Validity and Reliability Study of the Turkish Version of the Orbach Mikulincer Mental Pain Scale-8 in a Clinical Population.

Purpose: Suicide is a growing public health issue for all societies; identifying suicide risk is crucial. This study aims to evaluate the psychometric properties of the Turkish version of the Orbach and Mikulincer Mental Pain Scale-8 (OMMP-8), which enables the assessment of suicidality in a short time. Patients and Methods: We conducted this study with 148 individuals diagnosed with major depressive disorder and 130 healthy controls. We administered the Hamilton Depression Scale (HDRS), Beck Hopelessness Scale (BHS), Beck Scale for Suicidal Ideation (BSIS), and Mee Bunney Psychological Pain Assessment Scale (MBPPAS) to all participants. Results: Cronbach's alpha values were 0.96, 0.97, and 0.98 for Factors 1, 2, and 3, respectively, and 0.92 for the entire scale. Exploratory (EFA) and confirmatory factor analyses (CFA) proved the 3-factor structure of the scale. The OMMP-8 total score and HDRS (r = 0.851), BSIS (r = 0.836), BHS (r = 0.825), and MBPPAS (r = 0.881) total scores were statistically significantly correlated, indicating convergent and concurrent validity of the scale. The scale successfully discriminated between depression and control groups (89.6%) and participants with and without suicide attempts in the depression group (82.4%). Conclusion: This study demonstrates that the Turkish version of the OMMP-8 scale is valid and reliable for both individuals with depression and healthy controls and can be used in studies investigating suicide risk.

Associations Between the Suicidal Ideation and the Tolerance for Psychological Pain and Tolerance for Physical Pain in Patients Diagnosed with Major Depressive Disorder.

Purpose: Patients with major depressive disorder (MDD) may experience more frequent and severe psychological and physical pain complaints compared to those without depression. As the tolerance to psychological pain decreases in patients with MDD, the severity of suicidal ideation tends to increase. Furthermore, the tolerance for physical pain (TPP) has been related with suicidal behavior. We aimed to demonstrate the impact of TPP on suicidal ideation in patients with MDD in the presence of psychological pain. Patients and Methods: We included 123 patients with MDD and 114 healthy volunteers who had no previous psychiatric diagnosis. Sociodemographic data form, Psychache Scale (PS) and Tolerance for Mental Pain Scale (TMPS) were used to assess psychological pain. Beck Scale for Suicide Ideation (BSIS) and Beck Depression Inventory (BDI) were administered to participants. To assess the TPP, we used a device based on the principle of electronic dynamometry. Results: The mean BDI, BSIS, PS, and TPP scores in the MDD group were higher, and the mean TMPS score was lower than those in the control group (p < 0.001 for each, p = 0.03 for TPP). We found statistically significant correlations between BDI, TMPS, BSIS, PS, and TPP scores (p < 0.05 for each). TPP was a partial mediator in the relationship between TMPS and BSIS scores (ß = -1.814; p < 0.001). Conclusion: We found that tolerance of psychological pain was a strong predictor of suicidal ideation, and TPP was mediating this relationship. These findings suggest that considering both tolerance to psychological pain and TPP may be beneficial when assessing the risk of suicide in individuals with MDD.

The relationship of coping skills with psychache in patients with depressive disorder.

Suicide is a leading cause of death and disability worldwide. Psychache (psychological pain) and diminished tolerance of psychaches are important risk factors for suicide. People experiencing psychaches of similar severity may not demonstrate the same levels of tolerance because of various coping skills. This study aimed to determine the relationship between psychache, tolerance for psychache, and coping skills in individuals with depression and healthy controls. We included 73 patients with depressive disorders without comorbid mental disorders and 65 healthy controls. We applied beck depression inventory, beck hopelessness scale, beck suicidal ideation scale, psychache scale, tolerance for mental pain scale (TMPS), and coping attitudes evaluation scale (COPE) to all participants. People with depression had significantly higher COPE dysfunction scores than those in the control group did. Patients who had previously attempted suicide attempt(s) previously had significantly higher beck hopelessness scale, beck depression inventory, COPE dysfunction, and psychache scale scores, and lower TMPS-10 scores than those who did not attempt suicide. Mediation analyses revealed that dysfunctional coping skills played a partial mediating role in the relationship between psychache and the TMPS. The study revealed that dysfunctional coping skills were related to suicidal ideation and previous suicide attempts. These findings suggest that improving coping skills could help reduce the severity of suicidal ideation.

