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Turkiye, with its origins in an enduring civilisation rooted in preceding Turkish states from ancient and medieval eras, possesses its own firmly established legal traditions. Legislation concerning to the mentally ill was introduced post the French Revolution in the Ottoman Empire and underwent reforms with the advent of Turkiye's modern Republic in 1923, led by Mustafa Kemal Atatürk. This remains an ongoing process of enhancement, despite the absence of a well-established mental health law. Although forensic psychiatry is not considered to be an official subspecialty of psychiatry in Turkiye, the former constitutes a considerable amount of psychiatric practice in the country today. This article provides an overview of the legal basis and the organisation of forensic psychiatry in Turkiye. The primary forensic psychiatric practices of expertise, court-ordered treatments and prison psychiatry are described. Facilities as well as models of care are outlined. Finally, we consider the strengths and challenges of forensic psychiatry in Turkiye, to summarise the practice and system as well as to address rooms for improvement and highlight their possible reflections on the future. [ABSTRACT FROM AUTHOR]

Objective: Activation of the inflammatory response system may cause depressive symptoms and psychological distress. Therefore, it is important to emphasize the link between the proinflammatory state, psychological distress, and clinical features in acne vulgaris (AV), a chronic inflammatory disease. We aimed to examine psychological distress and systemic inflammatory markers (systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI)) and their relationship with illness-related factors in AV patients to address this potential link. Method: This study recruited 129 patients with AV without any psychiatric disorder and 60 healthy subjects matched with the patient group regarding age and gender. All participants' current depressive, anxiety, and stress levels were assessed with the Depression Anxiety Stress Scale-21 (DASS-21). The severity of acne of the patients was evaluated with Global Acne Scoring System (GASS). SII [neutrophils x platelets/lymphocytes] and SIRI [neutrophils x monocytes/lymphocytes] were calculated through routine blood screenings during the current admission. Results: DASS-21 Anxiety was significantly higher in the patient group than in controls (t=2.544; p<0.05), while DASS-21 Depression and Stress, SII, and SIRI did not differ between the groups (p>0.05). Duration of illness was positively correlated with DASS-21 Stress (r=0.30, p<0.001). A multivariate regression model using duration of illness, GASS score, SII, and SIRI revealed that only duration of illness predicted DASS-21 Stress (β=0.31, p<0.05). Conclusion: Independent of systemic proinflammatory status, psychological distress is associated with the duration of illness in AV patients. Clinicians should be more attentive in monitoring psychological distress in AV patients, particularly those with prolonged illness duration, and be more willing to seek help from a specialist psychiatrist to increase the quality of life of patients with AV. [ABSTRACT FROM AUTHOR]

Current data on chronotype and sleep quality and their relationship with clinical characteristics of schizophrenia are insufficient to evaluate whether these variables are associated with cardiometabolic risk. We aimed to identify the interplay between chronotype, sleep quality and metabolic indices that can potentially predict negative cardiometabolic outcomes in schizophrenia patients. One-hundred schizophrenia patients who were under a stable antipsychotic regime were enrolled in the study. Clinical information, anthropometric measurements, as well as recent metabolic parameters including serum lipids, atherogenic, and metabolic indices suggestive of cardiometabolic risk were recorded. High and low sleep quality groups (HSQ and LSQ) were determined via the Pittsburgh Sleep Quality Index and chronotypes were evaluated with the Morningness–Eveningness Questionaire. Patients with eveningness chronotype had poorer sleep quality compared to intermediate or morningness (p =.017) patients. The LSQ group had higher total cholesterol (p =.004) and low-density lipoprotein (LDL) (p =.041) compared to the HSQ group. Mean blood pressure was higher in the eveningness chronotype patients compared to intermediate or morningness patients (p =.015). According to a logistic regression model, total cholesterol, disposition index, and having an eveningness chronotype significantly predicted LSQ in schizophrenia. Eveningness chronotype may lead to impaired cardiometabolic regulation with the mediation of poor sleep quality in schizophrenia patients. Cardiovascular diseases, sleep quality, and sleep patterns can influence each other; thus, this complex relationship in schizophrenia should be considered while configuring both pharmacological and behavioral interventions. [ABSTRACT FROM AUTHOR]