Examining the roles of cognitive flexibility, emotion recognition, and metacognitions in adult Attention Deficit and Hyperactivity Disorder with predominantly inattentive presentation.

The evaluation of cognitive functions in Attention Deficit and Hyperactivity Disorder (ADHD) is fundamental to improve the efficacy of therapeutic interventions. However, the role of specific higher-order cognitive functions in adult ADHD, including cognitive flexibility, emotion recognition, and metacognitions, remains unclear. Therefore, in the current study, we aimed to examine these three distinct higher-order cognitive functions among adult ADHD individuals. Forty patients with ADHD with predominantly inattentive presentation and 42 healthy controls participated in the study. The Adult Attention Deficit and Hyperactivity Disorder Scale (AADHDS), the Wisconsin Card Sorting Test (WCST), the Reading the Mind in the Eyes Test (RMET), and the Metacognitions Questionnaire-30 (MCQ-30) were administered. Results indicated that patients with ADHD had worse metacognitions scores, in specific subdimensions, relative to healthy controls. However, cognitive flexibility and emotion recognition did not differ between the groups. Moreover, the cognitive confidence subdimension of the MCQ-30 was found to be sole significant predictor in the attention deficit subdimension of the AADHDS. Our findings suggest that lack of cognitive confidence may contribute to ADHD symptomatology despite regularly functioning cognitive flexibility and emotion recognition. Therefore, metacognitions could be a suitable target to alleviate the severity of ADHD symptoms.

The Effect of Short-Wave Diathermy and Exercise on Depressive Affect in Chronic Low Back Pain Patients.

OBJECTIVE: The aim of this study was to compare exercise, continuous short-wave diathermy (SWD) and intermittent SWD treatment modalities and to evaluate the effects of these treatments on chronic back pain and depression. METHODS: This study is an intervention trial which evaluated patients who applied to our clinic due to chronic low back pain between 2008-2009. The study group consisted of 90 patients between the ages of 40-65 who had had low back pain for more than 6 months. The patients were randomized into three groups. The first group received placebo short-wave diathermy, the second group received continuous short-wave diathermy, and the third group received pulsed short-wave diathermy. Pain was evaluated by Visual Analog Scale (VAS) and the Pain Disability Index (PDI).The Modified Oswestry Low Back Pain Disability Questionnaire Form was used for the measurement of functional deficiency and the Beck Depression Inventory (BDI) was used for the evaluation of depression.All scales were performed before the treatment, immediately after treatment and 3 months after treatment. RESULTS: Significant decreases in PDI and VAS scores were found in all groups (p<0.05 for each). Similarly, there was a significant improvement in all groups in terms of functional deficiency(p<0.001 for each), while no differences were found between groups (p = 0.895). In terms of BDI scores, there was no improvement in those receiving only exercise, while Group 2 and 3 had significant improvements (p <0.05). When groups were compared for BDI scores, no differences were found between any of the groups (p = 0.189). CONCLUSION: Continuous SWD treatment with exercise was found to be more effective in reducing pain in patients with chronic low back pain than other treatment modalities used in our study. Although there was no significant difference between the groups in terms of depressive mood, it was found that those receiving continuous and pulsed SWD treatment had significant improvements in depression as measured by the BDI.

The relationship between dysfunctional metacognitive beliefs and problematic social networking sites use.

Social networking sites (SNSs) enrol new subscribers each day. However, problematic SNS use has undesirable effects on psychological functioning. Therefore, it is important to identify the factors that contribute to the development of problematic SNS use. Very few studies have focused on revealing the underlying mechanisms of problematic SNS use. Although many past studies have examined the relationship between metacognitive beliefs and Internet addiction, the association between metacognitive beliefs and problematic SNS use has not been adequately explored. In this study, we aimed to explore the association between metacognitive beliefs and problematic SNS use among young adults. A total of 308 individuals participated in this study. A socio-demographic data form, the Metacognitions Questionnaire-30 (MCQ-30), and Social Media Addiction Scale (SMAS) were administered. Group comparisons were performed using multivariate analysis of covariance. Pearson's correlational and multiple linear regression analyses were conducted to examine the associations between metacognitive beliefs and problematic SNS use. The SNS addicts scored higher in all of the SMAS assessments. When compared to non-addicts, SNS addicts obtained higher scores on all the subtests of the SMAS and MCQ-30 except cognitive self-consciousness. The negative beliefs about the uncontrollability and danger of worry, cognitive confidence, and need for control thoughts were associated with SMAS mood modification, relapse and conflict subdimensions. Our findings revealed that dysfunctional metacognitive beliefs are related to problematic SNS use among young adults. These findings indicate that mental health workers should consider the modification of metacognitive beliefs in the treatment of problematic SNS use.

