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The chronotype, which reflects the circadian rhythm preferences of individuals in their daily activities and sleep-wake cycles, can be considered on a dimension of extreme morningism and extreme eveningism. Individuals with extreme morning and extreme evening chronotypes face many physical and psychological dangers due to accumulated sleep debt, short total sleep time and insufficient sleep efficiency. In extreme chronotypes, especially in extreme evening people, the social jet-lag effect due to the mismatch between social and circadian clocks is thought to exacerbate these dangers. More recent studies have suggested that social jet-lag and chronotype have many negative effects on cognitive functioning. The aim of this article is to review the impact of social jet-lag and chronotype on cognitive functioning.

In this paper, functional confusion defined as clinical condition which is the patient can not focus on a certain issue, reply the questions and explain his/her story during psychiatric interview is focused. It is hypothesized that functional confusion seem most prevelant in patients with borderline personality disorder and somatic symptom and related disorders. Relationship between inability of mentalization, dissociation, cognitive disturbances and functional confusion seen in patients with borderline personality disorder is emphasized. Similarities are explained between alexitimia and can not expression of emotional complaints in the patients with somatic symptoms and related disorders. Relationship between somatoform dissociation and confusion has been discussed. In the article, also it has been argued that childhood traumatic experiences might play a role on vulnerability to functional confusion. Functional confusion may contribute to emergence of clinical conditions and severity of illness in adulthood period. Patients with functional confusion should be treated with psychotropic medications including low dose antipsychotic drugs rather than psychotherapeutic interventions.

The definition of reality is that the presence of which can not be denied, what is right, reflects nature as it is, and is not a product of thought. Rationality as a concept, is the quality or state of being rational or of making decisions purely based on thought and reason. In this article, it is emphasized that drawing the patient to the axis of reality and rationality may be an option in the psychotherapy process. In fact, all kind of psychotherapy apply this method using different techniques. As discussed here, reality and rationality as aim and method in psychotherapy focuses on immediate pragmatic intervention similar to holistic psychotherapy.

The rational choice approach has become more prevalent in many disciplines in recent years. The rational choice theory of neurosis maintains that patients consciously and deliberately adopt neurotic disorders when confronted with intolerable levels of stress. Despite the striking differences, rational choice theory of neurosis continues Freud's framework of thinking as it employs a new concept of repression. According to this new theory, all therapies exert their effect either by disrupting patients’ ability to preserve unawareness, increasing the cost of the symptom, decreasing the patient’s emotional distress, or eliminating the stressor. Repression is defined as a conscious coping mechanism by which the individual deliberately employs distractive measures to eliminate stress-related thoughts from attention in this theory. This article aims to review the definition of rational choice theory and its integrative therapeutic approach in psychiatry.

With the growing prevalence of shift work all over the the world, the relationship between the daily lives of irregular lifestyles and rhythms is being investigated for those working as shift workers and their families. The effect of shift work on physical and mental health is a very important field of research in recent years. The onset and persistence of medical complications in shift workers includes impaired synchronization between work schedule rhythms and circadian clock. In this context, studies have been carried out showing the increased risk of sleep-wake disorders, gastrointestinal problems, and cardiovascular diseases. There is little information about the actual frequency, effect on health and treatment of shift work disorder, known as circadian rhythm sleep disorder. Shift work disorder includes insomnia and/or excessive sleepiness related with the work schedule. The aim of this rewiev, mentioning about the physical and mental effects of shift work, and to provide information about the diagnosis, clinic and treatment methods of shift-work disorder.

Bright light treatment is a treatment modality that leads elevation of mood due to attenuation in depressive symptoms, regulation in circadian rhythm activity, increase the effect of antidepressants and amelioration in sleep quality. Bright light treatment is considered among the first-line treatments for seasonal affective disorder because of high response rates. Additionally, bright light treatment being extended to other conditions, including non-seasonal mood disorders, Alzheimer's disease, circadian rhythm sleep disorders, eating disorders, attention deficit hyperactivity disorder and other behavioral syndromes is likely to have a far reached use. Side effects are often temporary and can generally be overcome by reducing exposure time. The central focus on this paper is to review the action mechanisms, efficacy, usage areas, the ways of administration and side effects of the light treatment. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(2.000): 177-188]

Glutamate is the major excitatory neurotransmitter in the brain. It has a role several cognitive functions including learning, memory and perception. Glutamatergic neurotransmission is also involved in regulating neuronal migration, synaptogenesis, and the pruning neurons. Glutamatergic exci-totoxicity has been implicated in various neuropsychiatric disorders. Accumulating evidence suggests that glutamatergic dysfunction may contribute to the pathogenesis of schizophrenia. The N-methyl-D-aspartic acid (NMDA) receptor antagonists such as phencyclidine and ketamine can cause both the positive and negative symptoms psychotic symptoms in normal humans, and worsen these symptoms in persons with schizophrenia. Hence, it has been hypotesized that schizophrenia may be associated with decreased NMDA-receptor activity. According to the hypothesis, NMDA reseptor hypofunction can lead to decreased inhibition of glutamatergic neurons and excessive glutamate release. Finally, the reduction of gray matter in several brain regions seen in patients with schizophrenia has been suggested to be the result of neurotoxicity mediated by NMDA receptors. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(4.000): 394-405]

Narcolepsy is a lifelong sleep disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucination, and sleep paralysis. The exact cause remains unknown, but there is significant evidence that hypocretin deficiency plays an integral role. There have been advances in the understanding of the pathogenesis of narcolepsy. It has a negative effect on the quality of life and can restrict the patients from certain careers and activities. Diagnosis relies on patient history and objective data gathered from polysomnography and multiple sleep latency testing. Treatment focuses on symptom relief through medication, education, and behavioral modification. Both classic pharmacological treatments as well as newer options have significant problems, especially because of side effects and abuse potential. Some novel modalities are being examined to expand options for treatment. In this review, the pathophysiological, clinical, and pharmacotherapeutic aspects of narcolepsy are discussed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(3.000): 271-283]

Personality is the integration of characteristics acquired or brought by birth which separate the individual from others. Personality involves aspects of the individual's mental, emotional, social, and physical features in continuum. Several theories were suggested to explain developmental processes of personality. Each theory concentrates on one feature of human development as the focal point, then integrates with other areas of development in general. Most theories assume that childhood, especially up to 5-6 years, has essential influence on development of personality. The interaction between genetic and environmental factors reveals a unique personality along growth and developmental process. It could be said that individual who does not have any conflict between his/her basic needs and society's, has well-developed and psychologically healthy personality.