Purpose: Higher homocysteine (HHcy) levels have been detected in bipolar disorder (BD) patients, and BD patients show circadian rhythm disorders even during remission. Here, we determined the homocysteine (Hcy) levels and chronotype of patients with BD during remission and investigated whether this was related to the clinical course of the disease. Materials and methods: In total, 80 BD outpatients were included. Clinical evaluation was conducted using the Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), Pittsburgh Sleep Quality Index (PSQI) and the Morningness–Eveningness Questionnaire (MEQ). Hcy, folic acid, vitamin B12 levels and protein consumption the day before clinical evaluation were measured. Results and conclusions: HHcy was found in 11 patients (8.8%), most of whom were males (n = 8, 72.7%). During the course of BD, patients with HHcy had significantly more mixed episodes than patients without HHcy (p = .007, z = −2696). In addition, patients with HHcy had significantly lower MEQ scores than patients without HHcy (p = .04, t = 2018). There was no significant difference in chronotype between patients with and without HHcy. The HHcy group had significantly lower levels of vitamin B12 (p = .003, t = 2870). There were no statistically significant differences in daily protein intake and folic acid levels between HHcy and non-HHcy groups. Our study showed a significant relationship between the number of mixed episodes and HHcy. In terms of potential confounds, patients who abused alcohol were excluded, but alcohol consumption was not evaluated. This result should be considered in BD and should be evaluated in larger samples of BD patients.

The circadian rhythm is a 24-hour internal oscillation regulated by the suprachiasmatic nucleus in the hypothalamus (Danielsson et al. 2019). It controls sleep patterns, body temperature, hormonal ...

Objective: We adapted the Ford Insomnia Response to Stress Test to Turkish (FIRST-T) and validated it. Methods: We randomly divided 774 Turkish university students into two equal groups for exploratory (EFA) and confirmatory factor analysis (CFA). McDonald’s omega and Cronbach’s alpha values were utilized for reliability analyses. Item response theory (IRT) approach also used for psychometric properties on the full sample. For discriminant validity, study sample were classified into high and low sleep reactivity groups, and their sociodemographic and sleep data were compared. Results: EFA results suggested a one-factor structure of the FIRST-T, which was confirmed by CFA results. The FIRST-T had solid internal reliability. Item analysis results showed that all the items could distinguish between low and high scorers. This scale showed the same construct (clinical insomnia vs good sleepers) across the sexes in multi-group CFA and differential item functioning results. In the high FIRST-T score group, sleep quality, severity of insomnia, and anxiety scores were higher. In this group, more participants had clinical insomnia according to the Insomnia Severity Index (ISI) and were poor sleepers according to the Pittsburg Sleep Quality Index (PSQI) (p < 0.01). Conclusion: The FIRST-T has robust psychometric properties that assesses sleep reactivity among university students.

Introduction: In this study, we mainly evaluated the associations of borderline personality disorder (BPD), neuroticism, and childhood trauma with the self-rated and clinician-rated overall functional impairment levels of adult euthymic patients with bipolar disorder-1 (BD-1). In addition, we compared patient and healthy control groups regarding the levels of of childhood trauma, neuroticism, BPD and functional impairment.Methods: In total, 90 euthymic BD-1 patients and 90 healthy controls were enrolled. The Childhood Trauma Questionnaire–Short Form, the neuroticism subscale of the Eysenck Personality Questionnaire Revised–Abbreviated Form, the Borderline Personality Questionnaire, the Functioning Assessment Short Test, and the Sheehan Disability Scale were administered to the participants.Results: The study revealed that the levels of BPD, neuroticism, emotional abuse, physical abuse, global childhood trauma, self-rated overall functional impairment, all the subdomains of self-rated functional impairment, clinician-rated overall functional impairment, and all the subdomains of clinician-rated functional impairment (except leisure time) were significantly higher in the patients than those in the healthy controls (p < 0.05). Clinician-rated functional impairment levels were significantly correlated with levels of BPD (r = 0.555, p<0.001), neuroticism (r = 0.429, p < 0.001), global childhood trauma (r = 0.391, p <0.001), and all subtypes of childhood trauma except sexual abuse. Self-rated functional impairment levels were significantly correlated with levels of neuroticism (r= 0.289, p = 0.006), physical neglect (r = 0.213, p = 0.044), and BPD (r = 0.557, p < 0.001). In the regression analyses, the self-rated overall functional impairment levels were only significantly associated with the BPD feature levels (β = 0.319, p < 0.001) and the clinician-rated overall functional impairment levels were only significantly associated with the BPD feature levels (β = 0.518, p < 0.001).Conclusion: The present study’s findings suggest that BPD features should be addressed in psychosocial interventions aimed at ameliorating functional impairment in patients with BD-1. Only BPD features were associated with self-rated and clinician-rated overall functional impairment levels in the regression analyses in the BD-1 patients. Performing self-rated and clinician-rated functional impairment assessments in the same clinical trial may give rise to relevant findings in the future.

Objective We aimed to assess the interplay between functional impairment and anxiety, depression, and problematic Internet use levels in front-line healthcare workers who work in inpatient clinics of coronavirus disease-2019 (COVID-19) during the COVID-19 pandemic.Methods Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Internet Addiction Test (IAT), and Sheehan Disability Scale (SDS) were administered to assess the depression, anxiety, problematic Internet use, and functional impairment levels of the participants.Results Two hundred thirteen participants were enrolled in the present study. Medical doctors showed significantly higher scores of IAT than the nurses and other medical staff (Kruskal–Wallis=6.519, p=0.038). Levels of SDS total are significantly correlated with scores of IAT (r=0.257, p<0.001), BDI (r=0.383, p<0.001), and BAI (r=0.308, p<0.001). All subdomain scores of SDS (social, family, work) and total scores of SDS were significantly and positively correlated with BAI, BDI, and IAT scores (p<0.05). In the separation mediation analysis, problematic Internet use partially mediated the relationship between anxiety-depression and global functional impairment.Conclusion Health politicians should produce policies to develop strategies for coping with consequences of anxiety and depression in healthcare professionals during any health crisis. In addition, we should raise healthcare professionals’ awareness that problematic Internet use is not suitable for dealing with anxiety and depression and may even lead to increase of functional loss.