Are there differences in oxidative stress and inflammatory processes between the autogenous and reactive subtypes of obsessive-compulsive disorder? A controlled cross-sectional study.

OBJECTIVE: To date, no study has investigated whether autogenous and reactive obsessive-compulsive disorder (OCD) types are different entities in terms of oxidative stress and inflammatory processes. The aim of this study is to compare them in terms of these features. METHODS: The study was conducted in subjects with reactive OCD (n=19), autogenous OCD (n=14), and a control group (n=17). All participants were non-smokers. Sociodemographic data were collected and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Obsessive Beliefs Questionnaire (OBQ), and Overvalued Ideas Scale (OVIS) were administered. High-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), paraoxonase (PON1), total oxidant status (TOS), and total antioxidant status (TAS) were measured. RESULTS: There were no significant differences in TAS, TOS, or oxidative stress index (OSI) between the OCD and control groups. PON1 and hs-CRP levels were higher in the OCD group, whereas IL-6 and IL-10 levels were lower. Comparison across the three groups revealed no differences in TAS, TOS, OSI, or PON1 levels; however, hs-CRP was significantly higher while IL-6 and IL-10 were significantly lower in the reactive group compared to controls. CONCLUSION: Our results show that, although inflammatory processes may play a role in OCD, the autogenous and reactive subtypes do not differ from each other in these respects. The classification of OCD into autogenous and reactive subtypes should be reevaluated.

Association of Nicotine Use Disorder with Neurexin 3 Gene Polymorphisms. / Nikotin Kullanim Bozuklugunun Neurexin 3 Gen Polimorfizmi ile Iliskisi.

OBJECTIVE: In this study, we aimed to investigate the Neurexin 3 gene (NRXN3) polymorphisms in the rs 221473, rs 221497, rs1004212 and rs11624704 regions in relation to nicotine use disorder (NUD) in the Turkish population. METHOD: Power analysis indicated that the NUD group and the control group of this study should each comprise 200 participants in the 18-65 year age range. The NUD group consisted of individuals without a psychiatric first axis disorder except for NUD, mental retardation, past head trauma or a neurological disorder, who had smoked minimally10 cigarettes per day for at least 1 year. The control group included individuals without a serious chronic physical illness, a previous psychiatric disorder or mental retardation and who responded "no" to the question "have you ever smoked?" A sociodemographic questionnaire and the Fageström nicotine dependence scale (FNDS) for the NUD group were utilized. Venous blood samples of all participants were taken into tubes containing EDTA (ethylene daimine tetra acetic acid) for DNA extraction. Duplex fluorescence melting curve analysis was used for genotype detection and differentiation. RESULTS: The individuals carrying the AC allele and the AG allele at the rs11624704 and the rs1004212 regions respectively had a high risk of being addicted to cigarettes. CONCLUSION: This is first study investigating the relationship of the NRXN3 gene and nicotine addiction in the Turkish population. It was observed that the risk of NUD in the Turkish population may be related to the Neurexin gene.

Association of Nicotine Use Disorder with Neurexin 3 Gene Polymorphisms. / Nikotin Kullanim Bozuklugunun Neurexin 3 Gen Polimorfizmi ile Iliskisi.

OBJECTIVE: In this study, we aimed to investigate the Neurexin 3 gene (NRXN3) polymorphisms in the rs 221473, rs 221497, rs1004212 and rs11624704 regions in relation to nicotine use disorder (NUD) in the Turkish population. METHOD: Power analysis indicated that the NUD group and the control group of this study should each comprise 200 participants in the 18-65 year age range. The NUD group consisted of individuals without a psychiatric first axis disorder except for NUD, mental retardation, past head trauma or a neurological disorder, who had smoked minimally10 cigarettes per day for at least 1 year. The control group included individuals without a serious chronic physical illness, a previous psychiatric disorder or mental retardation and who responded "no" to the question "have you ever smoked?" A sociodemographic questionnaire and the Fageström nicotine dependence scale (FNDS) for the NUD group were utilized. Venous blood samples of all participants were taken into tubes containing EDTA (ethylene daimine tetra acetic acid) for DNA extraction. Duplex fluorescence melting curve analysis was used for genotype detection and differentiation. RESULTS: The individuals carrying the AC allele and the AG allele at the rs11624704 and the rs1004212 regions respectively had a high risk of being addicted to cigarettes. CONCLUSION: This is first study investigating the relationship of the NRXN3 gene and nicotine addiction in the Turkish population. It was observed that the risk of NUD in the Turkish population may be related to the Neurexin gene.

