The association between temperament features and childhood traumas in patients with juvenile myoclonic epilepsy

Background/aim: Epilepsy is a common chronic neurological problem that impairs daily activities, functionality, and quality of life. Childhood traumas (CTs) are known to be critical factors in the onset or development of many psychiatric and medical disorders. They also play a critical role in the development of temperament and personality. This study aimed to investigate the association between CTs and common temperament patterns and features seen in epilepsy patients. Materials and methods: The study included 38 patients who were diagnosed with juvenile myoclonic epilepsy (JME) and volunteered to participate in the study. In addition to the sociodemographic form and questions on disease features, Structured Clinical Interview for DSM-IV Axis I Disorders, Temperament Evaluation of Memphis, Pisa, Paris and San Diego Questionnaire (TEMPS-A), Childhood Trauma Questionnaire (CTQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were administered to all participants. In the present study, a cut-off value of 35 was used for the CTQ scale. The patients with CTQ scores lower than 35 (50%, n = 19, Group 1) and the patients with CTQ scores above 35 (50%, n = 19, Group 2) were compared. Results: The comparison of TEMPS-A and its subscale scores in the JME patients in the groups with CTQ scores above or below a cut-off value detected significant differences between the groups in depressive and irritable temperament scores. The mean BDI scores were also different between the two groups. Furthermore, a significant positive correlation was detected between the disease duration, anxiety, and depression scores in the JME patients. A significant relationship was detected between the emotional neglect subscale score of the JME patients and the BDI scores. A significant positive correlation was found between the total disease duration, BDI, and BAI. Significant moderate-level relationships were found between the BDI score and irritable, depressive, cyclothymic, and anxious temperaments and between the BAI score and irritable, depressive, cyclothymic, and anxious temperaments. Conclusion: Several temperamental features of JME patients are related to CTs. More depressive symptoms are seen in JME patients with higher disease durations.

Effects of Asenapine and Paliperidone on Depression, Anxiety and Analgesy in Mice: Alterations in Brain Neurotrophic Factors, Neurogenesis, and Blood Enzyme Levels.

Schizophrenia, an important brain neurodevelopmental disorder, is observed in 1% of the global population. New-generation antipsychotics have been developed as alternatives to typical antipsychotics for more effective and safe therapy. Chronic administration of asenapine and paliperidone compared to haloperidol on depression, anxiety and analgesy in the forced swimming test (FST), elevated plus maze (EPM) and hot plate tests were examined in mice. Moreover effects of drugs, on expression levels of brain neurotrophic factors [brain-derived neurotrophic factor (BDNF), cAMP response element binding protein (CREB),nerve growth factor (NGF), synapsin and fibroblast growth factor 2 (FGF2)] in the hippocampus of mice, neurogenesis and neurodegeneration, and blood enzyme levels were also investigated. In FST, haloperidol (0.25 mg/kg) significantly increased immobility time while both asenapine (0.075 mg/kg) and paliperidone (0.25 and 0.50 mg/kg) significantly diminished this parameter. In EPM test, haloperidol significantly increased both % time spent in open arms and % open arm entries. Asenapine (0.075 mg/kg) and paliperidone (0.50 mg/kg) significantly increased % time spent in the open arms. They also increased % open arm entries, but this parameter failed to reach a statistically significant value. In hot plate test, haloperidol (0.125 and 0.25 mg/kg) and paliperidone (0.25 and 0.50 mg/kg) significantly increased the latency to lick the hind paws but asenapine had no effect. Asenapine and paliperidone upregulated more neurotrophic factors in the brain and caused less neurodegeneration compared to haloperidol. Investigated drugs had no effect on liver enzymes and plasma glucose levels. Asenapine and paliperidone may be preferred over classical antipsychotics since they have antidepressant-like effect, upregulate more neurotrophic factors and cause less neurodegeneration in naive mice without having diabetogenic and liver damaging effects. Paliperidone seems to possess superior effects compared to asenapine since it also exerts analgesic-like effect.

A Randomized-Controlled Trial of EMDR Flash Technique on Traumatic Symptoms, Depression, Anxiety, Stress, and Life of Quality With Individuals Who Have Experienced a Traffic Accident.

