The Relationship Among Seasonality, Night Eating, and Chronotype in Bipolar Disorder: Exploring the Mediating Role of Sleep Quality.

ABSTRACT: The purpose of the study was to explore the association among chronotype, seasonality, sleep quality, and night eating syndrome (NES) among patients with bipolar disorder (BD) and the mediating role of sleep quality in this relationship. Ninety-two individuals with BD type 1 who had been euthymic for at least 8 weeks and 87 healthy controls were included. In addition to sociodemographic/clinical data, chronotype, seasonality, sleep quality, and NES were evaluated using the Morningness-Eveningness Questionnaire (MEQ), Seasonal Pattern Assessment Questionnaire, Pittsburgh Sleep Quality Index, and Night Eating Questionnaire. The prevalence of NES (17.4%) was higher among BD than the controls. BD patients with NES had poorer sleep quality, greater seasonality, and lower MEQ scores. Chronotype had an indirect effect that was partially mediated by sleep quality on night eating symptoms in BD patients, in addition to a direct effect. Seasonality was found to have a direct effect on night eating symptoms. Therapeutic interventions that target both sleep and circadian disruption should be implemented when addressing NES in patients with BD.

DETERMINING THE RISK OF CARDIOVASCULAR DISEASE IN PATIENTS DIAGNOSED WITH SCHIZOPHRENIA AND BIPOLAR AFFECTIVE DISORDER.

BACKGROUND: In Schizophrenia (SCZ) and Bipolar Affective Disorder (BAD) patients using the Framingham Heart Risk Scoring (FHRS), we aimed to investigate the possible cardiac arrhythmia risk by calculating electrocardiogram (ECG) parameters (QT, QTc, Tpe, and TPE/QTc ratios), which are ventricular repolarization markers. SUBJECTS AND METHODS: A total of 140 BAD and 253 SCZ patients were included in the study. Age, blood test results (fasting blood glucose, LDL-HDL-TC levels, hemogram values), blood pressure and heart rate, smoking status, antihypertensive drug use, and FHRS were calculated from the patient files, and sociodemographic information was recorded. In addition, ECG calculations were performed, and QT, QTc, TPe, TPe/QTc ratios and heart rate were measured. RESULTS: When we evaluated the cardiac risk indexes of SCZ and BAD patients, we detected that FHRS was higher in smokers, female patients, and those with other medical diseases such as diabetes mellitus (DM) (p<0.05). In addition, we found that QTc rates, markers of ventricular repolarization, were associated with FHRS, the number of antipsychotics used, patient age, disease duration, and the number of hospitalizations. TPe and QT rates were found to increase in parallel with FHRS. In addition, a positive correlation was found between QTc rates in females, patients with DM, and those using additional medical drugs. (p<0.05) CONCLUSIONS: In BAD and SCZ patients, diabetes diagnosis, other medical drug use, a high Framingham heart score, the number of antipsychotics, the disease duration, the patient's age, and an increased number of hospitalizations may increase the risk of cardiac arrhythmia. Therefore, possible cardiac risk should be considered in patients with chronic drug use, such as BAD and SCZ. Regulating the treatment and follow-up of this group of patients against possible cardiac risks will reduce cardiac mortality and morbidity

Correlates of Patient Satisfaction in Psychiatric Inpatient Care: A Survey Study from a Tertiary Hospital in Turkey.

In the current study, a questionnaire to evaluate satisfaction levels and related factors upon discharge was completed by 100 patients receiving care for mental illness in a tertiary care hospital in Turkey. The relationships among sociodemographic variables, nonpharmacological interventions, and participants' views about the treatment course and quality of care they received were investigated. Overall satisfaction levels of participants were good. Older participants reported more positive opinions. Involuntary hospitalization, use of restraints/seclusion, or electroconvulsive therapy did not change overall satisfaction. Participants who were hospitalized for the first time were more afraid of other patients, which may imply that this population needs special care from the treatment team. Spending an adequate amount of time and providing necessary information about their treatment plan impact patients' treatment experience positively. [Journal of Psychosocial Nursing and Mental Health Services, 59(4), 38-47.].

