28th National Clinical Education Symposium Presentation Abstracts

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OP-35 Changes in Stigmatizing Attitudes Toward Schizophrenia Before and After Psychiatric Training in Medical Students

Onur Küçükakça, Canberk Emri, Yağmur Kır, Kazım Cihan Can, Rifat Serav İlhan

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BACKGROUND-AIM: Stigma toward individuals with schizophrenia remains a major barrier to mental health care and social inclusion. This study aimed to examine whether psychiatric education and clinical exposure reduce stigmatizing attitudes toward individuals with schizophrenia among medical students.
METHODS: This cross-sectional study included two independent groups: 170 fourthyear medical students assessed before starting their psychiatry rotation (no prior psychiatric training or patient contact) and 119 sixth-year medical students assessed during their internship after completing psychiatric training. Participants completed a 20-item stigma questionnaire developed by the authors, based on selected items from the ATIDQ (Attitudes Toward Intellectual Disability Questionnaire) short form and the SSRPP (Social Distance Scale Revised for People with Psychiatric Problems). Responses were recorded as “agree,” “partly agree,” or “disagree.” Group differences between fourth- and sixth-year students were analyzed using chi-square or Fisher’s exact tests. Benjamini–Hochberg correction was applied for multiple comparisons. The study was approved by the institutional ethics committee (2025, No: 895) and conducted per the Declaration of Helsinki.
RESULTS: After Benjamini–Hochberg correction for multiple comparisons, 9 of 20 items remained statistically significant (adjusted p < 0.05). Sixth-year students demonstrated significantly lower stigmatizing attitudes compared to fourth-year students, particularly regarding employment in socially interactive roles (p < 0.001), perceived dangerousness and crime risk (p = 0.001), inability to live independently (p = 0.002), and perceived incurability with reduced life quality (p = 0.002). Additional significant differences were observed in attitudes toward institutionalization (p = 0.004), social participation (p = 0.008), and the need for separate healthcare services (p = 0.005), reflecting a consistent pattern of reduced exclusionary beliefs among students who had completed psychiatric training.
CONCLUSIONS: Psychiatric education with clinical exposure is associated with reduced stigmatizing attitudes toward schizophrenia among medical students. These findings support structured psychiatric training and direct patient contact in reducing stigma. Keywords: Medical Student,Schizophrenia,Stigma,

OP-36 Associations Between Emotional Dysregulation and Childhood and Adult ADHD Symptoms in Adults with ADHD: A Multivariable Regression Analysis

Selin Karakaya, , Bedriye Öncü

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BACKGROUND AND AIM:Emotional dysregulation (ED)—including emotional lability, low frustration tolerance, and heightened emotional reactivity—is common in adults with ADHD and contributes to greater clinical severity and comorbidity. Although ED has increasingly been conceptualized as a core dimension of ADHD, its associations with both childhood and adult ADHD symptom characteristics remain insufficiently examined. In light of these considerations, this study aimed to investigate how childhood and adult ADHD characteristics influence emotional dysregulation.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):This retrospective study included 242 adults(mean age = 23.72 ± 5.88, 145 female) diagnosed with ADHD who attended a psychiatry clinic between 2021 and 2024. The Wender Utah Rating Scale (WURS), the Self-Report Wender-Reimherr Adult Attention Deficit Disorder Scale (SR-WRAADDS), and the Hospital Anxiety and Depression Scale (HADS) were administered. Data were analyzed using hierarchical multiple linear regression models to examine factors associated with ED (as measured by the SR-WRAADDS ED subscale) while controlling for sex, HADS subscales, and psychotropic medication use.(Approval number: I01-06-26)
RESULTS:Female participants had significantly higher SR-WRAADDS ED scores than males (U=5857.5,p=0.028). Individuals not receiving medication had significantly higher SR-WRAADDS ED scores than those receiving stimulant treatment(U=1580.50,p=0.004) Hierarchical regression analyses demonstrated that SR-WRAADDS ED subscale score was differentially predicted across models. In the model including WURS subscales, female sex(?=?0.13,p=0.035), HADS anxiety(?=0.22,p=0.001), HADS depression(?=?0.28,p<0.001), and combined treatment(?=0.20,p=0.002) emerged as significant predictors, whereas none of the WURS subscales independently predicted. In contrast, in the second model, the SR-WRAADDS attention deficit (?=0.52), impulsivity/hyperactivity (? = 0.21), and temperament traits (?=0.20) subscales were the strongest independent predictors(p<0.001), while sex, anxiety and depressive symptoms were no longer significant.
CONCLUSIONS:The present findings indicate that ED is more strongly associated with adult ADHD symptom domains than with childhood ADHD characteristics. Clinically, these results underscore the importance of focusing on current ADHD symptom profiles and treatment status when assessing and managing emotional dysregulation in adults. Keywords: Attention-Deficit/Hyperactivity Disorder, Childhood ADHD Symptoms, Emotional Dysregulation, Multivariable Regression Analysis

OP-37 Frequency of Post Traumatic Stress Disorder and Associated Factors Among Survivors of Van Avalanche: 6-Month Follow-up Study

