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Cognitive reserve and aging: impacts on theory of mind and executive functions
(Routledge, 2025-03) Şandor, Serra; Hıdıroğlu Ongun, Ceren; Yıldırım, Elif
Aim: This study examines the effects of cognitive reserve (CR) on Executive Functions (EF) and Theory of Mind (ToM). While CR is suggested to mitigate age-related cognitive decline, its relationship with social cognition remains limited and inconsistent in the literature. It was hypothesized that the effect of CR on ToM might be indirect, mediated by EF and working memory. Methods: 225 cognitively healthy participants were included. CR was measured with the Cognitive Reserve Index Questionnaire, EF with verbal fluency and the Stroop Test, and WM using digit span tasks. Structural Equation Modeling was used to analyze the relationships among CR, EF, WM, and SC, controlling for age and gender. Results: CR was significantly associated with both RMET and FPRT performances. Mediation analysis revealed the direct effects of CR on RMET performance, while the effects on FPRT performance were mediated by executive functions. WM had a partial mediating effect on EF and ToM, but did not directly influence FPRT. Education was most strongly associated with RMET performance, while leisure activities were linked to FPRT performance. Conclusion: These findings suggest that CR indirectly supports ToM by enhancing EF and highlight the importance of interventions aimed at strengthening executive control to support social cognition in aging.
Exploring the impact of Flash technique on test anxiety among adolescents
(SAGE Publications Ltd, 2025-07) Çitil Akyol, Canan; İnci İzmir, Sevim Berrin
This study aims to investigate the specific effects of Flash Technique (FT) on adolescents with test anxiety. This follow-up study consists of 38 adolescents, 14–17 years of age (M = 15.39, SD = 1.13). Pre-post assessments were conducted using the Test Anxiety Inventory (TAI), Scale of Attitudes Negatively Affecting the Performance I/Test (POET), and Beck Anxiety Inventory (BAI) at baseline, at the end of the 4thand 12thweeks of therapy. The FT was applied for 12 weeks, with one weekly session as an intervention. As a result of the therapy process, the baseline means of total BAI scores decreased from 25.26 to 2.18; the baseline means of TAI decreased from 149.79 to 39.13, and the baseline mean of POET decreased from 298.47 to 73.84 at the end of the 12th week of therapy. Also, the baseline means of SUD scores decreased from 9.42 to zero at the end of the 12th week of treatment. All the adolescents showed complete improvement after the 12th week of the FT. The study findings showed that the test anxiety symptoms significantly decreased with the treatment of the FT. FT can be an effective intervention for test anxiety in adolescents.
Treatment and long-term outcome of mental disorders: The grim picture from a quasi-epidemiological investigation in 54,826 subjects from 40 countries
(Elsevier Ireland Ltd, 2025-06) Fountoulakis, Konstantinos N.; Karakatsoulis, Gregory; Abraham, Seri; Adorjan, Kristina; Uddin Ahmed, Helal; Alarcòn, Renato Daniel; Arai, Kiyomi; Auwal, Sani Salihu; Berk, Michael; Levaj, Sarah; Yılmaz Kafalı, Helin
Introduction: This study registered rates of specific treatment options for mental disorders as well as their long-term outcome. Material and methods: The history of mental disorders was used as a proxy for diagnosis. The data came from the COMET-G study (40 countries; 54,826 subjects, 64.73 % females, 35.45±13.51 years old). The analysis included descriptive statistics, Risk Ratios, t-tests, and ANCOVA's. Results: 24.14 % reported a history of any mental disorder (depression >12 %, non-affective psychosis and Bipolar disorder 1 % each, >20 % self-injury, >10 % had attempted suicide, 7.17 % illegal substance abuse). Most patients were not under any kind of treatment (59.44 %) and most were not receiving treatment as recommended (e.g. 90 % of Bipolar and 2/3 of psychotic patients). No treatment at all and psychotherapy as monotherapy were consistently related to poorer outcomes. In anxiety or depression, only antidepressant monotherapy and benzodiazepines, in Bipolar disorder only antipsychotic monotherapy in males and antidepressant monotherapy in females and in non-affective psychosis antipsychotics and psychotherapy in females only, were related to good outcomes. No treatment modality was related to a good outcome in those with a history of self-harm, suicidal attempts, or illegal substance use. Only depression and treatment with antidepressants were related to metabolic syndrome. Discussion: In the community, the overwhelming majority of mental patients do not receive appropriate treatment or, even worse, no treatment at all. The outcome is unfavourable for the majority and only a few selective treatment options seem to make a difference.
