Validity and Reliability of the Turkish Version of Mahony Psychological Assessment for Bariatric Surgery.

Background: The aim of this study was to determine the validity and reliability of the Turkish version of Mahony Psychological Assessment for Bariatric Surgery which can be easily administered and used as a guide by health professionals who will be included in the treatment of patients who are potential candidates for bariatric surgery. Methods: A total of 310 patients who were admitted to health institutions for bariatric surgery in 3 different provinces of Turkey answered these questions in the Turkish translation of Mahony Psychological Assessment for Bariatric Surgery. Eating disorder examination questionnaire was also administered to the patients in addition to Mahony Psychological Assessment for Bariatric Surgery. Results: Early life problems due to weight scores of women were significantly higher than men (P = .001). Among the age groups, both the early life problems due to weight scores (P = .008) and dysphoric feelings about weight scores (P < .001) of the 18-44 age group were significantly higher than the participants who are over the age of 45. There is a weak-to-medium and positive correlation between the total Mahony Psychological Assessment for Bariatric Surgery total scores and all the subscale and total scores of the Eating Disorder Examination Questionnaire (P < .05 for all). These correlation results support the co-validity of Mahony Psychological Assessment for Bariatric Surgery and Eating Disorder Examination Questionnaire. Internal consistency of the Mahony Psychological Assessment for Bariatric Surgery was at a high level except for the subscale of positive treatment attitude and supportive environment. Cronbach's ɑ values were calculated to be 0.902 for the subscale of emotional and binge eating, 0.820 for the early life problems due to weight, 0.856 for the dysphoric feelings about weight, 0.539 for the positive treatment attitude and supportive environment, and 0.919 for the whole scale. Conclusion: The analyses have shown that the Turkish version of Mahony Psychological Assessment for Bariatric Surgery may be used in clinical interviews and psychiatric evaluation of bariatric surgery patients in Turkey.

Theory of Mind in Somatization and Depression: Is It Cause or Phenomenon?

ABSTRACT: Although mentalization is important in somatic symptom disorder (SSD) and major depressive disorder (MDD), it is not fully understood. In this study, we aimed to investigate the relation between somatic and depressive symptoms with mentalization. A total of 48 patients diagnosed with SSD, 50 patients diagnosed with MDD, and 50 healthy individuals, participated the study. The Montgomery-Asperg Depression Scale, Symptom Checklist-90 Revised, and Reading the Mind in the Eyes Test (RMET) were applied to the participants. The patients with SSD showed significantly the lowest performance of theory of mind. There was no significant difference between MDD and healthy controls. High somatization score was found to be a predictor for low RMET scores (95% confidence interval, -0.339; p = 0.014). Mentalization deficit seems to be associated with somatization rather than depression.

Study on Dorsolateral Prefrontal Cortex Neurochemical Metabolite Levels of Patients with Major Depression Using H-MRS Technique. / Major Depresyon Bozuklugu Olan Hastalarda H-MRS Yöntemi ile Dorsolateral Prefrontal Korteks Nörokimyasal Metabolit Düzeyleri.

OBJECTIVE: . The aim of the study is to investigate, by using proton magnetic resonance spectroscopy (1H-MRS), the effects of major depression on the biochemistry of the brain, the relationship between the parametric changes demonstrated and cognitive functions, and the effects of antidepressant treatment. METHOD: The study included 30 patients, diagnosed with moderate/ severe non-chronic major depression disorder (NC-MDD) according to the DSM-5 diagnostic criteria, and 30 healthy individuals as the control group. The dorsolateral prefrontal cortex (DLPFC) areas of the patients and the control individuals were scanned bilaterally by 1H-MRS. The participants were also tested on the brief computerized version of the Wisconsin Card Sorting Test (or, Berg's "Wisconsin" Card Sorting TestWCST). After antidepressant treatment for a minimum of 8 weeks, the patients who scored below 7 on the Hamilton Depression Rating Scale (HAM-D), were assessed with the 1H-MRS scan and the WCST. RESULTS: The Glx level in the left DLPFC was significantly lower in the patient group. Differences were not determined between the NAA, Cr, Cho levels in the right and the left DLPFC of the patient and the control groups. After the treatment, Glx level in the left DLPFC increased; but the levels of the other metabolites did not change. Before the treatment, the abilities of the patient group in changing strategy and problem solving, as assessed by the WCST, were lower in comparison to the control group. After the treatment the patient group improved clinically and performed significantly better on the WCST. CONCLUSION: In the present neuroimaging (NI) study, it was determined that the Glx level in the left DLPFC of patients with moderate/severe NC-MDD improved together with the clinical features after treatment. Neurocognitive functions also improved after treatment. However, a correlation between the change in the metabolite levels and the performance on the WCST could not be demonstrated.

