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ObjectiveThe main objective of the present study is to examine the relationship between perceived social support and the quality of sleep and to determine the predictors of sleep quality in a sample of patients undergoing hemodialysis (HD) in Somalia.MethodsA sample of 200 patients with end-stage renal disease (ESRD) who were undergoing hemodialysis treatment approximately two to three times a week were included. All participants were administered a sociodemographic data form, the Multidimensional Scale of Perceived Social Support (MSPSS), the Insomnia Severity Index (ISI), and the Pittsburgh Sleep Quality Index (PSQI). Patients undergoing HD for less than 3 months prior to the study date were excluded.ResultsOf the patients undergoing hemodialysis, 200 patients aged between 18 and 68 years (mean = 52.29; SD = 14.13) gave consent and participated in the study. Sixty-three subjects (31.5%) reported poor sleep quality, defined as having a total PSQI score > 5. Forty-one subjects (20.5%) reported clinically significant (moderate-to-severe) insomnia. The majority of our patients undergoing HD reported remarkably high family support, but low friends and significant other support. Poor sleep quality significantly correlated with perceived friends’ support and perceived total social support. While perceived family support significantly correlated with both family income and the duration of chronic kidney disease (CKD), perceived friends’ support significantly correlated with age and family income. Hierarchical regression analyses showed that perceived family support and friends’ support were significant predictors of poor sleep quality. Perceived friends’ support was a significant predictor of insomnia severity. Perceived family support was a significant predictor of subjective sleep quality and sleep duration. Perceived friends’ support was a significant predictor of subjective sleep quality, sleep duration, sleep latency, sleep disturbance, and daytime dysfunction. Family income was a significant predictor of sleep duration. Age and gender were significant predictors of sleep efficiency. The duration of CKD and duration of HD were significant predictors of sleep disturbance.ConclusionThis present study has highlighted the value of family as a principal support system in Somalian culture. Understanding the impact of perceived social support on the quality of sleep in patients undergoing HD will help healthcare providers and social services to focus on and improve the social support systems of the patients as an integral part of their treatment.

Objective In this study, we aimed to examine the validity, reliability, and factor structure of the TCI-R in a Turkish sample. Methods Participants were 1026 (786 female, 240 male) college students at Hasan Kalyoncu University in Turkey. The study protocol was approved by the local Ethics Committee. Sociodemographic information of the participants was collected and the TCI-R, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Personality Belief Questionnaire (PBQ) were administered. All statistical analyses were performed by using SPSS version 24 for Windows. Results The internal consistency was satisfactory for all dimensions (Cronbach alpha coefficients above 0.7). The highest Cronbach alpha was found for Persistence Dimension (0.92) and the lowest Cronbach alpha was found for Novelty Seeking Dimension (0.73) and test-retest correlation coefficients for all dimensions were relatively high and statistically significant. TCI-R temperament and character scales were found significantly correlated with the BDI, the BAI, and the PBQ total scores. A principal-components analysis with Promax rotation yielded four factors with an Eigenvalue greater than one, representing 62.67% of the total variance for temperament dimension. A principal-components analysis with Promax rotation yielded three factors with an Eigenvalue greater than one, representing 56.14% of the total variance for character dimension. The addition of four new subscales to the original scale for Persistence has produced a very reliable dimension in the TCI-R with the loadings ranging from 0.82 to 0.86. Conclusions Our findings suggested that Turkish TCI-R was a valid and reliable tool with a robust factorial structure for further use in the assessing of personality psychopathology in clinical populations in Turkey.

I said to my soul, be still, and wait without hope For hope would be hope for the wrong thing; wait without love For love would be love of the wrong thing; there is yet faith But the faith and the ...

Simplicity is the ultimate form of sophistication. – Leonardo da VinciMost psychiatric disorders including major depressive disorder (MDD), anxiety disorders, bipolar disorder, obsessive-compulsive...

OBJECTIVES: Empathy is an essential ability that allows us to tune into how others are feeling or thinking. Empathy makes it possible to resonate with others' positive and negative feelings alike so that we can thus feel happy when we vicariously share the joy of others and we can share the experience of suffering when we empathize with someone in pain. Empathy training not only promotes prosocial behaviour, but also augments positive affect and resilience, which in turn fosters better coping with stressful situations. The Empathy Quotient (EQ) is a self-report questionnaire that was developed to measure the cognitive, affective, and behavioural aspects of empathy. Here, we aimed to examine the validity, reliability, and factor structure of the EQ in a Turkish sample. METHODS: Participants were 436 mostly college students and civil servants (195 female, 241 male). Sociodemographic information, the Turkish version of the EQ, Marlowe-Crowne Social Desirability Scale (MC-SDS) 33-item full version and MC-SDS 13-item shorter versions were administered. All statistical analyses were performed by using SPSS version 23 for Windows. RESULT: EQ scores were significantly higher in female participants ((X) over bar (Female)=46.45, SDFemale=0.62) compared to the male participants ((X) over bar (Male)=43.68, SD (Male)=0.56). The Cronbach's alpha coefficient for the scale was 0.76, Guttman's split-half reliability coefficient was 0.61, and test-retest reliability coefficient was 0.95. A positive and statistically significant correlation was found between the Turkish EQ and MC-SDS Full version (r=0.299, p

OBJECTIVE: The objective of the current study is to establish the psychometric properties and factorial validity of the Turkish version of the Luebeck Questionnaire for Recording Preoperational Thinking (LQPT) in a Turkish sample. METHODS: The study was conducted in Istanbul Metropolitan area and comprised of healthy controls (n = 33) and patients with psychiatric diagnoses (n = 60). Socio-demographic data of the participants were collected and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Dysfunctional Attitude Scale (DAS-A), and the LQPT were administered. RESULTS: The mean age of the study participants was 30.51 +/- 8.75; 64.5% (n = 60) of the participants were female; 35.5% (n = 33) were male. The LQPT scores were non-normally distributed. The Cronbach's alpha for the LQPT scale was found 0.887 and the split-half reliability coefficient was 0.902. The inter-item correlation was ranging from 0.189 to 0.705. A negative and statistically significant correlation was found between the Turkish LQPT and the DAS-A and its subscales. The principal-components analysis with Promax rotated solution yielded two factors which accounted for 46.43% of the total variance. CONCLUSIONS: Our results suggested that Turkish LQPT was a valid and reliable instrument with a robust factorial structure for tapping the cognitive components associated with the development of depression in clinical psychiatric populations in Turkey.