Decision making, emotion recognition and childhood traumatic experiences in murder convicts ımprisoned with aggravated life sentence: a prison study
(Turkish Neuropsychiatric Society, 2025-03) Çıkrıkçılı, Uğur; Yıldırım, Elif; Buker, Seda; Ger, Can; Erözden, Ozan; Gürvit, Hakan; Saydam, Bilgin
Introduction: Decision-making and emotion recognition are two fundamental themes in social cognition. Disorders in these areas can lead to interpersonal, psychosocial, and legal problems for the individual and society. The likelihood of consequent aggression and crime makes them foci of forensic psychiatry over time. In this study, two developmental disorders that have a clear relationship with crime, that are antisocial personality disorder (ASPD), and psychopathy are investigated for their relationship with these social cognitive deficits.Methods: The present study involved 23 male prison inmates who were diagnosed with both antisocial personality disorder and psychopathy, as well as 23 control participants who were matched for age, gender, and level of education. Following the psychiatric interview, Reading the Mind in the Eyes Test (RMET), the Iowa Gambling Test (IGT), Toronto Alexithymia Scale (TAS), Defense Styles Questionnaire (DSQ), Childhood Psychic Trauma Scale (CTQ), Hare Psychopathy Checklist (PCL-R) were administered to all participants. Results: The results of the study showed that ASPD group performed statistically worse than healthy controls in TAS, CTQ, all items of DSQ, PCL-R Factor 1 and 2, and all the IGT scores (p<0.05). There were no statistically significant difference between in the RMET test performancesConclusion: These results suggest that ASPD and psychopathy lead to impaired decision-making behaviors due to the inability to recognize one’s own emotions and impulsivity, and that these characteristics play a critical role in the criminal behavior of individuals. In addition, contrary to expectations, the results of affective theory of mind assessed with the RMET showed similar characteristics in homicide convicts and healthy controls. These data indicate the need for further research in the field of forensic psychiatry.
Reliability of direct-to-home teleneuropsychological assessment: a within-subject design study
(Routledge, 2025-07-04) Yıldırım, Elif; Soncu Büyükişcan, Ezgi; Akça Kalem, Şükriye; Gürvit, Hakan
Objective: During the COVID-19 pandemic, the need to continue diagnosis and treatment processes, in addition to scientific research, led to a rapid shift towards direct-to-home tele-neuropsychology administrations, the reliability and validity of which had not been clearly established then. This study, therefore, aimed to examine the reliability of direct-to-home tele-neuropsychological assessment (TNP). Method: The sample included 105 cognitively healthy individuals aged between 50–83 years, and 47 patients diagnosed with neurocognitive disorders (mild cognitive impairment and early-stage Alzheimer’s type dementia). All participants underwent both face-to-face and teleneuropsychological assessments in a counterbalanced order. Results: The results revealed that performances across measures of attention, working memory, verbal fluency, verbal and visual memory, and visual perception were comparable across assessment modalities. Intraclass correlation coefficients of the tests ranged from.54 to.92. Conclusions: The findings of the study provide support for direct-to-home teleneuropsychological assessment among patients with neurocognitive disorders. Neuropsychological tests relying on verbal administration and independent of motor performance may represent a reliable alternative for this patient group when administered in settings where external distractions or technological limitations are controlled. For cognitively healthy individuals, on the other hand, the reliability of the TNP application is more questionable for memory and some executive function tests and therefore needs further exploration.