The Relationship among Dyadic Adjustment and Disease Burden in Patients with Bipolar Disorder and Their Spouses.

(1) Background: Spouses of individuals with bipolar disorder (BD) experience significant burdens, and the perception of the burden may affect dyadic adjustment. We aimed to investigate the sexual functions, alexithymic traits, marital satisfaction, and burden in patients with BD and their spouses. We also aimed to assess the mediating role of sexual functions and alexithymia in the relationship between burden and dyadic adjustment. (2) Methods: We included 81 patients with BD type 1 (40.69 ± 8.55 years, 65.4% female, and 34.6% male) and their healthy spouses (40.95 ± 7.30 years, 34.6% female, and 65.4% male) and 78 healthy controls (38.90 ± 5.88, 48.7% female, and 51.3% male). The participants were evaluated using the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), Dyadic Adjustment Scale (DAS), Hamilton Depression Rating Scale (HDRS), Toronto Alexithymia Scale-20 (TAS-20), and Burden Assessment Scale (BAS). (3) Results: The GRISS scores of the control group were significantly lower than the spouses and BD groups. The DAS total score of the control group was significantly higher than that of the spouses and BD groups. Regression analyses revealed that TAS, GRISS, and HDRS scores were associated with DAS scores in the BD group. In the spouse group, TAS and BAS scores were associated with DAS scores. The GRISS scores partially mediated the relationship between dyadic adjustment and burden in the spouses of patients with BD. (4) Conclusions: Mental health professionals should regularly scan caregivers' perceptions of burden. Appropriate psychosocial interventions could help spouses of patients with BD to cope better with the burden and improve dyadic adjustment.

Impact of Childhood Trauma and Adult Separation Anxiety Disorder on Quality of Life in Individuals with Schizophrenia.

Background: Childhood trauma and anxiety disorders are common in individuals with schizophrenia. This study aimed to investigate the effects of childhood trauma and adult separation anxiety disorder on the quality of life of individuals with schizophrenia. Methods: This cross-sectional study included 111 individuals with schizophrenia and 85 control subjects. The separation anxiety symptom inventory (SASI), adult separation anxiety questionnaire (ASAQ), Positive and Negative Syndrome Scale (PANSS), childhood trauma questionnaire (CTQ), and World Health Organization quality of life questionnaire (WHOQoL-BREF) were administered to the participants. Results: More individuals with schizophrenia than control subjects were unemployed and single (p<0.05). Individuals with schizophrenia scored significantly higher on the SASI, ASAQ, and CTQ (p<0.05), whereas the control subjects scored significantly higher on the WHOQoL-BREF (p<0.05). ASAQ scores had mild positive correlations with total PANSS and PANSS subscale scores, and moderate positive correlations with total CTQ, CTQ emotional subscale scores, and CTQ physical abuse subscale scores. A negative moderate correlation was found between ASAQ and total WHOQoL-BREF scores. Mediation analysis revealed that CTQ scores significantly affected total WHOQoL-BREF and ASAQ scores. The model pathway for ASAQ scores showed a significant direct and indirect effect of CTQ on the total WHOQoL-BREF scores. Conclusion: Childhood trauma predicts adult separation anxiety disorder, which partially mediates the impact of childhood trauma on quality of life in individuals with schizophrenia. Therapeutic interventions for adult separation anxiety disorder in individuals with schizophrenia and a history of childhood trauma may help increase their quality of life.

The Relationship Among Autistic Traits, Impulsivity, and Functionality in Patients With Obsessive-Compulsive Disorder.

