Examining cognitive disengagement syndrome in a psychiatric outpatient sample: Psychometric support and associations with internalizing symptoms and sleep problems.

OBJECTIVE: The internal (structural) and external validity of a self-report measure of cognitive disengagement syndrome (CDS, formerly sluggish cognitive tempo) relative to a self-report measure of attention-deficit/hyperactivity disorder-inattention (ADHD-IN) was evaluated with adults from university outpatient psychiatric clinics in Turkey. METHODS: A total of 274 outpatients (75.9% women; ages 18-64 years; Mage = 31.06; SDage = 10.84; 50.4% anxiety disorders; 41.6% depressive disorders; 2.9% ADHD; 1.5% sleep disorders; 0.7% eating disorders; 2.9% no mental disorder) completed self-report measures of CDS, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), sleep problems, depression, and stress. RESULTS: All 15 CDS symptoms measured by the Adult Concentration Inventory (ACI) showed convergent (moderate to high loadings on the CDS factor) and discriminant (loading close to zero on the ADHD-IN factor) validity. CDS also showed stronger first-order and unique associations than ADHD-IN with sleep problems, depression, anxiety, and stress, whereas ADHD-IN showed stronger first-order and unique associations than CDS with ADHD-HI. CONCLUSION: This is the first study to provide support for the scores from this 15 item self-report measure of CDS by the ACI in a clinical sample of adults, with findings consistent with previous studies examining parent and teacher rating scale measures with the same 15 CDS symptoms. These findings provide additional support for usefulness of these 15 CDS symptoms as measured by the ACI to study CDS across various cultures.

Efficacy of accelerated deep transcranial magnetic stimulation wi̇th double cone coi̇l in obsessive-compulsive disorder: A double-blind, placebo-controlled study.

High-frequency deep transcranial magnetic stimulation (dTMS) targeting the medial prefrontal cortex (mPFC) and the anterior cingulate cortex (ACC) with an H-coil has received approval from the Food and Drug Administration for the treatment of obsessive-compulsive disorder (OCD). Nevertheless, there is limited evidence regarding the efficacy of a similar procedure performed using a double-cone coil or in an accelerated regimen. In this study, patients in the active TMS group (n = 14) underwent stimulation of the mPFC and ACC twice daily at a frequency of 20 Hz for three weeks, using a double-cone coil. The same procedure was applied to the control group (n = 15) using a placebo coil. Throughout the study, the patients continued their antidepressant and/or antipsychotic treatments at the same dose. Following treatment, the active TMS group exhibited a more significant reduction in Yale-Brown Obsessive-Compulsive Scale scores (pre-treatment: 25.36 ± 5.4, post-treatment: 18.43 ± 6.86) and Hamilton Anxiety Rating Scale scores (pre-treatment: 10.6 ± 3.5, post-treatment: 6.7 ± 2.7) compared to the sham TMS group. However, there was no statistically significant reduction in symmetry-related obsessive-compulsive symptoms in the TMS group compared to the sham TMS group. dTMS applied to the mPFC and ACC, using a double-cone coil at a 20-Hz frequency twice daily for three weeks, was found to be effective as an adjunctive treatment for treatment-resistant OCD.

Disruption of consciousness depends on insight in OCD and on positive symptoms in schizophrenia.

Disruption of conscious access contributes to the advent of psychotic symptoms in schizophrenia but could also explain lack of insight in other psychiatric disorders. In this study, we explored how insight and psychotic symptoms related to disruption of consciousness. We explored consciousness in patients with schizophrenia, patients with obsessive-compulsive disorder (OCD) with good vs. poor insight and matched controls. Participants underwent clinical assessments and performed a visual masking task allowing us to measure individual consciousness threshold. We used a principal component analysis to reduce symptom dimensionality and explored how consciousness measures related to symptomatology. We found that clinical dimensions could be well summarized by a restricted set of principal components which also correlated with the extent of consciousness disruption. More specifically, positive symptoms were associated with impaired conscious access in patients with schizophrenia whereas the level of insight delineated two subtypes of OCD patients, those with poor insight who had consciousness impairments similar to patients with schizophrenia, and those with good insight who resemble healthy controls. Our study provides new insights about consciousness disruption in psychiatric disorders, showing that it relates to positive symptoms in schizophrenia and with insight in OCD. In OCD, it revealed a distinct subgroup sharing neuropathological features with schizophrenia. Our findings refine the mapping between symptoms and cognition, paving the way for a better treatment selection.

