Evaluation of peripheral inflammatory parameters of cases with suicide attempts.

PURPOSE: The purpose of the present study was to examine the inflammation markers of patients who have attempted suicide by comparing them with those of healthy controls. The leukocyte cell levels, Neutrophil/Lymphocyte Ratios (NLR), Basophil/Lymphocyte Ratios (BLR), Platelet/Lymphocyte Ratios (PLR), Monocyte/Lymphocyte Ratios (MLR), Systemic Inflammation Index (SII), Neutrophil/Albumin Ratios (NAR) values were compared with those of healthy controls. METHOD: A total of 376 people were included in the study (276 patients who attempted suicide, and 100 healthy people (the control group)). The demographic data and laboratory parameters of the participants were analyzed from the hospital automation system. RESULTS: The participants' female/male ratio was 158/118 (42.8%/57.1%) in the group of patients who attempted suicide and 41/59 (41/59%) in the control group. When the distribution of laboratory parameters was evaluated, although the NLR, BLR, NAR, SII, and MLR values, which are indicators of peripheral inflammation, were high in patients who attempted suicide (p = 0.049 for MLR, p = 0.000 for other values), the PLR (p = 0.586) value did not differ significantly between the groups. Patients who had attempted more than one suicide had elevated BLR (p = 0.007), SII (p = 0.003), and NAR (p = 0.003) values. DISCUSSION: Based on the results obtained, it was considered that paying attention to inflammation parameters in patient follow-ups, and monitoring of SII, NLR, BLR, and NAR values of patients who had attempted suicide once would be beneficial in preventing future suicide attempts. These results strengthen the idea that inflammatory processes play roles in the pathophysiology of suicidal behavior. However, further studies are needed to elucidate the complex pathophysiological mechanisms of immune pathways underlying suicidal behavior.

A novel ternary pattern-based automatic psychiatric disorders classification using ECG signals.

Neuropsychiatric disorders are one of the leading causes of disability. Mental health problems can occur due to various biological and environmental factors. The absence of definitive confirmatory diagnostic tests for psychiatric disorders complicates the diagnosis. It's critical to distinguish between bipolar disorder, depression, and schizophrenia since their symptoms and treatments differ. Because of brain-heart autonomic connections, electrocardiography (ECG) signals can be changed in behavioral disorders. In this research, we have automatically classified bipolar, depression, and schizophrenia from ECG signals. In this work, a new hand-crafted feature engineering model has been proposed to detect psychiatric disorders automatically. The main objective of this model is to accurately detect psychiatric disorders using ECG beats with linear time complexity. Therefore, we collected a new ECG signal dataset containing 3,570 ECG beats with four categories. The used categories are bipolar, depression, schizophrenia, and control. Furthermore, a new ternary pattern-based signal classification model has been proposed to classify these four categories. Our proposal contains four essential phases, and these phases are (i) multileveled feature extraction using multilevel discrete wavelet transform and ternary pattern, (ii) the best features selection applying iterative Chi2 selector, (iii) classification with artificial neural network (ANN) to calculate lead wise results and (iv) calculation the voted/general classification accuracy using iterative majority voting (IMV) algorithm. tenfold cross-validation is one of the most used validation techniques in the literature, and this validation model gives robust classification results. Using ANN with tenfold cross-validation, lead-by-lead and voted results have been calculated. The lead-by-lead accuracy range of the proposed model using the ANN classifier is from 73.67 to 89.19%. By deploying the IMV method, the general classification performance of our ternary pattern-based ECG classification model is increased from 89.19 to 96.25%. The findings and the calculated classification accuracies (single lead and voted) clearly demonstrated the success of the proposed ternary pattern-based advanced signal processing model. By using this model, a new wearable device can be proposed.

Attention TurkerNeXt: Investigations into Bipolar Disorder Detection Using OCT Images.