ABSTRACT: Obsessive-compulsive disorder (OCD) is a chronic mental disorder that causes disabilities. This study investigated the relationship among impulsivity, autistic traits, and disabilities in patients with OCD. We included 88 patients with OCD and 90 healthy volunteers without any mental disorders. The participants were evaluated using the Yale-Brown Obsessive-Compulsive Scale, Autism Spectrum Quotient (AQ), Barratt Impulsiveness Scale-11 (BIS-11), and World Health Organization Disability Assessment Schedule (WHODAS 2.0). Regression analyses revealed that AQ-attention switching and BIS-attentional subscale scores were associated with WHODAS-overall score in the OCD group ( p = 0.017 and p = 0.034, respectively). In the OCD group, AQ total, social skills, and communication subdomain scores partially mediated the relationship between impulsivity and disability. BIS total, attentional, and nonplanning subscale scores partially mediated the relationship between autistic traits and disability. Developing new treatment strategies for cognitive recovery, in addition to traditional treatment approaches in patients with OCD, may help increase functionality in patients with OCD.

Piperazine derivatives with potent drug moiety as efficient acetylcholinesterase, butyrylcholinesterase, and glutathione S-transferase inhibitors.

Cholinesterases catalyze the breakdown of the neurotransmitter acetylcholine (ACh), a naturally occurring neurotransmitter, into choline and acetic acid, allowing the nervous system to function properly. In the human body, cholinesterases come in two types, including acetylcholinesterase (AChE; E.C.3.1.1.7) and butyrylcholinesterase (BChE; E.C.3.1.1.8). Both cholinergic enzyme inhibitors are essential in the biochemical processes of the human body, notably in the brain. On the other hand, GSTs are found all across nature and are the principal Phase II detoxifying enzymes in eukaryotes and prokaryotes. Specific isozymes are identified as therapeutic targets because they are overexpressed in various malignancies and may have a role in the genesis of other diseases such as neurological disorders, multiple sclerosis, asthma, and especially cancer cell. Piperazine chemicals have a role in many biological processes and have fascinating pharmacological properties. As a result, therapeutically effective piperazine research is becoming more prominent. Half maximal inhibition concentrations (IC50 ) of piperazine derivatives were found in ranging of 4.59-6.48 µM for AChE, 4.85-8.35 µM for BChE, and 3.94-8.66 µM for GST. Also, piperazine derivatives exhibited Ki values of 8.04 ± 5.73-61.94 ± 54.56, 0.24 ± 0.03-32.14 ± 16.20, and 7.73 ± 1.13-22.97 ± 9.10 µM toward AChE, BChE, and GST, respectively. Consequently, the inhibitory properties of the AChE/BChE and GST enzymes have been compared to Tacrine (for AChE and BChE) and Etacrynic acid (for GST).

The Mediating Role of Time Perspective in the Relationship between Chronotype and Suicide in Bipolar Disorder.

(1) Background: Suicide in patients with bipolar disorder (BD) is related to the chronotype of the person from a biological perspective. However, it is not known whether there is a relationship between suicide and psychological time in BD. The aim of our study was to evaluate the relationship between time perspective (TP) and suicide and the effect of TP on the relationship between suicide and chronotype in euthymic patients with BD. (2) Methods: We included 150 BD patients and 84 healthy controls in this cross-sectional study. We administered the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), Beck Scale for Suicidal Ideation (BSSI), Zimbardo Time Perspective Inventory (ZTPI), and Morning−Evening Questionnaire (MEQ). (3) Results: There was a statistically significant difference between the median scores of past negative TP, present fatalistic TP, future TP, and MEQ total score (p < 0.001, p < 0.001, p = 0.010, and p = 0.020, respectively). There was a significant correlation between past negative TP, future TP, MEQ scores, and BSSI scores in the patient group (p < 0.001, p = 0.018, and p = 0.028, respectively). An inverse and significant relationship between the MEQ total score and BSSI score and TP types had a mediator role in this relationship. (4) Conclusions: Our study shows that TP, which evaluates time from a psychological perspective, has a direct relationship with suicidal ideation and a mediating role in the relationship between chronotype and suicide. According to our results, we can conclude that ZTPI can also be used to evaluate the risk of suicidality in patients with BD. Appropriate therapy methods for TP may help to prevent some suicide attempts.