The trait anxiety as a predictor of the suicidal risk in patients with cancer.

Studies investigating the psychological aspects of cancer have gained importance in recent years. In these studies, the rates of depression and anxiety in cancer patients were examined, but the risk of suicide had not been examined. This study investigated the psychiatric diagnoses of depression, anxiety, and suicide risk in cancer patients. Eighty patients who met the inclusion criteria were administered the Beck Depression Inventory, State-Trait Anxiety Inventory, Structured Clinical Interview for DSM (SCID), and Suicide Probability Scale. The examination of the relationships across variables was assessed with Pearson's correlation analysis and stepwise multiple regression analysis. Due to SCID assessment, 45% of patients were found to have depression diagnosis, and 11.25% were found to have anxiety diagnosis. In the patients who had previous psychiatric diagnosis and treatment, total suicide probability scores demonstrated statistically significant differences. The frequency of depressive disorders and anxiety disorders in cancer patients is high. The studies investigating that suicide are rare, and in our findings, previous psychiatric diagnosis and treatment were risk factors. In the past studies, depression has been reported to be the most important factor in increasing the risk of suicide in cancer. Contrary to previous findings, according to the data obtained from this study, anxiety is the most important predictor of suicidal risk among all the determinants.

Chronic Pain and Pain Belief in Active Military Personnel: a Cross-sectional Study.

BACKGROUND: Chronic pain (CP) and mental disorders are common among active military personnel (AMP) due to their potential exposure to various physical and psychological stressors. AIM: The aim of this study was to evaluate pain perception and beliefs regarding their pain among AMP suffering from CP using self-reported measures, and to understand the development and persistence of pain in AMP. METHODS: Sixty male AMP outpatients suffering CP were included. All participants completed the following forms and questionnaires: Oswestry Disability Index(ODI), Visual Analogue Scale(VAS), Neck Disability Index(NDI), Bournemouth Questionnaire for neck(BQN), International Physical Activity Questionnaire(IPAQ), Hospital Anxiety and Depression Index(HADS), 36-item Short Form Survey(SF-36), Automatic Thoughts Questionnaire(ATQ), and Pain Belief Questionnaire(PBQ). RESULTS: The mean age of the participants was 22.85±3.50 years, the median duration and frequency of pain were 12 months and 14.5 days in a month, respectively. The median of ODI scores was 26; three of patients were evaluated as crippled while 8 patients had severe disability. The HADS and PBQ-psychological scores were high in the patient group. Positive correlations were found between pain frequency and the ODI, VAS, NDI and PBQ-psychological scores. Relationships were also shown between PBQ-psychological and the VAS and ATQ scores. Correlations between ODI scores and ATQ scores were also revealed. CONCLUSIONS: Our results suggest that, in addition to the organic basis of pain, there is strong evidence for significant contribution from the psychological characteristics and pain-related beliefs of the patients. Physicians may choose a multi-dimensional perspective in the diagnosis and treatment of pain, especially in patients suffering from CP.

Associations between emotion recognition and social networking site addiction.

With the widespread use of the internet today, many studies have been conducted regarding the use of social networking sites (SNS). Despite the growing literature on the effects of SNS on human life, there are limited successful therapeutic interventions for SNS addiction. Our study aimed to elucidate the potential role of emotion recognition in the development of SNS addiction and to propose novel strategies for alleviating problems emerging from SNS addiction. A total of 337 individuals participated in the study. A sociodemographic data form, the Reading the Mind in the Eyes Test (RMET), and the Social Media Addiction Scale (SMAS) were administered. The results revealed the presence of emotion recognition deficits among individuals with SNS addiction, relative to non-addicts. RMET positive and negative scores were associated with SNS addiction in a negative direction. Additionally, RMET negative scores predicted SNS addiction. Our findings indicate a possible link between SNS addiction and emotion recognition, which might serve as a crucial target in novel treatment strategies.

Poor Sleep Quality I Related to Impaired Functional Status Following Stroke.