The Relationship between COVID-19 Protection Behaviors and Pandemic-Related Knowledge, Perceptions, Worry Content, and Public Trust in a Turkish Sample.

Background: This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Methods: Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective behaviors (hand cleaning, wearing a face mask, and physical distancing) to prevent COVID-19 were examined. The impacts of the following variables on protective behaviors were investigated using logistic regression analysis: knowledge, cognitive and affective risk perception, pandemic-related worry content, public trust, conspiracy thinking, and COVID-19 vaccine willingness. Results: Out of a total of 4210 adult respondents, 13.8% reported nonadherence to protection behavior, and 86.2% reported full adherence. Males and young (aged 18−30 years) people tend to show less adherence. Perceived self-efficacy, susceptibility, and correct knowledge were positively related to more adherence to protective behavior. Perceptual and emotional factors explaining protective behavior were perceived proximity, stress level, and worrying about the relatives who depended on them. Trust in health professionals and vaccine willingness were positive predictors, while conspiracy thinking and acquiring less information (<2, daily) were negative predictors. Unexpectedly, trust in the Ministry of Health showed a weak but negative association with protection behavior. Conclusions: Perceived stress, altruistic worries, and public trust seem to shape protection behaviors in addition to individuals' knowledge and cognitive risk perception in respondents. Males and young people may have a greater risk for nonadherence. Reliable, transparent, and culture-specific health communication that considers these issues is required.

Are “not just-right experiences” trait and/or state marker for obsessive-compulsive disorder?

Background and objectives. “Not Just Right Experiences” (NJREs) are common phenomena in individuals with obsessive-compulsive disorder (OCD), involving a feeling that something is ‘not right’ or as it should be. Some evidence suggests that NJREs may be an endophenotypic marker. This study aimed to investigate whether NJREs are a trait marker present in unaffected first-degree relatives of OCD and/or a state marker associated with obsessive-compulsive symptoms. Methods. The study included 51 OCD patients, 47 first-degree relatives and 45 healthy controls. Not Just Right Experiences Questionnaire Revised (NJRE-QR), Frost Multidimensional Perfectionism Scale (FMPS), and Dimensional Obsessive-Compulsive Scale (DOCS) were administered to the participants. Results. There was no significant difference between the first-degree relatives and healthy controls in respect of NJRE-total and NJRE-severity scores. In the hierarchical regression analysis performed in OCD group, the severity of NJREs were associated with the severity of obsessive-compulsive symptoms and the 'doubts about actions' dimension of perfectionism. Conclusions. This is the first study investigating NJREs in relatives of a clinical OCD group. The results of this study support the view that NJREs are state markers for OCD.

Iconic Memory in Obsessive Compulsive Disorder. / Obsesif Kompulsif Bozuklukta Ikonik Bellek.

OBJECTIVE: In this study, we aimed to investigate whether there is a fast decay in the iconic memory of patients with Obsessive Compulsive Disorder (OCD) compared to healthy individuals by taking into consideration the clinical OCD subtypes. METHOD: The study included 74 patients diagnosed with OCD on the basis of the DSM 5 criteria and 63 healthy individuals. The OCD patients were grouped as washers, checkers, both washers and checkers, and non-washers and non-checkers. All participants took a partial report test (PRT) to compare iconic memory performance between the healthy control group and the OCD group as a whole and in OCD subgroups. RESULTS: Loss of iconic memory did not differ between OCD group and the controls. The iconic memory scores, expressed as the d' values, at specified time points correlated negatively with age and positively with education duration in all groups. When the subgroup data were analyzed by controlling for age, the d1'value showing formation of iconic information was lower in the washers subgroup in comparison to the checkers subgroup and the nonwashers and non-checkers subgroup. The d7' value was also lower in the washers subgroup than in the the non-washers and non-checkers subgroup and the healthy control group. The iconic decay rate of the washers subgroup between the time points d6' and d7' was significantly higher in comparison to the healthy control group. The scores of OCD patients on the washing subscale of the Maudsley Obsessive Compulsive Inventory (MOCI) showed negative correlations with the iconic memory scores at all time points. CONCLUSION: This study showed that washer OCD patients may have impaired iconic formation and fast iconic decay, which could significantly affect the amount of information transferred to visual memory.

