Relationship between Alexithymia, Depression and the Negative Symptoms in Schizophrenia with and without Deficit Syndrome. / Eksiklik Sendromu Olan ve Olmayan Sizofrenide Aleksitimi, Depresyon ve Negatif Belirtiler Arasindaki Iliski.

OBJECTIVE: The aim of this study was to compare schizophrenia patients with and without Deficit Syndrome (DS) with respect to alexithymia, depression and negative symptoms and to investigate the relationship between these variables. METHOD: A total of 210 schizophrenia patients who joined the study were grouped on the basis of the Schedule for the Deficit Syndrome (SDS). Each patient was evaluated using the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), the Toronto Alexithymia Scale (TAS) and the UKU - Side Effect Rating Scale (UKU-SERS). RESULTS: The DS group had higher alexithymia scores that were not related to the negative symptoms. The prevalence of depression was significantly lower in the same group. Positive symptoms in the DS group were negatively correlated with the two TAS subscales of difficulty describing and identifying feelings. The negative symptoms scores of all the patients with and without DS correlated positively with the mean score on the TAS subscales. The severity of depressive and the negative symptoms predicted alexithymic symptoms. CONCLUSION: Lack of a correlation between the negative symptoms and alexithymic symptoms in DS suggested that the respective symptoms represented different independent phenomena in schizophrenia. A future study might explore the relationship between alexithymia and negative symptoms in association with cognitive functioning.

Do mentalization skills affect the perception of stigma in patients with epilepsy?

PURPOSE: We aimed to study the relationship between the mentalizing ability and stigma in patients with epilepsy. METHODS: Patients with epilepsy were administered the following battery of tests: Mini-International Neuropsychiatric Interview (MINI) form, Reading the Mind in the Eyes Test (Eyes Test), Stigma Scale of Epilepsy (SSE), Internalized Stigma of Mental Illness (ISMI) Scale, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). RESULTS: Assessment of an association between the Eyes Test score, ISMI Scale total score, and subscale scores revealed a negative significant correlation of Eyes Test scores with approval of stereotypes, perceived discrimination, stigma resistance, and total score. Eyes Test score and BDI scores appears to be significant predictor of internalized stigma among the clinical variables that were studied. A positive significant correlation was detected between BDI score and alienation, perceived discrimination, and total score. CONCLUSION: The presence of a correlation between the mentalization and stigma perception in our study demonstrates that these two concepts are connected and that this connection needs further study. In particular, mentalization-based therapy can have an effect on the reduction of the stigma perceptions and in this way can improve the course of the disease, potentially improving the patients' quality of life.

Are Mentalizing Abilities and Insight Related to the Severity of Obsessive-Compulsive Disorder.

OBJECTIVE: The aim of this study is to investigate whether insight and mentalizing abilities are related to the severity of Obsessive Compulsive Disorder (OCD) in treatment resistant OCD. We look at the association between treatment resistance, insight, and mentalizing ability. METHODS: The study was conducted with 71 OCD patients; 30 of them met the criteria for treatment resistant OCD, whereas the other 41 (57.7%) were labeled as responder group. All patients were assessed with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Reading the Mind in the Eyes Test (RMET), Brown Assessment of Beliefs Scale (BABS), Mini International Neuropsychiatric Interview, Beck Depression Inventory, and Beck Anxiety Inventory. RESULTS: The resistant group received higher depression and anxiety mean scores and had significantly longer illness duration. The RMET score was significantly higher for responders. The Y-BOCS insight score and the BABS score were significantly higher for the resistant group. BABS scores were negatively correlated with RMET total scores. RMET scores were found to be significant predictor of insight even when other potential factors were controlled for. RESULTS: suggest that better mentalizing abilities may be a predictor of better treatment outcome in patients with OCD.

The Effect of Religious Belief and Forgiveness on Coping with Diabetes.

We aimed to investigate the relationship of religious beliefs and forgiveness in diabetic patients with various sociodemographic characteristics, emotional problems and glycaemic control. The study comprises 100 patients diagnosed with type 2 DM. We used a data collection form, the Scale of Forgiveness and Religiosity (SFR), Problem Areas in Diabetes Scale (PAID), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and the Audit of Diabetes-Dependent Quality of Life (ADDQoL). We also recorded blood glucose and HbA1c test results. A statistically significant relationship was determined only between the scores of the STAI-I and the religious belief scales (r = 0.198, p = 0.049). A statistically significant negative relationship was determined between the forgiveness scale points and the BDI (r = 0.326, p = 0.001), the STAI-II (r = 0.308, p = 0.002) and PAID (r = 0.313, p = 0.001) and a positive correlation with ADDQoL (r = 0.284, p = 0.004). To conclude, forgiveness by patient himself or others reduced the emotional problems which were experienced related to diabetes by reducing stress levels and could increase quality of life.

Clinical characteristics of synthetic cannabinoid-induced psychosis in relation to schizophrenia: a single-center cross-sectional analysis of concurrently hospitalized patients.

