A rare clinical presentation after COVID-19: Manic episode with psychotic features.

Neuropsychiatric manifestations of the COVID-19, caused by SARS-CoV-2, are under close scrutiny as the virus is shown likely to either directly or indirectly affects the central nervous system although it mainly targets the respiratory tract. Here, we describe a middle-aged male who developed acute psychiatric symptoms after a recent COVID-19 infection with no prior personal or family history of psychiatric disorder. Although there are reported cases of diagnosed psychosis or affective disorders following COVID-19 infection in the literature, to our knowledge, this is the first case where the development of autoimmune encephalitis after COVID-19 was considered and ruled out. This case report describes the comprehensive evaluation of all possible organic etiology. We also aimed to discuss possible biological underpinnings of such an exceptional comorbidity.

Turkish Validity and Reliability Study of the ECT Perception and Knowledge Scale.

Introduction: Electroconvulsive Therapy (ECT) is an effective and safe treatment method used in the treatment of various psychiatric diseases. However, negative attitudes associated with ECT are common. This causes many negative consequences, from the treatment preference to treatment response and stigma. In this study, we aimed to carry out a validity-reliability analysis of the ECT Perception and Knowledge Scale (ECT-PK), which was developed to determine the perception and knowledge levels related to ECT, and adapt it to Turkish. Method: The Turkish adaptation of the ECT-PK was made using the translation-retranslation method. Our study included 50 patients with schizophrenia, 50 patients with bipolar disorder, 50 patients with major depression who met the remission criteria determined separately for each disorder, and 150 healthy controls.. To measure test-retest reliability, the scale was re-applied to 30 patients randomly selected from the patient group 14-21 days after the first application of the scale. Results: In our study, a significant difference was found in both the patient and control groups in terms of the history of ECT application in the past and the status of accepting ECT application when recommended, and the perception and knowledge subscales of the ECT-PK. These results support the construct and criterion validity of the ECT-PK. Cronbach's alpha coefficient was found to be 0.85 for the perception subscale and 0.78 for the knowledge subscale. The intra-class correlation coefficient used to evaluate the test-retest reliability was 0.86 for the perception scale and 0.83 for the knowledge subscale. Conclusion: It has been shown that the ECT-PK is a valid and reliable measurement tool that can be used to measure the perception and knowledge levels related to ECT in both clinical and non-clinical groups.

Mother-Infant Bonding in Patients with Bipolar Disorder.

Introduction: The quality of mother-infant bonding might play a role in future psychopathologies of the infant. The present study aims to compare the mother-infant bonding in mothers with remitted bipolar disorder (BD) and healthy mothers. Methods: We included 51 mothers who have bipolar disorder in remission and 53 healthy mothers during postpartum one-year period. All participants were interviewed with Structured Clinical Interview for DSM-IV (SCID-IV). Young Mania Rating Scale and the Hamilton Depression Rating Scale were given to the patient group to evaluate depressive and manic symptoms. Mother-infant bonding in both groups were evaluated with the Postpartum Bonding Questionnaire (PBQ). Results: There was no significant difference in PBQ scores between the bipolar group and the control group. Age was negatively correlated with PBQ scores in the patient group. Conclusion: Women with bipolar disorder can develop healthy bonding patterns with their babies, during remission.

The role of the brain-derived neurotrophic factor SNP rs2883187 in the phenotypic expression of obsessive-compulsive disorder.

We investigated the association between a brain-derived neurotrophic factor (BDNF) gene polymorphism and clinical features in a sample of patients with obsessive-compulsive disorder (OCD). A total of 100 patients diagnosed with OCD according to the Diagnostic and Statistical Manual IV criteria and 110 control subjects were included in this study. The distribution of a single nucleotide polymorphism rs2883187 was compared in OCD patients and normal controls. Clinical features were compared between the subgroups of OCD patients with different genotypes. There was no significant difference for the allele frequencies and genotype distributions between the OCD and control groups. The Hamilton Anxiety Rating Scale, Yale-Brown Obsessive Compulsive Scale obsession and total scores were found to be higher in patients with the CC genotype than in the patients who are homozygous for the T allele. The rates of OCD in first-degree relatives of OCD patients who were homozygous for the C allele were significantly higher, compared to those with CT and TT genotypes. Our results indicate that the CC genotype may be associated with the severity and increased familial loading of OCD. Further investigation based on larger populations is needed to reveal the full association of the BDNF polymorphism with OCD.

A comparison of comorbidity in body dysmorphic disorder and obsessive-compulsive disorder.