Inflammation and Oxidative Stress in Deficit Schizophrenia.

INTRODUCTION: Differences in parameters related to inflammatory and oxidative stress in deficit (DS) and nondeficit schizophrenia (non-DS) may support the DS/non-DS categorization of schizophrenia. For DS patients, non-DS patients, and for healthy controls, this study aims to evaluate the serum levels of: proinflammatory cytokines of interleukin (IL) 1ß, tumor necrosis factor (TNF) α, Interferon (IFN) γ, IL-12, and IL-17; anti-inflammatory cytokines of IL-10, IFN-α, and transforming growth factor (TGF) ß; and antioxidant biomarkers of paraoxonase1 (PON1) and Total Antioxidant Capacity (TAOC). METHOD: Serum IL-1ß, TNF-α, IFN-γ, IL-12, IL-17, IL-10, IFN-α, TGF-ß, PON1 and TAOC levels were measured and performed in DS (n=26), non-DS (n=28), and healthy control (n=28) groups. RESULTS: Patients in the DS group had higher IL-17 levels than the non-DS group did. TGF-ß values for both patient groups were significantly higher than those of the controls. PON1 and TAOC values for both patient groups were significantly lower than those of the controls. CONCLUSION: Our findings may be evidence for the consideration that DS reflects a coherent entity within schizophrenia. Increased levels of IL-17 from pro-inflammatory cytokines may be related with DS.

Post-traumatic stress disorder and related factors among female victims of sexual assault required to attend a University Hospital in Turkey: A cross-sectional cohort study.

BACKGROUND: Post-traumatic stress disorder (PTSD) is one of the most common consequences of sexual assault, but it is not invariable. AIM: Our aim was to investigate pre-, peri- and post-traumatic factors associated with post-traumatic stress disorder among adult women who had been sexually assaulted. METHODS: All women attending a specialist university clinic for victims of sexual assault referred by the courts for a mental health assessment were invited to participate. At the time, the Turkish penal code required such referral (the year up to September 2015). Consenting women completed a sociodemographic information form, the Traumatic Stress Symptom Checklist, the Multidimensional Scale of Perceived Social Support, the Short Form-36 reflecting perceived quality of life, the Beck Depression Scale and the Beck Anxiety Scale. RESULTS: Sixty women were eligible and agreed to participate. Two-thirds of them (41, 68%) reported features of PTSD. In bivariate analyses, the women with PTSD also rated themselves as having a wide range of health and social disadvantages. Self-perceived poverty of social support and having suicidal thoughts were independently associated with PTSD. CONCLUSIONS: Although the rate of mental health and social problems among the women with PTSD were high, less than a third had actually sought help for their difficulties. While a requirement in the penal code that such women should have a psychiatric assessment seems over-intrusive and has since been dropped, our findings suggest that more efforts should be made to ensure that such women have help available if they want it.

The relationship between separation anxiety and intolerance of uncertainty in pregnant women.

Background and aim: Pregnancy is a risky period to develop Adult Separation Anxiety Disorder (ASAD). The aim of this study was to investigate the frequency of separation anxiety in pregnant women, and the relationship of separation anxiety with sociodemographic variables and intolerance of uncertainty.Methods: This study included 310 pregnant women and used the Adult Separation Anxiety Questionnaire (ASAQ) and Intolerance of Uncertainty Scale-Short Form (IUS-12).Results: The average age in pregnant women with ASAD was lower. IUS-12 total score, prospective anxiety, and inhibitory anxiety subscale scores were significantly higher in the ASAD group. There were moderate and statistically significant positive correlations between the ASAD score and the IUS-12 total, prospective anxiety and inhibitory anxiety subscale scores.Conclusion: Intolerance of uncertainty may be an important factor in the mental processes of individuals with separation anxiety. Pregnancy period can be a risky period for developing ASAD. Cognitive behavioral treatments including intolerance of uncertainty may be effective in the treatment of ASAD. There is a need for follow-up studies on the effects of separation anxiety during pregnancy on maternal-fetal health.

No Interaction Between Childhood Maltreatment and Serotonin Transporter Gene in Recurrent Major Depressive Disorder: A Clinical Sample.