Do emotional demands and exhaustion affect work engagement? the mediating role of mindfulness
(Frontiers Media SA, 2024-1014) Karahan Kaplan, Merve; Bozkurt, Gözde; Aksu, Bumin Çağatay; Bozkurt, Serdar; Günsel, Ayşe; Gencer Çelik, Gülşah
Aim: The current paper seeks to elucidate the interrelationships among emotional demands (ED), emotional exhaustion (EE), mindfulness, and work engagement (WE), with an explanation of the mediating role of mindfulness within indicated relationships. Background: Nurses working in a stress-related environment face some emotional challenges. New methods such as mindfulness should be learned; therefore, positive outcomes occur along with new developments. Method: Responses were received from nurses through a self-report questionnaire using the convenience sample technique. Four hundred and twenty-nine nurses from health institutions in Istanbul participated in the study. The PLS-SEM technique was used to test the research model. Results: ED and mindfulness, EE and mindfulness, and mindfulness and WE relationships were found. While mindfulness was a mediator between EE and WE, it was not a mediator between ED and WE. Conclusion: It has been revealed that nurses cope with job-related challenges by being present at the moment with high awareness. Furthermore, mindful nurses also foster positive outcomes. Implications for nursing management: Precautions should be taken because of the nursing shortage. It is better to provide mindfulness training to nursing students in schools before their professional lives. Implementing and using technologies might be helpful for nurses.
Analyzing language ability in first-episode psychosis and their unaffected siblings: a diffusion tensor imaging tract-based spatial statistics analysis study
(Elsevier Ltd, 2024-11) Çabuk, Tuğçe; Şahin Çevik, Didenur; Çakmak, Işık Batuhan; Yılmaz Kafalı, Helin; Şenol, Bedirhan; Avcı, Hanife; Karlı Oğuz, Kader; Toulopoulou, Timothea
Schizophrenia (SZ) is a highly heritable mental disorder, and language dysfunctions play a crucial role in diagnosing it. Although language-related symptoms such as disorganized speech were predicted by the polygenic risk for SZ which emphasized the common genetic liability for the disease, few studies investigated possible white matter integrity abnormalities in the language-related tracts in those at familial high-risk for SZ. Also, their results are not consistent. In this current study, we examined possible aberrations in language-related white matter tracts in patients with first-episode psychosis (FEP, N = 20), their siblings (SIB, N = 20), and healthy controls (CON, N = 20) by applying whole-brain Tract-Based Spatial Statistics and region-of-interest analyses. We also assessed language ability by Thought and Language Index (TLI) using Thematic Apperception Test (TAT) pictures and verbal fluency to see whether the scores of these language tests would predict the differences in these tracts. We found significant alterations in language-related tracts such as inferior longitudinal fasciculus (ILF) and uncinate fasciculus (UF) among three groups and between SIB and CON. We also proved partly their relationship with the language test as indicated by the significant correlation detected between TLI Impoverished thought/language sub-scale and ILF. We could not find any difference between FEP and CON. These results showed that the abnormalities, especially in the ILF and UF, could be important pathophysiological vulnerability indexes of schizophrenia. Further studies are required to understand better the role of language as a possible endophenotype in schizophrenia with larger samples.
The comparison of psychological factors and executive functions of children with Attention Deficit Hyperactivity Disorder and Cognitive Disengagement Syndrome to ADHD and ADHD comorbid with Oppositional Defiant Disorder
(SAGE Publications Inc., 2024-10) İnci İzmir, Sevim Berrin; Aktan, Zekeriya Deniz; Ercan, Eyüp Sabri
Objective: The study aims to examine family functionality, emotion regulation difficulties, preference for loneliness, social exclusion, internalizing and externalizing disorders, and executive functions in children with Attention Deficit Hyperactivity Disorder (ADHD) and Cognitive Disengagement Syndrome (CDS) and compare with ADHD, and ADHD+ Oppositional Defiant Disorder (ODD). Method: This study included 842 children aged 8–12 years. The subjects were categorized according to DSM-V as ADHD (n = 246), ADHD + ODD (n = 212), ADHD + CDS (n = 176), and Control group (n = 207). The solitude and social exclusion, difficulties in emotion dysregulation and Barkley SCT scales, Child Behavior Checklist, family assessment device, and Central Vital Signs (CNSVS) test were used. Results: According to the study, children with ADHD + CDS had higher rates of internalizing disorders. They also preferred being alone and experienced more difficulty communicating with their parents and solving problems within the family. Additionally, these children had difficulty recognizing and understanding the emotional reactions of others. The ADHD + ODD group presented a poorer performance on CNSVS domain tests except for the psychomotor speed test than other groups. Also, ADHD + CDS children had the lowest psychomotor speed scores and lower scores on reaction time and cognitive flexibility than pure ADHD children. Conclusion: This study will contribute to the etiology, treatment, and clinical discrimination of ADHD + CDS.
