Empathy, Alexithymia, and Theory of Mind in Borderline Personality Disorder.

The purpose of this research was to determine the differences in empathy, alexithymia features, and theory of mind between healthy controls and patients with borderline personality disorder (BPD). Thirty-five patients with BPD and 35 healthy controls were included in the study. To measure the clinical variables, the Empathy Quotient (EQ), Reading the Mind in the Eyes Test (RMET), Toronto Alexithymia Scale (TAS-20), Barratt Impulsivity Scale-11 (BIS-11), and Beck Depression Inventory (BDI) were applied. We found that the BPD group had significantly worse total RMET and neutral RMET scores than the control group. There were no differences in the EQ scores between the BPD and control groups. The patients with BPD were more alexithymic than the controls, and alexithymia and depression scores predicted BPD status. Patients with BPD who have difficulty identifying their own emotions tend to display deficits in perceptions of facial emotions, which, in turn, may lead to misperceptions of social signals and thus contribute to excessive emotional intensity and tension in social situations. The study results reveal that alexithymia and depression are important variables in predicting BPD traits.

May nesfatin-1 be a state marker in major depressive disorder with suicidal ideation?

The best known effects of nesfatin-1 are on appetite and metabolic regulation. Moreover, several research suggest that nesfatin-1 play a role in stress responses. This molecule may be involved in the pathophysiology of mood disorders and suicidal behavior. We compared nesfatin-1 levels between depressed patients with suicidal ideation (n = 32, mean ±â€¯SD, 1,40 ±â€¯0.11), without suicidal ideation(n = 31, 1.46 ±â€¯0.14) and healthy controls (n = 32, 1.52 ±â€¯0.13). Suicidal ideation was assessed with the Suicide Probability Scale, Scale for Suicide Ideation and depressive symptoms were evaluated with the Hamilton Depression Rating Scale. Blood samples were collected to measure serum nesfatin-1levels by using ELISA method. The study revealed that serum nesfatin-1 levels were significantly lower in MDD with suicidal ideation than in healthy volunteers (p < 0.001). There were a negative correlation between the scores of suicidal ideation and nesfatin-1 levels in MDD with SI group (r = -0.215; p = 0.016). In the future, nesfatin-1 levels may one day be applied in predicting and monitoring patients' suicide risk. Further prospective studies are required to elucidate this potential association.

Is depression associated with functional recovery after hip fracture in the elderly?

AIM: The aim of this study was to examine the effects of depression on functional healing and the return to pre-fracture daily activities in elderly patients with a hip fracture. METHODS: The study comprised 104 elderly patients, who had a unilateral hip fracture between 2009 and 2012. To evaluate daily activities and functional healing of the cases, the study was designed as a prospective comparative study. RESULTS: The analysis results revealed that the change in the mean ADL scores was related to depression at a statistically significant level (p = 0.000). DISCUSSION: This study results showed that depression had a negative effect on the daily activity level of these cases.

Toxic keratopathy associated with abuse of topical anesthetics and amniotic membrane transplantation for treatment.

AIM: To evaluate the clinical findings of toxic keratopathy associated with abuse of topical anesthetics and the treatment efficacy of amniotic membrane transplantation (AMT). METHODS: Fifteen eyes of 10 patients with abuse of topical anesthetics were included in this study. The data collected included patients' demographic information, initial best corrected visual acuity (BCVA), clinical findings, time to AMT, duration of epithelization, additional treatments, posttreatment BCVA, and the results of psychiatric examination. RESULTS: All patients were male, with the mean age of 37.9±5.4y. The patients had received 0.5% proparacaine hydrochloride due to pain resulting from foreign bodies, such as welding flash burns and car battery explosions, for a mean of 18.2±12.4d. The mean initial BCVA of the patients was 0.069±0.100. All patients had persistent epithelial defects, stromal infiltration, ring ulcer, and corneal edema. Initially, medical treatment was attempted in all cases. Because of severe pain, persistent epithelial defects and progressing stromal thinning did not improve with medical treatment, thus, the patients underwent AMT. The mean posttreatment BCVA of the patients was 0.33±0.27. All of them, except for two patients, showed improved visual acuity. One patient underwent evisceration for corneal melting and endophthalmitis in another center, and one patient underwent evisceration for severe pain of unknown origin. All 5 patients who consented to a psychiatric examination had depression, had personality disorder, and used tobacco. CONCLUSION: AMT appears to be an effective method for pain relief, rapid epithelial and stromal healing; however, visual prognosis is still poor despite medical and surgical interventions.