INTRODUCTION: There is inconsistent evidence of interaction between childhood adversities and a serotonin transporter promoter polymorphism (5-HTTLPR) in depression. It is hypothesized that genetic sensitivity to stress could be more specific to recurrent major depressive disorder (MDD). The aim of the study is to replicate a recent study which provided preliminary evidence of interaction between severity of childhood maltreatment and the 5-HTTLPR polymorphism in recurrent MDD. METHODS: Participants included a well-characterized clinical sample of 70 recurrent MDD cases and 67 never psychiatrically ill controls, aged 18 years or over. Socio-demographic and clinical information form, Composite International Diagnostic Interview (CIDI), Childhood Trauma Questionnaire (CTQ), Beck Depression Inventory (BDI) were applied to both groups, along with genotyping. RESULTS: There was no interaction between childhood maltreatment and the 5-HTTLPR in relation to recurrent MDD. All forms of childhood maltreatment were reported as more severe by cases than controls, and there was an independent association between maltreatment and recurrent MDD. CONCLUSION: The path forward to detect genetic risk loci for depression remains challenging. Taking childhood maltreatment history into account could lead to a richer understanding of differences in biological correlates, genetic underpinnings, and outcomes.

[The Effect of Chronic Cigarette Use on Cognitive Function]. / Kronik Sigara Kullaniminin Bilissel Islevler Üzerine Etkisi.

OBJECTIVE: In this study, we aimed to investigate the effect of chronic cigarette smoking on the cognitive function in people who have no other mental or physical illness other than tobacco use disorder. METHOD: The study was carried out on three groups: smokers (n = 71), former smokers (n = 39), and non-smokers (n = 49). The Wisconsin Card Sorting Test (WCST), Stroop Color and Word Test (ST), Trail Making Test (TMT), Auditory Verbal Learning Test (AVLT), and Serial Digit Learning Test (SDLT) were applied to the 3 groups participating in the study. Groups were compared with the Three-Factor Covariance Analysis. RESULTS: Stroop test 4th card time score which determined the basic level of color discourse in the smoker group was significantly higher than the non-smoker group. The Trail Making Test-B time scores were significantly higher in the smoker group than the non-smoker group. And Trail Making Test-B time points were significantly higher in the former smoker group than nonsmoker group. Auditory Verbal Learning Test - verbal learning scores were lower in the smoker group than the non-smoker and former smoker group. There was no significant difference in verbal learning scores between the non-smoking and former smoker groups. The neurocognitive deficits in smokers appear to be related to dose and duration. CONCLUSION: This study suggests that auditory verbal memory, visualspatial processing, and attention areas may be a selective area of disability in smokers. A major limitation is the fact that general cognitive performance levels of participants was not assessed by a general criteria such as Wechsler Adult Intelligence Scale (WAIS).

Evaluation of the Decision-making Capacity of Two Cases Planning to Undergo Uterine Evacuation.

Psychiatric disorders in the perinatal period can lead to a deterioration in one's judgment and decision-making ability. These disorders may cause sensitive and complex legal and ethical issues relating to psychiatric, obstetric, and neonatal care. Clinicians should ethically respect the autonomy of the individual, but at the same time, they must assess the individual's decision-making process with the use of forensic psychiatric and consultation-liaison psychiatric practice. While the literature related to mental disorders in pregnancy has been increasing, there is limited information regarding the medico-legal and ethical aspects of this topic. Herein, we present two cases who are pregnant and have psychiatric disorders, and we aim to discuss their evaluation process of uterine evacuation.

Femicide: Psychosocial Characteristics of the Perpetrators in Turkey.

Female homicides are widely prevalent in Turkey with rising trend. The aim of this study is to identify gender role attitudes, childhood trauma histories, and individual characteristics of men who have been involved in the femicide, and to compare them with men who do not exercise violence against women. Participants completed a Sociodemographic and Clinical Information form, Semistructured Interview form, and the Childhood Trauma Questionnaire. Case group was not significantly different than the control group in terms of any measured individual characteristics including childhood traumas, psychopathology, and gender attitudes. Our data indicate that only migration history may be linked to femicide. A unique psychopathology that could be related to being a femicide perpetrator was not identified. Migration and perception of gender roles stand out as factors that separate men who exercise violence from men who do not.

The Relationship Between Obsessive Belief Level and Cognitive Flexibility in Patients with Obsessive Compulsive Disorder.

