Association of Orthorexic Tendencies with Obsessive-Compulsive Symptoms, Eating Attitudes and Exercise.

PURPOSE: The term orthorexia nervosa is used to describe the pathological fixation associated with consuming healthy food. It is assumed that orthorexia nervosa shares some phenomenological features with anorexia nervosa, obsessive-compulsive disorder (OCD), and other mental disorders. Individuals with orthorexic tendencies may have high physical activity as well as a healthy diet. This study aimed to investigate the relationship of orthorexia nervosa with obsessive-compulsive symptoms, eating attitudes, and several sociodemographic features. PATIENTS AND METHODS: We included 63 patients diagnosed with OCD, 63 healthy volunteers who perform physical exercises at least three days a week, at least 30 minutes a day, and 63 healthy volunteers who do not perform physical exercises regularly. Sociodemographic data form, Yale-Brown Obsessive Compulsive Scale, ORTO-11 Scale, Eating Attitude Test, Hamilton Anxiety Scale, and Structured Clinical Interview for DSM-5 Disorders (SCID-5 CV) were administered to all participants. OCD data form was also applied to patients with OCD diagnosis. RESULTS: We found a statistically significant relationship between current order-symmetry obsessions and orthorexic tendencies in patients with OCD (p<0.05). There was no relationship between the severity of the disorder and orthorexia nervosa in patients with OCD (p>0.05). Orthorexic tendencies were found to increase as impaired eating attitudes increased in participants who regularly performed physical exercises and patients with OCD (p<0.05). The orthorexic tendencies of participants who regularly performed physical exercises were higher than those diagnosed with OCD and healthy individuals who did not perform physical exercises. CONCLUSION: The absence of a significant relationship between disorder severity and orthorexia nervosa in patients diagnosed with OCD and the increase in orthorexic tendencies as the deterioration in eating attitudes increases in both patients with OCD and the participants who regularly perform physical exercises suggest that orthorexia nervosa may be closer to the eating disorders group than obsessive-compulsive spectrum. Studies with large samples and different diagnoses are needed to determine the place of orthorexia nervosa in diagnosis and classification systems.

Assessment of Dyadic Adjustment and Sexual Functions in Patients with Bipolar Disorder.

INTRODUCITON: There are limited studies investigating the relation between dyadic adjustment, and sexual functions. The aim of this study was to compare patients with bipolar disorder (BD) in euthymic phase with healthy controls, and confirm our hypothesis which we expect to find that dyadic adjustment is negatively affected in bipolar patients with sexual dysfunctions (SDs). METHODS: A total of 50 euthymic bipolar patients (32 female, 18 male), and 50 healthy individuals as a control group (27 female, 23 male) were included in the study. A data form for socio-demographic features and two other forms for clinical characteristics of bipolar disorder and sexual functions have been filled by clinician. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-4) Axis I was used to determine axis I psychiatric disorders. All patients completed Golombok Rust Inventory of Sexual Satisfaction (GRISS), and Dyadic Adjustment Scale (DAS). RESULTS: Twenty-five (50%) of bipolar patients, and 13 (48.8%) of healthy controls were found to have SDs. There was a significant difference between bipolar patients, and healthy controls in regard to the presence of SDs (p=0.013). Dissatisfaction, communication, and anorgasmia subscale scores, and total scores of GRISS was found to be higher in female patients with BD. Intercourse frequency, impotence and premature ejaculation subscale scores and total scores of GRISS were higher in male patient group than healthy controls. When bipolar patients and healthy controls were compared, there was a significant difference between dyadic cohesion and affectional expression scores as measured by DAS. As a result of the univariate and regression analyzes, it was determined that the variable affecting the dyadic adjustment in bipolar patients was affected by sexual dysfunction rather than disease presence. CONCLUSION: The results of this study have shown that the prevalence rate of SDs is higher in bipolar patients than healthy individuals. It was determined that the variable affecting the dyadic adjustment of patients with BB was affected by sexual function rather than disease presence. The presence of SDs in bipolar patients have negative effects on dyadic adjustment.

The Value of Etiological Tests and Skin Biopsy in the Management of Prurigo Simplex Subacuta.

It has been emphasized that prurigo simplex subacuta may be associated with various disorders and may be clinically confused with dermatitis herpetiformis. Aim of the study was to evaluate the value of our set of tests for finding possible associations and for the aforementioned differential diagnosis. Rates of implementations and abnormal results in our set of tests, including skin prick test, skin biopsy, complete blood count, blood chemistry panel, and psychiatric evaluation were analyzed retrospectively between the years of 2010 and 2015 in 130 patients clinically diagnosed with prurigo simplex subacuta. The set of tests was implemented completely in 43.8% patients and with only a single missing test in 31.5% of the patients. The least implemented procedure was psychiatric evaluation (66.9%). The most commonly found issues were psychiatric abnormalities (55.2% of 87 psychiatrically evaluated patients) and atopy (53.8% of 104 skin prick tested patients). The most common finding suggestive of internal diseases was hyperglycemia (25.4% of 130 patients). It was a striking result that hematological malignancies were suspected upon complete blood count and peripheral blood smear and confirmed by further investigations in 4 of 102 patients. Dermatitis herpetiformis was diagnosed in 2 of 120 skin biopsied patients. Because of the substantial rate of implementation, the high frequencies of psychiatric abnormalities and atopy, and detection of hematological malignancies and dermatitis herpetiformis even in just a few patients, we recommend our set of tests for patients clinically diagnosed as prurigo simplex subacuta.