INTRODUCTION: Sleep disorders are more prevalent in patients with previous stroke compared to healthy individuals. The main objective of the present study was to investigate the impact of sleep quality on the functional status of patients with a history of stroke, upon admission to inpatient rehabilitation. METHODS: Fifty patients (mean age: 69 ± 11 years) with previous stroke were consecutively included in this single center cross-sectional observational study upon admission to inpatient rehabilitation. Pittsburgh Sleep Questionnaire Index (PSQI) was calculated for all patients and patients were divided into 2 groups according to PSQI scores (PSQI ≤ 5 as good sleepers and PSQI > 5 as poor sleepers). A specialist evaluated the level of muscle spasticity and disability, walking capability, and overall performance of daily activity of all enrolled patients using the functional ambulation scale (FAS) score, modified Brunnstrom Classification, Modified Ashworth scale, and Beck Depression Inventory. RESULTS: The FAS score (3.4 ± 1.3 versus 1.8 ± 1.7, P = .004) and Brunnstrom scores of upper limb (3.8 ± 1.1 versus 2.5 ± 1.6, P = .005), lower limb (4.3 ± 1.4 versus 3.1 ± 1.7, P = .013) and hand (3.6 ± 1.5 versus 2.3 ± 1.6, P = .006) were significantly higher in good sleepers than poor sleepers. Linear regression analysis revealed that PSQI score (coefficient ß = -.360, 95% CI: -.212-.032, P = .009) and age (coefficient ß = -.291, 95% CI: .100-.245, P = .032) were independently associated with FAS score. CONCLUSION: Results of the present study indicate that presence of poor sleep quality is associated with poor functional status which might further impair the outcomes of the rehabilitation and accordingly the health-related quality of life in patients admitted for stroke rehabilitation.

Retinal Nerve Fiber Layer Thickness Measurement by Spectral-Domain Optical Coherence Tomography in Patients with Major Depressive Disorder.

INTRODUCTION: In recent years, an increasing number of studies have researched retinal nerve fiber layer (RNFL) changes in neurodegenerative disorders. In this study, our aim was to determine structural RNFL changes in patients with major depressive disorder. METHODS: A total of 30 patients with major depressive disorder and 30 age- and sex-matched controls were recruited. Using optical coherence tomography (OCT), the peripapillary RNFL thickness in major depressive disorder patients and control subjects was measured and compared at each location. RESULTS: Patients with major depressive disorder did not show a statistically significant reduction in overall peripapillary RNFL thickness. CONCLUSION: Our study showed that RNFL thickness is not reduced in major depressive disorder patients and that OCT is not a useful tool for diagnosing and monitoring the progression of major depressive disorder. This study suggests that the pathophysiology of unipolar depression is different than in neurodegenerative disorders, pervasive developmental disorders, schizophrenia, and bipolar disorder.

[Synthetic Cannabinoid Receptor Agonist-Associated Psychotic Disorder: A Case Report]. / Sentetik Kannabinoid Reseptör Agonisti Kullanimina Bagli Psikotik Bozukluk: Olgu Sunumu.

Synthetic cannabinoid receptor agonists (SCRA) has become one of the most abused substances, recently. JWH-018 street name known as Bonzai is one of the most abused substances in Turkish Republic of Northern Cyprus. The most common symptoms in cases reported with synthetic cannabis use are agitation, angry, paranoia and reference delusions, disorientation, seizure and nausea. Although the effects are very similar to cannabis, stimulant effects are more likely in SCRA use. In preparations containing SCRA do not contain cannabinidol agent which is reported to reduce the psychotic effects of the cannabis. This may explain the relationship between SCRA and psychotic disorders. We aimed to discuss a brief psychotic disorder associated with SCRA use and treatment which is less reported in the literature in this case report.

[The Relationship between Violence and Clinical Features, Insight and Cognitive Functions in Patients with Schizophrenia]. / Sizofrenide Siddet Davranisinin Klinik Özellikler, Içgörü ve Bilissel Islevler ile Iliskisi.

OBJECTIVE: We aimed to investigate the predictive factors of violent behavior in schizophrenia and the relationship between violent behavior and insight and cognitive functions in this study. METHOD: 68 patients diagnosed with schizophrenia were separated into two groups; with a history of violent behavior (n = 30) and without (n = 38). Both group swere administered the Positiveand Negative Syndrome Scale (PANSS), Buss-Perry Aggression Questionnaire, Schedule for Assessing the Three Components of Insight, California Verbal Learning Test (CVLT), Trail Making Test, Wisconsin Card Sorting Test, and Stroop Test. RESULTS: Male gender, the number of hospitalizations, incompliance with the treatment, alcohol and substance abuse, the number of suicide attempts, the mean score of PANSS positive symptoms, PANSS general symptoms and PANSS total were significantly higher in patients with schizophrenia with a history of violent behavior, compared to non-violent group. Long delayed response subsection of CVLT mean score was lower in patients with violent behavior. Incompliance with the treatment (OR:5.927, p=0.041), alcohol and substance abuse (OR:21.089, p=0.000), and PANSS total score (OR:1.053, p=0.011)were identified as predictive factors of violent behavior in patients with schizophrenia. CONCLUSION: Lack of insight and executive function impairment are the core symptoms of schizophrenia and not seems to be associated with violent behavior in patients with schizophrenia. Impairment of memory may be associated with violent behavior in patients with schizophrenia. Incompliance with treatment, alcohol and substance abuse, and the severity of positive symptoms are important factors in predicting violence behavior in patients with schizophrenia.