INTRODUCTION: It is known that dysfunctional beliefs are important in the onset and maintenance of symptoms of Obsessive Compulsive Disorder (OCD) according to the cognitive model of OCD. OCD patients with higher obsessive beliefs would be expected to have greater deficits in cognitive flexibility. In this study, we aimed to examine the relationship between obsessive belief levels and cognitive flexibility in OCD patients. METHODS: Patients with OCD (50) and Panic Disorder (30) as a control group were evaluated and diagnosed using Structured Clinical Interview for DSM-IV Axis I Disorders. A socio-demographic data form, Beck Depression Inventory, Beck Anxiety Inventory and Wisconsin Card Sorting Test (WCST) were administered to all the patients. The Yale-Brown Obsessive Compulsive Scale and Obsessive Beliefs Questionnaire-44 (OBQ-44) were administered to the OCD group. The OCD group was divided into two subgroups as higher obsessive beliefs (OCD-H) (n=29) and lower obsessive beliefs (OCD-L) (n=21) according to a cluster analytic approach. RESULTS: When the subgroups were compared according to WCST; the number of completed categories was statistically significantly lower, and the numbers of total errors, perseverative errors and non-perseverative errors were significantly higher in the OCD-H group. CONCLUSION: The results of our study show that cognitive flexibility is impaired in OCD patients with higher obsessive beliefs.

[Forensic Psychiatric Assessment with the Claim of Incitement, Solicitation, Assistance to Suicide, and Reinforcement of Suicide Decision: A Case Report]. / Intihara Azmettirme, Tesvik, Yardim ve Intihar Kararini Kuvvetlendirme Iddiasinda Adli Psikiyatrik Degerlendirme: Bir Olgu Sunumu.

Although the act of suicide is not considered a crime in Turkish Criminal Law, any contribution (incitement, solicitation, assistance and reinforcement of suicide decision) to the commitment of suicide is a crime according to the 84th item. However, the number of cases opened with respect to this item as well as request for forensic psychiatric expertise is very rare. In these cases, forensic psychiatric expertise depends on the psychiatric evaluation of the individual that committed suicide and the analysis of his/her relationship with the person that incited the suicide. If the suicide is completed, then the psychiatric process gains the qualification of a "psychological autopsy". In this paper, we examined a reporting process prepared for an individual that died as a result of suicide and the person accused of inciting him to suicide.Evidence and forensic aspects are discussed.

Theory of Mind and Selective Attention, Response Inhibition, Cognitive Flexibility in Patients with Schizophrenia.

INTRODUCTION: The aims of the current study are to investigate the relationship between selective attention, response inhibition, and cognitive flexibility that are among executive functions and sociocognitive and socioperceptual theory of mind (ToM) functions and also to investigate whether selective attention, response inhibition, and cognitive flexibility are predictive factors for ToM functions in patients with schizophrenia. METHODS: Forty-seven patients diagnosed with schizophrenia and a control group consisting of 42 individuals were administered demographic information form, Wisconsin card sorting test (WCST), Stroop test, Eye test, Hinting test. Positive and negative syndrome scale was applied to the schizophrenia group. RESULTS: In comparison to the control group, the schizophrenia group performed significantly worse on Eyes test and Hinting test. Eyes Test score and age, WCST perseverative error scores were significantly negatively correlated; education and WCST categories achieved scores were significantly positively correlated in patients with schizophrenia. Age and cognitive flexibility were found to predict the Eyes test score in patients with schizophrenia. CONCLUSIONS: ToM functions that are important in maintaining socioperceptual functioning are closely related with cognitive flexibility, and impairment in cognitive flexibility may predict the ToM functions in patients with schizophrenia.

The risk factors of possible PTSD in individuals exposed to a suicide attack in Turkey.

The aims of this study were to determine both the rate of possible PTSD in individuals who were exposed to a suicide attack in Ankara, Turkey, and the factors that relate to the elevated risk for PTSD in individuals who survived that suicide attack. The researchers carried out the study with 93 participants who had attended a meeting held in Ankara on October 10, 2015. Participants completed a sociodemographic information form, the Traumatic Stress Symptom Checklist (TSSC), the Post-Traumatic Cognitions Inventory, the Beck Depression Inventory (BDI), and the Influence of Perceived Societal Attitudes Questionnaire (IPSAQ). Twenty-three of participants were determined to have possible PTSD (24.7%). Participants who were exposed previously to a suicide attack, who witnessed a life-threatening injury, who had the need for psychological help, and who had suicidal thoughts had significantly higher rates of possible PTSD. The IPSAQ, BDI, and TSSC scores were significantly higher in the participants with possible PTSD. The IPSAQ score was found to be related to the development of possible PTSD. This study demonstrated that in participants who had been exposed to a terrorist attack, the negative impact of perceived societal attitudes toward the victims was related to the possible development of PTSD.