Elif Sütçü, Faruk Kurhan

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BACKGROUND AND AIM:Avalanche disasters are life-threatening events that may cause severe and long-lasting psychological consequences. Post-Traumatic Stress Disorder (PTSD) is one of the most frequently observed psychiatric outcomes following disasters. Although avalanches occur relatively often in Turkey, particularly in the eastern regions, there is a lack of research examining their psychiatric effects. Rescue workers, especially volunteers, are exposed to intense trauma during disaster response and may be at increased risk for PTSD.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):This study included 35 male rescue workers who were trapped under two consecutive avalanches that occurred in Van’s Bahçesaray district in 2020. Participants were assessed through face-to-face clinical interviews at two and six months after the disaster. PTSD diagnosis was made according to DSM-5 criteria using clinical evaluations and the Post-Traumatic Stress Disorder Symptom Scale–Self Report (PSSSR). Trauma severity was measured using the Impact of Event Scale (IES). Sociodemographic and disaster-related risk factors were also recorded.(Ethics Committee Approval no: 2020/03-27)
RESULTS:PTSD prevalence was 71.4% at two months and decreased to 57.1% at six months after the avalanche. Longer duration under the avalanche (more than 30 minutes), being a volunteer rescuer, and having no prior disaster exposure were identified as significant risk factors for PTSD. Although symptom severity decreased over time, PTSD symptoms remained common, particularly among volunteer rescuers.
CONCLUSIONS:Avalanche disasters are associated with a high and persistent risk of PTSD among rescue workers. Professional training, psychological preparedness, and prior disaster experience may have protective effects. These findings highlight the need for early psychosocial interventions, regular mental health screening, and sustained psychological support for individuals involved in disaster response. Keywords: Avalanche, Psychiatric Disorders, Post-Traumatic Stress Disorder

OP-38 Association Between Cognitive Emotion Regulation Strategies and Depression and Anxiety in Infertile Women

Raziye Akman Erdoğan, Bengü Yücens

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BACKGROUND-AIM: Infertility is a significant psychosocial stressor for women.Cognitive emotion regulation strategies may shape perceptions of this process and emotional responses; therefore, this study examined their relationship with depression and anxiety levels in infertile women.
METHODS: This study included 64 infertile women who attended the Pamukkale University In Vitro Fertilization Center and completed the sociodemographic information form, the Cognitive Emotion Regulation Questionnaire (CERQ), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Inclusion criteria were a diagnosis of infertility, age ?18, literacy, and voluntary participation. Exclusion criteria included age <18, refusal to participate, severe psychiatric disorders (e.g., psychotic or bipolar disorders, substance dependence, dementia, or psychotic depression), significant medical or neurological illness, intellectual disability, physical or neurological conditions that impair communication, and illiteracy.Psychotropic medication use was recorded. Ethical approval for the study was obtained from the university ethics committee (E-60116787-020-811463).
RESULTS: The mean age of the participants was 30.11 ± 4.45 years, and the mean duration of marriage was 4.73 ± 2.92 years. The rate of receiving psychological support was 4.7%; 35.9% reported that they would like to receive support, while 59.4% stated that they did not wish to receive psychological help. The mean BDI score was 8.85 ± 7.80, and the mean BAI score was 11.45 ± 9.69. Age was positively associated only with the acceptance and blaming others subscales. BDI scores were positively correlated with self-blame, rumination, catastrophizing, and blaming others, whereas BAI scores were positively correlated with self-blame, rumination, and catastrophizing. Discussion and CONCLUSION: Consistent with the literature, depression and anxiety levels in infertile women are associated with maladaptive cognitive emotion regulation strategies. In particular, self-blame, rumination, and catastrophizing were significantly linked to both depression and anxiety. The association between age and certain strategies suggests that coping patterns may change across the lifespan. Keywords: Infertility, emotion regulation, depression, anxiety

OP-39 A Retrospective Evaluation of Antipsychotic Selection in Patients Diagnosed with Delirium During Psychiatric Consultations at Pamukkale University Hospital Over the Last Year

Engin Ergül, Bengü Yücens

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INTRODUCTION AND OBJECTIVE: Delirium is a clinically significant condition associated with adverse outcomes. This study aimed to identify key clinical features and treatment approaches in delirium by retrospectively examining recommended antipsychotic treatments, psychiatric comorbidities, re-consultation needs, and selected laboratory findings. METHOD: Sociodemographic and medical data of patients diagnosed with delirium and consulted to the psychiatry department between 01.01.2025 and 01.01.2026 were retrospectively reviewed from hospital records. Reviewed variables included survival status, psychiatric comorbidities, selected laboratory findings, treatments recommended after consultation, and re-consultation status. Continuous variables were presented as mean ± standard deviation and categorical variables as number and percentage (%). Categorical comparisons were performed using the chi-square test. Ethical approval was obtained (E-60116787-020-811452).
RESULTS: Among 342 patients, 58.5% were male and 41.5% female; mean ages were 70.9 ± 12.7 and 74.2 ± 12.0 years. In-hospital mortality was 22.1%. Dementia was present in 17%, and other psychiatric comorbidities in 40.6%. Antipsychotic treatment was recommended in 97.7% of cases; haloperidol (oral drops) was most frequently prescribed (88.6%), followed by quetiapine (6.3%). Re-consultation during hospitalization occurred in 25.1% of patients. A significant association was found between antipsychotic use within the previous six months and re-consultation (?²=12.704; p<0.001). Mean initial doses were 1.40 ± 0.65 mg for haloperidol, 38.10 ± 27.52 mg for quetiapine, 3.93 ± 2.34 mg for olanzapine, and 1.0 ± 0.0 mg for risperidone. DISCUSSION AND CONCLUSION: Consistent with the literature, haloperidol was the most frequently preferred antipsychotic in delirium management, as supported by Wilson et al. and the NICE guideline. The relatively low doses suggest that a cautious titration strategy was adopted, considering the mortality and cardiovascular risks emphasized by Tomlinson et al. Increased re-consultation among patients with prior antipsychotic use may reflect dopaminergic adaptation. Given the multifactorial nature of delirium, individualized treatment and close monitoring remain essential. Keywords: Delirium, Antipsychotic, Haloperidol

