Investigation of carotid intima-media thickness in patients with schizophrenia.

BACKGROUND: Patients with schizophrenia (SCZ) have a higher risk of cardiovascular diseases than the average population. Early diagnosis of SCZ patients with subclinical atherosclerosis is great importance in reducing cardiovascular morbidity and mortality. The aim of this study was to investigate some clinical risk factors for atherosclerosis in patients with SCZ. METHODS: Fifty-one SCZ patients (20 females, 31 males) and 55 healthy controls (HCs) (25 females, 30 males) were included in the study. Electrocardiography (ECG), lipid parameters, hemogram, and biochemistry values of the participants were taken. Low-density lipoprotein (LDL), high-density lipoprotein (HDL), fasting triglycerides, and total cholesterol were measured. The arrhythmogenic index of plasma (AIP) was analyzed. The recorded right and left carotid intima-media thickness (CIMT) measurements by carotid ultrasonography were scanned. RESULTS: QT interval (p = 0.035), CIMT-left (p = 0.008), CIMT-right (p = 0.002), fasting triglyceride (p = 0.005), AIP (p = 0.005) in the SCZ group compared to HCs (< 0.001) was statistically higher, while HDL (p = 0.003) was statistically lower. Smoking rates, QT interval (p = 0.035), CIMT-left (p = 0.008), and CIMT-right (p = 0.002) were significantly higher in the the SCZ group than in the HCs. According to odds ratios, individuals with SCZ have a 6.3-fold higher smoking rate. According to Pearson correlation analysis, CIMT-left was positively correlated with age and QT interval (r = 0.568, p < 0.001 and r = 0.589, p < 0.001, respectively). CIMT-right value was also positively correlated with age and QT interval (r = 0.533, p < 0.001 and r = 0.555, p < 0.001, respectively). QT interval positively and significantly predicted CIMT-left and CIMT-right (p < 0.001, ß = 0.549 and p = 0.001 and ß = 0.506 accordingly). CONCLUSION: In this study, a close relationship was found between the QT interval and CIMT in SCZ patients. This finding could be valuable for using an easy-to-calculate data such as QT in place of a laborious test such as CIMT.

Comparison of accidental findings of brain magnetic resonance imaging of patients with obsessive-compulsive disorder and healthy controls.

BACKGROUND: Abnormalities in brain magnetic resonance imaging (MRI) have been reported in drug-naive and chronic patients with obsessive-compulsive disorder (OCD). The Fazekas scale is a method used to categorize and grade the severity of white matter hyperintensities (WMH) in brain MRI. These lesions can be indicative of various neurological conditions, particularly small vessel disease or cerebrovascular pathology. METHODS: Brain MRIs of patients followed up with the diagnosis of OCD were retrospectively analyzed. 58 OCD (36 females, 22 males) and 58 healthy controls (HC) (30 females, 28 males) were included in the study. Age, gender, and brain MRI findings of the participants were recorded. RESULTS: The mean ages of the OCD and HC groups were 33.4 ± 10.6 and 35.9 ± 9.3. There was no difference between the groups in terms of mean ages and gender distribution (p = 0.180 and p = 0.260, accordingly). Generalized cerebral atrophy was more common in patients with OCD than in HC (p = 0.008). Fazekas grade 1 was detected in 17.2% of the patients with OCD and 1.7% of HC. Accordingly, it was significantly more common in Fazekas grade 1 OCD patients (p = 0.002). Fazekas grade 2 was detected in only 2 patient with OCD. CVI was present in 20.7% of the patients with OCD and 1.7% of HC. There was a significant difference between the groups regarding CVI (p = 0.001). Ethmoidal thickening was more common in patients with OCD than in HC (p = 0.004). The YBOCS scores and ages of OCD patients with Fazekas grade 1 and 2 were significantly higher than those of patients with Fazekas grade 0. Likewise, the YBOCS scores and ages of OCD patients with generalized cerebral atrophy were significantly higher than those of patients without atrophy. CONCLUSION: It is understood from the present study's findings that CVI, a neurodevelopmental malformation, is more common in patients with OCD. Due to the potential relationship of this anomaly with neuronal migration, it would be appropriate to pay attention to OCD symptoms in individuals with CVI and to perform white matter examination on brain imaging. In future studies, Fazekas grade can be evaluated in drug-naive OCD patients, and data on the pre-disease period can be obtained.