Validity and Reliability Study of the Turkish Version of the Unbearable Psychache Scale.

Background: : Suicide is a significant public health issue globally, and psychological pain (psychache) is one of the principal risk factors for suicide. It is suggested that when psychache becomes intolerable, suicide attempts are made to get rid of the pain. This study aims to investigate the reliability and validity of the Turkish version of the Unbearable Psychache Scale, which assesses psychache quickly. Methods: In this study, we included 136 patients with depression, 45 (33.09%) of whom had previous suicide attempts, and 120 healthy controls. The participants filled out the Unbearable Psychache Scale, Beck Depression Inventory, Beck Suicidal Ideation Scale, Beck Hopelessness Scale, Psychache Scale, and Mee-Bunney Psychological Pain Assessment Scale. Results: The Beck Depression Inventory, Beck Hopelessness Scale, Beck Suicidal Ideation Scale, Psychache Scale, Mee-Bunney Psychological Pain Assessment Scale, and Unbearable Psychache Scale mean scores were significantly higher in the patients than healthy controls (P < .001 for each). The Cronbach's alpha coefficient of the Unbearable Psychache Scale was 0.96 in the internal consistency analysis. The item-total score values were between 0.96 and 0.97. The exploratory factor analysis demonstrated that the Unbearable Psychache Scale was loaded under 1 factor with an eigenvalue above 1 and explained 89.80% of the total variance. The factor loads were between 0.94 and 0.96. There was a significant correlation between the Unbearable Psychache Scale and the Beck Depression Inventory, Beck Hopelessness Scale, Beck Suicidal Ideation Scale, Psychache Scale, and Mee-Bunney Psychological Pain Assessment Scale (P < .001 for each). The Unbearable Psychache Scale differentiated 82% of the patients from the control group and 66.90% of the patients with suicidal attempts from those without suicide attempts. Conclusion: This study demonstrated that the Turkish version of the Unbearable Psychache Scale was valid and reliable and can be used in depressive patients and healthy individuals.

The Relationship Among Anxiety Sensitivity, Psychache, and Suicidality in Patients With Generalized Anxiety Disorder.

ABSTRACT: Although generalized anxiety disorder (GAD) is associated with suicide, not all dimensions of this relationship have been addressed. This study aimed to investigate the relationship between psychache and anxiety sensitivity with suicidality in patients with GAD. We included 80 patients with GAD (17 of whom had previous suicide attempts). The Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Scale (HAM-D), Beck Scale for Suicidal Ideation (BSIS), Psychache Scale (PS), and Anxiety Sensitivity Index-3 (ASI) were applied to the participants. The patients with previous suicide attempts had significantly higher scores on ASI total, ASI-physical and cognitive subdimensions, HAM-A total and psychic subscale, PS, and BSIS than those without ( p < 0.05 for each). Mediation analyses revealed that psychache was a full mediator in the relationship between ASI-cognitive subdimension and suicidal ideation. Therapeutic interventions for anxiety sensitivity and psychache in patients with GAD will help reduce the risk of suicide.

Type D personality and self-esteem in patients with fibromyalgia: a cross-sectional case-control study.

Fibromyalgia (FM) is a complex disease related to several factors. Psychosocial elements, such as type D personality and low level of self-esteem, might increase disease burden. The current study aimed to investigate type D personality and self-esteem in patients with FM. Female patients with FM and age-matched, healthy controls were enrolled in this cross-sectional study. Type D personality was evaluated using the type D scale (DS-14). The Rosenberg self-esteem scale (RSES) was used to assess self-esteem and psychosomatic symptoms. Type D personality was observed in 58.6% of the patients (n = 70) and in 21.7% of the controls (n = 60) (p < 0.001). When compared to patients with non-type D personality, those with type D personality revealed lower self-esteem and poorer health status (p < 0.05 for both), and higher anxiety and depression scores (p < 0.001 for both). In binary logistic regression analysis, the odds of FM were 3.6 times higher (OR = 3.653, 95% CI 1.547-8.625) for patients with type D personality, after adjusting for age and education level. In addition, depression (OR= 1.178, Cl 95% 1.055 - 1.316) and lower education level (OR= 0.818, Cl 95% 0.682 - 0.982) were significantly related to type D personality in FM. Type D personality is closely associated with FM. Type D personality is more common in female patients with FM when compared to healthy women. Depression and lower education level are potential confounders of type D personality in FM.