Schwannoma of the lower limb: a case report
(Springer Nature, 2024-08-11) Kutalia, Nikolozi; Bolkvadze, Magda; Erdem, Mehmet Nuri
Schwannoma is a benign tumor of the peripheral nerve sheath and is a unique clinical entity when localized to a lower limb. Growing as a painless nodule, it might be misdiagnosed by many medical professionals as another benign soft tissue skin condition, such as lipoma, myxoma, or ganglion cyst. Definitive diagnosis of peripheral schwannoma is made by biopsy and histopathologic evaluation, followed by surgical excision, which is the definitive treatment of the tumor. Classic symptoms of schwannoma of the lower limb are peripheral neuropathy (tingling, burning sensations) and motor impairment (weakness, paralysis of the affected limb). MRI imaging and biopsy are the most useful diagnostic methods for peripheral schwannoma, followed by surgical excision, which is the treatment of choice. Postoperative complications, if present, are minimal and rare. Because of the slow-growing nature of the tumor and the complexity of the lower limb's nervous and structural network, it is often asymptomatic and is challenging to diagnose at a primary stage. That is why we want to spread awareness and draw the reader's attention to this rare case of a patient with schwannoma on the left lower limb.
Uzaktan nöropsikolojik değerlendirme: telenöropsikoloji
(BAYT Yayıncılık, 2024-05-25) Yıldırım, Elif; Soncu Büyükişcan, Ezgi; Akça Kalem, Şükriye; Gürvit, İ. Hakan
Amaç: Nöropsikolojik testlerin hastalara uzaktan, telefon ve videokonferans aracılığı ile yapılan uygulamalarını içeren telenöropsikoloji, uzakta yaşayan ya da hareket kısıtlılığı bulunan hastaların sağlık hizmetlerine ulaşım imkânını genişletebilmektedir. Covid-19 pandemisinin ortaya çıkması ile kognitif değerlendirmelerde telenöropsikoloji kullanımı önemli bir artış göstermiştir. Bu derlemede telenöropsikoloji ile ilgili yapılan çalışmaların sonuçlarının ve telenöropsikolojik değerlendirme ile ilgili temel esasların eleştirel bir şekilde gözden geçirilmesi amaçlanmıştır. Buna ek olarak, bu derlemede Türkiye uygulamaları için geliştirilmiş “ev temelli telenöropsikoloji uygulama rehberi” genel hatları ile paylaşılmıştır. Yöntem: Web of Science ve Pubmed veri tabanları kullanılarak konu ile ilgili erişilebilen tüm makale türlerini kapsayan bir şekilde literatür taraması yapılmıştır. Bulgular: Klinik temelli ve ev temelli telenöropsikolojik değerlendirme ile ilgili çalışmaların sonuçları dikkat, bellek, yürütücü işlevler ve dil gibi kognitif işlevleri değerlendiren ve özellikle sözel uygulamaya dayanan nöropsikolojik testlerin telenöropsikolojik değerlendirmede güvenilir bir şekilde uygulanabileceğini göstermektedir. Fakat telenöropsikolojik değerlendirmeye alınacak hastaların yönlendirilmesinde, değerlendirmede kullanılacak testlerin seçiminde ve etik konularda dikkat edilmesi gereken unsurlar bulunmaktadır. Buna ek olarak, telenöropsikolojik değerlendirmenin etkili bir şekilde yürütülmesi için görüşme öncesinde ve sırasında hem klinisyenin hem de hasta ve/veya hasta yakınının uygulanması önerilen adımların takip edilmesi önemlidir. Sonuç: Her ne kadar klinik nöropsikoloji pratiğinde hasta ile doğrudan temas kurmak önemli bir unsur olsa da gerekli durumlarda ve yetkin uzmanlar tarafından uygun uygulama prosedürleri takip edilerek yapılan telenöropsikolojik değerlendirmeler yüz yüze değerlendirmeler için iyi bir alternatif olabilir.
