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Impulsivity, aggression, and suicide are the major clinical symptoms of borderline personality disorder (BPD). Although previous studies indicated poor sleep quality and its relationship with clinical symptoms in patients with BPD, chronotype, an important sleep parameter, was not investigated in these patients. This study aimed to analyze chronotype and its relationship with clinical symptoms in patients with BPD. Participants in this study consisted of 68 BPD patients and 65 healthy controls. Subjective sleep characteristics, impulsivity, aggression, suicide probability, and chronotype were assessed using the Pittsburgh Sleep Quality Index (PSQI), Barratt Impulsivity Scale, Buss-Perry Aggression Scale (BPAQ), Suicide Probability Scale, and Morningness – Eveningness Questionnaire, respectively. PSQI total and subscale scores subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, and daytime drowsiness were significantly higher in the BPD group (p < 0.001). There was a positive correlation between the PSQI total score and the BPAQ total score (r = 0.268, p = 0.027). The rate of evening type was significantly higher in the control group (p = 0.004). Suicide attempts and the subscale of suicide probability hopelessness, suicidal ideation, and negative self-evaluation scores were significantly higher in evening type BPD patients. (p = 0.017, p = 0.009, p = 0.001, p = 0.047). Sleep quality is associated with aggression, and the eveningness chronotype is associated with suicide. It may be useful to focus on sleep problems in treating BPD patients. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Parkinson's disease (PD) increases patient load and requirements of care. Determining the burden on PD patients' caregivers and associated factors may help to identify methods to reduce caregiver burden. This study investigated the factors associated with caregiver burden among PD patients caregivers.Eighty‐five PD patients and 85 caregivers were included in the study. Zarit Burden Interview (ZBI) was used to measure caregiver burden; the Ways of Coping Scale (WCS) was used for coping; Modified Hoehn‐Yahr Staging (MHYS) was used for staging patients. The International Parkinson and Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) parts 1 and 3 were used to evaluate non‐motor and motor problems. Caregivers' depression and anxiety levels were evaluated with the Beck Depression Inventory and Beck Anxiety Inventory (BAI). Spearmen correlation coefficient was used to evaluate the relationship of variables with the ZBI score, and multiple linear regression analysis was used to determine the predictors of the ZBI score.A positive significant relationship was found between the ZBI score and BAI score, MHYS score, WCS total score, and subscales: keeping to self, seeking refuge in fate, and seeking refuge in supernatural forces. MHYS score, WCS total score, BAI score, and MDS‐UPDRS‐1 were predictors of the ZBI score.The anxiety levels of caregivers, their ways of coping, and the patient's stage of the disease are important in caregiver burden. Coping ways can be changed to reduce the care burden. Developing psychological interventions for caregivers to change their coping styles can be important. [ABSTRACT FROM AUTHOR]

Objective: There are a few studies on the relationship between personality and temperament types and functionality and pain felt in patients with knee osteoarthritis (OA). This study aimed to determine the relationship between personality and temperament characteristics and pain and function in patients with knee OA. Methods: The study included 126 patients diagnosed with knee OA who met the inclusion criteria. Eysenck Personality Questionnaire Revised-Short Form (EPQR-S) and Type D Personality Scale (DS-14) were used for personality assessment, Temperament Evaluation of Memphis, Pisa, and San Diego Auto-questionnaire (TEMPS-A) was employed for temperament assessment, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used for OA pain and general function assessment. Results: Of the participants, 58 (46%) showed Type D personality traits, while depressive temperament was dominant in 18 (14.3%) participants, irritable temperament in 12 (9.5%), and anxious temperament in 16 (17.3%) participants. Those with Type D personality had worse functions, and Type D personality was positively associated with pain and total WOMAC score. Total WOMAC score showed a positive correlation with neuroticism and psychoticism personality traits and cyclothymic and nervous temperament traits. Conclusion: This study demonstrates that pain and total WOMAC score are associated with personality and temperament characteristics in patients with knee OA. In addition to pharmacological and physical therapy, interventions in these areas may be beneficial. [ABSTRACT FROM AUTHOR]