The Relationship Between the Oxytocin Level and Rejection Sensitivity, Childhood Traumas, and Attachment Styles in Borderline Personality Disorder.

OBJECTIVE: In this study, it is aimed to investigate the relationship between the oxytocin level and the rejection sensitivity, childhood mental traumas, and attachment styles in patients diagnosed with borderline personality disorder (BPD). METHODS: Participants between the ages of 18-30 were included in the study. The patient group consists of 31 participants and the healthy control group consists of 31 participants. Sociodemographic/Clinical Variables Questionnaire, Relationship Scales Questionnaire, Rejection Sensitivity Questionnaire and Childhood Trauma Questionnaire were administered to the participants included in the study. Serum oxytocin levels of the participants were measured using the Elisa method. RESULTS: The oxytocin levels were found to be significantly lower in patients with BPD than in healthy control subjects, whereas the rejection sensitivity and childhood traumas were found to be significantly higher. No difference was found between the patient and control groups in terms of attachment styles, yet it was determined that there may be differences between the oxytocin levels of the BPD patients according to the attachment styles the patients have. CONCLUSION: In conclusion, the findings of this study revealed that the rejection sensitivity in BPD patients is not associated with oxytocin levels and childhood traumas, indicating the need to assess the BPD patients in terms of other biopsychosocial factors related to the etiopathogenesis of BPD.

The Use of Pesticides in Suicide Attempts in the Eastern Mediterranean Region of Turkey. / Türkiye Dogu Akdeniz Bölgesinde Intihar Girisimlerinde Pestisit Kullanma Durumu.

OBJECTIVE: In parallel with common usage areas, pesticide poisonings are encountered in the community due to reasons such as no wearing of protective clothing and masks during use, unintentional consumption and suicide-intended intake. In this study was aimed to examine the cases who applied to the emergency department with pesticide poisoning and share of suicide cases. METHOD: This study is a retrospective record study based on the files of 234 patients who reported to the emergency department for pesticide and rodenticide poisoning between 2014 and 2018. The patients were compared in terms of sociodemographic, substance type, prognosis, and accident/suicide status. Chi-square test, Binary logistic regression analysis were used in the analysis of the data. RESULTS: Organophosphates was the most common substance recorded as a cause of poisoning, while rat poison placed second. 38% of the acute poisoning cases were suicide attempts. Poisoning among men was found to be prominently due to accident whiles among women suicidal poisoning was more prominent. While the mortality rate is 4.7% in all acute intoxication cases, the mortality rate in poisonings with suicidal purposes is 5.6%. Patients with psychiatric diseases have a 28-fold higher risk of intoxication of attempting suicide. The most common comorbid psychiatric disorders in acute pesticide poisoning are anxiety and depression. CONCLUSION: A major proportion of pesticide poisoning cases is suicide attempts. Suicide attempt is at the forefront in women and death rates are higher in people with psychiatric illness. It may be advisable to avoid the easy accessibility of pesticides.

The Relationship Between Peritraumatic Dissociation and Anxiety Level, Perceived Stress, Anxiety Sensitivity and Coping with Earthquake Stress in Post-Earthquake Acute Stress Disorder Patients. / Deprem Sonrasi Akut Stres Bozuklugu Olanlarda Travma Esnasindaki Çözülmenin, Anksiyete Düzeyi, Algilanan Stres, Anksiyete Duyarliligi ve Deprem Stresiyle Bas Etme ile Iliskisi.

