Facial emotion recognition difficulties may be specific to skin picking disorder, but could also be related to the presence of alexithymia in trichotillomania

Background and objectives. Previous research has shown high rates of alexithymia and emotion dysregulation in trichotillomania (TTM) and skin picking disorder (SPD). Unfortunately, there are no data on facial emotion recognition (FER) in TTM and SPD. The present study aimed to compare patients with TTM and SPD and a healthy control group for the severity of alexithymia and rates of FER. Methods. Forty patients with SPD, 30 patients with TTM, and 30 healthy controls were enrolled in this study. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Clinical Global Impression (CGI), Toronto Alexithymia Scale (TAS-20), and the Facial Emotion Recognition Test were applied to the participants. Results. Patients with TTM and SPD had less FER accuracy and higher alexithymia scores compared with healthy controls. According to ANCOVA analysis, when anxiety, depression, and alexithymia were fixed as covariates, disgusted facial expressions and total facial emotion recognition were still significantly lower in patients with SPD compared with the control group, but there was no difference between the TTM and control groups and TTM and SPD groups. Conclusion. Alexithymia rates were high in patients with TTM and SPD. Interestingly, difficulty in recognizing disgusted facial expressions may be a distinctive sign in SPD. Future neuroimaging studies are needed to support possible FER impairment in patients with TTM/SPD.

Can miRNA Expression Levels Predict Treatment Resistance to Serotonin Reuptake Inhibitors in Patients with Obsessive-Compulsive Disorder?

Background: Obsessive-compulsive disorder is a psychiatric disorder with different clinical manifestations caused by the interaction of genetic and environmental factors. Recently, it has been shown that microRNAs play a role in the pathogenesis of some psychiatric diseases. We aimed to compare the expression levels of microRNAs between obsessive-compulsive disorder patients and healthy controls and investigate the association between miRNA expression levels and treatment resistance. Methods: Twelve miRNA expression levels in venous blood of 100 obsessive-compulsive disorder patients and 50 healthy controls were detected by real-time polymerase chain reaction. Patients were assessed using the Hamilton Depression Rating Scale, Yale-Brown Obsessive-Compulsive Scale, and Yale-Brown Obsessive-Compulsive Symptom Checklist. Each patient was scheduled for a monthly follow-up for a minimum 6-month-period after serotonin receptor inhibitor treatments were initiated. Results: We found that miR-26a-5p (P < .001), miR-21-3p (P < .001), miR-219a-1-3p (P = .016), miR-106b-5p (P = .039), miR-6740-5p (P = .020), miR-320a (P = .001), miR-22-3p, and miR-16b-5p (P = .010) expression levels were statistically higher in obsessive-compulsive disorder patients than healthy controls; miR-135a-5p (P < .001) and miR-129-6b-5p (P < .001) expression levels were statistically lower. Also, it was determined that increased miR-106b-5p levels were associated with treatment-resistance (P = .020) and there was a negative correlation between miR-374b-3p and disease severity (P = .042). Conclusion: In obsessive-compulsive disorder, there may be a potential value in the relationship between various miRNA expression levels and treatment resistance and disease severity, and future studies may be beneficial.

Clinical Characteristics and Comorbidities of Patients with Trichotillomania and Skin Picking Disorder Who Admitted to a Psychodermatology Outpatient Clinic: A Comparative Study. / Psikodermatoloji Poliklinigine Basvuran Trikotillomani ve Deri Yolma Bozuklugu Tanili Hastalarin Klinik Özellikleri ve Es Tanilari: Bir Karsilastirma Çalismasi.

OBJECTIVE: Trichotillomania (TTM) and Skin Picking Disorder (SPD) are psychiatric disorders characterized by chronic and compulsive pulling and picking to remove hair and skin. There are very few studies on the clinical and phenomenological differences of TTM and SPD. In this study we aimed to compare the clinical characteristics and comorbidities of patients diagnosed with TTM and SPD. METHOD: We enrolled 56 TTM and 113 SPD patients who were assessed with SCID-I for DSM-IV. In addition, we evaluated the DSM- 5 criteria for Obsessive and Compulsive Disorder spectrum. We also utilized sociodemographic form, the Clinical Global Impression Scale, the Beck Anxiety Inventory and the Beck Depression Inventory. RESULTS: Although patients with TTM and SPD had many common clinical features and comorbidities, statistically significant differences were determined in the number of the pulling/picking sites (Z=- 7.084; p<0.001), the type of the outpatient clinics which they initially consulted (χ2=19.451; p<0.001), reasons for pulling/picking behavior (p<0.05) and comorbidities of depression (χ2=3.878; p=0.049) and onychophagia (χ2=7.173; p=0.007). Disease severity and depression and anxiety scores of patients with TTM and SPD who had comorbid diseases were statistically significantly higher compared to the patients without comorbidities (p<0.005). CONCLUSION: TTM and SPD often present with common clinical characteristics and a high incidence of psychiatric comorbidities. Finding out the clinical characteristics, the triggering factors and determining the comorbidities are important to gain an understanding of the course and determine the appropriate treatment for these disorders. Hence, phenomenological studies on large patient populations are needed.