OP-40 Lactose intolerance symptoms, irritable bowel syndrome and symptom severity in patients with major depressive and anxiety disorders under antidepressant treatment

Habib Berhan Akyıldız, Sinan Yetkin

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BACKGROUND AND AIM:There is increasing evidence for a bidirectional interaction between MDD, anxiety disorders and GI dysfunctions. This study aims to evaluate the prevalence of GI symptoms in patients with MDD and anxiety disorders using lactosecontaining antidepressants, the relationship between IBS symptoms and psychiatric symptom severity and the association of lactose intolerance symptoms with the lactose content of medications.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):This study was conducted using a hybrid design incorporating both crosssectional and prospective cohort methodologies. The sample consisted of 300 participants with MDD, anxiety disorders and healthy controls. Antidepressants were classified as lactose-containing or lactose-free based on excipient information obtained from official database of the TITCK. A subgroup of patients reporting lactose intolerance symptoms was re-evaluated after a 6–8 week lactose-free diet and continued antidepressant therapy. Patients reporting lactose intolerance symptoms received standardized information regarding lactose-containing foods. Those who did not adhere to recommendations and lactose intake during follow-up were excluded to minimize external lactose exposure as a confounding factor. It was approved by the Ethics Committee for Scientific Research of the University of Health Sciences Gulhane with decision no:2024-73 (14.11.2024).
RESULTS:Increased IBS severity was associated with HADS-Anxiety, HADS-Depression and SDQ-20, whereas SSAS scores did not differ significantly between IBS severity groups. Furthermore, patients using lactose-free antidepressants showed more prominent reductions in lactose intolerance symptoms particularly gas, bloating, nausea/vomiting and belching within 6–8 weeks compared to those using lactosecontaining medications. Multivariate logistic regression analysis identified age, HADSDepression, SSAS and SDQ-20 scores as independent risk factors for IBS.
CONCLUSIONS:Patients with IBS complaints exhibited increased psychiatric symptoms and heightened somatic sensitivity; age, depression scores, dissociative symptoms and somatic amplification were identified as important predictors of IBS. Although the lactose content of antidepressants is relatively low, heightened visceral sensitivity may render excipient exposure clinically significant. Keywords: Major depressive disorder, anxiety disorder, lactose intolerance, irritable bowel syndrome

OP-41 Extrapyramidal symptom severity across neuroanatomical subtypes of schizophrenia identified by machine learning

Ibrahim Sungur, Simay Selek, Gozde Bildircin, Ali Saffet Gonul

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BACKGROUND AND AIM:Machine-learning approaches have identified distinct neuroanatomical subtypes of schizophrenia. However, the clinical relevance of these subtypes for extrapyramidal symptoms (EPS) has received limited attention. Given the role of basal ganglia circuits in EPS, examining EPS across neuroanatomical subtypes may provide translational insight. Based on schizophrenia subtypes derived using the HYDRA (Heterogeneity Through Discriminative Analysis) algorithm, we compared EPS across two neuroanatomical subtypes.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Structural MRI data from 222 participants (136 schizophrenia; 86 healthy controls) were analysed. Two HYDRA-defined schizophrenia subtypes were examined: Subtype 1 with cortical atrophy (n=75) and Subtype 2 with preserved cortical morphology and enlarged subcortical volumes (n=61). EPS were assessed using the Extrapyramidal Symptom Rating Scale (ESRS). Demographic, clinical, and ESRS scores were compared using the Mann–Whitney U test. EPS severity was analysed using linear regression models with log-transformed ESRS scores, adjusting for age, sex, chlorpromazine-equivalent dose, and subtype. Additional region-of-interest analyses examined bilateral volumes of the putamen, pallidum, caudate, and nucleus accumbens in separate models adjusted for age, sex, chlorpromazine-equivalent dose, total intracranial volume, and subtype. Ege University Ethics Committee approval number:19–12T/42.
RESULTS:ESRS scores were available for 108 of 136 patients (79.4%), and availability did not differ between subtypes (Subtype 1 vs 2:84.0% vs 73.8%; p=0.142). Subtypes were comparable in demographic and clinical characteristics. ESRS total scores were significantly higher in Subtype 1 than Subtype 2 (median:8 vs 5; U=1000.5, p=0.009). EPS prevalence did not differ significantly between Subtype 1 and Subtype 2 (93.7% vs 82.2%; p=0.062). In linear regression analyses, subtype remained independently associated with ESRS severity (Subtype 2 vs 1:?=-0.41, p=0.019), and age showed a positive association with ESRS severity (?=0.01, p=0.037). No basal ganglia structures were associated with ESRS (p>0.05).
CONCLUSIONS:Neuroanatomical subtypes of schizophrenia differed in EPS severity. This difference, independent of antipsychotic dose and basal ganglia volumes, suggests subtype-specific vulnerability of motor circuits. Keywords: Extrapyramidal system, Machine learning, Neuroimaging, Schizophrenia, Structural magnetic resonance imaging, Subtypes

OP-42 A Retrospective Analysis of the Clinical Characteristics, Substance Use Profiles, and Discharge Treatments of Patients Hospitalized in the AMATEM Service