Background and Aim: In the era of deep learning, numerous models have emerged in the literature and various application domains. Transformer architectures, particularly, have gained popularity in deep learning, with diverse transformer-based computer vision algorithms. Attention convolutional neural networks (CNNs) have been introduced to enhance image classification capabilities. In this context, we propose a novel attention convolutional model with the primary objective of detecting bipolar disorder using optical coherence tomography (OCT) images. Materials and Methods: To facilitate our study, we curated a unique OCT image dataset, initially comprising two distinct cases. For the development of an automated OCT image detection system, we introduce a new attention convolutional neural network named "TurkerNeXt". This proposed Attention TurkerNeXt encompasses four key modules: (i) the patchify stem block, (ii) the Attention TurkerNeXt block, (iii) the patchify downsampling block, and (iv) the output block. In line with the swin transformer, we employed a patchify operation in this study. The design of the attention block, Attention TurkerNeXt, draws inspiration from ConvNeXt, with an added shortcut operation to mitigate the vanishing gradient problem. The overall architecture is influenced by ResNet18. Results: The dataset comprises two distinctive cases: (i) top to bottom and (ii) left to right. Each case contains 987 training and 328 test images. Our newly proposed Attention TurkerNeXt achieved 100% test and validation accuracies for both cases. Conclusions: We curated a novel OCT dataset and introduced a new CNN, named TurkerNeXt in this research. Based on the research findings and classification results, our proposed TurkerNeXt model demonstrated excellent classification performance. This investigation distinctly underscores the potential of OCT images as a biomarker for bipolar disorder.

Evaluation of Psychiatric Symptomatology, Quality of Life, and Caregiver Burden in Mothers and Children with Primary Immunodeficiency.

BACKGROUND: The present study aimed to evaluate the quality of life, depression, and anxiety scores of children with primary immunodeficiency (PID) and depression, anxiety scores, and the caregiving burden of their mothers. METHODS: A total of 149 children aged 2-18 years and their mothers were included in the present study, along with 125 healthy children and their mothers as a control group. The Pediatric Quality of Life Inventory (PedsQL), Child Depression Inventory (CDI), and Screening for Child Anxiety-Related Emotional Disorders (SCARED) questionnaire were used based on the views of children and their mothers. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire (TEMPS-A), and Zarit Caregiver Burden Scale (ZCB) were used for the mothers. RESULTS: According to children and their mothers, the scores of the PedsQL were lower than that of the control group (P < 0.05). In addition, according to the views of children and mothers, we found that PID children had higher depression and anxiety scores than healthy children (P < 0.05). The depression and anxiety levels of mothers in the patient group were also significantly higher than those in the control group (P = 0.05 and P = 0.001). CONCLUSION: Statistically, we found significantly lower psychosocial health summary scores and total scale score levels from the subclass of PedsQL in the patient group than in the control group. According to the views of both children and mothers, we observed that PID children had higher depression and anxiety scores than healthy children. It was also found that the BDI and BAI values in case of mothers in the patient group were significantly higher than those in the control group.

Alexithymia and Forgiveness Levels of Forensic Psychiatric Patients.

The current cross-sectional study was performed to examine levels of alexithymia and forgiveness in forensic psychiatric patients. Data were collected between March 2022 and August 2022 at a high-security forensic psychiatric hospital affiliated with a city hospital in Turkey. A personal information form prepared by the researchers, the Toronto Alexithymia Scale, and the Heartland Forgiveness Scale were used to obtain data. Participants comprised 132 forensic psychiatric patients who agreed to participate in the study. A significant negative correlation was found between alexithymia and forgiveness levels of participants (p < 0.01, r = -0.259). In other words, as alexithymia levels increased, participants were found to be less forgiving. In addition, results suggest that forensic psychiatric patients are susceptible to alexithymia and higher levels of forgiveness. Determining forgiveness and alexithymia levels of forensic psychiatric patients will contribute to the structuring of care to be offered to these patients. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Quality of life in children with food allergies, psychiatric symptoms, and caregiving burden of their mothers.

