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PurposeThis paper aims to investigate associations between early childhood and current indicators of socioeconomic inequality and the onset (incident), persistence and progression (increase in severity) of psychotic experiences (PEs) in a longitudinal follow-up of a community-based population.MethodsHouseholds in the metropolitan area of Izmir, Turkey were contacted in a multistage clustered probability sampling frame, at baseline (T1,n = 4011) and at 6-year follow-up (T2,n = 2185). Both at baseline and follow-up, PEs were assessed using Composite International Diagnostic Interview 2.1. The associations between baseline socioeconomic features and follow-up PEs were analysed using logistic regression models. Indicators of social inequality included income, educational level, current socioeconomic status (SES), social insurance, the area resided, ethnicity, parental educational level, and SES at birth.ResultsThe risk of onset of PEs was significantly higher in lower education, lower SES, and slum-semi-urban areas. The persistence of PEs was significantly associated with the lowest levels of education and current SES, and rural residency. Persistent PEs were significantly and negatively associated with paternal SES at birth. Progression of PEs was significantly higher among respondents with educational achievements lower than university level and lower levels of SES, who have no social insurance and who reside in slum-semi-urban areas. Parental education and paternal SES at birth were not associated with the persistence of PEs.ConclusionIndicators of social inequality (low education, low SES, low income, and poverty in the neighbourhood) were associated with the onset and persistence of PEs and progression along the extended psychosis phenotype. The early indicators seem to have a modest life-long impact on the psychosis phenotype.

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

Purpose: This paper aims to investigate associations between early and recent indicators of socioeconomic inequality and the emergence, persistence and progression of psychotic experiences (PEs) in a longitudinal follow-up of a community-based population.Methods: Households in the metropolitan area of Izmir, Turkey, were contacted in a multistage clustered probability sampling frame, at baseline (T1, n = 4,011) and at 6-year follow-up (T2, n = 2,185). Both at baseline and follow-up, PEs were assessed using Composite International Diagnostic Interview (CIDI). The associations between baseline socioeconomic features and follow-up PEs were analysed using logistic regression models. Indicators of social inequality included income, educational level, current socioeconomic status (SES), social insurance, the area resided, ethnicity, parental educational level, and SES at birth.Results: The risk of follow-up incident PEs was significantly higher in lower education, lower SES, and slum-semi urban areas. The persistence of PEs was significantly associated with the lowest levels of education and current SES, and rural residency. Persistent PEs were significantly associated with paternal SES at birth. Progression of PEs was significantly higher among respondents with educational achievements lower than university level and lower levels of SES, who have no social insurance and who reside in slum-semi urban areas. Parental education and paternal SES at birth were not associated with the persistence of PEs. Conclusion: Indicators of social inequality (low education, low SES, low income, poverty in the neighbourhood) were associated with the emergence and persistence of PEs and progression along the extended psychosis phenotype. The early indicators seem to have a modest life-long impact on the psychosis phenotype.

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 O'Donovan is supported by MRC programme grant (G08005009) and an MRC Centre grant (MR/L010305/1), Henquet, C., Van Os, J., Pries, L.K., Rauschenberg, C., Delespaul, P., Kenis, G., Luykx, J.J., Lin, B.D., Richards, A.L., Akdede, B., Binbay, T., Altlnyazar, V., Yallnçetin, B., Gümüş-Akay, G., Cihan, B., Soygür, H., Ulaş, H., Cankurtaran, E.S., Kaymak, S.U., Mihaljevic, M.M., Petrovic, S.S., Mirjanic, T., Bernardo, M., Mezquida, G., Amoretti, S., Bobes, J., Saiz, P.A., Garciá-Portilla, M.P., Sanjuan, J., Aguilar, E.J., Santos, J.L., Jiménez-López, E., Arrojo, M., Carracedo, A., López, G., González-Penãs, J., Parellada, M., Maric, N.P., Atbaşoelu, C., Ucok, A., Alptekin, K., Saka, M.C., Arango, C., O'Donovan, M., Rutten, B.P.F., Gülöksüz, S.

Background Social capital is thought to represent an environmental factor associated with the risk of psychotic disorder (PD). This study aims to investigate the association between neighbourhood-level social capital and clinical transitions within the spectrum of psychosis. Methods In total, 2175 participants, representative of a community-based population, were assessed twice (6 years apart) to determine their position within an extended psychosis spectrum: no symptoms, subclinical psychotic experiences (PE), clinical PE, PD. A variable representing change between baseline (T1) and follow-up (T2) assessment was constructed. Four dimensions of social capital (informal social control, social disorganisation, social cohesion and trust, cognitive social capital) were assessed at baseline in an independent sample, and the measures were aggregated to the neighbourhood level. Associations between the variable representing psychosis spectrum change from T1 to T2 and the social capital variables were investigated. Results Lower levels of neighbourhood-level social disorganisation, meaning higher levels of social capital, reduced the risk of clinical PE onset (OR 0.300; z = -2.75; p = 0.006), persistence of clinical PE (OR 0.314; z = -2.36; p = 0.018) and also the transition to PD (OR 0.136; z = -2.12; p = 0.034). The other social capital variables were not associated with changes from T1 to T2. Conclusions Neighbourhood-level social disorganisation may be associated with the risk of psychosis expression. Whilst replication of this finding is required, it may point to level of social disorganisation as a public health target moderating population psychosis risk., Scientific and Technological Council of Turkey 1001 programme [107S053, 112S476], This work is part of the TurkSch project, which was funded by the Scientific and Technological Council of Turkey 1001 programme (Project numbers: 107S053 and 112S476).

BackgroundThere is evidence that environmental and genetic risk factors for schizophrenia spectrum disorders are transdiagnostic and mediated in part through a generic pathway of affective dysregulation.MethodsWe analysed to what degree the impact of schizophrenia polygenic risk (PRS-SZ) and childhood adversity (CA) on psychosis outcomes was contingent on co-presence of affective dysregulation, defined as significant depressive symptoms, in (i) NEMESIS-2 (n = 6646), a representative general population sample, interviewed four times over nine years and (ii) EUGEI (n = 4068) a sample of patients with schizophrenia spectrum disorder, the siblings of these patients and controls.ResultsThe impact of PRS-SZ on psychosis showed significant dependence on co-presence of affective dysregulation in NEMESIS-2 [relative excess risk due to interaction (RERI): 1.01, p = 0.037] and in EUGEI (RERI = 3.39, p = 0.048). This was particularly evident for delusional ideation (NEMESIS-2: RERI = 1.74, p = 0.003; EUGEI: RERI = 4.16, p = 0.019) and not for hallucinatory experiences (NEMESIS-2: RERI = 0.65, p = 0.284; EUGEI: −0.37, p = 0.547). A similar and stronger pattern of results was evident for CA (RERI delusions and hallucinations: NEMESIS-2: 3.02, p < 0.001; EUGEI: 6.44, p < 0.001; RERI delusional ideation: NEMESIS-2: 3.79, p < 0.001; EUGEI: 5.43, p = 0.001; RERI hallucinatory experiences: NEMESIS-2: 2.46, p < 0.001; EUGEI: 0.54, p = 0.465).ConclusionsThe results, and internal replication, suggest that the effects of known genetic and non-genetic risk factors for psychosis are mediated in part through an affective pathway, from which early states of delusional meaning may arise.