A novel diagnosis method for schizophrenia based on globus pallidus data.

This research aims to diagnose schizophrenia with machine learning-based algorithms. Bayesian neural network, logistic regression, decision tree, k-nearest neighbor, and gaussian kernel classification techniques are investigated to diagnose schizophrenia with data from 125 persons. This study showed that left lateral ventricles and left globus pallidus volumes and their percentages in the brain were significantly lower than HCs in FEP patients. Using brain volumes, we were able to diagnose FEP with an accuracy of 73.6 % via logistic regression and with an accuracy of 86.4 % using the SVM kernel classifier method. Therefore, brain volumes can be used to diagnose FEP with the SVM kernel classifier method.

Comparison of frontal QRS-T angle and inflammatory parameters between the patients with drug-naive first episode psychosis and healthy controls.

BACKGROUND: Frontal QRS-T (fQRS-T) angle is a novel marker to predict many cardiovascular diseases. The present study aims to compare the fQRS-T angle of first episode psychosis (FEP) patients and healthy controls (HC) and evaluate the relationship between fQRS-T angle and blood count-related inflammatory markers such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to high-density lipoprotein cholesterol ratio (MHR). METHODS: Electrocardiogram (ECG) and complete blood count (CBC) of 63 patients who were diagnosed with drug-naive FEP in the psychiatry clinic of a training and research hospital and 78 healthy controls (HC) individuals who had applied to the health committee polyclinic for recruitment or pre-military examination between 2016 and 2021 were included. RESULTS: fQRS-T angle was wider in FEP patients (55.5o) than in healthy controls (22o) (p < .001). NLR, PLR, and MHR were higher in FEP patients than in healthy controls (p = .001, p < .001, and p < .001, respectively). fQRS-T angle was positively correlated with NLR (r = 0.52 and p < .001) and MHR (r = 0.39 and p = .002) in FEP patients. NLR (t = 2.196 and p = .032) and MHR (t = 5.469 and p < .001) values were found to be the predictors of fQRS-T angle in FEP patients. CONCLUSION: In summary, we can conclude that patients with FEP tend to exhibit a wider fQRS-T angle compared to their healthy controls. Additionally, the values of NLR and MHR could potentially serve as useful indicators for predicting the fQRS-T angle in FEP patients. Conducting subsequent long-term studies could provide deeper insights into the interpretation of the fQRS-T angle and its potential connection to cardiovascular diseases in schizophrenia patients.

The Relationship of Ten-Year Cardiovascular Disease Risk and Clinical Features in Patients with Schizophrenia.

Introduction: Cardiovascular diseases (CVD) are the one of the most important causes of mortality in patients with schizophrenia. This study aimed to investigate ten-year CVD risk and its relationship with clinical features in patients with schizophrenia. Methods: The sample of the study consisted of 208 patients with a diagnosis of schizophrenia. The Positive and Negative Syndrome Scale (PANSS) was administered to each patient to assess symptom severity of schizophrenia. The 10-year CVD risk of the participants was calculated with the QRISK*3 model. Results: 10-year CVD risk of the patients was found to be 7.4%. The mean healthy heart age (QAGE) of the patients was 53.1. Duration of disease, body mass index (BMI), and negative symptoms severity was positively correlated with 10-year CVD risk in patients with schizophrenia (r=0.57, r=0.37, and r=0.49, respectively). Duration of disease, BMI, and severity of negative symptoms predicted a 10-year CVD risk in patients with schizophrenia (t=4.349 and p<0.001; t=2.108 and p=0.037; t=2.836 and p=0.006 respectively). Conclusion: The findings of this study have shown that duration of disease, negative symptoms, and BMI may be important risk factors for increased CVD risk in patients with schizophrenia.

Reduced olfactory bulb volume and olfactory sulcus depth in obsessive compulsive disorder.