Impulsivity is a key feature of numerous psychiatric disorders. This paper reviews the recent evidences on the impulsivity in elderly, relationship between impulsivity and borderline personality disorder (BPD) with attention-deficit/hyperactivity disorder (ADHD), impulsivity with anxiety and mood disorders, and the psychopharmacological approaches to impulsivity evaluating previously published studies. A literature review of the theoretical bases of the relationship between psychiatric disorders and impulsivity is presented. Measurements of impulsivity and neurobiological hypothesis are defined. Treatment approaches are discussed. Previous researches have shown significantly higher levels of impulsivity among patients with BPD, ADHD, anxiety, and mood disorders. In addition, older adults could be more impulsive than younger adults. But the nature of this relationship remains unclear. This is probably due to the fact that there is much overlap between them. Impulsivity is a risk for suicidality and influences pathogenesis, course, clinical severity of many psychiatric disorders. Pharmacological interventions for treating impulsivity should be incorporated into treatment plans for these disorders. Identifying the role of pharmacological interventions in modulating the development of trait impulsivity may prevent progression to psychiatric disorders and associated adverse consequences.

Major depressive disorder (MDD) is a highly prevalent psychiatric disorder and is reported as one of the most leading cause of disabilities and markedly contributes to a significant global burden o...

In this article, we have reviewed neuroimaging studies on the neural circuitry associated with suicidal behaviour in order to identify the neural substrates of suicidal behaviour. The Medline and ScienceDirect databases were comprehensively and systematically searched and articles published from 1990 through 2017 were reviewed. Reviewed brain-imaging modalities included structural magnetic resonance imaging, diffusion tensor imaging, positron-emission tomography, single-photon emission computed tomography, resting-state functional Imaging, and functional magnetic resonance imaging. Although subject characteristics and imaging methods vary across studies, convergent findings involving the structure and function of frontostriatal network and fronto-limbic structures, and the serotonergic system were identified. These neuroimaging studies of suicide behaviour have provided crucial information on the neural circuitry associated with suicide risk. Future studies examining neural changes associated with before and after pharmacologic and behavioural interventions would be instrumental in suicide risk reduction.

Objective: Although most burnout research has focused on environmental job-related correlates, it is possible that personality factors also play an important role in the development of burnout. The aim of present study is to examine the relationship between personality and burnout in healthcare workers by using Cloninger's psychobiological model and Maslach's three-dimensional burnout model in a healthcare worker sample in Turkey. Methods: Our samples consisted of 66 male, 14 female and totally 80 healthcare organization workers. Sociodemographic form for all the participants was completed during the interviews. The Maslach Burnout Inventory and Turkish TCI were completed by the participants. Multiple hierarchical regression analyses that determine best predictor of independent variables were performed to examine the association between the independent and dependent variables. Results: The hierarchical regression analysis has indicated that Self-Directedness was a significant predictor of depersonalization (beta = -.347, R-2 = .233, F = 1.878, p = .013) and Self-Transcendence and Self-Directedness were significant predictors of Personal Accomplishment (beta = -.317, R-2 = .176, F = 1.319, p = .029; beta = -.328, R-2 = .176, F = 1.319, p = .022; respectively), and Empathy and Self-Forgetfulness subscales were significant predictors of Personal Accomplishment (beta = -.426, R-2 = .106, F = 1.323, p = .013; beta = -.400, R-2 = .106, F = 1.323, p = .030; respectively). Conclusions: Our findings have shown that Self-Directedness, Empathy subscale of Cooperativeness and Self-Transcendence with its Self-Forgetfulness subscale were significant predictors of personal accomplishment dimension of burnout. Our results suggested a strong association between temperament and character dimensions of personality and burnout in healthcare workers.

BACKGROUND: Comorbid mood disorders affect the prognosis of obsessive-compulsive disorder (OCD) negatively. Affective temperaments are assumed to be subsyndromal symptoms and precursors of mood disorders, but its effects on OCD outcome still remain unclear. There is a body of evidence, which supports the association between circadian rhythm disturbances and mood disorders in the literature. In contrast, there is limited data concerning the effects of chronobiological differences among the patients with OCD and OCD comorbid mood disorders. The main objective of this present study was to examine the clinical effects of affective temperaments and chronotype differences in patients with OCD. METHODS: The study participants were 76 patients with OCD, who have been under treatment at least for 12 weeks, and 55 healthy controls. The participants were administered the Yale-Brown Obsessive Compulsive Scale, Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-questionnaire, Morningness and Eveningness Questionnaire, Hamilton Depression Rating Scale, and Hamilton Anxiety Scale. RESULTS: OCD patients scored higher in depressive, cyclothymic, irritable, and anxious temperament scores compared to the healthy controls. There were significant differences between patients with remission and not remission in depressive, cyclothymic, irritable, and anxious temperaments. Eveningness chronotype was more frequent in OCD patients; however, the difference was not statistically significant. CONCLUSIONS: Understanding the effects of affective temperaments and chronotype differences on the outcome of patients with OCD might provide valuable insights in developing new treatment approaches especially in treatment-resistant OCD cases.

OBJECTIVE: The Weight Self-Stigma Questionnaire (WSSQ) is a comprehensive instrument for the assessment of weight self-stigma in obesity and has been validated in several languages. The purpose of this study was to examine the psychometric properties and validate the Turkish version of the WSSQ in a sample of severely obese patients in Turkey. METHODS: A cross-cultural adaptation of the WSSQ into Turkish was carried out, strictly according to recommended methods. The questionnaires including the Sociodemographic data form, the WSSQ, Beck Depression Inventory, Beck Anxiety Inventory, Eating Disorder Examination-Questionnaire, Rosenberg Self-esteem Scale, Dutch Eating Behavior Questionnaire Emotional Eating Subscale, and Impact of Weight on Quality of Life Questionnaire were completed by 120 consecutive severely obese patients (96 female, 24 male) in the outpatient clinics of the Department of Bariatric and Metabolic Surgery in a university setting in Turkey. All statistical analyses were performed by using SPSS version 23 for Windows. RESULTS: The Cronbach's a (internal reliability) for the two subscales of the WSSQ-self-devaluation and fear of enacted stigma, and for the whole questionnaire (WSSQ Total) were 0.74, 0.81, and 0.83, respectively. The self-devaluation subscale, the enacted stigma subscale and the total WSSQ have a good internal consistency. Construct validity also appeared adequate as the WSSQ correlates with other measures largely in the manner we expected. Principal component factor analyses revealed a two-factor structure with an almost identical factor structure to that reported in the original study. Kaiser-Meyer-Olkin Measure of Sampling Adequacy was found to be 0.81 and Barlett's test of Sphericity chi(2) was found as 457.068 (p

