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Objective: The present study aimed to compare the intensity of inflammation between major depressive disorder (MDD) and bipolar disorder-depressive episode (BD-D) by using neutrophil to lymphocyte (NLR) and platelet to lymphocyte ratios (PLR) as nonspecific markers for peripheral immune response, and to investigate whether and how these parameters correlate with the clinical characteristics of the depressive episodes within and between the diagnoses. Patients and Methods: The medical records of 209 psychiatric inpatients (126 diagnosed with MDD, 83 with BD-D) and 150 healthy controls (HC) were retrospectively screened to obtain NLR and PLR values. Results: Both MDD and BD-D presented with significantly elevated NLR and PLR compared to HC, with the increase being associated with the severity of depression but not with the presence of psychotic features. The severity of inflammation was found to be of a comparable magnitude between the two conditions, or at least indistinguishable by means of the NLR and PLR. Conclusion: Our results suggest that both MDD and BD-D involve a presumably complex inflammatory process resulting in an observable, albeit nonspecific alteration in the distribution of peripheric blood cells. Moreover, the magnitude of the observed immune response appears to relate to the severity of the depressive episode for both conditions.

OBJECTIVE: Children and adolescents facing difficult life circumstances due to social, economic and cultural adversity, form a disadvantaged group in terms of social functioning and healthy psycho-social development. The goal of this study was to evaluate the psychological resilience of high school students in Muş City - which was ranked last in the general life index among 81 provinces according to 2015 data from the Turkish Statistical Institute - and to examine different dimensions of psychological resilience in relation to a variety of variables including adverse life events and demographic characteristics. METHOD: The study sample consisted of 1025 students from the 10th and 11th grades of five different high schools operating in the city centre of Muş. Participants were asked to fill in a socio-demographic questionnaire, the List of Adverse Life Events and the 59-item Resilience and Youth Development Module (RYDM). A series of correlational and descriptive analyses were then performed. RESULTS: Correlational analyses revealed that among the demographic factors, low economic status, a criminal record and poor academic performance were associated with poor psychological resilience, while among adverse life events, the deterioration of parental economic status, frequent arguments between parents as well as a history of mental illness and alcohol/substance abuse in the family were also linked to low levels of psychological resilience. It was also determined that girls had higher scores on internal assets of RYDM (empathy, problem solving, self efficacy, communication and cooperation, goals, self awareness and educational aspirations), while exposure to a larger number of adverse life events negatively affected internal resilience assets. Finally, trauma exposure, just as the low RYDM scores, seems to be associated with frequent arguments between parents, alcohol/substance abuse in the family, male gender and a criminal record. However, there was no significant relationship between psychological resilience and trauma alone. CONCLUSION: Interventions to improve psychological resilience, which is a dynamic process, need to be comprehensive and multi-dimensional. In this context, it is crucial to elucidate the factors associated with the psychological resilience of children and adolescents exposed to a specific risk factor, such as adverse living conditions. In order to improve our understanding of psychological resilience and youth development in Turkey and to determine specific needs for interventions, future studies on various risk groups in different pilot cities - as in the example of Muş  - are needed.

Obsessive-compulsive disorder is a mental disorder that may cause severe disability. Insight in obsessive-compulsive disorder has been an issue of debate since the disorder was described for the first time. Formerly, obsessive-compulsive disorder was regarded as one of the neurotic disorders and patients were supposed to find their symptoms as totally senseless and exaggerated. However, the idea that obsessions have to be regarded egodystonic has changed recently. Firstly in the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV), the term ẅith poor insight and rdquo; was used as a specifier for obsessive-compulsive disorder. Obsessive-compulsive disorder with low or no insight may differ from obsessive-compulsive disorder with good insight in terms of sociodemographic, clinical and treatment features. Along with types of obsessions, the levels of insight are subject to change. Obsessive-compulsive disorder with poor insight can either be a subtype with different features or a severe form of Obsessive-compulsive disorder. Along with DSM-5 insight in obsessive-compulsive disorder is no longer classified as absent or present. Insight in obsessive-compulsive disorder needs to be conceptualized as a spectrum or continuity. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000): 126-141]

Despite its severe morbidity and mortality, studies regarding the psychosocial treatments of anorexia nervosa are limited in number. This paper aims to present the general outlines of various psycho-social interventions developed for the treatment of anorexia nervosa and to provide an up-to-date review of the randomized-controlled studies on the effectiveness of these approaches. Reviewed studies were classified by age spectrum of samples under two main headings: adolescents and mixed samples of adults and adolescents. Specific issues about other variables were then discussed separately.