Impulse control disorder comorbidity among patients with bipolar I disorder.

OBJECTIVE: Impulsivity is associated with mood instability, behavioral problems, and action without planning in patients with bipolar disorder. Increased impulsivity levels are reported at all types of mood episodes. This association suggests a high comorbidity between impulse control disorders (ICDs) and bipolar disorder. The aim of this study is to compare the prevalence of ICDs and associated clinical and sociodemographic variables in euthymic bipolar I patients. METHOD: A total of 124 consecutive bipolar I patients who were recruited from regular attendees from the outpatient clinic of our Bipolar Disorder Unit were included in the study. All patients were symptomatically in remission. Diagnosis of bipolar disorder was confirmed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Impulse control disorders were investigated using the modified version of the Minnesota Impulsive Disorders Interview. Impulsivity was measured with the Barratt Impulsiveness Scale Version 11. Furthermore, all patients completed the Zuckerman Sensation-Seeking Scale Form V. RESULTS: The prevalence rate of all comorbid ICDs in our sample was 27.4% (n = 34). The most common ICD subtype was pathologic skin picking, followed by compulsive buying, intermittent explosive disorder, and trichotillomania. There were no instances of pyromania or compulsive sexual behavior. There was no statistically significant difference between the sociodemographic characteristics of bipolar patients with and without ICDs with regard to age, sex, education level, or marital status. Comorbidity of alcohol/substance abuse and number of suicide attempts were higher in the ICD(+) group than the ICD(-) group. Length of time between mood episodes was higher in the ICD(-) group than the ICD(+) group. There was a statistically significant difference between the total number of mood episodes between the 2 groups, but the number of depressive episodes was higher in the ICD(+) patients as compared with the ICD(-) patients. There was no statistically significant difference between the age of first episode, seasonality, presence of psychotic features, and chronicity of illness. A statistically significant difference was observed between the ICD(+) and ICD(-) groups in terms of total impulsivity, attention, nonplanning, and motor impulsivity scores as determined by the Barratt Impulsiveness Scale Version 11. CONCLUSION: The present study revealed that there is a high comorbidity rate between bipolar disorder and ICDs based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria. Alcohol/substance use disorders, a high number of previous suicide attempts, and depressive episodes should alert the physician to the presence of comorbid ICDs among bipolar patients that could affect the course and treatment of the disorder.

Comorbidity of adult attention-deficit hyperactivity disorder and bipolar disorder: prevalence and clinical correlates.

The aim of this study was to determine the frequency of adult attention deficit hyperactivity disorder (ADHD) comorbidity with lifetime bipolar disorder, and the influence of this comorbidity on various demographic and clinical variables in patients. Patients (n=159) with a previous diagnosis of bipolar disorder (79 female, 80 male) were included in this study. All patients were interviewed for the presence of current adult and childhood ADHD diagnosis and other axis I psychiatric disorder comorbidities using the structured clinical interview for DSM-IV (SCID) and the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL). The subjects also completed a Wender Utah rating scale (WURS-25) and a Current Symptoms Scale for ADHD symptoms. In particular, patients' clinical characteristics, the age of onset of bipolar disorder, and the number of episodes were noted. Twenty-six of the 159 bipolar patients (16.3%) were diagnosed with adult ADHD, while another subgroup of patients (n=17, 10.7%) received a diagnosis of childhood ADHD but did not fulfill criteria for adult ADHD. Both of these two subgroups (patients with adult ADHD, and patients with only childhood ADHD) had an earlier age of onset of the disease and a higher number of previous total affective or depressive episodes than those without any lifetime ADHD comorbidity. However only bipolar patients with adult ADHD comorbidity had higher lifetime comorbidity rates for axis I psychiatric disorders, such as panic disorder and alcohol abuse/dependence, compared to patients without lifetime ADHD. Bipolar patients with comorbid adult ADHD did not differ from bipolar patients with comorbid childhood ADHD in terms of any demographic or clinical variables except for adult ADHD scale scores. In conclusion, ADHD is a common comorbidity in bipolar patients, and it adversely affects the course of the disease and disrupts the social adjustment of the patients. Regular monitoring of ADHD will help to prevent problems and complications that could arise in the course of the disease, particularly in patients with early onset bipolar disorder.