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Purpose: We aimed to investigate the relationship theory of mind abilities with functionality and metabolic alteration in patients with bipolar disorder-1 (BD-1) during the remission period.Materials and Methods: This cross-sectional study is consisted of 68 patients with bipolar disorder-1 and 45 healthy controls. Sociodemographic form, Reading the Mind in the Eyes Test (RMET), Bipolar Disorder Functioning Questionnaire (BDFQ) were administered to the participants. Body mass index (BMI), waist circumference (WC), fasting plasma glucose (FG), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), total cholesterol (TC), triglyceride (TG) levels were recorded. Results: There were significant differences between the patient group and healthy control group in terms of WC, BMI, HDL, LDL, TG. The results of independent samples t-test indicated a statistically significant difference in RMET score between the two groups with control group significantly higher than patient group. Conclusion: Patients with BD-1 during the remission period have lower performance on theory of mind abilities and more alteration in metabolic parameters than healthy controls. Metabolic alteration and theory of mind impairment should be potential treatment target for BD, Amaç: Bu çalışmada bipolar bozukluk-1 (BB-1) tanılı hastaların remisyon dönemlerindeki zihin kuramı becerileri ile, işlevsellik ve metabolik değişimleri arasındaki ilişkiyi araştırmayı amaçladık.Gereç ve Yöntem: Bu kesitsel çalışma, remisyonda BB-1 tanılı 68 hasta ve 45 sağlıklı kontrolden oluşmaktadır. Katılımcılara sosyodemografik form, Gözlerden Zihin Okuma Testi, Bipolar Bozukluk İşlevsellik Anketi uygulandı. Katılımcıların beden kitle indeksi (BKİ), bel çevresi (BÇ), açlık plazma glukozu (PG), yüksek yoğunluklu lipoprotein kolesterol (HDL), düşük yoğunluklu lipoprotein kolesterol (LDL), toplam kolesterol, trigliserit (TG) seviyeleri kaydedildi.Bulgular: Hasta grubu ile sağlıklı kontrol grubu arasında BÇ, BKİ, HDL, LDL, TG düzeyleri açısından anlamlı farklılıklar vardı. Bağımsız örnekler t-testi sonuçlarına göre kontrol grubunda hasta grubuna göre Gözlerden Zihin Okuma Testi’nde istatistiki olarak anlamlı daha yüksek skorlar elde edilmiştir.Sonuç: Remisyon döneminde BB-1 tanılı hastalar, sağlıklı kontrollere göre zihin kuramı becerilerinde daha düşük performansa ve metabolik parametrelerde daha fazla değişikliğe sahiptir. Metabolik değişiklik ve zihin bozukluğu teorisi, BD için potansiyel tedavi hedefi olmalıdır.

Introduction: The current study aimed to investigate the rates of anxiety, clinical depression, and suicidality and their changes in health professionals during the COVID-19 outbreak. Materials and methods: The data came from the larger COMET-G study. The study sample includes 12,792 health professionals from 40 countries (62.40% women aged 39.76 ± 11.70; 36.81% men aged 35.91 ± 11.00 and 0.78% non-binary gender aged 35.15 ± 13.03). Distress and clinical depression were identified with the use of a previously developed cut-off and algorithm, respectively. Statistical analysis: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses, and Factorial Analysis of Variance (ANOVA) tested relations among variables. Results: Clinical depression was detected in 13.16% with male doctors and ‘non-binary genders’ having the lowest rates (7.89 and 5.88% respectively) and ‘non-binary gender’ nurses and administrative staff had the highest (37.50%); distress was present in 15.19%. A significant percentage reported a deterioration in mental state, family dynamics, and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (24.64% vs. 9.62%; p < 0.0001). Suicidal tendencies were at least doubled in terms of RASS scores. Approximately one-third of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop clinical depression was associated with a history of Bipolar disorder (RR = 4.23). Conclusions: The current study reported findings in health care professionals similar in magnitude and quality to those reported earlier in the general population although rates of clinical depression, suicidal tendencies, and adherence to conspiracy theories were much lower. However, the general model of factors interplay seems to be the same and this could be of practical utility since many of these factors are modifiable. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

Background A low-grade inflammation is presumed to be related to the etiopathogenesis of major depressive disorder (MDD) and bipolar disorder. Tumor necrosis factor (TNF) superfamily members have roles in the pathogenesis of neuropsychiatric disorders because of the relationship with inflammation and neurogenesis. The aim of this study was to investigate the serum TNF-related weak inducer of apoptosis (TWEAK) and TNF-related apoptosis-inducing ligand (TRAIL) levels in patients with bipolar depression (BD), MDD and a healthy control (HC) group to determine any differences between MDD and BD in terms of inflammation biomarkers. Subjects and methods After a 12-hour overnight fast, 5 milliliter (mL) samples of fasting blood were obtained from the participants. The TWEAK and TRAIL plasma levels were calculated using ELISA kits. Results The TWEAK levels were found to be higher in the BD group than in the HC group (p=0.03). No statistically significant differences were determined between the BD vs MDD and MDD vs HC groups (p=0.17, p=0.37, respectively). There were no statistically significant differences between the three groups (BD vs HC; BD vs MDD; MDD vs HC) in terms of TRAIL levels (p=0.21). Conclusion To the best of our knowledge, this study is the first to have explored TWEAK levels in patients with BD. The higher TWEAK levels in BD than in the control group is compatible with the inflammation hypothesis of BD. Limitations of the study were the differences in medications of the patient groups and that it was a cross-sectional study. There is a need for further longitudinal studies with larger sample size and medication-free patients.

Objective The aim of this study was to explore the effect of physical activity and metabolic parameters on irisin levels in patients with schizophrenia and healthy controls. Methods Ninety-six patients with schizophrenia and 63 healthy controls comprised the study population. The participants were separated into three groups: inactive, low activity, and sufficiently active according to International Physical Activity Questionnaire short form (IPAQ-SF). We measured irisin levels using Enzyme linked immunosorbent assay. We also calculated exercise levels by using the IPAQ-SF for each individual. The independent samples ttest was used in the data analysis to compare irisin levels according to the activity levels of the patients with schizophrenia and controls. Results The levels of irisin were higher in the healthy controls (p < 0.001) compared to schizophrenia groups. When the activity levels of the schizophrenia and healthy control groups were compared, the irisin levels of the low activity and sufficiently active groups with schizophrenia were found to be lower than those of the low activity and sufficiently active groups in the healthy controls (respectively p = 0.014; p < 0.001). Conclusion Irisin levels could be affected by physical activity and these results must be supported with new studies.

