Effect of Hypnosis on Pain, Anxiety, and Quality of Life in Female Patients with Fibromyalgia: Prospective, Randomized, Controlled Study.

This prospective, randomized, controlled study aimed to investigate the effects of standardized adjuvant hypnosis on pain, depression, anxiety, aerobic exercise practices, quality of life, and disease impact score in female patients with fibromyalgia syndrome (FMS). This study included 47 female patients with FMS who had been under treatment for at least six months. The hypnosis group (n = 24) received a total of three hypnosis sessions and was taught to patients' self-hypnosis. The patients in this group practiced self-hypnosis for six months. During this period, all patients also continued their medical treatment. The Visual Analogue Scale (VAS) was used to determine the intensity of pain. At the end of the six-month follow-up period, it was determined that the patients of FMS with hypnosis therapy had lower pain intensity, FMS symptoms, depression, and anxiety symptoms, and better well-being than those in the control group (p < .05). Standardized hypnosis is an effective method in reducing pain, depression and anxiety symptoms and improving quality of life in patients with FMS.

Personality Traits Interact With Sleep and Biological Rhythm in Patients With Bipolar Disorder.

ABSTRACT: Sleep disturbances and circadian rhythm changes in bipolar disorder (BD) may have behavioral components as well as biological components. This study aimed to examine the relationship between personality traits, sleep and circadian rhythm in BD. A total of 150 participants with BD, and 150 healthy controls completed the Big Five Personality Test-50 (B5PT-50-TR), Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN), Functioning Assessment Short Test (FAST), Pittsburgh Sleep Quality Index (PSQI), Young Mania Rating Scale and Beck Depression Inventory. In the BD group, B5PT-50-TR emotional stability and openness subscale scores were significantly lower in comparison with the healthy control group. Agreeableness and emotional stability subscales were covariates for the BRIAN sleep subscale and emotional stability was a covariate for PSQI total score. Emotional instability might be a vulnerability factor for sleep disorders and biological rhythm abnormalities in BD. Improvement in emotional instability may relieve sleep disorders and biological rhythm, thereby leading to better treatment outcomes in BD.

Evidence for the Association between Chronotype and Lifelong Premature Ejaculation.

PURPOSE: This study aimed to investigate the relationships between intravaginal ejaculatory latency time (IELT), severity of disease, and chronotype in lifelong premature ejaculation (PE). MATERIALS AND METHODS: Evaluation was made of 114 males with PE and 103 healthy individuals, and comparisons were made of self-estimated IELT, Arabic Index of Premature Ejaculation (AIPE), Pittsburg Sleep Quality Index (PSQI), and Morningness-Eveningness Questionnaire (MEQ). RESULTS: The frequency of morningness chronotype (78.1%) was significantly higher, and Morningness-Eveningness Questionnaire (MEQ) scores were negatively correlated with both IELT (r = -0.490, p < 0.001) and Arabic Index of Premature Ejaculation (AIPE) scores (r = -0.639, p < 0.001) in the PE group. MEQ scores significantly predicted IELT (t = -2.465, p = 0.015) and AIPE scores (t = -4.003, p = 0.000) in the PE group but not in the control group. CONCLUSION: It can be asserted that morningness chronotype is more common, and ejaculatory latency time and PE severity are associated with chronotype in males with PE.

Evidence for the atherogenic index of plasma as a potential biomarker for cardiovascular disease in schizophrenia.

BACKGROUND: Schizophrenia is known to be accompanied with increased cardiovascular mortality, which causes reduced life expectancy. AIM: The aim of the current study was to investigate if atherogenic index of plasma (AIP) could be a good marker in assessing cardiovascular disease (CVD) risk in patients with schizophrenia. METHODS: Patients with schizophrenia (n = 328) and healthy controls (n = 141) were recruited. Schizophrenia patients were evaluated according to the presence of antipsychotic (AP) drug use as AP(+)Sch group and AP(-)Sch group. Atherogenic indices, such as AIP, Castelli's risk index-I (CRI-I), Castelli's risk index-II (CRI-II), and atherogenic coefficient (AC), were calculated according to the laboratory examination of serum lipid parameters. RESULTS: According to the comparison of serum lipid levels, triglyceride (TG) levels were found to be highest and high-density lipoprotein-cholesterol levels were lowest in AP(+)Sch group than AP(-)Sch group and control group (CG) (p < 0.001). AIP, CRI-I, and CRI-II scores were found to be significantly higher in AP(+)Sch group than AP(-)Sch group, and in AP(-)Sch than healthy controls (p < 0.001). Mean AC scores were higher in AP(+)Sch group than both AP(-)Sch and CG and were similar in AP(-)Sch and control subjects (p < 0.001). According to the correlation analysis, AIP scores were positively correlated with duration of disease (r = 0.235; p = 0.002) and age (r = 0.226; p = 0.003) in AP(+)Sch group but not in drug-free subjects. In all groups, atherogenic indices of CRI-I, CRI-II, and AC scores were found to be positively correlated with AIP scores (p < 0.001). CONCLUSION: Our results suggest that AIP is an easily calculable and reliable marker for determining the CVD risk in both drug-free schizophrenia patients and patients under AP treatment.

