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The fact that there are many limitations of the current classification systems led to the emergence of transdiagnostic approaches (TA) that focus on the common psychopathological processes underlying disorders rather than categorical diagnoses. TA focuses on the underlying common psychopathological processes in the emergence and persistence of mental disorders. Thus, even if the disorders are categorically diagnosed differently, it can be determined how they overlap or separate with each other. TA aims to treat mental disorders using these aspects. TA has a flexible and modular structure that can be easily integrated into cognitive behavioral therapies. The rest of this review will focus on the Unified Protocol (UP), one of the most popular TA examples. The main purpose of the UP is to enable patients to recognize their feelings and give more adaptive reactions to their negative emotions. Accordingly, UP consists of eight modules. The modules can usually be completed in a total of 11 - 17 weeks. Each 50 to 60-minute individual session is held once a week. If necessary, changes can be made to the number or the frequency of sessions allocated to modules. The goals of each module of the UP and the treatment approaches towards these goals allow a very clearly defined approach. For this reason, there is a need for a detailed evaluation, conceptualization and treatment plan before the UP is put into practice. We hope that mental health professionals from Turkey will contribute to the developments in the UP., Kategorik sınıflandırmaya imkân veren yaklaşımların pek çok kısıtlılığının olması, tanılardan ziyade tanıların altında yatan ortak psikopatolojik süreçlere odaklanan ve kesitsel yerine boylamsal (uzunlamasına) değerlendirmeyi vurgulayan ötetanısal (transdiyagnostik, tanılarötesi) yaklaşımların (ÖY) öne çıkmasına yol açmıştır. ÖY ruhsal bozuklukların ortaya çıkmasında ve sürmesinde altta yatan ortak psikopatolojik süreçlere odaklanır. Böylelikle kategorik açıdan bozukluklar farklı şekilde tanı alsa dahi birbirleriyle ne açıdan örtüştükleri ya da ayrıştıkları tespit edilebilir. ÖY, bu yönleri kullanarak ruhsal bozuklukları tedavi etmeyi amaçlar. ÖY, bilişsel davranışçı terapilerin işleyişine kolaylıkla entegre edilebilecek esnek ve modüler bir yapıya sahiptir. Bu gözden geçirme yazısının geri kalan kısmında en popüler ÖY örneklerinden biri olan Bütünleşik Protokol (BP) üzerinde durulacaktır. BP’de temel amaç hastaların duygularını tanımaları ve olumsuz nitelikteki duygularına daha işlevsel tepkiler vermelerini sağlamaktır. Bu doğrultuda BP sekiz modülden oluşur. Modüller genellikle haftada bir sıklıkta, her biri 50 – 60 dakika süren bireysel görüşmeler ile toplam 11 – 17 hafta içerisinde tamamlanabilir. Gereklilik olması halinde modüllere ayrılan oturum sayılarında veya oturumların sıklığında değişiklik yapılabilir. BP’nin her bir modülü hedefleri ve bu hedeflere dönük tedavi yaklaşımları son derece net bir şekilde belirlenmiş bir yaklaşıma imkân verir. Bu nedenle BP’nin uygulamaya geçirilmesinden önce detaylı bir değerlendirme, olgu kavramsallaştırması ve tedavi planı ortaya çıkarma gereği vardır. BP konusundaki gelişmelere Türkiye’den ruh sağlığı ve hastalıkları uzmanları ve çalışanlarının da katkı yapması ümit edilmektedir.

Nöroleptik malign sendrom (NMS) hipertermi, müsküler rijidite, bilinç değişikliği, otonomik disfonksiyon, serum kreatin fosfokinaz (CPK) düzeyinde yükselme ve lökositoz ile karakterize olan, nadir görülen ancak mortal seyreden bir sendromdur. Yorgunluk, dehidrasyon ve yetersiz beslenme NMS için risk faktörleri olarak kabul edilir ve kanser hastaları NMS için yüksek risk grubunu temsil etmektedir. Bu yazıda yetmiş üç yaşında şizofreni tanısıyla takipli bir hastada psikotik ajitasyonu kontrol altına almak amacıyla haloperidol 5 mg/gün intramüsküler olarak uygulanmasından iki gün sonra gelişen yüksek ateş, müsküler rijidite , otonomik instabilite, CPK ve C-reaktif protein (CRP) düzeylerinde yükselme , lökositoz saptanması NMS düşündürmüştür. Takip sırasında istenen beyin bilgisayarlı tomografisinde (BT) metastatik kanamadan şüphelenilen hastanın, biyopsi sonucu memenin invaziv duktal karsinomu olarak raporlanmıştır. Bilgilerimize göre literatürdeki, meme kanseri olan şizofreni hastasında antipsikotik kullanımım sonucu gelişen ilk NMS olgusudur.

