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Objective: The present study aimed to compare the intensity of inflammation between major depressive disorder (MDD) and bipolar disorder-depressive episode (BD-D) by using neutrophil to lymphocyte (NLR) and platelet to lymphocyte ratios (PLR) as nonspecific markers for peripheral immune response, and to investigate whether and how these parameters correlate with the clinical characteristics of the depressive episodes within and between the diagnoses. Patients and Methods: The medical records of 209 psychiatric inpatients (126 diagnosed with MDD, 83 with BD-D) and 150 healthy controls (HC) were retrospectively screened to obtain NLR and PLR values. Results: Both MDD and BD-D presented with significantly elevated NLR and PLR compared to HC, with the increase being associated with the severity of depression but not with the presence of psychotic features. The severity of inflammation was found to be of a comparable magnitude between the two conditions, or at least indistinguishable by means of the NLR and PLR. Conclusion: Our results suggest that both MDD and BD-D involve a presumably complex inflammatory process resulting in an observable, albeit nonspecific alteration in the distribution of peripheric blood cells. Moreover, the magnitude of the observed immune response appears to relate to the severity of the depressive episode for both conditions.

As non-specific markers of immune dysregulation, neutrophil-lymphocyte and platelet-lymphocyte ratios (NLR and PLR) have been consistently shown to be increased in major neuropsychiatric disorders. Although this increase seems to be trans-diagnostic, the extent to which its magnitude differs between disorders remains largely unclear.The aim of this study was to directly compare the severity of inflammation (as reflected by NLR and PLR) between schizophrenia (Sch), bipolar mania (BD-M), bipolar depression (BD-D), major depressive disorder (MDD) and obsessive compulsive disorder (OCD).NLR and PLR were obtained for a total of 417 subjects (91 Sch, 70 BD-D, 37 BD-M, 93 MDD, 37 OCD, and 95 controls) and analyzed for group differences.Sch, BD-M, BD-D and MDD presented with significantly higher NLR compared with both OCD and HC. NLR in BD-M was significantly higher than all the remaining groups, whereas Sch, BD-D and MDD presented with comparably elevated NLR. Moreover, BD-M, Sch and MDD had significantly higher PLR compared with HC.These results suggest that the underlying inflammation may be most severe in BD-M, followed by Sch, BD-D and MDD. On the other hand, inflammation may be of negligible intensity in OCD, or at least undetectable by means of NLR or PLR.

Background: Approximately half of the children with attention-deficit hyperactivity disorder continue to meet diagnostic criteria in adulthood. The prevalence of adult attention-deficit hyperactivity disorder is reported between 2.5% and 4.4% and is associated with significant impairment in quality of life and increased psychiatric comorbidity. Attention-deficit hyperactivity disorder in adults remains mostly undiagnosed and/or untreated despite the availability of effective treatments. The majority of people who do not receive necessary treatment are in the nonclinical or nonpsychiatric clinical population. Screening is an important step for diagnosing adults with attention-deficit hyperactivity disorder. Yet, there are no valid and reliable screening questionnaires calibrated for the Diagnostic and Statistical Manual for Mental Disorders-5 in Turkish. Aims: We aimed to test the reliability and the validity of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 screening questionnaire designed according to DSM-5 in the Turkish population. Study Design: Methodological and cross-sectional study. Methods: The translation was carried out according to the World Health Organization Composite International Diagnostic Interview translation guide using a linguistic adaptation approach. We used a convenience sampling method to recruit an individual with adult attention-deficit hyperactivity disorder (n = 68) and a control group (n = 68). The participants completed a sociodemographic form, 6-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, and the previous version 18-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 for the concurrent validity analysis. For the diagnostic validity, clinical diagnosis made by psychiatrists according to the Diagnostic and Statistical Manual for Mental Disorders-5 criteria was used. Internal consistency and item-total correlation coefficients, exploratory factor analyses, correlation with Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1, and receiver operating characteristic curve analysis were conducted. Results: The internal consistency measured by Cronbach alpha was 0.869. Item-total correlation coefficients were calculated to be between 0.602 and 0.717, and the correlations were statistically significant (P < 0.0001). The Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 showed to have a unidimensional factor structure explaining 60.54% of the variance. The correlation between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 total score was calculated as 0.992 (P < 0.0001), and that between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 attention-deficit subdimension was 0.868 (P < 0.0001). In the receiver operating characteristic analysis of Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, the area under the curve was found to be 0.916. The cut-off score was calculated as 9 of 10 with a sensitivity of 85.2% and specificity of 89.7%. Conclusion: Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 is a valid and reliable self-report measure to assess and screen attention-deficit hyperactivity disorder in the Turkish population. It may be useful for both clinical and population studies.