Assessing the mediating relationships between psychological factors in children with attention deficit hyperactivity disorder and cognitive disengagement syndrome
(Routledge Journals, Taylor & Francis Ltd, 2024-04) İnci İzmir, Sevim Berrin; Aktan, Zekeriya Deniz; Ercan, Eyüp Sabri
This study aims to investigate the predictive and mediating relationships between emotion dysregulation, internalizing disorders, family functionality, loneliness preference, and executive functions (EF) in children with attention deficit hyperactivity disorder and cognitive disengagement syndrome (ADHD + CDS). This study included 176 children and adolescents (92 boys, 84 girls) who were diagnosed with ADHD + CDS according to the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition criteria by a fellowship-trained child and adolescent psychiatrist, between ages 8 -12 (M = 10, SD = 1.52) with a convenience sampling method. The solitude scale for children, difficulties in emotion dysregulation scale, Child Behavior Checklist, Barkley Sluggish Cognitive Tempo Scale, Family assessment device, and CNS Vital Signs test were used. The results showed that difficulty in emotion regulation, preference for loneliness, internalizing disorders and CDS symptom severity did not have a mediating effect between family functionality and EF. Still, emotion dysregulation mediates the relationship between EF and internalizing disorders by itself and through loneliness preference. Also, preference for loneliness and emotion dysregulation had a mediating effect between family functionality and internalizing disorders. Finally, it was found that the effect of emotion regulation difficulty, loneliness preference, and internalizing disorders had a mediating role between CDS symptom severity and family functionality. In conclusion, the information obtained from this study on the etiology of CDS may guide future studies.
EMDR Flash technique in adolescents with depression: a twelve-week follow-up study
(Sage Publications Inc, 2024-07) İnci İzmir, Sevim Berrin; Çitil Akyol, Canan
This study aims to investigate the specific effects of the EMDR Flash Technique on adolescents with depression. This follow-up study consists of 32 adolescents, 12-17 years of age (M = 14.34, SD = 1.56), including 7 males and 25 females. They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present, the Beck Depression Inventory (BDI), and Children Revised Impact of Event Scale-8 (Cries-8). These were administered at baseline, at the end of the 4th and 12th weeks of treatment. The EMDR Flash Technique which can be utilized in the preparation phase of Eye Movement Desensitization and Reprocessing (EMDR) to reduce the intensity of highly distressing memories rapidly and relatively painlessly was applied for 12 weeks, one session per week as a free-standing intervention. Also, the EMDR Flash Technique can be effective in decreasing the rate of noncompliance and drop-outs of adolescents. The baseline means of total BDI scores decreased from 48.19 to 2.16 at the end of the 12th week of treatment. Also, the CRIES scores decreased from 31.78 to 0.44 at the end of the 12th week of treatment. In addition, the baseline means of SUD scores decreased from 9.53 to zero at the end of the 12th week of treatment. Overall, our results underscore the effectiveness of the EMDR-Flash Technique in adolescents with depression. Depression is a significant mental health concern for adolescents due to its early onset and chronic nature. Depression can be observed in conjunction with PTSD, and sometimes, depressive symptoms may transform into traumatic experiences. EMDR is an 8-stage protocol that includes history taking, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation, used to alleviate the effects of traumatic experiences. It is hypothesized that unpleasant and traumatic events are stored in a dysfunctional way, and it promotes an adaptive processing and resolution of the traumatic experience. The goal of EMDR is to achieve an adequate processing of negative experiences and to create new adaptive information. The EMDR Flash Technique (FT) is utilized in the preparation phase of EMDR to reduce the intensity of highly distressing memories rapidly and relatively painlessly. Although a few studies have shown that the FT is effective in adults, there is only one study to investigate the effectiveness of the FT in children and adolescents. This research, in determining the efficacy of the EMDR FT on adolescents with depression, particularly focused on depression symptoms and assessed the observed changes in these symptoms. It aims to evaluate the specific effects of EMDR-FT on adolescents with depression, providing a unique perspective compared to previous research that has mainly focused on broader mental health disorder indicators. It is hypothesized that EMDR-FT is an effective therapy for treating adolescents with Depression. In the present study, adolescents with depression showed significant improvements in symptom severity and their traumatic events impact levels decreased. As a result of our study, a 12-week EMDR-FT treatment was observed to be effective for adolescents with depression and in reducing and improving traumatic stress levels and depression. Our results underscore the effectiveness of the EMDR-FT in adolescents with depression.