Objective: The aim of this study is to evaluate the associations between alcohol-cannabis use and forensic/stressful events with the risk of incident clinical psychosis during follow-up. Method: A community-based sample (n: 2142) was screened for clinical psychosis (schizophrenia and other psychotic disorders, affective disorders with psychotic features) at baseline and follow-up. Thus, incident clinical psychosis cases to develop during follow-up (individuals with no clinical psychosis at the baseline assessment and with clinical psychosis at the follow-up assessment) were detected (n: 27). These cases and the controls who did not report any psychotic symptoms at the follow-up assessment (n: 1691) were compared for exposure to environmental risk factors during follow-up (total n: 1718). Results: Individuals reporting heavy alcohol drinking or cannabis use during follow-up had significantly higher risk of incident clinical psychosis. The monthly frequency of drinking and cannabis use was also associated with the risk. Higher number of stressful life events exposed predicted higher risk of incident clinical psychosis. The risk of incident clinical psychosis was significantly higher in case of coexistence of two risk factors (heavy drinking, cannabis use, >= 3 stressful events), in comparison with the existence of a single risk factor (17.7 vs. 1.6%, p

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: In this review, a historical and conceptual panorama of symptomatic remission will be provided with a focus on the whole clinical psychosis beyond schizophrenia. Methods: We included all published articles on remission in psychosis, without any restrictions regarding language or year. We used a string to detect relevant articles in PubMed. We reviewed the abstracts to exclude out of scope results. Then, we evaluated the remaining articles to extract data. Variables included year of publication, language of publication, country of origin, type of article, main topic of research, main disorder studied, and reference to remission criteria. Results: The final dataset included 439 citations which dates back to 1950. The Remission in Schizophrenia Working Group (RSWG) criteria which was proposed in 2005 had a major effect on remission research in schizophrenia. The RSWG criteria changed the yearly published numbers of research, the main land of remission research and the scope of the articles. After 2005, the number of publications rapidly increased, and English became the primary language of the articles. Beyond prominent clinical effect, the criteria did have little impact on functional remission in schizophrenia. And also research in the last decade provided very few information about remission in other clinical aspects of psychosis spectrum including acute, transient and chronic forms. Furthermore, although there has been a conceptual unity in the last decade the heterogeneity of the studies is still far from decreasing, which still blurs the efforts to evaluate remission in psychosis. Conclusion: Although studies on remission in schizophrenia started in the 1950s, the criteria published in 2005 changed the whole area. However, remission discussions are not yet valid for psychotic diagnoses other than schizophrenia and are limited.

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

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 O’Donovan is supported by MRC programme grant (G08005009) and an MRC Centre grant (MR/ L010305/1). Dr Rutten was funded by a VIDI award number 91718336 from the Netherlands Scientific Organisation. Drs Guloksuz and van Os are supported by the Ophelia research project, ZonMw grant number: 636340001. Dr Arango was supported by the 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., Pries, L.-K., Dal Ferro, G.A., Van Os, J., Delespaul, P., Kenis, G., Lin, B.D., Luykx, J.J., Richards, A.L., Akdede, B., Binbay, T., Altlnyazar, V., Yallnçetin, B., Gümüş-Akay, G., Cihan, B., Soygür, H., Ulaş, H., Åžahin Cankurtaran, E., Ulusoy Kaymak, S., Mihaljevic, M.M., Andric Petrovic, S., Mirjanic, T., Bernardo, M., Mezquida, G., Amoretti, S., Bobes, J., Saiz, P.A., Garciá-Portilla, M.P., Sanjuan, J., Aguilar, E.J., Santos, J.L., Jiménez-López, E., Arrojo, M., Carracedo, A., López, G., González-Penãs, J., Parellada, M., Maric, N.P., AtbaşoÄalu, C., Ucok, A., Alptekin, K., Can Saka, M., Arango, C., O'Donovan, M., Tosato, S., Rutten, B.P.F., Guloksuz, S., and Genetic Risk and Outcome of Psychosis (GROUP) investigators

COVID-19 pandemic causes substantial psychosocial stress on individuals and the community. Due to social isolation, neurotrophic potential of coronaviruses and the inflammatory processes, occurrence and relapse of psychotic symptoms may increase during the pandemic. Furthermore, pandemic has limited some protective factors for psychosis (i.e. social support, community mental health practices and physical activity). Additionally, admission of individuals suffering from psychotic symptoms may decrease due to risk of viral contamination. This may lead to under-detection of the problem, persistence of psychotic symptoms, poorer prognosis and more severe outcomes. Psychotic symptoms were reported among infected individuals during the recent coronavirus outbreaks (SARS CoV-1 and MERS CoV). Furthermore, mental problems were of the most substantial causes of long term disability associated with these outbreaks. In this paper, limited data on psychotic symptoms during the COVID-19 pandemic will be reviewed. Furthermore, psychosocial stress during the pandemic and plausible associations between the coronaviruses and psychotic symptoms will be discussed in light of the previous research.

Historically, formal thought disorder has been considered as one of the distinctive symptoms of schizophrenia. However, research in last few decades suggested that there is a considerable clinical and neurobiological overlap between schizophrenia and bipolar disorder (BP). We conducted a meta-analysis of studies comparing positive (PTD) and negative formal thought disorder (NTD) in schizophrenia and BP. We included 19 studies comparing 715 schizophrenia and 474 BP patients. In the acute inpatient samples, there was no significant difference in the severity of PTD (d = -0.07, CI = -0.22-0.09) between schizophrenia and BP. In stable patients, schizophrenia was associated with increased PTD compared to BP (d = 1.02, CI = 0.35-1.70). NTD was significantly more severe (d = 0.80, CI = 0.52-0.1.08) in schizophrenia compared to BP. Our findings suggest that PTD is a shared feature of both schizophrenia and BP but persistent PTD or NTD can distinguish subgroups of schizophrenia from BP and schizophrenia patients with better clinical outcomes. (C) 2016 Elsevier B.V. All rights reserved.

