Turk psikiyatri dergisi = Turkish journal of psychiatry最新文献

Objectives: The aim of this study is to examine the prevalence of digital technology tool use in individuals with schizophrenia or schizoaffective disorder in Turkey, as well as evaluating the association between the use and psychosocial functionality and clinical symptoms.

Method: Data were collected from 100 patients who were diagnosed with schizophrenia or schizoaffective disorder based on the DSM-5 criteria. The use of technology was evaluated with a questionnaire developed for this study. The level of psychosocial functioning was assessed using the Personal and Social Performance Scale (PSP), and the positive and negative symptom severity was evaluated using the Positive and Negative Syndrome Scale (PANSS).

Results: The digital technology users were significantly younger than the non-users. The majority of patients own a mobile phone (86%) and a computer (67%). Furthermore, 61% of patients used mobile applications, with Facebook and WhatsApp being the most popular social media platforms (48%). Patients who used digital technology tools had higher PSP scores. Furthermore, patients who used digital technology tools had significantly lower scores in PANSS negative subscale. There was no difference in PANSS positive subscale scores between digital technology tool users and non-users.

Conclusion: Patients diagnosed with schizophrenia may benefit from mobile applications and social media tools that can help them participate in daily activities and improve their overall well-being.

Objective: Affective lability, which is an important aspect of mood dysregulation, is seen in many psychiatric conditions. The aim of this study is to examine the psychometric properties of the Affective Lability Scale-18 in the Turkish sample of the non-clinical group.

Method: A total of 615 individuals (312 females and 303 males) who did not have a past or current psychiatric disorder were included in the study. The participants were administered sociodemographic data form, Affective Lability Scale-18, Difficulties in Emotion Regulation Scale, and Beck Depression Inventory. The participants were divided into 4 groups; a pilot group, EFA (exploratory factor analysis) group, CFA (confirmatory factor analysis) group and test-retest group.

Results: The factor analysis conducted for the construct validity of the scale, revealed similar results to that of the original scale. The Cronbach's alpha internal consistency coefficient was 0.92 for the EFA group and 0.92 for the CFA group. The test-retest reliability coefficient was 0.82. Difficulties in Emotion Regulation Scale (DERS) and Beck's Depression Inventory (BDI) were used tp measure validity. The correlation between the total scores of participants on the ALS-18 and their scores on the DERS and BDI was determined to be positive and moderate (r=0.38, r=41).

Conclusion: The Affective Lability Scale-18 in the Turkish sample, three sub-dimensions, anxiety/depression, depression/elevation, anger and the general factor all have sufficient internal consistency and it has been demonstrated that the scale can be applied in our country to evaluate the situations in which affect variability is evaluated.

Objective: We investigated the relationship between health-related quality of life (HRQoL), childhood trauma (CT), sociodemographic factors, and clinical characteristics in patients with severe mental disorders.

Method: A total of 158 patients diagnosed with schizophrenia spectrum disorders or bipolar disorder were evaluated. Data were collected using the Short Form-12 (SF-12), Childhood Trauma Questionnaire, Clinical Global Impression-Severity Scale, and sociodemographic information form.

Results: CT was reported in 62.7% of participants. SF-12 physical component scores were lower in women (p=0.012), married individuals (p=0.002), and patients with comorbidities (p=0.005). SF-12 mental component scores were lower in patients who smoked (p=0.013) and used substances (p=0.030), treated with long-acting injectable antipsychotics (p=0.008), and had a history of suicide attempts (p=0.014). Physical HRQoL scores were negatively correlated with age (r=-0.222, p=0.006), body mass index (r=-0.277, p=0.002) and illness duration (r=-0.215, p=0.010); mental HRQoL scores were negatively correlated with antipsychotic dose (r=-0.166, p=0.041) and CGI-S scores (r=-0.376, p <0.001). Emotional neglect (β=0.220, p=0.018) and physical abuse (β=0.252, p=0.006) were associated with lower physical HRQoL scores; emotional neglect (β=0.212, p=0.019) and sexual abuse (β=0.299, p<0.001) were associated with lower mental HRQoL scores.

Conclusion: CT was found to be a key factor contributing to lower HRQoL in individuals with severe mental disorders. Our findings emphasize the importance of screening for CT and trauma-focused care approaches in mental healthcare services.