OBJECTIVE: The present study aimed to evaluate the quality of life in children with food allergies, the accompanying depression and anxiety disorders, and caregiving burden of their mothers. MATERIAL AND METHODS: A total of 168 children with food allergy visiting our clinic and their mothers were included in the study group. The control group included 152 children who visited the healthy child follow-up clinic of our hospital and their mothers. Studying mothers' opinions, the Food Allergy Quality of Life Questionnaire Parent Form (FAQLQ-PF) was used for evaluating children, and the Beck's Depression Inventory, Beck's Anxiety Inventory, Temperament Evaluation of Memphis, Pisa, Paris, San Diego Auto-questionnaire, and Zarit Caregiver Burden Scales were used for evaluating mothers. RESULTS: No differences were noticed between the study and control group regarding mean age and gender distribution (P > 0.05). In the study, the FAQLQ-PF total and subscale scores of children with food allergies were determined according to the opinions of their mothers, and scores tended to increase with age (P < 0.0001). In addition, it was determined that mothers of children with food allergies had higher levels of anxiety, depression, and caregiving burden than mothers of the control group (P < 0.0001). CONCLUSION: In order to develop a multidisciplinary approach for children with food allergies, we conceived as appropriate to inform their families about the difficulties of caregiving and psychosocial disorders that could develop over time. They also must be informed to take preventive measures as well as the medical aspects of their children's disease.

Examination of the Relationship between Peripheral Inflammation Markers and Impulsivity and Aggression in Schizophrenia Patients Involved and Not Involved in Crime.

AIM: The aim of this study was to examine the relationship between peripheral inflammatory markers and aggression and impulsivity in schizophrenia patients with and without criminal histories. MATERIALS AND METHODS: The study was conducted with patients with schizophrenia involved in crimes and hospitalized in the Forensic Psychiatry ward of Elazig Fethi Sekin City Hospital and patients with schizophrenia not involved in crimes and hospitalized in the psychiatry ward of Elazig Mental Health and Diseases Hospital. All participants completed the Buss-Waren Aggression Scale (BWAS), the Barratt Impulsiveness Scale-11 (BIS-11), and the Positive and Negative Symptom Scale (PANSS). Before treatment, venous blood samples were taken for laboratory measurements on the first day of hospitalization. RESULTS: All participants were male. The mean age of those involved in a crime was 39 ± 9.7 years, while the mean age of those not involved in a crime was 41.2 ± 10.7 years. The PANSS all subscale and total scores of the patients with schizophrenia who were involved in a crime were significantly higher than the group who were not involved (p values were p < 0.001, p = 0.001, p = 0.043, p = 0.001, respectively). The BWAS-physical aggression (p = 0.007) and total scores of the scale (p = 0.046) and BIS-11-inability to plan (p = 0.002) scores of the group involved in a crime were higher than the group not involved. As for laboratory parameters, MCH, MCHC, PDW, eosinophils, basophils, RDW-CV, and RDW-SD values were significantly higher in those involved in crime, while MPV, creatinine, albumin, and LDH values were lower. CRP and CRP/albumin values were significantly higher, while neutrophil/albumin values were significantly lower in those who committed murder in the first degree than those who committed other crimes. CONCLUSION: Based on our results, we found that inflammatory agents were significantly increased in forensic schizophrenia patients with high aggression scores. Significant correlations between some inflammatory factors and impulsivity and aggression scores and differences in these factors according to crime types showed that these factors might be related to violence and criminal behavior. There is a need for further large-scale studies on this subject at different stages of the disease.

Monocyte/HDL Cholesterol Ratios as a New Inflammatory Marker in Patients with Schizophrenia.

PURPOSE: Monocyte/HDL cholesterol ratio (MHR) is a novel inflammatory marker that is used as a prognostic factor for cardiovascular diseases and has been studied in many diseases. The aim of this study was to investigate the role of inflammatory factors in schizophrenia patients by examining MHR levels and to compare schizophrenia patients and healthy controls in terms of cardiovascular disease risk. METHOD: A total of 135 participants between the ages of 18-65, 85 diagnosed with schizophrenia, and 50 healthy individuals in the control group were included in this cross-sectional study. Venous blood samples were taken from the participants and CBC parameters and lipid profiles were analyzed. The sociodemographic and clinical data form and positive and negative symptoms scale (PANSS) were administered to all participants. RESULTS: Although monocyte levels were significantly higher in the patient group, HDL-C levels were lower at significant levels. MHR was found to be higher in the patient group compared to the control group at significant levels. When compared to the control group, total cholesterol, triglyceride, WBC, neutrophil, basophil, and platelet levels were higher in the patient group at significant levels, and RBC, hemoglobin, and hematocrit levels were significantly lower. CONCLUSION: The elevated MHR in patients with schizophrenia may contribute to our understanding that inflammation plays important roles in the pathophysiology of schizophrenia. Additionally, knowing the levels of MHR and considering the recommendations, such as diet and exercise, in the treatment approaches made us think that it might be beneficial in protecting schizophrenia patients against cardiovascular diseases and early death.