Iconic Memory in Obsessive Compulsive Disorder. / Obsesif Kompulsif Bozuklukta Ikonik Bellek.

OBJECTIVE: In this study, we aimed to investigate whether there is a fast decay in the iconic memory of patients with Obsessive Compulsive Disorder (OCD) compared to healthy individuals by taking into consideration the clinical OCD subtypes. METHOD: The study included 74 patients diagnosed with OCD on the basis of the DSM 5 criteria and 63 healthy individuals. The OCD patients were grouped as washers, checkers, both washers and checkers, and non-washers and non-checkers. All participants took a partial report test (PRT) to compare iconic memory performance between the healthy control group and the OCD group as a whole and in OCD subgroups. RESULTS: Loss of iconic memory did not differ between OCD group and the controls. The iconic memory scores, expressed as the d' values, at specified time points correlated negatively with age and positively with education duration in all groups. When the subgroup data were analyzed by controlling for age, the d1'value showing formation of iconic information was lower in the washers subgroup in comparison to the checkers subgroup and the nonwashers and non-checkers subgroup. The d7' value was also lower in the washers subgroup than in the the non-washers and non-checkers subgroup and the healthy control group. The iconic decay rate of the washers subgroup between the time points d6' and d7' was significantly higher in comparison to the healthy control group. The scores of OCD patients on the washing subscale of the Maudsley Obsessive Compulsive Inventory (MOCI) showed negative correlations with the iconic memory scores at all time points. CONCLUSION: This study showed that washer OCD patients may have impaired iconic formation and fast iconic decay, which could significantly affect the amount of information transferred to visual memory.

Multifaceted impulsivity in obsessive-compulsive disorder with hoarding symptoms.

OBJECTIVE: Hoarding is common in obsessive-compulsive disorder (OCD), and OCD with hoarding may have poorer prognostic features than OCD without hoarding. The aim of this study was to investigate the relationship between multifaceted impulsivity and hoarding symptoms in individuals with OCD. This relationship is important to be able to understand the psychopathological mechanisms of hoarding symptoms in OCD patients. METHODS: The study included 136 individuals with OCD classified as OCD with high hoarding symptoms (OCDwHH, n = 41) and OCD with low/none hoarding symptoms (OCDwLH, n = 95), together with 94 healthy control subjects. All the participants completed the Hoarding Rating Scale-Interview, Barratt Impulsiveness Scale-11, Yale-Brown Obsessions and Compulsions Scale, Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale. RESULTS: The OCDwHH group had more severe anxiety (p = 0.016) and attentional impulsivity (p = 0.002) than OCDwLH. Attentional impulsivity scores were positively correlated with hoarding symptom scores (p < 0.001). Both attentional and motor impulsivity scores were positively correlated with anxiety levels (p = 0.037, p = 0.045, respectively). In partial correlation analysis, motor impulsivity was positively correlated with the severity of hoarding symptoms controlling for anxiety severity (p = 0.045). In hierarchical linear regression analysis, only attentional impulsivity predicted the severity of hoarding symptoms independently of anxiety, severity of obsessive-compulsive symptoms and motor impulsivity (ß = 0.268, Adjusted R2 = 0.114, p = 0.006). CONCLUSION: Attentional impulsivity is associated with hoarding symptoms in OCD. Future studies that reveal this relationship may contribute to treatment modalities for the OCD patients with hoarding symptoms.

Impaired Spontaneous Attention to Gaze Cueing in Obsessive-Compulsive Disorder: Eye Tracking Study. / Obsesif Kompulsif Bozukluk Hastalarinin Insanlarin Bakis Isaretine Spontan Olarak Odaklanmalari Bozuktur: Bir Göz Izleme Çalismasi.

