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 Emotional Dysregulation and Impulsivity on Suicidality in Patients with Bipolar Disorder.

BACKGROUND: We aimed to evaluate the effect of emotional dysregulation and impulsivity on suicidality in patients with bipolar disorder by comparing patients with bipolar disorder with healthy individuals. SUBJECTS AND METHODS: The study included 85 patients (59 women, 26 men) with bipolar disorder and education and age-matched 65 (44 women, 21 men) healthy volunteers. The patient group was separated into 3 different groups if they have a suicide attempt history, or have suicidal ideation without attempt, or have neither suicide attempt nor ideation. Sociodemographic Form, The Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsivity Scale (BIS-11), Scale for Suicidal Ideation, Suicide Behaviors Questionnaire scales were applied to the participants. RESULTS: Patients with bipolar disorder (n=85) had significantly higher scores for emotion dysregulation and impulsivity than the healthy controls (p<0.001, p<0.001). The scores of DERS, BIS-11, Suicidal ideation, and Suicide behavior scores were significantly correlated. DERS Total and BIS Total scores of bipolar patients with suicide attempts were significantly higher than bipolar patients with suicidal ideation and bipolar patients with neither attempt nor ideation. According to the hierarchical regression analysis, strategies, clarity, and non-planning impulsiveness were found as the predictors of suicidal ideation in bipolar patients. CONCLUSIONS: Suicidal behavior has a significant relationship between emotional dysregulation and impulsivity in patients with BD. Clinicians must carefully evaluate emotional dysregulation and impulsivity among this population to develop treatment strategies in suicide prevention.

Rates and correlates of post-traumatic stress disorder and symptoms during the immediate onset of COVID-19 pandemic in a sample of patients from an outpatient psychiatric clinic in Turkiye.

OBJECTIVE: This study was designed to investigate the traumatic stress levels, participants demonstrating higher than post-traumatic stress disorder (PTSD) cutoff, thus PTSD possibility, levels, and related factors of patients who felt the need to apply to the outpatient clinic for the 1st time during the first period of the outbreak of the pandemic as a traumatic event, when many psychiatry outpatient clinics were mostly closed to face-to-face admissions. In our research, we targeted three objectives. First, we evaluated PTSD as indicated with measure cutoff points and post-traumatic stress symptom (PTSS) rates among the individuals who were admitted to an outpatient psychiatric clinic for the 1st time, 3 months after the first COVID-19 case was reported in Turkiye. Second, we investigated the relationship between PTSS and PTSD cutoff with anxiety, stress, depression, hopelessness, fear of COVID-19, and disability levels. Third, we aimed to explore the sociodemographic data and risk factors related to PTSD cutoff and PTSS controlling levels of disability, hopelessness, fear of COVID-19, anxiety, depression, and stress. METHODS: For our study, a total number of 85 cases were recruited. Post-traumatic Stress Diagnostic Scale (PDS), Beck Hopelessness Scale (BHS), Depression, Anxiety, and Stress Scale (DASS-21), Sheehan Disability Scale (SDS), and Fear of COVID-19 Scale (FCS) were administered to each patient. RESULTS: The rates of possible PTSD and PTSSs were found to be 25.9% and 88.2%. The majority of participants were women (65.9%) who have been presenting complaints with anxiety symptoms (60.1%) and social media users (74.1%). The mean DASS-21 all subscales (anxiety, depression, and stress) (p<0.01), BHS (p<0.01), FCS (p=0.03), and SDS family life/home responsibilities subscale (p<0.01) scores of PTSD cutoff subgroup (n=22) were higher than non-PTSD group (n=63). We observed significant positive correlations between the FCS scores and DASS-21 anxiety subscale (p<0.01), SDS family life/home responsibilities and social life/leisure activities subscales (p<0.05), and PDS symptom severity subscale (p<0.01) scores. CONCLUSION: These results demonstrate that a COVID-19 pandemic is a traumatic life event that causes high rates of possible PTSD, PTSS, anxiety, depression, hopelessness, and disability and leads to admissions to psychiatric outpatient clinics.