Background Burning mouth syndrome (BMS) is an idiopathic condition that presents with chronic pain and/or burning sensations in the oral structures. The syndrome mostly affects elderly women with hormonal changes and/or with a diagnosis of comorbid psychiatric disorder. In some rare conditions, the clinical appearance of BMS may also overlap with oral cenestopathy (OC), which is defined in the literature as a special form of delusional disorder of somatic type. Patients with OC may complain about abnormal experiences such as melting, feeling of stickiness, as well as extremely strange feelings of wires, metal coils, etc being present in their mouths. Case presentation We present an elderly woman whose ongoing symptoms of BMS (burning in the mouth and tongue, taste alterations etc) were, over time, superimposed by cenesthopatic delusions that her gums had melted, and her palate had totally dissolved. We believe that the case is clinically striking and demonstrative for the understanding of complex nosology of BMS and OC, given that (a) the patient exhibited a relatively rare example of overlapping BMS and OS symptoms, which both are not sufficiently recognised by clinicians, (b) OC symptoms have disappeared with low-dose aripiprazole and psychoeducation-based cognitive therapy, which resulted in significant improvement in the patient's quality of life. Conclusion Clinicians are required to be aware of BMS and OC, two syndromes with multifactorial aetiology and highly heterogeneous presentation, in order to determine the most appropriate treatment options from a multidisciplinary perspective, as well as to avoid unnecessary medical interventions.

OBJECTIVE: Children and adolescents facing difficult life circumstances due to social, economic and cultural adversity, form a disadvantaged group in terms of social functioning and healthy psycho-social development. The goal of this study was to evaluate the psychological resilience of high school students in Muş City – which was ranked last in the general life index among 81 provinces according to 2015 data from the Turkish Statistical Institute – and to examine different dimensions of psychological resilience in relation to a variety of variables including adverse life events and demographic characteristics. METHOD: The study sample consisted of 1025 students from the 10th and 11th grades of five different high schools operating in the city centre of Muş. Participants were asked to fill in a socio-demographic questionnaire, the List of Adverse Life Events and the 59-item Resilience and Youth Development Module (RYDM). A series of correlational and descriptive analyses were then performed. RESULTS: Correlational analyses revealed that among the demographic factors, low economic status, a criminal record and poor academic performance were associated with poor psychological resilience, while among adverse life events, the deterioration of parental economic status, frequent arguments between parents as well as a history of mental illness and alcohol/substance abuse in the family were also linked to low levels of psychological resilience. It was also determined that girls had higher scores on internal assets of RYDM (empathy, problem solving, self efficacy, communication and cooperation, goals, self awareness and educational aspirations), while exposure to a larger number of adverse life events negatively affected internal resilience assets. Finally, trauma exposure, just as the low RYDM scores, seems to be associated with frequent arguments between parents, alcohol/substance abuse in the family, male gender and a criminal record. However, there was no significant relationship between psychological resilience and trauma alone. CONCLUSION: Interventions to improve psychological resilience, which is a dynamic process, need to be comprehensive and multi-dimensional. In this context, it is crucial to elucidate the factors associated with the psychological resilience of children and adolescents exposed to a specific risk factor, such as adverse living conditions. In order to improve our understanding of psychological resilience and youth development in Turkey and to determine specific needs for interventions, future studies on various risk groups in different pilot cities – as in the example of Muş – are needed.

