Feryal Cam Celikel

Comorbidity of Adult Attention Deficit and Hyperactivity Disorder in Bipolar and Unipolar Patients

INTRODUCTION The co-occurrence of attention deficit hyperactivity disorder (ADHD) in affective disorder patients is considerably high. The aims of the present study were to search for the frequency and impact of ADHD co-occurrence on the clinical features of affective disorders and to examine the relationship between the dominant affective temperaments and ADHD. METHODS In total, 100 patients with bipolar disorder (BD), 100 patients with major depressive disorder (MDD), and 100 healthy controls (HC) were included. All diagnoses were assigned according to DSM-IV-TR criteria. The Adult Attention Deficit and Hyperactivity Self-Report Scale (ASRS); Wender Utah Rating Scale (WURS); and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) were applied to all participants. RESULTS The percentage of BD patients meeting the criteria for a diagnosis of current ADHD was 48% compared with the percentage of MDD patients and HCC subjects, i.e., 25% and 12%, respectively. ADHD was significantly more frequent in bipolar adults than in not only HC but also depressive patients. In the BD group, patients with a comorbid ADHD diagnosis had significantly more suicidal history than those without ADHD. The scores of the temperament traits, namely depressive, cyclothymic, irritable, and anxious, were significantly higher in subjects with ADHD in all groups, including in HC. CONCLUSION The most important findings of the present study were the observations that (1) the frequency of ADHD is considerably high among bipolar patients; (2) the frequency of suicide attempts is high in the bipolar patient group with comorbid ADHD; and (3) depressive, cyclothymic, irritable, and anxious temperaments are significantly associated with ADHD comorbidity in bipolar and depressive patients as well as in HC. The high comorbidity and chronic course of ADHD and its possible negative influence on the course of both disorders increase the importance of screening for adult ADHD.

Reliability, validity, and factorial structure of the Turkish version of the Empathy Quotient (Turkish EQ)

ABSTRACT OBJECTIVES Empathy is an essential ability that allows us to tune into how others are feeling or thinking. Empathy makes it possible to resonate with others’ positive and negative feelings alike so that we can thus feel happy when we vicariously share the joy of others and we can share the experience of suffering when we empathize with someone in pain. Empathy training not only promotes prosocial behaviour, but also augments positive affect and resilience, which in turn fosters better coping with stressful situations. The Empathy Quotient (EQ) is a self-report questionnaire that was developed to measure the cognitive, affective, and behavioural aspects of empathy. Here, we aimed to examine the validity, reliability, and factor structure of the EQ in a Turkish sample. METHODS Participants were 436 mostly college students and civil servants (195 female, 241 male). Sociodemographic information, the Turkish version of the EQ, Marlowe-Crowne Social Desirability Scale (MC-SDS) 33-item full version and MC-SDS 13-item shorter versions were administered. All statistical analyses were performed by using SPSS version 23 for Windows. RESULTS EQ scores were significantly higher in female participants ( Female = 46.45, SDFemale = 0.62) compared to the male participants ( Male = 43.68, SD Male = 0.56). The Cronbach’s alpha coefficient for the scale was 0.76, Guttman’s split-half reliability coefficient was 0.61, and test–retest reliability coefficient was 0.95. A positive and statistically significant correlation was found between the Turkish EQ and MC-SDS Full version (r = 0.299, p < .01) and short form of MC-SDS (r = 0.273, p < .01). A three-factor solution that accounted for 25.28% of the variance observed. CONCLUSIONS The Turkish version of the EQ has satisfactory validity, good internal and test–retest reliability with a robust factorial structure to use in a clinical population in Turkey. Moreover, as predicted, women scores were statistically significantly higher on the EQ than men. This result was consistent with a series of earlier studies reporting gender differences (female superiority) on questionnaires that measure empathy. A better knowledge of empathy will have important implications for the examination and understanding of certain neurological and psychiatric disorders, including autism, narcissistic and antisocial personality disorders, and may also provide important clues about the relevant brain circuitry underlying empathy.

Normative data and factorial structure of the Turkish version of the Junior Temperament and Character Inventory-Revised

ABSTRACT Objective: Junior Temperament and Character Inventory (J-TCI) was developed by Luby, Svrakic, McCallum, Przybeck, and Cloninger based on Cloninger’s biopsychosocial model to assess temperament and character dimensions in children and adolescents. Methods: The Turkish version of J-TCI-Revised (J-TCI-R) was administered to 1129 elementary and middle-school (male/female, 546/583) students. Internal consistency reliabilities were measured by Cronbach’s alpha; test–retest was assessed across one month. Results: Cronbach’s alphas for the subscales of J-TCI-R ranged from 0.60 to 0.75 for temperament and character subscales, which were comparable to US and other populations. The correlations between baseline and one month after administration of J-TCI-R were highly and statistically significant (r = 0.578–0.674 for scales and 0.366–0.582 for subscales) (n = 795). Factor analysis results using Eigenvalue greater than one rule indicated three out of four factors for temperament scales and one out of two factors for character subscales which were similar to findings from the other countries. When all of the subscales were subjected to factor analysis, four out of six factors were retained. To our knowledge, this is the first study analysing psychometric properties and factorial construct of the J-TCI-R. Conclusions: The internal reliability coefficients and test–retest indicated a good stability of scores over time and the factorial structure was consistent with Cloninger’s model of personality. The reliability and validity of the Turkish version of the TCI is therefore supported.

Influence of ABCB1 polymorphisms and serum concentrations on venlafaxine response in patients with major depressive disorder

Abstract Background: The pharmacokinetics and the pharmacodynamics of antidepressants show large inter-individual variations which result in unpredictable clinical responses. Aim: The aim of the study was to examine the effect of ABCB1 polymorphisms and the serum concentrations on the efficacy and tolerability of venlafaxine in patients with major depressive disorder (MDD). Methods: Fifty-two outpatients who met the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria for MDD were recruited for the study. The severity of depression was assessed using the 17-item Hamilton Rating Scale for Depression scale (HDRS17) and tolerability was assessed based on a query regarding side-effects for 6 weeks. The ABCB1 C3435T/A and G2677T/A polymorphisms were genotyped by PCR/RFLP and steady-state serum venlafaxine concentrations were measured by high-performance liquid chromatography. Results: Patients with the TT genotype for the C3435T and the TT/TA genotype for the G2677T/A polymorphism showed significantly higher frequencies in venlafaxine-induced akathisia. This relationship was not observed for efficacy. As regards serum venlafaxine concentrations, patient groups showed no significant differences in efficacy and tolerability. Conclusion: The results suggest that individuals with the TT-TT/TA genotypes for the C3435T-G2677T/A polymorphisms of ABCB1 may be pre-disposed to a risk of akathisia.