OBJECTIVE: The aim of this study was to determine whether or not patients with obsessive compulsive disorder (OCD) differed from the control group in paying spontaneous attention to gaze cueing. METHOD: The OCD patient and control groups were tested on a shortened version of Social Distance Judgement Task using pictures of two human cartoon figures with their bodies directed toward the observer and their heads facing each other or in opposite directions. Participants were asked to compare the distances between the cartoon figures and between the blocks drawn under each figure, while their eye movements were recorded by eye-tracking equipment. Before the recording, a rectangular area, with its lower side located at the shoulder region of the cartoon figures, was determined as the area of interest for visual fixation. During the test, human cartoon figures were presented on a computer screen, and the number and duration of visual fixations on the area of interest by both patients and controls were recorded and compared with each other. RESULTS: In comparison to the control group, the patients with OCD had less number (p=0.029) and duration (p=0.051) of visual fixations on the head and surrounding region of the cartoon figures. The number and duration of fixations on the region of interest did not show correlation with the severity of symptoms. CONCLUSION: Patients with OCD are less likely to pay spontaneous attention to gaze cueing in comparison to healthy individuals. Impairment in spontaneous attention to social cues may underlie the social functioning disorders observed in these patients.

[Is Clinical Insight Associated with Working Memory Components in Schizophrenia and Schizoaffective Disorder?] / Sizofreni ve Sizoaffektif Bozuklukta Klinik Içgörü Isleyen Bellek Bilesenleri ile Iliskili midir?

OBJECTIVE: Previous studies suggest that the level of clinical insight in schizophrenia patients is related to working memory functions. However, these studies were not specifically concerned with the components of working memory and had not focused in detail on working memory functions. For this reason, the current study investigated the relationship between clinical insight and working memory components in patients with schizophrenia and schizoaffective disorder.  METHOD: The patient group was evaluated by using the Scale for Assessment of Negative Symptoms, the Scale for Assessment of Positive Symptoms, and the Scale to Assess Unawareness of Mental Disorder to measure clinical insight. Moreover, all participants underwent a "Situation Awareness" test in order to measure working memory functions. Based on published data, the first stage of this test was accepted to measure the "visual spatial sketchpad" component of working memory, and the second stage was accepted to measure the "episodic buffer" (bound information storage) component. The functions of these components were measured separately as top-down and bottom-up cognitive processes.  RESULTS: The episodic buffer function (managed by the bottom-up cognitive process) was related with clinical insight. This relationship also continued after correcting for the effect of positive symptoms on insight. The patients performed worse than the controls in terms of visual spatial sketchpad function, which was managed by both topdown and bottom-up cognitive processes. The patients performed worse than the controls in terms of both top-down and bottom-up cognitive processes and visual spatial sketchpad function. Furthermore, the patients were also worse than the controls in terms of episodic buffer function (managed by top-down cognitive processes).  CONCLUSION: Clinical insight may be associated with binding function (associated with episodic buffer function) managed by bottom-up cognitive processes in patients with schizophrenia and schizoaffective disorder. Further studies are necessary to confirm this novel finding.

What is the real effect of pregabalin in patients with diabetic neuropathic pain?(Do patients suffer from less pain or do they less care about it?).

BACKGROUND AND PURPOSE: Depression and anxiety are frequent in patients with chronic diseases such as diabetic neuropathic pain. The pain seems to be more severe in patients in whom depressive findings accompanied pain symptoms. Pregabalin was reported to have positive effects on anxiety and depression. This brings out the question, whether the pain relief effect of pregabalin is due to its analgesic effect or to its effects on mood? The aim of this study is to find out whether the positive effect of pregabalin in patients with diabetic neuropathic pain is limited to its effect on pain. Thus the question - do patients suffer from less pain or do they less care about pain? - should be answered. METHODS: With this aim the NRS scores of 46 patients with diabetic neuropathic pain, whose HADS scores did not change with pregabalin treatment were compared with their baseline levels, retrospectively. RESULTS: The NRS scores of the group were reduced with pregabalin treatment. CONCLUSION: This results suggests that the reduced pain in pregabalin treatment should be independent from its effects on depression and anxiety.