BackgroundFirst-degree relatives of patients with psychotic disorder have higher levels of polygenic risk (PRS) for schizophrenia and higher levels of intermediate phenotypes.MethodsWe conducted, using two different samples for discovery (n = 336 controls and 649 siblings of patients with psychotic disorder) and replication (n = 1208 controls and 1106 siblings), an analysis of association between PRS on the one hand and psychopathological and cognitive intermediate phenotypes of schizophrenia on the other in a sample at average genetic risk (healthy controls) and a sample at higher than average risk (healthy siblings of patients). Two subthreshold psychosis phenotypes, as well as a standardised measure of cognitive ability, based on a short version of the WAIS-III short form, were used. In addition, a measure of jumping to conclusion bias (replication sample only) was tested for association with PRS.ResultsIn both discovery and replication sample, evidence for an association between PRS and subthreshold psychosis phenotypes was observed in the relatives of patients, whereas in the controls no association was observed. Jumping to conclusion bias was similarly only associated with PRS in the sibling group. Cognitive ability was weakly negatively and non-significantly associated with PRS in both the sibling and the control group.ConclusionsThe degree of endophenotypic expression of schizophrenia polygenic risk depends on having a sibling with psychotic disorder, suggestive of underlying gene–environment interaction. Cognitive biases may better index genetic risk of disorder than traditional measures of neurocognition, which instead may reflect the population distribution of cognitive ability impacting the prognosis of psychotic disorder.

WOS: 000479142300001, PubMed ID: 31447712, Objective: TurkSch is a prospective, longitudinal study in a representative community sample (Izmir, Turkey), consisting of several data collection stages, to screen and follow-up mental health outcomes, with a special focus on the extended and transdiagnostic psychosis phenotype. The aim of the present paper is to describe the research methodology, data collection results, and associations with noncontact and refusal in the longitudinal arm. Methods: Households were contacted in a multistage clustered probability sampling frame, covering 11 districts and 302 neighborhoods at baseline (n = 4,011) and at 6-year follow-up (n = 2,185). Both at baseline and at follow-up, participants were interviewed with the Composite International Diagnostic Interview. Participants with probable psychotic disorder were reinterviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID)-I either at the hospital or at the participant's residence. Relevant neighborhood-level measures were assessed in a separate sample (n = 5,124) in addition to individual-level measures. Candidate gene-by-environment interactions were investigated using two nested case-control studies. Results: Individuals with a mental health problem had lower refusal rates. Older and lower educated individuals had a lower probability of noncontact. Discussion: The TurkSch study has an advanced design to meet the challenges of evaluating the multidimensional etiological and phenomenological nature of the extended and transdiagnostic psychosis phenotype., Scientific and Technological Council of Turkey 1001 program [107S053, 112S476], This work is a part of the TurkSch project, funded by the Scientific and Technological Council of Turkey 1001 program, project no: 107S053 and 112S476.

INTRODUCTON: The impact of social environment on the frequency and prevalence of schizophrenia is well known. However, in schizophrenia and other psychotic disorders, there are few studies which investigate the effect of social environment on disease prognosis and relapse. The aim of this study was to investigate the effect of neighborhood social capital level and address change on relapse in schizophrenia and similar psychotic disorders. METHODS: The research sample consisted of 147 patients (schizophrenia, 76.1%; n=112), who were being followed up at regular intervals of at most six months at the Psychotic Disorders Unit outpatient clinic. Patients were followed-up for relapse indicators between January 1, 2009 and December 31, 2013. During the follow-up, relapse criteria including hospitalization, increased need for help, self-harm, suicidal thoughts, violent behavior, suicide attempts, antipsychotic dose increase and electroconvulsive therapy were used. At least one of these criteria was accepted as a relapse for that period. Neighborhood social capital levels were obtained from a general public survey conducted in Izmir city center in 2008 and the voting rates in the neighborhood during the follow-up period. In addition, during the follow-up period, any change in the address of the patient was recorded. RESULTS: While there was no correlation between the neighborhood social environment and relapse, a significant relationship was found between relapse and address changes. The probability of relapse was 1.3 times higher in patients with change of address (95%CI: 1.0–1.6; p

Background Psychotic experiences (PEs) are not exclusive to psychotic disorders and highly correlated with mood episodes. In this representative general population-based study, longitudinal bidirectional associations between the extended psychosis phenotype and mood episodes were investigated, accounting for other possible causes. Methods Households were contacted in a multistage clustered probability sampling frame covering 11 districts and 302 neighbourhoods at baseline (n = 4011) and at 6-year follow-up (n = 2185). Participants were interviewed with the relevant sections of the composite international diagnostic interview both at baseline and at follow-up. Sociodemographic, familial and environmental risk factors associated with the extended psychosis phenotype and mood episodes were assessed. Logistic regression and cross-lagged panel correlation models were used for the associations between the extended psychosis phenotype and mood episodes. Results PEs were associated with subsequent depressive and manic episodes. There was bidirectionality in that mood episodes were associated with subsequent PEs, and PEs were associated with subsequent mood episodes. The associations occurred in a sub-additive pattern. There were substantial synchronous and cross-lagged correlations between these psychopathology domains, with reciprocally similar cross-lagged correlations. Familial risk and adverse life events were associated with both psychopathology domains, whereas some sociodemographic risk factors and alcohol/cannabis use were associated with only one domain. Conclusion The sub-additive bidirectional associations between PEs and mood episodes over time and the similarity of cross-lagged correlations are suggestive of mutually causal connections between affective and psychotic domains of psychopathology.

WOS: 000459452000003, PubMed ID: 29785763, There is little research on genetic risk for the extended psychosis phenotype ranging from psychotic experiences (PEs) to psychotic disorders (PDs). In this general population-based prospective cohort study, the longitudinal associations between BDNF-Val66Met polymorphism and the different levels of the extended psychosis phenotype were investigated. Addresses were contacted in a multistage clustered probability sampling frame covering 11 districts and 302 neighborhoods at baseline (n = 4011). A nested case-control study (n = 366) recruited individuals with PEs and PDs as well as individuals with no psychotic symptoms. In this subgroup, blood sampling for genetic analysis and assessment of environmental exposures were carried out, followed by clinical re-appraisal at follow-up 6 years later (n = 254). The BDNF-Val66Met polymorphism was significantly associated with the extended psychosis phenotype. The pattern of the association was that the BDNF-Val66Met polymorphism impacted in a dose-response but extra-linear fashion, with stronger impact at the PD end of the extended psychosis phenotype. Associations were still significant after adjusting for sociodemographic factors and environmental exposures including life events, childhood adversity, socioeconomic status, urbanicity, and cannabis use. The BDNF-Val66Met polymorphism may index susceptibility to expression of psychosis along a spectrum., Turkiye Bilimsel ve Teknolojik Arastirma KurumuTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [107S053, 112S476], Turkiye Bilimsel ve Teknolojik Arastirma Kurumu, Grant/Award Numbers: 107S053 and 112S476

Formal thought disorder (FTD) is one of the fundamental symptom clusters of schizophrenia and it was found to be the strongest predictor determining conversion from first-episode acute transient psychotic disorder to schizophrenia. Our goal in the present study was to compare a first-episode psychosis (FEP) sample to a healthy control group in relation to subtypes of FTD. Fifty six patients aged between 15 and 45 years with FEP and forty five control subjects were included in the study. All the patients were under medication for less than six weeks or drug-naive. FTD was assessed using the Thought and Language Index (TLI), which is composed of impoverishment of thought and disorganization of thought subscales. FEP patients showed significantly higher scores on the items of poverty of speech, weakening of goal, perseveration, looseness, peculiar word use, peculiar sentence construction and peculiar logic compared to controls. Poverty of speech, perseveration and peculiar word use were the significant factors differentiating FEP patients from controls when controlling for years of education, family history of psychosis and drug abuse. (C) 2016 Elsevier Inc. All rights reserved.