Ihsan Anil Dogruyol, Bengü Yücens

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BACKGROUND AND AIM:Alcohol and substance use disorder (ASUD) is a chronic, relapsing condition with significant individual and societal consequences. This study examined the clinical characteristics, substance use profiles, and post-discharge treatments of patients treated at an AMATEM.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Sociodemographic and medical data of patients hospitalized at Pamukkale University AMATEM between 01.12.2020 and 01.12.2025 were retrospectively reviewed; ethical approval was obtained(No.E-60116787-020-811471).
RESULTS:A total of 632 patients were included; 87.3% were male and 55.2% were single.The mean age was 29.37±9.42 years, with 2.07±1.55 hospitalizations and a hospitalization duration of 16.27±11.55 days.The mean age at onset was 17.65±5.64 years, the duration of use was 11.70±8.29 years, and the longest abstinence period was 10.50±12.84 months. Opioids were most common in current use (56.3%), and cannabis in past use (67.2%).Legal involvement, intravenous use, and a family history of substance use were present in 22%, 26.7%, and 16.9% of patients, respectively.Polysubstance use disorder was the most common discharge diagnosis (35.9%), followed by opioid (32.1%) and alcohol use disorder (17.2%).Acamprosate was used in 39.7% of patients with alcohol use disorder, while the mean daily buprenorphine/naloxone dose at discharge was 10.1 mg for opioid use disorder.31% of patients (n=196) were discharged before completing treatment; most refused treatment (85.7%).Age at onset was negatively correlated with hospitalizations and positively with longest abstinence (p<0.001).Patients in the opioid group were younger, had earlier onset, and more frequent hospitalizations than other ASUD patients.Within the opioid group, those with a history of IV use had more hospitalizations, earlier onset, and longer use duration.Alcohol patients were older, had later onset and longer use duration; they had fewer hospitalizations, longer stays, and shorter longest abstinence.
CONCLUSIONS:In this study, the clinical and demographic characteristics of AMATEM patients were evaluated, demonstrating distinct clinical profiles of alcohol and opioid use disorders; consideration of real-world data in treatment planning is recommended. Keywords: addiction, alcohol, amatem, substance

OP-43 Cognitive Subtyping in Schizophrenia: An Analysis of Neuropsychological Profiles, Clinical Symptomatology, and the Impact of Illness Duration using the COBRE Dataset

Melike Nur Altunç, Ali Tarık Altunç, Yusuf Çiçek, Abdullah Ekrem Okur, Halil Aziz Velioglu

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BACKGROUND AND AIM:Cognitive impairment, a hallmark feature of schizophrenia, is known to exhibit significant heterogeneity among patients. Classification studies often reveal three primary clusters based on deficit severity. This study aimed to categorize patients with schizophrenia using the COBRE dataset, examining the relationship between cognitive clusters, sociodemographic variables, and clinical findings.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Data from 68 patients with schizophrenia and 67 healthy controls were analyzed. Cognitive categories were established via K-means clustering based on seven MATRICS domains. Groups were compared using independent samples t-tests and one way ANOVA. Pearson correlation assessed the relationship between clinical parameters and the MATRICS overall composite score. Data processing and statistical analyses were facilitated by Python libraries and the Antigravity software. The COBRE dataset is a publicly accessible repository released under a Creative Commons Attribution–Non Commercial license; written informed consent was obtained from all participants in compliance with the University of New Mexico (UNM) Institutional Review Board (IRB) protocols.
RESULTS:Three distinct cognitive clusters emerged: Relatively Preserved (n=23), Moderately Impaired (n=22), and Severely Impaired (n=19). No statistically significant differences were found between groups regarding age, gender, education, PANSS total scores, illness duration, or antipsychotic medication dosage. However, the Severely Impaired group exhibited significantly higher scores on PANSS "Disorientation" (p=0.021) and "Lack of Judgment and Insight" (p=0.043). While the Severely Impaired group showed a 4.6-point IQ decrease compared to estimated premorbid levels, no significant decline was detected in other groups. A very strong positive correlation was identified between age of onset and overall cognitive performance (r=0.77, p<0.001).
CONCLUSIONS:These findings indicate that cognitive impairment in schizophrenia does not depend on illness chronicity, aligning with existing literature that deficits emerge early and stabilize over time. Additionally, the 'Severely Impaired' cluster appears to follow a unique trajectory defined by an earlier onset of illness, impaired insight, and severe neurocognitive deficits. Keywords: cognitive impairment, k-means clustering, scizophrenia,

OP-44 State Anxiety and Uncertainty Processing: A Hierarchical Gaussian Filter Study in Generalized Anxiety Disorder

Furkan Bekdemir, Selçuk Özdin

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BACKGROUND AND AIM:Generalized Anxiety Disorder (GAD) is characterized by persistent worry and heightened sensitivity to uncertainty. Computational models suggest that anxiety may involve excessive belief updating rather than impaired learning. The Hierarchical Gaussian Filter (HGF) quantifies learning under uncertainty through the tonic volatility parameter (?2). This study examined how state anxiety relates to uncertainty processing in individuals with GAD.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Thirty-six participants, comprising 18 individuals with Generalized Anxiety Disorder and 18 age and education matched healthy controls, completed a probabilistic reversal learning task. Belief updating was modeled using a Hierarchical Gaussian Filter with higher-level volatility fixed to assess tonic environmental volatility (?2). Participants completed the State–Trait Anxiety Inventory (STAI) and the Intolerance of Uncertainty Scale (IUS-12). Group differences were examined using Mann–Whitney U tests, and associations were assessed using Spearman rank-order correlations. The study was approved by the Ondokuz Mayıs University Clinical Research Ethics Committee (Approval No: 2026/43).
RESULTS:Individuals with Generalized Anxiety Disorder exhibited significantly higher ?2 values than healthy controls (U = 51.0, p <.001), indicating increased sensitivity to environmental volatility. They showed lower win-stay and higher lose-shift behavior (both p <.001), while overall task accuracy showed a smaller but statistically significant group difference (p =.033). Volatility sensitivity was associated with state anxiety (STAI S; ? = 0.42, p =.010), intolerance of uncertainty (IUS-12; ? = 0.39, p =.020), and lose–shift behavior (? = 0.55, p <.001). The association with trait anxiety (STAI-T) was weaker and did not reach statistical significance (? = 0.32, p =.059).
CONCLUSIONS:Individuals with Generalized Anxiety Disorder tend to update beliefs excessively under uncertainty rather than exhibiting generalized learning deficits. State anxiety was more closely related to uncertainty processing than trait anxiety, particularly following negative feedback. Computational models of uncertainty may help clarify mechanisms underlying anxiety and inform targeted interventions. Keywords: Generalized Anxiety Disorder, Hierarchical Gaussian Filter, Belief Updating, Uncertainty Processing, Reversal Learning