Social Support Promotes Mental Health During the COVID-19 Outbreak: A Cross-Sectional Study from Turkey.

BACKGROUND: Coronavirus-19 (COVID-19) has several negative effects on mental health, given its rapid transmission, hygiene and isolation measures and associated social and financial difficulties. In this study, we aimed to investigate the mental health burden of the Turkish population and vulnerable groups during the COVID-19 outbreak, especially exploring the effects of social support. SUBJECTS AND METHODS: We assessed depression, anxiety, stress symptoms and perceived social support among 894 people all over Turkey, using the Depression Anxiety Stress Scales (DASS-21) and Multidimensional Scale of Perceived Social Support (MSPSS) two months after the declaration of the first COVID-19 case in Turkey. RESULTS: According to DASS-21 subscale scores, the findings showed that the prevalence of moderate to severe depression, anxiety and stress-related symptoms was 24.8%, 21.9% and 12.6%, respectively. Female gender, being single, having a lifetime psychiatric disorder, lower education level and financial concerns were significantly associated with higher DASS-21 scores. Also, there was a negative correlation between all subgroups of perceived social support, especially from the family, and the total DASS-21 score. CONCLUSIONS: Vulnerable groups should be identified and protected to reduce adverse psychiatric outcomes of COVID-19. Besides, further strategies should be provided to maintain protective factors, such as social support, under stressful conditions.

Comparing attention, impulsivity, and executive functions between patients with opiate use disorder: Buprenorphine maintenance treatment versus active users, in comparison with healthy controls.

Background: Opioid use disorders (OUDs) affect over 16 million people worldwide, with a particularly high prevalence rate in Asia. OUDs are associated with significant health consequences, including neurocognitive impairment, which affects individuals' ability to make decisions, respond to stressful situations, and regulate behavior. Understanding the specific ways in which OUDs affect cognitive functioning is important in treatment considerations. Methods: This study compared the attention, impulsivity, and executive functions of Turkish men with active OUD (n = 40) with those of men in remission from OUD who were on buprenorphine/naloxone maintenance (BMT; n = 41) and with those of a comparison group of healthy controls (HC; n = 43). The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess neurocognitive functioning. Results: Analyses found significant impairment in measures of continuous attention, cognitive impulsivity, motor impulsivity, and executive functions in the two patient groups compared to the control group, but the two patient groups did not differ from each other. Conclusion: The data from this study indicate that individuals with OUD exhibit neurocognitive damage, and those in remission from OUD who receive maintenance treatment do not show improvement in this domain. Neurocognitive damages should be considered in long-term treatment planning of patients with OUD.

Correlations between attitudes towards the COVID-19 vaccine and psychiatric symptoms among pregnant women.

OBJECTIVE: As data continue to show that COVID-19 vaccines are safe for pregnant women, determining the factors that affect their attitudes towards vaccines has become increasingly important. Pregnancy increases the risk of depressive and obsessive-compulsive (OC) symptoms. We aimed to determine the correlations between psychiatric symptoms and attitudes towards vaccination in pregnant women. METHODS: A total of 100 pregnant women were enrolled in the present cross-sectional study. We used a standard data form to obtain the participants' sociodemographic and clinical characteristics. The Attitudes Towards the COVID-19 Vaccine Scale, the Maudsley Obsessive-Compulsive Inventory (MOCI) and the Depression Anxiety Stress Scale (DASS-21) were used to measure attitudes towards vaccination and psychiatric symptoms. We then investigated the correlations between the scale scores. RESULTS: There was a significant correlation between positive, negative, and total attitudes towards vaccines and MOCI total and subscale scores. According to the linear regression model, variables of MOCI total score, planned/unplanned pregnancy, and age were determined as the predictors for vaccination attitudes towards COVID-19 vaccines. CONCLUSION: Increased OC symptoms seem to be associated with negative attitudes towards vaccination. It is important to screen pregnant women with lower vaccination rates for OC symptoms more carefully. A multidisciplinary approach would be beneficial to increase vaccination rates.

Investigation of the Relationship Between Cognitive Functions and Retinal Findings From Spectral Optical Coherence Tomography in Patients With Schizophrenia and Their Healthy Siblings.