Amaç: Bu çalışmada, üniversite öğrencilerinin tütün, alkol veya diğer madde kullanımlarına göre psikolojik sıkıntı düzeylerinin ve bağımlılık konusundaki farkındalık, olumsuz tutum ve damgalama düzeylerinin araştırılması amaçlanmıştır. Yöntem: Çalışmaya 612 üniversite öğrencisi dahil edilmiştir ve katılımcılar çevrimiçi olarak uygulanan Sosyodemografik Veri Formu, Bağımlılık İçin Üç Boyutlu Farkındalık, Tutum ve Damgalama Ölçeği, Fagerström Nikotin Bağımlılık Testi, Alkol Kullanım Bozuklukları Tanıma Testi, Madde Kötüye Kullanımı Tarama Testi, Depresyon Anksiyete Stres 21 Ölçeğini yanıtlamıştır. Bulgular: Çalışmamızda sigara içenlerde içmeyenlere göre anlamlı düzeyde daha yüksek stres, anksiyete, depresyon puanları; daha düşük farkındalık, olumsuz tutum, damgalama puanları saptanmıştır. Alkol veya madde kullananlarda kulanmayanlara göre anlamlı düzeyde daha yüksek anksiyete puanları; daha düşük farkındalık, olumsuz tutum puanları saptanmıştır. Farkındalık ile olumsuz tutum, damgalama, sigara kullanım puanları arasında pozitif yönlü korelasyon saptanırken, farkındalık ile anksiyete ve alkol kullanım puanları ile negatif yönlü korelasyon saptanmıştır. Alkol kullanım puanları ile anksiyete, depresyon, stres, nikotin kullanım puanları arasında pozitif yönlü korelasyon tespit edilmiştir. Sonuç: Alkol ve madde kullanımına sıklıkla psikiyatrik semptomlar eşlik etmektedir ve klinik değerlendirmede bu durum göz önünde bulundurulmalıdır. Özellikle riskli grup olan genç bireylerde bağımlılık konusunda farkındalığı artırmaya yönelik müdahaleler bağımlılığa karşı koruyucu olabilir.

Objective:In this study, sociodemographic characteristics and diagnoses of patients who presented to Tokat Gaziosmanpaşa University Faculty of Medicine Department of Psychiatry for disability evaluation and who were confirmed to be psychiatrically disabled.Methods:The files of the patients who presented to the health board for disability determination between 01.01.2019 and 31.12.2019 were reviewed retrospectively. Descriptive statistical analyses were performed for demographic and clinical data.Results:There were 494 patients over the age of 18 years, who presented for disability determination. It was concluded that 43 of 157 cases with psychiatric diagnosis at the time of presentation were confirmed to be disabled. The average age of these cases was 42.56±8.50 years and 37 (86%) were male. The most common diagnoses of disability were mental retardation with an IQ of 50 and below (n=18, 41.86%) and schizophrenia and its subtypes (n=12, 27.9%), which does not allow employment despite treatment.Conclusion:The results of our study will guide future studies on the recognition of mental disorders that result in disability and adversely affect the employment of individuals and their integration into working life.

Background: The aim of this study was to determine the validity and reliability of the Turkish version of Mahony Psychological Assessment for Bariatric Surgery which can be easily administered and used as a guide by health professionals who will be included in the treatment of patients who are potential candidates for bariatric surgery.Methods: A total of 310 patients who were admitted to health institutions for bariatric surgery in 3 different provinces of Turkey answered these questions in the Turkish translation of Mahony Psychological Assessment for Bariatric Surgery. Eating disorder examination questionnaire was also administered to the patients in addition to Mahony Psychological Assessment for Bariatric Surgery.Results: Early life problems due to weight scores of women were significantly higher than men (P=.001). Among the age groups, both the early life problems due to weight scores (P=.008) and dysphoric feelings about weight scores (P < .001) of the 18-44 age group were significantly higher than the participants who are over the age of 45. There is a weak-to-medium and positive correlation between the total Mahony Psychological Assessment for Bariatric Surgery total scores and all the subscale and total scores of the Eating Disorder Examination Questionnaire (P < .05 for all). These correlation results support the co-validity of Mahony Psychological Assessment for Bariatric Surgery and Eating Disorder Examination Questionnaire. Internal consistency of the Mahony Psychological Assessment for Bariatric Surgery was at a high level except for the subscale of positive treatment attitude and supportive environment. Cronbach’s ɑ values were calculated to be 0.902 for the subscale of emotional and binge eating, 0.820 for the early life problems due to weight, 0.856 for the dysphoric feelings about weight, 0.539 for the positive treatment attitude and supportive environment, and 0.919 for the whole scale.Conclusion: The analyses have shown that the Turkish version of Mahony Psychological Assessment for Bariatric Surgery may be used in clinical interviews and psychiatric evaluation of bariatric surgery patients in Turkey

This study aims to investigate the prevalence of risk for substance-related and behavioral addictions among university students in Turkey. In total, 612 students were included in this study, and they completed an online questionnaire consisting of the Fagerström Test for Nicotine Dependence, the Alcohol Use Disorders Identification Test, the Drug Abuse Screening Test, the Smartphone Addiction Scale-Short Version, the Young’s Internet Addiction Test-Short Form, the South Oaks Gambling Screen, and the Burden of Behavioral Addiction Form. Results revealed that the rates of potential alcohol dependence, pathological internet use, and potential smartphone addiction were 2.0%, 11.4%, and 24.7%, respectively. Approximately 0.3% of students reported severe problems related to substance use. The rates of high risk of compulsive shopping, problematic social media use, food addiction, gaming addiction, and sex/pornography addiction were 2.0%, 3.6%, 3.4%, 4.9%, and 5.6%, respectively. The rates of potential alcohol dependence, pathological gambling, gaming addiction, and sex/pornography addiction were found to be higher in men. Mild nicotine addiction, problematic internet use and possible smartphone addiction, food addiction, and gaming addiction rates were higher in the age group of 18 to 24 years. In conclusion, screening for addiction risk among youth is important for effective prevention, early diagnosis, and treatment.

