Personality Traits Interact With Sleep and Biological Rhythm in Patients With Bipolar Disorder.

ABSTRACT: Sleep disturbances and circadian rhythm changes in bipolar disorder (BD) may have behavioral components as well as biological components. This study aimed to examine the relationship between personality traits, sleep and circadian rhythm in BD. A total of 150 participants with BD, and 150 healthy controls completed the Big Five Personality Test-50 (B5PT-50-TR), Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN), Functioning Assessment Short Test (FAST), Pittsburgh Sleep Quality Index (PSQI), Young Mania Rating Scale and Beck Depression Inventory. In the BD group, B5PT-50-TR emotional stability and openness subscale scores were significantly lower in comparison with the healthy control group. Agreeableness and emotional stability subscales were covariates for the BRIAN sleep subscale and emotional stability was a covariate for PSQI total score. Emotional instability might be a vulnerability factor for sleep disorders and biological rhythm abnormalities in BD. Improvement in emotional instability may relieve sleep disorders and biological rhythm, thereby leading to better treatment outcomes in BD.

Evaluation of Eating Attitudes, Anger and Impulsivity in Atypical and Non-Atypical Depression and Assessment of Comorbidity of Binge Eating.

BACKGROUND: Although there have been studies investigating emotional eating, impulsivity and anger, the relationship between differentiated eating attitudes, impulsivity and anger in atypical depression has not yet been studied. Therefore, the aim of this study was to evaluate eating attitudes, impulsivity and anger in participants with atypical and non-atypical depression and to compare their behaviours with those of the control group. Binge eating comorbidity was also investigated. The relationship between eating attitudes, impulsivity and anger was explored and the factors contributing to disordered eating attitudes were analysed. SUBJECTS AND METHODS: The participants were divided into three groups; 56 with atypical depression, 36 with non-atypical depression and 32 healthy controls for comparison. Clinical assessment was carried out using the Structured Clinical Interview for DSM-IV Axis I Disorders, Barratt Impulsiveness Scale, Multidimensional Anger Scale, Eating Attitude Test, and Hamilton Depression Scale. RESULTS: Deteriorated eating attitudes, increased anger symptoms and motor impulsivity were observed more in participants with atypical depression compared with participants with non-atypical depression. The frequency of binge eating was statistically significantly higher in participants with atypical depression (50%) than in participants with non-atypical depression (8%). A positive relationship was identified between deteriorated eating attitude, anger, and impulsivity. Behaving anxiously as a reaction to anger was found to be the significant predictor of disordered eating attitudes in participants with depression. The percentage of the variance explained by anxious behavior in disordered eating attitudes was 7%. CONCLUSION: Participants in the atypical and non-atypical depression groups can be differentiated from each other based on their eating attitudes, anger symptoms, motor impulsivity and binge eating frequency.

Psychopathology in Violent Offenders Against Healthcare Workers.

Workplace violence in healthcare is gradually becoming a major concern in many countries around the world and research has usually been focused on the victims of violence. The aim of this study was to investigate the psychopathology of individuals who commit violence against healthcare workers. The study included 50 subjects (patient or relative of patient) aged 18-65 years who had committed violence against a healthcare worker (study group) and a control group of 55 subjects with no history of violence. A Sociodemographic Questionnaire, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Barratt Impulsiveness Scale (BIS-11), State-Trait Anger Expression Inventory (STAXI), and Eysenck Personality Questionnaire-Revised Short Form (EPQ-RSF) were administered to both the study group and the control group. A psychiatric disorder was diagnosed in 50% of the violent offenders group and in 16.4% of the control group. It was determined that 54.8% of the patient relatives and 44.4% of the patients themselves who committed a violent act against healthcare workers had at least one psychiatric diagnosis and these rates did not differ between the patients and their relatives (χ2 = 0.492, p = 0.483). Comparisons of the scale scores between the groups revealed that the STAXI scores (p < .001), BIS-11 total scores (p < .001), BDI, and BAI scores were statistically significantly higher in the violent offenders group. Considering the higher rates of psychiatric disorders and higher levels of anger and impulsivity among people who commit violent acts against healthcare workers, psychotherapeutic interventions such as stress and anger management interventions, improvement of interaction and communication between patients, their relatives and healthcare workers, and the implementation of rehabilitating punitive programs for violent offenders may be beneficial to reduce the rates of violent behavior against healthcare workers.

