The effects of antipsychotics on negative symptoms are limited. The most appropriate approach in the treatment of schizophrenia is the integration of drug therapy with psychological and social interventions. The purpose of this study was to evaluate and compare the effects of art therapy and psychosocial skills training (PSST) in the treatment of schizophrenia. A total of 15 patients diagnosed with schizophrenia according to the criteria in DSM-5 and 12 patient relatives were included in the study. The patients were randomly divided into 2 groups, 7 were included in the art therapy program and 8 were included in the PSST program for schizophrenia. 90-minute sessions of art therapy and PSST were carried out once a week for 17 weeks. Participants with schizophrenia were evaluated with the Positive and Negative Syndrome Scale (PANSS), Social Functioning Scale (SFS) and the Calgary Depression Scale for Schizophrenia and the relatives were given Beck Depression Inventory, Beck Anxiety Inventory and Zarit Burden Interview. There was a significant decrease in the PANSS negative symptoms, PANSS general psychopathology, SFS pro-social activities and SFS recreation scores in both groups, while the SFS social withdrawal scores decreased significantly only in the art therapy group. In the PANSS negative symptoms subscale, passive social withdrawal, difficulty in abstract thinking, lack of spontaneity and flow of conversation and stereotyped thinking scores were significantly lower in the art therapy group. In the PSST group only the score for difficulty in abstract thinking declined significantly. The findings of the present study suggest that art therapy and PSST have positive effects on the improvement of negative symptoms as well as improvements in social and cognitive functionality in schizophrenia.

Objective: This study investigates differences in personality characteristics, including perfectionism, ruminative thinking style, and self-compassion, between individuals who have undergone rhinoplasty and a control group without any history of cosmetic surgery. Methods: The study included 33 adult patients who underwent rhinoplasty between 2021 and 2023 at Bursa Uludağ University Faculty of Medicine Hospital and 33 adult patients who visited our centre for other complaints as a control group. The rhinoplasty group consisted of primary surgical patients with functional and cosmetic concerns, excluding those who sought revision surgery or had only functional problems. The control group consisted of individuals with no prior cosmetic surgery history and no expectations of aesthetic interventions. Psychiatric analysis was performed using Frost multidimensional perfectionism scale, ruminative thinking style questionnaire, and self-compassion scale. Results: This research revealed that individuals who had rhinoplasty scored higher in perfectionism 109.3 (±23.3) and ruminative thinking 87.9 (±22) compared to those who did not undergo surgery 94.15 (±22.2) and 77.7 (±23), respectively. Additionally, the rhinoplasty group had lower self-compassion scores, 80.4 (±17.3), than the control group, 86.1 (±11.2). Statistically significant differences were observed in perfectionism between the groups (p = 0.009). In rhinoplasty patients, a notably positive correlation was found between perfectionism and ruminative thinking scores (r = 0.482; p = 0.005), while a moderately significant negative correlation was observed between self-compassion and ruminative thinking scores (r = − 0.465; p = 0.006). Conclusion: Individuals who undergo rhinoplasty generally show increased levels of perfectionism and are more prone to ruminative thinking. They also demonstrate reduced self-compassion compared to non-surgical control groups. Cosmetic surgeons should be aware of these psychological trends and consider using appropriate scales during pre-surgery consultations and follow-up visits. Adopting this informed approach can improve the surgeon–patient relationship and help overcome communication challenges. Level of Evidence III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Primary immunodeficiencies (PIDs) are a group of diseases that develop as a result of primary or congenital malfunction of the immune system and progress with chronic and/or recurrent bacterial, fungal, protozoal and/or viral infections. In this study, we aimed to examine the effects of the COVID-19 pandemic on depression, anxiety levels and psychological resilience in patients with PID and to compare them with those in controls. Seventy patients, aged 18–65 years, who were being followed up with a diagnosis of PID and 69 people as healthy control group, participated in our study. The participants were evaluated cross-sectionally once; sociodemographic data form, Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Resilience Scale for Adults (RSA), and COVID-19 Evaluation form were administered to the participants. HAM-A and HAM-D scores were significantly higher in PID patients compared to controls (HAM-D: 5.5 vs. 3.0, p < 0.001; HAM-A: 6.0 vs. 4.0, p = 0.008). RSA was significantly lower in the patient group (RSA total: 122.5 vs. 136.0, p < 0.001), and pandemic-related risk perception was higher (PRPS: 33.9 vs. 28.3, p < 0.001). Sleep, appetite, and attention-related disturbances were also more common in the patient group. Multivariate regression analyses revealed that PID diagnosis was an independent predictor of increased depression severity (HAM-D), lower psychological resilience (RSA), and greater pandemic-related risk perception. Female sex was independently associated with higher anxiety severity (HAM-A). A personal psychiatric history and greater number of comorbidities were also significant predictors of psychological vulnerability, particularly in relation to depression and anxiety. Given the observed associations between PID and increased levels of depression, anxiety, and reduced psychological resilience during the pandemic, clinicians may consider heightened vigilance for psychological symptoms in this population during times of public health crisis.