BACKGROUND: This study aimed to evaluate synthetic cannabinoid (SC)-induced psychosis in terms of patient profile and clinical characteristics with reference to concurrently hospitalized schizophrenic patients. METHODS: A total of 81 male patients diagnosed with psychotic disorder induced by the use of SCs (n=50; mean (standard deviation [SD]) age: 25.9 (5.5) years) or with schizophrenia (n=31, mean (SD) age: 42.9 (11.6) years) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosis criteria who were concurrently hospitalized at Erenköy Mental and Neurological Diseases Training and Research Hospital were included in this cross-sectional study. Data on sociodemographic characteristics, Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Frontal Assessment Battery (FAB), Hamilton Rating Scale for Depression (HRSD), and Hamilton Anxiety Rating Scale (HAM-A) were recorded in all the patients. RESULTS: Mean (SD) age at disease onset in SC-induced psychosis patients was 22.3 (5.6) years; 26.0% had suicidal ideation and 58.4% were hospitalized involuntarily. Marijuana was the most common first used substance (72.0%), and solitary use of SC was noted in 38.0% of patients. SC-induced psychosis patients had similar PANSS positive, BPRS, HRSD, and FAB scores and significantly lower PANSS negative scores (18.0 [6.5] vs 22.3 [6.0], P=0.004) than patients with schizophrenia, while they had similar HAM-A scores (17.8 [10.3] vs 21.6 [5.5], P=0.085) as young schizophrenics. Age at onset for SC (r=0.364, P=0.05) or substance (r=0.395, P=0.01) use was correlated positively with total FAB scores. CONCLUSION: In conclusion, our findings revealed SC-induced psychosis to influence young individuals and be associated with remarkable rates of suicidal ideation and involuntary hospitalization as well as similar clinical picture with schizophrenia in terms of PANSS positive, BPRS, HRSD, HAM-A, and FAB scores. Younger age at onset was associated with poorer frontal lobe functions overall, regardless of the type of substance, and with poorer inhibitory control and programming performance in case of SC use.

Are trauma and dissociation related to treatment resistance in patients with obsessive-compulsive disorder?

OBJECTIVE: Previous research has indicated a relation between obsessive-compulsive disorder (OCD), childhood traumatic experiences and higher levels of dissociation that appears to relate to negative treatment outcome for OCD. The aim of the present study is to investigate whether childhood trauma and dissociation are related to severity of OCD in adulthood. We also intend to examine the association between treatment resistance, dissociation, and each form of trauma. METHODS: Participants included 120 individuals diagnosed with OCD; 58 (48.3 %) of them met the criteria for treatment-resistant OCD (resistant group), whereas the other 62 (51.7 %) were labeled as responder group. The intensity of obsessions and compulsions was evaluated using Yale-brown obsessive-compulsive scale (Y-BOCS). All patients were assessed with the traumatic experiences checklist, dissociative experiences scale, beck depression inventory, and beck anxiety inventory. RESULTS: Controlling for clinical variables, resistant group had significantly higher general OCD severity, anxiety, depression, trauma, and dissociation scores than the responders. Correlation analyses indicated that Y-BOCS scores were significantly related to severity of dissociation, anxiety, depression, and traumatic experiences. In a logistic regression analysis with treatment resistance as a dependent variable, high dissociation levels, long duration of illness, and poor insight emerged as relevant predictors, but gender, levels of anxiety, depression, and traumatic experiences did not. CONCLUSIONS: Our results suggest that dissociation may be a predictor of poorer treatment outcome in patients with OCD; therefore, a better understanding of the mechanisms that underlie this phenomenon may be useful. Future longitudinal studies are warranted to verify if this variable represents predictive factors of treatment non-response.

Effects of childhood trauma on somatization in major depressive disorder: The role of alexithymia.

BACKGROUND: Childhood trauma (CT) is often associated with later psychopathology, including depression, somatization, and alexithymia. The aim of the present study was to investigate the relationships of CT with somatization and alexithymia. Moreover, the effect of specific subtypes of trauma on alexithymia and somatization was also investigated. METHODS: The present study was conducted on 100 outpatients with major depressive disorder (MDD) and 50 age and gender matched healthy controls (HC). Data were collected on each of the participants, including the Childhood Trauma Questionnaire (CTQ-28), the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS), a 20-item Toronto Alexithymia Scale (TAS), and a somatization subscale of the Symptom Check List-Revised Form (SCL-90 R). Patient groups were divided into two categories according to the TAS-20 cut-off score. Reliability and validity were assessed, and factor analyses were conducted on the CTQ-28. Next, the relationships among CT subtypes, alexithymia, and somatization were investigated using Pearson's and partial correlation analysis. Additionally, the types of CT that predict alexithymia and somatization were also investigated. RESULTS: Significantly higher scores on the clinical variables were noted in the patient group compared with the control group, except for physical neglect on the CTQ. The partial correlation of the CT types with somatization and alexithymia showed that the HARS, HDRS, somatization subscale of the SCL-90 R (for alexithymia), and the TAS-total (for somatization) were covariates. None of the CT types was correlated with somatization, whereas physical abuse and emotional neglect were correlated with alexithymia. Moreover, emotional abuse and emotional neglect predicted scores on the TAS and on the somatization subscale of the SCL-90 R. Conclusions CT is associated with alexithymia and ongoing somatic complaints. Alexithymia contributes to the emergence of somatic symptoms in MDD, particularly following CT. Somatization also contributes to alexithymia. Interestingly, the present study found that the relationship of emotional neglect and physical abuse with alexithymia was independent from somatization. Taken together, these results indicate that emotional abuse and neglect predict the later emergence of alexithymia and somatization.