Early Maladaptive Schemas, Depression, Distress and Discomfort Tolerance in Migraine Headache

ABSTRACT Background: Depression and maladaptive schemas were found to worsen the pain experience in individuals with chronic pain. Objectives: The aim of the present study was to evaluate the relationship between depressive symptoms, early maladaptive schemas, distress and discomfort tolerance in female patients with migraine. Methods: Seventy eight female migraine patients(37 depressed and 41 non-depressed subjects according to BDI scores) and 55 healthy controls were evaluated with Numeric Pain Rating Scale(NPRS),Beck Depression Inventory(BDI),Young Schema Questionnaire-Short Form-3(YSQ-SF-3),Discomfort Intolerance Scale(DIS) and Distress Tolerance Scale(DTS). Results: Distress and discomfort tolerance were lower in both migraine groups than control subjects. EMSs were higher in depressed migraine patients than in non-depressed migraine group and non-clinical controls. A positive correlation between BDI and YSQ-SF-3 scores(p<0.001), a negative correlation between BDI and DIS(p<0.01), and also a negative correlation between BDI and DTS(p<0.001) were found among migraine patients. Hierarchical regression analysis revealed that 20% of the depressive symptoms were explained with DIS scores, while explanatoriness raised up to 46% by addition of YSQ-SF-3 scores to the model. Discussion: Cognitive interventions for modifying EMSs and improving distress and discomfort tolerance might be added to the treatment strategies in female migraine patients.

Type D Personality is Associated With Disease Severity and Poor Quality of Life in Turkish Patients With Fibromyalgia Syndrome: A Cross-Sectional Study.

OBJECTIVES: This study aims to investigate the rate of type D personality in Turkish patients with fibromyalgia (FM) and evaluate its associations with clinical parameters of FM as well as its effects on health-related quality of life (HRQoL). PATIENTS AND METHODS: The study included 100 patients with FM (14 males, 86 females; mean age 34.6±7.4 years; range, 22 to 49 years) fulfilling 1990 American College of Rheumatology diagnostic criteria and 50 healthy controls (9 males, 41 females; mean age 32.6±6.5 years; range, 21 to 50 years). Type D personality was assessed using the type D scale-14 (DS-14). FM disease severity was determined by Fibromyalgia Impact Questionnaire (FIQ), functional status by Stanford Health Assessment Questionnaire (HAQ), and HRQoL by Nottingham Health Profile (NHP). Severity of pain and fatigue were measured by visual analog scale (VAS). RESULTS: The frequency of type D personality was 33% in FM patients and 12% in controls (odds ratio=3.612, 95% confidence interval 1.398-9.333) (p=0.006). Type D FM patients scored higher in tender point count (TPC), FIQ, HAQ, VAS-pain and all NHP subgroups except energy (p<0.01). Type D personality was found to be correlated with FIQ, TPC, HAQ, VAS-pain and NHP subgroups except energy (p<0.01). CONCLUSION: Based on our findings, assessment of personality characteristics of patients with FM may hold the key for the treatment of the disease. Besides, a better understanding of personality-related pain in FM patients may provide a more targeted approach to pain treatment.

Psychopathology in Violent Offenders Against Healthcare Workers.

Workplace violence in healthcare is gradually becoming a major concern in many countries around the world and research has usually been focused on the victims of violence. The aim of this study was to investigate the psychopathology of individuals who commit violence against healthcare workers. The study included 50 subjects (patient or relative of patient) aged 18-65 years who had committed violence against a healthcare worker (study group) and a control group of 55 subjects with no history of violence. A Sociodemographic Questionnaire, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Barratt Impulsiveness Scale (BIS-11), State-Trait Anger Expression Inventory (STAXI), and Eysenck Personality Questionnaire-Revised Short Form (EPQ-RSF) were administered to both the study group and the control group. A psychiatric disorder was diagnosed in 50% of the violent offenders group and in 16.4% of the control group. It was determined that 54.8% of the patient relatives and 44.4% of the patients themselves who committed a violent act against healthcare workers had at least one psychiatric diagnosis and these rates did not differ between the patients and their relatives (χ2 = 0.492, p = 0.483). Comparisons of the scale scores between the groups revealed that the STAXI scores (p < .001), BIS-11 total scores (p < .001), BDI, and BAI scores were statistically significantly higher in the violent offenders group. Considering the higher rates of psychiatric disorders and higher levels of anger and impulsivity among people who commit violent acts against healthcare workers, psychotherapeutic interventions such as stress and anger management interventions, improvement of interaction and communication between patients, their relatives and healthcare workers, and the implementation of rehabilitating punitive programs for violent offenders may be beneficial to reduce the rates of violent behavior against healthcare workers.