EgeUn###, Background. Psychotic experiences (PEs) may predict a range of common, non-psychotic disorders as well as psychotic disorders. In this representative, general population-based cohort study, both psychotic and non-psychotic disorder outcomes of PE were analysed, as were potential moderators. Methods. Addresses were contacted in a multistage clustered probability sampling frame covering 11 districts and 302 neighbourhoods at baseline (n = 4011). Participants were interviewed with the Composite International Diagnostic Interview (CIDI) both at baseline and at 6-year follow-up. Participants with PE at baseline were clinically re-interviewed with the SCID-I at follow-up. The role of socio-demographics, characteristics of PE, co-occurrence of mood disorders and family history of mental disorders were tested in the association between baseline PE and follow-up diagnosis. Results. In the participants with baseline PE, the psychotic disorder diagnosis rate at follow up was 7.0% - much lower than the rates of DSM-IV mood disorders without psychotic features (42.8%) and other non-psychotic disorders (24.1%). Within the group with baseline PE, female sex, lower socio-economic status, co-occurrence of mood disorders, family history of a mental disorder and persistence of PE predicted any follow-up DSM diagnosis. Furthermore, onset of psychotic v. non-psychotic disorder was predicted by younger age (15-30 years), co-presence of delusional and hallucinatory PE and family history of severe mental illness. Conclusion. The outcome of PE appears to be a consequence of baseline severity of multidimensional psychopathology and familial risk. It may be useful to consider PE as a risk indicator that has trans-diagnostic value., Scientific and Technological Council of Turkey 1001 programmeTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [107S053, 112S476], This work is part of the TurkSch project, funded by the Scientific and Technological Council of Turkey 1001 programme, project no: 107S053 and 112S476.

Objective Mobbing at work has become an alarming phenomenon worldwide. The prevalence of mobbing among women is higher than among men. The aim of this study is to investigate the relationship of mobbing as a psychosocial stress in the workplace with general psychopathology and psychotic experiences among women. Method 428 women from the Medical Faculty of Dokuz Eylul University were included in the study. Of the 428 women, 139 were doctors, 190 were nurses, and 99 were sub-contracted employees. Stratified and cluster sampling METHODS were used. Sociodemographic data form, mobbing scale and symptom checklist (SCL-90-R) were used in order to collect the data. Results 304 (71%) of the participants had experienced mobbing at least once. It was determined that nurses had experienced mobbing more frequently than doctors and sub-contracted employee. Total and subscale scores of the mobbing scale were statistically higher in participants who went to psychiatry outpatient clinics and who use psychiatric medication and alcohol. There was a positive statistically significant correlation between SCL-90-R and mobbing scale scores. Correlation coefficients ranged from 0.25 to 0.56. The highest correlation was between the paranoid sub-scale of SCL-90-R and mobbing (r= 0.56) CONCLUSION: Generally, exposure to mobbing seems to be related with higher psychopathology. Also, according to our research results, mobbing is a psychosocial stress source that might be triggering subthreshold psychotic experiences.

WOS: 000482712600001, Objective: Psychotic disorders were previously associated with catechol-O-methyltransferase (COMT) val(158)met (rs4680) and brain-derived neurotrophic factor (BDNF) val(66) met (rs6265) polymorphisms. This article evaluates the association between COMT/BDNF polymorphisms and the extended psychosis phenotype which covers not only schizophrenia but also subclinical expressions of psychotic experiences. Method: The participants of this study were part of the TurkSch (Izmir Mental Health Survey for Gene-Environment Interaction in Psychoses), a longitudinal study Psychotic experiences and disorders were screened 437. The extended psychosis phenotype was grouped into four: (1) no psychotic experiences (n: 194), (2) subclinical psychotic experiences (n: 87), (3) clinically relevant psychotic experiences (n: 104), and (4) schizophrenia-like disorders (n: 52). BDNF rs6265 was genotyped occurred in every participant whereas COMT rs4680 genotyping could be done on 366 individuals. Results: There was no association between the extended psychosis phenotype and BDNF rs6265/COMT rs4680 polymorphisms. The frequency of met carriers in the BDNF rs6265genotype was slightly higher in individuals with subclinical psychotic experiences than in the group with no psychotic experiences, which was just below the significance level (p=0.08). Conclusion: The lack of an association between different expression levels of the extended psychosis phenotype and the BDNF rs6265/COMT rs4680 polymorphism might be related to sample characteristics, underlying gene-gene, gene-environment and gene-environment-gene interactions., Scientific and Technological Council of Turkey 1001 programmeTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [107S053, 112S476], This work is part of the TurkSch project, funded by the Scientific and Technological Council of Turkey 1001 programme, project no: 107S053 and 112S476.

Amaç: Psikotik bozukluklar ile Katekol-O-metiltransferaz (COMT) val158met (rs4680) ve beyin kökenli nörotrofik faktör (Brain-derived neurotrophic factor; BDNF) val66met (rs6265) polimorfizmleri arasında ilişki olabileceği düşünülmektedir. Bu araştırmada genel toplumdan seçilmiş bir örneklemde eşik altı psikotik yaşantılardan şizofreniye geniş psikoz fenotipi boyunca bu polimorfizmlerin dağılımının incelenmesi amaçlanmıştır. Yöntem: Örneklem, uzunlamasına bir izlem araştırması olan Psikozlarda Gen-Çevre Etkileşimi İçin İzmir Akıl Sağlığı Araştırması’na (TürkSch) dayanmaktadır ve psikotik yaşantı ve bozuklukların tarandığı bir genel toplum örneklemi içinden seçilen 437 kişiden oluşmaktadır. Geniş psikoz fenotipi, tarama ve klinik tanı görüşmelerine göre psikotik yaşantısı olmayanlar (n: 194), eşik altı psikotik yaşantısı olanlar (n: 87), psikotik yaşantısı olanlar (n: 104) ve şizofreni-benzeri bozukluk (n: 52) grupları olarak oluşturulmuştur. BDNF rs6265 genotiplendirmesi araştırmaya katılan tüm kişilerde ve COMT rs4680 genotiplendirmesi ise 366 kişide yapılmıştır. Bulgular: Geniş psikoz fenotipi grupları arasında BDNF rs6265 ve COMT rs4680 polimorfizmleri açısından anlamlı farklılık bulunmamıştır. Sadece herhangi bir psikotik yaşantı bildirmeyenlere göre eşik altı psikotik yaşantı bildirenlerde BDNF rs6265 genotipinde met taşıyanların bulunma olasılığı anlamlılığa yakın düzeyde daha düşük bulunmuştur (p=0,08). Sonuç: Geniş psikoz fenotipinin farklı basamakları ile BDNF rs6265 ve COMT rs4680 arasında bir ilişki bulunmaması altta yatan gen-gen etkileşimi, gen-çevre ve gen-gen-çevre etkileşimi gibi daha karmaşık mekanizmaların varlığıyla ilişkili olabilir., Objective: Psychotic disorders were previously associated with catechol- O-methyltransferase (COMT) val158met (rs4680) and brain-derived neurotrophic factor (BDNF) val66met (rs6265) polymorphisms. This article evaluates the association between COMT/BDNF polymorphisms and the extended psychosis phenotype which covers not only schizophrenia but also subclinical expressions of psychotic experiences. Method: The participants of this study were part of the TürkSch (Izmir Mental Health Survey for Gene-Environment Interaction in Psychoses), a longitudinal study Psychotic experiences and disorders were screened 437. The extended psychosis phenotype was grouped into four: (1) no psychotic experiences (n: 194), (2) subclinical psychotic experiences (n: 87), (3) clinically relevant psychotic experiences (n: 104), and (4) schizophrenia-like disorders (n: 52). BDNF rs6265 was genotyped occurred in every participant whereas COMT rs4680 genotyping could be done on 366 individuals. Results: There was no association between the extended psychosis phenotype and BDNF rs6265/COMT rs4680 polymorphisms. The frequency of met carriers in the BDNF rs6265genotype was slightly higher in individuals with subclinical psychotic experiences than in the group with no psychotic experiences, which was just below the significance level (p=0.08). Conclusion: The lack of an association between different expression levels of the extended psychosis phenotype and the BDNF rs6265/ COMT rs4680 polymorphism might be related to sample characteristics, underlying gene-gene, gene-environment and gene-environment-gene interactions.