Introduction: The aims of the present study were 1) to identify the major psychosocial challenges faced by students of a university in Istanbul, during the initial period of the COVID-19 outbreak, 2) to assess how these interacted with their level of knowledge, attitudes, and practices toward COVID-19 and the related health measures in place Methods: As part of an international research, a total of 2583 university students from Istanbul participated in an online survey, which included questions in several domains including their studies and daily life before and after the outbreak, their concerns and worries about the pandemic, their level of knowledge on COVID-19, their views on the policies implemented by the government and their institution, their attitude and practices toward the protective measures Results: Majority of the students reported to suffer from financial adversities due to the outbreak The closure of residential facilities and the cancellation of face-to-face lectures resulted in the vast majority of the students moving back to their family home Their daily routines were largely replaced by individual home activities, and social interactions shifted almost totally to digital platforms They also reported high levels of anxiety and worries concerning a wide range of the possible detrimental outcomes of COVID-19, which were in close association with their knowledge, attitudes, and practices towards the disease, as well as their adherence to the policy measures and their satisfaction with the policies of the government Conclusion: These results may help policymakers in better understanding the psychosocial impacts of COVID-19 on the life of university students, and to develop more comprehensive strategies to address their multifaceted struggles, as well as to improve their compliance with the health measures in the future [ABSTRACT FROM AUTHOR] Copyright of Archives of Neuropsychiatry / Noropsikiatri Arsivi is the property of Turkish Association of Neuropsychiatry and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Different compounds of hyoscine (scopolamine) are widely used for the treatment of a variety of conditions, ranging from motion sickness to colic spasms and smoking cessation. In some rare conditions, the administration of scopolamine may lead to severe idiosyncratic reactions, including central anticholinergic intoxication syndrome. Here, we present a young female patient who progressively developed a series of complex neuropsychiatric symptoms including ataxia, slurred and rambling speech, stereotypic movements, vivid visual and auditory hallucinations, and self-mutilative behaviours in the days following the injection of hyoscine butylbromide in the emergency room to treat her menstrual cramps. Referred to psychiatry, detailed screening of her medical records and collateral information from the family revealed that the neurobehavioural manifestations were indeed preceded by severe peripheral anticholinergic toxicity, which were mostly overlooked during the initial evaluations. Started on olanzapine treatment, the patient's symptoms gradually subsided over time, though it took several weeks to achieve full clinical recovery.

Functional (psychogenic) movement disorders (FMD) constitute a cluster of heterogeneous diagnoses involving motor symptoms that cannot be explained by organic pathology and are often associated with underlying psychological problems. In psychiatry, patients with FMD are often placed within the scope of somatoform disorders and conversion disorders. Functional Parkinsonism (FP) is a rare form of FMD seen in 1.5% of all patients presenting with symptoms of parkinsonism. Although almost all symptoms of parkinsonism can be present in FP, clinical features such as sudden onset and a nonprogressive course, inconsistent response to pharmacotherapy, and atypical findings in neurological examination are considered as important clues of psychogenic aetiology. Limited data in the literature on FP indicate that the average age of onset is between 37-53 years of age, whereas the average onset age of Idiopathic Parkinson's Disease (IPD) is around 60; and Juvenile Parkinsonism, a rare condition presenting before the age of 21, is often familial and more closely related to genetic mutations. Here, we present the case of a female patient, who, after the diagnosis of Juvenile Parkinsonism at the age of 17, had been treated with antiparkinsonian medications for about 14 years in the neurology clinic. Even though the age of onset of this case was far earlier than expected for both IPD and FP and the symptoms became chronic despite close monitoring, it is believed that this case is a striking example for the importance of the recognition of FP and early intervention.

10th International Congress on Psychopharmacology & 6th International Symposium on Child and Adolescent Psychopharmacology[Abstract:0103][Mood disorders]A forgotten diagnosis: funeral maniaABSTRACT...

Despite its severe morbidity and mortality, studies regarding the psychosocial treatments of anorexia nervosa are limited in number. This paper aims to present the general outlines of various psychosocial interventions developed for the treatment of anorexia nervosa and to provide an up-to-date review of the randomized-controlled studies on the effectiveness of these approaches. Reviewed studies were classified by age spectrum of samples under two main headings: adolescents and mixed samples of adults and adolescents. Specific issues about other variables were then discussed separately. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(3.000): 329-345]