Relationship of Apathy with Depressive Symptom Severity and Cognitive Functions in Geriatric Depression.

INTRODUCTION: Apathy which is known as loss of primary motivation is observed more frequently in elderly depression in comparison with younger adults. It is put forth that apathy is related with depressive symptom severity and cognitive functions, that the existence of apathy may be a predictor of neurocognitive impairment. The objective of this study was to examine the apathy levels in elderly patients with major depression as well as the relationship between depressive symptom severity and cognitive functions. METHODS: The study was carried out with 40 major depressive disorder patients (MDD) aged 60 and above, 40 healthy controls aged 60 and above. Sociodemographic data form, structured psychiatric interview (SCID-I), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Montgomery-Asberg Depression Rating Scale (MADRS), Standardized Mini Mental State Examination (SMMSE), Montreal Cognitive Assessment Scale (MoCA), Apathy Evaluation Scale (AES) and Sheehan Disability Scale (SDS) were applied to the participants. RESULTS: In our study, HAM-D, HAM-A and MADRS scale scores of MDD group was determined to be higher in comparison with those of the healthy control group. A positive correlation was determined in the MDD groups between the AES scores and depressive symptom severity, whereas a negative correlation was determined between the AES scores and cognitive functions. The SMMSE and MoCA scores of the geriatric MDD group were determined to be lower in comparison with healthy control group. Low performance was observed in the geriatric MDD group especially in the fields of orientation, visual/spatial functions, memory and language. Functionality was found to be lower in MDB group than in the control group, and functionality decreased as the level of apathy increased. CONCLUSION: Our results indicate that the apathy levels in geriatric depression are higher in comparison with the control group. Cognitive functions are affected adversely in geriatric patients in major depressive disorder, depressive symptom severity, impairment in cognitive functions and functionality are observed to be related with apathy level.

Psychological Symptoms in Obesity and Related Factors.

INTRODUCTION: This study aimed to investigate the relationship between levels of depression and anxiety symptoms and quality of life, self-esteem in obesity. METHODS: Fifty-two subjects whose Body Mass Index (BMI) is 30 kg/m2 and over and 43 control whose BMI is normal were recruited for this study. The socio demographic data form, Hamilton Depression Rating Scale (HAM-D17), Hamilton Anxiety Rating Scale (HAM-A), Quality of Life Scale Short Form (WHOQOL-Brief-TR), Coopersmith Self Esteem Scale (CSES), The Eating Attitudes (EAT), were applied to the participants. RESULTS: In this study most of the patients are women, married, postgraduated and live in urban areas. It was determined to scores of HAM-D17, HAM-A and EAT are higher in obese group than control group; WHOQOL-Brief-TR physical field scores was lower in obese group than control group. CSES scores wasn't difference between obese and control group. In obese group, there was HAM-D17 and HAM-A scores a negative correlation between quality of life physical field score, negative correlation between CSES score, positive correlation between EAT scale score. There is no correlation between scores of HAM-D17 and HAM-A and BMI. CONCLUSION: Our results suggest that depressive and anxiety levels are high in induvidual with obesity. They have problems in eating attitudes and their quality of life especially physical field is poor. The psychological symptoms have negative effects on the quality of life, self-esteem, and eating attitudes. Our results suggest that psychiatric support to improving positive effects quality of life and self-esteem in individual with obesity.