Systemic lupus erythematosus (SLE) or Lupus is a chronic and idiopathic autoimmune connective tissue disease that involves several organs and organ systems. SLE may lead to a group of psychiatric manifestations, including delirium, anxiety disorders, cognitive dysfunction, mood disorders, and psychosis, which are caused by organic or non-organic factors. In addition, it is thought that the most common cause of neuropsychiatric lupus is corticosteroid use; central nervous system involvement and inflammatory processes also have an important role in the development of psychiatric manifestations. In other respects, structural brain abnormalities induce proneness to psychotic and manic symptoms. Along with this proneness, cavum vergae, an anomaly closely related to the anatomic areas associated with mood regulation, may precipitate manic symptoms. In this case report, we present a manic episode case emerging after delirium, with a 1-year history of SLE, which has recently been diagnosed with cavum vergae and discuss the process of infection and corticosteroid treatment, which contributed to the proneness effect of a structural brain anomaly.

Background Subclinical and clinical depression is common, widely distributed in the general population, and usually associated with role impairment and help-seeking. Reliable information at the population level is needed to estimate the disease burden of depression and associated care needs in Turkey. Method The cross-sectional study aimed to assess the prevalence of subthreshold (SubD) and clinical major depressive disorder (MDD) in Izmir, Turkey. In the 5242 eligible households, a total of 4011 individuals were successfully interviewed, yielding a response rate of 76.5%. Prevalence estimates of MDD and SubD depression were formed by using the responses to the questions of the CIDI section E. Short Form 36 (SF-36) to assess health status and functional impairments in eight scaled scores during the last four weeks. All respondents were questioned about receiving 12-month treatment for any psychological complaints, the route of help-seeking, as well as prescribed medicines and any hospitalization. Results The one year prevalence estimate for CIDI/DSM IV MDD was 8.2% (95% CI, 7.4–9.1). Less educated, low income, uninsured, low SES, unemployed/disabled and housewives, slum area residents had higher one year MDD prevalence. Determined prevalence of help seeking from mental health services of SubD and MDD cases were 23.6%, 30.6% respectively. Only 24.8% of clinically depressive patients received minimally adequate treatment. Limitations Cross sectional design. Conclusion Higher MDD prevalence correlates with younger ages, female gender, unemployment, less education, lower monthly income, lower SES and uninsurance. Help seeking from mental health services were low. There are treatment gap and impairment in depressive group.

Objectives: To determine the prevalence of and factors influencing premenstrual syndrome (PMS) in first-year students at a university health campus and to evaluate the relationship between depression and PMS. Methods: This cross-sectional study was conducted on a population of 618 university students from March to June 2016 at Dokuz Eylul University, Izmir, Turkey. Data were collected using the Premenstrual Syndrome Scale (PMSS), Beck Depression Inventory and Student Identification Form. The data were analyzed with Version 20.0 of the Statistical Package for the Social Science. Descriptive statistics, Pearson’s chi-square test, and Chi-square test for trend, and independent samples t test and logistic regression analysis were used. Results: The prevalence of PMS in the university students was 58.1%. Premenstrual syndrome was significantly higher in students who smoked, drink alcohol, and consumed a large amount of fatty and high-calorie foods, in students who had a bad to very bad perception of their economic situation, and those who had any chronic disease or anemia ( p less than 0.05). Premenstrual syndrome was significantly higher in students who had a risk of depression ( p less than 0.01). A statistically significant relationship was determined between the risk of depression and PMSS total score and all PMSS subscale scores except for appetite changes ( p less than 0.01). Conclusion: Premenstrual syndrome was found in more than half of the students who participated in the study. Premenstrual syndrome was higher in students who had a chronic disease and/or an unhealthy lifestyle. There was a statistically significant relationship between PMS and risk of depression. Students who have PMS symptoms should be evaluated for the risk of depression. Saudi Med J 2017; Vol. 38 (11): 1125-1131 doi: 10.15537/smj.2017.11.20526 How to cite this article: Acikgoz A, Dayi A, Binbay T. Prevalence of premenstrual syndrome and its relationship to depressive symptoms in first-year university students. Saudi Med J . 2017 Nov;38(11):1125-1131. doi: 10.15537/smj.2017.11.20526.

There is no report on various patterns of alcohol drinking and related impairment, help-seeking in Turkey. We investigated the 12-month prevalence and correlates of drinking patterns and alcohol use disorders in the general population of Izmir-Turkey, with further analyses on role impairment and help-seeking. A multi-stage clustered area probability sample of adult household residents in the Izmir Metropolitan Area was assessed using the Composite International Diagnostic Interview 2.1 (n = 4011). Estimation focused on prevalence and correlates of 12-month drinking pattern and DSM-IV alcohol use disorders. The 12-month drinking pattern included groups of non-regular users, regular non-heavy drinkers, regular heavy drinkers, and alcohol abuse disorder and alcohol dependence. All respondents were questioned about receiving 12-month treatment for any psychological complaints, the route of help-seeking, and were assessed with Short Form-36 for functional impairments. Multinomial logistic regression was used for underlying associations between the covariates and the drinking patterns. The rate of lifetime alcohol abstinence was 52.3% while the prevalence of past-year users was 14.8%. The 12-month prevalence estimates of regular heavy drinkers, and alcohol abuse disorder and dependence were 2.5%, 3.2 and 1.6%, respectively. Any of the drinking patterns and alcohol use disorders was associated with male gender, and higher levels of education, monthly income and socioeconomic status. Alcohol dependence was associated with mental health impairment but not with physical impairment. The 12-month rates of help-seeking in alcohol abuse and dependence were 11.6 and 16.5%. Although alcohol use disorders are lower than estimates of Western countries, alcohol use constitute a major reason of disability with prominent treatment gap.

