The prevalence and psychological relation of problem shopping: data from a large-scale sample from Turkey.

BACKGROUND: The purpose of the present study was to comprehensively examine the measurement aspects, the prevalence, and the psychological correlates of problem shopping among a large-scale national sample of Turkish adults. RESULT: Participants (N = 24,380, 50% men, M age = 31.79 years, age range = 18-81 years) completed a questionnaire that comprised the Shopping Addiction Risk Questionnaire, the Brief Symptom Inventory, the Positive and Negative Affect Schedule, and the Experiences in Close Relationships-Revised. Results showed that 1.8% of the participants had probable shopping addiction. Being female, being younger, psychiatric distress, positive affect, negative affect, anxious attachment, and avoidant attachment were positive correlates of problem shopping. CONCLUSION: The results of this large sample size study suggest that shopping addiction is not a rare condition in Turkey. Further research is needed to understand different motives that underlie the problematic shopping behavior in the young and female population in comparison to older and male populations. Preventive programs or any interventions for people with PSB needs to address regulation difficulties and development of healthy strategies to cope with psychiatric distress.

CONNECTOME or COLLECTOME? A NEUROPHILOSOPHICAL Perspective.

Human beings exist in a biological and social system from a micro to a macro level, by means of "collectivity", a dynamic collaboration that they have established together with the elements in that system in a way to complement each other and realize a common goal. Many neuroscientific concepts used today to explain neuronal processes from which mental functions originate are far from searching answers to traditional philosophical questions. However, the brain - as the generator of highly abstract concepts - is so complex that it cannot be explained by minimalistic approaches. The concept of connectome used in recent years to describe neuronal connections from which brain functions originate exemplifies this minimalistic approach, because it only describes structural and functional connections but does not look at brain functions in a holistic view. For this reason, we propose the concept of collectome - to replace the concept of connectome - that describes a homeomorphic and homotopic neuronal framework that has a bicontinuous style of work from micro to macroscale which is based on fractal rules.

Vaccination and Immunotherapy for Major Depression.

Depression is a very common disease with increasing incidence resulting from complex interactions of genetic, environmental, and immunological processes. To this day, the etiopathogenesis and treatment of depression unfortunately seem to be stuck in the synaptic gap. Despite highly potent antidepressants, the treatment rate cannot reach 100%, the treatment resistant group cannot be eliminated, and relapse cannot be prevented. These problems lead researchers to further and different research to understand and treat psychopathology. Immune dysfunction and neuroinflammation have been one of the main issues that psychiatry has focused on in recent years and helps us to understand depression. Extraneuronal components of all neuropsychiatric disorders, especially depression, have begun to be revealed in detail thanks to a better understanding of the immune system and an increase in experimental and technological possibilities. There is increasing evidence of a causal relationship between the etiopathogenesis of major depression and low-level chronic neuroinflammation. In this article, the role of neuroinflammation in the etiopathogenesis of depression and the possibilities of vaccination and immunotherapy are discussed.

Assesment of Risk Factors for Tardive Dyskinesia.

Objective: Aim of the study is to evaluate sociodemographic and clinical features that may be associated with the development of Tardive dyskinesia (TD). Methods: 80 patients attending an outpatient psychiatry clinic in Istanbul, Turkey were divided into TD (n = 50) and control groups (CG) (n = 30). Sociodemographic and clinical data was collected through face-to-face interviews and a retrospective search of medical records. Results: There was a significant difference between TD and control group (CG) in terms of mean; onset of psychiatric disease at or after 35 years of age; first use of APD at or after 35 years of age; use of long-acting injectable APD; history of extrapyramidal side-effects; history of akathisia and family history of psychiatric disease. There was no significant difference between the two groups in terms of DSM- IV-based psychiatric diagnosis distributions, the existence of complete recovery periods during the course of the disease; total duration of APD use for at least 10 years; APD holidays; regular APD use; history of ECT and smoking or alcohol and substance abuse/addiction. Conclusion: Advancing age seemed to be the most significant risk factor in the development of TD. Clinicians need to be cautious about TD when prescribing APD for elderly patients.

Entropy: A Promising EEG Biomarker Dichotomizing Subjects With Opioid Use Disorder and Healthy Controls.

