Serum HMGB1 and Beclin 1 Levels in Patients with a Diagnosis of Schizophrenia. / Sizofreni Tanili Hastalarda Serum HMGB1 ve Beklin 1 Düzeyleri.

OBJECTIVE: It is known that inflammation plays a role in the etiopathogenesis of schizophrenia. In this study, we examined high mobility group box 1 protein (HMGB1) and Beclin 1 levels and their relationship with clinical variables in patients with schizophrenia. METHOD: Forty-three patients with schizophrenia and 43 healthy controls were included in this study. The patients were administered sociodemographic data form, the Positive Negative Symptoms Assessment Scale (PANSS) and the Clinical Global Impressions (CGI) scale. After the scales were filled, venous blood samples were taken from both the patient and control groups to measure serum HMGB1 and Beclin 1 levels. Serum samples obtained at the end of centrifugation were measured by Enzyme-Linked ImmunoSorbent Assay (ELISA) method. RESULTS: The mean serum HMGB1 levels were significantly increased and the mean serum Beclin 1 levels were significantly decreased in the schizophrenia group compared to the control group. In addition, a negative correlation was found between HMGB1 and Beclin 1 levels. CONCLUSION: In conclusion, current research shows that HMGB1 is increased and Beclin 1 is decreased in patients with schizophrenia, and these findings may contribute to the role of autophagy in the pathogenesis of schizophrenia.

Evaluation of Optical Coherence Tomography Findings in Antisocial Personality Disorder Patients.

Background: Antisocial personality disorder is a frequently studied personality disorder, and its etiopathogenesis is still investigated. Neuroimaging demonstrated that certain regions of the brain could be associated with this disorder, and in the present study, we aimed to investigate the changes in retina, which could be considered an extension of the brain in antisocial personality disorder patients with optical coherence tomography. Methods: The study was conducted with 35 patients and 35 healthy controls. The study data were collected with the Sociodemographic and Clinical Data Form, Beck Anxiety Inventory, Beck Depression Inventory, and Barratt Impulsivity Scale-Short Form. Retinal nerve fiber layer thickness, choroidal thickness, and macular thickness were analyzed based on optical coherence tomography. Results: The Beck Depression Inventory (P = .044), Beck Anxiety Inventory (P = .005), Barratt Impulsivity Scale-motor (P < .001), Barratt Impulsivity Scale-non-planning dimension (P < .001), and Barratt Impulsivity Scale-total scores (P < .001) of the patients were significantly higher when compared to the controls. The superior (P = .013) and inferior retinal nerve fiber layer thickness (P < .001) of the patients were significantly lower when compared to the control group. Conclusion: Retinal nerve fiber layer thickness was significantly lower in the patient group when compared to healthy controls, which suggested that it could be associated with the pathophysiology of antisocial personality disorder.

Inflammation Markers in Patients with Bipolar Disorder Who Have Committed Offenses and Their Relationship with Criminal Behavior.

Background and Objectives: This study aimed to examine the function of various inflammation parameters and their interactions in the pathology of Bipolar disorder (BD) and to assess whether they could be biomarkers in the relationship between criminal behavior and BD. Materials and Methods: Overall, 1029 participants, including 343 patients with BD who have committed offenses, 343 nonoffending patients with BD, and 343 healthy controls, were included in this retrospective study. Neutrophil, lymphocyte, monocyte, and platelet counts; high-density lipoprotein (HDL-c) levels; systemic immune-inflammatory index (SII), systemic inflammatory response index (SIRI), neutrophil to high-density lipoprotein ratio (NHR), lymphocyte to high-density lipoprotein ratio (LHR), monocyte to high-density lipoprotein ratio (MHR), platelet to high-density lipoprotein ratio (PHR) were measured. Results: Significant differences were observed between the groups in terms of SII, SIRI, NHR, LHR, MHR, PHR, neutrophil, and monocyte values (p < 0.001). The lymphocyte counts were significantly higher in the patients with BD who committed offenses (p = 0.04). The platelet counts were significantly lower in the patients with BD who committed offenses compared to nonoffending patients with BD (p = 0.015). The HDL-c levels were significantly lower in the patients with BD who have committed offenses than those of nonoffending patients with BD (p < 0.001). Bipolar disorder, not receiving active psychiatric treatment, having a diagnosis of bipolar manic episodes, and having low platelet and HDL values constitute a risk of involvement in crime. Conclusions: The present study emphasizes the role of systemic inflammation in the pathophysiology of patients with BD with and without criminal offenses and the relationship between inflammation and criminal behavior.

The effect of functional remission and cognitive insight on criminal behavior in patients with schizophrenia.

