Executive function deficits contribute to poor theory of mind abilities in adults with ADHD.

INTRODUCTION: Studies exploring the theory of mind (ToM) in adults with Attention/Deficit Hyperactivity Disorder (ADHD), have tended to result in mixed findings. The contribution of neuropsychologic functions to ToM has not been investigated yet in adults with ADHD. The aim of this study was to investigate ToM abilities and the role of attention and executive functions in ToM of adults with ADHD. METHODS: This study was conducted in Bakirkoy Training and Research Hospital. Forty adults with ADHD and 40 healthy controls were administered a sociodemographic data form, and scales. Both groups were also assessed by Reading Mind From the Eyes Test (RMET), Trail Making Test (TMT) Part A-B and Continuous Performance Test (CPT). RESULTS: ToM was significantly impaired in adults with ADHD relative to controls (23.50 ± 3.44 and 26.25 ± 1.67, t(77) = 4.543, p = 0.003). Adults with ADHD performed worse on TMT Part B (76.02 ± 51.47 and 46.39 ± 18.33 seconds, t(78) = -3.429, p < 0.001), and CPT than the controls (46.20 ± 8.09 and 52.00 ± 3.56, t(78) = 4.145, p < 0.001). A significant regression equation was found: F (1,38) = 6.494, ß = -0.382, p < 0.05 with an R² of 0.146. CONCLUSION: Our findings suggest that adults with ADHD demonstrated social cognition difficulties and executive function deficits contributed to poor ToM abilities in ADHD.

Evaluation of the relationship between perceived social support, coping strategies, anxiety, and depression symptoms among hospitalized COVID-19 patients.

OBJECTIVE: We aimed to evaluate the relationship between perceived social support, coping strategies, anxiety, and depression symptoms among hospitalized COVID-19 patients by comparing them with a matched control group in terms of age, gender, and education level. METHOD: The patient group (n = 84) and the healthy controls (HCs, n = 92) filled in the questionnaire including the socio-demographic form, Hospital Anxiety Depression Scale, Multidimensional Perceived Social Support Scale, and Brief Coping Orientation to Problems Experienced through the online survey link. RESULTS: The COVID-19 patients had higher perceived social support and coping strategies scores than the HCs. However, anxiety and depression scores did not differ significantly between the two groups. In logistic regression analysis performed in COVID-19 patients, the presence of chest CT finding (OR = 4.31; 95% CI = 1.04-17.95) was a risk factor for anxiety and the use of adaptive coping strategies (OR = 0.86; 95% CI = 0.73-0.99) had a negative association with anxiety. In addition, the use of adaptive coping strategies (OR = 0.89; 95% CI = 0.79-0.98) and high perceived social support (OR = 0.97; 95% CI = 0.93- 0,99) had a negative association with depression symptoms. CONCLUSIONS: Longitudinal studies involving the return to normality phase of the COVID-19 pandemic are needed to investigate the effects of factors such as coping strategies and perceived social support that could increase the psychological adjustment and resilience of individuals on anxiety and depression.

Minor Physical Anomalies in Bipolar Disorder.

OBJECTIVE: High-arched palate is more frequent in schizophrenia and bipolar disorder (BD). Upto 40% of patients develop schizophrenia in 22q11.2 Deletion Syndrome manifested with cleft lip and palate, which originate from the first pharyngeal arch in embryo. The auricle also originates from the dorsal ends of the first and second pharyngeal arches; hence, we aimed to determine the associations between auricular anomalies and BD. METHODS: We screened for 36 minor physical anomalies of the auricle in 146 patients with BD. RESULTS: 7 out of the of 36 assessed anomalies highly differed between healthy subjects and BD patients. A regression model including the differing anomalies predicted healthy subjects and BD-patients by 78.8% and 68.5%, respectively. CONCLUSIONS: Assessing minor anomalies in psychiatric disorders may help to discover novel pathogenesis pathways and even new endophenotypes.