INTRODUCTION[|]Regular and comprehensive follow-up of the side effects of antipsychotic drugs is an essential part of the treatment process. Self-report scales which are user friendly and which do not take too much time to complete are required. The aim of this study was to adapt the Glasgow Antipsychotic Side Effect Scale (GASS) into Turkish, and to evaluate its validity and reliability.[¤]METHODS[|]For this study, patients over the age of 18 presenting to the outpatient psychiatry clinics of secondary healthcare facilities in three different cities were recruited. Two hundred and ninety-seven of these patients who were on at least one antipsychotic drug except for clozapine for at least three months and who were diagnosed with any psychiatric disorders, and fifty-six patients of them were not on any antipsychotic drug treatment. The patients completed the GASS and the Systematic Monitoring of Adverse events Related to TreatmentS (SMARTS). The clinicians completed a demographic and clinical data form and the Clinical Global Impression Scale (CGI). Exploratory factor analysis was undertaken and concurrent validity, discriminating validity, internal consistency, test – retest reliability, and responsiveness of the GASS were calculated.[¤]RESULTS[|]Results demonstrated that the GASS consisted of seven factors,that it had concurrent validity with the SMARTS and the CGI (rho=0.706 & 0.381 respectively,p's

A transdiagnostic approach to psychiatric disorders presents an opportunity to evaluate the relationship between alexithymia and the concepts of psychopathology according to the psychological flexibility model. This study aimed to investigate the relationship between alexithymia, cognitive fusion and experiential avoidance. A total of 133 outpatient participants were included in this cross-sectional study. Sociodemographic Data Form, Toronto Alexithymia Scale-20, Acceptance and Action Questionnaire-II, Cognitive Fusion Questionnaire, Hospital Anxiety and Depression Scale, and Ten-Item Personality Inventory were used. The non-alexithymic group consisted of 37 participants while the alexithymic group of 26. The alexithymic group had higher scores in terms of depression, anxiety, experiential avoidance, and cognitive fusion. Difficulty in identifying and differentiating feelings and total alexithymia scores had positive correlations with anxiety, experiential avoidance, and cognitive fusion. In hierarchical regression analysis, the only difficulty in identifying feelings was predicted by both experiential avoidance and cognitive fusion. These results revealed that alexithymia might also be conceptualized adopting the psychological flexibility point of view.

INTRODUCTION[|]The aim of this study was to determine the validity and reliability of the Clinically Useful Depression Outcome Scale (CUDOS) in the Turkish population.[¤]METHODS[|]408 participants were included in the study. Exploratory factor analysis, internal consistency, Quick Inventory of Depressive Symptoms, State Trait Anxiety Inventory and Self-Report Tool for Mania were used to analyze the correlation between the scales and the discriminitave properties of the CUDOS was investigated.[¤]RESULTS[|]As a result of the exploratory factor analysis, 'Depression and Anxiety' and 'Atypical and Mixed Feature Depression' factors were determined. It was observed that the CUDOS had convergent validity with other relevant scales. It was demonstrated that the CUDOS had distinctive validity. Internal consistency was found to be high. According to clinician evaluation and scale scores, there was no difference in the detection of depression subtypes.[¤]DISCUSSION AND CONCLUSION[|]The CUDOS can be completed by patients in a short time and provides a quick and easy evaluation opportunity for clinicians. This validity and reliability study in the Turkish population showed that these scales were suitable for clinical use.[¤]

Undergraduate medical students' attitudes and beliefs toward mental illnesses are a crucial phenomenon as these students will be care providers of the future. The current study aimed to analyze whether the psychiatry clerkship/internship affects these students' level of knowledge about schizophrenia as well as their attitudes and beliefs toward schizophrenia and other mental illnesses. A total of 158 medical students, 92 in their fifth year and 66 in their sixth year, were included in the study. The participants completed the Knowledge About Schizophrenia Questionnaire (KASQ), Beliefs toward Mental Illness Scale (BMI), and Attitudes toward People with Mental Disorders Scale (APMDS) before and after the psychiatry clerkship/internship. The KASQ and APMDS total scores were significantly higher whereas BMI and BMI-Dangerousness subscale scores were significantly lower after the clerkship/internship in psychiatry. Postclerkship/internship KASQ total scores were negatively correlated with BMI total scores and BMI-Dangerousness subscale scores. Additionally, BMI total scores and APMDS total scores were also negatively correlated. Although the change in KASQ scores was significantly associated with the decrease in BMI total scores after the clerkship/internship, it was not associated with the increase in APMDS total score in the hierarchical multiple linear regression analysis. In conclusion, the present study revealed that knowledge about schizophrenia and attitudes and beliefs toward mental illnesses improved significantly after the clerkship/internship in psychiatry. While improvement in medical students' knowledge about schizophrenia and mental illnesses is a predictor of the decrease in negative beliefs about mental illnesses, a similar relationship was not found regarding attitudes. This study not only provides information about the relationship between knowledge about schizophrenia and attitudes and beliefs about mental illness but also highlights the need to consider the multifactorial nature of attitudes when developing intervention programs for medical students.