A Potential Biomarker for Predicting Schizophrenia: Metallothionein-1.

It has been thought that oxidative damage may occur in the pathophysiology of schizophrenia; metallothioneins (MT) have strong antioxidant functions. In this study, we aimed to measure MT-1 levels in schizophrenia patients. A total of 52 patients diagnosed with schizophrenia and 38 healthy controls were included in the study. Serum MT-1 concentrations were measured using the Human Metallothionein-1 ELISA Kit. In addition, Cu and Zn levels were measured. PANSS (Positive and Negative Syndrome Scale) was used to determine the disease severity of patients with schizophrenia. The MT-1 levels of the schizophrenia group were lower than the MT-1 levels of the control group. When the correlation analyses were examined, a positive correlation was found between MT-1 and illness duration and Cu/Zn. A negative correlation was found between MT-1 levels and PANSS total scores and PANSS positive scores. In the regression analysis, it was seen that the decrease in MT-1 levels poses a risk for schizophrenia. It was observed that a decrease of 1 ng/mL in MT-1 levels increased the risk of schizophrenia 1.115 times. The low concentration of MT-1 is likely to cause a deficiency in antioxidant defense in patients with schizophrenia. MT-1 may be a useful biomarker for predicting schizophrenia.

Stigmas and childhood traumas associated with psychological help-seeking in suicide attempted individuals.

PURPOSE: The aim was to investigate the possible associations of suicide attempt with childhood trauma, social support, psychological support seeking, stigmatizations. The study was case-control study and included 100 participants (50 suicide, 50 controls). CONCLUSION: BDI, BAI scores were higher in the patient (p < 0.001). While scores of all-subscales of Childhood-Trauma-Questionnaire were higher (p < 0.05) in the patients, scores of Perceived-Social-Support were lower (p < 0.001). Repeating suicide attempts has higher Stigma-Scale-for-Receiving-Psychological-Help scores than the patients who attempted to the first time (p = 0.045). PRACTICE IMPLICATION: Suicide is relationship with more childhood traumas, less social support. Repeating suicide attempts, individuals felt public stigma for receiving psychological help.

Increased ghrelin and decreased leptin levels in patients with antisocial personality disorder.

OBJECTIVE: The study aimed to compare acyl ghrelin (AG), des-acyl ghrelin (DAG), and leptin levels considered to be used as biological markers in the etiopathogenesis of antisocial personality disorder (ASPD) with healthy controls, and to investigate the relationship between these hormones and aggression and impulsivity. METHOD: The study included 45 patients with ASPD and 61 healthy people in the control group. Sociodemographic data form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Barratt Impulsiveness Scale (BIS-11), and Buss-Durkee Aggression Scale (BDAS) were applied to all participants. Fasting venous blood samples were taken from all participants at the same time of the day and the height and weight of the participants were measured. RESULTS: It was found that the mean serum AG and DAG levels were significantly higher than that of healthy controls whereas leptin hormone levels were significantly lower in patients compared to healthy controls. BDI, BAI, BIS-11, and BDAS scores of the patients were significantly higher compared to healthy controls. There was a positive correlation between AG and DAG hormone levels and impulsivity and aggression. DISCUSSION: The present study is the first in the literature to examine AG, DAG, and leptin hormone levels of patients diagnosed with ASPD. According to the results of the study, it is believed that changes in serum leptin and ghrelin levels will bring a new perspective in terms of understanding the pathophysiological mechanism of ASPD. Further studies are required to explain the definitive roles of these hormones in ASPD.

Investigating the Association of Criminal Behavior With Childhood Traumas, Impulsivity, and Dominant Temperaments in Bipolar I Disorder.