OBJECTIVE: Retinal structural changes which were investigated by optical coherence tomography (OCT) have been reported in schizophrenia. Since cognitive dysfunction is a core feature of schizophrenia, the correlations between retinal findings and cognitive functions of patients and their healthy siblings may provide insight into the pathophysiological processes of the disorder. We aimed to investigate the relationship between neuropsychiatric tests and retinal changes in schizophrenia patients and their healthy siblings. METHODS: We measured OCT parameters and cognitive performance (via Trail Making Tests, verbal fluency tests, and The Digit Span Tests) of 72 participants (36 patients with schizophrenia and 36 healthy siblings) and disease severity (with Positive and Negative Syndrome Scale, Global Assessment of Functioning, and Clinical Global Impression scales) in patients with schizophrenia and evaluated the relationship between retinal findings and clinical parameters, especially neurocognitive tests. RESULTS: We found decreased ganglion cell layer-inner plexiform layer thickness and macular volume in the patient group. There were strong correlations between neurocognitive tests and OCT findings in both groups. On the other hand, there was not any correlation between retinal findings and disease parameters. CONCLUSION: The cognitive symptoms of schizophrenia may be more closely related to structural changes in the retina.

The Relationship Between Emotional Dysregulation, Alexithymia and Somatization in Patients with Bipolar Disorder.

Objective: Emotional dysregulation is a basic feature found in patients with bipolar disorder. It was also reported that higher alexithymia scores are a predictive factor for a decrease in social functionality. It is known that patients with bipolar disorder experience more somatic symptoms than the general population. No study has yet been conducted on the interrelation of these 3 clinical domains, which are known to negatively affect the functionality and quality of life in bipolar disorder patients. Methods: This study included 72 bipolar disorder-1 patients. The Difficulties in Emotion Regulation Scale was used to determine the emotional state of the patients, the Toronto Alexithymia Scale was used to determine the alexithymia scores, and the Somatization Scale was used to determine the somatization scores. Results: As a result of hierarchical multiple linear regression analysis, the first model was found to be significant (P < .001), and the emotional dysregulation total scale score significantly predicted the Toronto Alexithymia Scale total scale score (P < .001). The second model was also found to be significant (P < .001), and the emotional dysregulation total scale score significantly predicted the somatization total scale score (P < .001). Conclusion: This study found that ED predicted alexithymia and somatization in euthymic bipolar patients. The therapeutic approaches targeting these 3 clinical domains that negatively affect patients' quality of life and functionality may provide positive clinical outcomes.

Attitudes toward COVID-19 pandemic measures and clinical symptom severity in schizophrenia patients: a preliminary cross-sectional study.

OBJECTIVES: The study aim was to compare clinical symptom severity and quality of life (QoL) among schizophrenia patients according to their attitudes toward pandemic measures and reported lockdown-related disruption. METHODS: Patients with schizophrenia attending follow-up sessions at two community mental health centers were included in this cross-sectional study. Sociodemographic and clinical characteristics of patients were assessed using a standardized form and the following psychometric instruments: the Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale, State-Trait Anxiety Inventory, Heinrich-Carpenter Quality of Life Scale and Clinical Global Impressions Ratings-Severity scale. Patients were grouped according to their attitudes toward pandemic measures (positive attitudes or non-positive attitudes). RESULTS: No significant differences were found in sociodemographic and clinical variables, clinical symptom severity or QoL between schizophrenia patients with positive attitudes and those without positive attitudes toward pandemic measures. Guilt feelings and trait anxiety levels were positively related to lockdown-related disruption. CONCLUSIONS: Positive attitudes toward pandemic measures may be affected by factors other than the sociodemographic and clinical status of schizophrenia patients. It is important that such factors are assessed in future studies to better manage pandemic-related challenges among schizophrenia patients.

Retinal changes in bipolar disorder as an endophenotype candidate: Comparison of OCT-detected retinal changes in patients, siblings, and healthy controls.