OP-45 The Effect of Shift Work on Emotion Regulation and Life Satisfaction in Healthcare Workers

Esra Vargeloğlu, Zuhal Koç Apaydın, Burak Öksüzoğlu, Dilanur Cinkavuk

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BACKGROUND AND AIM:This study aimed to identify clinical, sociodemographic, and emotion regulation difficulties, life satisfaction, depression, anxiety, and stress variables in healthcare workers working in shifts, to compare these variables with those of healthcare workers working outside of shifts, and to determine the differences between at-risk populations and occupational groups.
METHODS:(Ethics Committee Approval No. 2026/2705) This study was created by collecting data from healthcare professionals working at Karabük Training and Research Hospital who agreed to participate between January 1, 2026 and January 23, 2026, through face-to-face interviews. Sociodemographic data, the Depression Anxiety Stress Scale-21, the Life Satisfaction Scale, and the Emotion Regulation Difficulty Scale-Short Form were examined.
RESULTS:No significant age difference was found when comparing shift-working (n=53) and non-shift-working (n=50) healthcare workers [28 (28–48) vs 28.5 (23–56); p=0.678]. The presence of comorbidities was higher in the non-shift-working group (p=0.013), and occupational distribution showed a significant difference between the groups (p<0.001). When scale scores were evaluated, the DDGO score was higher in shift-working employees [35 (18–80) vs 25 (16–56); p<0.001]. DASS depression, anxiety, and stress subscale scores were also found to be higher in shift-working employees (p<0.001 for each). Although the YDO score tended to be lower in the shift-working group, no statistically significant difference was found between the groups [26 (11–35) vs 28 (9 35); p=0.495].
CONCLUSIONS:When our study results were compared with literature data, we found that healthcare workers on shifts had significantly higher levels of emotion regulation difficulties, depression, anxiety, and stress, while life satisfaction tended to be lower compared to those working non-shifts; however, this difference was not statistically significant. These findings suggest that shift work may have negative effects on the mental health of healthcare workers and highlight the importance of planning preventive and supportive mental health interventions, especially for at-risk groups. Keywords: shift work, life satisfaction, healthcare worker, emotion regulation

OP-46 Emotional, Behavioral and Social Functioning in Children of Parents with Alcohol and Substance Use Disorders: A Case–Control Study

Başak Güldür, Başak Bağcı, Aslı Tuğba Esen, Canem Kavurma, Ercan Durmaz

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BACKGROUND AND AIM: Parental alcohol and substance use disorders (AUD/SUD) can impair parental capacity and lead to emotional and behavioral difficulties. This study compared emotional-behavioral problems and social skills in children of parents with AUD and SUD versus healthy controls.
METHODS: This study included parents with AUD or SUD attending the AMATEM clinic of Izmir Katip Çelebi University Atatürk Training and Research Hospital and their children aged 4-15 years and matched healthy controls. Sociodemographic data were collected from children and parents. Parents completed the Strengths and Difficulties Questionnaire (SDQ) and the SOBECE (Social Skills Assessment Scale) for their children. Ethical approval was obtained (2024-SAEK-0017)
RESULTS: Ninety children (mean age 9.31 ± 3.62 years) were categorized into three groups (n = 30 each): children of parents with AUD, SUD, and healthy controls. Significant intergroup differences were found in SDQ hyperactivity (?² = 9.10, p = 0.011), peer problems (?² = 10.29, p = 0.006) and total SDQ scores (?² = 6.87, p = 0.032), with higher scores in the SUD group compared to healthy controls. Significant differences were also observed in SOBECE total scale scores (?² = 12.80, p = 0.002) and subscales, including assertiveness (?² = 7.16, p = 0.028), problem solving (?² = 6.67, p = 0.036), planning (?² = 7.05, p = 0.029), group interaction and task management (?² = 16.65, p < 0.001), and coping with aggression and impulses (?² = 14.72, p < 0.001). The SUD group scored lower across all SOBECE domains than healthy controls.
CONCLUSIONS: Children of parents with SUD demonstrate greater emotional behavioral difficulties and poorer social skills than healthy controls. Our findings highlight the need for routine mental health screening in children of parents receiving treatment for use disorders. Early intervention strategies such as parenting support, resilience-building, and school-based interventions may improve long-term developmental outcomes. Keywords: Alcohol and Substance Use Disorders, Social Skills, Children, Strengths and Difficulties Questionnaire, Parental Addiction

OP-47 Assessing mentalization via self-report measures in borderline personality disorder: how self-mentalizing impacts other-mentalizing

