Paraphilias, Sociodemographic and Forensic Profiles of Men Convicted of Sexual Offenses in Turkey.

This study investigated the psychiatric, paraphilic, and forensic profiles of men who were convicted of sexual offenses. It also examined childhood trauma exposure in the group with potential paraphilia. The study was performed in the closed prison located in the Istanbul Silivri Penal Institutions Campus. The interview data of 100 men convicted of sexual offenses were obtained from the psychiatric interview notes based on the DSM-5 criteria, the results of the 28-item Childhood Trauma Questionnaire administered to the participants with paraphilia, and the forensic profiles from examination files. It was found that 39% of individuals were drug users and 36% were alcohol users. Considering the crime scenes, 42% of men convicted of sexual offenses committed the offense in their own house. Pedophilia was the most common among men with paraphilia (59%). The victim age was significantly lower (p < .001), and the male victim ratio was higher (p < .05) in the group with paraphilia than in the group without paraphilia. Sexual offenses against children aged 10 years and below and against males may be suggestive of paraphilia and an increased risk of recidivism.

Lymphocyte-related ratios, systemic immune-inflammatory and systemic inflammatory response index in alcohol use disorder.

Addictive disorders are associated with systemic and central nervous system inflammation, which may be important for the onset and development of these diseases. Although lymphocyte-related parameters have recently been studied in alcohol use disorder (AUD), systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) haven't. Lymphocyte-related ratios, SII and SIRI levels were evaluated between AUD and healthy controls (HC) in this study. It was a retrospective and cross-sectional study. This study included 72 patients with AUD and 184 individuals in the HC group. Lymphocyte related ratios such as neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR) and platelet to lymphocyte ratio (PLR), SII and SIRI values were compared. Compared to HC group, NLR (p < 0.001), MLR (p < 0.001), and SIRI (p < 0.001) levels were significantly higher in AUD group. There was also a significant relationship between NLR and AST/ALT ratio in the AUD group (p = 0.022). The results of this study support that AUD is a chronic inflammatory psychiatric disorder. In addition, it may be useful to evaluate these markers in relation to liver enzymes in patients with AUD, as alcohol consumption causes liver damage. These markers may also be used in future studies to assess treatment response and disease severity.

Effects of Sexual Myths and Intimate Partner Violence on Women's Sexual Self-Schemas.

Sexual self-schemas (SSSs) are cognitive generalizations about one's sexual aspects. The aim of this study was to explore the possible effects of intimate partner violence (IPV) and the sexual myths about sexual behavior or roles on women's sexual self-schemas. The research had a cross-sectional and observational design. Fifty women from a psychiatry outpatient clinic between the ages of 18-50 were given the Sexual Self-Schema Scale, sexual myths questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, Golombok-Rust Inventory of Sexual Satisfaction, and Domestic Violence Against Women Scale. A significant relationship was found between the duration of marriage (years) and "Direct/Outspoken" schema (p = .020, r = 0.29). This schema was also correlated with emotional (p = .037, r = - 0.29), total violence score (p = .028, r = - 0.27), and sexual myth score (p = .033, r = 0.26). After the regression analysis, it was observed that the effect of emotional violence and sexual myth score on the "Direct/Outspoken" schema remained significant. Correcting sexual myths through sexual education can make women's SSSs into positive way. In addition, interventions can be made to increase SSSs positively in women exposed to IPV. It is recommended that clinicians take a holistic approach by questioning the sexual functions and schemas of women in addition to IPV in women who experience it and have depression or anxiety disorders. As a policy implication, education about women's rights and sexuality should also be given. Adequate psychological support should be provided to reduce the impact of IPV on SSS.

MAY PPAR GAMMA BE SIGNIFICANT IN BIPOLAR DISORDER ONLY IN THE PRESENCE OF METABOLIC SYNDROME?

BACKGROUND: Peroxisome proliferator-activated receptor γ (PPARγ) has a key role in regulating both neurogenesis and various metabolic processes, including adipogenesis and glucose homeostasis. In this study, it was aimed to compare the serum PPARγ levels and metabolic syndrome (MetS) parametres of patients with Bipolar Disorder (BD) diagnosed manic-depressive-euthymic episodes with those of healthy subjects. SUBJECTS AND METHODS: We included 121 male patients with BD type I, 44 in mania, 35 in depression and 42 in euthymic state, and 41 healthy controls. Serum PPARγ levels, inflammation indicators (CRP, neutrophil, leukocyte, and albumin) and Mets parametres were measured. RESULTS: There were no statistically significant differences between the groups in terms of PPARγ values. PPARγ serum level is highest in the control group and then euthymic, manic and depressive episodes continue to decrease, respectively. However, there was a significant difference between the depressive group with MetS and without MetS in terms of serum PPARγ levels. A statistically significant correlation was found between PPARγ and the other serum markers such as low-density lipoprotein (p=0.022), HbA1c (p=0.002), neutrophils levels (0.001), white blood cell (p=0.025), and clinical features such as age at first treatment (p=0.024), age at first episode (p=0.039), and smoking (0.013). CONCLUSIONS: We suggest that PPARγ may be a key factor in the BD depressive group with MetS. Not finding any relationship between the PPARγ levels and the episode of BD may be related with the absence of MetS in the individuals. MetS parametres must also be considered if PPARγ is to be evaluated in the future investigations.