Background Current evidence suggests that the etiology of gender dysphoria (GD) is multifactorial: this, however, remains unclear. Endocrine-disrupting chemicals (EDCs) are one of the etiological hypotheses. Objectives In this study, we aimed to evaluate the urinary levels of bisphenol A (BPA), thiamethoxam, and fipronil in hormone-naïve transmen compared with case-matched cis-women as well as the relation between sex hormone levels and EDCs. Methods Drug-naïve transmen diagnosed with GD and who were referred from the psychiatry outpatient clinic to the outpatient clinic of the Department of Endocrinology, Marmara University Hospital, were included in the study. These individuals were assessed for eligibility; 38 drug-naïve transmen and 22 cis-women were recruited as the control group. After anthropometric evaluation laboratory tests for FSH, LH, total testosterone, and estradiol were carried out, spot urine samples were collected to evaluate the urine metabolic excretion of BPA, thiamethoxam, and fipronil. Results We found that androgens, total testosterone, androstenedione, and DHEAS levels were significantly higher in transmen than in cis-women. Thiamethoxam was considerably higher in cis-women than in transmen, whereas fipronil and BPA levels were similar in both groups. A negative correlation was found between thiamethoxam and testosterone and between thiamethoxam and BPA levels. Conclusion The available data suggest that the EDCs that we are most exposed to in our lives are not the only factor in GD development. Even transmen who have not taken hormone replacement have high testosterone levels; however, the mechanism has not as yet been elucidated. The challenge is to determine whether this is a factor leading to GD or a condition that develops in common with GD.

The aims of the present study were 1) to identify the major psychosocial challenges faced by students of a university in Istanbul, during the initial period of the COVID-19 outbreak, 2) to assess how these interacted with their level of knowledge, attitudes, and practices toward COVID-19 and the related health measures in place. As part of an international research, a total of 2583 university students from Istanbul participated in an online survey, which included questions in several domains including their studies and daily life before and after the outbreak, their concerns and worries about the pandemic, their level of knowledge on COVID-19, their views on the policies implemented by the government and their institution, their attitude and practices toward the protective measures. Majority of the students reported to suffer from financial adversities due to the outbreak. The closure of residential facilities and the cancellation of face-to-face lectures resulted in the vast majority of the students moving back to their family home. Their daily routines were largely replaced by individual home activities, and social interactions shifted almost totally to digital platforms. They also reported high levels of anxiety and worries concerning a wide range of the possible detrimental outcomes of COVID-19, which were in close association with their knowledge, attitudes, and practices towards the disease, as well as their adherence to the policy measures and their satisfaction with the policies of the government. These results may help policymakers in better understanding the psychosocial impacts of COVID-19 on the life of university students, and to develop more comprehensive strategies to address their multifaceted struggles, as well as to improve their compliance with the health measures in the future.

Different compounds of hyoscine (scopolamine) are widely used for the treatment of a variety of conditions, ranging from motion sickness to colic spasms and smoking cessation. In some rare conditions, the administration of scopolamine may lead to severe idiosyncratic reactions, including central anticholinergic intoxication syndrome. Here, we present a young female patient who progressively developed a series of complex neuropsychiatric symptoms including ataxia, slurred and rambling speech, stereotypic movements, vivid visual and auditory hallucinations, and self-mutilative behaviours in the days following the injection of hyoscine butylbromide in the emergency room to treat her menstrual cramps. Referred to psychiatry, detailed screening of her medical records and collateral information from the family revealed that the neurobehavioural manifestations were indeed preceded by severe peripheral anticholinergic toxicity, which were mostly overlooked during the initial evaluations. Started on olanzapine treatment, the patient’s symptoms gradually subsided over time, though it took several weeks to achieve full clinical recovery.

Despite its severe morbidity and mortality, studies regarding the psychosocial treatments of anorexia nervosa are limited in number. This paper aims to present the general outlines of various psychosocial interventions developed for the treatment of anorexia nervosa and to provide an up-to-date review of the randomized-controlled studies on the effectiveness of these approaches. Reviewed studies were classified by age spectrum of samples under two main headings: adolescents and mixed samples of adults and adolescents. Specific issues about other variables were then discussed separately. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(3.000): 329-345]