Osman Demirci, B. Mert Savrun

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BACKGROUND AND AIM:Mentalization, the ability to interpret intentional mental states, is an umbrella term that includes concepts such as theory of mind and emotional awareness. Evaluating the sub-dimensions of mentalization can be challenging. This study aims to comparatively investigate self- and other-mentalizing in patients with borderline personality disorder(BPD) and healthy controls.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Our study included 82 BPD patients and 82 healthy controls matched for age, sex, education level. Mentalization Scale(MentS), Trait Meta-Mood Scale(TMMS), Reading the Mind in the Eyes Test(RMET) were used. Statistical analysis was performed with the SPSS v26. MODEL 16 in the PROCESS macro was used for moderated mediation analysis. Istanbul University–Cerrahpasa Clinical Research Ethics Committee approved this study with decision number 743969, dated 01.08.2023.
RESULTS:Significant relationships were found between MentS-Self and attention to feelings(AF) (p=0.001), clarity of feelings(CF) (p<0.001), and mood repair (p<0.001) subscales of TMMS. In contrast, no significant relationship was found between MentS Other and RMET (p=0.231). CF had a significant positive effect (B=0.689, 95% CI[0.038, 1.340]), whereas AF had a significant negative effect (B=-0.578, 95% CI[-1.118, -0.037]) on MentS-Other. The mediation of AF in the effect of MentS-Self on MentS-Other is partially moderated by MentS-Motivation (B=0.004, 95% CI[0.000-0.009]) in BPD patients.
CONCLUSIONS:Our findings show that RMET and MentS-Other may evaluate different areas of mentalizing regarding others based on behavioral and self-report characteristics, respectively. Self- and other-mentalizing interact with each other by their developmental nature. Also, other-mentalizing may be influenced by self mentalizing due to asses via self-report. Furthermore, the intertwining of self- and other mentalizing in BPD patients may be dissipating when the motivation for mentalizing is high. Keywords: self-mentalizing, other-mentalizing, mentalization, borderline personality disorder

OP-48 Personality functioning, mentalization, and symptomatic recovery in accelerated transcranial magnetic stimulation treatment of major depressive disorder: preliminary findings

Osman Demirci, Ali Tarık AltunçIstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Psychiatry, Sarp YoldaşIstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Psychiatry, Burç Çağrı PoyrazIstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Psychiatry

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BACKGROUND AND AIM:Impairments in personality functioning and mentalization are closely related to depression, yet their treatment response remains understudied. This study investigates changes in these constructs in major depressive disorder patients undergoing accelerated transcranial magnetic stimulation(TMS) treatment.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):23 patients receiving accelerated TMS treatment targeting the dorsomedial prefrontal cortex were evaluated before and after treatment using Hamilton Depression Rating Scale(HAMD), Beck Depression Inventory(BDI), Level of Personality Functioning Scale–Brief Form 2.0(LPFS-BF 2.0), and Mentalization Scale(MentS). Independent samples t-tests, Pearson correlations, and linear mixed models were applied to examine relationships and pre–post changes in depression(HAMD, BDI), personality functioning(LPFS-BF 2.0), and mentalization(MentS). Istanbul University–Cerrahpasa Clinical Research Ethics Committee approved the study with decision number 1210653, dated 23.01.2025.
RESULTS:No significant differences were found in baseline LPFS-BF 2.0(p=0.15) or MentS(p=0.65) scores when participants were grouped by post-treatment HAMD severity(?8 vs <8). Improvement in HAMD was correlated with improvement in LPFS-BF 2.0(r=0.54, p=0.008), whereas improvement in BDI was correlated with improvement in MentS(r=0.67, p<0.001). HAMD and LPFS-BF 2.0 scores showed significant reductions(21.4?9.1, 29.0?23.6, respectively) with a significant time and measure interaction(F(1,22)=21.57, p<0.001) that implies a reduction in HAMD significantly greater than that in LPFS-BF 2.0. BDI score showed a significant reduction(28.7?17.8), whereas MentS score increased modestly(80.1?82.3) without reaching significance, and a significant time and measure interaction was found(F(1,22)=12.92, p=0.002).
CONCLUSIONS:Baseline LPFS-BF 2.0 and MentS scores did not differentiate between remitted and non-remitted patients. While depressive symptoms show a strong response to treatment, improvements in personality functioning and mentalization are more limited. Correlation between improvements in LPFS-BF 2.0 and HAMD scales underscores the interaction between personality dysfunction and depression, while relationship between changes in mentalization and BDI scores may reflect patients’ capacity to recognize their symptomatology as reported in self-assessment measures. Despite the small sample, these preliminary findings offer valuable insights, warranting research in larger populations. Keywords: personality dysfunction, mentalization, major depressive disorder, transcranial magnetic stimulation

OP-49 Digital Ethical Attitudes Among Medical Students: Physicians’ Use of Social Media