Electroencephalography (EEG) signals are known to be nonstationary and often multicomponential signals containing information about the condition of the brain. Since the EEG signal has complex, nonlinear, nonstationary, and highly random behaviour, numerous linear feature extraction methods related to the short-time windowing technique do not satisfy higher classification accuracy. Since biosignals are highly subjective, the symptoms may appear at random in the time scale and very small variations in EEG signals may depict a definite type of brain abnormality it is valuable and vital to extract and analyze the EEG signal parameters using computers. The challenge is to design and develop signal processing algorithms that extract this subtle information and use it for diagnosis, monitoring, and treatment of subjects suffering from psychiatric disorders. For this purpose, finite impulse response-based filtering process was employed rather than traditional time and frequency domain methods. Finite impulse response subbands were analyzed further to obtain feature vectors of different entropy markers and these features were fed into a classifier namely multilayer perceptron. The performances of the classifiers were finally compared considering overall classification accuracies, area under receiver operating characteristic curve scores. Our results underline the potential benefit of the introduced methodology is promising and is to be treated as a clinical interface in dichotomizing substance use disorders subjects and for other medical data analysis studies. The results also indicate that entropy estimators can distinguish normal and opioid use disorder subjects. EEG data and theta frequency band have distinctive capability for almost all types of entropies while nonextensive Tsallis entropy outperforms compared with other types of entropies.

Immune-Kynurenine Pathways and the Gut Microbiota-Brain Axis in Anxiety Disorders.

Anxiety disorders are a complex set of illnesses in which genetic factors, particularly stress, play a role in the etiopathogenesis. In recent years, inflammation and intestinal microbiota have also been included in this complex network of relationships. The functions associated with tryptophan catabolism and serotonin biosynthesis have long been associated with anxiety disorders. Tryptophan catabolism progresses toward the path of the kynurenine in the presence of stress and inflammation. The catabolism of kynurenine is a pathway in which many enzymes play a role and a large number of catabolites with neuroactive properties occur. The body's serotonin biosynthesis is primarily performed by enterochromaffin cells located in the intestines. A change in the intestinal microbiota composition (dysbiosis) directly affects the serotonin biosynthesis. Stress, unhealthy nutrition, and the use of antibiotics cause dysbiosis. In the light of this new perspective, the role of dysbiosis-induced inflammation and kynurenine pathway catabolites activated sequentially come into prominence in the etiopathogenesis of anxiety disorders.

Neuroinflammation, Gut-Brain Axis and Depression.

Psychiatric diseases are the manifestations that result from the individual's genetic structure, physiology, immunology and ways of coping with environmental stressors. The current psychiatric diagnostic systems do not include any systematic characterization in regard to neurobiological processes that reveal the clinical picture in individuals who got psychiatric diagnosis. It is obvious that further research in different areas is needed to understand the psychopathology. The problems in the functions of immune system and the correlation of neuroinflammatory processes with psychiatric disorders have been one of the main research topics of psychiatry in recent years and have contributed to our understanding of psychopathology. Recent advances in the fields of immunology and genetics as well as rapidly increasing knowledge on the effects of immunological processes on brain functions have drawn attention to the correlations between psychiatric disorders and immune system dysfunctions. There are still unfilled gaps in the biology, pathophysiology, and treatment of major depressive disorder, which is quite prevalent among the psychiatric disorders, can lead to significant disability, and frequently has a recurrent course. It appears that low-grade chronic neuroinflammation plays a key role in forming a basis for the interaction between psychological stress, impaired gut microbiota and major depressive disorder. In this review, the role of neuroinflammation in the etiopathogenesis of depression and the mechanism of action of the gut-brain axis that leads to this are discussed in the light of current studies.

Psychobiotics.