Purpose: This study was performed to determine the prevalence of depression and to investigate the correlation between sociodemographic, individual and health-related factors and depression. Materials and Methods: This cross-sectional study was carried out on 618 university students. Participants of the study were first year female students of Vocational School of Health Services, School of Physical Therapy and Rehabilitation, Faculty of Nursing, Faculty of Medicine in the health campus of Dokuz Eylül University in İzmir, Turkey. Data were collected by Beck Depression Inventory and Student Identification Form. Chi-square test, independent samples t test, Mann-Whitney U test, one way ANOVA test and logistic regression analysis were used for the statistical analyses. Results: The mean Beck Depression Inventory score was 11.5±9.6 points and prevalence rate of depression (Beck Depression Inventory ≥17) was 25.6%. The mean Beck Depression Inventory score and depression prevalence were found higher among the students who had anemia, chronic illness, mental/psychological problems, low economic status, smoking and alcohol use, seperated parents and were living in dormitories. Conclusion: It was concluded that approximately one–fourth of the students had depression. Low economic level, unhealthy lifestyle behaviors, chronic disease and a history of mental problems were the major factors affecting depression prevelance. Intervention studies for university students aiming to decrease unhealthy lifestyle behaviors such as smoking, alcohol use, and unhealthy diet should be made. Preventive mental health programs for university students should be developed and implemented, maç: Bu çalışma, üniversitede okuyan kız öğrencilerde depresyon prevalansını belirlemek; bireysel, sosyodemografik ve sağlıkla ilişkili faktörlerin depresyonla ilişkisini araştırmak amacıyla yapılmıştır. Gereç ve Yöntem: Bu kesitsel araştırma 618 üniversite öğrencisi üzerinde yapılmıştır. Dokuz Eylül Üniversitesi’nin sağlık kampüsündeki Tıp Fakültesi, Hemşirelik Fakültesi, Fizik Tedavi ve Rehabilitasyon Yüksekokulu, Sağlık Hizmetleri Meslek Yüksekokulu’nun birinci sınıfında okuyan kız öğrenciler araştırma kapsamına alınmıştır. Öğrencilere öğrenci tanıtım formu ve Beck Depresyon Ölçeği (BDÖ) uygulanmıştır. Verilerin istatistiksel analizinde ki-kare testi, bağımsız gruplarda t testi, Mann-Whitney U testi, tek yönlü ANOVA testi ve lojistik regresyon analizi uygulanmıştır. Bulgular: Araştırma grubunun BDÖ skoru ortalaması 11.5±9.6 ve depresyon prevalansı (Beck Depresyon Ölçeği puanı ≥17) %25.6 olarak bulunmuştur. Anne babası ayrı olan, yurtta kalan, ekonomik algısı çok kötü ve kötü olan, kronik hastalığı olan, anemisi olan, sigara ve alkol kullanan, ruhsal/psikolojik sorun öyküsü olan öğrencilerde BDÖ puanı ortalaması ve depresyon prevalansı daha yüksek bulunmuştur. Sonuç: Öğrencilerin yaklaşık dörtte birinde depresyon vardır. Ekonomik düzey düşüklüğü, sağlıksız yaşam biçimi davranışları, kronik hastalık ve ruhsal sorun öyküsü, öğrencilerde depresyon prevalansını etkileyen en önemli faktörlerdir. Öğrencilere sigara, alkol, yanlış beslenme gibi sağlıksız yaşam biçimi davranışlarının azaltılmasına yönelik girişim çalışmaları yapılabilir. Üniversite öğrencilerine yönelik koruyucu ruh sağlığı programlarının geliştirilmesi ve uygulanması önerilir.

Objective To evaluate the association between psychotic experiences (PEs) and social stress and discrimination during adaptation to a new social context. Method First-term university students (n: 164) were screened to determine if they had had any PEs, social adaptation-related stress, and/or perceived discrimination in the prior six months. The positive dimension of the Community Assessment of Psychic Experiences (CAPE) was used to define PEs. Social relations and discrimination in the students' new social contexts (both narrow (i.e., their class) and wider (i.e., urban environment) were screened with relevant questionnaires regarding social capital and discrimination. Responders were classified as either the "High CAPE" group (first and second quartiles; n: 82) or the "Low CAPE" group (third and fourth quartiles; n: 82), which was used as the baseline/control group. Analyses included associations between these two groups and social stress, discrimination, and demographic/non-demographic variables. Results were re-analyzed after excluding irregular students and regrouping with the first and fourth quartiles in CAPE. Results High CAPE scores were associated with perceived discrimination in narrow and wider social environments (adjusted 0,08; 95% CI: 0,01-0,11), and with adaptation-related stress in narrow social environment (adjusted 0,02; 95% CI: 0,01-0,05). In addition, high CAPE scores were associated with smoking and lower maternal educational level. Associations were stronger when the data was re-analyzed based on the first and fourth quartiles. However, associations between discrimination, social stress, and high CAPE scores were attenuated after exclusion of irregular students. Conclusion Adaptation-related social stress and perceived discrimination in a new social context may increase the risk of PEs. This particular association seems to be more prominent in groups with higher social stress (e.g., those with academic failure or high perceived discrimination).

Objective: The purpose of this study was to evaluate the impact of parental consanguinity on the clinical features in schizophrenia. Methods: The sample of the study was based on DSM-IV schizophrenia patients admitted to Ataturk State Hospital of Sinop betwe 2009 and 2001. Sociodemographic (age, gender, marital status, completed years of education, employment status) and clinical features (family history of psychiatric disorders, age of onset, number of hospitalization), and parental consanguinity were retrieved retrospectively from case registries. Results: A total of 182 patients (51.1% female and mean age 38.8) were included. Frequency of any parental consanguinity and first degree cousin marriages were 19.9% and 13.2% respectively. Mean age of onset of schizophrenia was significantly lower among patients with parental consanguinity than patients with no parental consanguinity (22.1 and 25.5 respectively; t(180)=2.1; p < 0.05). Parental consanguinity was significantly associated with higher number of hospitalization (adjusted odds ratio [OR]=2.8; 95% confidence interval [C1]=1.1-7.1; p < 0.02). The association between parental consanguinity and number of hospitalization was slightly stronger in patients whose parents were first degree cousins (adjusted OR= 3.0; 95% CI=1.0-8.7; p < 0.04). Conclusion: Frequency of parental consanguinity in schizophrenia is similar to rates in general population, however first degree cousin consanguinity may be mildly higher in parents. Parental consanguinity is associated with earlier age of onset and higher number of hospitalization. Both associations may indicate a relative poor prognosis, and are mildly stronger in first degree cousin consanguinity which may represent a unique genetic effect.