Symptoms of swallowing anxiety in panic disorder patients and associated psychopathologic factors.

AIM: The aim of this study was to investigate symptoms of swallowing difficulty in Panic Disorder (PD) patients and the factors associated with these symptoms. METHODS: In the pre-phase of the study, 22 PD patients who were treated in psychiatry outpatient clinics and who were found to have swallowing difficulty were evaluated. PD patients were asked to write about their thoughts, feelings and behaviors associated with swallowing difficulty. Later, these texts were examined and 41 expressions were identified in which patients described their swallowing difficulty. These expressions were evaluated by mental health workers in the field and twelve different swallowing difficulty items were defined. In the main phase of the study, 119 PD outpatients were evaluated using twelve different swallowing difficulty items and psychometric tests [Panic and Agoraphobia Scale (PAS), Separation Anxiety Symptom Inventory (SASI), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI-1/STAI-2)]. RESULTS: As a result of the validity and reliability analysis, a valid one-factor instrument with ten items was obtained. Cronbach's alpha value for this measurement tool was 0.89 and it was termed the "Swallowing Anxiety Scale (SAS)". It was found that SAS items "always" accompany PD patients at rates of 5-20.2%. According to hierarchical regression analysis, 35% of SAS scores were explained by PAS, SASI, STAI-2 and BDI scores. CONCLUSION: Swallowing difficulty items in PD patients involved anxious, phobic and somatic symptoms associated with swallowing. In addition, swallowing difficulty symptoms in PD patients can be confounded with eating disorder symptoms.

Examination of personality traits and social problem-solving skills of individuals whose driving licenses have been confiscated due to drunk driving.

OBJECTIVE: Drunk driving is one of the major behavioral issues connected with problematic alcohol consumption. The objective of this study was to evaluate the relationship between personality traits and social problem-solving skills of individuals who drive while intoxicated. METHOD: One hundred forty-four individuals apprehended twice while driving drunk and sent to a driver behavior training program (9 females and 135 males) participated in our study. The Eysenck Personality Questionnaire Revised-Abbreviated (EPQ-RA) composed of 4 subscales (Extroversion, Neuroticism, Psychoticism, and Lying) and the Social Problem Solving Inventory (SPSI) composed of 7 subscales (Cognitive, Emotion, Behavior, Problem Definition and Formulation, Creating Solution Options, Solution Implementation and Verification, and Decision Making) were used to evaluate the participants. RESULTS: A positive relationship was found between the Extroversion subscale of the EPQ-RA and the Cognition subscale (P <.01), Emotion subscale (P <.01), Behavior subscale (P <.01), Generation of Alternatives subscale (P <.01), Decision Making subscale (P <.05), and Solution Implementation and Verification subscale (P <.01). For individuals who repeated intoxicated driving, all subscales of the EPQ-RA (Extroversion, Lying, Neuroticism, and Psychoticism subscales) explained 12% of the scores of the Cognition subscale and 16.2% (P <.001) of the Emotion subscale of the SPSI. There was no significant relationship between the first and second incident alcohol blood levels (P >.05). CONCLUSION: Drinking and driving behaviors appear to be negative or maladaptive behaviors closely related to personality traits and may represent an effort to avoid negative emotions. Evaluation of negative emotions may have an important place in training programs intended to change drunk driving behavior.

Acute dystonia after using single dose duloxetine: case report.

Duloxetine is a balanced and potent serotonin and noradrenaline reuptake inhibitor which is known to be effective in depression and anxiety disorders. The common adverse effects include dry mouth, nausea, insomnia, somnolence, dizziness and constipation. Reported adverse effects of the extra pyramidal symptoms (EPS) are rare. In this case, a patient who suffered from acute dystonia, after only one dose of 30 mg duloxetine is presented.

The relationship between metacognitions and insight in obsessive-compulsive disorder.

This study aimed to determine the relationship between metacognitions and insight in obsessive compulsive disorder. One hundred individuals who had been diagnosed according to "Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision" criteria as having obsessive compulsive disorder and 50 healthy controls are included in the study. A sociodemographic and clinical data form, the Yale-Brown Obsession and Compulsion Scale and the Beck Depression Inventory were given to the participants. Insight is assessed by the 11th item of the Yale-Brown Obsession and Compulsion Scale. The Metacognition Questionnaire-30 was administered to both the obsessive compulsive disorder and the control groups to assess metacognitions. We found that the metacognition scores were statistically different in all groups and that the metacognition scores were higher in the obsessive compulsive disorder with good insight group than in the obsessive compulsive disorder with poor insight and control groups. In the obsessive compulsive disorder with poor insight group, all of the metacognition subscale scores were lower than those in the obsessive compulsive disorder with good insight group. Our findings elucidate the relationship between metacognitions and insight in obsessive compulsive disorder.