The Flash Technique of Eye Movement Desensitization and Reprocessing (EMDR) is widely recognized for its effectiveness in reducing the effects of emotional responses associated with traumatic memories. Using a randomized-controlled trial methodology, this study attempts to establish the efficacy of the EMDR Flash Technique. This study's sample includes volunteers who were involved in traffic accidents and were given the randomized EMDR Flash Technique and Improving Mental Health Training for Primary Care Residents (mhGAP) Stress management module. The participants were given a socio-demographic data form, the Depression-Anxiety-Stress 21 scale (DASS-21), the Impact of Event Scale-Revised (IES-R), and the WHOQOL Quality of Life scale. Participants were evaluated using measurements taken before and after the application, as well as a one-month follow-up. The mean age of the participants was 36.20 (11.41) years and 82.1% (n = 32) were female. The DASS-21 Anxiety (η 2 = 0.085), IES-R Intrusion (η 2 = 0.101), Avoidance (η 2 = 0.124), Total (η 2 = 0.147), and WHOQOL-BREF Psychological (η 2 = 0.106) score improvements of the EMDR Flash Technique group were shown to be statistically significant when compared to the mhGAP group. However, no statistically significant difference in the DASS-21 Depression, Stress, Impact of Event Scale-Revised Hyperarousal WHOQOL-BREF General Health, Physical, Social Relationships, and Environment component scores was reported between the two groups. The present study's findings clearly demonstrate that the EMDR Flash technique, when applied to persons involved in traffic accidents, is successful in improving anxiety, intrusion, avoidance, total traumatic stress, and mental quality of life symptoms for at least 1 month. We believe that these findings will improve the reliability and applicability of the EMDR Flash Technique, which was tested for the first time in a clinical randomized-controlled trial (RCT).

Validity and Reliability of the Turkish Version of Generalized Anxiety Disorder Scale-Revised.

OBJECTIVE: This study aims to assess the psychometric values of the Generalized Anxiety Disorder Scale-Revised (GADS-R) which measures the intensity and duration of worry, various coping and avoidance strategies to cope with worrying, and positive and negative metacognitive beliefs about worrying. METHODS: 114 patients with generalized anxiety disorder and 198 healthy controls were included in the study. These patients were diagnosed according to DSM-IV TR, and the primary diagnosis of the patients was generalized anxiety disorder which was confirmed via SCID I and II, subsequently. Sociodemographic form, GADS-R total and subscale scores, and Meta-Cognitions Questionnaire-30 (MCQ-30), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Generalized Anxiety Disorder-7 Scale (GAD-7), and Penn State Worry Questionnaire (PSWQ) were used to assess validity, reliability and cut-off point. RESULTS: GADS-R total and subscale scores and MCQ-30, BDI, BAI, GAD-7, and PSWQ were found to be statistically higher in the patients with GAD compared to a healthy control group. GADS-R has five factors and showed relatively acceptable sensitivity and specificity for detecting anxiety disorders at a cut-off point of 1188. CONCLUSION: The GADS-R is a valid and reliable scale that can be used in the Turkish population as an assessment tool.

Anxiety and hopelessness levels in COVID-19 pandemic: A comparative study of healthcare professionals and other community sample in Turkey.

COVID-19 affected our mental health as well as our physical health. In this study, the anxiety and hopelessness levels of healthcare workers and non-healthcare workers and the factors affecting them were evaluated in Turkey. Beck Hopelessness Scale and State-Trait Anxiety Inventory (STAI) was applied online to participants. Totally 2156 individuals were included in the study and 52.0% (n:1121) of them are healthcare workers. The hopelessness and state anxiety levels of healthcare workers were higher than non-healthcare workers. Nurses' hopelessness levels are higher than doctors, and state anxiety levels are higher than both doctors and other healthcare workers. Anxiety and hopelessness levels were higher in women, those living with a high-risk individual at home during the pandemic, those who had difficulty in caring for their children, and those whose income decreased. Anxiety levels are an important predictor of hopelessness. The increase in anxiety levels explained 28.9% of the increase in hopelessness levels. Increased working hours is one of the important factors affecting anxiety. As a conclusion, healthcare workers were more affected psychologically in the COVID-19 pandemic compared to the society. Nurses were affected more than other healthcare workers. It is important to identify the factors affecting anxiety, hopelessness, and individuals who may be more psychologically affected during the pandemic. An important contribution can be made to the protection of public health by ensuring that psychosocial interventions for high-risk groups are planned in advance.

Aspects of cognitive performance relating to Theory of Mind (ToM) among people diagnosed with Post-Traumatic Stress Disorder (PTSD).