Psychobiotics are live bacteria that directly and indirectly produce positive effects on neuronal functions by colonizing into the intestinal flora. Preliminary studies, although in limited numbers, have found that these bacteria have anxiolytic and antidepressant activities. No research has yet been published on the antipsychotic efficacy of psychobiotics. However, these preliminary studies have opened up new horizons and raised the idea that a new class is emerging in psychopharmacology. About 70 years have passed since the discovery of chlorpromazine, and while the synaptic transmission is understood in almost all details, there seems to be a paradigm shift in psychopharmacology. In recent years, the perspective has shifted from synapse to intestinal microbiota. In this respect, germ-free and conventional animal experiments and few human studies were examined in a comprehensive manner. In this article, after a brief look at the history of contemporary psychopharmacology, the mechanisms of the gut-brain relationship and the evidence of metabolic, systemic, and neuropsychiatric activities of psychobiotics were discussed in detail. In conclusion, psychobiotics seem to have the potential for treatment of neuropsychiatric disorders in the future. However, there are many questions and we do not know the answers yet. We anticipate that the answer to these questions will be given in the near future.

Aspects of cognitive performance relating to Theory of Mind (ToM) among people diagnosed with Post-Traumatic Stress Disorder (PTSD).

OBJECTIVE: This study investigated Theory of Mind (ToM) abilities as measured by a hinting task and the Reading the Mind in the Eyes Test (RMET) in individuals diagnosed with post-traumatic strees disorder (PTSD) in relation to different types of childhood trauma and compared to a healthy control group. METHOD: RMET, a Clinician Administered PTSD Scale (CAPS), a Beck Depression Inventory (BDI), a Childhood Trauma Questionnaire (CTQ), a hinting task, and a socio-demographic questionnaire were administered to PTSD (n=30) patients and healthy controls (n=30). RESULTS: There was a significant difference in ToM performance between healthy participants and the PTSD group (p<0.001). A significant correlation was found between trauma types and ToM performance (p<0.01). The diagnosis of PTSD and the severity of PTSD symptoms showed significant correlations with ToM performance (p<0.01). In comparison with the healthy control group, the PTSD group demonstrated lower performance on both ToM tasks. Regardless of the PTSD diagnosis, those people who had a history of childhood trauma had slowed reaction times in response to photographs representing emotionally salient mental states and demonstrated difficulties in the identification of irony/hints in the context of the administered assessment task. CONCLUSION: The findings of the present study suggest that a diagnosis of PTSD and a history of different types of trauma have an effect on ToM performance. PTSD seems to lead to deterioration in ToM capacities. This may mean that the experience of childhood adversity may lead to long-lasting damage to social cognition. The current study is helpful in that it contributes to a better understanding of the pathogenesis of PTSD; moreover, it will be beneficial in the development of new treatment options. Our research findings suggest that we must concentrate not only on traumatic events during the treatment process of PTSD follow-up and treatment; we must also target deficiencies in cognitive and emotional capabilities.

The psycho-periodic cube.

The current diagnostic classification systems in psychiatry have been developed primarily for evidence-based clinical decision making with both categorical and dimensional approaches having their own advantages and disadvantages. Efforts have been made to improve these classification systems, and we are now at the point where we must expand beyond the one-dimensionality of these systems. In this paper, we propose that psychiatric disorders can be arranged in a three-dimensional classification system according to the degree of dysfunctions on three specific axes in a way that is similar to the arrangement of chemical elements according to their atomic weights in Mendeleyev's periodic table. For the three axes, we chose externalization, drive, and attention to represent the three-dimensional descriptions of mental health, namely, well-being in social, motivational, and cognitive areas, respectively. Throughout the paper, we explain our reasons for choosing these three axes and compare our hypothesis with categorical diagnostic systems as well as Cloninger's dimensional diagnostic system using personality disorders, affective disorders, and schizophrenia as the specific diagnostic samples.

Therapeutic Potential of the Microbiome in the Treatment of Neuropsychiatric Disorders.

The search for rational treatment of neuropsychiatric disorders began with the discovery of chlorpromazine in 1951 and continues to evolve. Day by day, new details of the intestinal microbiota⁻brain axis are coming to light. As the role of microbiota in the etiopathogenesis of neuropsychiatric disorders is more clearly understood, microbiota-based (or as we propose, "fecomodulation") treatment options are increasingly discussed in the context of treatment. Although their history dates back to ancient times, the importance of psychobiotics and fecal microbiota transplantation (FMT) has only recently been recognized. Despite there being few preclinical and clinical studies, the evidence gathered to this point suggests that consideration of the microbiome in the treatment of neuropsychiatric disorders represents an area of significant therapeutic potential. It is increasingly hoped that such treatment options will be more reliable in terms of their side effects, cost, and ease of implementation. However, there remains much to be researched. Questions will be answered through germ-free animal experiments and randomized controlled trials. In this article, the therapeutic potential of microbiota-based options in the treatment of neuropsychiatric disorders is discussed in light of recent research.