Many studies have shown that limbic system abnormalities are seen in obsessive-compulsive disorder (OCD), but the neurobiological changes in OCD are still unclear. Moreover, olfactory bulb volume (OBV) and its association with symptom severity have not been yet investigated in patients with OCD. This is the first study on OBV and olfactory sulcus depth (OSD) values in OCD patients, to the best of our knowledge. Between January 2018 and March 2022, 25 patients with OCD and 26 healthy controls with brain magnetic resonance imaging (MRI) were included. Detailed disease history of OCD patients was taken, and Yale-Brown obsessive-compulsive scale (YBOCS) was applied. The mean age of the patient group was 33.40±9.58, the mean age of the control group was 32.84±8.01. LOBV, ROBV, TOBV, and LOSD in the patient group were significantly lower than in the control group (p=.013, p=.005, p=.001, p=.015, respectively). ROBV and TOBV were negatively correlated with YBOCS total and subscale scores. A negative correlation was found between ROBV and TOBV and disease duration (r=-0.749 and r=-0.640, respectively). The negative correlation of ROBV and TOBV values with disease duration and disease severity can be used to monitor the neurodegenerative process of OCD disease.

Comparison of Incidental Findings of Brain Magnetic Resonance Imaging of Schizophrenia Patients, First-Episode Psychosis Patients and Healthy Controls.

BACKGROUND: It has been emphasized for a long time that neurodevelopmental and neurodegenerative processes play an important role in the etiology of schizophrenia. SUBJECTS AND METHODS: In this study, brain magnetic resonance imaging (MRI) of 97 patients with schizophrenia (SCH), 42 first-episode psychosis (FEP) patients, and 70 healthy controls (HC) were analyzed, and abnormal findings on brain MRI were recorded. Participant's age, gender, and brain MRI findings were recorded retrospectively. Fazekas grades evaluated the distribution of white matter hyperintensities in the brain. RESULTS: The mean ages of FEP, SCH, and HC were 24.8±6.3, 36.9±11.5, and 36±10.5, respectively. Generalized cerebral atrophy was higher in SCH and HC than in FEP groups, and frontoparietal atrophy was higher in the SCH group than in HC and FEP groups (p<0.001). The percentage of Fazekas Grade-1 was higher in the SCH group than HC and FEP groups (p=0.006). Additionally, the cavum veli interpositi (CVI) rate was higher in FEP and SCH groups than in the HC group (p=0.042). CONCLUSION: Although there was no significant age difference between the SCH and HC groups, the higher prevalence of generalized cerebral atrophy in the SCH group may indicate the neurodegenerative process of schizophrenia. The fact that CVI, a congenital brain anomaly, was detected more frequently in the FEP and SCH groups may suggest that schizophrenia may be associated with neurodevelopmental process.

Is there a Relationship Between Caffeine Intake and Smoking and Positive and Negative Symptom Severity in Schizophrenia?

BACKGROUND: It has been reported that caffeine intake and smoking are more frequent in patients with schizophrenia than the general population. However, the cause of high caffeine and smoking and its correlation with positive and negative symptoms is unclear. Therefore, the aim of the present study is to evaluate the correlation between daily caffeine intake and smoking and the severity of positive and negative symptoms in patients with schizophrenia. SUBJECTS AND METHODS: This study included 177 participants, 89 of whom were healthy controls and 88 patients with schizophrenia. Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) scales were applied to the patients with schizophrenia to measure the severity of positive and negative symptoms of the disease. RESULTS: The amounts of caffeine and tobacco consumption were significantly higher in the patients group than healthy controls (p=0.001 and p<0.001, respectively). There was no significant correlations between daily caffeine consumption and SAPS or SANS scores in patients with schizophrenia. There was a significant positive relationship between SAPS-delusions score and tobacco consumption. CONCLUSIONS: Our study is the first study in the literature that examines the relationship between caffeine and cigarette intake and SANS and SAPS scales in patients with schizophrenia. Although caffeine intake is higher in patients with schizophrenia than healthy controls, this study is valuable as it shows that it is not associated with symptom severity. In addition, although it is known that smoking is high in patients with schizophrenia, this study showed a positive relationship between SAPS-delusion scores and tobacco consumption.

Comparison of Frontal QRS-T Angle in Patients with Panic Disorder and Healthy Control Group: A Preliminary Study.

