Comparison of Social-Evaluative Anxiety and Theory of Mind Functions in Social Anxiety Disorder, Schizophrenia, and Healthy Controls.

INTRODUCTION: Despite the similarities in poor social competence and clinical manifestations of poor social behavior, no study has compared the theory of mind performance between social anxiety disorder (SAD) and schizophrenia, considering the effect of social-evaluative anxiety and neurocognitive functions. In our study, we aimed to compare the theory of mind functions and social-evaluative anxiety between patients with SAD and schizophrenia and healthy controls and to examine the relationship between the theory of mind, neurocognitive skills, and social-evaluative anxiety. METHODS: Thirty-four consecutive patients with schizophrenia, 29 patients with SAD, and 30 controls matched by age, education level, and sex were enrolled in the study. Structured Clinical Interview for DSM, Beck Depression Inventory, Liebowitz Social Anxiety Scale, Theory of Mind measures (Reading the Mind in the Eyes Test, Hinting Task, Faux Pas Test), Social Appearance Anxiety Scale, Fear of Positive Evaluation Scale, Fear of Negative Evaluation Scale-Short Form, and neuropsychological tests were administered to all participants. RESULTS: A greater significant deterioration in theory of mind and neurocognitive functions was found in patients with schizophrenia compared to those with SAD and healthy controls. Social evaluation anxiety was highest in patients with SAD. Although social-evaluative anxiety was associated with the theory of mind function in schizophrenia, only fear of positive evaluation was associated with SAD. In all groups, neither theory of mind nor neurocognitive ability measures were correlated with social anxiety levels and related symptoms. CONCLUSIONS: The impaired theory of mind functioning detected in our study is more prominent in the schizophrenia group and largely independent of anxiety in schizophrenia and SAD. Although social evaluation anxiety, as a transdiagnostic concept, seems to be independent of theory of mind function in general, fear of positive evaluation seems to be associated with hinting in both disorders.

Temperament, Character, and Defense Mechanism Changes With Treatment in Depression: A 9-Month Naturalistic Follow-up.

The aim of this study was to evaluate the changes in temperament, character, and defense mechanisms with the treatment and remission in patients with major depressive disorder. The study was designed as a longitudinal observational follow-up study of patients with repeated measures at 0, 12, and 36 weeks. In baseline comparisons, the major depression group showed higher harm avoidance and novelty seeking scores and lower self-directness and mature defense styles scores compared with healthy controls. In the follow-up, temperament dimensions and neurotic defenses remained unchanged, mature defense styles and self-directness revealed significant increase, and immature defense styles revealed significant decrease. Although there was no significant difference in the defense styles, harm avoidance and novelty seeking scores remained higher in MDD patients compare with healthy controls in 36 weeks. Our findings regarding continuation of hierarchically upward improvement in defense mechanism after the remission may support importance of treatment after remission.

Clinical Characteristics of Healthcare Workers Attended to a Mental Health Support Line in the Very Early Phase of COVID-19 Pandemic.

Introduction: This study aimed to analyze and report findings from the sessions conducted with healthcare workers during the early phase of COVID-19 pandemic. Method: The study sample consisted of 130 healthcare workers who have consecutively reached out to nationwide psychosocial support line within the first ten days of COVID-19 pandemic and had a 30-minute video session and received psychological first aid and were evaluated using a socio-demographic data form. Mental state severity and progress were assessed using CGI (clinical global impressions) at the first and follow-up interviews. Results: 90.4% of the applicants were female, 50.4% were nurses, 34.4% were doctors, 68.8% were frontline workers, whereas second-line healthcare workers had significantly higher rates of psychiatric illness history. Contracting the virus (n=83, 66.4%), infecting others (n=72, 57.6%) were the situations that caused the highest level of anxiety. Most common psychiatric complaints were anxiety (n=107, 85.6%), restlessness (n=80, 64%), fear (n=72, 64.0%) and insomnia (n=68, 57.6%). A second session was conducted with 36.8% (n=46) of the callers, and it was detected that 93.48% (n=43) of them were able to manage their stress and 33 of them reported that the severity of their complaints decreased. Conclusion: Our findings have shown that healthcare workers were significantly affected in the early stage of COVID-19 pandemic with a significant level of anxiety and insomnia symptoms. Healthcare workers with a history of psychiatric illness should be considered as a vulnerable group regardless of their position.