Erhan Yuksek

Facial emotion recognition in male antisocial personality disorders with or without adult attention deficit hyperactivity disorder

OBJECTIVE We aimed to investigate facial emotion recognition abilities in violent individuals with antisocial personality disorder who have comorbid attention deficient hyperactivity disorder (ADHD) or not. METHOD The photos of happy, surprised, fearful, sad, angry, disgust, and neutral facial expressions and Wender Utah Rating Scale have been performed in all groups. RESULTS The mean ages were as follows: in antisocial personality disorder with ADHD 22.0 ± 1.59, in pure antisocial individuals 21.90 ± 1.80 and in controls 22.97 ± 2.85 (p>0.05). The mean score in Wender Utah Rating Scale was significantly different between groups (p<0.001). The mean accurate responses to each facial emotion between groups were insignificant (p>0.05) excluding disgust faces which was significantly impaired in ASPD+ADHD and pure ASPD groups. Antisocial individuals with attention deficient and hyperactivity had spent significantly more time to each facial emotion than healthy controls (p<0.05) while pure antisocial individual had more time to recognize disgust and neutral faces than healthy controls (p<0.05). CONCLUSION Study of complex social cognitive abilities in adults with ADHD and violent behaviors is lacking. This study is the first, investigating the differences according to social cognition cues in violent individual that revealed no significance within pure antisocial individuals and antisocial individuals with ADHD.

Differential effects of clozapine and risperidone on facial emotion recognition ability in patients with treatment-resistant schizophrenia

ABSTRACT Objective: Clozapine and risperidone are used for treatment-resistant schizophrenia and known to improve the positive and negative symptoms. However, there are some conflicts about effects on social cognition, which is measured with facial emotion recognition ability. The impairments in facial emotion recognition ability have frequently been in different stages of the illness and might have negative influences on psychosocial functioning. In the present study, we aimed to examine clozapine and risperidone effects recognizing facial emotions in patient with treatment-resistant schizophrenia. Methods: Thirty-four patients were screened for the study, and 19 patients were included. All patients were evaluated with Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia, and Functional Remission of General Schizophrenia Scale at baseline and after 16–20 weeks of clozapine (n = 12) or risperidone (n = 7) treatment. Furthermore, the Facial Emotion Recognition Test was performed before and after treatment. The test included the photos of four male and four female models (totally 56 mixed photos) with happy, surprised, fearful, sad, angry, disgusted, and neutral facial expressions from Ekman and Friesen’s catalog. Results: The mean dose of the index drug in clozapine group was 295.83 ± 103.26 mg/day. The mean positive (p = .002), negative (p = .050) general psychopathology (p = .002), and total score (p = .002) according to the PANSS were significantly improved after treatment. The mean dose of the index drug in risperidone group was 6.86 ± 1.57 mg/day. The mean positive symptom (p = .018) and total score (p = .041) were significantly improved after treatment but negative symptom scale (p = .396) and general psychopathology (p = .149) scores did not change. There were no significant differences between baseline and after treatment in clozapine and risperidone group according to the accuracy rate of facial emotion recognition expressions (p > .05 for each). At baseline phase, the patients were significantly impaired in recognizing disgusted faces in risperidone than those in clozapine group (p = .032) and it was significantly poorer after treatment with risperidone than with clozapine (p = .031). The patients responded significantly faster after the treatment to all facial emotions except for fearful faces (p = .355). Conclusions: Clozapine and risperidone were not found to have extensive effects on the ability to recognize facial emotions because of ineffectiveness to negative symptoms as in our study. We speculated that the higher dopaminergic receptor occupancy rate of risperidone in insular cortex than that of clozapine might be related with hypo-activation of insula that was associated with particular deficit in ability to recognize expressions of disgust in patients with schizophrenia. Impaired facial emotion recognition ability is present even in first-episode psychosis, which might be a trait marker in schizophrenia.

EPA-0487 - The relationship between internalized stigma and psychopathology in sexually abused individuals

Objective The internalized stigma is a concept that is discussed mostly in severe mental illnesses and especially in schizophrenia. However, this concept is not studied in sexually traumatized people, yet. In this study, we aimed to investigate the internalized stigma and related features in sexually abused individuals. Methods The participants who were the victim of sexual abuse and sent by courts to be examined for mental state were planned to be included in the study and after giving informed consent, 44 females were included. Participants were asked to complete the scales of Internalized Stigma Questionnaire for Mental Disorders, Beck Depression and Hopelessness Scales. Results No significant differences were found between participants who had been diagnosed a psychiatric disorder or not after victimization according to total score of internalized stigma scale and subscale scores (p>0.05). There were significant correlations between mean Beck depression and hopelessness scale scores and internalized stigma scale mean total score and subscale scores (alienation, stereotype endorsement, discrimination experience, social withdrawal, and resistance to stigma). Conclusion Self-stigmatized behaviors are seen in all participants who have been sexually abused and there was no difference according to such behaviors between participants whom had been diagnosed as mentally ill or not after victimization. However, an existing self-stigmatization is increasing in the existence of psychopathology. The responsibility of the professionals in mental health should develop new therapeutic or rehabilitative approaches to all sexually abused victims whether they meet psychiatric diagnostic criteria or not.

EPA-0486 - Facial emotion recognition ability after brain radiotherapy

Aims Brain radiation therapy (BRT) is a mainstay of treatment for tumors in brain. The most determined adverse effects in patients after BRT are as follows: problems in new memory consolidation, attention, visuospatial and executive functions domains. Although studies about cognitive side effects are increasing in BRT literature, knowledge about social cognition is lacking. We aimed to investigate the alteration in facial emotion recognition ability in patients after BRT. Methods Thirteen patients with various brain tumors even primary or metastatic were enrolled in the study. All participants were asked to complete a manual based Facial Emotion Recognition Test. Bilateral hippocampi were delineated by use of contouring protocol of hippocampal avoidance during whole-brain radiotherapy for brain metastasis (Radiation Therapy Oncology Group) Results No differences between initial and post radiotherapy among identifiying facial emotions of happiness (p=0.480), anger (p=0.336), disgust (p=0.157), neutral (p=0.276) while there was trends in identifying sad (p=0.054) and surprised (p=0.058) faces. Trends of improvement in sad facial emotion and impairment in surprised facial emotions have been detected. Identifying ability of fearful emotions was significantly better after radiotherapy (p=0.039). There was a positive correlation between frontal dose and impairment in identifying surprised face (p=0.050 and r=0.553) was detected. Conclusion Facial emotion recognition is an important cognitive skill for social adjustment, proper relationship, working and living independently and brain radiotherapy seems to have mixed effects on this ability. Amygdala has important role in recognizing fear and sad emotions and those emotions were found to be improved after brain radiotherapy.