Introduction: The Cognitive Distortions Questionnaire (CD-Quest) is a self-report questionnaire that assesses common cognitive distortions. Although the CD-Quest has excellent psychometric properties, its length may limit its use. Methods: We attempted to develop short-forms of the CD-Quest using RiskSLIM - a machine learning method to build short-form scales that can be scored by hand. Each short-form was fit to maximize concordance with the total CD-Quest score for a specified number of items based on an objective function, in this case R2, by selecting an optimal subset of items and an optimal set of small integer weights. The models were trained in a sample of US undergraduate students (N = 906). We then validated each short-form on five independent samples: two samples of undergraduate students in Brazil (Ns = 182, 183); patients with depression in Brazil (N = 62); patients with social anxiety disorder in the US (N = 198); and psychiatric outpatients in Turkey (N = 269). Results: A 9-item short-form with integer scoring was created that reproduced the total 15-item CD-Quest score in all validation samples with excellent accuracy (R2 = 90.4-93.6%). A 5-item ultra-short-form had good accuracy (R2 = 78.2-85.5%). Discussion: A 9-item short-form and a 5-item ultra-short-form of the CD-Quest both reproduced full CD-Quest scores with excellent to good accuracy. These shorter versions of the full CD-Quest could facilitate measure-ment of cognitive distortions for users with limited time and resources.

WOS:000497024900001 OBJECTIVES: We aimed to compare patients with bipolar disorder and major depressive disorder, who were either in an acute depressive episode or in remission, and a healthy control group on their cognitions related to depression and mania/hypomania, and on their response styles. METHODS: A total of 300 participants who presented to our outpatient psychiatry department were included in the study (100 participants with unipolar depression (DG), 100 with bipolar disorder, and 100 with no previous or current psychiatric disorder (CG)). The participants completed the Cognition Checklist (CCL), the Cognition Checklist for Mania (CCL-M-R), the Cognitive Distortions Questionnaire (CDQ), the Dysfunctional Attitude Scale (DAS), the Hypomanic Attitudes and Positive Predictions Inventory (HAPPI), the Brief Core Schemas Scale (BCSS), Ruminative Response Scale (RRS), and the Responses to Positive Affect Questionnaire (RPAQ). The groups were compared with each other by one-way analysis of variance, independent samples t-test, and chi-square tests. RESULTS: The DG scored higher than the other groups on the CCL, the frequency and intensity subscales of the CDQ, the DAS, and the negative-self and negative-others subscales of the BCSS, the RRS, and on the dampening subscale of the RPAQ. The clinical groups scored higher than the CG on the scores of the relationships subscale of the CCL-M-R, the total score of the CDQ, and the HAPPI. The CG scored higher than the clinical groups on the positive-self subscale of the BCSS, and on the emotion focused positive rumination subscale. CONCLUSIONS: These findings are important in the differential diagnosis of mood disorders, and for their treatment with cognitive behavioural psychotherapy.

We aimed to investigate the similarities and differences between patients with OCD and PD, and healthy control subjects (NPC) on their metacognitive beliefs, emotional schemas, and cognitive flexibility. We hypothesized that the clinical groups would score higher than the NPC group on their dysfunctional metacognitive beliefs and negative beliefs about emotional schemas, and lower than the control subjects on their cognitive flexibility. Regarding the metacognitive beliefs, the clinical groups scored higher than the NPC group on the scores of the uncontrollability and danger, the need to control thoughts subscales, and on the total score of the MCQ-30. On the uncontrollability, comprehensibility, rumination, dissimilarity, dangerousness, and guilt dimensions, and on the total score of the LESS, the clinical groups scored significantly higher than the NPC group. The NPC group obtained higher scores than the clinical groups on the Cognitive Flexibility Inventory. Focusing on the psychological concepts that differentiate patients with OCD and PD from healthy controls might help identify potential targets for psychotherapy.

Batmaz, Sedat/0000-0003-0585-2184 WOS: 000492590900004 This study determined the effect of a cognitive behavioral group therapy (CBGT) program administered to infertile women on infertility-related stress, depressive and anxious thoughts, and general health state. A randomized controlled design was used for this study. The study was conducted with 107 infertile women: 55 in the experimental group and 52 in the control group. The CBGT was administered to the experimental group for 11 weeks. The pretest, posttest, and trimester follow-up results of this group were compared with those of the control group. The experimental group's Fertility Problem Inventory pretest mean score was 188.47 +/- 30.699, posttest mean score was 135.84 +/- 22.571, and follow-up mean score was 140.61 +/- 20.16. A statistically significant difference was found between the experimental and control groups' pretest, posttest, and follow-up mean scores on depressive and anxious cognitions (CCL), FPI and its subscales, and the General Health Questionnaire-28 and its subscales (p < 0.05). The CBGT intervention reduced the infertility-related psychosocial problems experienced by infertile women and promoted improvement in their depressive and anxious cognitions, and their mental health.

