The effect of the COVID-19 pandemic on health behavior and psychopathology in patients with psychotic disorders.

In our study we aimed to investigate the effect of the pandemic period on disease severity, medication adherence, suicidal behavior, physical health and health behavior in patients with psychotic disorders. 255 patients with any of the diagnoses of Schizophrenia, Schizoaffective Disorder, Delusional Disorder, Bipolar Disorder with psychotic features and Major Depressive Disorder with psychotic features were included, 200 were assessed by telephone and 55 face-to-face. The patient's sociodemographic status, cigarette-alcohol use, physical diseases, body weight, suicidal behaviors, and the effects of the pandemic period on general health were assessed. Clinical global impression scale(CGI) and modified medication adherence scale(MMS) were also administered. We showed that the MMS scores of the patients significantly decreased compared to the pre-pandemic period. In our study, suicidal behavior and decrease in medication adherence during the pandemic period were found to be correlated with higher scores of CGI- Severity and Improvement Scale. Our study is one of the few studies that addresses the effects of the pandemic period on patients with psychotic disorders. The results show that the pandemic period is associated with an increase in negative health behavior and clinical worsening in patients with psychotic disorders. In order to confirm these findings, more research is needed in this area.

Associations Between Subclinical Inflammatory Markers and OCD: A Retrospective Study.

Obsessive-compulsive disorder (OCD) is characterized by unwanted, intrusive and disturbing thoughts or images that cause anxiety and repetitive behaviours or mental acts to relieve these thoughts or images. Considering controversial aetiology of OCD and growing evidence for the role of inflammation in OCD, the aim of this study was to examine the association between OCD and subclinical inflammatory markers, namely neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio(PLR) in adult patients and to investigate the association between antidepressant medications and NLR, PLR. Electronic medical records(EMR) of 24,635 patients aged 18-64 were reviewed and after exclusion of comorbid psychiatric and medical diagnosis 135 EMR of OCD patients were included into final analyses and compared with the healthy control group (n=133). Blood cell counts were noted to calculate NLR and PLR. Medications of patients were gathered from all patients to calculate fluoxetine-equivalent-dose(FED) to examine the effects of antidepressants on NLR and PLR. NLR and PLR were significantly higher in OCD. Contrary to the correlation of FED with NLR, PLR was found to not correlate with FED. Hence, PLR would be considered as a robust biomarker to medication effect contrary to NLR. OCD was significantly predicted by both NLR and PLR in logistic regression analyzes.

Risk factors for valproic acid induced hyperammonemia and its association with cognitive functions.

OBJECTIVE: Valproic acid (VPA)-induced hyperammonemia (VIH), is an increase in blood ammonia levels without any alteration of hepatic enzymes, which can occur during VPA treatment. We aimed to determine the prevalence rate and the risk factors for VIH and its association with cognitive functions. METHOD: A prospective, cross-sectional study was conducted. Patients aged between 18 and 64 who were on VPA treatment and who diagnosed with mood disorders or epilepsy were enrolled in this study (n = 107). For cognitive assessment, Serial 7's and Subjective Memory Complaints Questionnaire (SMCQ) were used. Blood samples were collected for blood VPA and ammonia levels along with other laboratory tests. RESULTS: 55,3% of the sample were considered as VIH. Blood ammonia level significantly correlates with VPA blood levels, total daily dose of VPA and total number of medications concurrently used, but no significant correlation was found between blood ammonia level and cognitive test scores. Gender, body weight, blood VPA levels and the total number of medications concurrently used significantly predicted blood ammonia levels (F(4,81) = 2670, p = 0,038, R2 = 0,116). CONCLUSION: VIH is relatively high in our sample. There is a dose-dependent association between VPA and blood ammonia level. No association was found between cognitive functions and hyperammonemia however with some limitations. Future, prospective cohort studies are needed.

[Psychosocial Functioning in Euthymic Patients with Bipolar Disorder Type–II and Associated Clinical and Cognitive Factors]. / Ötimik Bipolar Tip II Bozuklugu olan Hastalarda Psikososyal Islevsellik Düzeyleri ve Iliskili Klinik ve Bilissel Etmenler.

OBJECTIVE: The aim of this study was to investigate psychosocial functioning of euthymic Bipolar Disorder Type-II (BD-II) patients and the association between psychosocial functioning with cognitive functions and subclinical symptoms. The hypothesis was BD-II patients would have low level of psychosocial functioning comparing to healthy subjects and psychosocial functioning would be associated independently with cognitive dysfunction and subclinical symptoms. METHOD: Thirthy-three subjects who met criteria for BD-II according to Structured Clinical Interview for DSM-IV and thirty-five healthy subjects were included. Clinical symptoms were assessed by Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS); Hamilton Anxiety Rating Scale (HARS); psychosocial functioning was assessed by Functioning Assessment Short Test (FAST). Neurocognitive assessment battery was consisted of WAIS-R general information subtest; Wisconsin Card Sorting Test (WCST) perseverative errors, nonperseverative errors and category completed subtests; Trail Making Test-B (TMT-B); Stroop TBAG form; Trail Making Test-A(TMT-A) Auditory Consonant Trigrams (ACT) ACT; Wechsler Memory Scale Revised (WMS-R). RESULTS: Clinical symptoms assessed by HDRS, HARS scores; psychosocial functioning scores assessed by FAST; neurocognitive functions assessed by WCST category completed and, TMT-B, Stroop test, TMT-A, ACT, and WMS-R scores were significantly different between the two groups. FAST scores were associated with ACT scores in BB-II group. CONCLUSION: BB-II patients had cognitive dysfunctions and low level of psychosocial functioning even in their euthymic states. Working memory dysfunction was independently associated with psychosocial functioning of euthymic BB-II patients.

[Clinical and cognitive predictors of psychosocial functioning during the euthymic period in bipolar disorder type II]. / Bipolar Tip II Bozuklukta Ötimik Dönemde Islevselligin Klinik ve Bilissel Yordayicilari.

AIM: Review of clinical and cognitive predictors of psychosocial functioning during the euthymic period in patients with bipolar disorder type II (BD II) was aimed in this paper. Psychosocial functioning status, clinical and cognitive predictors of psychosocial functioning and assessment of psychosocial functioning during the euthymic period in patients with BD-II were discussed. METHOD: Studies investigated psychosocial functioning and its clinical and cognitive predictors were reviewed. Studies conducted between 1990 and 2013 were scanned. RESULTS: It's been seen that there were limited studies investigating psychosocial functioning and predictors of psychosocial functioning. Findings from these limited studies indicated that patients with BD-II experienced psychosocial disability as much as BD-I did. It was reported that subclinical depressive symptoms and cognitive impairment were the prominent predictors of psychosocial functioning during the euthymic periods in patients with BD-II. CONCLUSION: There are limited studies conducted in euthymic BD-II patients. There are various findings among the studies. Nevertheless, subclinical depressive symptoms and cognitive impairments are the prominent predictors of psychosocial functioning in euthymic BD-II patients. However, follow-up and cross-sectional studies are needed in this area.