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Inflammation and the cytokine hypotheses have been proposed for schizophrenia. Several proinflammatory and anti-inflammatory cytokines have been studied in drug-naive, first-episode, and/or chronic schizophrenia patients. However, there were limited data on clinical stable outpatients reflecting daily routine. The aim of this study was to compare the serum levels of cytokines, including transforming growth factor-beta (TGF-β), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α), between clinically stable patients with schizophrenia and healthy controls, as well as to examine the relationship between these inflammation parameters and clinical variables (positive and negative symptom severity and cognitive functions). Thirty clinically stable outpatients with schizophrenia and 30 healthy controls with similar sex and age were included in this study. Serum IL-6, TGF-β, and TNF-α levels were assessed by enzyme-linked immunosorbent assay (ELISA) and immunoenzyme microplate measurement, respectively. Illness severity was evaluated using the Positive and Negative Syndrome Scale (PANSS), and the cognitive functions of the participants were assessed using a broad neuropsychological test battery. The serum levels of IL-6 and TGF-β were significantly higher in patients with schizophrenia compared to healthy controls (p = .048, p = .012). There was no significant difference between groups in terms of TNF-α levels (p = .726). Global impairment of cognitive functions was observed in the patient group compared to healthy controls, and PANSS scores and cognitive functions showed no correlation with cytokine levels (IL-6, TNF-α, and TGF-β). The present study demonstrated an increased inflammatory response in clinically stable patients with schizophrenia compared to healthy controls. However, symptom severity and cognitive functions showed no correlation with cytokine levels. Further research studies are needed to clarify the effects of cytokine levels on schizophrenia symptomatology and etiopathogenesis.

Objective: The aim of this study is to compare the frequency of depression, anxiety, alexithymia and somatosensory sensitivity in patients with benign palpitation with healthy controls. Method: Sixty-one patients with palpitation and 59 age- and sex-matched control subjects were enrolled. All study subjects were undergone thorough cardiac evaluation, and patients with palpitation also had echocardiography and 24-hour ECG monitoring to rule out significant arrhythmias, coronary artery disease and structural heart disease. All subjects were assessed by Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Toronto Alexithymia scale, Whiteley Index (WI) and Somatosensory Amplification Scale (SAS). Results: Patients with benign palpitation had significantly increased BAI, BDI, WI and SAS scores. Anxiety is the only independent predictor of benign palpitation (odds ratio = 1.12, 95% confidence interval = 1.05-1.19, p < 0.001). Conclusion: This study shows that patients with benign palpitation had increased anxiety levels and somatization disorders. So an integrated psycho-cardiological approach is needed in this special population.

Objective: Personality disorders (PDs) are characterized by specific sets of dysfunctional personality beliefs which can result in distinctive behavioral patterns associated with the PD. Dysfunctional personality beliefs are maladaptive thought patterns related to people’s sense of self, interpersonal relationships, and worldview. The Enneagram Personality Theory (EPT) categorizes personality into nine interconnected types, each with distinct patterns of thinking, feeling, and behaving. Enneagram subtypes represent a different focus or emphasis within the main type’s core motivations and behaviors. The association of EPT with various personality approaches has been studied. However, we aim to assess the relationship between EPT and personality beliefs, which has not been previously studied. Method: A sociodemographic form, Personality Belief Questionnaire-Short Form (PBQ-SF), and Enneagram Types and Subtypes Inventory (ETASI) were applied to 203 participants. Results: A canonical correlation analysis was conducted to investigate the multivariate association between nine Enneagram types and subtypes and ten personality belief variables. The analysis unveiled four significant functions for the association between Enneagram types and personality beliefs. Function 1 was contributed by Types 3, 8, and 5 and was negatively related to borderline and dependent beliefs, and positively related to schizoid beliefs. Function 2 featured obsessive-compulsive beliefs and was related to Types 1 and 6. Function 3 was related to histrionic, narcissistic, and antisocial beliefs and Types 2,3,7, and 8. Function 4 presented schizoid, borderline, and narcissistic beliefs, with Type 4 as the predominant predictor. Among the subtypes, only the self-preservation subtype was correlated with schizoid beliefs. Conclusions: The results revealed that EPT comprises multidimensional layers that vary according to specific personality beliefs and types. Personality beliefs were found to be aligned with the core characteristics of the respective types.