Most treatment guidelines emphasize the use of psychotropic drugs for both the acute and maintenance treatment of bipolar disorder (BD). However, relying only on psychotropics without adjunctive psychosocial interventions may be insufficient in treating patients with BD. Given its unique view in the explanation of psychopathological states, metacognitive therapy (MCT) might be helpful for BD. Metacognitive theory posits that psychopathology is a result of the cognitive attentional syndrome (CAS) and that it is influenced and maintained by dysfunctional metacognitive beliefs, perseverative thinking, attentional biases, and dysfunctional coping strategies. In this review, literature data regarding these areas in BD are examined. Studies suggest that perseverative thinking might be among the emotion regulation strategies endorsed in individuals with BD. Regarding attentional biases, literature data show that state-dependent, mood-changing attentional biases and a ruminative self-focused attention are present. Studies also suggest that cognitive self-consciousness is higher in BD compared to controls. It is seen that maladaptive coping strategies are frequently reported in BD, and that these strategies are associated with depression severity, negative affect and relapse risk. Studies focusing on dysfunctional metacognitive beliefs in BD reported that individuals with BD had higher scores for negative metacognitive beliefs, self-consciousness, need to control thoughts, and a lack of cognitive confidence. Also, dysfunctional metacognitive beliefs were associated with depressive symptomatology. These findings suggest that the components of CAS and dysfunctional metacognitive beliefs are evident in BD. For a subgroup of patients with BD who fail to respond to evidence-based psychopharmacological and adjunctive psychotherapeutic interventions, MCT might be an alternative way to consider as a treatment option. In conclusion, taken the available data together, we propose a sequential treatment protocol for BD, mainly based on the MCT treatment plan of depressive disorders.

Background: Suicide is one of the major public health problems in young adults. Detecting the risk factors and correlates among university students might help identify students who are under risk and who need early interventions for suicide prevention.Aims: The current study aimed to investigate the cognitive style, self-esteem, hopelessness, rumination, cognitive reactivity, and personality characteristics of Turkish university students, who previously attempted suicide and who did not.Method: A total of 355 university students (34 previous suicide attempters) were recruited for this study, and they completed the Ten-Item Personality Inventory (TIPI), the Ruminative Response Scale (RRS), the Leiden Index of Depression Sensitivity–Revised (LEIDS-R), the Beck Hopelessness Scale (BHS), the Cognitive Style Questionnaire–Short Form (CSQ), the Rosenberg Self-Esteem Scale (RSES), and the Hospital Anxiety and Depression Scale (HADS).Results: Higher RRS, BHS, CSQ scores and lower TIPI-A and RSES scores were significantly associated with a previous suicide attempt.Conclusion: Negative cognitive style, hopelessness, and rumination were significant correlates of a previous suicide attempt. These cognitive factors may be targets in psychotherapy to reduce suicide attempts in college-age individuals.

Standardized scales are increasingly recommended to measure response when treating psychiatric disorders in routine clinical practice. The Clinically Useful Anxiety Outcome Scale (CUXOS) is a short self-report scale to evaluate the severity of anxiety quickly and optimally. In this study, validity and reliability of the CUXOS was investigated in a Turkish population. 155 patients with anxiety disorders, obsessive-compulsive disorder, posttraumatic stress disorder, and 132 participants with no history of psychiatric diagnosis were included in the study. As the assessment tools, the Turkish version of CUXOS, the State- Trait Anxiety Inventory, the Clinically Useful Depression Outcome Scale, the Clinical Global Impression Scale – Severity subscale were used. With FACTOR 10.8.04 software, explained variance, eigenvalues, loading factors and common factor variances were calculated. For the internal consistency, Cronbach α values, corrected item-total correlations and Cronbach α values of the extracted factors and the whole scale were calculated. MedCalc 17.2 software was used for these analyses. Cronbach α values were found to be 0.957 for CUXOS, 0.936 for CUXOS-Somatic subscale and 0.934 for CUXOS-Psychic subscale. No significant change in internal consistency was observed in the entire scale with the removal of the item. Adjusted item - total correlations values ranged from 0.466 to 0.792. Convergent and discriminant validity of the scale were demonstrated. Turkish version of CUXOS is a valid and reliable scale that measures the severity of anxiety and suitable for clinical use in Turkish population.

WOS:000562483100010 PubMed: 32187318 Objective: The metabolic syndrome (MS) is highly prevalent among patients with bipolar disorder (BD), and may affect progression, functioning, and comorbid conditions in BD. The aim of this study was to investigate the effect of clinical variables and MS on overall functioning and specific areas of functioning in patients with BD. Methods: A total of 210 participants (140 participants with BD I and BD II in remission and 70 nonpsychiatric control subjects) were included. The investigators administered the Young Mania Rating Scale (YMRS), the Bipolar Depression Rating Scale (BDRS), the Global Assessment of Functioning Scale (GAF), and the Bipolar Disorder Functioning Scale (BDFS). The participants completed the Beck Depression Scale (BDS) and the Beck Anxiety Scale (BAS). MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Hierarchical regression analysis was used to investigate potential correlations of comorbid MS with clinical variables and level of functioning. Results: Level of functioning did not differ between patients with and without MS. However, there were significant correlations between the level of functioning subscales and the number of depressive episodes (p = 0.033), level of general functioning (p = 0.012), duration of illness (p = 0.012), BDS (p = 0.005), BDRS (p = 0.021), BAS total scores (p = 0.021), number of hypomanic episodes (p = 0.022), number of hospitalizations (p = 0.003), employment status (p = 0.032), and diagnosis of BD I (p = 0.007) and BD II (p = 0.044). Conclusion: Our findings suggest that clinical variables had a greater effect on functioning than MS in BD patients.

