Rukiye Tekdemir

Objective: This study examined the incidence of metabolic syndrome (MetS) in individuals with bipolar disorder (BD) and identified clinical and biological predictors of incident MetS during a 1-year follow-up. Methods: The study included 100 euthymic BD type-1 patients consecutively recruited from outpatient clinics between July 2023 and July 2024. MetS was defined according to International Diabetes Federation criteria. Patients without MetS at baseline but with MetS during follow-up were classified as having incident MetS. A logistic regression model was utilized to estimate the adjusted odds ratios (OR) and corresponding 95% confidence intervals (CIs) for associations between predictors and incident MetS. Results: Of the participants enrolled in the study (n = 100, 92% response rate), 29% met MetS criteria at baseline. Of the 71 without baseline MetS, 29 (40.8%) developed MetS over a 1-year period. Significant predictors of MetS onset included a higher number of manic/hypomanic episodes (OR = 1.459, 95% CI = 1.005-2.118, P = .047), increased chlorpromazine-equivalent antipsychotic dosages (OR = 1.007, 95% CI = 1.001-1.013, P = .024), high waist circumference (OR = 1.247, 95% CI = 1.052-1.479, P = .011), and hypertriglyceridemia (OR = 1.041, 95% CI = 1.007-1.077, P = .020). Conversely, lamotrigine use was inversely associated with MetS development (OR = 0.030, 95% CI = 0.001-0.659, P = .026). Conclusion: A high incidence of MetS (41%) was observed during a 1-year follow-up of patients with BD in Turkey. Identified risk factors highlight opportunities for intervention through mood recurrence prevention, careful pharmacotherapy management, and treatment of pre-existing components of MetS.

The aim of this study is to investigate the associations between impulsivity, night eating symptoms (NES), and sleep quality in patients with BD in remission, while also investigating confounding effects of chronotype differences, demographic/clinical variables, and the presence of metabolic syndrome (MetS). One hundred and twelve euthymic patients with bipolar disorder (BD) type 1 were enrolled in this cross-sectional study. In addition to sociodemographic/clinical data, sleep quality, impulsivity, night eating syndrome and chronotype were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Barratt Impulsiveness Scale-11 Short Form, Night Eating Questionnaire, and The Munich Chronotype Questionnaire. The MetS was examined according to the criteria of the International Diabetes Federation. Our study showed a positive correlation between poor sleep quality, impulsivity, and NES. When the sample was divided into two groups based on sleep quality, as scored according to the PSQI, 58% of the patients had poor sleep quality. Those with poor sleep quality exhibited higher levels of impulsivity and severe NES than those with good sleep quality. The mediation regression model indicated that NES fully mediates the relationship between impulsivity and sleep quality, after controlling for confounding factors, including certain sociodemographic and clinical variables, antipsychotic dose (mg/day), the presence of MetS, and chronotype differences. Evaluating night eating behaviors and impulsivity associated with poor sleep quality during remission in BD patients may be crucial for developing effective intervention strategies to prevent relapses and improve the prognosis of the disease.

Aims: This study investigates the prevalence and clinical correlates of predominant polarity (PP)—depressive predominant polarity (DPP) and manic predominant polarity (MPP)—in patients with bipolar disorder (BD) type 1, as well as their association with chronotype and lithium response. Method: Eighty patients aged 18-65, in remission from BD type 1, participated in this cross-sectional study. In addition to sociodemographic and clinical data, remission status, lithium response levels, and chronotype were evaluated using the Young Mania Rating Scale, Hamilton Depression Rating Scale, Biological Rhythms Interview of Assessment in Neuropsychiatry, Morningness-Eveningness Questionnaire, and Alda Scale. DPP and MPP were defined as a lifetime ratio of ≥2:1 of either hypomanic/manic episodes or depressive episodes, respectively. Results: The mean age of participants was 35.32 ± 11.39 years, with 61.25% being female (n=49). The dominant polarities were 46.25% (n=37) DPP and 53.75% (n=43) MPP. No significant differences were found between the two groups in terms of treatment types, total duration of illness, or total episode number (p>0.05). However, the onset age of the disorder was significantly earlier in the MPP group (p=0.009). This group also had significantly higher scores on the BRIAN, MEQ, and Alda Scale (t=-7.183, p=0.00; t=-3.968, p=0.00; t=-6.971, p=0.00, respectively). A weak positive correlation was found between manic episodes and BRIAN, while a strong positive correlation was observed with MEQ (respectively rs1=-0.355, rs2=-0.373). Strong positive correlations were noted between the Alda Scale and both BRIAN and MEQ, alongside strong negative correlations with the total number of depressive episodes (respectively rs1=-0.355, rs2=-0.373, rs3=-0.274). Conclusion: This cross-sectional study demonstrates that PP and chronotype significantly influence lithium response in individuals with BD-I. The MPP group was found to have an earlier onset of the disorder and exhibit more pronounced evening characteristics. Additionally, the MPP group showed a stronger response to lithium. These findings suggest that lithium may have a greater effect on individuals with MPP and evening chronotype and highlight the need for validation through larger sample sizes and longitudinal studies