Objective: Circular RNA (circRNA) molecules may play a significant role in the pathogenesis of psychiatric disorders by regulating synaptic gene expression. This study aimed to evaluate the relationship between the peripheral expression levels of three circRNA molecules (chr3_196488683, chr5_69175537, and hsa_circ_0084021) and clinical characteristics, specifically behavioral phenotypes related to self-harm and harm to others, in individuals diagnosed with schizophrenia and schizoaffective disorder.

Methods: The study included 104 patients aged 18–65 diagnosed with schizophrenia or schizoaffective disorder. RNA was isolated from peripheral blood, and circRNA molecules were identified using RNA sequencing techniques. Clinical status was assessed using the Positive and Negative Syndrome Scale, Clinical Global Impressions Scale, Global Assessment of Functioning, Calgary Depression Scale for Schizophrenia, Beck Anxiety Inventory, Beck Scale for Suicide Ideation, and Suicide Probability Scale. The relationship between concurrent circRNA levels and clinical features was investigated.

Results: A significant positive correlation was observed among the circRNAs (p<0.001). Apart from a weak positive correlation between chr3_196488683 and the Beck Anxiety Inventory score (r=0.213, p=0.03), no significant relationship was found between clinical scales and circRNAs. No significant difference was detected between groups regarding suicidal behavior. However, mean levels of all circRNAs were found to be statistically significantly higher in the group with self-injurious behavior (chr3_196488683, p=0.036; chr5_69175537, p=0.001; hsa_circ_0084021, p=0.045). Similarly, levels of chr3_196488683 and chr5_69175537 were significantly higher in the group with homicidal behavior (p<0.001).

Conclusion: The findings suggest that peripheral circRNA levels may be associated with anxiety and behavioral risk profiles involving harm to self or others, indicating their potential value as biomarkers.

I have read an interesting article recently published in your journal regarding the Turkish adaptation, validity and reliability study of the Bush Francis Catatonia Rating scale (BFCRS) and the Katatonia, Autism, Neuropsychiatric and Neuromovement Examination Rating (KANNER) Scale (Erdoğan et al. 2023). The article delighted me as catatonia is, in my opinion, the most fascinating syndrome of neuropsychiatry, if not of entire medicine. Catatonia needs further and deeper studies. I feel these scales and others such as Northoff Catatonia Scale (NCS) need to be adapted all around the world. Only then clinicians and researchers will be able to collaborate closer in better and stronger studies.

Objective: Both general medical and mental health services were disrupted during the pandemic. It is unclear how these disruptions played out for people with various mental health diagnoses. We compared change in mental health status and use of mental health services between four psychiatric groups: schizophrenia spectrum disorders, bipolar disorder, unipolar depression, and anxiety/obsessive- compulsive disorder (OCD).

Method: Using a semi-structured interview, 492 outpatients with psychiatric disorders who had used psychiatric services at a university hospital before the pandemic were assessed on the phone during the pandemic.

Results: About half of the sample reported a need for contact with mental health services during the pandemic, half of whom actually used services. Need for contact was much lower in the schizophrenia group than other diagnostic groups, whereas actual use of services was lower in the unipolar depression and anxiety/OCD groups.

Conclusions: Patients with severe mental disorders, such as schizophrenia or bipolar disorders, may not be in a more disadvantageous position in terms of psychiatric service use during the pandemic. The pandemic response structure of mental health services should be modified to fit the needs of anxiety/depression spectrum patients.

Objective: This study aims to evaluate the suitability of the automatic item generation (AIG) for producing Turkish case-based multiplechoice questions (MCQs) in psychiatry.

Method: The study was planned as a descriptive study. In the first stage, topics were determined and a cognitive model was created by subject matter experts. In the second stage, a question template was created, variables were determined, the format of answer options was organized, and two equivalent templates of question content with different combinations were created. In the final stage, questions were generated using Python-based software based on these models. Following the question generation, random samples were selected and evaluated by experienced educators using a structured form.

Results: A total of 1189 questions were generated, with 11 questions sampled for each diagnosis. In the evaluation conducted by experts, six of the questions were deemed appropriate for each parameter, while minor corrections were suggested for five questions. It was stated that all the questions assess clinical reasoning skills rather than factual recall.