To what extent the COVID-19 pandemic and its containment measures influenced mental health in the general population is still unclear.To assess the trajectory of mental health symptoms during the first year of the pandemic and examine dose-response relations with characteristics of the pandemic and its containment.Relevant articles were identified from the living evidence database of the COVID-19 Open Access Project, which indexes COVID-19-related publications from MEDLINE via PubMed, Embase via Ovid, and PsycInfo. Preprint publications were not considered.Longitudinal studies that reported data on the general population's mental health using validated scales and that were published before 31 March 2021 were eligible.An international crowd of 109 trained reviewers screened references and extracted study characteristics, participant characteristics, and symptom scores at each timepoint. Data were also included for the following country-specific variables: days since the first case of SARS-CoV-2 infection, the stringency of governmental containment measures, and the cumulative numbers of cases and deaths.In a total of 43 studies (331 628 participants), changes in symptoms of psychological distress, sleep disturbances, and mental well-being varied substantially across studies. On average, depression and anxiety symptoms worsened in the first 2 months of the pandemic (standardized mean difference at 60 days, -0.39 [95% credible interval, -0.76 to -0.03]); thereafter, the trajectories were heterogeneous. There was a linear association of worsening depression and anxiety with increasing numbers of reported cases of SARS-CoV-2 infection and increasing stringency in governmental measures. Gender, age, country, deprivation, inequalities, risk of bias, and study design did not modify these associations.The certainty of the evidence was low because of the high risk of bias in included studies and the large amount of heterogeneity. Stringency measures and surges in cases were strongly correlated and changed over time. The observed associations should not be interpreted as causal relationships.Although an initial increase in average symptoms of depression and anxiety and an association between higher numbers of reported cases and more stringent measures were found, changes in mental health symptoms varied substantially across studies after the first 2 months of the pandemic. This suggests that different populations responded differently to the psychological stress generated by the pandemic and its containment measures.Swiss National Science Foundation. (PROSPERO: CRD42020180049).

European Community, FP7 [HEALTH-F2-2009-241909]; Spanish Ministry of Science and Innovation; Instituto de Salud Carlos III [SAM16PE07CP1, PI16/02012, PI19/024]; CIBERSAM; Madrid Regional Government [B2017/BMD-3740 AGES-CM-2]; Fundación Familia Alonso and Fundación Alicia Koplowitz, Fusar-Poli, L., Pries, L.-K., van Os, J., Radhakrishnan, R., Pençe, A.Y., Erzin, G., Delespaul, P., Kenis, G., Luykx, J.J., Lin, B.D., Akdede, B., Binbay, T., Altınyazar, V., Yalınçetin, B., Gümüş-Akay, G., Cihan, B., Soygür, H., Ulaş, H., Cankurtaran, E.Ş., Kaymak, S.U., Mihaljevic, M.M., Andric-Petrovic, S., Mirjanic, T., Bernardo, M., Mezquida, G., Amoretti, S., Bobes, J., Saiz, P.A., García-Portilla, M.P., Sanjuan, J., Aguilar, E.J., Santos, J.L., Jiménez-López, E., Arrojo, M., Carracedo, A., López, G., González-Peñas, J., Parellada, M., Maric, N.P., Atbaşoğlu, C., Üçok, A., Alptekin, K., Saka, M.C., Aguglia, E., Arango, C., Rutten, B.P., Guloksuz, S., Genetic Risk and Outcome of Psychosis (GROUP) investigators

Background Empirical evidence suggests that people use cannabis to ameliorate anxiety and depressive symptoms, yet cannabis also acutely worsens psychosis and affective symptoms. However, the temporal relationship between cannabis use, anxiety and depressive symptoms and psychotic experiences (PE) in longitudinal studies is unclear. This may be informed by examination of mutually mediating roles of cannabis, anxiety and depressive symptoms in the emergence of PE. Methods Data were derived from the second longitudinal Netherlands Mental Health Survey and Incidence Study. Mediation analysis was performed to examine the relationship between cannabis use, anxiety/depressive symptoms and PE, using KHB logit in STATA while adjusting for age, sex and education status. Results Cannabis use was found to mediate the relationship between preceding anxiety, depressive symptoms and later PE incidence, but the indirect contribution of cannabis use was small (for anxiety: % of total effect attributable to cannabis use = 1.00%; for depression: % of total effect attributable to cannabis use = 1.4%). Interestingly, anxiety and depressive symptoms were found to mediate the relationship between preceding cannabis use and later PE incidence to a greater degree (% of total effect attributable to anxiety = 17%; % of total effect attributable to depression = 37%). Conclusion This first longitudinal cohort study examining the mediational relationship between cannabis use, anxiety/depressive symptoms and PE, shows that there is a bidirectional relationship between cannabis use, anxiety/depressive symptoms and PE. However, the contribution of anxiety/depressive symptoms as a mediator was greater than that of cannabis.