Double-Edged Sword: A Case with Withdrawal-Emergent Dyskinesia. / Iki Ucu Keskin Biçak: Nöroleptik Kesilmesiyle Gelisen Diskinezi Olgusu.

Tardive dyskinesia is defined as involuntary athetoid or choreiform movements that develop due to the use of neuroleptic drugs for at least a few months. Tongue, lower face, jaw, upper and lower extremities are the most affected parts of the body in tardive dyskinesia. Quality of life is negatively affected because of the low remission rates. Besides tardive dyskinesia, involuntary movements may appear after discontinuation, change or a reduction in the dose of antipsychotic medications, which is called withdrawal-emergent dyskinesia (WED). Unlike tardive dyskinesia, the involuntary movements involve mainly the neck, trunk, and limbs and regress in shorter period of time in WED. A consensus has not yet been reached for the treatment of WED. Restarting the previous antipsychotic agent with slow titration or switching to an atypical antipsychotic with low affinity for dopamine D2 receptors are among the primary options for treatment. As WED is one of the predictors of tardive dyskinesia development, early detection and treatment is believed to have positive effect on the quality of life. In this report, the case of a patient followed up for bipolar disorder type I (BD-I) and started on clozapine for WED after discontinuation of haloperidol on account of adverse effects is discussed. It is necessary for clinicians to consider these types of complications when discontinuing or changing treatment. Further research is needed in order to reach a common approach for the treatment of WED.

Could Weight Loss During Clozapine Therapy be an Indicator of Poor Response?: A Case Report. / Klozapin Tedavisi ile Kilo Kaybi Tedaviye Zayif Yanitin Göstergesi Olabilir mi?: Olgu Sunumu.

Even though effectiveness of clozapine on treatment resistant schizophrenia has been repeatedly demonstrated, it is also associated with many adverse effects including weight gain. Curiously, significant weight loss may occur in some patients. In this case report we discussed whether the observed weight loss could be a negative prognostic factor. The 56 year-old male patient, followed up with the diagnosis of schizophrenia for 20 years, had persistent positive and negative symptoms despite concurrent use of different antiypsychotics. He was diagnosed with treatment-resistant schizophrenia and started on clozapine with dose titration to 500 mg/day over 3 months. He was observed to have lost 17.6% of his initial body weight after 7 months of therapy. The Positive and Negative Syndrome Scale (PANSS) score of the patient did not change significantly. There are a few case reports in the literature on weight loss during clozapine therapy. Some proposed that the weight loss could be a sign of weak response to treatment which is based on the observation that the clinical response might be poor when there is a weight loss and no change in blood triglyceride levels is observed with the treatment. There is a need for more case-control and preclinical studies to explain the mechanisms underlying weight loss and weak response to clozapine therapy in schizophrenia.

Resolvin D1 as a novel anti-inflammatory marker in manic, depressive and euthymic states of bipolar disorder.

Background: Resolvin D1 (RvD1) is a soluble mediator, which is the metabolite of docosahexaenoic acid (DHA), an omega-3 fatty acid. It is thought that RvD1 may contribute to the etiology of bipolar disorder (BD) because of its anti-inflammatory and antidepressant effect. In this study, it was aimed to compare the serum RvD1 levels of patients with BD diagnosed manic-depressive-euthymic episodes with those of healthy subjects. The secondary objective of this study is to investigate the relationship between RvD1 measures and inflammatory markers.Methods: We included 121 male patients with BD type I, 44 in a mania, 35 in depression and 42 in euthymic state, and 41 healthy controls. Serum RvD1 levels and inflammation indicators (CRP, neutrophil, leukocyte, and albumin) were measured.Results: When the RvD1 values of patients were compared, the median (interquartile range) RvD1 value was 11.2 (5.2) for manic patients, 11.2 (6.6) for depressive patients, 9.6 (5.6) for euthymic patients and 8.4 (7.7) for the control group. There were statistically significant differences between the groups in terms of RvD1 values (p < .001). After adjustment for age and current state with ANCOVA, there were statistically significant differences between manic vs. control groups and depression vs. control groups (p < .001, p=.047). Also mean CRP measures (p=.029) and neutrophil counts (p=.009) were significantly correlated with log transformed RvD1 levels.Conclusions: Our results of increased anti-inflammatory RvD1 during manic and depressive states suggest RvD1 may serve as a delayed resolvent possibly improving inflammatory imbalance. Further research is needed to confirm our findings.