Objective: Borderline Personality Disorder is a psychiatric condition, which is characterized by unstable interpersonal relationships, fear of abandonment, difficulties in regulating emotions, feeling of emptiness, chronic dysphoria and depression, and impulsivity and increased risk-taking behaviors. In this study, we aimed to translate and establish psychometric properties and factorial validity of the Borderline Evaluation of Severity over Time (BEST) in a representative Turkish university students sample and obtain normative data for future epidemiological and clinical studies in Turkey. Methods: Participants were 306 (201 females, 105 males) college students at the Hasan Kalyoncu University in Gaziantep, Turkey. The study protocol was approved by the Ethics Committee of Hasan Kalyoncu University. Sociodemographic information of the participants was collected and Turkish version of the BEST, the Turkish version of the Borderline Personality Questionnaire (BPQ), Beck Depression Inventory (BDI), Personality Belief Questionnaire (PBQ), and State–Trait Anxiety scales were administered. All statistical analysis were performed by using SPSS version 23 for Windows. Results: The Cronbach’s alpha coefficients for the Thoughts and Feelings, Negative Behaviors and Positive Behaviors subscales were 0.80, 0.65, and 0.67, respectively. For the whole scale, Cronbach’s alpha coefficient was 0.75. The test–retest correlation coefficients for Thoughts and Feelings, Negative Behaviors and Positive Behaviors were 0.61, 0.50, and 0.51, respectively. A positive and statistically significant correlation was found between the Turkish BEST and BPQ (r = 0.337, p

Objective: In this study, we aimed to evaluate a sample of suicide attempters regarding temperament and character dimension scores and compare them with psychiatrically healthy individuals considering the influence of demographic risk factors. Methods: This study enrolled consecutive 50 patients (39 women, 11 men) with a mean age of 24.12 (SD ± 8.83) years who were admitted to the Emergency Department of Bezmialem Vakif University hospital for a recent self – or not self-reported suicide attempt. The control group consisted of age – and gendermatched 50 healthy subjects (34 women, 11 men) who had not a documented axis I psychiatric disorder or a previous suicide attempt with a mean age of 26.46 (SD ± 5.6). A semi-structured sociodemographic and clinical data form, Structured Clinical Interview for DSM-IV axis I disorders (SCID-I), and the Turkish version of Temperament and Character Inventory (Turkish-TCI) were administered to all participants. Following screening of all variables for the accuracy of data entry, missing values, and homoscedasticity, statistical analyses were performed by using SPSS version 23 for Windows. Results: A statistically significant difference was found between the patients and psychiatrically healthy controls mean values in terms of Impulsiveness and Disorderliness subscales of Novelty Seeking; Harm Avoidance and its all subscales, Sentimentality subscale of Reward Dependence; Self-Transcendence and its subscales of Self-Forgetfulness, Transpersonal Identification and Spiritual Acceptance scores were significantly higher in patients with suicide attempt compared to the control group. Patient group also exhibited significantly lower mean values of Self-Directedness, Persistence, and Cooperativeness scales compared to the psychiatrically healthy controls. Conclusions: In conclusion, our results suggested that patients with a history of suicide attempts have abnormal TCI profiles linked to higher harm avoidance, novelty seeking and self-transcendence scores and lower self-directedness and cooperativeness scores compared to psychiatrically healthy controls. Since personality traits play an important role in the prediction of suicidality, clinicians should be aware of personality–psychopathology relations for assessment and developing treatment strategies of the patients with suicide attempt.

In this case report, we present two patients who developed serious dermatological adverse reactions following vortioxetine use. Dermatological signs and symptoms disappeared following discontinuation of vortioxetine. These two cases can be useful in routine clinical practice to recall the parameters that need to be systematically addressed in cases of suspected adverse drug reactions with vortioxetine use in depressed patients.

Objective: Mumford and colleagues developed the Bradford Somatic Inventory (BSI) that examines the somatic symptoms of anxiety and depression, which has transcultural applications. The objective of the current study was to establish the psychometric properties and factorial validity of the Turkish version of the BSI-44 in a healthy Turkish population and obtain normative data. Methods: The study was conducted at the Marmara University School of Medicine with a sample of 201 healthy students (18-30 years old). In order to estimate the test-retest reliability of the Turkish BSI, 53 participants from the original sample were asked to fill in the questionnaire one month after the initial testing. Socio-demographic data of the participants were collected and the Turkish BSI, Somatosensory Amplification Scale (SSAS), Whiteley Index (WI-7), and somatization subscale of the Symptom Check List (SCL-90-R) scales were administered. All statistical analysis were performed by using SPSS version 23 for Windows. Results: The mean age of the study participants was 22.9 +/- 1.95 years; 57.7% (n = 116) of participants were female; 42.3% (n = 85) were male. BSI scores were normally distributed. The scores of the BSI were categorized as high (> 40), middle (26-40), and low (0-25); no statistically significant differences were found between males and females. The Cronbach's alpha coefficient for the scale was 0.90 and the test-retest correlation coefficient was found to be 0.75. A positive and statistically significant correlation was found between the Turkish BSI and the WI (r = 0.38, p

Although recent research in neuroscience and genetics is providing new insights into the etiology of psychiatric disorders, progress in treatment development has been hindered by reliance on diagnostic categories that are based primarily on presenting signs and symptoms. The NIMH Research Domain Criteria (RDoC) framework seeks to provide a neuroscience-based nosological background for future research on psychopathology, categorizing individuals for research purposes using a dimensional approach that benefit from significant progress in modern neuroscience. These scientific advances combined with new approaches to classification can inform the development of novel, circuit-based interventions and the personalization of treatments available. In this editorial, we describe the RDoC framework compared with Diagnostic and Statistical Manual/International Classification of Disease systems and highlight some of the emerging progress in RDoC-based research that is consistent with these developments.