Fountoulakis K.N., Karakatsoulis G.N., Abraham S., Adorjan K., Ahmed H.U., Alarcón R.D., Arai K., Auwal S.S., Berk M., Bjedov S., Bobes J., Bobes-Bascaran T., Bourgin-Duchesnay J., Bredicean C.A., Bukelskis L., Burkadze A., Abud I.I.C., Castilla-Puentes R., Cetkovich M., Colon-Rivera H., Corral R., Cortez-Vergara C., Crepin P., De Berardis D., Delgado S.Z., De Lucena D., De Sousa A., Stefano R.D., Dodd S., Elek L.P., Elissa A., Erdelyi-Hamza B., Erzin G., Etchevers M.J., Falkai P., Farcas A., Fedotov I., Filatova V., Fountoulakis N.K., Frankova I., Franza F., Frias P., Galako T., Garay C.J., Garcia-Álvarez L., García-Portilla M.P., Gonda X., Gondek T.M., González D.M., Gould H., Grandinetti P., Grau A., Groudeva V., Hagin M., Harada T., Hasan T.M., Hashim N.A., Hilbig J., Hossain S., Iakimova R., Ibrahim M., Iftene F., Ignatenko Y., Irarrazaval M., Ismail Z., Ismayilova J., Jacobs A., Jakovljević M., Jakšić N., Javed A., Kafali H.Y., Karia S., Kazakova O., Khalifa D., Khaustova O., Koh S., Kopishinskaia S., Kosenko K., Koupidis S.A., Kovacs I., Kulig B., Lalljee A., Liewig J., Majid A., Malashonkova E., Malik K., Malik N.I., Mammadzada G., Mandalia B., Marazziti D., Marčinko D., Martinez S., Matiekus E., Mejia G., Memon R.S., Martínez X.E.M., Mickevičiūtė D., Milev R., Mohammed M., Molina-López A., Morozov P., Muhammad N.S., Mustač F., Naor M.S., Nassieb A., Navickas A., Okasha T., Pandova M., Panfil A.-L., Panteleeva L., Papava I., Patsali M.E., Pavlichenko A., Pejuskovic B., Da Costa M.P., Popkov M., Popovic D., Raduan N.J.N., Ramírez F.V., Rancans E., Razali S., Rebok F., Rewekant A., Flores E.N.R., Rivera-Encinas M.T., Saiz P., de Carmona M.S., Martínez D.S., Saw J.A., Saygili G., Schneidereit P., Shah B., Shirasaka T., Silagadze K., Sitanggang S., Skugarevsky O., Spikina A., Mahalingappa S.S., Stoyanova M., Szczegielniak A., Tamasan S.C., Tavormina G., Tavormina M.G.M., Theodorakis P.N., Tohen M., Tsapakis E.M., Tukhvatullina D., Ullah I., Vaidya R., Vega-Dienstmaier J.M., Vrublevska J., Vukovic O., Vysotska O., Widiasih N., Yashikhina A., Prezerakos P.E., Smirnova D.

Deep learning (DL) algorithms have achieved important successes in data analysis tasks, thanks to their capability of revealing complex patterns in data. With the advance of new sensors, data storage, and processing hardware, DL algorithms start dominating various fields including neuropsychiatry. There are many types of DL algorithms for different data types from survey data to functional magnetic resonance imaging scans. Because of limitations in diagnosing, estimating prognosis and treatment response of neuropsychiatric disorders; DL algorithms are becoming promising approaches. In this review, we aim to summarize the most common DL algorithms and their applications in neuropsychiatry and also provide an overview to guide the researchers in choosing the proper DL architecture for their research.

Previously, we established an estimated exposome score for schizophrenia (ES-SCZ) as a cumulative measure of environmental liability for schizophrenia to use in gene–environment interaction studies and for risk stratification in population cohorts. Hereby, we examined the discriminative function of ES-SCZ for identifying individuals diagnosed with schizophrenia spectrum disorder in the general population by measuring the area under the receiver operating characteristic curve (AUC). Furthermore, we compared this ES-SCZ method to an environmental sum score (Esum-SCZ) and an aggregate environmental score weighted by the meta-analytical estimates (Emet-SCZ). We also estimated ORs and Nagelkerke’s R2 for ES-SCZ in association with psychiatric diagnoses and other medical outcomes. ES-SCZ showed a good discriminative function (AUC = 0.84) and statistically significantly performed better than both Esum-SCZ (AUC = 0.80) and Emet-SCZ (AUC = 0.80). At optimal cut point, ES-SCZ showed similar performance in ruling out (LR− = 0.20) and ruling in (LR+ = 3.86) schizophrenia. ES-SCZ at optimal cut point showed also a progressively greater magnitude of association with increasing psychosis risk strata. Among all clinical outcomes, ES-SCZ was associated with schizophrenia diagnosis with the highest OR (2.76, P < .001) and greatest explained variance (R2 = 14.03%), followed by bipolar disorder (OR = 2.61, P < .001, R2 = 13.01%) and suicide plan (OR = 2.44, P < .001, R2 = 12.44%). Our findings from an epidemiologically representative general population cohort demonstrate that an aggregate environmental exposure score for schizophrenia constructed using a predictive modeling approach—ES-SCZ—has the potential to improve risk prediction and stratification for research purposes and may help gain insight into the multicausal etiology of psychopathology.

Background and objective The current article explored the possibility of using daily internet use time as an indicator for problematic internet use (PIU) among college/ university students based on observations from a multi-centric, multi-country study conducted across eight different countries. Additionally, the current article explored whether daily night time sleep and physical activity can serve as possible indicators of PIU. Methods The present article presents the findings from analysis of information collected from 2643 college/university students from eight countries. Area under the ROC curve (AUC) was calculated to compare the predictive performance of three different indicator variables in the study participants to determine PIU. Results The AUC for daily internet use time was 0.64 (95 % CI: 0.62 to 0.656), which was higher than the AUC for weekly physical activity (0.599; 95 % CI: 0.580 to 0.618) and daily night time sleep (0.563; 95 % CI: 0.544 to 0.582). The AUC for three indicator variables was compared, which showed that the AUC for daily internet time was significantly higher than the AUC for daily night-time sleep. Conclusions The assessment of daily internet use time as part of a larger battery of general health-related questions could be applied periodically among young students for screening of PIU in addition to a host of other important mental and physical health related conditions and behaviors. However, further studies are needed to determine optimal cut-off depending upon the desired trade-off between sensitivity and specificity for screening among different populations.