Modafinil Dependence: A Case with Attention-Deficit/Hyperactivity Disorder.

Modafinil is generally known as a drug with low addiction potential. There are few case reports in the literature demonstrating that Modafinil, stated being capable of diminishing symptoms of attention deficit/hyperactivity disorder (ADHD), causes addiction. In the present article a Modafinil addicted ADHD case, consuming usurious doses (5,000 mg/per day) of Modafinil is presented. The case presented to our psychiatry outpatient clinic due to: requirement of in taking high dose Modafinil in order to achieve the initial effects, difficulty in obtaining the drug, irritability, anxiousness, sleep irregularities, fatigue and unpleasant vivid dreams when he did not use the drug. It was realized that the patient, himself increased doses of Modafinil incrementally, in order to keep its effects on attention symptoms at the same level. It has to be kept in mind that ADHD patients can develop Modafinil addiction. It is necessary to carry out systemic studies on this subject.

Metacognitive Beliefs and Their Relation with Symptoms in Obsessive-Compulsive Disorder.

INTRODUCTION: Metacognitive constructs have shown promise in explaining the symptoms of Obsessive-Compulsive Disorder (OCD). Few studies have examined the role of metacognitions in symptom dimensions of OCD, despite mounting clinical, neuropsychological and imaging evidence for the distinctiveness of these dimensions. METHODS: Metacognitions were assessed using the Metacognitions Questionnaire (MCQ-30) in 51 participants with DSM IV OCD and 46 healthy controls. The Maudsley Obsessional Compulsive Inventory (MOCI) was used to quantify symptom dimensions, along with the Hamilton Anxiety Rating Scale (HAM-A) for anxiety, and Hamilton Depression Rating Scale (HAM-D) for depression. RESULTS: Individuals with OCD differed from healthy controls on beliefs of uncontrollability and danger when depression and anxiety were controlled for. Correlations between metacognitive beliefs and obsessive-compulsive symptom dimensions were largely similar across the OCD and healthy control groups. Hierarchical regression showed that need to control thoughts contributed to checking, cleaning and rumination symptoms; cognitive self-consciousness to symptoms of slowness; uncontrollability and danger to doubt symptoms; positive beliefs to checking symptoms. CONCLUSIONS: Specific associations between metacognitive variables and the different symptom dimensions of OCD are evident, however, severity of anxiety and depression also contribute to these associations.

Situation Awareness in Obsessive Compulsive Disorder and Their Relatives: an Endophenotype Study.

INTRODUCTION: It has been theorized that endophenotype models will help to understand the etiology of heterogeneous brain disorders such as obsessive-compulsive disorder (OCD). In this study, it was aimed to determine whether "situational awareness" impairments which can be defined as partially naturalistic working memory deficits, are an endofenotype for OCD. METHODS: In this study, situational awareness (SA) task performances of 67 OCD patients, 50 their unaffected first-degree relatives, and 41 healthy controls who matched with regard to sex, age and years of education were measured to investigate endophenotypes in OCD. For this purpose, a visuospatial working memory test was used. RESULTS: As a result, the relatives showed a task performance between patients with OCD and control group in both SA1 and SA2 tasks. Patients with OCD performed significantly worse than control group on SA1 single and dual task. On the other hand, there were no significant differences between relatives and patients of any SA assessment. CONCLUSION: These results indicated that poor situational awareness may be a candidate endophenotype for OCD. Early perceptual dysfunctions such as poor performance on SA1 task can mediate the genetic risk for OCD.

Reversal learning in patients with obsessive-compulsive disorder (OCD) and their unaffected relatives: Is orbitofrontal dysfunction an endophenotype of OCD?

It has been suggested that reversal learning deficits might be an endophenotype of OCD. To investigate this hypothesis, we administered a probabilistic reversal learning task (ProbRev) to OCD patients, their unaffected first-degree relatives, and healthy controls. Although the relatives had a performance in between OCDs and controls at the early phase of the ProbRev, their performance was similar to controls and was significantly better than OCD patients at the later stages of the test. Our findings imply that reversal learning impairment might be partly a trait-related feature of OCD but state-related factors can also contribute to observed deficits.