Objectives: Epilepsy, a neurological disorder affecting approximately 65 million people worldwide, frequently presents with various comorbidities, including cognitive impairment. The factors contributing to cognitive impairment are complex and multifaceted. This study aimed to investigate the influence of social phobia on cognitive function in patients with idiopathic generalized tonic-clonic epilepsy. Methods: This prospective study recruited 87 adult idiopathic generalized tonic-clonic epilepsy patients diagnosed according to the International League Against Epilepsy 2017 classification. Differential diagnosis involved electroencephalography, magnetic resonance imaging, and neurological examinations. All participants were assessed for cognitive impairment, social phobia, depression, and anxiety using the Montreal Cognitive Assessment, Liebowitz Social Anxiety Scale, Beck Depression Inventory, and Beck Anxiety Inventory, respectively. Results: A significant majority (73.6%) of participants reported social phobia. Compared to those without social phobia, the Montreal Cognitive Assessment total score was significantly lower in the social phobia group (P=0.002). Additionally, epilepsy duration was significantly longer in the social phobia group (P=0.03). Montreal Cognitive Assessment scores showed a negative correlation with Liebowitz Social Anxiety Scale-avoidance, Liebowitz Social Anxiety Scale-total, and age (P=0.003, P=0.005, and P<0.001, respectively). Conclusion: This study suggests that individuals with idiopathic generalized tonic-clonic epilepsy experiencing social phobia may exhibit lower cognitive function compared to those without. This indicates that comorbid social phobia might negatively impact cognitive abilities in idiopathic generalized tonic-clonic epilepsy patients. [ABSTRACT FROM AUTHOR]

Objective: The primary occurrence and persistence of negative symptoms observed in patients with schizophrenia is deficit syndrome. Although the association between thyroid hormones and schizophrenia symptoms has been reported, no studies have investigated thyroid function in patients with deficit schizophrenia (DS). This study aims to investigate the clinical features and thyroid function in DS patients by comparing them with patients with non-deficit schizophrenia (NDS) and a control group. Method: 33 subjects from DS, 35 subjects from NDS and 35 healthy control subjects were included in the study. Patients with schizophrenia were classified into DS and NDS using the deficit syndrome table. Thyroid function was assessed by the levels of TSH, free T3 (fT3), and free T4 (fT4). Sociodemographic data and clinical characteristics were evaluated using the Sociodemographic Data Form, the Positive Symptoms Evaluation Scale (SAPS), the Negative Symptoms Evaluation Scale (SANS), and the Calgary Depression in Schizophrenia Scale (CDSS). Results: There was no significant difference between DS and NDS groups in terms of age, gender, marital status and education (p>0.05). The percentage of unemployed was significantly higher in the DS group than in the NDS group (p=0.005). There were 14 (42.4%) suicide attempts in the DS group and 11 (31.4%) in the NDS group, and there was no significant difference between the groups (p>0.05). There was no significant difference between the groups when comparing the thyroid functions of the DS, NDS and healthy control groups regarding fT4, fT3 and TSH (p>0.05). There was no significant correlation between TSH, free T3, free T4 and total SANS, total SAPS and CDSS scores (p>0.05). Discussion: According to our study thyroid function is not different in DS, NDS and healthy controls and is not associated with positive, negative and depressive symptoms in patients with schizophrenia. [ABSTRACT FROM AUTHOR]

Aim: Bipolar disorder (BD) is one of the chronic psychiatric diseases. It has been reported that cardiovascular diseases are seen twice as often in patients with BD. Fragmented QRS (fQRS) has been found to be associated with myocardial scarring and is used as a marker of arrhythmia and mortality. Ventricular repolarization (VR) is often evaluated using QT interval and T wave measurement data. In our study, we aimed to evaluate fQRS, QTc interval, QT dispersion (QTd), Tp-e interval, Tp-e/QT ratio results and VR, together with blood biochemistry parameter results of cases with BD. Material and Method: Our research was conducted with 51 people diagnosed with bipolar disorder and 52 healthy people as the control group. fQRS, QTc interval, QT dispersion (QTd), Tp-e interval, Tp-e/QT ratio were measured using 12-lead electrocardiography (ECG). The results of the data obtained from ECG and blood biochemistry parameter levels were used to compare the healthy and patient groups. Results: Tp-e interval (p=0.018) and Tpe/QT ratio (p=0.036) were found to be statistically significantly higher and total cholesterol level (p=0.006) lower in patients with bipolar disorder compared to the control group. Conclusion: An increased Tpe/QT ratio, along with a prolonged Tp-e interval, may be a useful marker of ventricular arrhythmia risk in individuals with fQRS BD. [ABSTRACT FROM AUTHOR]