Symptoms of swallowing anxiety in panic disorder patients and associated psychopathologic factors.

AIM: The aim of this study was to investigate symptoms of swallowing difficulty in Panic Disorder (PD) patients and the factors associated with these symptoms. METHODS: In the pre-phase of the study, 22 PD patients who were treated in psychiatry outpatient clinics and who were found to have swallowing difficulty were evaluated. PD patients were asked to write about their thoughts, feelings and behaviors associated with swallowing difficulty. Later, these texts were examined and 41 expressions were identified in which patients described their swallowing difficulty. These expressions were evaluated by mental health workers in the field and twelve different swallowing difficulty items were defined. In the main phase of the study, 119 PD outpatients were evaluated using twelve different swallowing difficulty items and psychometric tests [Panic and Agoraphobia Scale (PAS), Separation Anxiety Symptom Inventory (SASI), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI-1/STAI-2)]. RESULTS: As a result of the validity and reliability analysis, a valid one-factor instrument with ten items was obtained. Cronbach's alpha value for this measurement tool was 0.89 and it was termed the "Swallowing Anxiety Scale (SAS)". It was found that SAS items "always" accompany PD patients at rates of 5-20.2%. According to hierarchical regression analysis, 35% of SAS scores were explained by PAS, SASI, STAI-2 and BDI scores. CONCLUSION: Swallowing difficulty items in PD patients involved anxious, phobic and somatic symptoms associated with swallowing. In addition, swallowing difficulty symptoms in PD patients can be confounded with eating disorder symptoms.

Personality-related core beliefs in patients diagnosed with fibromyalgia plus depression: A comparison with depressed and healthy control groups.

BACKGROUND: Personality has an important role in understanding both fibromyalgia syndrome (FMS) and major depressive disorder (MDD). AIMS: This study considers the question that specific personality features may characterize depressed FMS patients. MATERIALS AND METHODS: To this end, 125 individuals were included in the study: 40 of them diagnosed with FMS+ MDD, 40 with MDD only and 45 healthy controls. Individual Beck Depression Inventory (BDI) and Personality Belief Questionnaire-Short Form (PBQ-SF) scores were compared between the three groups. RESULTS: The mean scores for each personality domain of the PBQ-SF were the highest in the MDD group and the lowest mean scores appeared in the control group. Dependent personality and obsessive-compulsive personality scores were higher in the MDD group (t = 2.510, P = 0.014 and t = 2.240, P = 0.028, respectively) in comparison with the FM+ MDD group. However, this difference disappeared when PBQ-SF scores were controlled for depression severity. CONCLUSIONS: Although some common personality features are evident in FMS patients, it seems that the differences identified are primarily related to depression symptom severity.

Urinary neopterine levels in patients with major depressive disorder: alterations after treatment with paroxetine and comparison with healthy controls.

BACKGROUND: A close relationship has been shown between mood disorders and pteridine levels. The aim of this study was to examine alterations in the urine neopterine levels of patients with major depressive disorder (MDD) who responded to paroxetine during the initial treatment and to compare their levels to those of healthy controls. SUBJECTS AND METHODS: Sixteen patients with major depression and 19 healthy controls were enrolled in the study. In order to assess depression severity levels, the Beck Depression Inventory, the Beck Anxiety Inventory, and the State-Trait Anxiety Inventory were administered. Urinary neopterine values that were measured using high pressure liquid chromatography (HPLC) were compared using non-parametric tests for the MDD patients before and after treatment. Urine neopterine levels in MDD patients before and after treatment were compared to those of the healthy control group. RESULTS: Urinary neopterine levels were recorded as follows: For the MDD group before treatment the mean level was 187.92±54.79 µmol/creatinine. The same group under treatment at 4 to 8 weeks was at 188.53±4962 µmol/creatinine, and the healthy control group showed 150.57±152.98 µmol/creatinine levels. There was no statistically significant difference in the urinary neopterine levels among the MDD patients before and after treatment (p=0.938). When urine neopterine levels in MDD patients before and after treatment were compared to those of the healthy control group, levels in the MDD group were found to be significantly higher (p=0.004 and p=0.005, respectively). CONCLUSIONS: Findings from the current study suggest that despite treatment response, depression is related to higher levels of urine neopterine. Paroxetine treatment has no significant effect on urine levels of neopterine in MDD patients.

Adjuvant Hypnotherapy for Hyperemesis Gravidarum: A Randomized Pilot Study.

