Objective: Recent studies show that inflammation is related to the pathogenesis of acute mania of bipolar disorder. Neutrophil/high-density lipoprotein (HDL) ratio (NHR), lymphocyte/HDL ratio (LHR), monocyte/HDL ratio (MHR) and platelet/HDL ratio (PHR) have recently been investigated as novel markers of inflammation. In addition, the atherogenic index of plasma (AIP) and atherogenic coefficient (AC) are the leading atherogenic indices. The study aimed to investigate these inflammation and atherogenic index markers in acute mania of bipolar disorder. Another aim was to determine whether there is a relationship between these markers and disease severity and psychotic symptoms. Methods: A total of 109 BD-M and 101 (HC) were enrolled in the study. The differences in NHR, LHR, MHR, PHR, AIP and AC and their association with illness severity and psychotic symptoms were analysed after adjusting for age, sex, total cholesterol level, body-mass index and smoking status. Then, a receiver operating characteristic (ROC) curve and linear discriminant analysis (LDA) were used to analyse these parameters' diagnostic potential. Moreover, the Young Mania Rating Scale (YMRS) and Clinical Global Impression Scale for use in bipolar illness-Severity subscale (CGI-BP-S) were used to assess the severity of clinical symptoms. Results: We found higher levels of NHR, MHR, PHR and AIP, but not LHR and AC, after adjusting confounding factors in patients with BD-M compared to HCs. In logistic regression analysis, higher levels of MHR and NHR were associated with BD-M. MHR, NHR and PHR were predictors for differentiating the BD-M group from the HC group. However, the severity of the illness or the psychotic feature of the manic episode did not significantly affect the parameters. In the ROC curve analysis of BD-M, the indicators with an area under the curve (AUC) higher than 0.6 were the MHR, NHR, PHR and LHR. Conclusions: These results provide information about the role of inflammation in the pathophysiology of BD-M. Even after controlling for confounding factors, MHR, NHR, PHR and AIP are potential biomarkers for BD-M. Moreover, the increase in AIP may explain the co-morbidity between BD and cardiovascular diseases. However, the severity of the illness or the psychotic feature of the manic episode did not significantly affect the levels of inflammation ratios used in our study. Due to the low cost and widespread use of lipid metabolism and related inflammation rates, it may be beneficial to know the MHR, NHR, PHR and AIP levels in BD-M patients.

Şükrü Alperen Korkmaz, Semra Ulusoy Kaymak, Salim Neşelioğlu, Özcan Erel. Clin Psychopharmacol Neurosci 2024;22:139-50. https://doi.org/10.9758/cpn.23.1084

Background: Although deficits in facial emotion recognition (FER) significantly affect interpersonal communication and social functioning, there is no consensus on how FER affects Alzheimer's disease (AD). In this study, we aimed to investigate the clinical and neuropsychological factors affecting the possible deficits in the FER abilities of patients with AD.Methods: This cross‐sectional study included 37 patients with mild [clinical dementia rating (CDR) scale score = 1] or moderate (CDR = 2) AD, in whom vascular dementia and depression were excluded, and 24 cognitively normal (CDR = 0) subjects. FER ability was determined using the facial emotion identification test (FEIT) and facial emotion discrimination test (FEDT). All participants underwent mini‐mental state examination (MMSE), frontal assessment battery (FAB), and geriatric depression scale (GDS). The neuropsychiatric inventory‐clinician rating scale (NPI‐C), Katz index of independence in activities of daily living, and Lawton instrumental activities of daily living were also administered to patients with AD.Results: The FEIT and FEDT total scores showed that patients with mild and moderate AD had significant FER deficits compared to healthy controls. However, no significant difference was observed between patients with mild and moderate AD in the FEIT and FEDT total scores. FEIT and FEDT scores were not correlated with the MMSE and NPI‐C total and subscales scores in patients with AD. Linear regression indicated that FEIT and FEDT total scores were significantly related to age and FAB scores. The GDS score negatively moderated the relationship between FAB and FEDT.Conclusions: This study demonstrated a decreased FER ability in patients with AD. The critical point in FER deficits is the presence of dementia, not the dementia stage, in AD. It has been determined that executive functions and depression (even at a subsyndromal level), which have limited knowledge, are associated with FER abilities.

Introduction: Hemsley and Garety described the “jumping to conclusions bias” in which patients with delusions may reach unreasonable results with insufficient information. In this study patients with bipolar disorder and healthy volunteers were compared in terms of jumping to conclusions bias using the beads in the jar task. Methods: 37 patients with DSM-5 diagnosis of bipolar disorder and 30 healthy controls were tested with the Beads Task (BT), Tower of London Test (ToL) and Barrat Impulsiveness Scale (BIS). Results: In the BT, the mean score of DtD (draws to decision) and JTC (jumping to conclusions) scores were not statistically different between the two groups. In the ToL test, the duration of the total execution and the total time were significantly longer in the bipolar group than the control group. BIS scores were significantly higher in the bipolar group. YMRS (Young Mania Rating Scale) scores were not correlated with BT. Conclusions: This study is the first clinical study to assess the jumping to conclusions bias in patients with bipolar disorder. No JTC bias was detected in bipolar disorder. Further studies may assess JTC in larger samples to determine the effects of clinical state changes, psychotic symptoms, medication and impulsivity.

Background: Placenta previa (PP) is a major obstetric complication that can cause significant physical and emotional stress for expectant mothers. However, its psychological impact has received limited research attention. The purpose of this study was to examine perceived stress, depression, anxiety, post-traumatic stress symptoms, and sleep disturbances in patients diagnosed with PP. Methods: This cross-sectional study with prospectively collected obstetric outcomes included 70 cases of PP and 78 healthy pregnant women (HPs) in the third trimester of pregnancy. Depression, anxiety, post-traumatic stress symptoms, sleep disturbances, perceived stress, and resilience were assessed using the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Impact of Events Scale-Revised (IES-R), Jenkins Sleep Scale (JSS), Perceived Stress Scale (PSS-10), and Brief Resilience Scale (BRS), respectively. Results: According to the cutoff scores of the scales, 50%, 42.9%, 62.9%, and 51.4% of those diagnosed with PP met the criteria for depression, anxiety, sleep disturbances, and post-traumatic stress disorder, respectively, which were significantly higher than those in the HP group. After controlling for maternal age, gravida, parity, and resilience, the PHQ-9, GAD-7, and IES-R scale scores were significantly higher in patients with PP than in the HP group. The mediation model indicated that depression and anxiety partially mediate the relationship between perceived stress and post-traumatic stress symptoms (PSS-10 ➝ GAD-7/PHQ-9 ➝ IES-R). Conclusion: The findings of this study suggest that women diagnosed with PP who are anticipating labor have a significantly increased likelihood of developing depression, anxiety, sleep disturbances, and post-traumatic stress symptoms. Raising awareness of the adverse psychological effects associated with PP may help facilitate the implementation of screening, assessment, and intervention strategies for these patients.