The reduced Morningness-Eveningness Questionnaire: Psychometric properties and related factors in a young Swedish population.

During puberty, there is a delay in sleep patterns and the circadian clock, and the prevalence of sleep difficulties is high among young adults. Thus, it is important to be able to measure chronotype (CT) in this group, both in the clinic and for broader epidemiological studies, to better understand the sleep difficulties observed. The reduced version of one of the most widely used questionnaire to measure CT, the Horne & Östberg Morningness-Eveningness Questionnaire (MEQ), has been developed and validated in many languages. The aim of the present study was to investigate the reliability and validity of the Swedish reduced MEQ (rMEQ) and to investigate factors correlated with rMEQ scores in a random sample of young Swedish participants. We sent the rMEQ, sleep questions, demographic questions, the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale, and the Hospital Anxiety and Depression Scale (HADS-A and HADS-D) to 1000 randomly selected individuals aged 16-26 years in Uppsala, Sweden (response rate = 68%). A parallel analysis of the rMEQ revealed a single factor solution. Inter-item correlations within the questionnaire were between 0.08 and 0.46. One of the rMEQ items displayed weak correlations with the other questions. Cronbach's alpha of the rMEQ was 0.68. Low rMEQ scores (eveningness) were correlated with more frequent late bedtimes and difficulties getting up in the morning. Lower rMEQ scores were significantly related to male sex, no educational activity or work, nicotine use, younger age, and higher ISI and HADS-D scores. Even though the inter-item correlations of the rMEQ were very low to moderate, the rMEQ had a Cronbach's alpha not far off from acceptable levels, and the strong correlations of the rMEQ scores with responses to the sleep questions indicated that the rMEQ had an adequate validity. To conclude, the rMEQ can be used to effectively estimate CT when a short questionnaire is required; however, caution should be taken when interpreting the results considering the reliability of the questionnaire.

[The Relationship of Verbal Working Memory and Theory of Mind in First Degree Relatives of Patients With Schizophrenia and Bipolar Disorder]. / Sizofreni ve Psikotik Özellikli Bipolar Bozukluk Hastalarinin Birinci Derece Akrabalarinda Zihin Kurami ve Sözel Çalisma Belleginin Iliskisi.

OBJECTIVE: We aimed to compare Theory of Mind (ToM) functions and investigate the relationship between ToM functions and verbal working memory (VWM) in first degree relatives of bipolar disorder and schizophrenia patients. METHOD: The sample consisted of first degree relatives of patients with bipolar disorder (n=22), schizophrenia (n=28), and age, gender, education and total IQ matched healthy volunteers (n=27) without a family history of schizophrenia or bipolar disorder. We administered Auditory Consonants Test (ACT) to evaluate VWM, first and second order false belief tests (ToM-1, ToM-2), Faux Pas Test (FPT), Hinting Test (HT) to evaluate different domains of ToM functions. RESULTS: Both relative groups performed significantly lower in all components of ToM and VWM tests compared to the control group. When VWM scores were employed as covariate in the analyses, the FPT difference between the groups remained significant, HT difference regressed to a marginal level, and the difference between ToM-1 and ToM-2 disappeared. CONCLUSION: To our knowledge, this is the first study indicating the presence of ToM impairment among first degree relatives of bipolar disorder patients similar to relatives of schizophrenia patients. VWM performance seems to affect first and second order ToM functions in relatives of patients with schizophrenia and bipolar disorder. On the other hand, FPT and HT domains seem to be independent of VWM performances in these groups. FPT and HT impairments may be familial vulnerability markers that are independent from neurocognitive impairment.

[Dimensions of Agitation Based on the Cohen-Mansfield Agitation Inventory in Patients with Dementia]. / Demans Hastalarinda Cohen-Mansfield Ajitasyon Envanteri ile Degerlendirilen Ajitasyon Boyutlarinin Arastirilmasi.