Being one of the most renowned subjects in philosophy, mind-body problem focuses on the relationship between physical and mental phenomena. Various approaches have been developed throughout history with two perspectives having been the most prominent: the claim that mind is of material nature (physicalism) and that mind is radically separate from physical existence (dualism). With its core premises, mind-body problem and different approaches to it are crucially relevant for psychiatry. Psychiatry, in its daily practice and theory, is situated right at the site of this so-called mind-body gap. Psychiatrists’ conceptualization of mind-body problem is deeply related not only to their views on the nature of subjectivity and free will; but also to their implicit and explicit assumptions about psychopathology. In this mind-body problem framework, physicality is mostly attributed to the nervous system, more specifically to the brain. Advances in genetics, molecular biology, cognitive science, psychopharmacology and brain imaging techniques have led neuroscientific paradigm to be the de facto conceptual framework for understanding mental activity and psychic experience. In this view, as with the rest of all psychological phenomena, mental disorders are also brain disorders and physical (i.e. reductionist) methods are key to understand, prevent, and treat these conditions. With the advent of neuroscience, biological approaches to psychopathology have also paved the way for the birth of a popular neuro-culture that shadow other approaches to psychopathology. Explaining complex phenomena through neurobiological substrates has paralleled the acceptance of a popular motto that can be summarized as “you are your brain”. Despite all expectations, diverted resources, and intellectual interest, neurobiological reductionism has yet to bring about the anticipated breakthrough in clinical practice of psychiatry. In this article, we aim to provide a brief overview of the mindbody problem, describe various aspects of neurobiological reductionism, and address its theoretical impasses and implications for psychiatry.

Previous research has increased understanding of the neurobiological basis of emotional regulation. However, less is known concerning the unconscious processing of affective information. Three experiments were performed to investigate the extent to which complex affective stimuli can be processed outside of consciousness and demonstrate possible mechanisms for regulation of resulting emotional responses. In Experiment 1, participants were either instructed to passively observe blocked-picture cues (neutral and negative) or to down regulate their emotions by distancing. Resulting emotional regulation activity was assessed with 0.1-Hz heart rate variability (HRV) indices. In Experiment 2, participants were presented with affective pictures that were rendered consciously invisible by means of continuous flash suppression (CFS). In Experiment 3, two equivalent sets of negative affective pictures were covertly presented and the effect of a cognitive task on emotional regulation was evaluated. Our findings revealed that 0.1-Hz HRV indices exhibited greater change over baseline in response to negative compared to neutral stimuli for both presentation conditions (consciously perceived or not). The implementation of distancing and the cognitive task were both associated with higher 0.1-Hz HRV change scores. These results indicate that even complex affective stimuli can be processed without awareness, resulting in a congruent emotional response that is physiologically detectable. Cognitive strategies can help more effectively regulate this response, implying that conscious perception of a triggering stimulus may not be essential for cognitive regulation.

For 30 years, bright light therapy (BLT) has been considered as an effective, well-tolerated treatment for seasonal affective disorder (SAD). Because of low response rates, new treatment strategies are needed for bipolar depression (BD), which resembles SAD in certain respects. Few placebo-controlled studies of BLT efficacy have been carried out for BD. Accordingly, this study evaluates the efficacy and safety of BLT as an add-on treatment for BD. Thirty-two BD outpatients were randomly assigned to BLT (10000lx) or dim light (DL,500lx). During a two-week period, light was administered each morning for 30min. The Hamilton Rating Scale for Depression and the Montgomery-Ǻsberg Depression Rating Scale assessed clinical outcome, and the UKU Side Effects Rating Scale evaluated side effects. No significant difference was observed in baseline depression scores in the two groups. Response rates for BLT and DL were 81% and 19%, and remission rates were 44% and 12.5%, respectively. Analyses showed statistically significant reductions in depression scores for the BLT group compared with the DL group on all scales. Side effects were similar in both groups, with headache as the most common side effect. The results suggest that BLT is an effective and safe add-on treatment for BD.

Yüksek morbidite ve mortalitesine karşın anoreksiya nervozanın psikolojik tedavilerine yönelik araştırmalar sınırlı sayıdadır. Bu yazıda, anoreksiya nervozaya yönelik çeşitli psikososyal tedavi yöntemlerinin genel hatlarıyla tanıtılması ve bu yöntemlerin etkinliklerine dair randomize kontrollü çalışmaların güncel bir derlemesinin yapılması amaçlanmıştır. Derlenen araştırmalar, ergenler üzerinde yürütülen çalışmalar ve ergenlerle erişkinlerin birlikte olduğu çalışmalar olmak üzere iki ana başlık altında incelenmiş; diğer değişkenlerle ilgili hususlar ayrıca ele alınmıştır.&nbsp, Despite its severe morbidity and mortality, studies regarding the psychosocial treatments of anorexia nervosa are limited in number. This paper aims to present the general outlines of various psychosocial interventions developed for the treatment of anorexia nervosa and to provide an up-to-date review of the randomized-controlled studies on the effectiveness of these approaches. Reviewed studies were classified by age spectrum of samples under two main headings: adolescents and mixed samples of adults and adolescents. Specific issues about other variables were then discussed separately.