This study aimed to evaluate the sociodemographic factors, loss-related factors, and adult separation anxiety associated with a diagnosis of Prolonged Grief Disorder (PGD), after controlling for anxiety, depression, and perceived social support during the COVID-19 pandemic in Türkiye. Participants (n=126) completed an online survey that included socio-demographic and loss-related information, as well as the Hospital Anxiety and Depression Scale, Prolonged Grief Disorder Scale-13, Multidimensional Scale of Perceived Social Support, and Adult Separation Anxiety Questionnaire-27. Twelve participants were diagnosed with probable PGD (9.5%). In the linear regression analysis, it was found that when the deceased person was a first-degree relative and younger in age, the presence of guilt, increased separation anxiety, and higher depression scores significantly associated with the severity of PGD. Even when the pandemic is under control, it remains crucial to offer mental health services those who have lost a loved one during the COVID-19 outbreak.

Background and Objective Insomnia severity and poor sleep quality are linked with a poor response to depression treatments. Furthermore, they may heighten suicide risk, necessitating careful management and treatment of insomnia. This study explored how accelerated transcranial magnetic stimulation (aTMS) affects insomnia severity and sleep quality in patients with treatment-resistant depression (TRD).Methods This retrospective study included files from 28 patients with TRD who met specific inclusion and exclusion criteria. We assessed changes in insomnia severity and sleep quality by comparing scores before and after aTMS treatment. All patients underwent 50 sessions of intermittent theta burst stimulation over the left dorsolateral prefrontal cortex across 10 days.Results The mean age of the patients was 40.82±12.03 years. Before aTMS, the Insomnia Severity Index (ISI) score was 18.21±9.45, and the Pittsburgh Sleep Quality Index (PSQI) score was 12.85±4.75. After aTMS, ISI and PSQI scores improved to 5.75±6.70 and 6.75±5.01, respectively. The mean reductions in ISI and PSQI scores post-aTMS were 12.46 and 6.10, with Cohen’s effect sizes of 1.51 and 1.26, respectively. The sub-dimensions of subjective sleep quality and daytime dysfunction showed the most significant decreases, while sleep duration decreased the least. Improvements in all sleep parameters were statistically significant.Conclusions aTMS significantly alleviated insomnia severity and enhanced sleep quality in patients with TRD within just two weeks.

Objective: Digital technologies aid in remote patient monitoring, data collection, psychoeducation, self-help applications, disease recognition, and awareness enhancement. However, literature on the utilization of digital technologies among psychiatric patients is scarce. This study aimed to assess the prevalence of digital technology usage among patients attending psychiatric outpatient clinics and compare usage patterns across different diagnoses. Materials and Methods: Between September-November 2023, 500 patients who applied to Selcuk University Faculty of Medicine Psychiatry Outpatient Clinic as outpatients and volunteered to participate in the study were included in the study. After the psychiatric interviews were completed, a questionnaire was filled out asking about the characteristics of the use of mobile technologies, internet, social media, and health applications. Results: Of the study group, 69.4% were female (n=347) and the mean age was 33.9 (±13.01) years. The educational status of 50.4% of the participants was university or master's degree. While 96% of the participants used smartphones, 16% used wearable technology (n=80). Internet usage rate was 94.8% and social media usage rate was 91%. When 251 people who did not use any health application but would like to use one were asked which features they would like to have in the application they would like to use, 78.8% stated that they would like to create an appointment, 67.7% would like an appointment time reminder, 59.7% would like drug side effect query, 55.7% would like their physician to have access to their health information, and 54.9% would like online psychotherapy. Conclusions: The prevalence of smartphone and internet use among patients applying to psychiatry is similar to the national population. There is an unmet need in terms of health applications for the psychiatric patient group. When looking at the desired characteristics of health applications, it should be taken into account that there are different demands in psychiatric diagnosis groups.