Menstrual Cycle in Schizophrenic Patients: Review with a Case.

There are not enough studies about the relationship between menstrual psychosis and schizophrenia exacerbation during the menstrual cycle. In patients diagnosed with schizophrenia, it is important to examine the psychotic symptoms and depression and anxiety symptoms during the menstrual cycle and to adjust the treatment according to these symptoms. If depression and anxiety symptoms are present, selective serotonin reuptake inhibitors can be used. In patients with exacerbated psychotic symptoms, it may be effective to increase the dose of an antipsychotic drug, which has no effect on prolactin release, 3-5 days prior to menstruation. In addition, hormonal therapy or menstrual cycle suppression is an alternative option. In this article, a case of a schizophrenic patient whose psychotic symptoms exacerbated with the menstrual cycle is presented.

Birth Order and Sibling Sex Ratio in a Population with High Fertility: Are Turkish Male to Female Transsexuals Different?

Western studies have consistently found that androphilic (sexually attracted to men) male-to-female transsexuals have a later birth order and a relative excess of brothers compared with appropriate control participants. However, non-Western studies on birth order and sibling sex ratio in androphilic males (transsexual or non-transsexual) are rare. The objective of the study was to test the hypothesis that androphilic male-to-female transsexuals have a late birth order and a relative excess of brothers in a non-Western culture with a higher fertility rate. The participants were 60 androphilic male-to-female transsexuals and 61 male heterosexual controls. The transsexual participants had significantly more older brothers than the control participants, but the groups did not differ in their numbers of older sisters, younger brothers, or younger sisters. The foregoing pattern is usually referred to as the "fraternal birth order effect." Slater's and Berglin's Indexes both showed that the mean birth order of the control participants was very close to that expected from a random sample drawn from a demographically stable population whereas the mean birth order of the transsexual participants was later. A measure of sibship composition, brothers/all siblings, showed that the transsexual group had a higher proportion of male siblings compared with the control group. In conclusion, the present study found that Turkish androphilic male-to-female transsexuals show the same high fraternal birth order that has been found in comparable androphilic samples in Western Europe, North America, and the South Pacific, which suggests a common underlying biological causal mechanism.

Assessment of cadmium, lead, and nickel levels in hair care products marketed in Turkey.

This study evaluated the content of cadmium (Cd), lead (Pb), and nickel (Ni) in 105 hair care products commercially available in Turkey. Cd, Pb, and Ni were detected in 40%, 21.91%, and 94.29% of the samples, respectively. Maximum Cd concentrations were detected in two shampoo samples, and the highest Pb level was found in a hair conditioner, all of them were herbal-based formulations. The highest mean levels of Ni were detected in hairstyling agents. The overall results were lower than the Canadian and German regulatory limits; however, according to the European Council Directive and Turkish Cosmetic Legislation, Cd, Pb, and Ni are listed as the substances that are prohibited in any amounts in cosmetics. Moreover, Ni content of 17.14% of the samples was above the limit of allergic contact dermatitis. It is known that these toxic metals tend to accumulate in body and prolonged use of them may potentially pose threat to human health. Thus, regular market monitoring and safer limits should be seriously considered especially for susceptible groups of the population like the pediatric group.

Facial emotion recognition in patients with schizophrenia and their siblings.

BACKGROUND: Deficits in recognition of facial emotions have been widely reported in patients with schizophrenia. Previous studies that examined recognition of facial emotions in relatives of patients with schizophrenia brought out inconsistent results. AIMS: In this study, we aimed to examine facial emotion identification and discrimination abilities in patients with schizophrenia and their healthy siblings to find out whether familial vulnerability to schizophrenia is associated with deficits in facial emotion recognition. METHODS: Patients with schizophrenia (n=57), their unaffected biological siblings (n=58) and healthy controls (n=58) were included in the study. The three groups did not differ significantly for gender, age and education level. All the participants were evaluated with the Facial Emotion Identification Test (FEIT) and Facial Emotion Discrimination Test (FEDT). RESULTS: Patients with schizophrenia performed significantly worse than controls on FEIT and FEDT. Siblings performed significantly better than patients and significantly worse than controls on FEIT and FEDT. CONCLUSIONS: Impaired performance of siblings on facial emotion identification and discrimination tasks provides evidence for the hypothesis that facial emotion recognition deficits are transmitted in families and may represent a heritable endophenotype of schizophrenia.