Background: Autonomic instability is blamed for panic disorder pathophysiology. It has been suggested that this may raise the risk of cardiovascular disease. A new proposal for ventricular depolarization and repolarization impairment is the frontal QRS-T angle. Methods: In this cross-sectional study, 61 patients with panic disorder and 73 healthy controls were included. The severity of panic disorder was evaluated using the Severity Measure for Panic Disorder-Adult. Electrocardiography, echocardiography, hemogram, and biochemistry data were recorded. Results: Patients with panic disorder had a greater frontal QRS-T angle than healthy controls. In panic disorder patients, the values for hemoglobin, eosinophil count, and high-density lipoprotein cholesterol were all significantly lower than healthy controls. In comparison to healthy controls, panic disorder patients had significantly higher values for total cholesterol, fasting triglycerides, low-density lipoprotein cholesterol, platelet-to-lymphocyte ratio, and monocyte-to-high-density lipoprotein cholesterol ratio. Significant correlations were found between frontal QRS-T and Severity Measure for Panic Disorder-Adult, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio. The frontal QRS-T value is positively and significantly predicted by the neutrophil-to-lymphocyte ratio value according to the linear regression analysis for the frontal QRS-T angle [F(6.54) = 8.375, P < .001, adjusted R 2: 0.424]. Conclusion: The current study found that the frontal QRS-T angle increased with the severity of the disease in patients with panic disorder. Frontal QRS-T angle may help to estimate cardiovascular disease risk in patients with panic disorder. This relationship may be necessary in terms of cardiovascular events and inflammatory conditions.

Comparison of Psychiatric Symptoms in Patients with COVID-19 Hospitalized in Intensive Care Unit and Non-Intensive Care Unit.

BACKGROUND: The aim of this study was to compare of psychiatric symptoms in patients with COVID-19 hospitalized in intensive care units and non-intensive care units. SUBJECTS AND METHODS: 3351 hospitalized patients due to COVID-19 were retrospectively scanned, and 130 of patients were checked by attending consultation psychiatrists. RESULTS: The mean age of the patients with COVID-19 hospitalized in ICU (75±11.3) was higher than those hospitalized in non-ICU (57.9±14) (p<0.001). The rate of patients aged 65 and over was higher in patients with COVID-19 hospitalized ICU (86.3%) than those hopitalized in non-ICU (40.5%) (p<0.001). The frequency of psychiatric consultations due to delirium was higher in the patients hospitalized in ICU than those hospitalized in non-ICU (p<0.001). Haloperidol and SSRIs were preferred more frequently by psychiatrists in the patients hospitalized in ICU than those hospitalized in non-ICU (p<0.001 and p=0.041, respectively). CONCLUSIONS: Insomnia and delirium are the most frequent psychiatric manifestations in hospitalized COVID-19 patients, and delirium and anxiety are more common in the COVID-19 patients who are hospitalized in ICU.

Comparison of frontal QRS-T angle in patients with schizophrenia and healthy volunteers.

Cardiovascular diseases are the most prominent cause of death in patients with schizophrenia. Frontal QRS-T (fQRS-T) angle is a novel marker of myocardial depolarization and repolarization heterogeneity. Recent studies have indicated that the fQRS-T angle is associated with some cardiovascular abnormalities. This study aimed to investigate the fQRS-T angle and its relationship with symptoms severity in patients with schizophrenia. One hundred-six patients with schizophrenia and sixty-four healthy controls were included in this study. fQRS-T angle and QT interval measurements were calculated for each participant from the automatic report of the 12-lead electrocardiography (ECG) device. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and The Positive and Negative Syndrome Scale (PANSS) were performed on the patients with schizophrenia. Corrected QT (QTc) interval and fQRS-T angle were significantly higher in the patients with schizophrenia than healthy controls (p < 0.001 and p < 0.001, respectively). fQRS-T angle was positively correlated with age (r = 0.43), duration of disease (r = 0.37), and negative symptoms scores (r = 0.39). In linear regression analysis, the disease duration and negative symptom severity were the independent predictors of fQRS-T angle in patients with schizophrenia (t = 3.730, p = 0.003 and t = 2.257, p = 0.023, respectively). The fQRS-T angle may be an important ECG parameter to interpret cardiovascular disease risk in patients with schizophrenia.

Risk-Taking Behavior in Recovered COVID-19 Patients.