Many studies have described grief and psychiatric symptomatology as a typical feature following miscarriage. How women who had a miscarriage (MG) respond to trauma in terms of negative cognitions about their selves and the world, the coping strategies they employ to overcome the effects of the trauma, and what factors might be indicative of posttraumatic growth (PTG) in this population have not been extensively studied so far. We aimed to identify whether women who had a miscarriage (N = 74 vs. N = 82 control subjects) exhibited higher levels of psychological distress symptoms, dysfunctional cognitions, and maladaptive coping strategies, and whether women with lower PTG employed more maladaptive coping strategies, and reported higher levels of dysfunctional cognitions. Group comparisons according to the diagnostic groups based on self-report measures for depression, anxiety, posttraumatic stress disorder and according to the level of PTG, and stepwise linear regression analyses with PTG as the outcome were performed. Our study demonstrated that the MG does not necessarily differ from the control group on some measures of psychopathology, coping mechanisms, dysfunctional cognitions, or PTG. Yet, the MG who exhibited higher levels of PTG had specific predictors, and women with a psychiatric diagnosis differed from participants with no diagnoses on some measures of dysfunctional cognitions, coping mechanisms, and PTG. Further studies with a prospective design could further clarify the needs of the MG requiring psychotherapeutic interventions.

Background and objectives We aimed to investigate the depression and anxiety levels and to explore the coping strategies and personality traits of patients with euthyroid Hashimoto Thyroiditis (HT). Methods The study population consisted of 108 outpatients with euthyroid HT. The participants completed the Hospital Anxiety and Depression Scale (HADS), the Big Five Personality Inventory (BFI), and the Coping With Problems Experienced Inventory (COPE). Results Depression scores were negatively correlated with emotion-focused and problem-focused coping style scores. Emotion-focused and problem-focused coping style scores were negatively correlated with neuroticism, and positively correlated with openness scores. Emotion-focused coping style scores were also positively correlated with agreeableness scores. Dysfunctional coping style scores were negatively correlated with conscientiousness scores. Higher agreeableness and anxiety scores as well as lower neuroticism scores were predictive of emotion-focused coping style scores. Problem-focused coping style scores were predicted by lower depression scores. Dysfunctional coping style scores were predicted by lower conscientiousness scores. Conclusions The present study points the importance of taking personality features and individual coping strategies into account when evaluating patients with HT. Determining the personality features and coping strategies might be useful for identifying patients in need of particular counseling and support.

WOS:000468583500009 Objective: In this study, adults presenting to the emergency room after a suicide attempt were evaluated by means of some suicide risk assessment tools, and the effectiveness of these tools in identifying those who needed to be hospitalized was investigated. Method: A total of 60 participants were included in the study. The clinical risk assessment of a psychiatrist was considered to be the gold standard for evaluation, and the consistency of the scores obtained by the tools used in the study (Modified "SAD PERSONS" Scale, California Suicide Risk Estimator, Suicide Risk Assessment Tool) were compared with this gold standard by receiver operating curves (ROC). For each tool, the optimal cut-off score, and its sensitivity and specificity at this value, which identified those who needed to be hospitalized were calculated. Independent samples' t test was used to demonstrate whether the clinical assessment and the cut-off scores of the tools were able to differentiate the groups who needed to be hospitalized or not. The relationship between the clinical assessment and the tools was investigated by Pearson correlation analyses. Results: The sensitivity of the assessment tools for the need for hospitalization ranged from 44.4% to 72.2%, and their specificity ranged from 81.0% to 95.2%. No differences were found between the ROCs of the assessment tools when they were compared with each other. The cut-off scores of the assessment tools managed to differentiate those who needed to be hospitalized. Discussion: Although the assessment tools may not replace the clinical risk assessment of a psychiatrist, some of them may be helpful for the emergency room healthcare staff in identifying the adults who need to be hospitalized after an attempted suicide.

WOS:000449654800005 Background: The prevalence of obesity has more than doubled over the past three decades. Impulsivity is a multidimensional personality trait that potentially contributes to the development and maintenance of obesity. Mindful awareness can potentially minimize the automatic and inattentive reactions around food. Objectives: In our study, we aimed to research the relationship between impulsivity and mindful attention. Methods: The study population consisted of 60 outpatients aged 18 and older, with a body mass index (BMI) of at least 30 kg/m(2) presenting to the psychiatry clinics of a secondary health care facility. The participants completed the Barratt Impulsiveness Scale (BIS), and the Mindful Attention Awareness Scale (MAAS). Results: The average age of participants was 39 years, BMI was 35.70 +/- 4.54 kg/m(2). BMI was not statistically significantly correlated with any of the scales, and the MAAS total score was negatively correlated with the impulsiveness scores, except for the motor impulsiveness subscale score. Dispositional mindfulness was negatively associated with impulsiveness scores, except for motor impulsiveness. Discussion: This study showed that there was a negative relationship between impulsivity and mindfulness. Therefore, using mindfulness techniques may decrease impulsivity, and may be extremely helpful in promoting better eating behaviors and weight regulation.