Borderline Personality Disorder (BPD): In the Midst of Vulnerability, Chaos, and Awe.

Borderline personality disorder (BPD) is a chronic psychiatric disorder characterized by pervasive affective instability, self-image disturbances, impulsivity, marked suicidality, and unstable interpersonal relationships as the core dimensions of psychopathology underlying the disorder. Across a wide range of situations, BPD causes significant impairments. Patients with BPD suffer considerable morbidity and mortality compared with other populations. Although BPD is more widely studied than any other personality disorder, it is not understood sufficiently. This paper briefly reviews the recent evidence on the prevalence, etiology, comorbidity, and treatment approaches of borderline personality disorder (BPD) by examining published studies, and aims to offer a more coherent framework for the understanding and management of borderline personality disorder.

The tendency towards the development of psychosexual disorders in androgenetic alopecia according to the different stages of hair loss: a cross-sectional study.

BACKGROUND: Androgenetic alopecia is a common dermatological condition affecting both genders. OBJECTIVE: To evaluate the tendency towards development of psychosexual disorders according to the clinical stages of androgenetic alopecia. METHODS: A cross-sectional study was conducted including 353 patients of both sexes on different clinical stages of hair loss, and the patients were enquired about self-perception, self-esteem, sexual experiences, anxiety and depression states. Hair loss was classified by standardized hair loss scales, and psychological effects were assessed with questionnaires. Results were compared to p<0.05. RESULTS: Negative effects on each psychological parameter of androgenetic alopecia in females were higher than in males. While overall comparisons according to hair loss stages for each parameter were significant in males, only sexual experiences, anxiety and depression values were significant in females. Sexual experiences and depression values were higher in Ludwig 3 than in 1&2, while anxiety was higher in Ludwig 3 than 1. Self-perception values in Norwood 2&2A were higher than 3A, 3V, 4 and 4A, while self-esteem values in 2A were higher than 3&4. Sexual experiences values in 2&2A were lower than 3, 3A, 3V, 4 and 4A, while 3&3A were lower than 4&4A. Depression was lower in 2A than 3, 3A, and 3V, and lower in 2A than 4A. Anxiety was lower in 2A than in 4&4A. STUDY LIMITATIONS: Relatively small number of patients, who were from a single center. CONCLUSIONS: In the management of androgenetic alopecia, it should be considered that patients may need psychological support according to the clinical stages, because of increased tendency to develop psychosexual disorders.

The tendency towards the development of psychosexual disorders in androgenetic alopecia according to the different stages of hair loss: a cross-sectional study

Abstract: Background: Androgenetic alopecia is a common dermatological condition affecting both genders. Objective: To evaluate the tendency towards development of psychosexual disorders according to the clinical stages of androgenetic alopecia. Methods: A cross-sectional study was conducted including 353 patients of both sexes on different clinical stages of hair loss, and the patients were enquired about self-perception, self-esteem, sexual experiences, anxiety and depression states. Hair loss was classified by standardized hair loss scales, and psychological effects were assessed with questionnaires. Results were compared to p<0.05. Results: Negative effects on each psychological parameter of androgenetic alopecia in females were higher than in males. While overall comparisons according to hair loss stages for each parameter were significant in males, only sexual experiences, anxiety and depression values were significant in females. Sexual experiences and depression values were higher in Ludwig 3 than in 1&2, while anxiety was higher in Ludwig 3 than 1. Self-perception values in Norwood 2&2A were higher than 3A, 3V, 4 and 4A, while self-esteem values in 2A were higher than 3&4. Sexual experiences values in 2&2A were lower than 3, 3A, 3V, 4 and 4A, while 3&3A were lower than 4&4A. Depression was lower in 2A than 3, 3A, and 3V, and lower in 2A than 4A. Anxiety was lower in 2A than in 4&4A. Study limitations: Relatively small number of patients, who were from a single center. Conclusions: In the management of androgenetic alopecia, it should be considered that patients may need psychological support according to the clinical stages, because of increased tendency to develop psychosexual disorders.