Objective: Junior Temperament and Character Inventory (J-TCI) was developed by Luby, Svrakic, McCallum, Przybeck, and Cloninger based on Cloninger's biopsychosocial model to assess temperament and character dimensions in children and adolescents. Methods: The Turkish version of J-TCI-Revised (J-TCI-R) was administered to 1129 elementary and middle-school (male/female, 546/583) students. Internal consistency reliabilities were measured by Cronbach's alpha; test-retest was assessed across one month. Results: Cronbach's alphas for the subscales of J-TCI-R ranged from 0.60 to 0.75 for temperament and character subscales, which were comparable to US and other populations. The correlations between baseline and one month after administration of J-TCI-R were highly and statistically significant (r = 0.578-0.674 for scales and 0.366-0.582 for subscales) (n = 795). Factor analysis results using Eigenvalue greater than one rule indicated three out of four factors for temperament scales and one out of two factors for character subscales which were similar to findings from the other countries. When all of the subscales were subjected to factor analysis, four out of six factors were retained. To our knowledge, this is the first study analysing psychometric properties and factorial construct of the J-TCI-R. Conclusions: The internal reliability coefficients and test-retest indicated a good stability of scores over time and the factorial structure was consistent with Cloninger's model of personality. The reliability and validity of the Turkish version of the TCI is therefore supported. Publisher's Version

Objective: Long term alcohol use results in varying degrees of deficits in cognitive functions. Although the neocortex, particularly the frontal lobe; limbic system and cerebellum are the brain reg...

WOS: 000390418700002 Objective: Schizophrenia involves white matter abnormalities that might have a central role in the pathophysiology. Abnormal brain connectivity especially in prefrontal and temporal heteromodal cortex has been suggested as the leading structural impairment in patients with schizophrenia. In this study we examined the relationship between potential white matter changes and clinical response, as well as associations with antipsychotic treatment follow-up. Methods: 18 first-episode schizophrenia (FES) patients were recruited from the outpatient unit of the GATA (Gulhane Military Medical Academy) Haydarpasa Research and Training Hospital, between June 2009-February 2010. Fourteen patients with FES were recruited, and 16 healthy control subjects were recruited from the community. Diffusion tensor MRI (DT-MRI) was obtained from participants at baseline and after 4 weeks of standard antipsychotic treatment. A color-coded fractional anisotropy map for each 11 patient was extracted from the 4-week follow-up and the baseline splenium and genu FA measurements. According to Basser and others major eigenvector linear maps were transformed into the color-coded maps. Differences in Positive and Negative Syndrome Scale (PANSS) scores and Brief Psychiatric Rating Scale (BPRS) scores between baseline and follow up were also evaluated. Results: In this study; in the FES patients, both genu FA (p=0.001) and the splenium FA (p=0.013) values were statistically significantly lower than the healthy control group. There were mild FA increases respectively genu and splenium (p=0.533, p=0.318) in the FES patients after the treatment. But the FA changes did not correlate with the changes in clinical symptoms. A negative, moderate, statistically significant correlation (Pearson's r=-0.569, p=0.034) was found between baseline splenium FA values and BPRS scores. The duration of illness prior to treatment was negatively, weak, statistically non-significantly correlated (r=-0.066; p=0.846) between baseline and follow-up splenium FA changes. Conclusions: The reduced mean Callosal FA (CFA) values might indicate myelination defects and problems in axonal transport. The existence of white matter changes even in first episode drug-naive schizophrenia patients supports the view that these problems occurs in earlier stages of development. Although the callosal FA changes did not correlate with symptom improvement or the dose of antipsychotic medication, there was a mild increase in follow-up FA measurements. These findings show that CC which is the main conduit of interhemispheric connection is affected distinctly in patients with schizophrenia. Further collaborative studies are needed to clarify the potential long-term effects of antipsychotics on white matter microstructure and also its reversibility.

Objective: Impulsivity is an important neurobiological process that contributes to individual differences in substance use disorder vulnerability. Uric acid has been mentioned to be telated to some...

Since ancient times, various forms of the plant cannabis sativa have been used and more recently for therapeutic purposes including (but not limited to) antiemetic, anticonvulsant, anti-inflammator...

Postpartum depression (PPD) is a distinct and readily identified major depressive disorder that is one of the most common neurobiological complications of childbirth, which occurs in 13% of women a...

Although a number of medications are available for treatment of depressive disorders, one of the major limitations of all present antidepressants is delayed onset of action [1]. In addition, despit...

OBJECTIVE: In this present study, we aimed to examine the relationship between particular traumatic past experiences and clinical features of post-traumatic stress disorder (PTSD) in an outpatient sample from Turkey. Overt or unknown childhood traumas were also examined as a robust risk factor that might affect the development of PTSD in this population. METHODS: The sample of this study was composed of 100 female patients with a history of traumatic experiences and with a documented psychiatric diagnosis except PTSD who were admitted to Health Sciences University’s Bagcilar Training and Research Hospital Outpatient Clinic. Semi-structured sociodemographic data form, Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Clinician-Administered Posttraumatic Disorder Scale (CAPS) and Childhood Trauma Questionnaire (CTQ-28) were administered. Semi-structured sociodemographic form, were applied to the participants. Following clinical interviews and CAPS application, the patients were divided into two subgroups as patients with or without the diagnosis of current PTSD. Following screening of all variables for the accuracy of data entry, missing values, and homoscedasticity, statistical analyses were performed by using SPSS version 23 for Windows. RESULTS: The CTQ total scores (U = 233.000, z = −6.856, p = 0.000) and also Emotional Abuse (U = 235.000, z = −6.941, p = 0.000), Physical Abuse (U = 185.000, z = −7.424, p = 0.000), Emotional Neglect (U = 244.000, z = −6.851, p = 0.000), Physical Neglect (U = 208.000, z = −7.276, p = 0.000) and Sexual Abuse (U = 266.000, z = −7.554 p = 0.000) subscale scores were significantly higher in the PTSD present group. A statistically significant association was found between CAPS Total scores and Emotional Abuse (r = 0.870, p < 0.01), Physical Abuse (r = 0.879, p < 0.01), Emotional Neglect (r = 0.862, p < 0.01), Physical Neglect (r = 0.884, p < 0.01) and Sexual Abuse (r = 0.886, p < 0.01) subscale scores, and CTQ Total (r = 0.906, p < 0.01) scores. The regression analysis has indicated that CTQ Sexual Abuse scores were significant predictors of CAPS Total scores (p = 0.00) in patients with traumatic experiences when age was controlled. CONCLUSIONS: In addition to the sociodemographic risk factors, traumatic experiences of childhood are important risk factors for PTSD. Man-made traumas such as rape, assault have a higher risk and symptom severity than natural disasters and traffic accidents for PTSD. Our results suggested a strong association between childhood sexual trauma and post-traumatic stress disorder. © 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