Impact of climate change and land cover dynamics on nitrate transport to surface waters
(Springer Science and Business Media Deutschland GmbH, 2024-03) Boyacıoğlu, Hülya; Günaçtı, Mert Can; Barbaros, Filiz; Gül, Ali; Gül, Gülay Onuşluel; Öztürk, Tuğba; Kurnaz, M. Levent
The study investigated the impact of climate and land cover change on water quality. The novel contribution of the study was to investigate the individual and combined impacts of climate and land cover change on water quality with high spatial and temporal resolution in a basin in Turkey. The global circulation model MPI-ESM-MR was dynamically downscaled to 10-km resolution under the RCP8.5 emission scenario. The Soil and Water Assessment Tool (SWAT) was used to model stream flow and nitrate loads. The land cover model outputs that were produced by the Land Change Modeler (LCM) were used for these simulation studies. Results revealed that decreasing precipitation intensity driven by climate change could significantly reduce nitrate transport to surface waters. In the 2075–2100 period, nitrate-nitrogen (NO3-N) loads transported to surface water decreased by more than 75%. Furthermore, the transition predominantly from forestry to pastoral farming systems increased loads by about 6%. The study results indicated that fine-resolution land use and climate data lead to better model performance. Environmental managers can also benefit greatly from the LCM-based forecast of land use changes and the SWAT model’s attribution of changes in water quality to land use changes. Graphical abstract: (Figure presented.).
A review of recent innovations in remote health monitoring
(Multidisciplinary Digital Publishing Institute (MDPI), 2023-12) Dalloul, Ahmed Hany; Miramirkhani, Farshad; Kouhalvandi, Lida
The development of remote health monitoring systems has focused on enhancing healthcare services’ efficiency and quality, particularly in chronic disease management and elderly care. These systems employ a range of sensors and wearable devices to track patients’ health status and offer real-time feedback to healthcare providers. This facilitates prompt interventions and reduces hospitalization rates. The aim of this study is to explore the latest developments in the realm of remote health monitoring systems. In this paper, we explore a wide range of domains, spanning antenna designs, small implantable antennas, on-body wearable solutions, and adaptable detection and imaging systems. Our research also delves into the methodological approaches used in monitoring systems, including the analysis of channel characteristics, advancements in wireless capsule endoscopy, and insightful investigations into sensing and imaging techniques. These advancements hold the potential to improve the accuracy and efficiency of monitoring, ultimately contributing to enhanced health outcomes for patients.
The relationships of neuropsychological factors and loneliness preference in children with attention deficit hyperactivity disorder and cognitive disengagement syndrome
(Routledge Journals, Taylor & Francis Ltd, 2025-04-03) İzmir, Sevim Berrin İnci; Aktan, Zekeriya Deniz; Ercan, Eyüp Sabri
This study aimed to examine emotion dysregulation and internalizing disorders mediating the relationship between selective and sustained attention and loneliness preference in children diagnosed with attention deficit hyperactivity disorder (ADHD) and Cognitive Disengagement Syndrome (CDS). This study included 176 children and adolescents between ages 8 and 12. The solitude scale for children, Difficulties in Emotion Regulation Scale, Child Behavior Checklist, Barkley Sluggish Cognitive Tempo Scale, and CNS Vital Signs test were used. The results suggest that difficulties in emotion regulation and having an internalizing disorder had a mediating effect between difficulties in selective attention and preference for the loneliness of children with ADHD + CDS. Also, it was likely that the association between sustained attention and preference for loneliness is mediated by internalizing disorders. The results suggest that the social problems commonly exhibited by children with ADHD + CDS may be related to deficits in sustained and selective attention.
