Although generalized anxiety disorder (GAD) is associated with suicide, not all dimensions of this relationship have been addressed. This study aimed to investigate the relationship between psychache and anxiety sensitivity with suicidality in patients with GAD. We included 80 patients with GAD (17 of whom had previous suicide attempts). The Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Scale (HAM-D), Beck Scale for Suicidal Ideation (BSIS), Psychache Scale (PS), and Anxiety Sensitivity Index-3 (ASI) were applied to the participants. The patients with previous suicide attempts had significantly higher scores on ASI total, ASI-physical and cognitive subdimensions, HAM-A total and psychic subscale, PS, and BSIS than those without (p < 0.05 for each). Mediation analyses revealed that psychache was a full mediator in the relationship between ASI-cognitive subdimension and suicidal ideation. Therapeutic interventions for anxiety sensitivity and psychache in patients with GAD will help reduce the risk of suicide.

Suicide is a leading cause of death and disability worldwide. Psychache (psychological pain) and diminished tolerance of psychaches are important risk factors for suicide. People experiencing psychaches of similar severity may not demonstrate the same levels of tolerance because of various coping skills. This study aimed to determine the relationship between psychache, tolerance for psychache, and coping skills in individuals with depression and healthy controls. We included 73 patients with depressive disorders without comorbid mental disorders and 65 healthy controls. We applied beck depression inventory, beck hopelessness scale, beck suicidal ideation scale, psychache scale, tolerance for mental pain scale (TMPS), and coping attitudes evaluation scale (COPE) to all participants. People with depression had significantly higher COPE dysfunction scores than those in the control group did. Patients who had previously attempted suicide attempt(s) previously had significantly higher beck hopelessness scale, beck depression inventory, COPE dysfunction, and psychache scale scores, and lower TMPS-10 scores than those who did not attempt suicide. Mediation analyses revealed that dysfunctional coping skills played a partial mediating role in the relationship between psychache and the TMPS. The study revealed that dysfunctional coping skills were related to suicidal ideation and previous suicide attempts. These findings suggest that improving coping skills could help reduce the severity of suicidal ideation.

Purpose: Patients with major depressive disorder (MDD) may experience more frequent and severe psychological and physical pain complaints compared to those without depression. As the tolerance to psychological pain decreases in patients with MDD, the severity of suicidal ideation tends to increase. Furthermore, the tolerance for physical pain (TPP) has been related with suicidal behavior. We aimed to demonstrate the impact of TPP on suicidal ideation in patients with MDD in the presence of psychological pain. Patients and Methods: We included 123 patients with MDD and 114 healthy volunteers who had no previous psychiatric diagnosis. Sociodemographic data form, Psychache Scale (PS) and Tolerance for Mental Pain Scale (TMPS) were used to assess psychological pain. Beck Scale for Suicide Ideation (BSIS) and Beck Depression Inventory (BDI) were administered to participants. To assess the TPP, we used a device based on the principle of electronic dynamometry. Results: The mean BDI, BSIS, PS, and TPP scores in the MDD group were higher, and the mean TMPS score was lower than those in the control group (p < 0.001 for each, p = 0.03 for TPP). We found statistically significant correlations between BDI, TMPS, BSIS, PS, and TPP scores (p < 0.05 for each). TPP was a partial mediator in the relationship between TMPS and BSIS scores (β = − 1.814; p < 0.001). Conclusion: We found that tolerance of psychological pain was a strong predictor of suicidal ideation, and TPP was mediating this relationship. These findings suggest that considering both tolerance to psychological pain and TPP may be beneficial when assessing the risk of suicide in individuals with MDD.

(1) Background: Spouses of individuals with bipolar disorder (BD) experience significant burdens, and the perception of the burden may affect dyadic adjustment. We aimed to investigate the sexual functions, alexithymic traits, marital satisfaction, and burden in patients with BD and their spouses. We also aimed to assess the mediating role of sexual functions and alexithymia in the relationship between burden and dyadic adjustment. (2) Methods: We included 81 patients with BD type 1 (40.69 ± 8.55 years, 65.4% female, and 34.6% male) and their healthy spouses (40.95 ± 7.30 years, 34.6% female, and 65.4% male) and 78 healthy controls (38.90 ± 5.88, 48.7% female, and 51.3% male). The participants were evaluated using the Golombok–Rust Inventory of Sexual Satisfaction (GRISS), Dyadic Adjustment Scale (DAS), Hamilton Depression Rating Scale (HDRS), Toronto Alexithymia Scale-20 (TAS-20), and Burden Assessment Scale (BAS). (3) Results: The GRISS scores of the control group were significantly lower than the spouses and BD groups. The DAS total score of the control group was significantly higher than that of the spouses and BD groups. Regression analyses revealed that TAS, GRISS, and HDRS scores were associated with DAS scores in the BD group. In the spouse group, TAS and BAS scores were associated with DAS scores. The GRISS scores partially mediated the relationship between dyadic adjustment and burden in the spouses of patients with BD. (4) Conclusions: Mental health professionals should regularly scan caregivers’ perceptions of burden. Appropriate psychosocial interventions could help spouses of patients with BD to cope better with the burden and improve dyadic adjustment.

Orthorexia nervosa (ON) is defined as a pathological fixation on eating healthy and pure food. In this study, it was aimed to evaluate the psychometric properties of the Turkish version of the Düsseldorf orthorexia scale (DOS) in a clinical sample. A total of 385 individuals, 117 with generalized anxiety disorder (GAD), 108 with major depressive disorder (MDD), 56 with obsessive–compulsive disorder (OCD) and 104 healthy controls, participated in the study. Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Yale–Brown Obsessive–Compulsive Scale (Y-BOCS), Eating Attitude Test (EAT-40), Orthorexia Nervosa Inventory (ONI) and Düsseldorf Orthorexia Scale (DOS) were applied to all participants. The DOS demonstrated high internal consistency (Cronbach’s alpha = 0.87) and good construct validity. Confirmatory factor analysis supported a one-factor structure, explaining a significant portion of variance among responses. In the analyses performed to test the convergent validity of DOS, a positive correlation was found with ONI and EAT scores (p < 0.001 for each). There was no significant correlation between DOS and HAM-D and HAM-A scores (p > 0.05 for each). The severity of orthorexic symptoms measured by DOS was similar between each patient group and healthy control group. DOS was applied to 70 more participants two weeks apart and the test–retest reliability was determined as 0.99. This study shows that the Turkish version of DOS is valid and reliable in clinical samples and healthy individuals, is largely consistent with ONI, and that this scale can be used in studies investigating ON. Orthorexia nervosa (ON) is a phenomenon in which there is intense effort to eat foods that are believed to be healthy and pure. It has been stated that there is a decrease in the professional, social and academic functionality of orthorexic individuals due to their efforts on healthy eating, and their physical health may be affected over time. Therefore, there is a need for an appropriate screening scale for rapid screening of orthorexic symptoms. The Düsseldorf orthorexia scale (DOS) is a self-report scale consisting of 10 questions created to assess ON. Our study is the first study to evaluate this scale in a Turkish clinical sample. The main aim of our study was to test the psychometric properties of DOS in patients diagnosed with major depressive disorder, generalized anxiety disorder and obsessive–compulsive disorder. The results showed that DOS had satisfactory psychometric properties in the Turkish clinical sample and could be a short, useful, and valid scale to screen for ON in these individuals.