The Polymorphisms of Ser49Gly and Gly389Arg in Beta-1-Adrenergic Receptor Gene in Major Depression.

INTRODUCTION: It was reported that the genetic susceptibility of major depressive disorder (MDD) is related with genetic polymorphisms. The aim of this study was to investigate the possible association of the genotype and allele frequencies of Ser49Gly and Arg389Gly polymorphisms in MDD by comparing them with healthy subjects. METHODS: A total of 144 patients with MDD diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and 105 healthy controls were included in the study. Polymerase chain reaction (PCR) with restriction fragment length polymorphism (RFLP) was used for genotyping. RESULTS: Of the 144 participants in the MDD group, 77 (53.5%) had homozygous wild type (AA), 57 (39.6%) had heterozygous type (AG), and 10 (6.9%) had mutant (GG) genotype for Ser49Gly, whereas 75 (52.1%) had homozygous wild type (GG), 59 (41.0%) had heterozygous (GC) type, and 10 (6.9%) had mutant homozygous (CC) genotype for Gly386Arg. There were no significant difference in the allele and genotype frequencies of the beta-1-adrenergic receptor (ADRB1) gene for Ser49Gly and Arg389Gly polymorphisms after comparing with healthy controls (p=0.626; p=0.863 and p=0.625; p=0.914). CONCLUSION: The results of our study did not reveal a major effect of the polymorphism of Ser49Gly and Gly389Arg in the ADRB1 gene in MDD. Further studies with larger sample size are required to elucidate the role of other beta-1 adrenergic gene polymorphisms in MDD.

Evaluation of Eating Attitude in Patients with Migraine.

INTRODUCTION: This study aimed to investigate the eating attitudes in patients with migraine. METHODS: Fifty-nine patients (mean age: 32.54±8.47 years) diagnosed with migraine according to the International Classification of Headache Disorder, 2004, and 47 age-, gender- and education-matched healthy controls (mean age: 31.85±7.14 years) were enrolled for this study. Sociodemographic data were recorded, and the body mass index was calculated as kilograms per meter squared. Data regarding the duration of illness and attack, frequency of migraine attacks, and the presence of aura were recorded. Migraine severity was assessed by Migraine Disability Assessment Score (MIDAS). Eating Attitudes Test (EAT), Beck Depression Inventory (BDI), and Beck Anxiety Inventory were applied to all participants. RESULTS: The patients with migraine had significantly higher EAT scores, levels of anxiety, and depression than controls (p<.01). Furthermore, 11.9% of patients with migraine had an EAT score of 30 or higher, which is suggestive of a disordered eating attitude, whereas this rate was 2.1% in healthy controls (p<.05). The scores of EAT and BDI had positive correlation with the scores of MIDAS in patients with migraine (r=.298, p<.05; r=.332, p=.01, respectively). CONCLUSION: In our study, disordered eating attitudes and the levels of anxiety and depression were high in patients with migraine than controls. Our study is important to demonstrate the connection between migraine and disordered eating attitudes.

The impact of personality on quality of life and disease activity in patients with Behcet's disease: a pilot study.

BACKGROUND: The aim of this study was to examine the personality characteristics of patients with Behcet's Disease (BD) using the Temperament and Character Inventory (TCI) compared with healthy control subjects and to investigate the relationship between the temperament and character properties and quality of life, disease activity, depression and anxiety in Behcet's patients. METHODS: A total of 46 BD patients and 40 healthy subjects were included in the study. All patients and controls were determined using the TCI, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Clinical Version for Axis I disorders (SCID-CV), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Quality of life (QOL) Instrument for Skin Disorders and Behcet Disease Current Activity Form (BDCAF). RESULTS: BD patients demonstrated significantly lower Reward Dependence than healthy controls. Among the subscales; Explarotory Excitability, Shyness with Strangers, Attachment, Spiritual Acceptance were lower and Self-Acceptance was higher in patients compared to control subjects. Decreased quality of life and increased disease activity of the patients were correlated with increased anxiety and depression. Responsibility, Self-Forgetfulness and Transpersonal Identification were associated with quality of life while Responsibility was the major factor effecting QOL. Disease activity was not found related with TCI properties. CONCLUSION: Temperament and Character traits of BD patients were different from healthy group that might be due to many factors like genetics, biological or socio-cultural differences. BD patients were demonstrated as materialistic, self-contained, self-confident, cold, detached, and reserved although they are not shy. Considering the different personality traits of BD patients in psychotherapeutic approaches, may have a positive impact on QOL and comorbid major depressive disorder.