BACKGROUND: The aim of this study is to investigate risk-taking behavior and decision-making processes in recovered COVID-19 patients. SUBJECTS AND METHODS: Twenty patients recovered from COVID-19 as confirmed by polymerase chain reaction (PCR) tests and twenty-one healthy individuals were recruited. A computerized version of the Iowa Gambling Test (IGT) for measuring risk-taking behavior tendencies as a decision-making process and State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and WMS-R Digit Span Forward Test (DSFT) for clinical assessments included. The assessments of the recovered patients were applied on the initial phase that the tests of the patients were negative and on the 4-week follow up phase. RESULTS: The results showed that the anxiety scores were significantly higher in the healthy control group than in the group of recovered patients. The IGT-Net 4 scores were significantly and IGT-Net total scores were marginally significantly lower in the group of recovered patients. In other words, recovered patients showed higher risk-taking behavior tendencies. This tendency difference is consistent with the anxiety levels of the groups. These IGT scores showed to be persistent in the 4-week follow up phase. CONCLUSIONS: Our findings indicate that recovered patients show higher risk-taking behavior tendencies than healthy controls and this may be the result of overcoming the COVID-19 threat.

Munchausen by Proxy Syndrome Associated with Fecal Contamination: A Case Report. / Fekal Kontaminasyon ile Ortaya Çikan Munchausen by Proxy Sendromu: Bir Olgu Sunumu.

Factitious disorder imposed on another, also known as Munchausen Syndrome by Proxy (MSBP), is a serious form of child abuse that is difficult to diagnose. In general, signs and symptoms are fabricated or produced by the mother or the caregiver. Delay in diagnosis may cause serious morbidity and mortality. Here, we present the case of an 18-month-old boy who was admitted to the Paediatric Infection Clinic with a diagnosis of acute gastroenteritis. When on intravenous fluid therapy, he developed high fever and subsequently, polymicrobial growth was determined in his blood. He was later diagnosed with MSBP. Despite being a rare condition, MSBP is a disorder that is often overlooked and may have fatal outcomes. Early diagnosis is very important in this disorder, which is considerably difficult to diagnose. In suspected cases, interdisciplinary team work is necessary to prevent adverse consequences.

Forced migration-related traumatic experiences and collective memory in Ezidi asylum-seekers coming to Diyarbakir province from Shingal region.

PURPOSE: The purpose of this study was to investigate the collective memory of Ezidi asylum-seekers who migrated from Iraq to Turkey in 2014. METHODS: Kurdish-speaking Ezidi participants of 25-65 years of age (ten male and ten female) who have arrived to Fidanlik Camp in Diyarbakir, Turkey from the Iraqi Shingal region have been included in the study. Data were collected through semi-structured in depth interviews and qualitative content analysis was conducted on the collected data. RESULTS: The word "edict", which was used to define violent attacks, had a significant importance in all participants' memories. The collective memory observed in the Ezidi society leads a collective fear. Homelessness and religious discrimination are other concerns observed in the population. CONCLUSION: In conclusion, due to the depth and strength of the oral narrative tradition in the Kurdish culture, a significant collective memory is formed within the Ezidi society. Accumulation of previous negative events may prevent Ezidis to form a healthy identity. Traumas of the Ezidis should be investigated in more detail, and studies with larger scopes should be conducted in the future.

A Cross-Sectional Investigation of Quality of Life in Patients with Polycystic Ovary Syndrome.

OBJECTIVES: The aim of this study is to investigate the effect of physical signs and comorbid psychopathology on quality of life in women with polycystic ovary syndrome (PCOS). METHODS: This cross-sectional study was conducted to assess 84 women with PCOS according to Rotterdam diagnosis criteria. Structured Clinical Interview for DSM-IV Axis 1 Disorders (SCID-I) and the World Health Organization Quality of Life-Brief Form (WHOQOL-BREF) were applied to each participant. The biochemical parameters and physical signs of the participants were evaluated. RESULTS: A negative correlation was found between hirsutism score and physical, psychological, social, and environmental domains of WHOQOL-BREF (p=0.023, p=0.007, p=0.020, and p=0.033, respectively). Furthermore, a negative correlation was found between body mass index (BMI) and psychological domain of WHOQOL-BREF (p=0.001). Depression was found to be an important predictor for physical, psychological, and social domains of quality of life (p=0.002, p=0.001, and p=0.001, respectively). CONCLUSION: Comorbid depression and high BMI and hirsutism scores decrease the quality of life in women with PCOS.

The Association Between Childhood Traumatic Events and Headache-Related Parameters in Patients with Migraine: A Cross-Sectional Study in Turkish Population.