[The Importance of Camera Records In The Forensic Psychiatric Expert Practices]. / Adli Psikiyatrik Bilirkisilik Uygulamalarinda Kamera Kayitlarinin Önemi.

Letter to the editor.

Psychiatric disorders comorbid with epilepsy in a prison sample.

PURPOSE: Epilepsy is an extremely widespread and serious neurological disease. Although comorbidities of psychiatric disorders are prevalent in epilepsy patients, quite often this coexistence could be overlooked. Studies in this area demonstrated that depression, anxiety disorders and schizophrenia are the most common psychiatric disorders accompanying epilepsy. Mental health problems are known to be more common in prisoners compared to general population. The present study aims to demonstrate the psychiatric comorbidities in prisoners diagnosed with epilepsy. METHOD: In this study, demographic data and the psychiatric comorbidity of 200 patients who were diagnosed with epilepsy by a neurologist at Ankara Penal Institution Campus State Hospital between January 2013 and January 2014 were analyzed retrospectively. RESULTS: The mean age of study population was 32.6±10.1years. 181 of these patients were male (90.5%). 81 of 200 patients (40.5%) had a comorbid psychiatric disorder. The most common comorbid psychiatric disorders were depression (18.5%), anxiety (11%), and personality disorders (11%), respectively. CONCLUSION: The most common psychiatric comorbid disorders among prisoners diagnosed with epilepsy were depression and anxiety as general population with epilepsy whereas some disorders, personality disorder, substance dependence and bipolar affective disorders, were found to be more common among prisoners compared to the general population with epilepsy. It is crucial to question psychiatric symptoms and comorbidities while evaluating the patients with epilepsy, especially among prisoners.

[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.

Executive function in parents of patients with familial versus sporadic bipolar disorder.

OBJECTIVE: Studies investigating the cognitive function of healthy relatives of patients with bipolar disorder are conflicting, and the neurocognitive profile of relatives of bipolar disorder probands is still unclear. We aimed to evaluate executive function in unaffected parents of familial and sporadic patients with bipolar disorder. METHODS: The study included 24 unaffected familial parents (FP) of patients with bipolar disorder, 26 unaffected sporadic parents (SP) of patients with bipolar disorder and 26 controls matched with the parents for gender, age and duration of education (76 subjects in total). All of the subjects were interviewed with the Structured Clinical Interview for DSM-IV-Axis I. Executive function was assessed using the California Verbal Learning Test (CVLT), the Trail Making Test (TMT), the Wisconsin Card Sorting Test (WCST) and the Stroop test. RESULTS: In comparison to their respective matched controls, FP performed significantly worse on the CVLT, TMT, WCST and Stroop test, whereas SP performed significantly worse only on WCST perseverative errors and Stroop color test. FP performed significantly worse than SP on the CVLT, TMT, and WCST. CONCLUSION: The present study investigated relatives with and without a family history of bipolar disorder separately and found that executive function was impaired in parents with a positive family history of bipolar disorder. These findings bring more evidence suggesting that deficits in prefrontal executive function and verbal memory are associated with familial vulnerability to bipolar disorder and that executive function and verbal memory impairments may represent a potential endophenotype of bipolar disorder.

Relationship between dysfunctional attitudes and childhood traumas in women with depression.

AIM: Psychological traumas in childhood could lead to dysfunctional attitudes causing negative cognitive structuring and mistakes in data processing. In this study, we aimed to research the relation of childhood traumas with dysfunctional attitudes in female patients with depressive disorder. METHOD: Seventy female patients diagnosed with depressive disorder and 50 healthy volunteers participated in the study, and the participants were administered a socio-demographic form, the Beck Depression Inventory (BDI), the Childhood Trauma Questionnaire (CTQ) and the Dysfunctional Attitudes Scale (DAS). RESULTS: Comparing the two groups by median values of CTQ, total CTQ, sexual abuse, physical abuse, emotional abuse, physical neglect and emotional neglect, median values of the patient group were significantly higher compared to the control group, and comparison by median values of DAS revealed that median values of the patient group was significantly lower compared to the control group. In the correlation analysis carried out for finding the relation between CTQ and DAS, there was a significant negative correlation between DAS score and emotional abuse score. In the patient group, all kinds of abuses and neglects except for sexual abuse were at a higher rate in those with a history of depression in the family. CONCLUSION: In our study, a negative correlation was determined between DAS and only emotional abuse leading us to the finding that one of the factors mediating childhood traumas to cause depression could lead to dysfunctional attitudes.