Objective: We aimed to determine the effects of the COVID-19 outbreak on health workers' health concerns and life.Methods: The study included 293 healthcare professionals reached via e-mail. A questionnaire created by researchers and health anxiety inventory were applied online to all participants. The questionnaire questions investigated the sociodemographic characteristics of the participant, whether he received psychological support during the COVID-19 outbreak, whether he had a chronic disease, whether he had problems with the care of his children, whether he was actively involved in the COVID clinic / service, and how his social and work life was affected.Results: Participants consisted of 73 doctors, 145 nurses and 75 other healthcare professionals (OHP). It was determined that the COVID-19 test was performed to the healthcare personnel in the risk group at a very low rate (1.4%). The number of people receiving psychiatric support during the COVID-19 outbreak was 59 (20.1%). It was determined that the COVID-19 outbreak affected business life and social life of healthcare professionals very much and significantly (p, Amaç: Bu araştırma ile COVID-19 salgınının sağlık çalışanlarının sağlık kaygıları ve yaşamları üzerine etkilerini belirlemeyi amaçladık.Yöntem: Araştırmaya, e-mail yoluyla ulaşılan 293 sağlık çalışanı dahil edildi. Tüm katılımcılara araştırmacılar tarafından oluşturulmuş bir anket ve devamında sağlık kaygısı envanteri online olarak uygulandı. Anket soruları ile katılımcının sosyodemografik özellikleri, COVID-19 salgını süresince ruhsal destek alıp almadığı, kronik hastalığı olup olmadığı, çocuklarının bakımıyla ilgili sorun yaşayıp yaşamadığı, COVID polikliniğinde/servisinde aktif görev alıp olmadığı, sosyal ve iş yaşantısının nasıl etkilendiği araştırıldı.Bulgular: Katılımcıların 73‘ü (24.9%) doktor, 145’i hemşire ve 75’i (25.6%) diğer sağlık personelinden oluşmaktadır. Katılımcıların yaş ortalaması 35.22±8.51 ve çalışma süresi ortancası 10 (0.0-43.0) yıldır. Risk grubunda yer alan sağlık personeline COVID-19 testinin çok az oranda (1.4%) yapıldığı saptanmıştır. COVID-19 salgını sürecinde psikiyatrik destek alanların sayısı 59 (20.1%)’dur. Katılımcılardan 99’u (33.9%) COVID-19 salgını sürecinde çocuk bakımında problem yaşadığını belirtmiştir. COVID-19 salgınının sağlık profesyonellerinin iş ve sosyal yaşamını önemli ölçüde etkilediği saptanmıştır (p

Objective: We aimed to determine the effects of the COVID-19 outbreak on health workers' health concerns and life. Methods: The study included 293 healthcare professionals reached via e-mail. A questionnaire created by researchers and health anxiety inventory were applied online to all participants. The questionnaire questions investigated the sociodemographic characteristics of the participant, whether he received psychological support during the COVID-19 outbreak, whether he had a chronic disease, whether he had problems with the care of his children, whether he was actively involved in the COVID clinic / service, and how his social and work life was affected. Results: Participants consisted of 73 doctors, 145 nurses and 75 other healthcare professionals (OHP). It was determined that the COVID-19 test was performed to the healthcare personnel in the risk group at a very low rate (1.4%). The number of people receiving psychiatric support during the COVID-19 outbreak was 59 (20.1%). It was determined that the COVID-19 outbreak affected business life and social life of healthcare professionals very much and significantly (p

Objective: Bipolar disorder and unipolar depressive disorder are complex phenotypes. There appear to be phenotypical, mechanistic, and therapeutic differences between bipolar depression (BD) and unipolar depression (UD). There is a need for understanding the underlying biological variation between these clinical entities. The role of oxidative processes underlying bipolar disorder and depression has been demonstrated. Thiol-disulfide homeostasis (TDH) is a recent oxidative stress marker. In this study, we aimed to inspect patients with bipolar depression and unipolar depression in terms of thiol-disulfide balance and to compare them with healthy controls.Methods: Patients admitted to the outpatient clinic of Ankara Numune Training and Research Hospital and diagnosed either as a depressive episode with bipolar disorder (n = 37) or unipolar depression (n = 24) according to DSM-5 criteria, along with healthy controls (HC) (n = 50), were included in the study. Native thiol, total thiol, and disulfide levels were compared across the groups.Results: In comparison to HC, both BD and UD groups had higher disulfide levels, disulfide/native thiol ratio, and disulfide/total thiol ratio. No significant differences between BD and UD were detected in terms of disulfide level, disulfide/native thiol ratio, and disulfide/total thiol ratio.Conclusion: Increased levels of disulfide, native thiol, and disulfide/total thiol ratios compared to healthy controls in both UD and BD groups may be indicative of the presence of oxidative damage in these two clinical conditions. To clarify the role of oxidative stress in the pathophysiology of depressive disorders and investigate TDH, longitudinal studies in patients with medication-free UD and BD are required.

Amaç: Bu araştırmanın amacı, yatarak tedavi gören erkek alkol bağımlılarında tedavi motivasyonu, bağımlılık özellikleri, aşerme ve mizaç özellikleri arasındaki ilişkiyi incelemektir.Gereç ve Yöntem: Ankara Numune Eğitim ve Araştırma Hastanesi, Alkol-Madde Araştırma, Tedavi ve Eğitim Merkezi’nde (AMATEM) yatarak tedavi gören DSM-IV-TR’ye göre alkol bağımlılığı tanısı almış erkek hastalar çalışmaya dahil edilmiştir. Hastalar, sosyodemografik veri formunun yanı sıra, Penn Alkol Aşerme Ölçeği (PAAÖ), Bağımlılık Profil İndeksi (BAPİ), Değişime Hazır Olma ve Tedavi İsteği Ölçeği (SOCRATES), Memphis, Pisa, Paris ve San Diego - Self Mizaç Değerlendirme Ölçeği (TEMPS-A) kullanılarak değerlendirildi.Bulgular: Çalışmaya 85 erkek hasta dahil edildi. Çalışma kapsamındaki hastaların ortalama yaşı 46.36 ± 9.66’ydı. Katılımcıların ortalama alkol kullanma süreleri ise 23.32 ± 10.33 yıldı. Çalışmanın sonuçlarına göre BAPİ toplam puanı ve PAÖÖ toplam puanı arasında pozitif korelasyon hesaplanmıştır.Sonuç: Bağımlılık şiddetinin artmasıyla aşerme şiddetinin artması bağımlılık şiddeti yüksek olan hastalarda aşerme konusunda daha dikkatli olmak gerektiğini düşündürebilir. Baskın mizaç özelliğine sahip olup olmamanın aşerme, motivasyon ve bağımlılık şiddeti ile olan ilişkisi çalışmamızda saptanmamıştır., Purpose: The aim of this study is to investigate the relationship between the treatment motivation, addiction characteristics, craving and temperament traits in male patients with alcohol addiction having inpatient treatment.Materials and Methods: Male patients diagnosed with alcohol addiction according to DSM-IV-TR having inpatient treatment at Ankara Numune Training and Research Hospital’s Alcohol and Substance Abuse Treatment and Training Center (AMATEM) were included in the study. The patients were evaluated by sociodemographic data form, Penn Alcohol Craving Scale (PACS), Addiction Profile Index (API), The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A).Results: 85 male patients were included in the study. The mean age of the participants was 46.36 ± 9.66. The mean of the years of using alcohol was 23.32 ± 10.33. A positive correlation was found between API total score and PACS total score according to the study. Conclusion: Increasing craving severity aligned with increasing addiction severity may suggest that patients with high addiction severity should be given more care in terms of craving. The relationship between having a dominant temperament and craving, motivation and severity of addiction could not be determined in our study.

