Emotion dysregulation and affective temperaments in opioid use disorder: a 1-year follow-up study.

BACKGROUND: Opioid use disorder (OUD) remains a significant public health challenge with high recurrence rates and varied long-term outcomes. Affective temperament and emotion regulation have been identified as influencing addictive behaviors and treatment outcomes in OUD. However, limited research has explored their association with reversion over an extended period. OBJECTIVES: The EDATOUD (Emotion Dysregulation and Affective Temperaments in Opioid Use Disorder) study aimed to evaluate the effects of affective temperament and emotion regulation characteristics on recurrence over a 1-year follow-up period. The study aimed to compare the baseline characteristics of patients who achieved remission versus those who did not and identify potential predictors of recurrence risk. METHODS: The study included 63 patients with OUD who were assessed monthly for return-to-use through self-report, psychiatric examination, and urine analysis. Sociodemographic data, affective temperament, difficulties in emotion regulation, anxiety, and depression were measured at baseline. Statistical analyses were performed to compare the recurrent and remission groups and determine the predictive value of these clinical features on recurrence. RESULTS: Within the one-year, 77.8% of patients returned to use. Affective temperament characteristics did not differ between the groups. However, the recurrent group patients exhibited significantly more difficulties in emotion regulation. CONCLUSIONS: Difficulties in emotion regulation are associated with an increased risk of recurrence in patients with OUD. Understanding these factors can inform the development of tailored treatment strategies to improve long-term outcomes. Further research is needed to explore additional factors contributing to reversion and enhance intervention and support systems for sustained recovery in OUD.

The Relationship Between Family Accommodation and Anxiety Sensitivity in Obsessive-Compulsive Disorder.

Objective Anxiety sensitivity (AS) is an issue that has gained importance in obsessive-compulsive disorder (OCD) in recent years. Family accommodation (FA) is the participation of family members in compulsions and rituals. The objectives of this study were to (1) investigate the relationship between FA and AS in OCD and (2) determine the frequency and types of FA in a Turkish OCD sample. Methods This cross-sectional study was conducted with 81 OCD patients. The Yale-Brown Obsession Compulsion Scale (YBOCS), Family Accommodation Scale-Patient Form (FAS-PF), Anxiety Sensitivity Index-3 (ASI-3), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were administered to the patients. Results Family accommodation was extremely prevalent among family members of OCD patients. There were significant relationships between FA and ASI-3 total, ASI-3 cognitive subscale, ASI-3 psychical subscale, YBOCS, and BAI scores. In addition, ASI-3 total, ASI-3 cognitive subscale, and ASI-3 psychical subscale were significant predictors for family accommodation above and beyond the OCD severity. Conclusions The present study identified a significant association between anxiety sensitivity and family accommodation in OCD. Anxiety sensitivity is a relievable psychological trait. Alleviating anxiety sensitivity can decrease accommodating behaviors and may be beneficial in OCD treatment. Anxiety sensitivity may be a novel potential treatment target for OCD.

Is Orthorexia Nervosa a Non-specific Eating Disorder or a Disease in the Spectrum of Obsessive-Compulsive Disorder?

BACKGROUND: In recent years, there has been a dramatic increase in awareness in society that healthy nutrition has positive effects on health. However, obsession with these behaviors towards healthy foods causes negative effects on health and quality of life. AIM: The aim of this study was to elucidate the relationship between the incidence of orthorexia nervosa (ON) in medical school students and the level of conscious awareness, obsessive-compulsive disorder, eating attitudes and behaviors, health anxiety, and body image to clarify the unclear issues in the literature, such as whether orthorexia nervosa is among the psychological disorders, "where" it will take place, and which diagnoses it can be associated with. METHODS: Students between the 1st and 6th grades of medical school were invited to participate in this research. The Sociodemographic Data Form, Maudsley Obsessive-Compulsive Question Index (MOCI), Eating Attitude Test Short Form (EAT SF-26), Health Anxiety Inventory-Weekly Short Form (HAI-SF), ORTO-11 scale, Body Perception Scale, and Conscious Awareness Scale have been applied to the students. RESULTS: In univariate analysis, the eating disorder scale, body image scale, and awareness scale total scores all had an impact on orthorexia. Each increase in the eating disorder scale score increased the diagnosis of orthorexia 1.07 times, while each increase in the body image scale score increased the diagnosis of orthorexia 1.09 times. Additionally, each increase in the conscious awareness scale score decreased the diagnosis of orthorexia by 0.92 times. When all variables were re-evaluated in the multivariate analysis, it was seen that the total scores of the body image scale and conscious awareness scale affected the diagnosis of orthorexia. There was a weak inverse relationship between the orthorexia scale score and only the health anxiety inventory total score (p<0.05). CONCLUSION: Regarding the outcomes of this research, one can say that orthorexia affected the eating disorder scale, body image scale, and awareness scale total scores. While the increase in the eating disorder and body image scale scores increased orthorexia, the increase in the conscious awareness scale score had a decreasing effect.