INTRODUCTION: The aim of this study is to investigate the association between childhood traumatic events and headache-related clinical parameters in migraine patients. METHODS: 95 patients diagnosed with migraine and 50 healthy controls were included in the study. A socio-demographic form, the Childhood Trauma Questionnaire (CTQ), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) were completed by all participants. Additionally, the Visual Analog Scale (VAS) and the Migraine Disability Assessment Test (MIDAS) were applied to migraine patients. RESULTS: Positive correlations were found between emotional abuse, physical abuse, physical neglect, CTQ total scores, and headache frequency (r=0.33, r=0.24, r=0.26 and r=0.28 respectively) in migraine patients. A positive correlation was found between physical neglect and headache duration (r=0.28). Positive correlations were also found between emotional abuse and physical neglect, and MIDAS total scores (r=0.22 and r=0.23, respectively). Emotional abuse and CTQ total scores were associated with younger mean age of headache onset (r=-0.24 and r=-0.23). CONCLUSION: Childhood traumatic events are associated with more frequent and more severe headache episodes, and younger headache onset in migraine patients.

The relationship between burnout symptoms and Type D personality among health care professionals in Turkey.

The aim of this study was to investigate the relationship between burnout and Type D personality in health care professionals. The study randomly included 120 health care professionals (73 nurses, 47 doctors). Sociodemographic data form, Maslach Burnout Inventory, and Type D Personality Scale were applied to each participant; 38.3% of the health care professionals (n = 46) had the Type D personality. Emotional exhaustion and depersonalization of health care professionals with Type D personality were higher than of those without Type D personality (p = .006 and p = .005). Stepwise regression analysis indicated that Type D personality was a predictor of emotional exhaustion and depersonalization (p = .005 and p = .001, respectively). Our results suggest that Type D personality is associated with higher burnout levels.

Correlations between impulsiveness and biochemical parameters in women with polycystic ovary syndrome.

OBJECTIVE: The aim of this study was to investigate the relationship between anger, impulsiveness, and biochemical parameters (testosterone, insulin, insulin resistance) in women with polycystic ovary syndrome. STUDY DESIGN: We recruited 84 women diagnosed with polycystic ovary syndrome according to the Rotterdam diagnostic criteria. Psychiatric interviews were performed using the Structured Clinical Interview for DSM-IV Axis I Disorders. The Barratt Impulsiveness Scale and the State Trait Anger Expression Inventory were also administered to each participant. Lastly, the women's biochemical parameters, which included total testosterone, free androgen index, dehydroepiandrosterone sulfate, insulin and insulin resistance, thyroid functions, and prolactin, were measured. RESULTS: A statistically significant correlation was found between participants' increasing total testosterone levels and total impulsiveness scores, and their increasing free androgen index levels and motor and non-planning-related impulsiveness (r=0.24, p=0.027; r=0.27, p=0.015; and r=0.26, p=0.017, respectively). High insulin and insulin resistance levels were associated with high non-planning-related impulsiveness scores (r=0.26, p=0.018; and r=0.26, p=0.019). Lastly, high trait anger and anger expression scores were related to high total testosterone and insulin and insulin resistance levels. CONCLUSION: Androgens and glucose dysregulation seemingly affect anger expression as well as the attentional, motor, and non-planning-related impulsiveness of women with polycystic ovary syndrome.

Effects of onabotulinumtoxinA treatment on efficacy, depression, anxiety, and disability in Turkish patients with chronic migraine.

Chronic migraine causes a serious labour loss and disability in the society and increases the risk of depression and anxiety by negatively affecting the quality of life. The purpose of this study was to investigate the effects of onabotulinumtoxinA (BoNT-A) treatment on efficacy before and after treatment in our cases with chronic migraine as well as on depression, anxiety and disability caused by migraine. According to the International Headache Classification (ICHD-III beta version), 60 adult patients who were diagnosed with chronic migraine were included in the study. A total of 155 IU BoNT-A treatment from 31 regions was administered in accordance with the protocol of PREEMPT study. Information about the characteristics of patients' headaches, background and family history, drugs they used was recorded. At the baseline and in the first and third month after the BoNT-A injection, VAS scores, the number of both headache days and attacks, the headache duration, the frequency of application to emergency services and the intake of both analgesics and triptans during attacks were evaluated. MIDAS, BDI and BAI were evaluated at the baseline and in the third month after the BoNT-A injection. BoNT-A injection provided a significant decrease in the number of days and severity of headaches, MIDAS disability scores and psychiatric complaints in cases with chronic migraine who did not respond to prophylactic treatments in the third month of the treatment.