OBJECTIVE: The present study aims to determine the effects of anxiety sensitivity, anxiety level, perceived stress and coping strategies on peritraumatic dissociation in post-earthquake acute stress disorder (ASD) patients. METHOD: Sociodemographic data form, Beck Anxiety Index (BAI), Perceived Stress Scale (PSS), Anxiety Sensitivity Index-3 (ASI-3), Coping with Earthquake Stress Scale, and Peritraumatic Dissociation Scale (PDEQ) were applied to 477 patients diagnosed with ASD. RESULTS: Anxiety sensitivity cognitive sub-dimension explained 31.5%, anxiety explained 7%, and perceived stress explained 1% of the variation in peritraumatic dissolution development. A moderate positive correlation was determined between peritraumatic dissolution and anxiety, a weak positive correlation was found between peritraumatic dissolution and perceived stress, a weak positive correlation was determined between peritraumatic dissolution and positive thinking, and a very weak negative correlation was determined between peritraumatic dissolution and seeking social support. A moderate positive correlation was determined between peritraumatic dissolution and physical, cognitive and social sub-dimensions of anxiety sensitivity. CONCLUSION: The most important finding in the study was the fact that the highest contribution to the development of peritraumatic dissolution was by the cognitive sub-dimension of anxiety sensitivity. It could be suggested that individuals with high anxiety sensitivity may experience higher peritraumatic dissolution and these individuals could have a higher risk of PTSD later on.

The Mediating Roles of Psychological Pain and Dream Anxiety in the Relationship between Sleep Disturbance and Suicide.

ABSRTACTSuicide is a significant public health problem worldwide, and sleep disturbances have negative effects on mental health and suicidality. Several psychological concepts may mediate the relationship between sleep disturbances and suicide. We aimed to investigate the mediating roles of psychological pain and dream anxiety in this relationship. This cross-sectional study included 150 depressive patients with or without recent suicide attempts and 91 healthy controls. The Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Psychache Scale (PS), and Van Dream Anxiety Scale (VDAS) were used to assess sleep quality, depression severity, psychological pain, and dream anxiety, respectively. Depression group's mean depression, dream anxiety, psychache, and median sleep quality scores were higher than those of the control group. The ROC analyses indicated no relationship between the violence status of the suicides and the mean dream anxiety, sleep quality or psychache scores. Multivariate regression analysis demonstrated that only the depression score predicted suicide attempts. Mediation analyses revealed that both psychache and dream anxiety have full mediator roles in the relationship between sleep disturbance and suicide attempts. Psychotherapeutic approaches to relieve dream anxiety and psychache may help prevent suicide attempts of at-risk individuals.

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.

The Prevalence of Sarcopenia in Bipolar Disorder.

BACKGROUND: Sarcopenia (SP) is a syndrome described as generalized and progressive loss of muscle mass and strength that may cause fall, fractures, disability and death. Oxidative stress might be a probable etiologic factor in SP as well. SP is a comorbid syndrome that is seen in chronic illnesses. If these two considerations are taken together, one may also think that SP could be also seen in bipolar disorder (BD), because it is a chronic disorder and oxidative stress was related to both illnesses. In our study, we proposed to investigate the prevalence of SP in BD patients. METHODS: We recruited 111 consecutive BD patients who registered in Mood Disorders Unit of Çukurova University. Blood tests were taken from patients to exclude the possible confounding factor related to SP. Socio-demographic variable forms were filled out. Every patient underwent physical mass, strength, and performance tests for the diagnosis of SP, which was determined by the criteria of European consensus. RESULTS: The mean age of the patients was 38.00 ±11.44 years (18-68). Among the participants 69 (62.2%) were female, and 42 (37.8%) were male. Pre-SP was 6.3% (n=7), SP was 9.0% (n=10), and severe SP was 1.8% (n=2) in BD patients. The prevalence of pre-SP, SP and severe SP in BD patients was 7.1%, 16.7% and 2.4% in men and 5.8%, 4.3% and 1.4% in women, respectively. Although it was not marginally significant, a difference was observed in SP patients as they had more median psychotic features and median number of episodes per year for BD. CONCLUSION: This is the first study that investigated SP in BD patients. Sarcopenia was found more frequently in BD patients than in the general population.