Bipolar disorder (BD) is one of the leading causes of disability among medical and psychiatric dis-orders associated with prevalent, chronic, severe and highly disabling characteristics. This study was designed to identify clinical characteristics and practice patterns in the management of outpatients with BD across Turkey. Method: This multi-center cross-sectional study involving 1001 patients diagnosed with using DSM-IV criteria was conducted prospectively at 31 outpatient psychiatry clinics for 12 months. Patient demographics, clinical features, family history, comorbid psychiatric disorders, and the treatment modalities were assessed by means of semi-structured questionnaire. Results: Age at the onset of symptoms was 26.7±9.8 years, age at diagnosis was 28.9±10.4 years, and the time interval between them was 2.2±4.7 years. Misdiagnosis prior to current diagnosis was evident in 40.3% of bipolar patients. The most common type of first episode was mania (57.1%) and depres-sion (34.5%). Comorbid psychiatric illness was identified in 12.0% of patients. Only 10% of patients were re-ceiving monotherapy. The most commonly prescribed drugs for depressive, manic and mixed episodes were lithi-um, sodium valproate and quetiapine, respectively. Conclusion: The time interval between onset of symptoms and the initial diagnosis in Turkish sample was quite shorter than reported in the literature. The misdiagnosis rate in the present study and recent studies were similar. A low comorbidity rate appears to indicate a lower preva-lence of comorbid disorders in BD in Turkish sample. Lithium, sodium valproate and atypical antipsychotics were more commonly used drugs in the treatment of BD in Turkey.

In this present study, we aim to investigate the possibility of a link between psychotic disorders and traumatic experiences in a group of female patients diagnosed with psychotic disorders by comparing childhood trauma exposure with a group of non-psychotic psychiatric disorder attending the same pschiatric clinic. Secondary purpose of this study is to examine the clinical correlates of trauma exposure, dissociative phenomena and psychiatric symptomatology between these two group of patients. Two psychiatric sample groups, those with psychotic disorders—mostly schizophrenic—( n  = 54), and those with a non-psychotic severe psychiatric disorders ( n  =  24), were recruited. Data were collected for demographic, psychiatric and trauma histories and psychiatric symptomatology for all patients. In this study, high prevalance rates of childhood traumatic experiences and dissociative phenomena were found in both groups. Total scores of childhood trauma questionnaire in favor of the non-psychotic group were found to be close to significance ( p  = 0.052). DES scores of non-psychotic group were also higher although not statistically significant. 54.2 % of nonpsychotic cases had DES scores >20 on the other hand, that percentage of psychotic cases were found to be as 38.9 %. Furthermore, psychiatric patients who have suffered childhood traumatic experiences are far more likely to try to kill themselves than psychiatric patients who have not experienced such abuse. The high rates of childhood traumatic events in our present samples of both schizophrenia-spectrum patients and nonpsychotic patients confirm the need for clinicans to take trauma histories routinely.

Thought to be more common in psychotic disorders in the past, Schneiderian symptoms (SS) were also observed in other disorders such as dissociative disorders and bipolar disorders. As a result of this, specific attribution of Schneiderian first rank symptoms was eliminated from diagnostic criteria of schizophrenia in DSM-5. In this article, we aim to present two cases having schneiderian symptoms. Since these cases had additional symptoms such as amnesia, fugue, and Schneiderian symptoms related to psychosocial stressors, we also suggested that these patients might have dissociative disorders. In terms of Schneiderian symptoms; instead of antipsychotic treatments, psychotherapeutic interventions and removal from psychogenic stressors can be considered in management of these cases. In DSM-5 the elimination of specific attribution of SS in psychosis results in clinicians drawn attention to this issue in other disorders. Therefore, this alteration may provide better diagnosis of dissociative disorders and bipolar disorders and prevent these patients from taking high dose antipsychotic treatments unnecessarily. [PBS 2017; 7(4.000): 230-3]

[PBS 2016; 6(1.000): 45-6]

Despite being different medical conditions, functional somatic symptoms (FSSs) are common in patients with major depressive disorder (MDD) and fibromyalgia syndrome (FMS). Higher levels of depression, anxiety, somatosensory amplification, hypochondriacal worry and alexithymia may be related to the severity of somatization in patients with MDD and FMS. We aimed to investigate the typology and severity of FSSs and the association between FSSs and these psychiatric symptoms in patients with MDD and FMS. 56 MDD, 33 FMS, 21 CoMF (Comorbidity of MDD and FMS) patients, and 50 healthy participants were included in the study, respectively. Diagnosis of MDD and FMS was established according to DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, Revised Text), and ACR (American College of Rheumatology) 2010 diagnostic criteria. All participants were evaluated with self-report questionnaires including Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Somatosensory Amplification Scale (SSAS), Toronto Alexithymia Scale-20 (TAS-20), Whiteley Index-7 (WI-7), The Symptom Checklist-90-R (SCL-90-R) somatization subscale and Bradford Somatic Inventory-44 (BSI-44). The severity of somatization was statistically significantly highest in the CoMF group, and similar in the FMS and MDD groups, and lowest in the control group according to the BSI-44 and SCL-90-R results. The typology of FSSs was quite similar in patients with MDD and FMS, and weakness, tiredness and neck pain were the most common FSSs in both groups. Independent predictors of FSSs were age, the severity of anxiety and alexithymia in the MDD group, however, it was only the severity of anxiety in the FMS group. Our results show that the typology and severity of FSSs are similar in MDD and FMS patients. Moreover, somatization appears to be more associated with anxiety in patients with MDD and FMS.