OBJECTIVE: Digit ratios may be accepted as an indicator of level of prenatal androgen exposure during the fetal developmental period. Female-typical digit ratios have been suggested to be associated with better mentalizing and empathic abilities in general population. Recently, a number of studies have investigated the ratio of hand’s second and fourth digit fingers (2D:4D) in schizophrenia. The aim of this study was to investigate the hypothesis that positive symptoms are related to female-biased 2D:4D and relatively less impaired social cognition in schizophrenia, negative dimension is related to male-biased 2D:4D ratio and more pronounced deficits in social cognition. METHOD: The study was carried out in 48 patients with schizophrenia and 48 healthy controls. Patients were evaluated by Positive and Negative Syndrome Scale (PANSS). A digital caliper was used to measure 2D:4D finger lengths and social cognitive abilities were assessed using the Empathy Quotient (EQ) test and Reading Mind in the Eyes Test (RMET). RESULTS: Patients with schizophrenia had increased left 2D:4D finger lengths and showed poor theory of mind (ToM) and empathic abilities compared to healthy controls (p

ÖzetAmaç: Manisa’da 2007-2011 yılları arasındaki özkıyım girişiminde bulunan olguların özelliklerinin cinsiyete göre incelenmesidir. Yöntem: Tanımlayıcı tipteki araştırma, Manisa Halk Sağlığı Müdürlüğü’nün intihar girişimleri kayıt formlarının incelemesiyle yapılmıştır. Bulgular: Toplam 6827 olgunun 5311’i (%77.8) kadındır. Özkıyım girişiminde bulunan olguların %57.3’ü 15-24 yaş grubunda, %51.6’sı bekar, %62.2’si ilköğretim mezunudur. Olguların %95.8’inin özkıyım girişimi yöntemi zehirleyici maddedir. En yaygın özkıyım nedeni genel toplamda ve kadınlarda aile geçimsizliği-evlilik-çocuklarken, erkeklerde ruhsal hastalıktır. Özkıyım nedeni en sık, 15 yaş altında ve 15-24 yaş grubunda ebeveyn çatışmaları, 25-64 yaş grubunda aile geçimsizliği-evlilik-çocuklar, 65 yaş ve üzerinde ruhsal ve bedensel hastalıktır. Sonuç: Özkıyım girişiminde bulunan olguların çoğunluğu kadın, ergen/genç yaş grubu, ilköğretim mezunu olanlar, çalışmayanlardır. Başlıca özkıyım girişimi yöntemi ilaç ve zehirleyici madde kullanımıdır. Nedenler de yaş grubu ve cinsiyete göre değişmektedir.Anahtar Kelimeler: Özkıyım, özkıyım girişimi, epidemiyoloji, risk etmeniAbstractObjective: The study determined, by gender and age group, the characteristics of individuals who had attempted suicide in Manisa between the years 2007-2011.Method: This was a descriptive study conducted by retrospective research of "suicide attempt entry forms". Results:A total of 6827 suicides were evaluated. 5311 (77.8%) were women, 57.3% were aged 15-24 years, 51.6% were single, 62.2% had graduated from primary schools. In 95.8% of the suicides the method of suicide was self-poisoning with drugs. The most common reasons for the suicide attempts in total and among women were family problems, marriage and children; mental illness among men. The most frequent reasons for the suicide attempts among those who were 15-24 years of age were conflicts with parents; among the age group of 25-64 the reasons were family problems, marriage or children, and among those who were 65 years and over the reasons were mental or physical illnesses.Conclusion: The main determinants of suicide attempts were female gender, adolescents and/or young adults, primary school as an educational level, unemployed individuals. The most frequent suicide method was self-poisoning. Reasons of attempts displayed variation based on age group and gender.Key words: suicide, suicide attempt, epidemiology, risk factor

To provide registry-based prevalence estimates of schizophrenia, schizoaffective, and bipolar I (BPI) disorders in a defined area of Sinop, Turkey.All patients that presented to primary and secondary health services over three year time (2009-2011) with diagnosis of psychotic disorder (F06.1, F06.2, F10.5, F12.5, F19.5, F20-29, F30-31, F32.3, F33.3, F39 in ICD-10) covering a population of 73,503 aged 15-64 were included via case registry systems. All accessed case records were pooled. Case ascertainment and diagnostic assessment were achieved through structured clinical interview for DSM-IV, phone interview, or farming a best-estimated diagnosis via records on registers.Registries provided 1,410 probable cases. The successful clinical reappraisal rate was 66.8% (n: 955) while, the final diagnoses were determined via phone interview or best-estimate diagnosis in the rest of the cases. Seven hundred twenty seven individuals were diagnosed with DSM-IV yielding a prevalence of 9.8 per 1,000 (95% confidence interval [CI]: 8.2-11.5). Registry-based prevalence of schizophrenia, schizoaffective disorder, BPI disorder, and depression with psychotic features were 3.6 (95% CI: 3.0-4.2), 1.1 (95% CI: 0.8-1.4), 2.7 (95% CI: 2.0-3.3), and 1.0 (95% CI: 0.6-1.3) per 1,000, respectively.Ten individuals per 1,000 adult persons admit for any disorder with psychotic symptoms. Registry-based prevalence estimates are lower than the lifetime prevalence estimates. However, analyses of administrative data appear to provide information needed for effectively plan and implement psychiatric services.

Objective: The aim of this cross-sectional study is to examine the relation of formal thought disorder (FTD) with symptomatic remission (SR) and social functioning in patients with schizophrenia. Method: The study was carried out with a sample consisting of 117 patients diagnosed with schizophrenia according to DSM-IV. The patients were assessed with the Positive and Negative Syndrome Scale (PANSS), the Thought and Language Index (TLI), and the Personal and Social Performance Scale (PSP). We used logistic regression in order to determine the relation between FTD and SR and linear regression to identify the strength of association between FTD and social functioning. Results: Logistic regression analysis revealed that poverty of speech (odds ratio: 1.47, p