Evaluation of 2D:4D digit ratio in bipolar 1 disorder patients and its relationship with treatment response.

BACKGROUND: The role of sex steroids in bipolar disorder (BD) has been demonstrated in adults. We aimed to evaluate the 2D:4D ratio, which indirectly reflects prenatal sex steroids, in BD. Another purpose of this study was to determine the relationship between clinical features, especially lithium response, and digit ratio. METHODS: The study included 74 patients with bipolar 1 disorder and 74 healthy individuals matched according to age, gender, and educational status. The digit ratio was calculated by dividing the index finger (2D) length by the ring finger (4D) length in both hands. A lithium response scale was used to evaluate the lithium response history. RESULTS: There was no difference in 2D:4D ratio between the patients and controls in either right or left hands. The digit ratio was not different between groups with and without suicide attempts. The 2D:4D ratio in the patient group was lower in individuals unresponsive to lithium therapy than in partial and good responders for both right and left hands. DISCUSSION: According to the results of our study, the 2D:4D ratio in the BD group was not different from healthy controls but was lower in patients unresponsive to lithium. In this respect, the 2D:4D ratio can be considered as a biomarker for lithium response in BD. In large-sample studies, the 2D:4D ratio should be investigated for pathophysiology and treatment response of BD.

Reliability and Validity Study of the Turkish Version of Bipolar Spectrum Diagnostic Scale. / Bipolar Spektrumu Tani Ölçegi Türkçe Formu’nun Güvenilirlik ve Geçerlilik Çalismasi.

OBJECTIVE: The purpose of this study is to evaluate the reliability and validity of the Turkish Version of the Bipolar Spectrum Diagnostic Scale (BSDS). METHOD: The study was carried out with 130 patients diagnosed with bipolar I disorder, 15 patients diagnosed with bipolar II disorder, and 38 patients diagnosed with major depressive disorder attending the outpatient psychiatry departments of the Bakirköy Prof. Dr. Mazhar Osman Training and Research Hospital for Mental Health and Neurological Diseases. The Mood Disorder Questionnaire (MDQ) was used for convergent validity. The internal consistency coefficient, itemtotal score correlation coefficients, test-retest correlation coefficient, confirmatory factor analysis, correlation with concurrent scale, and ROC curve were statistically calculated. RESULTS: Confirmatory factor analysis indicated that the 20-item version did not show adequate goodness-of-fit. The item 4 with a relatively low regression weight was removed from the model. For the 19-item revised and corrected model, the observed goodness-of-fit indexes were RMSEA = 0.040, CFI = 0.900, GFI = 0.890, IFI = 0.900 and χ2/df = 1.230. The internal consistency Cronbach's alpha coefficient was 0.831. The correlation coefficient between the Turkish version of the BSDS and the MDQ was 0.54. The cutoff point of the scale calculated by the ROC analysis was 12 with a sensitivity of 78.6% and a specificity of 86.8%. CONCLUSION: The Turkish Version of the BSDS, has been shown to be reliable and valid tool for screening bipolar disorder after removal of the item 4 of the original version of the scale.

[Evaluation of the Association between Lithium Treatment and GSK3ß Polymorphism in Bipolar Disorder Patients]. / Iki Uçlu Bozukluk Hastalarinda Lityuma Yanit ile GSK-3ß Polimorfizmi Iliskisinin Degerlendirilmesi.