[Prefrontal cortex neurochemical metabolite levels in major depression and the effects of treatment: an HMRS study]. / Major depresyonda prefrontal korteks nörokimyasal metabolit düzeyleri ve sagaltimin etkileri: bir HMRS çalismasi.

OBJECTIVE: Neuronal degeneration in the prefrontal cortex during depression results in altered production of neurochemical metabolites. The aim of the present study is to examine changes in neurochemical metabolites in the prefrontal cortex and evaluate the effects of psychodrama group therapy and pharmacotherapy on neurochemical metabolism in the first episode depression using 1HMRS methodology. METHOD: Eighteen drug-free female patients with diagnosed first-episode major depression according to DSM-IV criteria and 10 healthy female subjects were enrolled in the study. The Hamilton Rating of Depression Scale (HAM-D) was used to asses the severity of depression in each of the study participants. Proton magnetic resonance spectroscopy (1HMRS) was applied to the right prefrontal cortex both before and after treatment and the concentration of N-Asetil Aspartate (NAA), choline (Cho), and creatine (Cr) were measured. All patients were prescribed ant-depressant medication at the time of the evaluation (essitalopram 10-20 mg/g). In addition, a psychodrama group therapy session was conducted in which 10 patients participated in one 3-hour session each week. HAM-D and 1HMRS were repeated after 16 weeks. RESULTS: Prior to treatment, the HAM-D score in the patient group was 14.55±4.55 while the HAM-D score was 3.88±2.47 after 16 weeks of treatment. The severity of symptoms among the patient group was determined to be mild/moderate. No neurochemical abnormalities were identified in the right prefrontal cortex of depressed patients compared to the healthy subjects in the baseline measurements and no significant change was observed in neurochemical metabolites following treatment with pharmacotherapy or pharmacotherapy with group psychotherapy. CONCLUSION: Our results identified no neurodegeneration, cell membrane dysfunction, alterations in energy metabolism, or altered neurochemical metabolite levels in patients undergoing a first episode of mild/moderate depression. Further studies will be needed to evaluate the effects of alternate treatments and the presence or absence of neuronal damage during follow-up of patients with depression.

[A neuropsychological comparison of bipolar disorder and adult attention deficit hyperactivity disorder]. / Bipolar bozukluk ve eriskin dikkat eksikligi hiperaktivite bozuklugunun nöropsikolojik açidan karsilastirilmasi.

AIM: The present study aimed to compare cognitive signs of bipolar disorder patients with that of adult attention-deficit/hyperactivity disorder (ADHD) patients. METHOD: The study comprised 66 bipolar disorder patients, 63 ADHD patients, and 58 healthy controls.Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I), Wender Utah Rating Scale, and Adult Attention-Deficit/Hyperactivity Rating Scale were performed in all subjects, whereas bipolar disorder patients underwent additional Hamilton Depression Rating Scale and Young Mania Rating Scale. Subsequently, all participants underwent cognitive assessment including Digit Ordering Test, Verbal Memory Process Test, Wisconsin Card Sorting Test and Stroop Test. RESULTS: Bipolar disorder, ADHD and control groups did not differ significantly from each other with regard to age, sex and duration of education. Bipolar patients displayed poorer performance in Digit Span Test, Verbal Memory Process Test, Wisconsin Card Sorting Test and Stroop Test as compared to the control group. ADHD patients were worse than the control subjects in Stroop Test (subtest of difference in times). Bipolar disorder patients were poorer than ADHD patients in cognitive tests except for Stroop Test. CONCLUSION: In general, bipolar disorder patients have much more severe cognitive impairment than ADHD patients in terms of verbal memory and executive functions. The results supports the idea of bipolar disorder and ADHD are different, at least in terms of cognitive performance.

Involuntary social cue integration in patients with obsessive compulsive disorder.