BackgroundThe aim of the current study was to explore the effect of gender, age at onset, and duration on the long-term course of schizophrenia.MethodsTwenty-nine centers from 25 countries representing all continents participated in the study that included 2358 patients aged 37.21 ± 11.87 years with a DSM-IV or DSM-5 diagnosis of schizophrenia; the Positive and Negative Syndrome Scale as well as relevant clinicodemographic data were gathered. Analysis of variance and analysis of covariance were used, and the methodology corrected for the presence of potentially confounding effects.ResultsThere was a 3-year later age at onset for females (P P P P = .001). No significant effects were found concerning duration of illness.DiscussionOur results confirmed a later onset and a possibly more benign course and outcome in females. Age at onset manifested a single peak in both genders, and surprisingly, earlier onset was related to a slower progression of the illness. No effect of duration has been detected. These results are partially in accord with the literature, but they also differ as a consequence of the different starting point of our methodology (a novel staging model), which in our opinion precluded the impact of confounding effects. Future research should focus on the therapeutic policy and implications of these results in more representative samples.

BackgroundEvidence suggests that environmental factors not only increase psychosis liability but also influence the prognosis and outcomes of psychotic disorders. We investigated temporal and cross-sectional associations of a weighted score of cumulative environmental liability for schizophrenia – the exposome score for schizophrenia (ES-SCZ) – with functioning in first-episode psychosis (FEP).MethodsData were derived from the baseline and 1-month assessments of the Athens FEP Research Study that enrolled 225 individuals with FEP. The Global Assessment of Functioning (GAF) and the Personal and Social Performance Scale (PSP) were used to measure social, occupational, and psychological functioning. The ES-SCZ was calculated based on the previously validated method.ResultsES-SCZ was associated with the total scores of GAF and PSP at baseline and 1-month assessments. These findings remained significant when accounting for several associated alternative explanatory variables, including other environmental factors (obstetric complications, migration, ethnic minority), clinical characteristics (duration of untreated psychosis, symptom severity, previous antipsychotic use), and family history of psychosis, demonstrating that the association between ES-SCZ and functioning is over and above other risk factors and cannot be explained by symptom severity alone. Functioning improved from baseline to 1-month assessment, but no significant ES-SCZ-by-time interaction was found on functioning, indicating that functioning changes were not contingent on ES-SCZ.ConclusionsOur findings suggest that rather than a predictor of functional improvement, ES-SCZ represents a stable severity indicator that captures poor functioning in early psychosis. Environmental risk loading for schizophrenia (ES-SCZ) can be beneficial for clinical characterization and incorporated into transdiagnostic staging models.

OBJECTIVE: Opioid addiction is a disease that is increasing in our country, Turkey, and around the world, which it is difficult to treat in medical, social, and economic terms. Pregabalin is a preparation used for the treatment of epilepsy, neuropathic pain, and anxiety disorders. In opioid users, pregabalin is increasingly being self-administered off-label due to its euphoria effect at high doses. We investigated the effects of pregabalin on addiction profile and opioid withdrawal severity by comparing patients with opioid addiction who were and were not using off-label pregabalin. METHODS: Between July and August 2016, a total of 120 patients (60 patients were pregabalin users and 60 patients were non-users) who presented to Ankara Numune Training and Research Hospital Psychiatry Clinic Alcohol and Substance Addiction Treatment Center and were diagnosed with opioid use disorder according to the DSM-5, were included in the study. Patients who were using other substances were excluded from the study. A sociodemographic data form, the Clinical Opiate Withdrawal Scale, and Addiction Profile Index (API) were applied to the patients. RESULTS: There was no statistically significant difference between pregabalin users and pregabalin non-users in terms of age, sex, age of onset, working status, and whether previous treatment had been received. In the pregabalin user group, the severity of opioid withdrawal, API substance use characteristics, diagnosis, effects on life, craving, motivation subscale scores, and API total score were found to be significantly higher than in the non-user group. CONCLUSION: Off-label pregabalin use among patients with opioid addiction is becoming more common. Off-label, high-dose pregabalin use may worsen existing opioid addiction, create a new area of ⁣⁣addiction, and an illegal market. Highlights We aimed to investigate the effects of pregabalin on addiction profile and opioid withdrawal severity by comparing patients with opioid addiction who were and were not using off-label pregabalin. In the pregabalin user group, the severity of opioid withdrawal, and API total score were found to be significantly higher than in the non-user group. The use of off-label, high-dose pregabalin may worsen existing opioid addiction.

OBJECTIVE: Schizophrenia is a neurodegenerative and neurodevelopmental disorder. For this reason, it is important to determine the level of markers that are neuroprotective and have been altered in other neurodegenerative diseases in inspecting the etiology of schizophrenia. Secretagogin (SCGN), is a member of Calcium (Ca) binding proteins and thought to have a neuroprotective effect. In this study, we aimed to compare the level of secretagogin (SCGN) between age and gender-matched schizophrenia and control group. METHODS: Fifty-three patients with schizophrenia who applied to outpatient clinics of our hospital and 37 healthy controls included in the study. Schizophrenia diagnoses of the patients were verified using the DSM-5 criteria. Serum secretagogin levels were measured with the enzyme-linked immunosorbent assay (ELISA) test. The Body Mass Index (BMI) of the patient group was measured. RESULTS: There was no significant difference between the controls and patients in terms of fasting blood glucose and insulin levels. We did not find any difference in terms of the levels of serum secretagogin between patients with schizophrenia and controls. Negative correlations were found between the level of secretagogin and PANSS positive score, PANSS negative score, PANSS general psychopathology score. CONCLUSION: There is increasing evidence that SCGN may play a role in central nervous system (CNS) activity. Future studies might help to explicitly present the relationship between secretagogin and schizophrenia.