OBJECTIVE: There is a lack of evidence regarding clinical predictors for the treatment response to lithium, which is the main stay treatment option for bipolar disorder. Studies that examined the mechanistic action of lithium revealed that glycogen synthase kinase 3ß (GSK-3ß) enzymeinhibition was important in regard to treatment responses. Based on this background, we aimed to investigate the association between responses to lithium treatment and five different polymorphisms of GSK-3ß. METHOD: Lithium treatment response scale (LTRS) scores for 100 patients diagnosed with bipolar disorders type I were calculated according to the hospital records. Blood samples were collected and genomic DNA was obtained using the MagNA Pure Compact automatic isolation method. The GSK-3ß: rs17183904, rs17183897, rs34009575, rs34002644, and rs17183890 polymorphisms were analyzed by real time PCR. RESULTS: In this cohort, the mean age of patients was 41.1±10.3 years, the mean age of disease onset was 24.5±8.2, and the mean LTRS score was 4.9±1.8. There was no statistically significant difference for LTRS scores between groups in terms of gender, marital status, level of education, and the type of first episode. LTRS was significantly higher in only the patients harbouring GSK-3ß rs17183890 AG genotype (p=0.008, t:2.71). Interestingly, no differences were found for the remaining polymorphisms. CONCLUSION: The specific GSK-3ß polymorphism that associated with lithium-response in our study may help to predict lithium responses and to develop individualized treatment. We presume that our pharmacogenomic findings may also provide important contributions to the clinical practice in regard to future evaluation of the treatment adherence and side effects. To obtain these goals, further genome-wide scanning studies conducted on larger sample cohorts are required.

Serum NUCB2/nesfatin-1 levels in different stages of alcohol dependence: Is there a relationship with craving?

INTRODUCTION: In the literature, the relationship between appetite regulating peptides and alcohol craving is on the debate. AIM: This study aims to investigate serum level of NUCB2/nesfatin-1, which is discovered as appetite-related neuropeptide, in patients with alcohol dependence who were in craving and abstaining phase and to compare with healthy controls. SETTINGS AND DESIGN: Research, Treatment, and Training Center for Alcohol and Substance Dependence, (AMATEM) Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, case-control and prospective study design were used. STATISTICAL ANALYSIS: Chi-square, Mann-Whitney U, paired samples, independent samples t- and Pearson correlation tests were used for analysis. MATERIALS AND METHODS: Forty-three patients with alcohol dependence who have been admitted for detoxification and thirty healthy controls were included in the study. The blood samples were drawn after the 1st day of admission and postdetoxification treatment in inpatients who reached to abstinence period and from 30 healthy controls. The Penn Alcohol Craving Scale and the Obsessive Compulsive Drinking Scale were applied to detect craving scores. RESULTS: Initial serum NUCB2/nesfatin-1 levels in patients were significantly lower than in the healthy control group (P < 0.001). The NUCB2/nesfatin-1 level of initial phase was significantly lower than abstinence phase (P = 0.027). No correlation was found between craving scores and NUCB2/nesfatin-1 level (P > 0.05). CONCLUSION: This study is the first that showed significant differences of serum NUCB2/nesfatin-1 level according to different stages of alcohol dependence. Plasma NUCB2/nesfatin-1 levels were lower in highest craving phase and tended to normalize after abstinence. Since we could not find a correlation between craving and NUCB2/nesfatin-1 levels, the increase of NUCB2/nesfatin-1 in abstinence phase might have been resulted from other reasons apart from craving.

Neutrophil-lymphocyte and platelet-lymphocyte ratios as inflammation markers for bipolar disorder.

In the present study we investigated the involvement of inflammatory cells and their ratios as inflammation markers in Bipolar Disorder. We have enrolled 61 manic, 55 euthymic patients and 54 control subjects to the study. Neutrophil-lymphocyte and platelet-lymphocyte ratios were found significantly higher in both manic and euthymic patients compared to control group. These findings suggest that the inflammatory cells have a role in the pathophysiology of bipolar disorder manic and even in euthymic state.

Initial and post-treatment total oxidant-antioxidant status and oxidative stress index in male patients with manic episode.

We investigated serum total oxidative and anti-oxidative status in manic patients. Group1 was formed as ECT+antipsychotic, group2 was antipsychotic and healthy volunteers as group3. The anti-oxidative status was significantly lower in group1 than group3. No significant change was found between pre and post-treatment oxidative and anti-oxidative status, whereas significantly increased oxidative stress index has been found in group2. Total anti-oxidative status in manic states seems to be inadequate which remains to be maintained after the treatment.