Hyperemesis gravidarum, which requires hospitalization in approximately 1% to 5% of patients, is characterized by severe nausea and vomiting in pregnancy. This study investigated the effects of hypnosis on nausea, vomiting, use of antiemetic medications, and hospital stay among patients diagnosed with hyperemesis gravidarum. Patients were randomized to receive either conventional therapy alone (control condition, n = 23) or adjuvant hypnotherapy plus conventional therapy (treatment group, n = 18). Sociodemographic data, severity of nausea, frequency of vomiting per day, rescue medications used, and length of hospital stay were recorded. Participants in the treatment group received 2 sessions of hypnosis and were instructed in daily self-hypnosis practice. Those in the control group received treatment as usual. Results from this study indicated that adjunctive use of hypnotherapy with patients diagnosed with hyperemesis gravidarum experienced significantly reduced severity of nausea and frequency of vomiting compared to treatment-as-usual alone. Also, hospital stay was found to be shorter in the treatment group as compared to the control group. These findings are encouraging and suggest it is feasible and potentially beneficial to include adjunctive hypnotherapy to treat hyperemesis gravidarum.

Evidence for the atherogenic index of plasma as a potential biomarker for cardiovascular disease in schizophrenia.

BACKGROUND: Schizophrenia is known to be accompanied with increased cardiovascular mortality, which causes reduced life expectancy. AIM: The aim of the current study was to investigate if atherogenic index of plasma (AIP) could be a good marker in assessing cardiovascular disease (CVD) risk in patients with schizophrenia. METHODS: Patients with schizophrenia (n = 328) and healthy controls (n = 141) were recruited. Schizophrenia patients were evaluated according to the presence of antipsychotic (AP) drug use as AP(+)Sch group and AP(-)Sch group. Atherogenic indices, such as AIP, Castelli's risk index-I (CRI-I), Castelli's risk index-II (CRI-II), and atherogenic coefficient (AC), were calculated according to the laboratory examination of serum lipid parameters. RESULTS: According to the comparison of serum lipid levels, triglyceride (TG) levels were found to be highest and high-density lipoprotein-cholesterol levels were lowest in AP(+)Sch group than AP(-)Sch group and control group (CG) (p < 0.001). AIP, CRI-I, and CRI-II scores were found to be significantly higher in AP(+)Sch group than AP(-)Sch group, and in AP(-)Sch than healthy controls (p < 0.001). Mean AC scores were higher in AP(+)Sch group than both AP(-)Sch and CG and were similar in AP(-)Sch and control subjects (p < 0.001). According to the correlation analysis, AIP scores were positively correlated with duration of disease (r = 0.235; p = 0.002) and age (r = 0.226; p = 0.003) in AP(+)Sch group but not in drug-free subjects. In all groups, atherogenic indices of CRI-I, CRI-II, and AC scores were found to be positively correlated with AIP scores (p < 0.001). CONCLUSION: Our results suggest that AIP is an easily calculable and reliable marker for determining the CVD risk in both drug-free schizophrenia patients and patients under AP treatment.

Associations Between Olfactory Impairment and Cognitive Functions in Patients with Parkinson Disease.

INTRODUCTION: Olfactory impairment and cognitive impairment are common non-motor symptoms in Parkinson's disease (PD). Olfactory impairment may be present even many years before the main symptoms of the disease develop. The associations between olfactory loss and cognition in PD are evaluated in this study. METHODS: 31 patients with PD and 31 healthy subjects were included in this study. The Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn and Yahr Scale (H&Y Scale) were administered to all subjects. Butanol threshold test and Sniffin'Sticks test were used to assess olfaction. The Mini Mental State Examination (MMSE) and Clock Drawing Test (CDT) and Stroop Color Word Test (SCWT) were used to assess cognition. RESULTS: The Sniffin'Sticks test scores were significantly lower in the Parkinson group in comparison to the control group (p<0.001). The rate of anosmia was 90% in the PD group while this rate was found to be 54.8% in control group (p=0.005). A significant correlation was found between butanol test scores and stoop 5 and 5 errors. Significant correlations were found between the Sniffin'Sticks scores and MMSE scores (p=0.047) and orientation (p=0.041) and language (p=0.003) functions of the MMSE test. Worse olfaction was associated with worse memory. CONCLUSIONS: In PD, olfactory impairment correlates with cognitive impairment and olfactory tests may be used to predict the likelihood of developing dementia in this patient population.