Cognitive dysfunctions are one of the main domains of symptom clusters in schizophrenia that are strongly related to poor prognosis and psychosocial impairment. We conducted a study to investigate the level of cognitive functions in patients with first episode psychosis (FEP) and effect of psychosocial factors related to psychosis and cognitive dysfunctions in this population. We included 60 FEP patients and 60 healthy control subjects. Cognitive functions of the study population were evaluated by using neuropsychological test battery including Stroop, Rey Verbal Learning and Memory, Digit Span, Trail Making, Digit Symbols, Controlled Word Association etc. Psychosocial risk factors were assessed using Childhood Trauma Questionnaire, Social Environment Measurement Tool, Life Events Scale, Tobacco Alcohol Use Scale and Substance/Marijuana Use Scale. Cognitive functions were significantly impaired in FEP patients compared to normal controls. Patients had poor performance in verbal memory, attention, processing speed, working memory and executive functions that is similar to the previous literature findings. Stressful life events in the last year and familial liability of schizophrenia and psychosis in 1st degree relatives were strong predictors to develop psychosis in patients with FEP. Both factors also seemed to be related to cognitive dysfunctions. In this study, patients with stressful life events in the last year were likely to have memory and executive dysfunctions. It has been shown that psychosocial risk factors had played an important role in developing psychosis. However, these factors also may negatively affect cognitive functions that may make the patient predispose to develop psychosis in FEP patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychotic symptoms and disorders can emerge due to structural brain abnormalities. The septum pellucidum is one of the midline brain structures, which consists of the fusion of two thin membranes. Cavum vergae is recognized as the most severe form of fusion defect in the membranes of septum pellucidum. Although cavum vergea is reported to be common in schizophrenia and other psychotic disorders, a significant relationship has been found only for anomalies greater than 6 mm. Large cavum vergae may be a marker of developmental anomalies in other midline structures and connections, which in turn may lead to psychotic symptoms and disorders. In this case report, we present cavum vergae in a schizophrenia case with a 25 year history of untreated psychosis, discuss the probable relation of psychotic symptoms to structural brain anomaly, and evaluate the treatment course.

OBJECTIVE To provide registry-based prevalence estimates of schizophrenia, schizoaffective, and bipolar I (BPI) disorders in a defined area of Sinop, Turkey. MATERIAL AND METHODS All patients that presented to primary and secondary health services over three year time (2009-2011) with diagnosis of psychotic disorder (F06.1, F06.2, F10.5, F12.5, F19.5, F20-29, F30-31, F32.3, F33.3, F39 in ICD-10) covering a population of 73,503 aged 15-64 were included via case registry systems. All accessed case records were pooled. Case ascertainment and diagnostic assessment were achieved through structured clinical interview for DSM-IV, phone interview, or farming a best-estimated diagnosis via records on registers. RESULTS Registries provided 1,410 probable cases. The successful clinical reappraisal rate was 66.8% (n: 955) while, the final diagnoses were determined via phone interview or best-estimate diagnosis in the rest of the cases. Seven hundred twenty seven individuals were diagnosed with DSM-IV yielding a prevalence of 9.8 per 1,000 (95% confidence interval [CI]: 8.2-11.5). Registry-based prevalence of schizophrenia, schizoaffective disorder, BPI disorder, and depression with psychotic features were 3.6 (95% CI: 3.0-4.2), 1.1 (95% CI: 0.8-1.4), 2.7 (95% CI: 2.0-3.3), and 1.0 (95% CI: 0.6-1.3) per 1,000, respectively. CONCLUSION Ten individuals per 1,000 adult persons admit for any disorder with psychotic symptoms. Registry-based prevalence estimates are lower than the lifetime prevalence estimates. However, analyses of administrative data appear to provide information needed for effectively plan and implement psychiatric services.

Chronic stress is known to affect the HPA axis. The few clinical studies which have been conducted on HPA-axis function in burnout have produced inconsistent results. The etiological relationship between sBDNF and burnout has not yet been studied. The aim of the current study was to investigate the role of BDNF and HPA axis in the neurobiology of burnout. In the current study 37 clinically diagnosed burnout participants were compared with 35 healthy controls in terms of BDNF, HPA axis, burnout symptoms, depression, anxiety and psychosomatic complaints. Basal serum cortisol, sBDNF and cortisol level after 1 mg DST was sampled. We found no significant differences in terms of HPA-axis function (for basal serum cortisol, p = 0.592; for cortisol level after 1 mg DST, p = 0.921), but we did find lowered sBDNF levels in burnout group (88.66 ± 18.15 pg/ml) as compared to healthy controls (102.18 ± 20.92 pg/ml) and the difference was statistically significant ( p = 0.005). Logistic Regression Analysis revealed that emotional exhaustion ( p = 0.05), depersonalization ( p = 0.005) and depression ( p = 0.025) were significantly associated with burnout. sBDNF levels correlated negatively with emotional exhaustion ( r = −,268, p = 0.026), depersonalization ( r = −,333, p = 0.005) and correlated positively with competence ( r = 0.293, p = 0.015) sub-scales of burnout inventory. However, there were no significant relationships between cortisol levels and sBDNF levels ( r = 0.80, p = 0.51), depression, anxiety, psychosomatic complaints and burnout inventory. Our results suggest that low BDNF might contribute to the neurobiology of burnout syndrome and it seems to be associated with burnout symptoms including altered mood and cognitive functions.

Objective: Thought disorders are one of the important and less understood characteristics of schizophrenia. Thought disorder is generally considered in two parts as thought content and thought process. However, it has been suggested that thought disorder in schizophrenia is strongly related to impairment in thought process. Thought and language disorder in schizophrenia is known to be associated with particular clinical symptoms. The aim of this study is to investigate relationship between thought and language disorder and subscales and items of PANSS in patients with schizophrenia. Methods: This study was conducted with 176 patients who met DSM-IV criteria for schizophrenia. Sociodemographic data form, Thought and Language Index (TLI) and Positive and Negative Syn-drome Scale (PANSS) were administered to the patients. Results: TLI score was significantly correlated with posi-tive, negative, general psychopathology subscale scores and total score of PANSS. When the relationship between TLI and items of PANSS was evaluated; conceptual disorganization (P2), suspiciousness/persecution (P6), blunted affect (N1), emotional withdrawal (N2), difficulty in abstract thinking (N5), lack of spontaneity and flow of conver-sation (N6), motor retardation (G7) and unusual thought content (G9) items of PANSS were significantly correlated with TLI. Conclusion: Thought and language disorder was found related with positive, negative, general psycho-pathology subscales of PANSS.

IntroductionBoth clinical and subclinical psychosis is probably a consequence of underlying genetic and environmental interactions.ObjectivesDefining differential impact of environmental/familial risk factors and psychotic experiences across the onset of clinical psychosis.AimsTo assess mental health outcomes in a 6-year follow-up of a representative general population sample with a special focus on extended psychosis phenotype.MethodsAddresses were contacted in multistage clustered area probability sampling frame covering 9 districts and 302 neighbourhoods (n: 4011) at baseline (T1) and 6 years after (n: 2142) (T2). Psychotic experiences were screened with Composite International Diagnostic Interview and probable cases were re-interviewed with SCID-I. Relations were tested using logistic regression models.ResultsOf subclinical psychotic symptoms at baseline, 6.4% transitioned to clinical psychosis; 44.4% persisted, 90.2% transitioned to any DSM disorder. Of newly onset clinical psychosis at T2, 62.8% had subclinical psychotic expressions at baseline. The risk of developing clinical psychosis was greater in those with baseline subclinical psychotic experiences, alcohol–cannabis abuse, stressful-forensic event history and family history of mental disorders. Most of risk factors associated with psychosis proneness at T1 were also associated with clinical psychotic outcome at T2 (Table 1).ConclusionsPsychotic experiences takes attention for the risk to develop psychosis due to underlying genetic and environmental interactions; also may be an important risk factor to develop any mental disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.