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Background: Childhood traumas affect the hypothalamo-pituitary-adrenal (HPA) axis functions, and therefore emotional regulation response to stress. Glucocorticoid receptor (GR) gene NR3C1 plays a key role in HPA axis. The aim of the study was to investigate the relationship between methylation of NR3C1 gene with childhood trauma and alexithymia in somatic symptom disorder (SSD) and major depressive disorder (MDD). Methods: A total of 48 patients with SSD, 50 patients with MDD and 50 healthy controls were included in the study. Mongomery-Asberg Depression Rating Scale (MADRS), Toronto Alexithymia Scale (TAS-20), and the Childhood Trauma Questionnaire (CTQ) were applied to the participants. Methylation levels of the NR3C1 gene were determined quantitatively in DNA blood samples. Results: TAS-20 and CTQ total scores were found to be the highest in patients with SSD. CTQ scores were observed to be higher in SSD and MDD compared with the control group. NR3C1 gene methylation levels were found to be lowest in SSD and highest in MDD. There was no correlation between scores of TAS-20 and NR3C1 methylation. High alexithymia level was predictive for SSD (OR: 1.237, 95% CI: 1.018-1.504). High methylation levels increase the risk of MDD (OR: 7.449, 95% CI: 3.702-14.986), decrease the risk of SSD (OR: 0.00006 95% CI: 0.000-0.038). Conclusion: Our results show that emotion processing processes and GR methylation are different in both disorders. Childhood trauma may be related to epigenetic changes in the GR gene. The type of epigenetic changes may result in vulnerability to different psychiatric disorders. © 2022, Mediafarm Group. All rights reserved.

Anorexia Nervosa (AN) is a mental illness having high mortality rate and characterized with serious impairment in eating behavior. AN leads to severe biological consequences and serious psychosocial dysfunction. Self-assessments of the patients are overly and excessively affected by their body shape and weight. Genetic, neurobiological and psychosocial factors play a role in etiology. Due to the presence of specific symptoms and evidences, generally it is not too hard to diagnose AN. However, the lack of insight of the patient, the existence of life-threatening medical consequences of the disorder and the presence of strong psychosocial factors in the etiology make medical treatment difficult. In AN, comorbidity is most often seen with depression and anxiety disorders. Concomitant mental disorders and the severity of these mental disorders are among the factors that make treatment difficult. A multifaceted approach to medical treatment is essential. Treatment requires the association of psychopharmacology and specific psychotherapeutic practices. Since family relationships play an important role in the etiology of the disease, participation of the family in the treatment process is required. Building strong and effective cooperation has a positive effect on the prognosis of the disease. This article presents a case diagnosed with AN, and it aims to summarize the difficulties encountered in treatment process and coping methods. © 2018, Istanbul Universitesi. All rights reserved.

INTRODUCTION: Metacognitive constructs have shown promise in explaining the symptoms of Obsessive-Compulsive Disorder (OCD). Few studies have examined the role of metacognitions in symptom dimensions of OCD, despite mounting clinical, neuropsychological and imaging evidence for the distinctiveness of these dimensions. METHODS: Metacognitions were assessed using the Metacognitions Questionnaire (MCQ-30) in 51 participants with DSM IV OCD and 46 healthy controls. The Maudsley Obsessional Compulsive Inventory (MOCI) was used to quantify symptom dimensions, along with the Hamilton Anxiety Rating Scale (HAM-A) for anxiety, and Hamilton Depression Rating Scale (HAM-D) for depression. RESULTS: Individuals with OCD differed from healthy controls on beliefs of uncontrollability and danger when depression and anxiety were controlled for. Correlations between metacognitive beliefs and obsessive-compulsive symptom dimensions were largely similar across the OCD and healthy control groups. Hierarchical regression showed that need to control thoughts contributed to checking, cleaning and rumination symptoms; cognitive self-consciousness to symptoms of slowness; uncontrollability and danger to doubt symptoms; positive beliefs to checking symptoms. CONCLUSIONS: Specific associations between metacognitive variables and the different symptom dimensions of OCD are evident, however, severity of anxiety and depression also contribute to these associations.

Psychiatric evaluation in patients with obstructive sleep apnea syndrome Introduction: Obstructive sleep apnea syndrome (OSAS) might cause neuropsychiatric problems as well as cardiovascular and cerebrovascular complications. Daily life of the patients are effected and their quality of life decreases. In the present study, we aimed to evaluate anxiety and depression and to test their ability to cope with stress in patients with OSAS. Materials and Methods: The patients with OSAS suspect admitting to our sleep laboratuary, were classed as simple snoring, mild-moderate and severe OSAS according to their apnea-hypopnea index (AHI). Hospital anxiety and depression, stress coping and skill loss scales were applied to the patients accepted to participate to the study. Results: Fifty four patients participated into the study. Forty-one (75.9%) were OSAS and 13 (24.1%) were simple snoring (control group). Mean age was 52.3 ± 9.2 years in OSAS group, while it was 50.5 ± 9.9 years in control group. Snoring was found in every patient of two groups. Thirty-one (79.5%) patients with OSAS had witnessed apneas and 23 (60.5%) had excessive OSAS patients had excessive daytime sleepiness. There was no significant differences in age, BMI, sleep efficiency, HAD and skill loss scales between both groups. Autism was found higher in OSAS group with stress coping test (p= 0.031). Moreover, social support necessicity was found higher in moderate and severe OSAS patients. Conclusion: We found that neuropsyhiatric problems are highly seen in moderate and severe OUAS patients.