Osman Mert Özcan, Sahabettin CETIN, Ahmet Furkan Kandemir, Furkan Bolat

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BACKGROUND-AIM: Digital technologies and social media in healthcare increase ethical challenges in patient confidentiality, data security, and professionalism and expose medical students to dilemmas early in training. These challenges are particularly salient in psychiatric practice, where therapeutic relationships rely heavily on trust, confidentiality, and clearly defined professional boundaries. This study aimed to evaluate medical students’ attitudes toward digital medical ethics scenarios and online privacy awareness, and to examine associations with clinical training level, social media use, and exposure to digital patient data.
METHODS: Cross-sectional study of 153 medical students. Measures: sociodemographic questionnaire; five researcher-developed digital medical ethics scenarios addressing patient confidentiality and professional boundaries, rated on a five-point Likert scale (Cronbach’s ?=0.795–0.890); and the Online Privacy Awareness Scale. Ethical approval was obtained on January 13, 2026 (Approval No: E-60116787 020-811447).
RESULTS: In S2 (communication with patients via social media), clinical students demonstrated stricter ethical attitudes (p=0.013). In patient image (S1) and patient clinician dialogue (S3) scenarios, students with higher social media use exhibited more flexible attitudes (p=0.003 and p=0.006). Students preferring surgical specialties showed more flexible attitudes in S3 (p=0.042). Regression analyses indicated that stricter attitudes in S1 were associated with social media use duration (?=?0.259, p=0.001) and exposure to digital patient data (?=?0.160, p=0.049), whereas stricter attitudes in S2 were associated with the communication subdimension of online privacy awareness (?=0.480, p<0.001).CONCLUSION: Digital medical ethics attitudes are associated with clinical training level, social media use, and digital exposure. Given the central role of confidentiality and professional boundaries in psychiatric practice, digital environments may increase vulnerability to ethical risk. These findings support the integration of structured, case based digital ethics education into medical curricula to safeguard therapeutic relationships in mental health care. Clear institutional policies and consistent role modeling may further enhance ethical sensitivity and professional responsibility in digital contexts Keywords: Digital medical ethics, Online privacy awareness, Social media

OP-50 Anxiety And Aggression Levels In Patients With Bipolar Disorder With And Without Criminal Involvement

Ejder Karabulut, Şüheda KAYA, Gülay Taşçı

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BACKGROUND AND AIM:This study aims to identify factors associated with anxiety and aggression levels in patients diagnosed with bipolar disorder with and without a history of criminal involvement
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):Patients with a history of criminal involvement were bipolar disorder patients hospitalized in the High-Security Forensic Psychiatry Unit of our hospital. Patients without criminal involvement were recruited from those receiving inpatient treatment in the general psychiatry ward and/or attending psychiatry outpatient clinic. All participants completed sociodemographic data form, the Beck Anxiety Inventory, and the Buss–Perry Aggression Questionnaire. Study was approved by the Non Interventional Ethics Committee of Elazığ Fethi Sekin City Hospital (Approval No: 2025/13-6; Date: 24 July 2025).
RESULTS:A total of 111 patients (93 males, 18 females) were included: 60 with and 51 without criminal involvement. No statistically significant differences were found between the groups in age, sex, marital status, place of residence, educational level, history of suicide attempts, tobacco and alcohol use. Both groups showed mild anxiety levels, with no significant difference. Similarly, no significant differences were observed in the BPAQ subscales of physical aggression, hostility, anger, or verbal aggression (p = 0.386, p = 0.541, p = 0.780, p = 0.205). In the criminally involved group, Beck Anxiety scores showed moderate positive correlations with physical aggression, hostility, anger, verbal aggression, and total aggression scores (r=0.366, r=0.428, r=0.340, r=0.343, r=0.413). In non-criminally involved group, moderate positive correlations were found between Beck Anxiety, Buss-Perry hostility and anger subscales (r=0.318, r=0.311).
CONCLUSIONS:No significant differences were identified between patients with and without criminal involvement in terms of anxiety and aggression levels. However, significant differences were observed in certain sociodemographic factors, such as occupation and substance use. Positive correlations between anxiety and aggression were present in both groups, indicating a complex and multifactorial relationship. Further large-scale and longitudinal studies are needed to better clarify these associations. Keywords: aggression,anxiety,Bipolar disorder,crime

OP-51 The Relationship Between Refusal of Antenatal Screening Test and Mother Fetus Attachment

Ali Görkem Gençer, Sertaç Zengil, Nurcan Yörük

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BACKGROUND AND AIM Mothers experience prenatal attachment by viewing the fetus as a distinct entity, resulting in meaningful emotional attachment. Antenatal screening test (AST) decisions shaped not only by emotional attachment but also by cognitive assessments, risk perception, socioeconomic status, and health literacy (1). We studied the relation between double/triple test (DTT) and oral glucose tolerance test (OGTT) uptake willingness and prenatal attachment, depression, and anxiety.
METHODS Under ethical approval 2023/05-52, 112 pregnant women recommended for AST (mean age 28.32±5.99; mean gestational age 19.85±7.98) joined this study. Participants were administered Prenatal Attachment Inventory (PAI), Beck Depression Scale (BDS), Beck Anxiety Scale (BAS).
RESULTS 57.1% of participants wanted to take the DTT, 33.9% wanted to take the OGTT. No significant correlations occurred between DTT/OGTT willingness and PAI, BDS, or BAS scores (p>0.05). PAI correlates weakly and negatively with BDS (r=-0.215; p=0.023). PAI weakly correlates with gestational age (r=0.216, p=0.022) and stillbirth rate (r=0.229, p=0.015). BDS scores correlate with duration of marriage (r=0.287, p=0.002), pregnancies (r=0.307, p=0.001), and child count (r=0.305, p=0.001).Willingness for DTT was higher among university graduates (p=0.022). Sociodemographics didn't correlate with OGTT testing willingness. Higher family incomes (p=0.022) and university-educated spouses (p=0.015) predicted superior PAI scores. BAS scores were higher in those with extended families (p=0.016), those with poor relationships with their spouse's family (p=0.005), and those without knowledge of infant care (p=0.029).
CONCLUSIONS The findings show that willingness to undergo AST is independent of the prenatal attachment level. This suggests that the decision to undergo testing may be related to cognitive and sociodemographic factors rather than emotional attachment (2,3). The negative relationship between prenatal bonding and depression supports the idea that depressive symptoms during pregnancy may weaken the bonding process, which is consistent with studies (4,5). Keywords: Prenatal attachment, depression, anxiety