Attitudes of psychiatrists towards people with mental illness: a cross-sectional, multicentre study of stigma in 32 European countries
(Elsevier Ltd, 2023-12) Őri, Dorottya; Szocsics, Péter; Molnár, Tamás; Bankovska Motlova, Lucie; Kazakova, Olga; Mörkl, Sabrina; Wallies, Michael; Abdulhakim, Mohamed; Boivin, Sylvie; Bruna, Krista; Cabaços, Carolina; Carbone, Elvira Anna; Dashi, Elona; Grech, Giovanni; Greguras, Stjepan; Ivanovic, Iva; Guevara, Kaloyan; Kakar, Selay; Kotsis, Konstantinos; Ingeholm Klinkby, Ida Maria; Maslak, Jovana; Matheiken, Shevonne; Mirkovic, Ana; Nechepurenko, Nikita; Panayi, Angelis; Pereira, Ana Telma Fernandes; Pomarol-Clotet, Edith; Raaj, Shaeraine; Prelog, Polona Rus; Soler-Vidal, Joan; Strumila, Robertas; Schuster, Florian; Kisand, Helena; Reim, Ann; Ahmadova, Gumru; Vircik, Matus; Yılmaz Kafalı, Helin; Grinko, Natalia; Győrffy, Zsuzsa; Rózsa,Sándor
Background Mental health-related stigma occurs among the public and professionals alike. The lived experience of mental illness has been linked to less stigmatising attitudes. However, data on psychiatrists and the relationship between stigmatising attitudes and psychotherapeutic activity or case discussion groups remains scarce.Methods A cross-sectional multicentre study was performed in 32 European countries to investigate the lived experiences and attitudes of psychiatrists toward patients with mental illness as well as the relationship between stigma, psychosocial and professional factors. The self-reported, anonymous, internet-based Opening Minds Stigma Scale for Health Care Providers was used to measure the stigmatising attitudes. The survey was translated into the local language of each participating country. All participants were practising specialists and trainees in general adult or child and adolescent psychiatry. The study took place between 2nd October, 2019 and 9th July, 2021 and was preregistered at ClinicalTrial.gov (NCT04644978).Findings A total of 4245 psychiatrists completed the survey. The majority, 2797 (66%), had completed training in psychiatry, and 3320 (78%) worked in adult psychiatry. The final regression model showed that across European countries more favourable attitudes toward people with mental illness were statistically significantly associated with the lived experience of participants (including seeking help for their own mental health conditions (d = -0.92, 95% confidence interval (CI) = -1.68 to -0.15, p = 0.019), receiving medical treatment for a mental illness (d = -0.88, 95% CI = -1.71 to -0.04, p = 0.040), as well as having a friend or a family member similarly affected (d = -0.68, 95% CI = -1.14 to -0.22, p = 0.004)), being surrounded by colleagues who are less stigmatising (d = -0.98, 95% CI = -1.26 to -0.70, p < 0.001), providing psychotherapy to patients (d = -1.14, 95% CI = -1.63 to -0.65 p < 0.001), and being open to (d = -1.69, 95% CI = -2.53 to -0.85, p < 0.001) and actively participating in (d = -0.94, 95% CI = -1.45 to -0.42, p < 0.001) case discussion, supervision, or Balint groups.Interpretation Our study highlights the importance of psychotherapy training, supervision, case discussions and Balint groups in reducing the stigmatising attitudes of psychiatrists toward patients. As the findings represent cross -national predictors, Europe-wide policy interventions, national psychiatric education systems and the management of psychiatric institutions should take these findings into consideration.Funding National Youth Talent Award (Ministry of Human Resources, Hungary, (NTP-NFTo-20-B-0134). All authors received no funding for their contribution.