Objective: To examine impulsivity, dominant temperaments, and childhood trauma in patients with bipolar I disorder who committed crimes by comparing them with bipolar I patients with no criminal history and with healthy controls.Methods: A total of 144 subjects in 3 groups (62 criminal history bipolar patients, 40 non-criminal bipolar patients, and 42 controls) participated in this cross-sectional study. All participants completed the Childhood Trauma Questionnaire (CTQ), the Barratt Impulsiveness Scale (BIS-11), and the TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire). Subjects were enrolled in the study between April 1, 2019, and March 1, 2020.Results: The mean age was higher (P = .029) and education level lower (P = .045) among the criminal history bipolar patients than the other 2 groups. Of quantitative variables, physical abuse and emotional abuse subscales and total CTQ score were significantly higher in both patient groups compared to healthy controls (P < .001 for all scores). For dominant temperament, hyperthymic temperament scores of the criminal history bipolar group were higher than that of the control group (P < .001).Conclusions: Patients with bipolar I disorder were found to have experienced more childhood traumas, and the criminal history bipolar group and those who were admitted to prison had suffered more physical abuse. Hyperthymic temperament was dominant in bipolar I patients involved in crime. Taking into account the temperaments of bipolar I disorder in treatment plans and providing psychosocial support to these patients could help prevent violent behaviors and the possibility of crime.

Peripheral Inflammatory Parameters in Patients with Antisocial Personality Disorder.

Introduction: The aim of the study was to examine the peripheral inflammatory parameters in patients with Antisocial Personality Disorder (APD) including white blood cell levels, red cell distribution width (RDW), mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), basophil-to-lymphocyte ratio (BLR) by comparing with those of healthy controls. Methods: 48 patients diagnosed with APD and a matched healthy control group of 52 individuals were included in our study. Venous blood samples were taken from the participants in the fasting state and at approximately the same time of the day. Socio-demographic data sheet, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Barratt Impulsiveness Scale (BIS-11), Buss-Durkee Hostility Inventory (BDHI) were applied to all of the participants. Results: RDW and basophil cell levels were found significantly higher in the patients than the controls (p=0.005, p=0.038 respectively). BLR was found significantly higher in the participants with alcohol use than those without alcohol use (p=0.016). No significant difference in other laboratory parameters was found between the patient group and the control group. Scores of BDI, BAI, BIS-11, motor impulsivity subscale and physical aggression, anger, hostility and verbal aggression subscales of BDHI, and the total score of BDHI were significantly higher in patients than controls (p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p=0.003, p=0.001, p<0.001 respectively). A positive correlation was determined between the scale scores and the RDW, basophil, monocyte, lymphocyte levels among the laboratory parameters, and a negative correlation was determined between the MPV levels and the depression and impulsivity levels. Conclusion: The results of our study suggested that inflammation might play a role in the etiopathogenesis of APD. Furthermore, a significant relationship was found between the severity of symptoms and some inflammatory parameter levels such as RDW and basophil in APD patients.

Nesfatin-1 Hormone Levels in Patients with Antisocial Personality Disorder and Their Relationship with Clinical Variables.

OBJECTIVE: This study aims to investigate the levels of nesfatin-1-hormone in patients with Antisocial Personality Disorder (ASPD) and their relationship with clinical variables. METHODS: A total of 90 people (45 ASPD, 45 controls) were included in our study. Sociodemographic Data Form, Beck-Depression-Inventory (BDI), Beck-Anxiety-Inventory (BAI), Barratt Impulsivity Scale (BIS-11), Buss-Durkee-Hostility-Inventory (BDHI) were applied to all participants. Venous blood samples were taken from participants at the same time of the day when they were hungry. RESULTS: It was found that the BDI and BAI scores of the ASPD were higher than those of the controls (p<0.001, for both scales). The scores in BIS-11; motor and nonplanning-impulsivity subscales were higher than those of the controls (p<0.001, 0.036, respectively). The scores obtained by the ASPD were higher in all subscales of BDHI (p<0.001). For the nesfatin-1-hormone, the values of the ASPD were lower than those of the controls (p=0.044). No relationship was found between the nesfatin-1-hormone and any other laboratory parameters and applied scales (p>0.05). CONCLUSION: This is the first study to examine the nesfatin-1-hormone levels in patients with any personality disorder. Further studies with more participants are needed in different types of personality disorders to understand the relationship between personality disorder and nesfatin-1-hormone levels.