Amaç: Klink deneyim ve gözlemler psikiyatriye direkt başvuran hastalar ile gastroenteroloji kliniğinden refere edilen hastalar arasında bazı tutarsızlıklar bulunduğunu göstermiştir. Bu yüzden, çalışmamızda bu hastaların demografik ve klinik özellikleri ile ilgili farklılıkları araştırmayı hedefledik. Yöntem: Çalışmaya ardışık olarak yaşları 18-64 arası olan 115 hasta alınmıştır. Bu hastaların 61'i direkt olarak başvurmuş, 54'ü konsültasyon istenerek refere edilmiştir. Primer gastrointestinal şikayetler, psikiyatrik tanılar ve kişilik özellikleri sosyodemografik veri formuna kayıt edilmiş, psikiyatrik bozuklukların şiddeti Klinik Global İzlenim Ölçeği - Şiddet Alt Ölçeği ile değerlendirilmiştir. Bulgular: Psikiyatriye direkt olarak başvuran hastaların çoğu kadın, daha yaşlı, evli hastalardı ve gastrointestinal belirtilerinin daha ziyade psikolojik kökenli olduğunu belirtmişlerdir. Direkt olarak psikiyatriye başvuran hastalar daha ziyade karında doluluk/abdominal gerginlikten yakınırken, refere edilmiş olan hastalar daha sık olarak gaz, abdominal ağrı ve kabızlıktan şikayet etmekteydi. Direkt başvurularda daha ziyade depresif bozukluklar, travma ile ilişkili bozukluklar ve kişilik bozuklukları ile ilgili tanı konmuşken, refere edilenlerde daha sıklıkla psikotik bozukluklar tanısı konmuştur. Direkt olarak başvuran hastalar aynı zamanda kişilik özelliği olarak daha fazla impulsivite göstermiştir.Sonuç: Gastrointestinal belirtileri olan ve psikiyatriye doğrudan başvuran hastalar kimi demografik yönleri, birincil psikiyatrik tanıları ve kişilik özellikleri açısından gastroenteroloji kliniklerinden yönlendirilenlerden farklılaşmaktadır. Gastrointestinal symptoms in psychiatry: comparison of direct applications and referralsObjective: Clinical experience and observations suggest that there are some discrepancies between patients who directly apply to psychiatry clinic, and who are referred from gastroenterology clinic to psychiatry clinic. Thus, we aimed to investigate differences related to the demographic and clinical characteristics of these patients. Method: The study included 115 consecutive patients aged between 18-65 years. Sixty-one of the patients applied directly to the psychiatry clinic, and 54 patients were referred for consultation to the psychiatry clinic. Primary gastrointestinal complaints, psychiatric diagnoses and personality features were recorded on the scoiodemographic data form, and the severity of psychiatric disorders were assessed by the Clinical Global Impression Scale - Severity Subscale. Results: Patients who directly applied to psychiatry clinic were more likely to be female, older, and married. They attributed their gastrointestinal symptoms also more likely to be of psychogenic origin. Patients who directly applied to psychiatry clinic suffered more likely from a sense of fullness/abdominal tension, while patients who were referred to psychiatry clinic more frequently complained of bloating, abdominal pain, and constipation. Patients who directly applied to psychiatry clinic were more frequently diagnosed with depressive disorders, trauma related disorders, and personality disorders, whereas referrals were more frequently diagnosed with psychotic disorders. Directly admitted patients were also more likely to exhibit impulsivity as a personality feature.Conclusion: Patients with gastrointestinal symptoms who directly presented to psychiatry differed from those who were referred from gastroenterology clinics on some of their demographic aspects, primary psychiatric diagnoses and personality traits.

Cognitive behavioral approaches have been able to demonstrate some of the underlying and perpetuating factors of depression such as cognitive reactivity (CR). The association of CR and the severity of depression is yet to be reported. We aimed to compare the CR of a group of outpatients based on their self-reported severity of depression (SRSD), and to identify the role of specific CR vulnerability markers in depression. The study population consisted of 221 outpatients diagnosed with Major Depressive Disorder. We used the Mini International Neuropsychiatric Interview, and completed a demographic and clinical data form. The participants completed the Leiden Index of Depression Sensitivity-Revised (LEIDS-R), and the Hospital Anxiety and Depression Scale. To identify how well CR, as measured by the scores of the LEIDS-R, could discriminate the groups based on the SRSD, one-way analysis of variance was used. To examine the unique associations between the CR and the SRSD, a hierarchical linear regression analysis was performed. To identify group membership to severe depression, the scores of the LEIDS-R were entered in a logistic regression model. Large, and small group differences emerged on the rumination, and control scores, respectively. The other group differences were all in the medium range. The control, risk aversion, and rumination scores were the subscales which explained a significant proportion of the variance in the SRSD. Overall, the logistic regression model classified 93.7 % of the severely depressed patients correctly. These results indicated that rumination, risk aversion, and perfectionism were particularly associated with severe depression.

Objective: According to the cognitive theory developed by Beck, cognitive distortions are important mediators for the onset and maintenance of depressive disorders. It has not been researched if these cognitive distortions are more frequently encountered during the depressive episode, or if they are trait-like features. This study aims to investigate this. The hypothesis of the study is that cognitive distortions are state dependent. Method: Three groups of outpatients (n=178 patients in acute major depressive episode, n=168 depressive patients in remission, n=177 healthy controls) presenting to the psychiatry clinics of three different state hospitals were recruited for the study. The participants were diagnostically interviewed by the MINI according to the DSM-IV criteria. The participants were asked to complete the Cognitive Distortions Scale and the severity of their depression was measured by the Inventory for Depressive Symptomatology. Results: According to the cognitive distortion subscales, except for the self-blame subscale, the acute depressive group scored the highest. Also it was found that the cognitive distortions of the depressive populations, except for the self-blame related ones, statistically differed from the healthy controls. Self-blame related distortions were mood state dependent. Conclusion: The results have revealed that self-criticism, helplessness, hopelessness and preoccupation with danger related distortions had trait-like features, whereas self-blame related distortions were state dependent. This has clinical implications for the psychotherapeutic treatment of cognitive distortions in depression. Specifically, self-criticism related distortions should be managed during cognitive therapy for depression since the other subscales seem rather problematic. [JCBPR 2015; 4(3.000): 147-152]