Objective: Mood stabilizers and antipsychotic drugs are known to have adverse effects on sexual function. However, patients often refrain from speaking about sexual complaints that may cause dose reduction and discontinuation of the drug without medical supervision. In this study we aimed to evaluate sexual functions of patients with bipolar disorder in remission period, considering prolactin levels and medications. Method: We recruited 52 patients with bipolar disorder in remission according to DSM-IV diagnostic criteria. Prolactin levels were measured in all patients. The Golombok Rust Inventory of Sexual Satisfaction (GRISS) was used to assess sexual dysfunction. Results: Mean prolactin levels were 24.71 ± 4.25 and 19.96 ± 5.52 ng/ml respectively for females and males. Patients taking mood stabilizer (MS) and mood stabilizer plus antipsychotic (AP) treatment had different prolactin levels (p

To understand the role of environment in the pathoetiology of psychosis spectrum disorders, research has thus far mainly investigated the effects of single exposures in isolation, such as the association between cannabis use and schizophrenia. However, this approach fails to acknowledge the complexity of the exposome, which represents the totality of the environment involving many exposures over an individual's lifetime. Therefore, contemporary research adopting the exposome paradigm has aimed at capturing the combined effect of different environmental exposures by utilizing an aggregate environmental vulnerability score for schizophrenia: the exposome score for schizophrenia. Here, we attempt to provide a comprehensive overview of studies applying the exposome score for schizophrenia. First, we describe several approaches estimating exposomic vulnerability for schizophrenia, which falls into three categories: simple environmental sum scores (sum of dichotomized exposures), meta-analysis-based environmental risk score (sum scores weighted by estimates from meta-analyses), and the exposome score (sum score weighted by estimates from an analysis in an independent training dataset). Studies show that the exposome score for schizophrenia that assumes interdependency of exposures performs better than scores that assume independence of exposures, such as the environmental sum score and the meta-analysis-based environmental risk score. Second, we discuss findings on the pluripotency of the exposome score for schizophrenia and summarize findings from gene-environment studies using the exposome score for schizophrenia. Finally, we discuss possible scientific, clinical, and population-based applications of exposome score for schizophrenia, as well as limitations and future directions for exposome research to understand the etiology of psychosis spectrum disorders.

Objectives: Violence by patients against health care professionals has been widely described. Although psychiatric trainees are particularly exposed, little is known about the extent, context, and impact of violence toward them in Europe. Methods: A cross-sectional online survey was distributed between June 2018 and December 2019 among European psychiatric trainees through professional networks, using a snowball approach. The questionnaire asked about experiences of verbal abuse and physical and sexual assaults, as well as their context and impact. Descriptive analyses of the obtained data were conducted. Results: The survey was completed by 827 trainees from 39 countries (68.4% females). Most (83.6%) reported having been abused/assaulted at least once (of these, 92% verbally, 44.1% physically, and 9.3% sexually). Emergency rooms and inpatient units were the most frequent settings. Psychological impact of these events was commonly reported. Most respondents did not report abuses and assaults to their supervisors. They also described a lack of training for staff and aggression management plans at their institutions or of being unaware of their existence. Conclusions: Violence from patients is reported by many psychiatric trainees across countries in Europe, with very frequent verbal abuse and worrisome figures of physical and sexual assaults. Particularly concerning are the low proportion of trainees reporting to authorities, the lack of staff training and management protocols, and trainees’ lack of awareness about those resources. Despite the study limitation of a small response rate, these results support a call for urgent efforts to address this problem in Europe, and possibly beyond.

European Community's Seventh Framework Program, European Commission [HEALTH-F2-2009-241909]; Scientific and Technological Research Council of Turkey, 2219 International Postdoctoral Research Fellowship Program; Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III (SAM16PE07CP1, PI16/02012, and PI19/024)..., Erzin, G., Pries, L.-K., van Os, J., Fusar-Poli, L., Delespaul, P., Kenis, G., Luykx, J.J., Lin, B.D., Richards, A.L., Akdede, B., Binbay, T., Altınyazar, V., Yalınçetin, B., Gümüş-Akay, G., Cihan, B., Soygür, H., Ulaş, H., Cankurtaran, E.Ş., Kaymak, S.U., Mihaljevic, M.M., Andric-Petrovic, S., Mirjanic, T., Bernardo, M., Mezquida, G., Amoretti, S., Bobes, J., Saiz, P.A., García-Portilla, M.P., Sanjuan, J., Aguilar, E.J., Santos, J.L., Jiménez-López, E., Arrojo, M., Carracedo, A., López, G., González-Peñas, J., Parellada, M., Maric, N.P., Atbaşoğlu, C., Ucok, A., Alptekin, K., Saka, M.C., Arango, C., O'Donovan, M.C., Rutten, B.P.F., Guloksuz, S., Genetic Risk and Outcome of Psychosis (GROUP) investigators

Introduction: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. ----- Material and methods: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. ----- Statistical analysis: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. ----- Results: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. ----- Conclusions: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them.

The aim of this review was to discuss early intervention options for clinical high-risk states of psychosis, the limitations of the high-risk concept, and the importance of population-based approaches in preventing psychosis. Interventions for individuals at high risk of psychosis can be classified into two main categories: pharmacological and non-pharmacological. When selecting any of these intervention options, it should be taken into account that only a small proportion of individuals in the high-risk group will have a transition to clinical psychosis. Therefore, it is necessary to avoid aggressive interventions. Pharmacotherapies, particularly antipsychotics, are generally not considered as a treatment of choice for individuals at high risk of psychosis due to their potential side-effect profiles, whereas cognitive behavioral therapies and family-oriented therapies are the leading alternatives with virtually no side effects. However, meta-analyses have shown that none of the interventions are specifically more effective than needs-based treatment (including placebo) in preventing transition to psychosis. These interventions might not be effective in preventing transition to psychosis; however, they may improve the outcomes of psychosis. Accumulating evidence suggests that the targeted prevention approaches focusing on the clinical high risk of psychosis concept have major limitations in terms of the impact on reducing psychosis incidence in the general population compared to the population-based approaches. Recently, psychosis-focused prevention approaches have been replaced by easily accessible youth mental health centers that provide services for transdiagnostic conditions. Future studies on the efficacy of these community-based youth mental health services may provide guidance on how to prevent psychosis.