The Mediating Effect of Depression and Disability in the Relationship Between Schizophreniaand Self-Esteem.

Depressive symptoms, in addition to positive and negative symptoms, are commonly observed in the course of schizophrenia. These symptoms may cause disability and reduced self-esteem. Disability and lower self-esteem may disrupt the quality of life and lead to social isolation. Demonstrating the relationships among these concepts and correcting possible disturbances may help to augment treatment compliance and improve the prognosis. In this study, the Calgary Depression Scale for Schizophrenia (CDSS), the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS), and the Rosenberg Self Esteem Scale (RSES) were applied along with a sociodemographic data form to 146 patients with schizophrenia. Path analyses were used to demonstrate the direct effect of schizophrenia severity on self-esteem and its indirect effect through disability and depression, the mediating effect of depression in the relationship between schizophrenia severity and disability, and the mediator effect of disability in the bidirectional relationship between self-esteem and depression. Statistically significant results were obtained. In multivariate regression analysis, significant effects on disability were demonstrated for PANSS General Psychopathology subscale, CDSS, and RSES. These data suggest that attention should be focused on concepts such as depression, disability, and self-esteem in schizophrenia patients.

The relationship between somatic sense perception levels and comorbid psychiatric diseases in chronic pain patients.

OBJECTIVES: The purpose of the study was to evaluate any comorbid psychiatric disorders in patients with chronic pain and to examine the effects of sociodemographic details and the level of somatic sense perception on the severity of these diseases. METHODS: In this study, 51 chronic pain patients were evaluated in a consultation with a psychiatrist. Sociodemographic characteristics of the patients, such as age, gender, education level, and marital status were recorded, and Structured Clinical Interview for DSM-IV results were assessed. The patients' chronic pains were classified as idiopathic or secondary to organic etiology. In addition, the Symptom Checklist-90, Somatosensory Amplification Scale (SSAS), Hamilton Depression Rating Scale, and the Hamilton Anxiety Scale (HAM-A) were used. RESULTS: The incidence of psychiatric disorders in chronic pain patients was found to be 74.5%. Somatoform disorders were the most frequently diagnosed, at 37.3%. The rate of depressive and anxiety disorders was, respectively, 29.4% and 23.5%. Comorbid anxiety scores (p=0.019) and SSAS scores (p=0.046) were significantly higher in chronic pain patients with a somatoform disorder. HAM-A scores were found to be significantly higher in patients with depression (p=0.004). A positive and linear relationship was determined between the SSAS score and depression, anxiety, and the severity of mental symptoms. CONCLUSION: Structured or semi-structured interviews can be performed in pain polyclinics or psychiatric outpatient clinics to determine the level of perception of somatic sensations. This could be beneficial in the treatment of chronic pain and comorbid psychiatric disorders.

Association of Psychache and Alexithymia With Suicide in Patients With Schizophrenia.

Suicide is a leading cause of death in patients with schizophrenia. Previous studies have mostly investigated the association between suicide and sociodemographics, positive and negative symptoms, and depressive symptoms. This study evaluated psychache and alexithymia in patients with schizophrenia, which have both been associated with suicide attempts and thoughts in patients with other psychiatric disorders. Positive and Negative Syndrome Scale (PANSS), Psychache Scale (PAS), Beck Scale for Suicidal Ideation (BSSI), Calgary Depression Scale for Schizophrenia (CDSS), and Toronto Alexithymia Scale (TAS) scores were obtained in 113 patients with schizophrenia, including 50 with suicide attempts. PANSS positive symptoms and general psychopathology subscale, CDSS, BSSI, TAS, and PAS scores were significantly higher in patients with suicide attempts. In multivariate logistic regression analysis, only the PAS score was an independent predictor of attempted suicide. Mediation analysis demonstrated that psychache (both directly and indirectly) and alexithymia (indirectly) might be associated with the risk of suicide in these patients.