Elif Oral, Zekai Halici, Irfan Cinar, Elif Ozcan, Zerrin Kutlu. Clin Psychopharmacol Neurosci 2019;17:211-21. https://doi.org/10.9758/cpn.2019.17.2.211

Objective: Alcohol Use Disorder (AUD) is a significant public health issue associated with serious health risks. This study aims to reveal the relationship between AUD and inflammatory, immunonutritive, and cardiovascular risk markers by evaluating hemogram and biochemistry parameters together in AUD. Method: The data of 54 male patients with AUD and 45 male controls were included in the study. Sociodemographic-clinical data of the participants and Alcohol Use Disorders Identification Test (AUDIT) results were obtained from medical records. Systemic immune inflammation index (SII) was obtained with the platelet x neutrophil/lymphocyte formula; systemic immune response index (SIRI) was obtained with the monocyte x neutrophil/lymphocyte formula, plasma atherogenicity index (AIP) was obtained with the ratio of triglyceride to High-density Lipoprotein (HDL) cholesterol. C-Reactive Protein (CRP) albumin-lymphocyte (CALLY) index was obtained with the albumin x lymphocyte/CRP x 104 formula. Results: Aspartate aminotransferase (AST), Gamma Glutamyl Transferase (GGT) activities, neutrophil, CRP, ferritin, SII, and SIRI levels were significantly higher in those with AUD compared to controls. Laboratory results of those with AUD were consistent with atherogenic dyslipidemia; higher triglyceride and total cholesterol levels and AIP values were found compared to controls. The amount of alcohol consumed was a predictor for high SII, SIRI, and AIP levels. The CALLY index, which evaluates immune function, inflammation, and nutritional status together, was significantly lower in patients compared to controls. The amount of alcohol use and the total AUDIT score were predictors for a low CALLY index. Conclusion: The results of this study support that AUD is a chronic inflammatory psychiatric disorder. We suggest that new inflammatory, immunonutritive, and cardiovascular biomarkers SII, SIRI, AIP, and CALLY index could be promising clinical tools to evaluate the severity, potential complications, and treatment response of AUD.

Objective People's attitudes about aging are formed in early childhood, develop in adulthood, and are fully shaped in old age. Our study aimed to investigate the effect of self-esteem on attitudes toward aging in the elderly. Method A total of 264 people over the age of 65 without any known psychiatric or neurologic disease were included in the study. The sociodemographic data form, Rosenberg Self-Esteem Scale (RSES) with 12 sub-dimensions, and Attitude to Aging Questionnaire (AAQ) with three sub-dimensions were applied to each participant. Pearson correlation analysis was used to evaluate the relationship between quantitative variables. Hierarchical multiple regression analysis was used to determine the factors predicting the attitude toward aging. Results A moderately significant negative relationship was found between the AAQ sub-dimension of psychosocial loss score and RSES sub-dimension self-esteem (r=-0.340, p=0<0.001), continuity of self-concept (r=-0.258, p<0.001), depressive affect (r=-0.423, p<0.001), and psychosomatic symptoms (r=-0.311, p<0.001). Self-esteem was found to be predictive of attitude toward aging. When sociodemographic factors were controlled, it was found that 25.6% of the variance in attitude toward psychosocial loss (R² change=25.6; p<0.001), 30.5% of the variance in attitude toward physical change (R² change=30.5; p<0.001), and 34.9% of the variance in attitude toward psychosocial development (R² change=34.9; p<0.001) could be explained by the specified sub-dimensions of RSES. Conclusion In our study, it was observed that self-esteem shaped from childhood to the present day is at least as effective as sociodemographic characteristics in the attitude toward aging.