BACKGROUND: The aim of this study is to compare 3 groups of patients with body dysmorphic disorder (BDD), obsessive-compulsive disorder (OCD), and comorbid BDD and OCD with respect to clinical characteristics and to study their similarities and differences. METHODS: Twenty-nine patients diagnosed with BDD, 20 diagnosed with comorbid BDD/OCD and 49 diagnosed with OCD were included in the study. Patients with BDD, comorbid BDD/OCD, and OCD were compared in terms of demographic and clinical variables and scores obtained from various scales. RESULTS: Patients in the comorbid BDD/OCD and OCD groups tended to have higher anxiety scores than in BDD group. Any depressive disorder was more common in the comorbid BDD/OCD and OCD groups than in the BDD group. A significantly higher proportion of patients with BDD/OCD had any anxiety disorder than those with BDD. Subjects with BDD were significantly more likely than subjects with OCD to have narcissistic and avoidant personality disorders and any Axis II personality disorder. Finally, the rate of any cluster B personality disorder was higher in the BDD and BDD/OCD groups than in the OCD group. CONCLUSIONS: Despite the similarities between BDD and OCD, these disorders appear to have different aspects especially on psychiatric comorbidity.

Assessment of myocardial damage by cardiac MRI in patients with anorexia nervosa.

OBJECTIVE: Cardiac damage is a major complication of anorexia nervosa (AN). The present study evaluated the prevalence of myocardial damage in patients with AN by cardiac magnetic resonance imaging (CMR). METHOD: This study was cross-sectional and observational. Forty consecutive female patients with a diagnosis of AN and 28 healthy female subjects were evaluated from January 2007 to 2011 at the Department of Psychiatry (University of Istanbul, Istanbul, Turkey). Following enrollment in the study, participants underwent a cardiac evaluation, a physical examination, a standard electrocardiogram (ECG), an echocardiography and a CMR. RESULTS: Body weight, body mass index and heart rate values were lower in patients with AN than in the control group. When compared with control groups, patients with AN showed reduced left ventricular mass with normal systolic function. Compared to control subjects, patients with AN had higher prevalence of pericardial effusion (30% in the AN group, 4% in the control group, p = .005) and mitral valve prolapses (23% in the AN group, 4% in the control group, p = .03). Myocardial fibrosis (detected as late gadolinium enhancement on CMR) was found in 23% of patients with AN. Myocardial fibrosis was not detected in any control subject (p = .007). CONCLUSION: A strong association was found between myocardial fibrosis and AN. Cardiac damage of myocardial fibrosis in asymptomatic patients with AN can be found by CMR examination.

COMT Val158Met polymorphism and executive functions in obsessive-compulsive disorder.

This study investigated the association between the catechol-O-methyl transferase (COMT) Val158Met polymorphism and executive functions in 101 patients with obsessive-compulsive disorder (OCD) and 100 healthy-control subjects (HS). Results showed that there was no significant difference for the genotype distributions between the OCD and HS groups. OCD-Met carrier subgroup's TMT B-A difference and lexical fluency scores were found to be significantly poorer than both HS subgroups. These findings suggest that lower activity of COMT associated with the Met allele, leading to higher levels of dopamine in the prefrontal cortex, lead to poorer executive function in OCD.

Brain-derived neurotrophic factor gene Val66Met polymorphism and cognitive function in obsessive-compulsive disorder.

In the present study, we have tested the hypothesis that brain-derived neurotrophic factor (BDNF) gene Val66Met polymorphism is associated with obsessive-compulsive disorder (OCD) and also investigated the association between the BDNF Val66Met polymorphism and the performance on tests measuring executive functions in a sample of patients with OCD. A total of 100 patients diagnosed with OCD according to DSM-IV criteria and 110 control subjects were included in this study. Single nucleotide polymorphism (G/A) leading to Val to Met substitution at codon 66 in BDNF was screened in the DNA samples of all participants. The genotype frequencies of BDNF Val66Met polymorphism were compared in OCD patients and healthy controls. The four subgroups of OCD and healthy control subjects, determined according to being Val homozygous or carrying a Met allele, were also compared according to their performance in a battery of neuropsychological tests of executive functions and verbal memory. There was no significant difference for the allele and genotype distributions of BDNF Val66Met polymorphism between the OCD and healthy control groups. Compared to the other three subgroups, OCD-Met carriers were slower on Trail-Making Test part A (TMT A), part B (TMT B) score and its speed-corrected score (TMT B-A). OCD-Met carriers had also poor performance on verbal fluency tasks and several CVLT measures compared only to the healthy control-Met carriers. These results demonstrate that the BDNF Val66Met polymorphism does not appear to be a risk factor for OCD. However, the presence of a BDNF Met allele, which is a known attenuator of BDNF activity, may be associated with a poorer executive functioning in OCD.