Evaluation of post-swallow residue with visual analysis of swallowing efficiency and safety in patients with idiopathic Parkinson's disease
(Sage Publications Inc, 2023-12) Doruk, Can; Çaytemel, Berkay; Şahin, Erdi; Kara, Hakan; Samancı, Bedia; Abay, Sevinç Nisa; Bilgiç, Başar; Hanağası, Haşmet; Başaran, Bora; Enver, Necati; Rameau, Anais
Objectives: Dysphagia is common in idiopathic Parkinson's disease (IPD) and is associated with impairments in both swallowing safety and swallowing efficiency. The goals of this study were to define post-swallow residue patterns in people with IPD and describe pathophysiological endoscopic findings affecting residue accumulation. Methods: This was a prospective single-blinded cross-sectional cohort study of patients with the diagnosis of IPD recruited from a Movement Disorder Clinic. Clinical variables included patient age, cognitive function, and measures of disease severity, and laryngoscopic examinations with a flexible endoscopic evaluation of swallowing (FEES) were completed for each patient. Visual Analysis of Swallowing Efficiency and Safety (VASES) was used to analyze FEES. Post-swallow residue outcomes and non-residue endoscopic outcomes including the Bowing index, Penetration Aspiration Scale (PAS) score, premature leakage, and build-up phenomenon were evaluated. Multiple regression models were used to evaluate factors affecting the residue at different anatomic levels. Results: Overall 53 patients completed the study. The multiple regression analyses showed a relation between (1) the presence of residue at the level of oropharynx and epiglottis with premature leakage, (2) the presence of residue at the level of the laryngeal vestibule and vocal folds with build-up phenomenon, and (3) the presence of residue at the level of the hypopharynx, laryngeal vestibule, and subglottis with airway invasion. Conclusion: Residue pattern during FEES is associated with specific swallow dysfunctions in IPD. Using residue localization and quantification may be a helpful tool in assessing the impact of targeted swallowing interventions in patients with IPD and dysphagia.
The effect of SARS-CoV-2 virus on resting-state functional connectivity during adolescence: Investigating brain correlates of psychotic-like experiences and SARS-CoV-2 related inflammation response
(Elsevier Ireland Ltd, 2023-12) Yılmaz Kafalı, Helin; Daşgın, Hacer; Şahin Çevik, Didenur; Sozan, Sara Sinem; Oğuz, Kader K.; Mutlu, Müge; Özkaya Parlakay, Aslınur; Toulopoulou, Timothea
We first aimed to investigate resting-state functional connectivity (rs-FC) differences between adolescents exposed to SARS-CoV-2 and healthy controls. Secondly, the moderator effect of PLEs on group differences in rs-FC was examined. Thirdly, brain correlates of inflammation response during acute SARS-CoV-2 infection were investigated. Eighty-two participants aged between 14 and 24 years (SARS-CoV-2 (n = 35), controls (n = 47)) were examined using rs-fMRI. Seed-based rs-FC analysis was performed. The positive subscale of Community Assessment of Psychotic Experiences-42 (CAPE-Pos) was used to measure PLEs. The SARS-CoV-2 group had a lesser rs-FC within sensorimotor network (SMN), central executive network (CEN) and language network (LN), but an increased rs-FC within visual network (VN) compared to controls. No significant differences were detected between the groups regarding CAPE-Pos-score. However, including CAPE-Pos as a covariate, we found increased rs-FC within CEN and SN in SARS-CoV-2 compared to controls. Among the SARS-CoV-2 group, neutrophil/lymphocyte and thrombocyte*neutrophil/lymphocyte ratio was correlated with decreased/increased FC within DMN and SN, and increased FC within CEN. Our results showed rs-FC alterations within the SMN, CEN, LN, and VN among adolescents exposed to SARS-CoV-2. Moreover, changes in rs-FC associated with PLEs existed in these adolescents despite the absence of clinical changes. Furthermore, inflammation response was correlated with alterations in FC within the triple network system.
Powering quantum Otto engines only with q -deformation of the working substance
(American Physical Society, 2023-11) Özaydın, Fatih; Müstecaplıoğlu, Özgür E.; Hakioğlu, Tuğrul
We consider a quantum Otto cycle with a q-deformed quantum oscillator working substance and classical thermal baths. We investigate the influence of the quantum statistical deformation parameter q on the work and efficiency of the cycle. In usual quantum Otto cycle, a Hamiltonian parameter is varied during the quantum adiabatic stages while the quantum statistical character of the working substance remains fixed. We point out that even if the Hamiltonian parameters are not changing, work can be harvested by quantum statistical changes of the working substance. Work extraction from thermal resources using quantum statistical mutations of the working substance makes a quantum Otto cycle without any classical analog.
The effect of psychotic proneness and psychopathy on theory of mind
(Wiley, 2024-02) Atakan, Begüm; Yıldırım, Elif
This study aimed to investigate the interaction between positive psychotic experiences and psychopathic traits on the theory of mind in a non-clinical sample. The results showed that distinct constructs of psychopathy can lead to distinct theory of mind profiles when interacting with psychotic proneness.

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