Objective: in this study, it was aimed to discuss the problems and working conditions of Early Career Psychiatrist (ECP) in the light of the literature Method: ECPs (in the first five years of their residency or under forty years of age) were included in the study via e-mail. An online questionnaire structured by the researchers was applied to all participants. The first 7 of the questionnaire questions are related to socio-demographic characteristics, and they were asked about age, gender, city of residence, year of profession, state service obligation, the hospital where he worked, the institution he specialized in. In the continuation of the questionnaire, a total of 24 questions were asked about the clinical and practical applications of psychiatry, education, career and working environment. Results: a total of 245 ECPs, 69.8% female and 30.2% male, aged between 27 and 41 years were included in the study. The average age of the participants in the study was 33.59 +/- 2.80 years. As a city, the most frequent (17.1%) attendance was from Istanbul. 71% of them had completed their compulsory service. The institution worked with was reported as the most frequently (39.2%) state hospital affiliated to the Ministry of Health. In our study, it was found that 65.7% of ECPs were subjected to violence in the working environment and 83.9% of those exposed to violence were exposed to verbal violence. Discussion: both legal and institutional arrangements need to be made in order to improve the working conditions of ECPs, to prevent violence, to feel safe in the working environment and to increase the level of satisfaction. In addition, there is a need to increase the educational opportunities of ECPs after their specialization and to encourage scientific research. / Amaç: bu çalışmada genç psikiyatri hekimlerinin sorunları ve çalışma koşullarının literatür eşliğinde tartışılması amaçlandı. Yöntem: araştırmaya e-mail yoluyla ulaşılarak genç psikiyatri hekimleri (uzmanlığının ilk beş yılında ya da kırk yaş altı) dahil edildi. Tüm katılımcılara araştırmacılar tarafından yapılandırılmış online bir anket uygulandı. Anket sorularının ilk 7 tanesi sosyo-demografik özelliklerle ilgili olup yaş, cinsiyet, yaşadığı şehir, meslekteki yılı, devlet hizmet yükümlülüğünü tamamlayıp tamamlamadığı, çalıştığı hastane, ihtisas aldığı kurum soruldu. Anketin devamında psikiyatri klinik ve pratik uygulamaları, eğitim, kariyer ve çalışma ortamı ile ilgili toplam 24 soru soruldu. Bulgular: çalışmaya yaşları 27 ile 41 yaş arasında değişen, %69.8’i kadın ve %30.2’si erkek toplam 245 genç psikiyatrist dahil edildi. Çalışmaya katılanların yaş ortalaması 33.59 ± 2.80 yaş idi. Şehir olarak en sık (%17.1) İstanbul’dan katılım vardı. %71’i mecburi hizmetini tamamlamıştı. Çalışılan kurum en sık (%39.2) Sağlık Bakanlığı’na bağlı devlet hastanesi olarak bildirildi. Çalışmamızda genç psikiyatristlerin %65.7’sinin çalıştığı ortamda şiddete maruz kaldığı ve şiddete maruz kalanların %83.9’unun sözel şiddete maruz kaldığı saptandı. Psikiyatri pratiğinde en çok ilgi duyulan alanın duygudurum bozuklukları ve en çok zorlanılan alanın adli ve askeri psikiyatri olduğu belirtildi. Herhangi bir psikoterapi eğitimi ve süpervizyonu alanların oranı %94.3 ve uzmanlık tezi haricinde herhangi bir araştırmaya katılanların oranı %78 idi. Sonuç: genç psikiyatristlerin çalışma koşullarının iyileştirilmesi, şiddetin önlenebilmesi, çalıştığı ortamda kendini güvende hissedebilmesi, memnuniyet düzeyinin arttırılması için hem yasal hem de kurumsal düzenlemeler yapılması gerekmektedir. Ayrıca genç psikiyatristlerin uzmanlık sonrasında da eğitim olanaklarının arttırılması ve bilimsel araştırma yapmaya teşvik edici düzenlemelere de ihtiyaç vardır., NA

The EUGEI project was supported by the European Community’s Seventh Framework Program under grant agreement No. HEALTH-F2- 2009-241909 (Project EU-GEI). Dr. Arango was supported by the Spanish Ministry of Science and Innovation; Instituto de Salud Carlos III (SAM16-PE07CP1, PI16/02012, PI19/024); CIBERSAM (...), Fusar-Poli, L; Pries, LK; van Os, J; Erzin, G; Delespaul, P; Kenis, G; Luykx, JJ; Lin, BCD; Richards, AL; Akdede, B; Binbay, T; Altinyazar, V; Yalincetin, B; Gumus-Akay, G; Cihan, B; Soygur, H; Ulas, H; Cankurtaran, ES; Kaymak, SU; Mihaljevic, MM; Andric-Petrovic, S; Mirjanic, T; Bernardo, M; Mezquida, G; Amoretti, S; Bobes, J; Saiz, PA; Garcia-Portilla, MP; Sanjuan, J; Aguilar, EJ; Santos, JL; Jimenez-Lopez, E; Arrojo, M; Carracedo, A; Lopez, G; Gonzalez-Penas, J; Parellada, M; Maric, NP; Atbasoglu, C; Ucok, A; Alptekin, K; Saka, MC; Aguglia, E; Arango, C; O'Donovan, M; Rutten, BPF; Guloksuz, S

BackgroundThe aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model.MethodsTwenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed.ResultsThe results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage.ConclusionsThe current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct “cores” of schizophrenia, the “Positive” and the “Negative,” while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.