The Effect of Hypnosis on Intraoperative Hemorrhage and Postoperative Pain in Rhinoplasty.

This prospective, randomized study investigated the effects of preoperative hypnosis on hemorrhage and pain in open septorhinoplasty (SRP). Twenty-two patients undergoing SRP under general anesthesia were included and equally divided into two groups. Patients in the hypnosis group (HG) received a total of three sessions of hypnotic induction. The first two sessions occurred 3 days and 1 day prior to surgery, respectively, and the last session was in the hospital the day of surgery. The other 11 patients constituted the control group (CG). Compared with the CG, the HG's intraoperative use of total remifentanil and the visual analog scale scores at the 2nd and 3rd postoperative hours were significantly lower (p < .05). Hypnosis did not affect the quality of the surgical field. However, preoperative use of hypnosis decreased intraoperative remifentanil requirements and postoperative pain.

Effect of Health Literacy on Help-seeking Behavior in Morbidly Obese Patients Agreeing to Bariatric Surgery.

BACKGROUND: We aimed to evaluate the effect of health literacy on agreement for bariatric surgery among morbidly obese patients. METHODS: The data of 242 morbidly obese patients (body mass index-BMI ≥ 40 kg/m2) were evaluated in a cross-sectional case-control pattern. The patients were classified into two groups as those who were attending the clinic for the purpose of receiving bariatric surgery (n = 138) and those who did not (n = 104). The Turkish version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47), consisting of 47 questions, was used for the health literacy evaluation. RESULTS: It was seen that patients who accepted bariatric surgery were younger and had higher weight and BMI values (p < 0.001). HLS-EU-Q47 index results were 33.33 (15.63-50) in the group who agreed to bariatric surgery and 26.04 (8.33:46.88) in the group who did not agree to bariatric surgery, and a statistically significant difference was determined between the two groups (p < 0.001). From the HLS-EU-Q47 questionnaire, an insufficient level (0-25) was found for 2.9% of the group who agreed to bariatric surgery and 45.2% of the group who did not (p < 0.001). The problematic-limited level was similar in the two groups (> 25-33) (respectively, 36.2%, 37.5%, p = 0.840). A sufficient level (> 33-42) and a perfect level were higher in the group who agreed to bariatric surgery (respectively, 42.8%, 18.1%, p < 0.001). CONCLUSION: There is a relationship between health literacy and acceptance of bariatric surgery in morbidly obese patients. The higher the health literacy level, the more the agreement to bariatric surgery increased.

Examination of personality traits and social problem-solving skills of individuals whose driving licenses have been confiscated due to drunk driving.

OBJECTIVE: Drunk driving is one of the major behavioral issues connected with problematic alcohol consumption. The objective of this study was to evaluate the relationship between personality traits and social problem-solving skills of individuals who drive while intoxicated. METHOD: One hundred forty-four individuals apprehended twice while driving drunk and sent to a driver behavior training program (9 females and 135 males) participated in our study. The Eysenck Personality Questionnaire Revised-Abbreviated (EPQ-RA) composed of 4 subscales (Extroversion, Neuroticism, Psychoticism, and Lying) and the Social Problem Solving Inventory (SPSI) composed of 7 subscales (Cognitive, Emotion, Behavior, Problem Definition and Formulation, Creating Solution Options, Solution Implementation and Verification, and Decision Making) were used to evaluate the participants. RESULTS: A positive relationship was found between the Extroversion subscale of the EPQ-RA and the Cognition subscale (P <.01), Emotion subscale (P <.01), Behavior subscale (P <.01), Generation of Alternatives subscale (P <.01), Decision Making subscale (P <.05), and Solution Implementation and Verification subscale (P <.01). For individuals who repeated intoxicated driving, all subscales of the EPQ-RA (Extroversion, Lying, Neuroticism, and Psychoticism subscales) explained 12% of the scores of the Cognition subscale and 16.2% (P <.001) of the Emotion subscale of the SPSI. There was no significant relationship between the first and second incident alcohol blood levels (P >.05). CONCLUSION: Drinking and driving behaviors appear to be negative or maladaptive behaviors closely related to personality traits and may represent an effort to avoid negative emotions. Evaluation of negative emotions may have an important place in training programs intended to change drunk driving behavior.