In recent years, regardless of the diagnostic categories instead of disorder-specific approaches, the primary aspects of comorbidity among the prominent aspects of the transdiagnostic approach (TA), which advocates targeting these processes in treatment and identifying common processes underlying psychopathological signs and symptoms is important to solve the dilemma that will be treated as an subthreshold symptoms in order to offer treatment to people who do not fully meet any diagnosis. Although there are many research articles on what are the transdiagnostic processes and the effectiveness of the TA, assessment tools that can be used to evaluate these processes collectively are limited to the Cognitive Behavioral Processes Questionnaire (CBPQ). Before this scale came into use, researchers tried to identify common processes with different methods. CBPQ was developed by Patel et al. as a self-report scale that allows to question the core processes previously defined in the literature, in line with the problematic areas that people face, based on the cognitive behavioral theory. In this study, it was aimed to examine the validity and reliability of the Turkish version of CBPQ.

According to the metacognitive model which explains an innovative perspective, some scales have been developed to evaluate obsessive compulsive disorder (OCD). In this context, the validity and reliability of the Turkish version of Thought Fusion Instrument (TFI), Beliefs About Rituals Inventory (BARI) and Stop Signals Questionnaire (SSQ) were tested in this study. 140 university students participated in the study. Participants were asked to fill in TFI, BARI, SSQ and also Obsessive-Compulsive Inventory (OCI), Thought-Action Fusion Inventory (TAFI), Obsessive Beliefs Questionnaire (OBQ) and Penn State Worry Questionnaire (PSWQ). According to the results of factor analysis, While TFI and BARI consisted of a three-factor structure, SSQ consisted of a single factor structure. Cronbach’s α value of TFI was 0.883 (Cronbach’s α value of subscales was 0.751- 0.858), Cronbach’s α value of BARI was 0.856 (Cronbach’s α value of subscales was 0.737-0.885) and Cronbach’s α value of SSQ was 0.941. Corrected item-total correlation values with a range of TFI from 0.281 to 0.702, of BARI from 0.324 to 0.730 and of SSQ from 0.669 to 0.788. The eigenvalues of factors for TFI5.856, 1.660 and 1.115; for BARI 4.800, 1.742 1.222; and for BARI 7.300. These factors explained 61.6% of the total variance for TFI, 64.7% for BARI and 60.8% for SSQ. Correlation of the scales was assessed with other OCD scales (for OCI r = 0.167-0.456, for TAFI r = 0.248-0.389, for OBQ r = 0.321-0.460, for PSWQ r = 0.206-0.258). The scales were found to be able to successfully distinguish between OCD and non-OCD groups (d = 0.43-0.88). Current findings have shown that the Turkish versions of the used TFI, BARI and SSQ in the OCD evaluation according to the metacognitive model are valid and reliable.

Dysfunctional attitudes are considered to be important risk factors in the onset and maintenance of depression. Thus, a psychometrically reliable and valid measure is necessary for understanding depression. The Dysfunctional Attitude Scale (DAS) is widely used and has good psychometric properties, but there is no consensus about its factor structure. To examine its psychometric properties and factor structure, a total of 885 individuals consisting of patients with depression and healthy controls were evaluated. After the sample was randomly divided into two subsets, exploratory and confirmatory factor analyses were performed. Then the DAS was abbreviated according to the factor profiles and theoretical background. Analyses indicated two factors, named Perfectionism/Achievement and Need for Approval/Dependency for the revised DAS . Reliability analyses revealed a good internal consistency, and the concurrent validity indicated significant correlations with the Beck Depression Inventory and the Automatic Thoughts Questionnaire.

WOS:000440051200008 Objective: The aim of this research was to assess the characteristics of the consultations required in a psychiatric department of a university hospital, and the distribution of psychiatric disorders in hospitalized patients and patients admitted to the emergency room. Method: In the study, the data of 539 patients 18 years or older (48.67 +/- 20.91 years) (46.8% women) who were hospitalized and who presented to the emergency room between 01/01/2015 and 31/12/2015, and for whom a psychiatric consultation was requested were recorded onto a structured form. Patients' electronic databases were reviewed retrospectively for the specified date range. Descriptive statistical analyzes (frequency of data, distribution, mean, standard deviation) were performed for the data examined in the study. Results: Medical departments (42.9%), surgical departments (31.7%) and the emergency medicine department (25.4%) were the most frequently psychiatric consultation requesting departments. The most frequent requests for consultation were agitation (15.4%), depressive symptoms and signs (14.7%) and suicide attempts (12.2%). The most frequent psychiatric diagnoses were depressive disorders (19.5%), delirium (18.2%) and schizophrenia and other psychotic disorders (7.4%). Musculoskeletal diseases (17.4%), mental disorders (15.0%), oncologic diseases (14.1%) and suicide attempts (12.2%) were the primary diagnoses of patients. Discussion: Consultation and liaison psychiatry services have an important role in our relationship with other departments in medicine. Priority to training of depressive disorders, delirium and suicide attempts should be offered to healthcare providers working in these departments.