Binomial Logistic Regression and Artificial Neural Network Methods to Classify Opioid-Dependent Subjects and Control Group Using Quantitative EEG Power Measures.

Logistic regression (LR) and artificial neural networks (ANNs) are widely referred approaches in medical data classification studies. LR, a statistical fitting model, is suggested in medical problems because of its well-established methodology and coefficients contributing to the evaluation of clinical interpretations. ANNs are graphical models structured with node networks interconnected with arcs each of which is expressed in terms of weights discovered throughout the modeling process. Since ANNs have a complex structure with its layers and nodes in the layers, which provides ANNs the ability to model any data with complex relationships. Among the various models having origins in statistics and computer science, LR and ANNs have prevailed in the area of mass medical data classification. In this study, we introduce the 2 aforementioned approaches in order to generate a model dichotomizing 75 opioid-dependent patients and 59 control subjects from each other. Quantitative electroencephalography (QEEG) absolute power value of each electrode were calculated for 4 consecutive frequency bands namely delta, theta, alpha, and beta with the frequencies, 0.5 to 4, 4 to 8, 8 to 12, and 12 to 20 Hz, respectively. Significant independent variables contributing to the classification were underlined in LR while a feature selection (FS) method, genetic algorithm, is being applied to the ANN model to reveal more informative features. The performances of the classifiers were finally compared considering overall classification accuracies, area under receiver operating characteristic curve scores, and Gini coefficient. Although ANN-based classifier outperformed compared with LR, both models performed satisfactorily for absolute power measure in beta frequency band. Our results underline the potential benefit of the introduced methodology is promising and is to be treated as a clinical interface in dichotomizing substance use disorders subjects and for other medical data analysis studies.

[Prevalence of bipolar spectrum disorders in migraine patients]. / Migren hastalarinda bipolar yelpaze bozukluklarinin yayginligi.

OBJECTIVES: Comorbidity of migraine and mood disorders has long been recognized. Most of the studies have focused on the relationship between migraine and major depression with only few studies suggesting a special association between migraine and bipolar spectrum disorders. We aimed to evaluate the prevalence of bipolar disorder in migraine patients in a specialized headache outpatient clinic. METHODS: The sample consisted of 78 consecutive patients with migraine headache presenting to the specialized headache outpatient clinic in a Medical Faculty. Migraine diagnosis was established with the International Headache Society's criteria for migraine. Patients were evaluated with Structured Clinical Interview for DSM-IV for mood disorders. Bipolar spectrum definition was broadened with the presence of Akiskal's criteria for affective temperaments (cyclothymic, hyperthymic, irritable, and depressive). RESULTS: Patients in the bipolar spectrum comprised 10.3% (n=8) of the sample. 11 patients (14.1%) had a diagnosis of unipolar depression and 7 patients (9%) had a diagnosis of dysthymic disorder. 41% of the patients (n=32) had an affective temperament. Bipolar disorder was observed with increased frequency in this migraine sufferer population, supporting previous findings of increased prevalence of bipolar disorders in patients with migraine. CONCLUSION: Increased frequency of affective temperaments might be considered in the context of a common pathophysiological background for migraine and bipolar disorders where these temperaments are sub-threshold presentations of mood disorders. Therefore, the definition of patients with comorbid migraine and bipolar disorder may serve as a more homogenic subgroup of mood disorders for further studies.

Polydipsia as a Precursor of Manic Episode in Bipolar Affective Disorder Patients with Alcohol Use Disorder.

