Emine Merve Akdağ

Background: Translocator Protein (TSPO) is a transmembrane protein located in the mitochondrial outer membrane and highly expressed in the brain, which makes it a potential biomarker for microglial activation and neuroinflammation in neurodegenerative diseases. However, its role in neuropsychiatric disorders and its contribution to methamphetamine (METH) addiction (MA) remain unclear. Here, we aimed to investigate the association of the TSPO rs6971 with susceptibility to MA and METH-associated psychosis (MAP) and to evaluate its effect on TSPO expression. Methods: We investigated the association of TSPO/rs6971 (Ala147Thr) with susceptibility to MA and METH-associated psychosis (MAP). Genotyping was performed on 300 individuals, including 200 diagnosed with METH use disorder, with 100 of these exhibiting MAP, along with 100 healthy controls (HCs). We explored how different genotypes influence TSPO expression at both the transcript and protein levels using RT-qPCR and ELISA. Results: Age- and sex-adjusted logistic regression analysis revealed nominal associations between the rs6971 AA genotype and MAP under the recessive and co-dominant genetic models, with stronger associations observed after excluding individuals with a family history of psychiatric disorders. Within the MAP group, carriers of the A allele exhibited increased circulating TSPO levels compared to those with the GG genotype. Additionally, higher protein concentrations (p = 0.036) were observed in heterozygous individuals with MAP, compared to METH users without psychosis. Conclusions: Our findings suggest that the expression of TSPO may be influenced by genotype, with A allele carriers showing elevated TSPO expression. Overall, these exploratory findings suggest potential for TSPO-based translational strategies for patients with MA, and highlight the need for more comprehensive evaluations in future research.

Objective: This study aimed to examine the prevalence and temporal trends of SUDs among psychiatric inpatients, investigate the factors predicting involuntary hospitalization, and assess the impact of SUDs and involuntary admission on pharmacological treatment practices. Methods: A retrospective cross-sectional analysis was conducted using medical records of all psychiatric inpatients (n = 5,887) admitted to the general psychiatric wards of a regional training and research hospital between 2019 and 2023. Descriptive statistics, logistic regression, linear regression, and seemingly unrelated regression (SUR) analyses were employed to evaluate clinical predictors and treatment trends. Results: The prevalence of SUD was 27.5% (n = 1,619), with mixed substance use being the most common pattern (76.1%). In the logistic regression model, substance use, male sex, and later years of admission were associated with a higher likelihood of involuntary hospitalization, whereas bipolar affective disorder was associated with a lower likelihood. Treatment trends showed an overall increase in atypical antipsychotics, depot antipsychotics, clozapine, and electroconvulsive therapy (ECT); compared with non-users, patients with SUD showed lower use of typical antipsychotics, mood stabilizers, clozapine, and ECT. Conclusions: This large-scale study demonstrates that SUDs are a strong predictor of involuntary psychiatric hospitalization and significantly influence pharmacological treatment patterns. The increasing trend of compulsory admissions, particularly among male patients with SUD, underscores the urgent need for clearer legal and ethical frameworks, as well as the expansion of community-based mental health services in Türkiye.

OBJECTIVE: This study aims to examine how internalized stigma differs in opioid use disorder (OUD) based on sociodemographic and clinical variables, and to what extent internalized stigma is related to treatment motivation, perceived social support, depression, and anxiety levels. METHODS: One hundred forty-five individuals with OUD included. Sociodemographic and clinical data form, the Internalized Stigma of Mental Illness Scale (ISMI), Treatment Motivation Questionnaire (TMQ), Multidimensional Scale of Perceived Social Support, the Beck Depression Inventory, and the Beck Anxiety Inventory were utilized in the study to collect data. Bivariate and partial correlation coefficients between variables were computed. ISMI and TMQ scores were compared between patients with depressive symptoms and patients without depressive symptoms by using t-test and Mann Whitney U test. RESULTS: Internalized stigma was high among male patients with heroin use disorder. There was a positive correlation between internalized stigma score and treatment motivation, depression, and anxiety levels. On the other hand, there was a negative correlation between internalized stigma score and multidimensional perceived social support. CONCLUSION: Internalized stigma occupies an important place in the treatment of OUD, which occurs with frequent relapses and which is hard to treat. Not only application for treatment but also adherence to treatment and treatment motivation at maintenance phase bestow a complicated relationship with depression and anxiety. In the struggle against internalized stigma, it plays a vital role to mobilize people’s social support systems, to educate families on the issue and to get in touch with support units exclusive to heroin users.