Objective: Type 2 Diabetes Mellitus (DM) is a chronic metabolic disease and a global health problem. Inadequate glycemic control and diabetes self-management can cause many secondary diseases. There are few studies on the association between attention deficit hyperactivity disorder (ADHD) and type 2 DM. Our study compares adult and childhood ADHD symptoms and signs and impulsivity in type 2 DM patients and healthy controls. Method: In this case-control study, data were collected voluntarily. The study was carried out with a total of 200 participants, including 100 people in both the Type 2 diabetes group and the healthy control group. The Barratt Impulsivity Scale version 11 (BIS-11), Adult ADHD Self-Report Scale (ASRS), Wender-Utah Rating Scale (WURS) and demographic information form were applied to the participants and compared between the groups. Results: The mean ASRS attention score, ASRS hyperactivity score, ASRS total score, WURS total score, BIS total score of the type 2 DM group were significantly higher than the control group. Moreover, the probability of ADHD was evaluated using the cut-off scores in the ASRS and WURS scales, and it was detected in significantly more people in the type 2 DM group. Discussion: Our study revealed that attention deficit, hyperactivity, and impulsivity symptoms are more common in type 2 DM patients than controls. Evaluation of these symptoms may be beneficial in the self-management of diabetes and in improving glycemic control. [ABSTRACT FROM AUTHOR]

Objective: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), mean platelet volume (MPV), and systemic immune inflammation index (SII) are recently used as indicators of inflammation. NLR, PLR, MLR, and MPV have been evaluated in many studies in patients with schizophrenia and bipolar disorder. However, there are no studies investigating SII. This study aims to evaluate NLR, PLR, MLR, MPV, and SII values and complete blood count elements in patients hospitalized with diagnoses of the schizophrenia with psychotic episode and bipolar disorder with manic episode by comparing them with the control group. Methods: A total of 149 patients who were hospitalized with diagnoses of the schizophrenia with psychotic episode and bipolar disorder with manic episode and who met the inclusion criteria were included in our study where the control group was composed of 66 healthy individuals. White blood cell (WBC), neutrophil, lymphocyte, platelet, and monocyte counts were obtained retrospectively from complete blood counts at the time of admission, based on which NLR, PLR, MLR, and SII were calculated. Results: In this study, higher NLR, PLR, and SII values and lower MPV and lymphocyte counts were observed in schizophrenia patients compared to the control group. NLR, PLR, and SII values and neutrophil counts were higher in patients with bipolar disorder compared to the control group. Lower MPV values were found in patients with schizophrenia compared to patients with bipolar disorder. Conclusion: Simple inflammatory and SII values in our study indicate the presence of low-grade systemic inflammation in schizophrenia and bipolar disorder. [ABSTRACT FROM AUTHOR]

Disulfiram is a medication that raises blood acetaldehyde levels by inhibiting aldehyde dehydrogenase. It has been reported that taking disulfiram can cause psychosis or mania. There are only a few case reports about mania in the literature. We introduce this case of disulfiram-induced mania without dose adjustment, whereas continuing maintenance alcohol addiction treatment with disulfiram at the prescribed amount in a patient with no psychiatric history. Mr KA, a 57-year old patient with a history of 25 years of alcohol consumption, had stopped drinking 5 months ago and had been taking disulfiram (500 mg/day) for 5 months. During treatment, he was admitted to the outpatient clinic with complaints of decreased need for sleep, increased speech, and psychomotor activity, in particular for 4-5 days. During the psychiatric examination, it was discovered that the rate of speech had increased, that flight of ideas was present, and that the affect was cheerful and nervous. There was an increase in self-esteem and grandiose delusion. The examination revealed psychomotor agitation. The patient was admitted to the hospital for examination, follow-up, and treatment. Mania was observed. Treatment with valproate 1000 mg/day and risperidone 4 mg/day was planned. The patient showed no psychotic or manic symptoms while continuing outpatient clinic controls. Rare complications, such as manic episodes, might occur even in patients receiving the prescribed amount and long-term disulfiram treatment. [ABSTRACT FROM AUTHOR]