OBJECTIVE: This study aims to examine how internalized stigma differs in opioid use disorder (OUD) based on sociodemographic and clinical variables, and to what extent internalized stigma is related to treatment motivation, perceived social support, depression, and anxiety levels. METHODS: One hundred forty-five individuals with OUD included. Sociodemographic and clinical data form, the Internalized Stigma of Mental Illness Scale (ISMI), Treatment Motivation Questionnaire (TMQ), Multidimensional Scale of Perceived Social Support, the Beck Depression Inventory, and the Beck Anxiety Inventory were utilized in the study to collect data. Bivariate and partial correlation coefficients between variables were computed. ISMI and TMQ scores were compared between patients with depressive symptoms and patients without depressive symptoms by using t-test and Mann Whitney U test. RESULTS: Internalized stigma was high among male patients with heroin use disorder. There was a positive correlation between internalized stigma score and treatment motivation, depression, and anxiety levels. On the other hand, there was a negative correlation between internalized stigma score and multidimensional perceived social support. CONCLUSION: Internalized stigma occupies an important place in the treatment of OUD, which occurs with frequent relapses and which is hard to treat. Not only application for treatment but also adherence to treatment and treatment motivation at maintenance phase bestow a complicated relationship with depression and anxiety. In the struggle against internalized stigma, it plays a vital role to mobilize people's social support systems, to educate families on the issue and to get in touch with support units exclusive to heroin users.

Objective: The present study aims to compare ToM traits among healthy controls, patients with OCD, and patients with schizophrenia. Methods: Participants were 38 patients with OCD, 37 patients with a schizophrenia diagnosis, and 38 healthy controls. The study protocol was approved by the Ethics Committee of Marmara University. Sociodemographic information of the participants was collected, and the Fear of Covid-19 Scale, Reading Mind in the Eyes Test (RMET), First Order False Belief (FOFB ) and Second-Order False Belief (SOFB), Hinting Task (HT) and Strange Stories (SS), Brown Assessment of Beliefs Scale (BABS) and the Hamilton Depression Scale (HAM-D) were administered. All statistical analyzes were performed using IBM SPSS Statistics (Statistical Package for the Social Sciences) 24.0 for Windows (SPSS Inc., Chicago, IL, USA). All variables were screened for accuracy of data entry, missing values, and homoscedasticity. Results: A significant impairment in both cognitive and affective ToM tests in OCD patients compared to the healthy controls was found. Furthermore, the present study results revealed that ToM impairment in OCD patients is less severe than ToM impairment in schizophrenia patients. Although a significant deterioration was observed in all ToM evaluations in OCD patients than healthy controls, it was determined that ToM performance in schizophrenia patients was significantly worse than both OCD and healthy controls. Conclusions: This cross-sectional study suggested that OCD and schizophrenia patients have different ToM profiles, mainly evident with lower ToM abilities in OCD patients. Understanding of ToM abilities–psychopathology relationship will have important implications for assessing and developing treatment strategies in patients with OCD and schizophrenia for clinical psychiatrists.

Objective: Cognitive impairments in schizophrenia are associated with different symptom subtypes of schizophrenia. It has been suggested that cognitive functions in the paranoid type of schizophren...

OBJECTIVES: In this present study, we aimed to examine the relationship between impulsivity and attention-deficit/hyperactivity symptoms in female patients with borderline personality disorder (BPD) and compare these symptoms with a healthy group. METHODS: The sample of this study was composed of randomly selected 90 female patients diagnosed with BPD according to Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (DSM-5) criteria and not receiving any medical treatment during the past six months since presented to the Bagcilar Training and Research Hospital and randomly selected 90 healthy controls who were free of any psychiatric disorders. Semi-structured sociodemographic data form, Adult ADHD Self-Report Scale (ASRS-v1.1), and Barratt Impulsiveness Scale (BIS-11) were administered. RESULTS: Total BIS scores were statistically significantly correlated with total ASRS (r = .557, p

Objective: Previous studies reported that there were significant associations between Attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD). In this study, we aimed to examine complex relationship between childhood trauma, impulsivity, dissociative symptoms, and the impact of ADHD on this relationship in a sample of patients with BPD. Methods: Our samples consisted of 165 BPD patients (128 female, 37 male) and 165 healthy subjects (128 female, 37 male) of similar age and gender. We administered the semi-structured socio-demographic data form, Adult Self-Report Scale, Barratt Impulsivity Scale (BIS-11), Childhood Trauma Questionnaire, and Dissociation Questionnaire. Results: The BPD group exhibited greater ADHD symptoms, impulsivity, childhood trauma, and dissociation compared to the healthy group. A statistically significant association was found between adult ADHD symptoms and impulsivity, childhood trauma, and dissociation scores. The logistic regression analysis indicated that gender, attentional and motor impulsiveness were the predictors of ADHD in BPD patients. Among these, gender and emotional neglect were the predictors of dissociation in BPD patients. Conclusion: Our results suggested a strong association between impulsivity, childhood trauma, dissociation, and ADHD symptoms in patients with BPD. The findings are mostly consistent with the literature. Clinicians should be aware of these symptoms among these populations to develop treatment strategies.

To the Editor,Early recognition of adverse drug reactions is crucial in the medication management of psychiatric disorders. Several diagnostic assessment tools have been proposed to evaluate and ma...

Novelty seeking among relapsed and non-relapsed male alcohol dependents during 12 month follow-up Objective: Aim of this study was to investigate the changes in novelty seeking and its subscales during 12 month follow-up among alcohol dependents. Methods: Participants were 102 consecutively admitted male alcohol dependents, who were available for a second evaluation at the end of 12 months. Patients were investigated with the Novelty Seeking (NS) dimension of the Temperament and Character Inventory (TCI). Results: Among alcohol dependent inpatients 61.8% (n=63) were considered to be relapsed. Sociodemographic variables did not differ between relapse and remission groups. Mean scores of NS and subscales did not differ between groups at the baseline evaluation, whereas they were higher in relapsed group at one year follow-up (other than Exploratory excitability-NS1- subscale). In the remission group, mean scores of NS and subscales decreased at one year follow-up (other than NS1 subscale), whereas in the relapsed group, mean scores of Impulsiveness (NS2) subscale and NS increased during follow-up period. Conclusion: Among alcohol dependent men, temperament dimension NS and subscales, which are suggested to be genetically determined, decreases during abstinence, whereas increases with relapse to alcohol use. Only exception is the NS1, which suggest that it might be the main trait NS subscale related with the occurrence of alcohol dependence, whereas other three subscales, particularly NS2 seems to