The present study evaluated the psychometric properties of a self-report scale for assessing Internet Gaming Disorder (IGD) symptoms according to the DSM-5 and ICD-11 among 3270 college/univers ity students (2095 [64.1%] females; age mean 21.6 [3.1] years) from different countries worldwide. Croatian, English, Polish, Portuguese, Serbian, Turkish, and Vietnamese versions of the scale were tested. The study showed that symptoms of IGD could be measured as a single underlying factor among college/university students. A nine itemsymptom scale following DSM-5, and a short four-item scale representing the main ICD-11 symptoms, had sound internal consistency and construct validity. Three symptom-items were found non-invariant across the language samples (i.e., preoccupation with on-line gaming, loss of interests in previous hobbies and entertainment, and the use of gaming to relieve negative moods). This study provides initial evidence for assessing IGD symptoms among college/university students and will hopefully foster further research into gaming addiction in this population worldwide especially with taking into account language/cultural differences. U ovoj studiji su procenjena psihometrijska svojstva skale samoprocene koja je namenjena proceni simptoma poremećaja igranja kompjuterskih igrara na internetu (eng. Internet Gaming Disorder-IGD) prema DSM-5 i ICD-11 klasifikacijama mentalnih bolesti na uzorku od 3270 studenata (2095 [64.1%] devojaka; prosečna starost 21.6 [3.1] godina) iz više zemalja. Ispitana je hrvatska, engleska, poljska, portugalska, srpska, turska i vijetnamska verzija skale. Rezultati su pokazali da se kod studenata IGD simptomi mogu izmeriti instrumentom u čijoj osnovi leži jedan faktor. Skala od devet stavki koje se odnose na DSM-5 kriterijume i kratka skala od četiri stavke koja se odnosi na glavne simptome prema ICD-11 kriterijumima imaju zadovoljavajuću internu konzistentnost i konstruktnu validnost. Merna invarijantnost u odnosu na različite jezike je utvrđena za tri ajtema (preokupiranost igranjem onlajn igara, gubljenje interesovanja za dotadašnje hobije i zabavu i korišćenje igranja za rasterećenje od negativnih emocija). Ova studija je ponudila početne podatke za procenu simptoma poremećaja igranja kompjuterskih igrara na internetu kod studenata i nadamo se da će podstaći buduća istraživanja zavisnosti od kompjuterskih igrara u populacijama širom sveta uzimajući u obzir jezičke/kulturološke razlike.

Many hypotheses have been proposed for the development of schizophrenia, including the one proposing that exogenous and endogenous factors are linked to inflammatory processes. There is strong evidence about the immunological and inflammatory dysfunction in schizophrenia. In this study, we aimed to measure serum 15-deoxy-delta(12,14)-prostaglandin J (15d-PGJ), peroxisome proliferator-activated receptor gamma(PPAR gamma), prostaglandin E2 (PGE2) and C-reactive protein (CRP) levels. Forty-four patients and 39 healthy volunteers were included in the study. Serum PGE2, 15d-PGJ, PPAR gamma and CRP levels were measured in both the groups. Demographic data forms were filled out for the patient group, and the Positive and Negative Syndrome Scale, Clinical Global Impression-Severity scale and Calgary Depression scale were used to assess patients' clinical status. Serum PGE2, 15d-PGJ and PPAR gamma levels were found to be significantly lower in patients with schizophrenia than in healthy controls. There was no significant relationship between the serum PGE2, 15d-PGJ and PPAR gamma levels and CRP levels.In this study, the evidence of systemic inflammatory conditions in patients with schizophrenia was found. The duration of the disease has been found to be the only variable that independently affects all three biomarker levels in the patients with schizophrenia.

OBJECTIVES: Bipolar disorder (BD) carries a high rate of morbidity and mortality, and the clarification of its aetiology continues to be an important field of research. In recent studies, the clinical characteristics of BDs have been explained through a number of underlying factors, including cytokines, steroids, neurotrophins, mitochondrial energy generation, oxidative stress, and neurogenesis. In this study, we aimed to investigate potential associations between BDs and inflammatory processes. METHODS: Patients with mania or in remission who attended outpatient clinics of the Department of Psychiatry of the Ankara Numune Training and Research Hospital, and who were diagnosed with BD according to the DSM-V criteria, were included in the study. IBM SPSS Statistics 23 software was used for statistical analyses of the data. The normality of the distribution of continuous and discrete numerical variables was tested with a Shapiro–Wilk Test. RESULTS: In this study, the measurements and statistical analyses revealed significantly lower 15-deoxy delta12, 14-prostaglandin J2 (15d-PGJ2) and Peroxisome Proliferator-Activated Receptor-Gamma (PPARγ) levels in patients with mania in comparison to healthy controls and patients in remission. Group comparisons did not reveal any significant differences between IL-4 levels. CONCLUSIONS: This study was not a longitudinal study evaluating the same patients during both relapse and remission periods; no group of patients in a depressive episode of BD were included in the group comparisons either. Although this evidence is not adequate for a definite conclusion, the available evidence suggests that anti-inflammatory markers such as 15d-PGJ2 and IL-4 and nuclear PPARγ receptors are potential biomarkers to clarify the aetiology of BD, and these markers may be included among the therapeutic targets for future pharmacological modulations. Further studies are required in this area.

Background and aims Internet use has increased worldwide exponentially over the past two decades, with no up-to-date cross-country comparison of Problematic Internet Use (PIU) and its correlates available. The present study aimed to explore the pattern and correlates of PIU across different countries in the European and the Asian continent. Further, the stability of factors associated with PIU across different countries were assessed. Materials and methods An international, cross-sectional study with a total of 2749 participants recruited from universities/colleges of eight countries: Bangladesh, Croatia, India, Nepal, Turkey, Serbia, Vietnam, and United Arab Emirates (UAE). Participants completed the Generalized Problematic Internet Use Scale -2 (GPIUS2) assessing PIU, and the Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS) assessing the depressive and anxiety symptoms. Results A total of 2643 participants (mean age 21.3 ± 2.6; 63% females) were included in the final analysis. The overall prevalence of PIU for the entire sample was 8.4% (range 1.6% to 12.6%). The mean GPIUS2 standardized scores were significantly higher among participants from the five Asian countries when compared to the three European countries. Depressive and anxiety symptoms were the most stable and strongest factors associated with PIU across different countries and cultures. Discussion and conclusions The PIU is an important emerging mental health condition among college/university going young adults, with psychological distress being the strongest and most stable correlate of PIU across different countries and cultures in this study. The present study highlighted the importance of screening university and college students for PIU.

WOS: 000468136700009, PubMed: 30951929, European Federation of Psychiatric Trainees (EFPT), We would like to thank the European Federation of Psychiatric Trainees (EFPT) Research working group for their support to the Brain Drain Study.