Introduction: Vortioxetine is an antidepressant that has a multimadal action mechanism and has recently come into use. The present study was planned to determine whether vortioxetine affects pain threshold in mice. Method: The experimental animals were divided into four groups with 10 mice in each group. The distilled water was given to the control group, 5 mg/kg of vortioxetine was intraperitoneally administered to the first group, 10 mg/kg of vortioxetine was intraperitoneally administered to the second group and 20 mg/kg of vortioxetine was intraperitoneally administered to the third group. Mice were placed on a hot-plate at 30 and 90 minutes. Hind paw licking and jumping times of the mice on the hot plate surface (55°C) were recorded.. Results: With increasing dose (0 mg p>0.05, 5 mg p<0.001, 10 mg p<0.001, 20 mg p<0.001) and increasing time (30th minute p<0.01, 90th minute p<0.01), it was observed that the reaction time per minute, which was a reflection of pain treshold was decreased. Conclusion: The results of this study shows that vortioxetine may have a decreasing effect on pain threshold in mice. Further studies are needed to determine the mechanism by which vortioxetine exerts its hyperalgesic effect. [ABSTRACT FROM AUTHOR]

Frontotemporal dementia (FTD) is one of the most prevalent forms of early-onset dementia cases and a kind of primary degenerative dementia. Assessment of criminal responsibility is one of the most important issues for forensic psychiatry due to the help of justice. A 55-year-old male who allegedly committed an offense of threat and libel to a doctor was referred to the psychiatric clinic at our hospital by the prosecution office for the evaluation of his criminal responsibility. Seventeen years ago, he suffered severe head trauma. After this trauma, his mental and behavioral problems began to develop. It was realized that his ability to think abstractly, reasoning, and reality testing are impaired. Brain magnetic resonance imaging revealed atrophy characterized by sulcal widening and brain parencymal volume loss, which are more prominent in the bilateral frontal and temporal lobes. Additionally, disinhibited behaviors in his medical history such as verbal violence and suddenly leaving the house were noticed. A diagnosis of frontotemporal dementia was made. We understood the onset of symptoms of our case began when he was 40-year-old from the medical records. With this aspect, our case has a remarkably young age of initiation of symptoms. The purpose of this case report is to draw physicians’ attention to the medical symptoms and medicolegal consequences of a patient with early-onset FTD. [ABSTRACT FROM AUTHOR]

A diagnosis of paradoxical insomnia is made in patients presenting with the complaint of insomnia despite normal polysomnographic findings. These patients argue that they never sleep or have little sleep only for a few hours. Pharmacological and non-pharmacological treatment options are available for the treatment of paradoxical insomnia. Although its prevalence can be as high as 50% in the clinical samples and studies, clinicians may not remember to include paradoxical insomnia in the differential diagnosis. In this article, we present a patient, who was diagnosed with paradoxical insomnia for the first time in our polysomnography laboratory. The patient had accompanying sleep apnea and responded to the treatment with olanzapine and psychoeducation, comprising polysomnographic video recordings and instructions of sleep hygiene. Because this is the first case presentation from our country, characterized by the abovementioned clinical features; we think that this article may increase clinician awareness and contribute to the information in the literature. [ABSTRACT FROM AUTHOR]