4 OZET: ‹lac tedavisi almayan major depresif bozukluklu ergenlerde plasma noropeptid Y duzeyleri Amac: Neuropeptide Y (NPY), anksiyete ve depresyon pa- tofizyolojisinde onemli bir maddedir. NPY'nin emosyonel duzenlemeyi surdurmesi icin kortikotropin sal›n›m›n› sa¤- layan faktor (CRF) taraf›ndan arac›l›k edilen stres etkilerini giderdii ileri surulmufltur. Bu cal›flmada ilk kez depresyon tan›s› alan ergenlerde NPY duzeyleri, hastalar›n intihar giri- flimi oykuleri gozununde bulundurularak araflt›r›lm›flt›r. Yontem: Major depresif bozukluk (MDB) tan›l› 33 ergen ca- l›flmaya al›nd›. 11 hasta, baflka bir psikiyatrik hastal›¤›n var- l›¤› nedeniyle cal›flma d›fl›nda tutuldu. MDB tan›l› 22 ergen- de, NPY'nin plazma konsantrasyonlar› olculdu. Beck Dep- resyon Envanteri-Turkce uyarlamas› ve Beck Anksiyete En- vanteri-Turkce uyarlamas›, depresyon ve anksiyete duzey- lerini olcmek icin kullan›ld›. Bulgular: Depresyonlu ergenlerde sal›kl› kontrollere oranla anlaml› derecede dufluk NPY duzeyleri bulundu. Hastalar intihar giriflimi oykulerine gore s›n›fland›r›ld›¤›nda her iki grup aras›nda NPY duzeyleri ac›s›ndan anlaml› bir fark bulunmad›. NPY duzeyleri, hastal›¤›n suresiyle ve suc- luluk duygular› ile negatif yonde, anksiyeteyle pozitif yon- de korelasyon gosterdi. Aksiyete, bir efldeiflken olarak al›nd›¤› zaman, NPY ile sucluluk duygular› aras›ndaki kore- lasyonlar kayboluyor, hastal›¤›n suresi bir efldeiflken ola- rak al›nd›¤›nda aradaki korelasyon anlaml›l›¤›n› koruyordu. Tart›flma: Ergen depresif hastalar sal›kl› kontrollere oran- la daha dufluk NPY plazma duzeylerine sahipti. Plazma NPY duzeyleri, hastal›¤›n suresiyle azal›yor, sucluluk duygusu ve anksiyetenin fliddetiyle art›yordu. NPY'nin, ergenlerde go- rulen MDB'de anksiyete ile ilgili depresyona bir eilim icin belirleyici olduu ileri surulebilir. ABSTRACT: Plasma neuropeptide Y levels in medication naive adolescents with major depressive disorder Objective: Neuropeptide Y (NPY) has been implicated in pathophysiology of anxiety and depression. It was proposed that NPY counteracts corticotropin-releasing factor-mediated stress effects to maintain emotional regulation. We investigated NPY concentrations in a sample of first episode medication-naive adolescent patients with MDD with regards to their history of suicide attempts. Method: 33 adolescents with MDD were enrolled. 11 patients were excluded due to comorbidity of another psychiatric illness. In 22 adolescents with MDD patients, the plasma concentrations of NPY were assessed. The Beck Depression Inventory-Turkish Version and the Beck Anxiety Scale- Turkish Version were used to rate the severity of depressive and anxiety symptoms. Results: Our sample of depressed patients showed lower levels of NPY compared to healthy controlsWhen the depressed patients were grouped with regards to suicidality, both groups did not show any significant differences. NPY levels were negatively correlated with duration of illness and feelings of guilt, and positively correlated with anxiety. When anxiety was taken as a covariate, significant correlations between NPY levels and feelings of guilt disappered; whereas, when duration of illness was taken as a covariate correlations were still significant. Conclusions: Adolescent depressed patients were found to have lower NPY plasma levels compared to healthy controls. Plasma NPY concentrations were decreasing with duration of illness, increasing with feelings of guilt and anxiety severity. Plasma NPY levels in adolescents MDD might indicate a predisposition to anxiety-related depression.

Alexithymia is thought to be a stable personality trait and a predisposing risk factor for depression. In this study, we aimed to identify the prevalence of alexithymia in a depressed and nondepressed sample and examined the relationship between Cloninger's psychobiological model of personality with alexithymia. The Turkish version of the 20-item Toronto Alexithymia Scale (TAS-20), the Turkish version of the Temperament and Character Inventory, and the 21-item Beck Depression Inventory (BDI) were administered to 81 depressed patients and 51 controls. The mean age of the groups was 30.5 +/- 7.7 and 32.75 +/- 8.73, respectively. Depression severity was evaluated with the BDI. In the depressed group, 33.3% were alexithymic, and alexithymic subjects had significantly higher BDI scores. Depressed individuals were significantly more alexithymic than the controls on the total and all the 3 subscales of TAS-20. The TAS-20 total score was negatively correlated with the temperament dimension of Reward Dependence (RD) and the character dimension of Self-Directedness (SD). In the TAS-20 subscale, difficulties in identifying feelings was positively correlated with Self-Transcendence and negatively correlated with SD. The difficulties in expressing feelings subscale was negatively correlated with RD and SD. In the depressed patient group, the temperament dimension of RD was significantly lower in the alexithymic group. The rate of alexithymia is found high among this sample of Turkish depressed patients, and the results suggested a strong connection between alexithymia and depression. Alexithymia is explained by specific dimensions and subscale within Cloninger's psychobiological model of personality in this sample of depressed Turkish patients.

Cloninger's dimensional psychobiological model of personality accounts for both normal and abnormal variation in 2 major personality components: temperament and character. Here, we examined the psychometric properties of the Turkish version of the Temperament and Character Inventory (TCI) in a healthy Turkish population, obtaining normative data for the Turkish TCI. The study was conducted in healthy volunteers at both Karadeniz Technical University School of Medicine and Atatürk University School of Medicine (n = 683). The Turkish sample had significantly lower mean scores on Novelty Seeking and Reward Dependence and higher mean scores on Harm Avoidance than the American sample. The Turkish sample had significantly lower scores on Self-Directedness, Cooperativeness, and Self-Transcendence. Self-Directedness and Harm Avoidance, Cooperativeness and Reward Dependence, and Cooperativeness and Self-Directedness were intercorrelated. The Cronbach coeficients were between 0.60 and 0.85 on temperament dimensions, and between 0.82 and 0.83 on character dimensions. The lowest Cronbach coefficients were found in Reward Dependence (0.60) and Persistence (0.62). A principal axis factor analysis with a 4-factor solution revealed the highest loadings on Novelty Seeking and Harm Avoidance and relatively weaker loadings on Reward Dependence and Persistence. A 3-factor solution for character subscales indicated the highest loadings on Cooperativeness and Self-Transcendence. The factorial structure was consistent with Cloninger's 7-factor model of personality, and test-retest indicated a good stability of scores over time. The reliability and factorial validity of the Turkish version of the TCI are therefore supported.