Bipolar affective disorder (BD) diagnosis and initiation of appropriate treatment are often delayed, and this is associated with poorer outcomes, such as rapid cycling or cognitive decline. Therefore, identifying certain warning signs of a probable successive episode during the inter-episode phase is important for early intervention. We present the retrospective data of three cases of BD. Our first case had a history of alcohol use disorder (AUD), where he drank in a dipsomaniac manner, and the other two cases had dipsomaniac alcohol use before their manic attacks, and none of them had any AUD after the mood episode was over. Two brothers also had hypertensive episodes during the manic attacks. None of the cases reported increased fluid intake when they were euthymic. We suggest that polydipsia in BD may be a warning sign of an upcoming manic episode, especially in those patients with AUD. Polydipsia in BD may be caused or facilitated by a combination of hyperdopaminergic activity, hypothalamic dysfunction, and dysregulated renin-angiotensin system. To be able to prevent new episodes, a patient's drinking habits and change in fluid intake should be asked at every visit. Those patients with a history of alcohol abuse should especially be informed about polydipsia and manic episode association.

The Soul, as an Uninhibited Mental Activity, is Reduced into Consciousness by Rules of Quantum Physics.

This paper is an effort to describe, in neuroscientific terms, one of the most ambiguous concepts of the universe-the soul. Previous efforts to understand what the soul is and where it may exist have accepted the soul as a subjective and individual entity. We will make two additions to this view: (1) The soul is a result of uninhibited mental activity and lacks spatial and temporal information; (2) The soul is an undivided whole and, to become divided, the soul has to be reduced into unconscious and conscious mental events. This reduction process parallels the maturation of the frontal cortex and GABA becoming the main inhibitory neurotransmitter. As examples of uninhibited mental activity, we will discuss the perceptual differences of a newborn, individuals undergoing dissociation, and individuals induced by psychedelic drugs. Then, we will explain the similarities between the structure of the universe and the structure of the brain, and we propose that consideration of the rules of quantum physics is necessary to understand how the soul is reduced into consciousness.

Major depressive disorder with religious struggle and completed suicide after hair transplantation.

OBJECTIVES: Psychological outcomes of aesthetic surgical procedures like hair transplantation are mostly positive including decreased anxiety, depression and social phobia and increased general well-being, self-efficacy and self-esteem. However, some patients may suffer from post-surgical depression and post-surgical increased suicide rates have been reported for breast augmentation patients. Difficulty adapting to the new image, unfulfilled psychological needs expected to be met by the surgery, side effects of the surgery like tissue swelling or bruising, uncontrolled pain, presence of body dysmorphic disorder and previous history of mood disorder may be some of the risk factors for post-surgical depression. METHODS: Here, we present a case without prior psychiatric history who developed major depressive disorder after hair transplantation and died of suicide. RESULTS: He started experiencing religious struggle related to his decision about the hair transplant which he interpreted as acting against God's will. While religious involvement has been reported to be a protective factor against depression, spiritual struggle, which includes religious guilt, has been described as an important risk factor for depression, hopelessness and suicidality which might explain the severity of depression in our patient. CONCLUSIONS: This case highlights the importance of a detailed psychiatric evaluation and exploration of religious concerns of any patient before any type of aesthetic surgery. Major depressive disorder is a treatable condition; however, mild depression can go unnoticed. Religious belief and related religious practices affect an individual's personal health attitudes; therefore, we think that every physician is needed to explore the religious concerns of any patient during any medical examination or surgical procedure. Relevant religious authorities should be consulted when necessary.

Seasonal mood changes in patients with obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) is frequently associated with mood disorders. However, to date, the co-occurrence of OCD with seasonal affective disorder (SAD) has not been investigated. We have aimed to estimate the prevalence of seasonal mood changes in patients with OCD and explore the contribution of seasonality in mood to the severity of OCD. The Seasonal Pattern Assessment Questionnaire (SPAQ), the Yale-Brown Obsession and Compulsion Scale (Y-BOCS), the Hamilton Depression Rating Scale-17 Items (HDRS-17), and the Beck Anxiety Inventory (BAI) were administered to patients with OCD (n=104) and controls (n=125). The degree of seasonality was measured by the Global Seasonality Score (GSS) calculated from the SPAQ. SAD and subsyndromal seasonal affective disorder (S-SAD) were significantly more prevalent in patients with OCD (53%, n=55) than controls (25%, n=31). When patients were assessed in the season in which SAD occurs, depression and compulsions (but not obsessions, OCD or anxiety) were more severe than those assessed in a season during which SAD does not occur. SAD frequently co-occurs with OCD and, given this co-occurrence, depression symptoms in some patients with OCD might be expected to vary on a seasonal basis.