Executive dysfunction and cognitive subgroups in a large sample of euthymic patients with bipolar disorder.

Bipolar disorder (BP), at the group level, is associated with significant but modest cognitive deficits, including executive dysfunction. Among executive functions, response inhibition deficits have been suggested to be particularly relevant to BP. However, BP is associated with significant heterogeneity in neurocognitive performance and level of functioning. Very few studies have investigated neurocognitive subgroups in BP with data-driven methods rather than arbitrarily defined criteria. Other than having relatively small sample sizes, previous studies have not taken into consideration the neurocognitive variability in healthy subjects. Five-hundred-fifty-six euthymic patients with BP and 416 healthy controls were assessed using a battery of cognitive tests and clinical measures. Neurocognitive subgroups were investigated using latent class analysis, based on executive functions. Four neurocognitive subgroups, including a good performance cluster, two moderately low-performance groups, which differ in response inhibition and reasoning abilities, and a severe impairment cluster were found. In comparison to healthy controls, BP patients were overrepresented in severe impairment cluster (27% vs 5.3%) and underrepresented in good performance cluster. BP patients with lower educational attainment and older age were significantly more likely to be members of cognitively impaired subgroups. Antipsychotic use was less common in good performance cluster. These results suggest that there is a considerable overlap of cognitive functions between BP and healthy controls. Neurocognitive differences between BP and healthy controls are driven by a subgroup of patients who have severe and global, rather than selective, cognitive deficits.

Relationship between Obsessive Beliefs and Symptoms in Patients with Obsessive Compulsive Disorder.

INTRODUCTION: Misinterpretation of intrusive thoughts because of obsessive beliefs has been thought to be important in the development of obsessive compulsive symptoms. In current study, (I) the difference between OCD patients and healthy controls in regard of obsessive beliefs and (II) the relation of obsesive beliefs with the prevelance and severity of obsessive compulsive symptoms was investigated. METHODS: The current study included 47 OCD patients and 44 healthy controls who have same properties with regard to age, sex and duration of education. All subjects were applied to Obsessive Beliefs Scale, Maudsley Obsessive Compulsive Scale, Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale. OCD patients were applied to Yale Brown Obsessive Compulsive Scale as well as the other scales. RESULTS: In analyses by controlling depression and anxiety scores, OCD patients had significantly higher scores than controls, with regard to all subscales of Obsessive Beliefs Scale. Also, prevalence of obsessive compulsive symptoms other than cleaning were correlated with obsessive beliefs about "responsibility and threat estimation" and "perfectionism and need for certainty". Hovewer, there was no correlation in between severity of obsessive compulsive symptoms and subscale scores of Obsessive Beliefs Scale. CONCLUSION: Excluding the effects of depression and anxiety, generally the results suggests that obsessive beliefs have an important role for development of obsessive compulsive symptoms. Future studies of seperated OCD subgroup with regard to obsessive compulsive symptoms will be helpful in determinig the difference among these subgroups in regard of obsessive beliefs.

[Prefrontal cortex neurochemical metabolite levels in major depression and the effects of treatment: an HMRS study]. / Major depresyonda prefrontal korteks nörokimyasal metabolit düzeyleri ve sagaltimin etkileri: bir HMRS çalismasi.