This study aims to assess the severity of depressive and anxiety symptoms among medical residents in a university hospital and identify the factors associated with these symptoms. We expected depression and anxiety symptoms to be associated with working conditions, workplace relationships, and social functioning. This cross-sectional study included 283 medical residents at a university hospital who participated on a voluntary basis. Data were collected using the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and a structured sociodemographic data form designed by the researchers. Significantly higher BDI and BAI scores were associated with female gender (p<0.001) and current use of psychiatric medication (p=0.029 and p=0.027, respectively). Key stressors identified included seeing more than 30 patients per day, finding the number of shifts excessive, and perceived inability to participate in social activities. Furthermore, negative workplace experiences -including exposure to threats, lack of peer support, poor relationships with superiors, and feeling unappreciated- were strongly correlated with increased psychological distress. Other contributing factors were overall workplace dissatisfaction, the desire to specialize in a different field, inadequate physical conditions, and a bleak professional outlook for one’s branch. Suicidal ideation during residency was specifically linked to higher depressive symptom severity (p<0.001). Lower professional experience and lower period of residency showed a significant negative correlation with anxiety scores (r=-0.177, p=0.003 and r=-0.146, p=0.014, respectively). In the adjusted regression models, female gender, fewer years of professional experience, current psychiatric medication use, and limited participation in social activities remained independently associated with higher BDI and BAI scores. These results suggest that severity of depressive and anxiety symptoms among resident physicians are closely related to modifiable occupational and environmental factors. Targeted interventions to improve these conditions are essential to support the mental well-being of physicians in training.

Valproik asit ensefalopatisi, ensefalopati etiyolojisinde nadir bir tablo olup VA tedavisi sırasında gelişen bilinç değişikliği, kognitif yavaşlama, fokal nörolojik defisitler ve epileptik hastada paradoksal nöbet artışı ile karakterizedir. Hiperamonyemik(en sık), non-hiperamonyemik ve hepatotoksisite ilişkili olabilir. Serum valproat düzeyleri yüksek veya terapötik aralıkta olabilir. EEG’de zemin aktivitesinde diffüz yavaşlama ve trifazik dalgalar yardımcıdır. Vakamızda, valproat kullanan ve belirgin metabolik veya hepatik predispozan faktörleri olmaksızın nöbet artışı ve ensefalopati geliştiren bir şizofreni hastası yer almaktadır. Serum valproik asit düzeyleri terapötik aralıkta olmasına rağmen, EEG'de zemin aktivitesinde diffüz yavaşlama ile birlikte ağır ensefalopati saptanmış ve yüksek serum amonyak düzeyleri ile tanıya gidilmiştir. Semptomlar valproat kesilmesi ve L-karnitin tedavisi düzelmiştir. Psikiatrik hasta grubunda bulguların ensefalopati ile ayırt edilmesi gerekliliği ve erken tanı tedavi ile geri dönüşümlü olması kritiktir.