OBJECTIVE: Patients with obsessive compulsive disorder (OCD) have inferior social functioning compared to healthy controls, but the exact nature of these social deficits, and the underpinning mechanisms, are unknown. We sought to investigate social functioning in patients with OCD by measuring their involuntary/spontaneous processing of social cues using a specifically designed test, which might reveal deficits in these patients that explicit voluntary tasks do not detect. METHODS: The sample of the study consisted of an OCD group (n = 25) and a control group (n = 26). Both groups performed an adaptation of the Social Distance Judgment Task (SDJT; Jellema et al., 2009), in which participants have to judge the geometrical distance between two human cartoon figures presented on a computer screen. Head/gaze direction and body direction were manipulated to be either compatible, i.e. both directed to the left or to the right (Compatible condition) or incompatible, i.e. body directed toward the observer (frontal view) and head/gaze directed to the left or right (Incompatible condition). RESULTS: In the Compatible condition, controls nor OCD patients were influenced by the social cues in their judgments of the geometrical distances. However, in the Incompatible condition, where the attentional cue was more conspicuous, both groups were influenced by the cues, but the controls to a significantly larger extent than the OCD patients. CONCLUSIONS: This study showed that patients with OCD are less likely, compared to controls, to automatically/spontaneously integrate the other's direction of attention into their visual percept. This may have resulted in their judgments of the geometrical distances between the agents to be more accurate than those of controls. The suggested impairment in automatically integrating social cues may have important repercussions for the social functioning of OCD patients.

Neurochemical metabolites in prefrontal cortex in patients with mild/moderate levels in first-episode depression.

BACKGROUND: Previous studies have determined the neurochemical metabolite abnormalities in major depressive disorder (MDD). The results of studies are inconsistent. Severity of depression may relate to neurochemical metabolic changes. The aim of this study is to investigate neurochemical metabolite levels in the prefrontal cortex (PFC) of patients with mild/moderate MDD. METHODS: Twenty-one patients with mild MDD, 18 patients with moderate MDD, and 16 matched control subjects participated in the study. Patients had had their first episode. They had not taken treatment. The severity of depression was assessed by the Hamilton Rating Scale for Depression (HAM-D). Levels of N-acetyl aspartate (NAA), choline-containing compounds (Cho), and creatine-containing compounds (Cr) were measured using proton magnetic resonance spectroscopy (1H-MRS) at 1.5 T, with an 8-cm(3) single voxel placed in the right PFC. RESULTS: The moderate MDD patients had lower NAA/Cr levels than the control group. No differences were found in neurochemical metabolite levels between the mild MDD and control groups. No correlation was found between the patients' neurochemical metabolite levels and HAM-D scores. CONCLUSION: Our findings suggest that NAA/Cr levels are low in moderate-level MDD in the PFC. Neurochemical metabolite levels did not change in mild depressive disorder. Our results suggest that the severity of depression may affect neuronal function and viability. Studies are needed to confirm this finding, including studies on severely depressive patients.

Depression in the elderly: clinical features and risk factors.

Depression in elderlies is not known quite well and thus cannot be treated adequately. The fact that elderliness is accepted as a property of depressive symptoms both by the relatives of the patients and doctors is one of the factors which make it difficult to recognize depression. Existence of multiple physical diseases in elderlies, use of multiple medicines, occurrence of pharmacokinetic and pharmacodynamics changes depending on the age necessitate to take several factors into account while diagnosing and using medicines. In this study, clinical properties and risk factors of depression in old age period was reviewed and the properties of such depressions were summarized.

A proton magnetic resonance spectroscopy study in schizoaffective disorder: comparison of bipolar disorder and schizophrenia.

The aim of this study was to compare schizoaffective disorder, bipolar disorder and schizophrenia based on (1)H-MRS metabolite values in dorsolateral prefrontal cortex and executive functions. The subjects comprised 15 patients with bipolar disorder type I (BD), 15 with schizophrenia (SCH), 15 with schizoaffective disorder (SAD) and 15 healthy controls. We performed proton magnetic resonance spectroscopy ((1)H-MRS) of the dorsolateral prefrontal cortex (DLPFC) bilaterally. Levels of N-acetyl aspartate (NAA), choline-containing compounds (Cho) and creatine-containing compounds (Cr) were measured in the DLPFC using (1)H-MRS. We administered the Wisconsin Card Sorting Test (WCST) and the Stroop Test (ST) to evaluate executive functions. The SAD, BD and SCH patients had lower levels of NAA than the control group. The SAD and BD patients had low levels of Cho compared to the control group. The left DLPFC Cr levels in all of the patient groups and the right DLPFC Cr levels in the BD and SAD groups were lower than in the control group. The levels of NAA Cho and Cr were not related to executive functions and attention performance. Cr level were related to attention processes, only in SCH. Our results indicate that NAA levels are reduced in schizoaffective disorder, bipolar disorder and schizophrenia, but the reduction in the levels of NAA is not a distinctive feature among these three illnesses. Schizoaffective and bipolar disorders have similar features related to the levels of compounds containing Cho and Cr. This similarity may be related to these illnesses both having an affective basis.

