Turkish Adaptation, Validity, and Reliability Study of Shitsu-Taikan-Sho (Alexisomia) Scale.

Background: The Shitsu-Taikan-Sho (Alexisomia) Scale is a self-report scale for measuring alexisomia, defined as the difficulty in awareness and expression of somatic emotions or feelings. The scale is available in Japanese and Finnish versions. This research aims to examine the psychometric properties of the Turkish version of the Shitsu-Taikan-Sho (Alexisomia) Scale. Methods: The study sample consists of 320 patients who applied to the outpatient clinic of consultation-liaison psychiatry. Participants completed the Sociodemographic Information Form, the Turkish version of the Shitsu-Taikan-Sho (Alexisomia) Scale, and the Toronto Alexithymia Scale. Internal consistency and test-retest reliability were used for reliability analyses. Exploratory factor analysis, confirmatory factor analysis, and co-validity analyses were used for validity analyses. Results: According to the exploratory factor analysis results, a 3-factor, 18-item model for the Turkish version of the Shitsu-Taikan-Sho (Alexisomia) Scale explained 48.3% of the variance (Kaiser-Meyer-Olkin = 0.866; χ 2 = 1535.3, P < .001). Confirmatory factor analysis results indicated a good fit (χ 2 = 234.893; SD = 132; χ 2/SD = 1.779; CFI = 0.927; GFI = 0.923; RMSEA = 0.049). In the co-validity analysis, a significant correlation was found between Toronto Alexithymia Scale-20 and Turkish version of the Shitsu-Taikan-Sho (Alexisomia) Scale (r = 0.556, P < .001). Cronbach's alpha coefficient was 0.825 for the total score, 0.711 for lack of health management based on bodily emotions, 0.794 for difficulty in describing bodily emotions, and 0.775 for over adaptation. The interclass correlation coefficient between the 2 measures of Turkish version of the Shitsu-Taikan-Sho (Alexisomia) Scale was 0.883 (P < .001). Conclusion: The Turkish adaptation of the Shitsu-Taikan-Sho (Alexisomia) Scale demonstrated adequate psychometric properties. It is an appropriate scale for evaluating the concept of alexisomia in the population of consultation-liaison psychiatry.

A kynurenine pathway enzyme aminocarboxymuconate-semialdehyde decarboxylase may be involved in treatment-resistant depression, and baseline inflammation status of patients predicts treatment response: a pilot study.

The kynurenine pathway (KP) and inflammation are substantial in depression pathogenesis. Although there is a crosstalk between the KP, inflammation, and neurotrophic factors, few studies examine these topics together. Novel medications may be developed by clarifying dysregulations related to inflammation, KP, and neurotrophic factors in treatment-resistant depression (TRD). We aimed to evaluate the serum levels of KP metabolites, proinflammatory biomarkers, and brain-derived neurotrophic factor (BDNF) in healthy controls (HC) and the patients with TRD whose followed up with three different treatments. Moreover, the effect of electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) on biomarkers was investigated. Study groups comprised a total of 30 unipolar TRD patients consisting of three separate patient groups (ECT = 8, rTMS = 10, pharmacotherapy = 12), and 9 HC. The decision to administer only pharmacotherapy or ECT/rTMS besides pharmacotherapy was given independently of this research by psychiatrists. Blood samples and symptom scores were obtained three times for patients. At baseline, quinolinic acid (QUIN) was higher in the patients with TRD compared to HC, whereas picolinic acid (PIC), PIC/QUIN, and PIC/3-hydroxykynurenine were lower. Baseline interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hsCRP) were higher in nonresponders and non-remitters. ECT had an acute effect on cytokines. In the rTMS group, tumor necrosis factor-α (TNF-α) decreased in time. PIC, QUIN, and aminocarboxymuconate-semialdehyde decarboxylase (ACMSD) enzyme may play a role in TRD pathogenesis, and have diagnostic potential. rTMS and ECT have modulatory effects on low-grade inflammation seen in TRD. Baseline inflammation severity is predictive in terms of response and remission in depression.

The role of neuropeptide Y, orexin-A, and ghrelin in differentiating unipolar and bipolar depression: a preliminary study.

BACKGROUND: When depressive symptoms in bipolar and unipolar patients were compared, a number of studies reported that atypical vegetative features such as hypersomnia and hyperphagia were more common in bipolar patients. Moreover, neuropeptides such as orexin-A (ORX-A), ghrelin (GRL), and neuropeptide Y (NPY) are involved in the regulation of these vegetative functions. MATERIALS AND METHODS: A total of 45 unipolar and 24 bipolar depressive patients, and 36 euthymic healthy controls were included in the study. The groups were compared in terms of peripheral blood samples of ORX-A, GRL, and NPY levels, as well as HAM-D, Epworth Sleepiness Scale, Three-Factor Eating Questionnaire-Revised, and Suicide Probability Scale scores. RESULTS: Both unipolar and bipolar patients had lower ORX-A, GRL, and NPY levels compared to the controls, whereas NPY levels of bipolar patients were lower than unipolar patients. There was a negative correlation between NPY levels and emotional eating in the bipolar group. CONCLUSION: While lower ORX-A, GRL, and NPY levels are associated with depressive episodes regardless of the diagnosis; NPY levels also differ in bipolar and unipolar depression patients.

Treatment Outcomes of Gamma-Knife Radio Surgery in Refractory Obsessive-Compulsive Disorder.

Background: Obsessive-compulsive disorder (OCD) is a common disease that has negative effects on functionality, and 10% of the patients do not respond to first-line treatments. Gamma-knife radiosurgery (GKRS) has been used in patients with treatment-resistant OCD, but the data on long-term outcomes are still unsatisfactory. Methods: In this study, 12 patients who underwent GKRS between 2005 and 2020 were evaluated retrospectively. Anterior capsulotomy was performed using two 4-mm isocenters at the midputaminal point of the anterior limb of the internal capsule on each side with a maximum radiation dose of 140-180 Gy. Patients were followed up with the Yale-Brown Obsession and Compulsion Scale (Y-BOCS), Montgomery-Asberg Depression Rating Scale (MADRS), and Brief Psychiatric Rating Scale (BPRS) on the first, third, and sixth months. Results: After the procedure, a 35% reduction was observed in the overall Y-BOCS scores, and full response rate was 50%. There was a 49.5% decrease in the MADRS scores and a 57.8% decrease in the BPRS. Conclusion: GKRS is an effective and non-invasive procedure with favorable side effects in treatment-resistant OCD with selected patients.