OP-52 Evaluation of ChatGPT, Gemini, Microsoft Copilot, and Deep Seek's performance in the psychiatry official board exams

Fatma Sevil Gökhan, Esra Kabadayi Sahin

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BACKGROUND AND AIM:Large language models(LLMs) using deep learning have advanced significantly in processing language.Potential applications of LLMs in medicine include research, education, and practice, especially as decision aids.The aim of this study was to investigate and compare the performance of LLMs and psychiatrists on board exam questions in various psychiatry association.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):175 multiple-choice board questions were collected from websites of the Turkish Psychiatric Association, American Board of Psychiatry and Neurology, European Psychiatric Association and Royal College of Psychiatrists.Ethics committee approval was waived, as it used only publicly available online questions and did not involve human participants.Questions were input into LLMs with input prompt as follows:“As a highly experienced professor of psychiatry, you assist in psychiatry questions. Your role is determine the correct answer”.Two psychiatrists also answered the questions without knowing the answers of LLMs.Results were analyzed using descriptive statistics and chi square test.
RESULTS:ChatGPT had an accuracy rate of 79.4%, Gemini 82.3%, Copilot 85.1% and DeepSeek 85.7%. Psychiatrists with 5 and 12 years of experience have accuracy rate of 88.6% and 90.1%.Only one of the 8 questions that no LLMs could solve was answered incorrectly by both psychiatrists.Of the 8 questions answered incorrectly by both psychiatrists, 7 were answered incorrectly by all LLMs.Only one of the questions was answered correctly by neither psychiatrists nor LLMs.No statistically significant difference was observed comparing the accuracy for Turkish and English questions(p>0.05).There was no statistically significant difference in performance of the large language models in accuracy assessment according to whether questions contained cases or not(p>0.05).
CONCLUSIONS:LLMs performed very close to psychiatrists both short and case questions in different languages. It has also shown in literature LLMs perform close to physicians in multiple-choice-exams of medical fields. However, their performance in image and open-ended questions have shown varying. Future research is needed to demonstrate their potential impact on patients. Keywords: Large Language Models, Board Exam, Artificial Intelligence, Deep Learning

OP-53 Cognition, Digital Engagement, and Functioning in Emerging Adults with Depression: Evidence for a Depression-Mediated Pathway

Hasan Bakay, Ziya Öksüz

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BACKGROUND AND AIM:Emerging adulthood is a critical developmental period characterized by heightened emotional sensitivity and intensive digital engagement. Although social media use (SMU) has been linked to psychological distress, its role in shaping cognitive and functional outcomes in clinical populations remains unclear. This study examined the relationships among SMU, cognitive failures, depressive symptoms, and real-life functioning in emerging adults with major depressive disorder (MDD), focusing on mediating mechanisms
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):This cross-sectional study included 56 patients with DSM-5–diagnosed MDD and 56 age- and sex-matched healthy controls (aged 18–35 years). SMU duration was obtained from smartphone application usage logs. Participants completed the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Cognitive Failures Questionnaire (CFQ), Social Media Use Integration Scale (SMUIS), and the Functioning Assessment Short Test (FAST). Ethical approval was obtained from the Necmettin Erbakan University Ethics Committee (IRB:2025/6069).
RESULTS:Compared with controls, patients showed higher BDI (22.6±12.8 vs. 10.4±6.7, p

BACKGROUND AND AIM:According to the Regulation on the Implementation of the Law on Private Security Services, candidates applying for armed or unarmed private security positions are required to obtain a medical board report, including a psychiatric evalua

Esra NadaroğluKarabük Training and Research Hospital, Zuhal Koç Apaydın

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BACKGROUND AND AIM:According to the Regulation on the Implementation of the Law on Private Security Services, candidates applying for armed or unarmed private security positions are required to obtain a medical board report, including a psychiatric evaluation, stating that they are fit to work as private security officers. Psychiatric assessment is essential to ensure individual suitability and public safety. This study aimed to describe the sociodemographic and clinical characteristics of applicants, compare approved and rejected outcomes, and identify factors associated with negative medical board decisions.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):This retrospective study included 133 individuals who applied to Karabük Training and Research Hospital between October 1 and December 31, 2025, for a private security officer certificate. Data were obtained from the hospital information system. Ethical approval was granted by the Karabük University Non-Interventional Clinical Research Ethics Committee (Application No: 2026/2707).
RESULTS:The median age of applicants was 23 years (range: 18–45), and 53.4% were female. Most were high school (54.1%) or university (43.6%) graduates, and 83.5% were single. More than half (55.6%) were employed. A psychiatric disorder within the previous two years was identified in 4.5% of cases. Alcohol use was reported by 1.5%, and a history of judicial or administrative incidents by 3.0%, with no history of substance use or suicide attempts. The Hacettepe Personality Inventory was valid in 99.2% of evaluations. Overall, 92.5% of applications were approved and 7.5% were rejected. Male gender was significantly associated with a negative outcome (OR = 5.11; 95% CI: 1.04 25.06; p = 0.045), and a recent psychiatric history was a strong predictor of rejection (p < 0.001).
CONCLUSIONS:Male gender and recent psychiatric illness were significantly associated with negative medical board decisions, highlighting the importance of systematic psychiatric evaluation and assessment of recent psychiatric history in private security officer applications. Keywords: Private security, medical board, sociodemographic characteristics, Hacettepe Personality Inventory

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.