A Case of Risperidone Induced Stuttering as a Paradox.

The main feature of stuttering is the disturbance in terms of both timing and fluency of speech inappropriate with the age. This disturbance is characterized with the repetition and prolongation of sounds and syllables. There are two types of stuttering as acquired and developmental. Acquired stuttering may begin suddenly at any age and may be seen rarely due to the adverse effects of drugs. Stuttering induced by antipsychotics may develop very rarely. Risperidone is a strong antagonist of dopamin 2 (D2) and serotonin 2A (5 HT2A) and shows a high affinity for α1 and α2 noradrenaline receptors. It's used in a wide spectrum including psychotic disorders, mood disorders, and behavioral disorders, even for the treatment of stuttering. Risperidone treats the symptoms of stuttering by the antagonism of D2 receptors with an increase in striatal metabolism. In literature, we haven't observed any other case reports except the two stuttering cases with psychotic disorders due to the short term and high-dose risperidone treatment. In our case, stuttering adverse effect of chronic low-dose risperidone treatment is remarkable that is discussed for the first time. As well as the use of risperidone for the treatment of stuttering, stuttering adverse effect seems to be interesting as a paradox.

Late-life Onset Mania After Varenicline Use: A Case Report.

Late-life onset manic attacks generally occur secondary to general medical conditions or drug use. Varenicline is an α4ß2 nicotinic acetylcholine receptor partial agonist, used for the cessation of smoking. In this case report, we present a 67-year-old male patient with a new-onset manic episode following varenicline treatment. The patient's manic symptoms started on the seventh day of varenicline treatment. His symptoms started on the 7th day of treatment. He was admitted to the psychiatric outpatient clinic since his symptoms did not improve despite discontinuing varenicline treatment. In the initial mental status examination, he scored 35/60 on the Young Mania Rating Scale (YMRS). On the twenty-fifth day of the hospitalization, the patient was discharged since his YMRS score improved (5/60). Varenicline may cause manic episodes in patients with bipolar disorder and in healthy individuals. An increasing number of serious psychiatric disorders are being reported due to varenicline treatment. Mental state examination before and during varenicline treatment seems necessary.

The prevalence of death ideation and attempted suicide and the associated risk factors in Isparta, Turkey.

OBJECTIVE: Suicide is a complex process from the initiation of ideation to planning, and finally to an attempt. This study aimed to investigate the prevalence of death ideation, attempted suicide, and the associated risk factors in Isparta, Turkey. MATERIALS AND METHODS: The study included 600 participants aged 18-65 years representative of the population of central Isparta that were selected via the stratified simple randomized sampling method. The participants were administered a questionnaire for collecting demographic data, and the participant's experiences of death ideations and suicide attempts, and the clinical version of SCID were used. RESULTS: The lifetime prevalence of attempted suicide and death ideations was 4.3% and 27.5%, respectively. Death ideas and attempted suicide were both more prevalent among women and younger adults. All those that attempted suicide were exposed to a stress factor prior to the attempt. The rates of death ideation and attempted suicide were lower among the participants that had children. A family history of attempted suicide was associated with an increase in the frequency of death ideations and attempted suicide. Attempted suicide and death ideas were more common among those with major depressive disorder. Generalized anxiety disorder was observed significantly more frequently among those that had attempted suicide. Panic disorder and a specific phobia were also significantly associated with death ideation. CONCLUSION: The present study's findings indicate that there were common risk factors for attempted suicide and death ideations in the study group. Determination of the prevalence of attempted suicide and death ideation in a population, identification of the associated risk factors and assessment of their relationship to mental disorders can facilitate a better understanding of suicidal behaviour.