Aims: Alexithymia, a personality trait characterized as having problems identifying, describing, and working with one's own feelings, often marked by a lack of understanding of the feelings of others, is only partly described within the context of personality. The aim of the present study was therefore to study the prevalence of alexithymia among male alcohol-dependent inpatients and investigate the relationship between alexithymia and the dimensions of Cloninger's psychobiological model of personality. Methods: The Turkish version of the Toronto Alexithymia Scale (TAS-20) and the Turkish version of the Temperament and Character Inventory (TCI) were administered to 111 male alcohol-dependent inpatients. Results: TAS-20 scores correlated positively with harm avoidance and self-transcendence and negatively with self-directedness and cooperativeness. Regression analysis identified high harm avoidance and self-transcendence and low self-directedness as independent predictors of alexithymia. Also harm avoidance and self-transcendence predicted alexithymia in a logistic regression model. Conclusions: Alexithymia can be explained by specific dimensions within Cloninger's psychobiological model of personality in alcohol-dependent Turkish men.

Dopamine D1 receptors play an important role in memory and cognition in non-human primates. Dopamine D1 agonists have been shown to reverse performance deficits in both aged non-human primates and in primates with lesions to dopamine systems. This study explored whether a single dose of the first full D1 agonist dihydrexidine (DAR-0100) would cause changes in brain activity (perfusion) in dopamine-rich brain regions. We used a new gadolinium-contrast magnetic resonance perfusion scanning technique to measure brain activity. A within-subject cross-over double-blind randomized design was used in 20 adults with SCID-diagnosed schizophrenia. Each morning at 0800 h, they were scanned on a 3.0 T MRI scanner for perfusion. They then received either 20 mg of dihydrexidine, or placebo, subcutaneously over 15 min. Over the next 45 min, they had intermittent MRI scans. Two days later, they had a repeat of the Day 1 schedule, but received the opposite treatment from that given on the first day. Within-day, as well as between-day, comparisons were made to test for perfusion effects of dihydrexidine. Analysis revealed that dihydrexidine induced a significant increase in both prefrontal and non-prefrontal perfusion compared to placebo. The greatest increases occurred approximately 20 min after dihydrexidine infusion, consistent with the short pharmacokinetic half-life of dihydrexidine. These data are consistent with the hypothesis formulated from studies of non-human primates that dihydrexidine and other D1 agonists may be able to modulate prefrontal dopaminergic function.

Vagus nerve stimulation (VNS) therapy has shown antidepressant effects in open acute and long-term studies of treatment-resistant major depression. Mechanisms of action are not fully understood, although clinical data suggest slower onset therapeutic benefit than conventional psychotropic interventions. We set out to map brain systems activated by VNS and to identify serial brain functional correlates of antidepressant treatment and symptomatic response. Nine adults, satisfying DSM-IV criteria for unipolar or bipolar disorder, severe depressed type, were implanted with adjunctive VNS therapy (MRI-compatible technique) and enrolled in a 3-month, double-blind, placebo-controlled, serial-interleaved VNS/functional MRI (fMRI) study and open 20-month follow-up. A multiple regression mixed model with blood oxygenation level dependent (BOLD) signal as the dependent variable revealed that over time, VNS therapy was associated with ventro-medial prefrontal cortex deactivation. Controlling for other variables, acute VNS produced greater right insula activation among the participants with a greater degree of depression. These results suggest that similar to other antidepressant treatments, BOLD deactivation in the ventro-medial prefrontal cortex correlates with the antidepressant response to VNS therapy. The increased acute VNS insula effects among actively depressed participants may also account for the lower dosing observed in VNS clinical trials of depression compared with epilepsy. Future interleaved VNS/fMRI studies to confirm these findings and further clarify the regional neurobiological effects of VNS.

Background The amygdala is repeatedly implicated as a critical component of the neurocircuitry regulating emotional valence. Studies have frequently reported reduced amygdala volumes in children and adolescents with bipolar disorder (BD). Brain derived neurotrophic factor (BDNF) and nerve growth factor (NGF) play critical roles in growth, differentiation, maintenance, and synaptic plasticity of neuronal systems in adolescent brain development. The aim of the present study was to assess amygdala volumesand its correlation with serum levels of NGF and BDNF in euthymic adolescents with BD and healthy controls. Methods Using structural MRI, we compared the amygdala volumes of 30 euthymic subjects with BD with 23 healthy control subjects aged between 13 and 19 years during a naturalistic clinical follow-up. The boundaries of the amygdala were outlined manually. Serum BDNF and NGF levels were measured using sandwich-ELISA and compared between the study groups. Results The right or left amygdala volume did not differ between the study groups.The right and left amygdala volumes were highly correlated with levels of BDNF in the combined BD group and the valproate-treated group.Both R and L amygdala volumes were correlated with BDNF levels in healthy controls. The left amygdala volumes were correlated with BDNF levels in the lithium-treated group. Limitations This cross-sectional study cannot inform longitudinal changes in brain structure. Further studies with larger sample sizes are needed to improve reliability. Conclusions The correlations between amygdala volumes and BDNF levels might be an early neuromarker for diagnosis and/or treatment response in adolescents with BD.

Objective: Alexithymia have the similar negative consequences for mental health in adolescence as in adulthood. However, there is no alexithymia scale for clinical and research purposes in Turkish adolescents. This study aims to evaluate the psychometric properties of the Turkish version of 20-Item Toronto Alexithymia Scale (Turkish TAS-20) in a Turkish adolescent sample. Methods: Turkish TAS-20 was administered to 948 adolescents aged between 12 to 17 years (439 male and 509 female). The participants were grouped as total sample (12-17 years old), younger (12-14 years old) and older (15-17 years old) adolescents. Cronbach’s α coefficients, mean inter-item correlations, intercorrelations of factors, confirmatory factor analysis, and measures of goodness-of-fit were determined. Results: The Cronbach’s α coefficients were 0.78 for the total scale, 0.80, 0.68, 0.40 for the factor 1, factor 2, and factor 3, respectively. The Cronbach’s α coefficient for full scale was favorable for total group. The Cronbach’s α coefficient for factor 3 was reasonable in older (0.55 for 15-17 years old), however, it was low in younger adolescents (0.20 for 12-14 years old). All criteria of goodness-of-fit met the standards for adequacy-of-fit for all age groups. The mean inter-item correlation coefficients for the total sample, 12-14 year old group, and 15-17 year old group were 0.15, 0.11, and 0.21, respectively and were in the acceptable range of 0.10 to 0.50. Conclusion: The psychometric properties of Turkish TAS-20 for adolescents were comparable with the results of the reliability and validity study of Turkish TAS-20 in Turkish adults. However, caution should be taken when interpreting the results, because factor 3 appears to have weak psychometric properties. Considering factor 3, we suggest that the Turkish TAS-20 best fits for adolescents who are older than 14 years old.