OBJECTIVE: Neuronal degeneration in the prefrontal cortex during depression results in altered production of neurochemical metabolites. The aim of the present study is to examine changes in neurochemical metabolites in the prefrontal cortex and evaluate the effects of psychodrama group therapy and pharmacotherapy on neurochemical metabolism in the first episode depression using 1HMRS methodology. METHOD: Eighteen drug-free female patients with diagnosed first-episode major depression according to DSM-IV criteria and 10 healthy female subjects were enrolled in the study. The Hamilton Rating of Depression Scale (HAM-D) was used to asses the severity of depression in each of the study participants. Proton magnetic resonance spectroscopy (1HMRS) was applied to the right prefrontal cortex both before and after treatment and the concentration of N-Asetil Aspartate (NAA), choline (Cho), and creatine (Cr) were measured. All patients were prescribed ant-depressant medication at the time of the evaluation (essitalopram 10-20 mg/g). In addition, a psychodrama group therapy session was conducted in which 10 patients participated in one 3-hour session each week. HAM-D and 1HMRS were repeated after 16 weeks. RESULTS: Prior to treatment, the HAM-D score in the patient group was 14.55±4.55 while the HAM-D score was 3.88±2.47 after 16 weeks of treatment. The severity of symptoms among the patient group was determined to be mild/moderate. No neurochemical abnormalities were identified in the right prefrontal cortex of depressed patients compared to the healthy subjects in the baseline measurements and no significant change was observed in neurochemical metabolites following treatment with pharmacotherapy or pharmacotherapy with group psychotherapy. CONCLUSION: Our results identified no neurodegeneration, cell membrane dysfunction, alterations in energy metabolism, or altered neurochemical metabolite levels in patients undergoing a first episode of mild/moderate depression. Further studies will be needed to evaluate the effects of alternate treatments and the presence or absence of neuronal damage during follow-up of patients with depression.

[A neuropsychological comparison of bipolar disorder and adult attention deficit hyperactivity disorder]. / Bipolar bozukluk ve eriskin dikkat eksikligi hiperaktivite bozuklugunun nöropsikolojik açidan karsilastirilmasi.

AIM: The present study aimed to compare cognitive signs of bipolar disorder patients with that of adult attention-deficit/hyperactivity disorder (ADHD) patients. METHOD: The study comprised 66 bipolar disorder patients, 63 ADHD patients, and 58 healthy controls.Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I), Wender Utah Rating Scale, and Adult Attention-Deficit/Hyperactivity Rating Scale were performed in all subjects, whereas bipolar disorder patients underwent additional Hamilton Depression Rating Scale and Young Mania Rating Scale. Subsequently, all participants underwent cognitive assessment including Digit Ordering Test, Verbal Memory Process Test, Wisconsin Card Sorting Test and Stroop Test. RESULTS: Bipolar disorder, ADHD and control groups did not differ significantly from each other with regard to age, sex and duration of education. Bipolar patients displayed poorer performance in Digit Span Test, Verbal Memory Process Test, Wisconsin Card Sorting Test and Stroop Test as compared to the control group. ADHD patients were worse than the control subjects in Stroop Test (subtest of difference in times). Bipolar disorder patients were poorer than ADHD patients in cognitive tests except for Stroop Test. CONCLUSION: In general, bipolar disorder patients have much more severe cognitive impairment than ADHD patients in terms of verbal memory and executive functions. The results supports the idea of bipolar disorder and ADHD are different, at least in terms of cognitive performance.

Involuntary social cue integration in patients with obsessive compulsive disorder.

OBJECTIVE: Patients with obsessive compulsive disorder (OCD) have inferior social functioning compared to healthy controls, but the exact nature of these social deficits, and the underpinning mechanisms, are unknown. We sought to investigate social functioning in patients with OCD by measuring their involuntary/spontaneous processing of social cues using a specifically designed test, which might reveal deficits in these patients that explicit voluntary tasks do not detect. METHODS: The sample of the study consisted of an OCD group (n = 25) and a control group (n = 26). Both groups performed an adaptation of the Social Distance Judgment Task (SDJT; Jellema et al., 2009), in which participants have to judge the geometrical distance between two human cartoon figures presented on a computer screen. Head/gaze direction and body direction were manipulated to be either compatible, i.e. both directed to the left or to the right (Compatible condition) or incompatible, i.e. body directed toward the observer (frontal view) and head/gaze directed to the left or right (Incompatible condition). RESULTS: In the Compatible condition, controls nor OCD patients were influenced by the social cues in their judgments of the geometrical distances. However, in the Incompatible condition, where the attentional cue was more conspicuous, both groups were influenced by the cues, but the controls to a significantly larger extent than the OCD patients. CONCLUSIONS: This study showed that patients with OCD are less likely, compared to controls, to automatically/spontaneously integrate the other's direction of attention into their visual percept. This may have resulted in their judgments of the geometrical distances between the agents to be more accurate than those of controls. The suggested impairment in automatically integrating social cues may have important repercussions for the social functioning of OCD patients.