, method of suicide attempt, whether hospitalization was recommended, and
diagnosis after evaluation were analyzed. RESULTS:There was no significant difference in mean age between women (32.97 ±
12.902) and men (33.09 ± 11.072). 55% of those who attempted suicide had depressive
disorder, 19.8% had anxiety disorder, and 13.5% had conduct disorder. Regarding the
gender distribution of diagnoses, depressive disorder was more common in women and
conduct disorder was more common in men than expected (p=0.001).
Men were more likely to attempt suicide by sharp objects, firearms, or hanging, while
women were more likely to attempt suicide by taking medication (p<0.001).
A history of self-harm behavior and alcohol or substance use was more common in men
(p<0.05).
A history of experiencing stressful events was more common in women (p=0.033). CONCLUSIONS:Our study is consistent with general literature data, showing that suicide attempts are more frequent in single individuals and those with a history of psychiatric treatment. It also aligns with findings that women more often attempt suicide using medication, while men more often attempt suicide by hanging, stabbing, or shooting. Keywords: Emergency department, suicide attempt, consultations
BACKGROUND AND AIM:Stigma toward mental illness reduces help-seeking and
treatment engagement. Medical students attitudes may shape future clinical practice.
We examined the association between completion of a psychiatry clerkship and levels
of general stigma and anticipated stigma, considering sex, smoking, and
sociodemographic factors. METHODS (Ethics Committee Approval must be obtained and the number should be
specified.):This cross-sectional comparative study was conducted at Selcuk University
Faculty of Medicine. Participants were students who had completed the psychiatry
clerkship (Years 56) and those who had not (Years 14). Data were collected using a
Sociodemographic Form, the Stigma Scale, and the Anticipated Stigma Scale. Analyses
used t tests/ANOVA, Pearson correlation, and multivariable regression. Ethics approval
was obtained (decision no: 2024/609). RESULTS:A total of 354 students participated; 58.5% were female (n=207) and mean age
was 21.05±2.71 years. Awareness of the stigma concept was higher in the clerkship
group (p<0.001). Stigma Scale scores did not differ between groups (40.67±10.84 vs
40.45±8.26; p>0.05). Anticipated stigma scores were higher among students who
completed the clerkship (36.64±8.73) than among those who had not (34.54±7.95;
p=0.033). Stigma and anticipated stigma were positively correlated (r=0.396). General
stigma scores were higher in male students than in female students (p<0.001) and
higher among students who smoke (p=0.003). Anticipated stigma was higher in students
with middle-to-high socioeconomic status. Clerkship completion remained associated
with anticipated stigma in the multivariable model (model R²=0.05). CONCLUSIONS:Clerkship completion was linked to greater conceptual awareness but
not to lower general stigma, and it was associated with higher anticipated stigma. The
quality of clinical contact, role modeling, and the hidden curriculum may contribute to
defensive distancing. Structured, contact-based and reflective anti-stigma modules
should be integrated into the curriculum; longitudinal studies are needed to clarify
causal pathways.
Keywords: medical education, psychiatry clerkship, stigma, anticipated stigma,
attitudes, hidden curriculum
BACKGROUND AND AIM:Vitiligo is a chronic depigmenting disorder that can lead to
significant psychosocial burden, particularly when lesions involve the face. Facial vitiligo
may impair social functioning and self-perception due to its high visibility; however, the
relationship between facial lesion characteristics and social appearance anxiety (SAA)
has not been sufficiently explored. METHODS (Ethics Committee Approval must be obtained and the number should be
specified.):In this cross-sectional casecontrol study included 156 adults with nonsegmental facial vitiligo and 143 healthy controls matched for age, sex, and education
level.. Participants completed the Social Appearance Anxiety Scale (SAAS) and the
Hospital Anxiety and Depression Scale (HADS). Vitiligo patients additionally completed
the Dermatology Life Quality Index (DLQI) and a Visual Analog Scale (VAS) for perceived
disease severity. Facial lesions were anatomically classified as forehead, periorbital,
perioral, or mandibular. Group comparisons, correlation analyses, subgroup analyses by
lesion location, and moderation analysis (PROCESS Model 1) were performed.
Ethics statement: Approval No: 2020/02-13, dated 21/02/2020 RESULTS:Patients with facial vitiligo had significantly higher SAAS scores than controls
(55.20 ± 9.17 vs. 19.70 ± 8.40; p < 0.001; Cohens d = 4.16). Within the vitiligo group,
SAAS scores showed strong positive correlations with anxiety, depression, impaired
quality of life, and perceived disease severity (all p < 0.01). Subgroup analysis revealed
that periorbital and perioral involvement was associated with significantly higher SAA
compared with forehead or mandibular lesions (p < 0.05). Moderation analysis
demonstrated that general anxiety significantly amplified the relationship between
perceived disease severity and social appearance anxiety (interaction p < 0.01). CONCLUSIONS:Facial vitiligo is associated with markedly elevated social appearance
anxiety, particularly when lesions affect socially expressive facial regions. General
anxiety acts as an important vulnerability factor that intensifies appearance-related
distress. These findings highlight the need for lesion-specific and anxiety-informed
psychosocial interventions in the management of facial vitiligo.