Optical coherence tomography (OCT) is a non-invasive imaging technique that detects retinal changes reflecting neurodegeneration. In recent studies in patients with bipolar disorder (BD) abnormal OCT findings have shown. In this study, we aimed to investigate the retinal changes in BD patients and their healthy siblings (HS) by comparing them with the healthy control (HC) group and to explore these findings as potential endophenotype candidates. 31 patients with BD, 31 age-matched HSs and 46 HCs were included and peripapillary retinal nerve fiber layer (RNFL), ganglion cell layer (GCL)+inner plexiform layer (IPL) and macular volume (MV) thicknesses were measured by OCT. The relationship between disease severity parameters, functionality and OCT measurements in the patient group was also investigated. In results, the mean RNFL thicknesses did not differ between groups. All GCL+IPL thicknesses were found to be significantly lower in the patient and sibling groups compared to the HCs. GCL+IPL thicknesses were significantly correlated with functionality of patients and severity of the disorder. Our findings suggest that analysis of retinal layers with OCT may be a beneficial indicator to show neuronal changes in BD and GCL+IPL may be a suitable endophenotype candidate.

Comparing retinal changes measured by optical coherence tomography in patients with schizophrenia and their siblings with healthy controls: Are retinal findings potential endophenotype candidates?

AIM: The aim of our study is to examine whether differences in retinal structure may reflect endophenotypes for schizophrenia by comparing thicknesses of retinal layers between patients with schizophrenia, their unaffected siblings, and healthy control groups and investigating the relationship between OCT findings and disease parameters. MATERIAL AND METHODS: 46 patients with schizophrenia, their 46 healthy siblings, and 46 age and gender-matched healthy controls were enrolled in the study and underwent spectral domain OCT (examinations to assess differences in peripapillary retinal nerve fiber layer (RNFL) thickness, ganglion cell layer (GCL)+ inner plexiform layer (IPL) thicknesses and macular volumes (MV) in both eyes). Clinical variables were also recorded in the patient group. RESULTS: There was no difference between the groups in terms of RNFL thicknesses. The GCL+IPL thicknesses of the siblings are between the patients and controls but according to post hoc comparisons the GCL+IPLs of the patients were only thinner than controls. Additionally, MVs were significantly lower in the patient group compared to the sibling group. There was no correlation between any clinical parameters and the GCL+IPLs of all groups, however there were some correlations between RNFL and clinical features especially in the patients group. CONCLUSION: GCL+IPL values do not seem to be affected by the disease parameters or the factors like body mass index or nicotine use. On the other hand, further studies are needed to determine whether GCL+IPL could be an endophenotype candidate.

Psychological Reactions of Turkish Healthcare Workers During Covid-19 Outbreak: The Impact of Stigmatization.

Introduction: The Coronavirus Disease 2019 (COVID-19) outbreak has resulted in huge psychological distress, especially for people working under risky conditions, such as healthcare workers. We aimed to investigate the psychological challenges of Turkish healthcare workers during the outbreak and discuss the factors that increase their burden, including stigmatization. Methods: A cross-sectional online survey composed of sociodemographic data, questions about perceived stigma, and concerns about working conditions was completed. Depression Anxiety and Stress Scale-21 (DASS-21) was also used. Results: 634 participants completed the survey and the prevalence of moderate to severe depression, anxiety, and stress-related symptoms were 36%, 35%, and 22%, respectively. Being female, working with close contact with patients with COVID-19 and having a psychiatric disorder history were risk factors for psychological distress. The healthcare workers with significantly higher depression, anxiety, and stress scores described having less amount of personal protective equipment, lower support from their supervisors, and more unsafe working conditions. Additionally, 7% of the participants stated that they perceived stigmatization by their families and close friends, 14% perceived stigmatization by their neighbours, relatives, and less intimate friends; and 7% perceived stigmatization by unfamiliar people. Healthcare workers who perceived other people as more dismissive had significantly higher depression and anxiety scores. Conclusion: Our study shows that healthcare workers are at risk of developing psychological disturbances during infectious outbreaks. To minimize the psychological impact, additional risk factors such as having a previous psychiatric disorder, working under unsafe conditions, and stigmatization should be taken into account and a more supportive and safer environment should be provided.