Introduction: Obstructive sleep apnea syndrome (OSAS) might cause neuropsychiatric problems as well as cardiovascular and cerebrovascular complications. Daily life of the patients are effected and their quality of life decreases. In the present study, we aimed to evaluate anxiety and depression and to test their ability to cope with strees in patients with OSAS., Materials and Methods: The patients with OSAS suspect admitting to our sleep laboratuary, were classed as simple snoring, mild-moderate and severe OSAS according to their apnea-hypopnea index (AHI). Hospital anxiety and depression, stres coping and skill loss scales were applied to the patients accepted to participate to the study., Results: Fifty four patients participated into the study. Forty-one (75.9%) were OSAS and 13 (24.1%) were simple snoring (control group). Mean age was 52.3 +/- 9.2 years in OSAS group, while it was 50.5 +/- 9.9 years in control group. Snoring was found in every patient of two groups. Thirty-one (79.5%) patients with OSAS had witnessed apneas and 23 (60.5%) had exceesive OSAS patients had excessive daytime sleepiness. There was no significant differences in age, BMI, sleep efficency, HAD and skill loss scales between both groups. Autism was found higher in OSAS group with stres coping test (p=0.031). Moreover, social support necessicity was found higher in moderate and severe OSAS patients., Conclusion: We found that neuropsyhiatric problems are highly seen in moderate and severe OUAS patients.

Objective: The aim of this study was to investigate cognitive function in individuals with schizophrenia and schizoaffective disorder. Method: Research participants included 48 outpatients with a diagnosis of schizophrenia, 35 outpatients with schizoaffective disorder, and 48 non-patients from the community. Scale for Assessment of Positive Symptoms (SAPS), Scale for Assessment of Negative Symptoms (SANS), and Brief Psychiatric Rating Scale (BPRS) were applied to the patients. Neuropsychological evaluation included Wisconsin Card Sorting Test (WCST) for executive functions, Verbal Memory Processes Test (VMPT) for verbal memory and Stroop Test (ST) for attention tasks. Results: There were significant differences among the groups in the number of categories completed, number of perseverative error, percentage of perseverative error, number of conceptual level responses and percentage of conceptual level responses in WCST; time diffrence in Stroop test; score of learning, score of maximum learning and long term memory-recall in VMPT. A post hoc analysis (Turkey) was performed. It was determined that there was no difference between schizoaffective and schizophrenia patients on neuropsyhological tasks. However, schizoaffective and schizophrenia patients had significantly poorer performance than control group on neuropsychological tests. Conclusion: Our study show that cognitive functions in patients with schizoaffective disorder and schizophrenia are similar and that they are both impaired compared with healthy controls.

Objective: The aim of the present study is to investigate the effect of a psychodramatic group work on psychological symptoms and coping styles with stressful life event in a group of psoriasis patients. Ten patients (a male and nine females), who have been followed by Dermatology out patient services of Medical Faculty, Pamukkale University, participated our group work. Seven patients completed eighteen psychodrama orientated group work sessions. Each session lasted three hours and took place only once a week. Methods: Before and immediately after the group work, the participants completed the Beck Depression Inventory and the State- Trait Anxiety Inventory and the Ways of Coping Questionnaire. Psoriasis severity was assessed by using PASI (Psoriasis Area Severity Index). Results: Before group work, the patients had suffered from significant depressive symptoms and the coping strategies most frequently used by patients were religious, emotion focused coping and planning. Three patients have reported that an overt stressful life event caused their psoriasis; the remaining had believed their disease as a result of the emotional aggregation of their life-time stressful experiences. The reported psychosocial stressors by the patients were mostly emotional problems with family member or close relationships. Compared to baseline, at the end of group, while there was a significant reduction of religious coping style and there was an increase of positive re-interpretation (p.05). The severity of psoriasis did not significantly change after group work although it was observed partial improvements in some patients. Discussion: Our results suggest that psychodrama orientated group work may effect positively on coping styles with stress in psoriasis patients.

The fact that health policies in developing countries make it easier to access drugs (controlled substances), might result in addiction and dependence problems despite initial treatment purposes for drug intake. Benzodiazepines are drugs that have been widely prescribed and have been classified as controlled drugs. In this clinical case report, a patient is described who began to use lorazepam, developed tolerance and dependence to mega-dose of drug because of easy access to drug. The patient has used lorazepam approximately for six months as he gradually increased dose up to 220 mg/day. His efforts to drop the drug was unsuccessful and subsequently he applied to emergency service because of disturbing withdrawal symptoms. He showed initial withdrawal symptoms of severe restlessness, hyperpnea, sweating, headache, anxiety, and irritability which were succesfully controlled in the second day. Seizure or any other life threatening adverse effect were not observed during treatment. The health policies in developing countries should be arranged strictly to control availability and access to controlled drugs even by prescribed patients in order to avoid development of addiction in such cases.

Erectile dysfunction and premature ejaculation are the most common male sexual disorders. Generally, it is considered that erectile dysfunction is related to organic factors whilst premature ejaculation is related to psychological factors. A detailed history along with physical examination such as using penile doppler, penile tumesans and ultrasonography are insufficient for differential diagnosis in 15-20% of cases. Therefore the role of neurophysiological techniques are important. In this study urological and biochemical investigations were used in conjunction with other neurophysiological methods. According to our results, using a neurophysiological test study on its own was ineffective. As a conclusion our study has shown that neurophysiological methods are important differential diagnosis of revealing suspicious organicity - generally believed to be due to psychological factors- in male sexual disorders.