OBJECTIVE: The aim of this study was to investigate the dimensions of agitation in dementia patients using the Turkish version of the Cohen-Mansfield Agitation Inventory (CMAI-T). MATERIALS AND METHODS: The study included 100 patients diagnosed as dementia, according to the DSM-IV-TR. The CMAI-T was administered to the patients' caregivers via face-to-face interviews. The Standardized Mini Mental State Examination (SMMSE) was used to assess cognitive functions. The severity of depression and the functional state of the patients were assessed using the Cornell Scale for Depression in Dementia (CSDD) and the Functional Activities Questionnaire (FAQ). Principal component analysis and varimax rotation were used to determine the factor structure of the CMAI-T. RESULTS: Factor analysis of the CMAI-T indicated a 3-factor structure: physically aggressive agitation, verbal agitation, and physically non-aggressive agitation. In 92% of the patients there was ≥1 agitation behavior during the previous 2 weeks. The CMAI-T total and factor scores were negatively correlated with the SMMSE scores, and positively correlated with the CSDD and the FAQ scores. CONCLUSIONS: The CMAI-T yielded 3 factors (physically aggressive agitation, verbal agitation, and physically non-aggressive agitation), which indicated the scale had construct validity. Agitation behaviors were associated with cognitive dysfunction, symptoms of depression and general level of functioning. Additional research is necessary to identify the predictors of these dimensions in different dementia samples, and to determine the efficacy of therapeutic interventions.

[Googling suicide: evaluation of websites according to the content associated with suicide]. / Internette Intihari Aramak: Internet Sitelerinin Intihar ile Iliskili Içeriklerine Göre Degerlendirilmesi.

OBJECTIVE: The Internet is increasingly being used to acquire information about personal experiences and health, but the credibility of this information is debatable. It has been reported that methods of suicide and access to suicidal means are explicitly discussed in some of the websites, with users being encouraged to attempt suicidal acts in some cases. Access to web content with pro-suicidal features is monitored in many countries. In Turkey, the frequency of people visiting these websites is unknown. Moreover, a program has not been established that targets online users. This study aims to provide information about the information that a person may come across after searching online for suicide and suicide methods in Turkish language. METHOD: After searching for particular suicidal phrases (i.e., "suicide methods," "painless suicide," "guaranteed suicide," "killing yourself" and "how can I die") in the Google search engine, three psychiatrists evaluated the results independently, according to the content. RESULTS: 42 of the 100 websites (42%) were found to have properties that are pro-suicidal, whereas 13 of them (13%) were found to have content that may be considered protective against suicidal thoughts and actions. Among the websites that were reported to be protective, none had any kind of supervision or guidance from mental health professionals. CONCLUSION: Suicidal content, as well as the possibility of content generated on the Internet, should be taken into account while planning suicide prevention programs. Further studies are needed to determine which risk factors and protective features of the Internet affect suicidal behavior among individuals.

[Fragile X premutation in adult psychiatry: four cases and overview of clinical presentation]. / Eriskin Psikiyatrisinde Frajil X Premutasyonu: Dört Vaka Sunumu ve Klinik Görünümün Tanitimi

Fragile X carrier status, also named as Fragile X premutation (FraX-PM), is defined by trinucleotide repeat expansions of shorter length compared to those that cause the full syndrome. Its clinical significance has been limited to the risk of further expansion to a full mutation in the offspring of carriers, until it was recently recognized as a clinical syndrome on its own, manifested by unique symptom constellations, as well as a combination of neuropsychiatric signs and symptoms that may be indistinguishable from several commonly seen disorders. The complex heterogeneity of its neuropsychiatric manifestations may render the diagnosis challenging, unless the clinician is familiar with the clinical picture and transmission pattern. We present four cases of FraX-PM, diagnosed in an adult psychiatry setting and confirmed by genetic testing. The aim of this report is to increase familiarity among psychiatric practitioners, since this common condition is seldom included in the current diagnostic practice, which is based on atheoretical definitions.