Background: The relationship between depression and severity of social media addiction is likely to be bidirectional. Nevertheless, current studies have addressed the depression score utilizing a scale in the general population instead of assessing this relationship in patients with major depressive disorder. Despite the fact that the negative relationship of social media addiction with emotional intelligence is acknowledged, the existence of this relationship in major depressive disorder has not been investigated yet. Hence, the objective of our study is to evaluate severity of social media addiction and emotional intelligence in major depressive disorder., Methods: This research was performed with 158 participants between the ages of 18 and 56 in Kars Harakani State Hospital Psychiatry Outpatient Clinic. Sociodemographic data form involving the age, gender, marital status, education level and employment status of the participants, Beck Depression Inventory, Bar-On Emotional Quotient Inventory, and Social Media Addiction Scale were implemented to the participants., Results: Creating the group to be none-less addicted and medium-highly addicted with regard to the social media addiction scale score, it was observed that the emotional intelligence of the medium-highly addicted group was significantly lower, and the depression score was higher ( P < .001). Furthermore, the severity of social media addiction had a positive relationship with the depression score and a negative relationship with the emotional intelligence score ( r  = 0.353, P < .001; r  = -0.376, P < .001)., Conclusion: Emotional intelligence in major depressive disorder is associated with both depression level and severity of social media addiction. Interventions, i.e., emotional intelligence skill training, might be practical for the aforementioned patients., Competing Interests: Declaration of Interests: The authors have no conflicts of interest to declare., (2024 authors.)

Background: Although an association has been newly reported between obsessive-compulsive disorder (OCD) and an increased risk of suicide, there are only a limited number of studies investigating suicide-related factors in OCD patients. The aim of this study is to evaluate the relationship between dysfunctional metacognitive activity, difficulty in emotion regulation, anxiety, depression, somatization symptom severity, and suicide probability in OCD patients by comparing them with a control group., Methods: Difficulties in Emotion Regulation Scale, Metacognition Scale, Suicide Probability Scale, and Patient Health Questionnaire Somatic, Anxiety, and Depression Symptom Scale were administered to 70 OCD patients and 70 healthy controls. The Dimensional Obsession Compulsion Scale was administered to assess OCD symptom dimensions among OCD patients., Results: Dysfunctional metacognition, difficulty in emotion regulation, probability of suicide, depression, anxiety, and somatization symptoms were significantly higher in OCD patients compared to the control group ( P < .05). Suicide probability was found to be positively correlated with depression, difficulty in emotion regulation, impulsivity dimension, metacognition, cognitive confidence dimension, contamination, cleaning, and symmetry scores among OCD symptom dimensions ( P < .05)., Conclusion: Recognizing the factors that were found to be associated with suicide probability in individuals with OCD may be of great importance in identifying patients at higher suicide risk., Competing Interests: Declaration of Interests: The authors have no conflict of interest to declare., (2024 authors.)

Purpose: To identify the factors associated with the pain level in patients receiving intravitreal injection., Methods: A total of 120 patients were prospectively evaluated, and 104 were included in the study. Patients were asked to rate their pain intensity from 0 to 10 on the visual analog scale. Factors that were possibly associated with pain level were evaluated using a sociodemographic data form, state anxiety inventory, and the hospital anxiety and depression scale., Results: Of the participants, 54 (51.9%) were female, and 50 (48.1%) were male, with a mean age of 65 ± 9.01 years. There was a positive correlation between pain level and state anxiety scores ( r = 0.30; P < 0.001) and a negative correlation between hospital anxiety score ( r = -0.23; P = 0.02) and hospital depression score ( r = -0.27; P = 0.01). The correlation between pain score and education level was significantly higher in primary and secondary school graduates ( P < 0.01). Smokers were observed to have higher pain scores (6.50 ± 2.21 in smokers and 4.87 ± 2.50 in nonsmokers; P = 0.01). Among diagnostic groups, pain scores were found to be significantly lower in the diabetic retinopathy (DR) group (6.82 ± 1.99 in age-related macular degeneration, 5.94 ± 2.27 in retinal vein occlusion, and 3.58 ± 1.97 in DR; P < 0.001). When pain scores were evaluated according to the drug injected, the group receiving bevacizumab injection was observed to have higher pain scores (7.32 ± 1.81 in bevacizumab, 4.00 ± 2.08 in aflibercept, and 3.92 ± 1.96 in ranibizumab; P < 0.001). Based on the multiple regression analysis, the state anxiety score, hospital anxiety score, hospital depression score, and smoking status were observed not to be significant predictors. The level of education, diagnosis, and active substance were found to have a statistically significant effect on pain perception., Conclusion: In this study, pain levels have been found to be high in smokers, those with a low educational level, individuals receiving bevacizumab for intravitreal injection, and those having a higher level of state anxiety, whereas patients with DR have lower pain scores., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Current Ophthalmology.)