OBJECTIVE: This study investigated Theory of Mind (ToM) abilities as measured by a hinting task and the Reading the Mind in the Eyes Test (RMET) in individuals diagnosed with post-traumatic strees disorder (PTSD) in relation to different types of childhood trauma and compared to a healthy control group. METHOD: RMET, a Clinician Administered PTSD Scale (CAPS), a Beck Depression Inventory (BDI), a Childhood Trauma Questionnaire (CTQ), a hinting task, and a socio-demographic questionnaire were administered to PTSD (n=30) patients and healthy controls (n=30). RESULTS: There was a significant difference in ToM performance between healthy participants and the PTSD group (p<0.001). A significant correlation was found between trauma types and ToM performance (p<0.01). The diagnosis of PTSD and the severity of PTSD symptoms showed significant correlations with ToM performance (p<0.01). In comparison with the healthy control group, the PTSD group demonstrated lower performance on both ToM tasks. Regardless of the PTSD diagnosis, those people who had a history of childhood trauma had slowed reaction times in response to photographs representing emotionally salient mental states and demonstrated difficulties in the identification of irony/hints in the context of the administered assessment task. CONCLUSION: The findings of the present study suggest that a diagnosis of PTSD and a history of different types of trauma have an effect on ToM performance. PTSD seems to lead to deterioration in ToM capacities. This may mean that the experience of childhood adversity may lead to long-lasting damage to social cognition. The current study is helpful in that it contributes to a better understanding of the pathogenesis of PTSD; moreover, it will be beneficial in the development of new treatment options. Our research findings suggest that we must concentrate not only on traumatic events during the treatment process of PTSD follow-up and treatment; we must also target deficiencies in cognitive and emotional capabilities.

Validity and Reliability of Cognitive Attentional Syndrome-1 Questionnaire.

OBJECTIVE: This study aimed to evaluate the reliability and validity of the Turkish version of Cognitive Attentional Syndrome-1 (CAS-1) questionnaire. METHODS: 221 participants were included in the study who do not meet any psychiatric diagnosis. Participants were applied SCID I and II and filled CAS-1 scale, Meta-Cognitions Questionnaire-30 (MCQ-30), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Generalized Anxiety Disorder-7 (GAD-7) Scale, and Penn State Worry Questionnaire (PSWQ). Testing the reliability Cronbach's alpha, item analysis and Item and total score correlation coefficients were applied. For testing structural validity, Confirmatory Factor Analysis was used, and for testing the content validity, the relationship between each item of CAS-1 and MCQ-30, BDI, BAI, GAD-7, PSWQ was examined. RESULTS: The correlation reliability coefficients were statistically significant except for using alcohol/drugs as a coping mechanism. Cronbach Alpha reliability coefficient of 16 items was 0.771 whereas, this ratio was 0.772 for the first eight items (CAS) and 0.685 for the last eight items (Metacognitive Beliefs) which showed that the internal consistency of CAS-1 was high. Structural and Content Validity of the scale was significant. CONCLUSION: The Turkish version of the CAS-1 was a reliable and valid measure to evaluate CAS in a Turkish population.

[Eye Movement Desensitization and Reprocessing (EMDR) Therapy on a Patient with Schizophrenia and Clinical Effects: A Case Study]. / Sizofreni Olgusunda Göz Hareketleri ile Duyarsizlastirma ve Yeniden Isleme (EMDR) Uygulamasi ve Klinige Etkileri: Olgu Sunumu.

Being exposed to traumatic experiences is rather common in patients with schizophrenia. Adverse experiences may induce the onset of psychotic symptoms or trigger current symptoms to be exacerbated. Eye Movement Desensitization Reprocessing (EMDR) is an effective therapy in the treatment of incidences with underlying traumatic experiences, there by it can be conducted on various cases in addition to other treatments such as psycho-medication or another therapy method. It was developed by Shapiro in 1980s. Although desensitization is widely applied on patients with Post-Traumatic Stress Disorder, it is unusual for EMDR therapy to be safely and effectively performed in the treatment of psychotic disorder sor symptoms. In the present case study, EMDR treatment process and course of psychiatric state in a patient with history of child hood abuse and forced psychiatric residency will be discussed. The patient who had a diagnosis of schizophrenia for 8 years was treated with antipsychotic treatment as well as 2 sessions of EMDR, and as a result, a positive change was observed in her general clinical course. Our thoughts on this phenomenon are that EMDR treatment is an effective, safe and short-term intervention in the comorbidity of PTSD and psychotic disorders. However, the literature about the place of EMDR in the treatment of schizophrenia cases is rather limited and much more research is needed.

Diagnosis of airway obstruction or restrictive spirometric patterns by multiclass support vector machines.

This paper presents the use of multiclass support vector machines (SVMs) for diagnosis of spirometric patterns (normal, restrictive, obstructive). The SVM decisions were fused using the error correcting output codes (ECOC). The multiclass SVM with the ECOC was trained on three spirometric parameters (forced expiratory volume in 1s--FEV1, forced vital capacity--FVC and FEV1/FVC ratio). The total classification accuracy of the SVM is 97.32%. The obtained results confirmed the validity of the SVMs to help in clinical decision-making.