Keywords: Body Image, Psychodermatology, Social Appearance Anxiety, Vitiligo
BACKGROUND AND AIM:Based on observations, domestic violence is becoming
normalized and underreported to judicial authorities, thus going unpunished. This study
aimed to determine the rate of women presenting to the psychiatry outpatient clinic who
have been exposed to (verbal and/or physical) violence. METHODS (Ethics Committee Approval must be obtained and the number should be
specified.):The study was approved by the Iğdır University Ethics Committee (February
28, 2024;No. 6/8). Written consent was obtained from participants. Literate women
aged 18-65 who consecutively visited the outpatient clinic at Iğdır State Hospital for
psychiatric symptoms were included. Patients with psychotic or bipolar disorders were
excluded. Sociodemographic data was collected, and a 5-question survey was
administered. Fifty participants were included. RESULTS:The mean age was 35.56±11.64 years. 60%(n=30) were married. Depressive
symptoms were reported by 40%(n=20) and anxiety symptoms by 56%(n=28).
Twenty participants(40%) reported the presence of domestic violence (verbal and/or
physical) in the family during childhood, and 17(34%) reported direct expose to violence
by in childhood. Nineteen participants(38%) reported exposure to verbal and/or physical
violence within the past three months; only three(6%) reported this to the police.
Half of married participants (n=15)(p=0.032); 55% of participants with depressive
symptoms (n=11)(p=0.043); 55% of participants who reported the presence of domestic
violence during childhood (n=11)(p=0.043); 58.8% of participants exposed to violence in
childhood (n=10)(p=0.029) reported being exposed to violence in the last 3 months.
In binary logistic regression analysis, it was observed that married individuals (Odds
Ratio-OR:118.7;p=0.003) had an increased risk of experiencing violence, and that this
risk decreased with age (OR:0.88;p=0.021). The effect of depressive symptoms
approached statictical significance (OR:5.9;p=0.06). CONCLUSIONS:Young women presenting with depressive symptoms, particularly those
who are married, should be routinely assessed for domestic violence risk. Despite a high
prevalence of recent violence, the low reporting rate suggests that violence remains
hidden and unpunished. Future studies should investigate why violence victims do not
report to judicial authorities.
Keywords: Domestic Violence, Failure to Report, Intimate Partner Violence, Law
Enforcement
BACKGROUND AND AIM: Alopecia Areata (AA) is a chronic autoimmune dermatologic
disorder characterized by non-scarring hair loss in visible regions such as the scalp,
eyebrows, and eyelashes. Although medically benign, AA may impose a substantial
psychosocial burden due to its impact on appearance. We hypothesized that lesion
visibility would be more strongly associated with social appearance anxiety than with
generalized anxiety or depressive symptoms.] METHODS: This comparative crosssectional study included 129 patients with AA and 142 age- and sex-matched healthy
controls (1865 years). Participants completed the Social Appearance Anxiety Scale
(SAAS; 16 items, total score range 1680) and the Hospital Anxiety and Depression Scale
(HADS). AA patients additionally completed the Dermatology Life Quality Index (DLQI)
and a Visual Analog Scale (VAS) assessing perceived disease severity. Dermatologists
evaluated lesion localization and visibility. Group comparisons, one-way ANOVA, and
correlation analyses were conducted.(Protocol No: 020/02-14; February 21, 2020) RESULTS: Patients with AA demonstrated significantly higher SAAS scores compared to
controls (65.32 ± 8.45 vs. 21.45 ± 9.32; p < 0.001), corresponding to a very large effect
size (Cohens d ? 3.4).Scores were within the validated SAAS range (1680), indicating a
substantial difference in appearance-related distress between groups. No significant
differences were observed in HADS-Anxiety or HADS-Depression scores. Within the AA
group, SAAS scores showed a moderate positive correlation with perceived severity
(VAS; r = 0.304, p < 0.05). ANOVA analyses indicated significantly higher SAAS scores in
patients with facial involvement, particularly eyebrow and eyelash involvement,
compared to less visible regions. DLQI scores were more strongly associated with
perceived severity and visibility than with lesion count or total affected area. CONCLUSIONS:Social appearance anxiety in AA appears more closely associated with
lesion visibility and subjective illness perception than with generalized psychopathology.
These findings underscore the importance of assessing appearance-related distress in
dermatology settings, particularly in patients with involvement of visible sites.
Keywords: Alopecia areata, Body image disturbance, Chronic skin disorders,
Psychodermatology, Quality of life, Social appearance anxiety
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.
