Burcu Eser

Purpose: To compare within-person renal and hepatic biochemical trajectories during lithium and valproate treatment in bipolar disorder and determine whether longitudinal slopes differed between treatment groups.Methods:This single-center retrospective cohort included 96 patients with bipolar disorder treated with lithium (n=35) or valproate (n=61), contributing 282 laboratory records. Random-intercept linear mixed-effects models for creatinine, blood urea nitrogen (BUN), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) included age at the first available laboratory record, sex, time, treatment group, and the time × treatment interaction. Outcome-specific adjusted models comprised 275-278 observations from 95 patients. For creatinine, a treatment-specific piecewise model with a 6-month knot was supplemented by data-quality and random-slope sensitivity analyses.Results: Mean follow-up was 312.22 ± 199.21 days. The time × treatment interaction was not statistically significant for creatinine (B=-0.0019, p=.303), BUN (B=-0.0853, p=.160), AST (B=-0.0070, p=.285), or ALT (B=-0.0059, p=.442). Male sex was associated with higher creatinine, AST, and ALT levels, whereas older baseline age was associated with higher BUN. In the piecewise model, neither early nor late slopes differed by treatment (joint Wald χ²(2)=0.544, p=.762). All sensitivity analyses supported the primary finding.Conclusion: No statistically detectable difference was observed between lithium and valproate groups in the longitudinal slopes of the evaluated markers. The findings do not establish equivalence or long-term safety; average short- to mediumterm trajectories did not diverge under regular, individualized laboratory monitoring.

Background/Objectives: Psychiatric readmissions are an important indicator for assessing disease progression and the effectiveness of healthcare services. The aim of this study was to explore factors associated with one-year readmission and to evaluate the performance of machine learning models using clinical information extracted from discharge summaries of patients receiving inpatient treatment in a psychiatric ward. Methods: This retrospective study included 622 patients hospitalized in the psychiatry department of a university hospital between 2020 and 2024. Clinical variables were extracted from discharge summaries using a theme-based structured coding approach. Factors associated with 1-year readmission were evaluated using univariate and multivariable logistic regression analyses, while length of hospital stay was analyzed using log-transformed linear regression. The predictive performance of logistic regression, Random Forest, HistGradientBoosting, and BERTurk-based machine learning models was also compared. Results: The 1-year psychiatric readmission rate was 17.0%. In univariate analyses, previous psychiatric hospitalization, longer index length of stay, and manic symptoms were associated with readmission. In multivariable analysis, only previous psychiatric hospitalization remained an independent predictor of readmission (adjusted OR = 2.14, 95% CI: 1.34–3.42; p = 0.001). Previous psychiatric hospitalization, unemployment, and depressive symptoms were independently associated with longer hospital stay. Among the machine learning models, logistic regression using structured clinical variables and theme-based features achieved the best performance (AUC = 0.602). Conclusions: Previous psychiatric hospitalization was the strongest independent factor associated with 1-year psychiatric readmission. These findings suggest that routinely collected clinical records may contain potentially useful information for understanding psychiatric readmission risk and support further investigation in larger, multicenter studies.

Stigma-related beliefs toward mental illness may change during psychiatric clinical exposure, but individual differences in this process remain insufficiently understood. This single-center observational pre–post study examined observed changes in mental illness-related beliefs among 185 medical interns who completed an approximately 30-day psychiatry clerkship between May 2025 and May 2026, with perceived dangerousness defined as the primary outcome. Beliefs were assessed before and after the exposure period using the Beliefs Toward Mental Illness Scale. Associations between baseline cognitive–metacognitive characteristics and observed change were evaluated using paired comparisons, linear mixed-effects models, and sensitivity analyses. Dangerousness scores decreased by the end of the exposure period, mean change = −2.66, 95% CI [−3.48, −1.81], q < 0.001, d_z = −0.47. Smaller decreases were observed in Helplessness and Deterioration in Interpersonal Relationships, whereas no significant change was found in the two-item Shame subscale. Higher baseline ruminative thought style was associated with a more limited decrease in dangerousness scores; B = 1.70, SE = 0.55, 95% CI [0.62, 2.77], q = 0.023. Although this association was consistent across sensitivity analyses, its incremental contribution was small (ΔR²_marginal = 0.017; f² = 0.018 in the focused model). The finding should therefore be interpreted as a quantitatively modest association with observed belief change, not as a clinically meaningful predictor. Because the study included no concurrent control group or experimental manipulation and was conducted at one center, it does not establish a causal clerkship effect or support educational screening based on ruminative thought style.

Amaç: Bu çalışmanın amacı, psikiyatri servisinde yatan hastalara yönelik istenen konsültasyonları, bu konsültasyonların yönlendirildiği uzmanlık alanlarını ve sonrasında konulan fiziksel hastalık tanılarını retrospektif olarak inceleyerek, psikiyatrik hastalarda fiziksel hastalık sıklığına dikkat çekmek ve bütüncül yaklaşımın önemini vurgulamaktır. Yöntem: Psikiyatri servisinde yatarak tedavi gören hastaların dosyaları retrospektif olarak taranmış, fiziksel sağlık sorunları nedeniyle istenen konsültasyonlar, bu konsültasyonlara ait branşlar ve sonuçta elde edilen fiziksel hastalık tanıları değerlendirilmiştir. Bulgular: Psikiyatri hastalarının önemli bir kısmında fiziksel hastalık bulunduğu, en sık dahiliye, nöroloji ve kardiyoloji branşlarına konsültasyon istendiği ve tanıların çoğunlukla metabolik, kardiyovasküler ve nörolojik hastalıklar olduğu görülmüştür. Sonuç: Psikiyatrik hastalarda fiziksel hastalıkların yaygınlığı ve tanı konulma oranları göz önüne alındığında, psikiyatri servislerinde biyopsikososyal yaklaşım ve multidisipliner iş birliği büyük önem taşımaktadır. Fiziksel sağlık taramalarının rutin uygulamaya alınması, tanı ve tedavi sürecine katkı sağlayacaktır.

Objective: Major depressive disorder (MDD) is a psychiatric illness characterized by severe functional impairment arising from biopsychosocial interactions. Understanding biological indicators has gained increasing importance in the diagnosis and treatment of depression. This study aimed to investigate the relationship between hemoglobin (Hb) levels and depression severity in individuals diagnosed with MDD.Methods: This retrospective, cross-sectional study included 80 patients diagnosed with MDD according to DSM-5 criteria who were hospitalized in a psychiatry clinic between 2023 and 2025. Sociodemographic and clinical data were obtained retrospectively from patient files. Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS). The relationship between Hb level and depression severity was analyzed using Spearman correlation, and associations with depression severity were evaluated using multiple linear regression analysis.Results: The mean age of participants was 38.13 ± 12.76 years, and 66. 25% were female. The mean MADRS score was 30.24 ± 7.50, and the mean Hb level was 12.97 ± 2.12 g/dL. Correlation analysis revealed a significant negative relationship between Hb level and depression severity (ρ = –0.278, p = 0.013). Regression analysis suggested that Hb level may be associated with depression severity(B = –1.47, p = 0.002).Conclusion: The findings suggest that lower Hb levels may be associated with greater depression severity. These results may indicate a potential relationship between hematological parameters and the biological aspects of depression. However, due to the retrospective cross-sectional design of the study, no causal inferences can be made regarding the relationship between Hb levels and depressive symptoms. Future prospective studies with larger samples may help to further clarify the association between Hb levels, anemia-related parameters, and depression severity.