Objective: Psychosocial factors have been implicated as being important in the onset and/or exacerbation of asthma. This study was performed to evaluate the personality profiles of asthma patients. Method: Ninety-five asthmatic, 98 psoriatic patients, and 96 healthy controls completed the Temperament and Character Inventory (TCI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). The relationships between asthma illness duration, asthma severity score, depression, anxiety, and temperament and character personality variables were evaluated. Results: Asthmatic patients had significantly higher mean scores on the BAI, Harm Avoidance, Persistence, and Self-transcendence dimensions and lower scores on the BDI, Novelty Seeking, and Reward Dependence dimensions of the TCI than the psoriatic patients. Significant group effect was found for the BDI and BAI scores in between groups. Significant differences in TCI scores were found across groups except for Persistence and Self-transcendence. Post hoc tests revealed significantly lower Novelty Seeking, higher Harm Avoidance, lower Reward Dependence, and higher Self-transcendence scores in patients with asthma. Regression analysis revealed a significant effect between duration of illness and Persistence and Self-transcendence. Illness severity had a significant effect on the Harm Avoidance. Anxiety scores had significant effect on the Harm Avoidance, Self-directedness, and Self-transcendence. Depression scores had no significant effect on any of the TCI dimensions. Conclusions: Asthmatic patients can be distinguished by a specific pattern of temperament (low NS) and character (high ST) dimensions and compared with both psoriatic patients and healthy controls. Illness duration is associated with ST scores, and illness severity is associated with HA.

The ability to learn, store, and retrieve information about relationships is impaired in schizophrenia. Here, we tested 38 control and 61 schizophrenia subjects for their ability to identify the novel pairing of stimuli, based on associations learned during training. Subjects were trained on 3 sets of paired associates: 30 face-house pairs (H-F1), 30 face-house pairs (H-F2, same house with new face), and 30 face-face pairs (F3-F4). After training, participants were tested on the 3 explicitly trained pair types, as well as 30 new face-face pairs (F1-F2), which could only be linked together via the same house during the H-F1/H-F2 training blocks. Of 99 subjects tested, 37 patients with schizophrenia and 36 age-matched healthy control subjects learned the premise pairs and performed the relational memory test. Healthy control subjects were significantly more accurate in identifying the inferential (F1-F2) pairs than the noninferential (F3-F4) pairs. In contrast, schizophrenia patients were equally accurate on inferential and noninferential pairs, providing evidence for a relational memory deficit in schizophrenia. However, the current version of the associative inference paradigm, suggested by the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia initiative, has limited feasibility, calling into question the generalizability of the findings for the larger schizophrenia population.

This study examined whether a single session of repetitive transcranial magnetic stimulation (rTMS) of the left prefrontal cortex would inhibit food cravings in healthy women who endorsed frequent food cravings. Ten participants viewed images of food and completed ratings for food cravings before and after receiving either real or sham rTMS over the left prefrontal cortex (10Hz, 100% rMT, 10 seconds-on, 20 seconds-off for 15 minutes; 3000 pulses). Sham TMS was matched with real TMS with respect to perceived painfulness of the stimulation. Each participant received both real and sham rTMS in random order and were blind to the condition in a within-subject cross-over design. With an improved sham control condition, prefrontal rTMS inhibited food cravings no better than sham rTMS. The mild pain from the real and sham rTMS may distract or inhibit food craving, and the decreased craving may not be caused by the effect of rTMS itself. Further studies are needed to elucidate whether rTMS has any true effects on food craving and whether painful stimuli inhibit food or other cravings. A sham condition which matches the painfulness is important to understand the true effects of TMS on behaviors and diseases.

Background: Oxytocin is a stress-attenuating and pro-social neuropeptide. To date, no study has looked at the effects of oxytocin in modulating brain activity in depressed individuals nor attempted to correlate this activity with attribution of mental activity in others. Method: We enrolled 10 unmedicated depressed adults and 10 matched healthy controls in a crossover, double blind placebo controlled fmri 40 i.u. intra-nasal oxytocin study (20 i.u. per nostril). Each subject performed Reading the Mind in the Eyes task (RMET) before and after inhalation of oxytocin or placebo control for a total of 80 scans. Results: Before oxytocin administration, RMET engaged medial and lateral prefrontal cortex, amygdala, insula and associative areas. Depressed subjects showed increased anterior ventral activation for the RMET minus gender identification contrast whereas matched controls showed increased dorsal and frontal activity. Compared to placebo, oxytocin in depressed subjects showed increased activity in the superior middle frontal gyrus and insula, while controls exhibited more activity in ventral regions. Oxytocin also led to inverse effects in reaction times on attribution task between groups, with controls getting faster and depressed individuals slower to respond. Conclusion: Depression is associated with increased paralimbic activity during emotional mental attribution of others, appearing to be distinctly modulated by oxytocin when compared to healthy controls. Further studies are needed to explore long-term exposure to pro-social neuropeptides on mood in depressed populations and assess their clinical relevance.

Objectives As part of a sham controlled treatment trial using daily left repetitive transcranial magnetic stimulation (rTMS), brain changes associated with 4 to 6 weeks of treatment were examined using diffusion tensor imaging to noninvasively evaluate prefrontal white matter (WM) microstructure. A decrease in fractional anisotropy values of the left prefrontal WM could indicate damage to the region. Methods Diffusion tensor imaging was performed before and after 4 to 6 weeks of daily rTMS treatments. Mean fractional anisotropy levels associated with active rTMS and sham rTMS for the right and left prefrontal WM were assessed. Results Adequate images were acquired for 8 participants (active n = 4, sham n = 4) before and after rTMS. A mean increase was found for the left prefrontal WM. The mixed model revealed a trend toward a significant treatment group × region interaction effect (P = 0.11). Furthermore, simple region effects (left prefrontal WM vs right prefrontal WM) were at a trend toward significance for difference after treatment within the active rTMS group (P = 0.07), but not within the sham rTMS group (P = 0.88). Conclusions Repetitive transcranial magnetic stimulation resulted in no evidence of damage to WM on the side of stimulation. Diffusion tensor imaging may offer a unique modality to increase our understanding of mechanisms of action for rTMS.