Ob jec tive:To ex am ine the lipid lev els in a sam ple of pa tients with comorbid gen er al ized anx i ety dis or der (GAD) and ma jor depres sive dis or der (MDD).Methods: Se rum lipid con cen tra tions were ex am ined in 40 pa tients with both GAD and MDD, in 27 pa tients with MDD only, in 26 pa tients with GAD only, and in 24 healthy con trol sub jects.Re sults: All mean se rum cho les terol con cen tra tions are pre sented in Ta ble 1. The mean se rum to tal cho les terol con cen tra tion in pa tients with both GAD and MDD was sig nif i cantly higher than in MDD-only pa tients, GAD-only pa tients, and con trol sub jects. The triglyceride con cen tra tion was also sig nif i cantly higher in pa tients with both GAD and MDD than in MDD-only pa tients, GAD-only pa tients, and con trol sub jects. Pa tients with both GAD and MDD had a lower mean high-density li po pro tein cho lesterol (HDL-C) con cen tra tion than did pa tients with GAD only and con trol sub jects. The se rum con cen tra tion of low-density li popro tein cho les terol (LDL-C) was higher in pa tients with both GAD and MDD than in pa tients with MDD only and GAD only and healthy con trol sub jects. Con clu sions: Our find ings in di cate that the pa tients with both GAD and MDD have in creased se rum cho les t erol, triglyceride, and LDL-C and re duced HDL-C lev els. These pa tients may have a greater risk of mor tal ity from cor o nary ar tery dis ease (CAD) than do pa tients with ei ther de pres sion or anx i ety dis or der. H igh se rum lipid con cen tra tions are closely as so ci ated with stress and anx i ety (1,2). Sev eral in ves ti ga tions have dem on strated that both nat u ral and ex per i men tally induced stress re sult in a sig nif i cant in crease in cho les terol (3,4). There fore, the pres ence of anx i ety may in crease the risk for cor o nary heart dis ease. Sym pa thetic ac ti va tion in gen er alized anx i ety dis or der (GAD) (5) and in panic dis or der (PD) (4,6) causes an in crease in the ac tiv ity of li po pro tein lipase through the re lease of epi neph rine and corticosteroids. This hy per ac tiv ity in li po pro tein lipase re sults in an in crease in free fatty ac ids which may be con verted into cho les terol. Previ ous stud ies also re ported an as so ci a tion be tween low choles terol lev els and ma jor de pres sive dis or der (MDD) (7-11). Maes and oth ers sug gested that MDD was ac com pa nied by re duced for ma tion of cholesteryl es ters and by im paired reverse cho les terol trans port (9). Hay ward and oth ers (12) and Bajwa and oth ers (13) found that PD pa tients had sig nif icantly higher cho les terol lev els com pared with MDD pa tients and healthy con trol sub jects. Bajwa and oth ers also re ported that among MDD pa tients, a his tory of anx i ety dis or ders (GAD, sim ple pho bia, PD) was as so ci ated with a sig nif i cant el e va tion of se rum cho les terol lev els (13). Agargun and others found that PD pa tients had higher se rum cho les terol than did PD pa tients with comorbid MDD and nor mal c...

The aim of this study was to evaluate the effectiveness of psychoeducation given to caregivers of patients diagnosed with schizophrenia on their perceptions of burden and on clinical course of patients. This was a quasi-experimental study with pre-post tests and a control group and designed as a nonrandomized controlled intervention trial. While the patients in both the intervention and the control group received treatment as usual (TAU), only the caregivers in the study group were offered two sessions of psychoeducation a week for one month, with a total of eight sessions. Effectiveness of the psychoeducation given was evaluated by comparing scores of Perceived Family Burden Scale (PFBS) and Positive and Negative Syndrome Scale (PANSS) obtained before and three months after delivery between the intervention and the control groups. Mean PFBS burden scores of the control group at baseline and follow-up were 45.7 and 44.5, respectively. Mean PFBS burden scores of the intervention group were 45.2 at baseline and 38.6 at follow-up. Analysis of variance revealed significant and medium to large size interaction effects of time and group factors on total burden scores of family members (F = 5.59; p < 0.05; η = 0.09) and on total PANSS scores of patients (F = 104.78; p < 0.001; η = 0.64). Our findings suggest that psychoeducation offered to the caregivers along with TAU offered to patients might result in diminished perceptions of burden among caregivers and enhanced improvement in the clinical course of patients as a result of psychoeducation offered to caregivers.

This study addresses longitudinal, expert, all data (LEAD) validity and reliability of the personality functioning ratings in Turkey, which are essential in assessing Criterion A for the entire DSM-5 alternative model for personality disorders (AMPD) diagnoses. A total of 120 consenting patients recruited at a university psychiatry clinic were rated by individual clinicians with respect to DSM-III-R and AMPD criteria. Subsequently, a LEAD panel consisting of 3 senior clinicians convened to reach a consensus personality disorder diagnosis for each participant. Blind personality functioning ratings of a subgroup of 20 participants by the same set of 4 clinicians were obtained for test-retest reliability investigation. Concordance between the LEAD and AMPD diagnoses was as good as that between the LEAD and DSM-III-R diagnoses (kappas = .68). The personality functioning scores correlated strongly (r > .50) with the sum of specific DSM-III-R diagnoses. Reliability estimates pertaining to the personality functioning scores and resultant AMPD Criterion A decisions were mostly in the good range. In conclusion, DSM-5 alternative model-oriented personality functioning ratings yield total or composite scores that are evidently valid and reliable tools to diagnose general personality disorder and to estimate its global severity.

Background: Data from Turkey on prevalence of personality disorders (PD) in the normal population are sparse. Aims: The present study conducted in a community sample aimed to investigate personality disorders in terms of prevalence, associated risk factors and personality dimensions. Methods: A stratified sampling procedure allowed us to compose a sample consisting of 774 participants residing in Aydin, Turkey. The DSM-IV and ICD-10 Personality Questionnaire (DIP-Q) and the Temperament and Character Inventory (TCI) were used to assess PDs and personality dimensions, respectively. Results: Roughly 20% of the participants received a PD diagnosis. Among the individual PD categories, schizotypal and obsessive-compulsive PDs were the most prevalent diagnoses. Participants with PD were more likely to have higher self-directedness and cooperativeness scores. These risk factors and personality dimensions were most strongly associated with the cluster B disorders. Conclusion: New versions of the diagnostic systems should include schizotypal, obsessive-compulsive and cluster B PDs as separate diagnostic categories, and impaired self-directedness as well as cooperativeness as a general diagnostic criterion for the sake of backward and forward compatibility of the research in this field.

Our findings suggest that majority of depressive patients, including those fulfilling the criteria for MDD, have been suffering from a persistent ailment rather than an episodic disorder. Clinicians with a cross-sectional perspective are more likely to diagnose MDD, whereas those with a longitudinal perspective are more likely to identify PDD in the majority of depressive patients. The incorporation of both of these perspectives into DSM-5 in a complementary manner will possibly enhance our insight into depressive disorders and improve our treatment results.