Emotion Dysregulation and Affective Temperaments in Opioid Use Disorder: the preliminary results of a prospective study.

BACKGROUND: Substance use disorder is a growing health problem all over the world. The coexistence of substance misuse, affective temperaments, and emotion dysregulation has not been studied sufficiently. OBJECTIVE: The present study aimed to evaluate the role of affective temperaments and emotion dysregulation on substance use disorder. The Emotion Dysregulation and Affective Temperaments in Opioid Use Disorder study was designed observational. This paper presents only the baseline assessments of the patient and control groups. One-year remission rates of the patients' group will be reported elsewhere after 1-year follow-up. METHODS: Sixty-seven patients with opioid use disorder and 68 healthy controls enrolled. All participants were administered to The Structured Clinical Interview for DSM-5, Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire, Difficulties in Emotion Regulation Scale, Beck Anxiety Inventory, and Beck Depression Inventory. RESULTS: Patients with opioid use disorder had higher scores from all temperamental scales and showed higher difficulties on emotion regulation than the control group. Even controlling the confounding effects of anxiety and depression levels, dysthymic and anxious temperament scores were found correlated with the emotion dysregulation score in the patient group. CONCLUSIONS: The emotional traits (i.e., affective temperaments) and emotion regulation abilities play a crucial role in substance use disorder. While managing substance use disorder, being aware of affective temperament characteristics and/or interventions to improve emotion regulation skills may be helpful.

Obsessive-Compulsive Disorder During the Initial Stage of COVID-19 Pandemic: Effect of Contamination Symptoms and Poor Insight on Obsessive-Compulsive Disorder Exacerbation.

ABSTRACT: We aimed to investigate the effect of the COVID-19 pandemic on the symptom severity and dimensions of obsessive-compulsive disorder (OCD) and how patients with different levels of insight have been impacted by the pandemic. This study included 58 patients with OCD. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS)-Obsession, Y-BOCS-Compulsion, and Y-BOCS-Total scores during the pandemic were significantly higher than the prepandemic scores (p = 0.001, p < 0.001, p = 0.002, respectively). Compared with the pre-COVID-19 period, severity of OCD symptoms increased in 39.7% patients, remained the same in 44.8% patients, and reduced in 15.5% patients during the pandemic. The obsession with contamination, Brown Assessment of Beliefs Scale (for insight assessment) score, and time spent following the news/data about COVID-19 were significantly associated with an increase in OCD severity. In patients with contamination obsessions as well as poor insight, close monitoring and facilitating access to treatment may reduce the negative impact of the COVID-19 pandemic.

Impact of Parental Impulsivity on Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder: Do Mothers' Attitudes Predict Symptom Severity in Children?

ABSTRACT: Attention deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder that occurs early in school-aged children, and it is highly comorbid with oppositional defiant disorder (ODD). Parents of children with ADHD frequently show mental problems related to impulsivity. The aim of this study was to examine the relationship between impulsivity of the mothers and the symptom patterns and severity of children. A total of 85 children between the ages of 6 and 12 and their mothers participated. Conners' Parent and Teacher Scales, Structured Clinical Interview for DSM-IV Personality Disorders, and iowa gambling task were applied. We found a positive correlation between the impulsivity of the mothers and the total symptom severity of ADHD and ODD in children. During the treatment process of ADHD, the evaluation of impulsivity in mothers of children with ODD comorbidity and treatment of impulsivity in the mother would be beneficial. In future studies, examining the effects after treatment of impulsivity may contribute to the literature.

Effect of prilocaine and its combination with tramadol on anxiety and pain during nasal packing removal.

PURPOSE: To investigate the effect of local usage of prilocaine and its combination with tramadol on the pain and anxiety levels of patients during nasal packing removal. METHODS: A total of 117 patients who were treated with the Merocel nasal packing after septoplasty were included in the study. Patients whose Merocel nasal packings infiltrated with prilocaine (P group), prilocaine combined with tramadol 1 mg/kg (P + T1 group), prilocaine combined with tramadol 2 mg/kg (P + T2 group), or normal saline solution (Control group) before nasal packing removal were compared for their pain, sedation, and anxiety related to this removal procedure. The visual analog scale (VAS), Ramsay sedation scale (RSS), and State-Trait Anxiety Inventory (STAI) scale were assessed to evaluate the pain, sedation, and anxiety levels of the patients. RESULTS: Groups were found similar according to sex, age, and preoperative STAI scores. The VAS score was significantly lower in P, P + T1, and P + T2 than control group during nasal packing removal (p < 0.001, p < 0.001, and p < 0.001, respectively). However, state anxiety inventory (STAI-S) and RSS were found significantly improved only in P + T1 and P + T2 (STAI-S: p = 0.032, RSS: p = 0.002, STAI-S: p = 0.000, RSS: p < 0.001, respectively). In the comparison of P + T1 and P + T2, no significant difference was found in VAS, RSS, and STAI-S (p = 0.604, p = 0.154, and p = 0.264, respectively). CONCLUSION: The combined infiltration of prilocaine and tramadol 1 mg/kg into the nasal packing is effective in reducing the pain and anxiety of patients during nasal packing removal.