Obsessive-compulsive disorder is a mental disorder that may cause severe disability. Insight in obsessive-compulsive disorder has been an issue of debate since the disorder was described for the first time. Formerly, obsessive-compulsive disorder was regarded as one of the neurotic disorders and patients were supposed to find their symptoms as totally senseless and exaggerated. However, the idea that obsessions have to be regarded egodystonic has changed recently. Firstly in the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV), the term "with poor insight" was used as a specifier for obsessive-compulsive disorder. Obsessive-compulsive disorder with low or no insight may differ from obsessive-compulsive disorder with good insight in terms of sociodemographic, clinical and treatment features. Along with types of obsessions, the levels of insight are subject to change. Obsessive-compulsive disorder with poor insight can either be a subtype with different features or a severe form of Obsessive-compulsive disorder. Along with DSM-5 insight in obsessive-compulsive disorder is no longer classified as absent or present. Insight in obsessive-compulsive disorder needs to be conceptualized as a spectrum or continuity., Obsesif kompulsif bozukluk ileri derecede yeti yitimine neden olabilen ruhsal bir bozukluktur. OKB hastalarında içgörü hastalığın ilk tanımlanmasından bu yana tartışma konusudur. Önceleri, nörotik bozukluklardan biri olarak kabul edilen obsesif kompulsif bozuklukta hastaların belirtilerini tamamen saçma ve abartılı bulmaları gerektiği düşünülmüştür. Ancak, obsesyonların ve kompulsiyonların her zaman egodistonik bulunacağı fikri giderek değişmiştir. İlk olarak Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabının 4. Baskısında (DSM-IV)'te obsesif kompulsif bozuklukta "içgörüsü az olan" ifadesine yer verilmiştir. İçgörüsü az olan ya da olmayan obsesif kompulsif bozukluğun içgörünün korunduğu obsesif kompulsif bozukluktan sosyodemografik, klinik ve tedavi özellikleri bakımından farklılıkları olabilir. Obsesif kompulsif bozuklukta belirti tiplerine göre içgörü düzeyleri değişebilmektedir. İçgörüsü az obsesif kompulsif bozukluk, obsesif kompulsif bozukluğun şiddetli bir formu ya da farklı özellikler gösteren bir alt tip olabilir. DSM-5 ile birlikte içgörü belirteci sınıflan-dırmadan çıkarılmıştır. Obsesif kompulsif bozukluk hastalarının içgörülerinin bir yelpaze ya da süreklilik şeklinde ele alınması gerekir.

Domestic violence (DV) is defined as all kinds of abusive behaviors between spouses or relatives living in the same house. Domestic violence is most commonly directed towards women and children. This study aims to review the extent of domestic violence among women consulting to psychiatric outpatient clinic, and to identify its relation with sociodemographic risk factors and psychological symptoms.Self-reported Domestic Violence Questionnaire and Symptom Checklist-90-R (SCL-90-R) information was collected from women who admitted to psychiatric outpatient clinic at Marmara University Research and Educational Hospital, and accepted to participate in the study.300 women participated in the study. Mean age of participants was 36.24±10.88, 75.7% of them were married, and mostly live within nuclear families. 70.1% of the participants reported verbal violence, and 49.0% reported physical violence. 65.3% of those who have experienced verbal violence have also experienced physical violence. 26.1% of them reported as not having experienced domestic violence before. The nature and extent of domestic violence, women's attitudes towards it, and its relation with experience of domestic violence during childhood have been explored. Participants' educational levels, current age and age of marriage, style of marriage, educational level and age of spouse were not found to be associated with experiencing of domestic violence. Both verbal and physical domestic violence were significantly associated with the economic status of women (p0.05). The mean SCL-90-R score was 1.40±0.68 with the highest mean subgroup score under depressive symptoms category (1.80±0.79). Mean SCL-90-R score showed significant association with the experience of domestic violence (p≤0.001).Most of the women participated in the study have experienced domestic violence. Both verbal and physical violence increased with lower economic status. Psychiatric symptoms increased with the experience of domestic violence. Considering its high prevalence and detrimental psychological effects, domestic violence should be inquired by clinicians as part of the psychiatric interview.