Does Weight Gain During the Operation Wait Time Have an Impact on Weight Loss After Laparoscopic Sleeve Gastrectomy?

BACKGROUND: The effect of preoperative weight changes on postoperative outcomes after bariatric surgery remains inconclusive. The aim of the present study was to evaluate the effect of preoperative weight gain on postoperative weight loss outcomes after laparoscopic sleeve gastrectomy (SG). METHODS: Ninety-two morbidly obese patients undergoing SG from January 2014 to April 2016 were separated into two groups according to whether they gained weight or not during the waiting time prior to surgery. RESULTS: Thirty-nine patients (42.4 %) gained weight during the waiting time and 53 patients (57.6 %) did not. The median body mass index (BMI; kg/m2) at surgery was significantly higher in weight-gained patients (47.8 (min-max, 40-62)) compared to patients who had not gained weight (45.10 (min-max, 41-67)), (P = 0.034). No significant difference was found between the two groups regarding the distribution of age, gender, family history of obesity, existence of comorbidity, smoking, weight gain during childhood or adulthood, preoperative Beck depression and Beck anxiety scores, waiting time period, and body weight at the initial visit (P > 0.05). The ASA I score was higher in weight-gained patients whereas ASA II score was higher in those who did not gain, and the difference was significant (P = 0.046). Postoperative % BMI loss and % weight loss were not significantly different between the two groups at the first, third, sixth months, and the end of the first year (P > 0.05). CONCLUSION: Weight gain during waiting time has no negative impact on % weight loss and % BMI loss after SG.

Evaluation of the Relationship between Major Depressive Disorder and Bereavement Symptoms in Elderly Patients Who Present Either to Psychiatry or Family Medicine.

INTRODUCTION: We aimed to determine the level of bereavement and depression symptoms among elderly patients who experience the loss of a significant other and the relationship between depressive symptoms and bereavement symptoms. METHODS: The study sample consisted of elderly adults who lost a significant other at least 6 months prior to the submission time. Participants were recruited from patients who presented to either the psychiatry or family medicine outpatient unit of a Training and Research Hospital. Cognitive functions were assessed using Standardized Mini Mental Examinations for Educated and Uneducated People (SMME/SMME-U). Participants were excluded from the study if their SMME or SMME-U scores were lower than 23 points. To assess the severity of depressive and bereavement symptoms, the Geriatric Depression Scale (GDS) and Core Bereavement Items (CBI) scales were used, respectively. RESULTS: Overall, 33 out of 67 individuals (49.2%) who presented to the psychiatry unit and 7 out of the 43 individuals (16.3%) who presented to the family medicine unit were diagnosed with major depressive disorder (MDD). CBI scale score means were higher in the MDD groups than in the non-depressive groups (p=0.012 and p=0.001, respectively). CBI scores were significantly correlated to acute (p=0.047) and chronic stress (p=0.007) in the psychiatry group and to chronic stress in the family medicine group (p=0.001). CONCLUSION: Probing loss experiences and reactions to them can be important to understand depression, to evaluate its symptoms, and to help manage the relevant symptoms. Considering the significant contributions of bereavement to depressive symptom severity in elders, interventions specific to bereavement symptoms should not be ignored.

The impact of sensation seeking on the relationship between attention deficit/hyperactivity symptoms and severity of Internet addiction risk.

The aim of this study was to investigate the relationship of attention deficit/hyperactivity symptoms (ADHS) with severity of Internet addiction risk (SIAR), while controlling the effects of variables such as depression, anxiety, anger, sensation seeking and lack of assertiveness among university students. Cross-sectional online self-report survey was conducted in two universities among a representative sample of 582 Turkish university students. The students were assessed through the Addiction Profile Index Internet Addiction Form Screening Version (BAPINT-SV), the Psychological Screening Test for Adolescents (PSTA) and the Adult Attention deficit/hyperactivity disorder Self-Report Scale (ASRS). The participants were classified into the two groups as those with high risk of Internet addiction (HRIA) (11%) and those with low risk of Internet addiction (IA) (89%). The mean age was lower in the group with HRIA, whereas depression, anxiety, sensation seeking, anger, lack of assertiveness and ADHS scores were higher in this group. Lastly, a hierarchical regression analysis suggested that severity of sensation seeking and ADHS, particularly attention deficiency, predicted SIAR. The severity of sensation seeking and ADHS, particularly attention deficit symptoms, are important for SIAR. Awareness of sensation seeking among those with high ADHS may be important in prevention and management of IA among university students.