OBJECTiVE: This study was planned to determine the relationship of functional remission with a criminal history and determine its effect on criminal behavior in patients with schizophrenia. METHODS: This cross-sectional study was conducted with 132 patients with schizophrenia (66 with and 66 without a criminal history). Data were collected between November 2020 and April 2021 using a personal information form, the Functional Remission of General Schizophrenia (FROGS), the Taylor Crime Violence Rating Scale, the Beck Cognitive Insight Scale, and the Positive and Negative Syndrome Scale (PANSS) was used to collect data. RESULTS: In terms of all scale variables, there were significant differences between the groups with and without a criminal history (p < 0.05). These differences were mostly clearly observed in the FROGS-social functionality (effect size: 16.79), PANSS-positive (effect size: 2.62) and FROGS-health and treatment (effect size: 2) subscales. CONCLUSIONS: In this study, it was determined that as the symptoms of the illness increased in schizophrenia, the patients' functional remission and insight decreased, and their tendency to commit crimes increased. Psychiatric nurses can plan therapeutic interventions to increase the functionality and insight levels of patients with schizophrenia.

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.

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 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 relationship of suicidal ideation with psychological pain and anger rumination in patients with major depressive disorder.

OBJECTiVE: The study was conducted to determine the association between ruminating anger and mental pain with suicidal ideation in patients diagnosed with major depression disorder. METHODS: The study with 156 patients diagnosed with major depressive disorder was carried out in a cross-sectional study design. Personal Information Form, Reflection on Anger Scale, Psychological Pain Scale and Beck Depression Scale were used. RESULTS: It was concluded that there was a statistically equal directional and linear relationship between the Meebunney and Beck depression scores of all patients diagnosed with a major depressive disorder and the total reflective anger score and its sub-dimensions. Suicidal attempts and psychological pain and depression levels were found to be effective in the increase in suicidal ideation in the patients with major depressive disorder. CONCLUSIONS: Studies with larger samples are recommended to determine the factors that may pose a risk of suicidal ideation in patients diagnosed with majör depressive disorder.

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.

Insula Volume in Patients Diagnosed with Obsessive Compulsive Disorder and its Relation with Clinical Variables.

INTRODUCTION: Neuroimaging studies performed in recent years on patients with obsessive compulsive disorder have determined anomalies that are possibly associated with the determinant signs and symptoms of the disease. The purpose of this study is to investigate the morphometric changes in insula volume and related parameters in order to understand the etiopathogenesis of obsessive compulsive disorder better. METHOD: Throughout the study, 20 patients eligible for the study criteria, who were diagnosed with OCD according to DSM-5 diagnostic criteria and receiving inpatient or outpatient treatment after applying to Firat University Hospital Psychiatry Department, and 13 healthy subjects in the control group have been included in the study. Sociodemographic and Clinical Data Form, Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Yale-Brown Obsession Compulsive Scale (Y-BOCS) and SCID-I have been applied to the patients. Volumetric measurements were performed on the insula by using magnetic resonance imaging (MRI) in patient and control groups. RESULTS: No significant difference was observed between patients with Obsessive Compulsive Disorder and healthy controls with regard to insula volume. DISCUSSION: It may be stated that insula may be associated with both the pathophysiology and clinical course of the disease. It is suggested that studies considering the imaging methods examining the functional characteristics of this area and tests on cognitive functions together may lead to significant and efficient results.

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.

Nitric oxide, asymmetric dimethylarginine, symmetric dimethylarginine and L-arginine levels in psychotic exacerbation of schizophrenia and bipolar disorder manic episode.

OBJECTIVES: To examine the changes in nitric oxide (NO), asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-arginine levels in schizophrenia during acute psychotic exacerbation and in bipolar disorder during mania and to compare those changes to healthy controls. METHODS: Thirty schizophrenia patients with acute psychotic exacerbation and 30 bipolar disorder patients with mania, who attended the Psychiatry Department,  Erenköy Hospital for Mental and Nervous Diseases, Istanbul, Turkey, in 2010. Thirty healthy controls were included. The diagnosis was made using the Structured Clinical Interview for Axis I Disorders (SCID-I) interviews. Patients' demographic data were recorded, and NO, SDMA, L-arginine, and ADMA levels were studied. RESULTS: Nitric oxide levels in schizophrenia patients were significantly lower than the control group. Nitric oxide levels in the bipolar group were lower than the control group but the difference was not statistically significant. The levels of SDMA, ADMA, and L-arginine were found to be significantly higher in schizophrenia and bipolar disorder patients than the control group. The disease duration was slightly negatively correlated with NO levels in bipolar patients. In schizophrenia patients, the disease severity was slightly positively correlated with NO levels. CONCLUSION: Significant changes in NO, SDMA, ADMA, and L-arginine levels in schizophrenia and bipolar disorder patients suggest that NO and inhibitors of NO might be implicated in the neurobiology of schizophrenia and bipolar disorder.

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.