Reliability and validity of the Turkish version of comprehensive assessment of at risk mental states.

AIMS: To perform the validation of the Comprehensive Assessment at Risk Mental State (CAARMS) in Turkish. METHODS: Sixty-five volunteers (15-24 years) were enrolled in this study. Concurrent validity was performed with Spearman's Correlation Test using Brief Psychiatric Rating Scale (BPRS). Median scores of the groups were compared using Mann-Whitney U Test. Interrater reliability was assessed by intragroup correlation coefficient method. Internal consistency was studied by the calculation of Cronbach Alfa Coefficient. RESULTS: The correlation of the severity scores of the CAARMS with unusual thought content, suspiciousness, hallucinations and conceptual disorganization items of the BPRS showed that the concurrent validity was good. ROC analysis revealed that CAARMS could discriminate between individuals with UHR and healthy volunteers well. We found a good correlation between the raters. Internal consistency was at very high level. CONCLUSION: Analyses of concurrent validity, criterion validity, interrater reliability and internal consistency indicate that the Turkish version is valid and reliable.

Relationship of negative symptom severity with cognitive symptoms and functioning in subjects at ultra-high risk for psychosis.

AIM: Negative symptoms and cognition are related with functioning in schizophrenia. However, it is not clear whether they have a similar effect in individuals at ultra-high risk (UHR) for psychosis. In this study, we aimed to explore relationship of negative symptoms with cognition and functioning cross-sectionally in people with UHR for psychosis. METHODS: In total, 107 people participated in this study. We assessed negative symptoms with Scale for Negative Symptoms (SANS). We applied a cognitive battery including seven tests. We evaluated functioning by using Global Assessment of Functioning Scale and work/study status as an indicator of role functioning. RESULTS: SANS scores were correlated to global functioning cross-sectionally. SANS total score was correlated to cognitive test scores related to cognitive flexibility and attention. Only Trail Making Test B (TMT B) was negatively correlated to global functioning. SANS-affective blunting and SANS-avolition scores were independently related to global functioning. There was a significant indirect effect of the TMT B and composite attention scores on global functioning through negative symptoms indicating a complete mediation. CONCLUSION: Our findings suggest that negative symptoms, particularly avolition have an impact on functioning and the association of cognition with functioning was mediated by negative symptoms in UHR.

Electroconvulsive Therapy in the Treatment of Mood Disorders: One-Year Follow-up.

INTRODUCTION: Electroconvulsive therapy (ECT) is known to be an effective option in the treatment of mood disorders, especially resistant depression. However, the remission achieved by ECT was reported to be not long lasting enough. The aim of the present study was to investigate the relapse/recurrence rates and associated risk factors during the first year after ECT in patients diagnosed with mood disorders. METHODS: In a naturalistic observation, patients diagnosed with unipolar depressive disorder or a depressive episode of bipolar disorder and who had achieved remission by ECT were followed up for at least one year. The patients were evaluated with structured interviews during the follow-up period. The relapse/recurrence rates were the primary outcome measurements, while hospitalization and suicide attempts were the secondary outcome measurements. The remitted and non-remitted patients were compared regarding the clinical features, ECT, and pharmacological variables. RESULTS: Fifty of 62 patients who had achieved remission with ECT completed the one year follow-up period. Thirty-three patients (66%) had relapse/recurrence, while 17 (34%) patients remained in remission. The relapse rates were similar in patients with unipolar depression and bipolar disorders. The mean number of ECT sessions was higher in relapsed patients with bipolar disorders. Multiple episodes were more frequent in non-remitted patients with unipolar depression. Comorbid psychiatric diagnosis was higher in non-remitted patients with unipolar and bipolar disorders. CONCLUSION: The relapse/recurrence rate was found to be fairly high in the first year of follow-up in patients who had achieved remission with ECT. ECT decisions should be made carefully in patients with comorbid psychiatric diagnosis and multiple episodes as these are more risky. The ECT application procedure and successive maintenance treatment (maintenance ECT, pharmacotherapy, and psychotherapy) should be planned to sustain the remission for patients with mood disorders in long-term follow-up.