Possible Risk Factors for Acute Stress Disorder and Post-Traumatic Stress Disorder After an Industrial Explosion.

INTRODUCTION: There have been deaths and injuries after an explosion which happened in an industrial region in Ankara in February 2011. The aim of this study was to determine the prevalence of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD), and to determine the variables which can be the risk factors for PTSD. METHODS: In this study, we included a total of 197 subjects who were present at the factory building and at the four offices nearby when the disaster occurred. All the participants were assessed one month after the explosion and 157 of them were reassessed six months after the explosion. Socio-demographic information forms were given and the Clinician-Administered PTSD Scale (CAPS) was administered to the participants one month after the explosion. Psychiatric assessments were done using the structured clinical interview for DSM-IV axis-I disorders (SCID-I). The CAPS was re-applied six month after the disaster. RESULTS: At the first-month assessments, ASD was detected in 37.1% of participants and PTSD in 13.7%, whereas PTSD was observed in 16.6% of subjects at the sixth month of the accident. According to the first month data, having any psychiatric disorder before the incident, physical injury, acquaintances among the dead and the injured people, being involved in the incident and seeing dead people were detected as the risk factors for PTSD. At the sixth month assessment, physical injury, acquaintances among the dead and the injured, being involved in the incident were seen as risk factors for PTSD. CONCLUSION: ASD and PTSD can be seen after an explosion. Having a previous psychiatric disorder and being directly affected by trauma and being injured are the risk factors for PTSD. This study implies that preventive mental health care services should include the management of current psychiatric condition and employee safety issues.

Measuring cognitive errors using the Cognitive Distortions Scale (CDS): psychometric properties in clinical and non-clinical samples.

The Cognitive Distortions Scale was developed to assess thinking errors using case examples in two domains: interpersonal and personal achievement. Although its validity and reliability has been previously demonstrated in non-clinical samples, its psychometric properties and scoring has not yet been evaluated. The aim of the current study was to evaluate the psychometric properties of the Cognitive Distortions Scale in two Turkish samples and to examine the usefulness of the categorical scoring system. A total of 325 individuals (Sample 1 and Sample 2) were enrolled in this study to assess those psychometric properties. Our Sample 1 consisted of 225 individuals working as interns at the Diskapi Yildirim Beyazit Teaching and Research Hospital and Sample 2 consisted of 100 patients diagnosed with depression presenting to the outpatient unit of the same Hospital. Construct validity was assessed using the Beck Depression Inventory, the State Trait Anxiety Inventory, the Dysfunctional Attitude Scale, and the Automatic Thought Questionnaire. Factor analyses supported a one-factor model in these clinical and non-clinical samples. Cronbach's α values were excellent in both the non-clinical and clinical samples (0.933 and 0.918 respectively). Cognitive Distortions Scale scores showed significant correlation with relevant clinical measures. Study Cognitive Distortions Scale scores were stable over a time span of two weeks. This study showed that the Cognitive Distortions Scale is a valid and reliable measure in clinical and non-clinical populations. In addition, it shows that the categorical exists/does not exist scoring system is relevant and could be used in clinical settings.

The comparison of risky and ambiguity decision making and cool executive functions between patients with obsessive compulsive disorder and healthy controls

Abstract Background: Executive functioning has been evaluated in obsessive compulsive disorder (OCD). Cool and hot executive functioning discrimination provided a different way of conceptualising executive functions. Objectives: The aim of this study was to compare ambiguity and risky decision-making and cool executive functions in an OCD and a healthy control group. The relationship between decision-making and cool executive functioning was investigated. Methods: Sixty-two OCD patients and 48 healthy control participants were compared. Decision-making was measured using the Iowa Gambling Task. The cool executive functioning was assessed using the Stroop Test and the Wisconsin Card Sorting Task (WCST). Results: The OCD group completed the WCST and the Stroop Test statistically significantly with a lower score than that of the control group. The OCD group had impaired response inhibition and set-shifting that indicate impaired cool executive functioning. In contrast to a lack of a statistically significant difference, the risky decision-making performance was worse in the OCD group than in the healthy control group and in the unmedicated OCD patients than in the medicated OCD patients. Discussion: The OCD patients had a poorer performance in risky decision-making and cool executive functioning. There was a link between risky decision-making performance and impaired cool executive functions.