Neurochemical metabolites in the medial prefrontal cortex in bipolar disorder: A proton magnetic resonance spectroscopy study.

The aim of this study was to investigate proton magnetic resonance spectroscopy metabolite values in the medial prefrontal cortex of individuals with euthymic bipolar disorder. The subjects consisted of 15 patients with euthymic bipolar disorder type I and 15 healthy controls. We performed proton magnetic resonance spectroscopy of the bilateral medial prefrontal cortex and measured levels of N-acetyl aspartate, choline and creatine. Levels of these three metabolites in the medial prefrontal cortex were found to be lower in patients with bipolar disorder compared with healthy controls. A positive correlation was found between illness duration and choline levels in the right medial prefrontal cortex. Our study suggests that during the euthymic period, there are abnormalities in cellular energy and membrane phospholipid metabolism in the medial prefrontal cortex, and that this may impair neuronal activity and integrity.

Characteristics of suicidal behavior in a Turkish sample.

BACKGROUND: Suicidal behavior is one of the most important problems in psychiatric clinics. Several sociodemographic and clinical characteristics may have different effects on suicidal behavior. AIMS: To examine the sociodemographic and clinical characteristics of a sample of 144 suicide attempters admitted to a Turkish emergency clinic for a suicide attempt. METHODS: All subjects were interviewed by a consultant psychiatrist. For all individuals, data on DSM-IV psychiatric diagnoses, sociodemographic data, Beck's Hopelessness Scale (BHS), Becks's Suicidal Ideation Scale (SIS), and Beck's Suicidal Intention Scale (BSIS) were collected. RESULTS: The majority of suicide attempters were females characterized by low educational status and low religious orientation. Drug overdose was the most common method of suicide attempt and conflict within the family was the most frequent psychological stress factor. Three-quarters of attempters (74.6%) met DSM-IV criteria for at least one psychiatric diagnosis. Of these, 28.5% met criteria for major depressive disorder. Suicide attempters with depression tended to be immigrant, urban dwellers with high scores on the suicide intent scale. CONCLUSIONS: In the present study, the findings are useful in showing the risk factors related to suicidal behavior.

Schizophrenia with obsessive-compulsive disorder and obsessive-compulsive disorder with poor insight: a neuropsychological comparison.

Schizophrenia patients with obsessive-compulsive disorder (OCD) may be a subgroup of schizophrenia, and OCD patients with poor insight may show psychotic-like symptoms. The aim of this work is to compare the neuropsychological performance of those patients with schizophrenic patients who do not have OCD symptoms and with OCD patients who have good insight. The sample consisted of 89 patients (16 OCD-schizophrenic patients, 30 non-OCD schizophrenic patients, 30 OCD patients with good insight, 13 OCD patients with poor insight). Neuropsychological evaluation included executive functions, verbal and visual memory and attention tasks. While schizophrenic patients with OCD did not differ from the non-OCD schizophrenia and OCD with poor insight groups on long-term visual and verbal memory performance, they showed poorer performance than the OCD group on long-term visual and verbal memory tests. Considering executive function, the OCD group with poor insight performed significantly worse than their counterparts with good insight, and the latter group performed better than the schizophrenia patients. The results of this study suggest that the neuropsychological performance of schizophrenia patients with OCD did not differ from that of non-OCD schizophrenic patients, and that OCD patients with poor insight were more likely to share similar cognitive characteristics with the schizophrenia groups. Our results also provide neuropsychological support for the hypothesis that OCD and schizophrenia may be a spectrum disorders.