Conclusion: The template-based AIG method allows for the rapid and effective production of high-quality questions needed in medical education. The study demonstrated that AIG in the Turkish language for generating MCQs that assess clinical reasoning is applicable in the field of psychiatry. This method enables the production of a large number of questions in a short time, enriched with various combinations. Keyword: Automated item generation, clinical reasoning, medical education, multiple choice question, psychiatry education.

Major depressive disorder (MDD), with its heterogeneous nature and variable course, poses significant challenges for clinicians in treatment planning and clinical decision-making. These challenges are further compounded by the rapid emergence of new treatment options and the uncertainty regarding their place within clinical algorithms. In this context, structured treatment guidelines that offer sequential, evidence-based recommendations based on comparative evaluation of available interventions have become essential reference tools for clinicians. Although various international guidelines offer comprehensive recommendations, the absence of a locally relevant and up-to-date guideline tailored to national clinical needs remains a critical gap. This guideline was developed to address that gap, aiming to provide a scientifically grounded and clinically applicable resource for the treatment of depression in Türkiye. This guideline reviews recent developments in MDD treatment and presents evidence-based, sequential recommendations applicable to clinical practice in Türkiye. It also systematically covers assessment tools, clinical subtypes, outcome measures and decision-making processes that may guide treatment planning. This article introduces the methodological framework, development process and the core concepts and definitions related to the guideline. Keywords: Psychometric rating, terminology, treatment of depression, treatment resistance.

The classification of sexual health-related conditions was reformulated in 11th revision of International Classification of Diseases (ICD-11) following current evidence, best practice, and taking human rights into consideration, which is expected to reflect and provide guidance for more integrative clinical approaches. Overcoming the artificial, yet historical, distinction between "organic" and "non-organic" conditions, sexual dysfunctions classified in the "Mental and Behavioral Disorders" and "Disorders of Genitourinary System" in ICD-10 were listed in a new chapter called "Conditions Related to Sexual Health." In practice, this approach has been consistently recommended. However, diagnostical clasification was not congruent with the recommendation. Dysfunctions, defined with a non-normative but individual-based threshold, are categorized according to different stages of the sexual response cycle, similar to ICD-10 and Diagnostic and Statistical Manual of Mental Disorders 5th version (DSM-5). However, similarities and distinctions in the clinical presentation of the dysfunction in men and women were also considered, resulting in differences from the DSM-5 approach. Gender Incongruence is classified in this newly formed "Conditions Related to Sexual Health" chapter, not with mental disorders as in the earlier version, reflecting the current non-pathologizing understanding of gender diversity. Furthermore, the criteria for these conditions were revised to embrace the variability in the experience of gender identity. In addition, the residuals of sexual orientation-related diagnostic categories were removed. Paraphilic disorders categories replaced "Disorders of sexual preference" in ICD-10, with significant modifications in conceptualization and classification.

Objective: Theory of mind (ToM) is a foundational ability for social functioning and interpersonal relationships. This study aims to examine theory of mind components in major depressive disorder and its relationship with metacognitive functions and attachment styles.

Method: The study enrolled 64 patients with major depressive disorder and 64 healthy controls. The control group was selected to match the patient group regarding age, gender, marital status, and educational level. Every participant completed the sociodemographic data form, the Hinting Test, the Reading the Mind in the Eyes Test, the Adult Attachment Style Scale, and the Metacognition Questionnaire. The severity of depression symptoms was evaluated using Hamilton Depression Rating Scale-17.

Results: The average overall score of the metacognition questionnaire was substantially greater in the patient group (p<0.001) compared to the control group. The average score for the Hinting Task was substantially lower in the patients compared to the control group (p<0.001). The severity of depressive symptoms showed a strong negative correlation with the Hinting Task score (r=-0.759; p<0.001), and a moderate negative correlation with the Reading the Mind in the Eyes Test score (r=-0.589; p<0.001).

Conclusion: This study showed that depressed individuals have impairments in reading the minds of others’ around them and in their metacognitive functions. The findings above highlight the need to integrate techniques centered on enhancing fundamental theory of mind reasoning into current therapy interventions in order to enhance the comprehension and interpretation of social information among individuals experiencing depression.