Introduction: The study aimed to evaluate, both comparatively and longitudinally, the effects of receiving services from community mental health centers on the stigma levels of patients and relatives and the burden of care for patients with severe mental illness.Methods: The study was planned to be conducted on patients with severe mental illness [schizophrenia spectrum disorders (SSDs) and bipolar disorder (BD)] and their relatives, followed by the community mental health center (CMHC group) and the outpatient clinic (outpatient group). It was planned to provide psychoeducation to relatives once a month for 2 h; meetings with the case manager at least once every 2 weeks; and psychosocial interventions (social inclusion, daily life activities studies, etc.) and psychoeducation for 2 h once a week for the patients. The Internalized Stigma of Mental Illness Scale (ISMI) was applied to the patients; the Zarit Caregiver Burden Scale (ZCBS) and the Self-Stigma Inventory for Families (SSI-F) were applied to the relatives at the beginning of the study, at the 6th and 12th month.Results: The study was completed with 53 patients from the CMHC group (number of patients with SSDs = 39, number of patients with BD = 14) and 60 patients from the outpatient group (number of patients with SSDs = 45, number of patients with BD = 15). In the CMHC group, in patients with SSD, there was a statistically significant decrease in ISMI (p < 0.001), ZCBS (p < 0.001), and SSI-F (p < 0.001) scores at the end of the 12th month. In the outpatient group, in patients with SSD, there was no statistically significant decrease in ISMI (p = 0.948), ZCBS (p = 1.000), and SSI-F (p = 1.000) scores at the end of the 12th month. In the CMHC group, in patients with BD, there was a statistically significant decrease in ISMI (p = 0.002), ZCBS (p < 0.001), and SSI-F (p < 0.001) scores at the end of the 12th month. In the outpatient group, in patients with BD, there was no statistically significant decrease in ISMI (p = 0.645), ZCBS (p = 0.166), and SSI-F (p = 0.142) scores at the end of the 12th month.Discussion: The results of our study suggest that multidimensional assessments of patients and their families, efforts to promote social participation, support for self-management in daily life, and psychoeducation may be helpful in reducing stigma and burden.

Objectives: This study aimed to assess serum Galectin-3 (Gal-3) and IL-6 levels, along with other inflammatory markers, in type-1 bipolar disorder (BD) patients and explore their relationship with clinical features, metabolic parameters, and symptom severity. Background: The study included 38 manic, 35 euthymic BD patients, and 40 healthy controls. Sociodemographic data, such as age, gender, alcohol and smoking habits, and body mass index (BMI), were recorded. Methods: The Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HAM-D) were administered to patients. Biochemical measurements included Gal-3, IL-6, CRP, neutrophil, lymphocyte, platelet counts, and inflammatory indices like NLR, PLR, SII, and SIRI. Results: Gal-3 levels significantly differed among the groups (F = 52.251, p < 0.001), with the highest levels in euthymic patients. IL-6 levels were elevated in both manic and euthymic patients compared to controls (F = 7.379, p = 0.001). Manic patients had significantly higher levels of neutrophils, monocytes, CRP, NLR, PLR, SII, and SIRI. A positive correlation was found between Gal-3 levels, the total number of episodes, and YMRS scores in manic patients. In euthymic patients, Gal-3 levels correlated positively with disease duration and episode count. Conclusions: Elevated Gal-3 levels, particularly in the euthymic phase, may serve as a biomarker for BD and indicate ongoing inflammation. These findings suggest Gal-3 could help identify BD and differentiate the euthymic phase.

Bu çalışmadaki temel amacımız, oral tedaviden uzun etkili antipsikotik tedavilere geçişin şizofreni hastalarında bakım veren yükü üzerinde oluşturduğu farkı araştırmaktır. Yükle ilgili olabilecek diğer faktörler de tartışılmıştır. Çalışmaya en az bir yıldır şizofreni tanısı almış ve oral paliperidon veya aripiprazol alan hastaların bakıcıları (n:138) dahil edildi. Zarit Bakıcı Yükü Ölçeği (ZBYÖ) ve Klinik Global İzlenim-Hastalık Şiddeti (KGİÖ-Ş) ölçeği başlangıçta ve uzun etkili enjektabl antipsikotiklere geçişten 1 yıl sonra uygulandı. Bakım yükü ile ilişkili olabilecek diğer faktörler de ele alındı. Uzun etkili enjekte edilebilir antipsikotiklere geçildikten sonra ZBYÖ ve KGİÖ-Ş puanlarında anlamlı düşüşler bulund. Paliperidon ve aripiprazol kullanan gruplar karşılaştırıldığında; ZBYÖ puanlarındaki düşüş anlamlı değilken, KGİÖ-Ş puanlarındaki düşüş anlamlıydı. Bakım veren yükü, hastanın yaşı, KGİÖ-Ş puanı, aynı evde geçirilen süre, hastalık süresi ve hastaneye yatış sayısı ile pozitif korelasyon gösterdi. Bakım verenin yaşı, eğitim düzeyi ve geliri arasında anlamlı negatif ilişki bulundu. Sonuç olarak bu çalışmada bakım veren yükünün azaltılmasında değiştirilebilir bir faktör olan uzun etkili enjekte edilebilir antipsikotiklere geçilmesinin önemi vurgulanmıştır.