A Neuroleptic Malignant Syndrome Without Rigidity.

Neuroleptic malignant syndrome (NMS) is an uncommon but potentially lethal idiosyncratic reaction which may emerge in the aftermath of the treatments with neuroleptics demonstrating itself with the symptoms of altered consciousness, high fever, impaired autonomic functions, and muscle rigidity. Although various risk factors have been identified for NMS, its etiology is not completely known. The mortality and morbidity related with NMS could be reduced by early diagnosis, interruption of the neuroleptics used within a short period and aggressive treatment. Our case is different from general NMS cases due to lack of rigidity. A NMS case which developed within a short time in the aftermath of multiple antipsychotic use and wherein no rigidity was observed shall be discussed in this case report.

The relationship between theory of mind and insight in obsessive-compulsive disorder.

BACKGROUND: It is known that obsessive-compulsive disorder (OCD) patients with poor insight display more severe neuropsychological impairments than other patients with OCD. There are limited studies of OCD and theory of mind (ToM). AIM: To investigate ToM skills in patients with OCD and the relationship between insight and ToM skills by comparing OCD patients with good and poor insight. METHODS: Eighty patients with OCD and 80 healthy controls completed the structured clinical interview for DSM-IV axis I disorders, the Yale Brown Obsessive-Compulsive Scale, the Beck Anxiety and Beck Depression Inventories, and the Brown Assessment of Beliefs Scale. To assess ToM skills, first- and second-order false-belief tests, a hinting test, a faux pas test, a reading the mind in the eyes test, and a double-bluff test were administered. RESULTS: Patients with OCD had poorer ToM abilities than healthy controls. All ToM scores were significantly lower in the poor insight group than in the good insight group (p < .001). A significant negative correlation was found between the BABS-total scores and all the ToM test mean scores (p < .05). CONCLUSIONS: The finding of significantly lower ToM skills in OCD with poor insight than in OCD with good insight may contribute to the idea of OCD with poor insight being a subtype with different clinical and neuropsychological characteristics.

The Effect of Antipsychotics on Bone Mineral Density and Sex Hormones in Male Patients with Schizophrenia.

BACKGROUND: The aim of this study was to compare the bone mineral density (BMD) of male schizophrenia patients with those of healthy controls in order to determine the relationship between BMD and hormonal changes. SUBJECTS AND METHODS: The study sample included male outpatients between 18 and 55 years old, diagnosed with schizophrenia who had used prolactin-raising antipsychotics (n=23) and prolactin-sparing antipsychotics (n=19) for at least twelve months, along with an age - matched healthy control group. A socio-demographic form was administered, BMD and T-score measurements were performed with a DEXA test, and hormone levels were measured with commercial test kits. RESULTS: The prolactin levels of the prolactin-raising group (PRG) were significantly higher than those of the healthy control group (CG) and the prolactin-sparing group (PSG). While prolactin levels were normal in the CG, hyperprolactinemia was found in 15.8% (n=3) of patients in the PSG and 65.2% (n=15) of subjects in the PRG. Estradiol levels for the PRG and PSG were similar but significantly lower than those of the CG. There was a statistically significant difference between the PRG, PSG and CG in terms of their L1-4 total actual bone density and T-scores. BMD and T-scores were lower for the PRG in comparison with the PSG and CG, and were consistent with osteopenia. Although not observed for every tested region, a negative correlation was found between age, duration of therapy, duration of illness, and T-scores. A positive correlation was found between subjects BMI and T-scores. A consistent negative correlation was found between total testosterone and L1-4 total T-scores when corrected according to prolactin and estradiol. A linear regression analysis found significant relationships between age, BMI, duration of therapy, duration of illness, chlorpromazine equivalent dose, estradiol and testosterone affected T-scores for some regions. CONCLUSIONS: The long-term use of prolactin - raising antipsychotic medications as well as hyperprolactinemia and hypoestrogenism accelerate bone degradation.

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.

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.