Stigma, Perception of Social Support, and Functionality Levels of Schizophrenia Patients with and without Legal Guardianship.

Background: The aim of our study was to determine the levels of internalized stigma, perceived social support, and social functioning of schizophrenia patients who made a guardianship decision and to investigate the effects of these parameters on the guardianship decision. Methods: A total of 160 patients, including 80 patients who were hospitalized in the psychiatric inpatient services of our hospital between December 1, 2021, and November 1, 2022, between the ages of 18 and 65, who were diagnosed with schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 diagnostic criteria (n = 80) and received guardianship and 80 patients (n = 80) who did not receive guardianship were included in the study. Sociodemographic data from the Internalized Stigma of Mental Illness Scale, Social Functioning Scale, and Multidimensional Scale of Perceived Social Support were administered to the study group. Results: Fifty percent of the patients (n = 80) made a guardianship decision. The number of hospitalizations and duration of illness were significantly higher in the group of patients who took the guardianship decision, whereas the scores of interpersonal functioning and perceived social support from the family were significantly lower (P = .049, P = .009). The number of hospitalizations, substance use, interpersonal functioning, perceived discrimination, and perceived social support from family and friends were determined as factors that facilitate the guardianship decision (P < .05, P < .001). Conclusion: Based on the results of our study, it is necessary to reduce the number of hospitalizations, substance use, and perceived discrimination among patients with schizophrenia and to enhance the social support and interpersonal relationships provided by family and friends.

Effect of Care Burden and Personality Traits of Caregivers on Treatment Compliance and Functionality of Patients With Schizophrenia.

Objective: To evaluate the effects of care burden and personality traits of caregivers on treatment compliance and social functionality of patients with schizophrenia.Methods: This cross-sectional study included 50 patients aged 18-65 years diagnosed with schizophrenia (DSM-5 criteria) who were followed up in the hospital between December 2020 and June 2021. Fifty caregivers (ie, spouses, parents, siblings, and children) were also included in the study. All study participants completed a sociodemographic data form. Caregivers completed the Temperament and Character Inventory (TCI) and the Zarit Care Burden Scale (ZCBS). Patients completed the Social Functioning Scale (SFS), the Morisky Treatment Adherence Scale (MTAS), and the Positive and Negative Syndrome Scale (PANSS).Results: There was a positive correlation between MTAS and PANSS scores (r = 0.293, P < .05) of patients with schizophrenia and a negative correlation between MTAS and SFS total scores (r = -0.468, P < .01). There was a positive correlation between MTAS and ZCBS-dependency subgroup scores (P < .05). A positive correlation was found between caregivers' TCI subdimensions, especially self-directedness total score and SFS total score (P < .01), as well as between self-transcendence total score and total ZCBS score (P < .05).Conclusions: Based on the study results, temperament and character characteristics of caregivers affect both the care burden of caregivers and the social functionality of patients; however, larger samples are required to measure the effects of caregivers' personality traits and care burden on patients' functioning and adherence to treatment.Prim Care Companion CNS Disord 2023;25(6):23m03522. Author affiliations are listed at the end of this article.

Neutrophil to lymphocyte and monocyte to high-density lipoprotein ratios are promising inflammatory indicators of bipolar disorder.

AIMS: The neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), and monocyte to high-density lipoprotein (MHR) are indicators of inflammation. In this study, we aimed to examine the possible association between NLR, PLR, MLR, and MHR in the same patients with bipolar disorder (BD) during their manic, depressive, and euthymic episodes. METHODS: The participants of this study consisted of 61 patients with BD, aged between 18 and 65, who were hospitalized with a diagnosis of BD. Patients who were hospitalized during their manic and depressive episodes and medication free for at least 1 month before hospitalization were included. White blood cell, neutrophil, lymphocyte, platelet, and monocyte counts, high-density lipoprotein (HDL) cholesterol, and C reactive protein (CRP) levels were recorded. RESULTS: Leukocytes (p = 0.000), neutrophil (p = 0.009), monocyte counts (p = 0.012), CRP levels (p = 0.026), NLR (p = 0.025), and MHR (p = 0.011) values were significantly higher in their manic episode and depressive episode compared with the values in their remission period. There was no significant difference between manic and depressive episodes in terms of inflammation parameters. Significant positive correlations were found between the number of depressive episodes and patients' CRP levels (p = 0.031). CONCLUSIONS: This study was the first study to examine the inflammatory markers such as NLR, MLR, PLR, and MHR levels in same patients with BD during their three episodes of disorder. Both NLR and MHR values in manic and depressive episodes were higher than euthymic episodes. NLR and MHR were useful inflammatory markers to evaluate inflammation in bipolar patients.

The effect of overt and subclinical hypothyroidism on the development of non-dipper blood pressure.

INTRODUCTION: 'Non-dippers' are individuals without the anticipated nocturnal decrease in blood pressure. An increased incidence of target organ damage and a worse outcome in terms of cardiovascular events have been reported in this group of people. The pathogenesis of non-dipper hypertension is not clear at present. We aimed to investigate the effects of overt and subclinical hypothyroidism on the development of a non-dipper blood pressure pattern via 24-hour ambulatory blood pressure monitoring. MATERIAL AND METHODS: 109 normotensive patients with overt and subclinical hypothyroidism were evaluated, and 95 of these patients without reverse dipping and masked hypertension were included in the study. The control group consisted of 75 gender- and age-matched, normotensive, euthyroid healthy individuals. RESULTS: Median serum TSH levels were 7.61 and 1.59 mUmL in patient and control groups, respectively. The number of non-dippers according to systolic, diastolic and mean blood pressure was significantly higher in the patients with hypothyroidism compared to the control group. In linear regression analysis, TSH had a negative effect on the night/day ratio of the systolic, diastolic and mean blood pressures. CONCLUSION: Despite the fact that the effect of hypothyroidism on non-dipper blood pressure pattern is not known, the present study has revealed that elevated TSH levels are likely to increase the risk of non-dipping in normotensive patients with either overt or subclinical hypothyroidism.