DSM-5 Diagnostic Criteria Research Articles

Dissociative psychosis or dissociative schizophrenia? Comparison of two phenomena

BackgroundIn recent years, researchers have reported crucial advances in the understanding of “Dissociative psychosis” and “Dissociative schizophrenia”. While clinical studies in this area have been sustained for well, it remains to be established for some aspects that a clear and valid relationship exists between dissociation, childhood traumatic experiences, and schizophrenia or psychotic spectrum disorders. Methods: To test such hypotheses, we divided the patients into two groups; the first group consisted of patients with psychotic disorders not otherwise specified (PNOS), and the second group consisted of schizophrenic patients. Further, we have investigated the symptoms of dissociation, its relation to childhood traumatic experiences, and psychotic symptoms. The study included 81 patients diagnosed with schizophrenia according to DSM-5 diagnostic criteria and 81 patients diagnosed with PNOS. Researchers assessed participants using the Dissociation Questionnaire (DIS-Q), the Childhood Trauma Questionnaire (CTQ, and the Positive and Negative Syndrome Scale (PANSS). Results: The present study showed that patients with PNOS have higher dissociation and childhood traumatic experiences scores than the schizophrenic group and that the patients with the PNOS group yielded elevated physical abuse, emotional abuse, emotional neglect, sexual abuse, and bodily neglect scores as compared to the schizophrenic group. However, the PNOS group exhibited significantly lower PANSS total, PANSS negative, and PANSS general psychopathology scores compared to the schizophrenia group. DIS-Q and total CTQ level were also significant predictors of PNOS. Conclusion: Our results of statistical comparisons have supported the existence of the clinical manifestation known as dissociative psychosis, not dissociative schizophrenia.

Depresyon ve Kabul-Kararlılık Terapisinin Kullanılması Üzerine Bir Derleme

The purpose of this review is to examine the use of acceptance and profitability therapy in individuals experiencing depression. Acceptance and commitment therapy is one of the third generation approaches and is an effective approach. For this purpose, depression and acceptance stability therapy were defined with many factors and subheadings in this study. Nine types of depression, diagnostic criteria, history, symptoms, epidemiology, etiology, theoretical approaches, development along DSM-5, DSM-5 diagnostic criteria and treatment are explained in detail. Acceptance stability therapy is explained with conceptual foundations, theoretical foundations, history, psychological flexibility model and psychopathological model. According to the information obtained from the studies screened in the study, the use of acceptance and commitment therapy in individuals with depression is at least as effective as the use of cognitive behavioral therapy, no difference was found between the two therapy methods. Acceptance and commitment therapy is highly effective not only in depression, but also in various areas such as anxiety disorders, substance abuse, trauma, PTSD and OCD, and other psychological difficulties. In this study, review method was used.. As a result of all studies, positive feedback was obtained from the use of acceptance and commitment therapy in individuals experiencing depression. The use of acceptance and commitment therapy in depression and various problems should be increased, and its use in the treatment of disorders should be given more place. It is a very effective form of therapy. The results of the studies used in this study support this idea. Keywords: acceptance and retention therapy, depression, review

Obsesif Kompulsif Bozukluğun Bilişsel Davranişçi Terapi Yaklaşimi İle Tedavisi: Bir Olgu Sunumu

In this case report, a 30 year old female client showed symptoms of Obsessive Compulsive Disorder (OCD) and requested professional support. As a result of the evaluations, the process was carried out with the client through Cognitive Behavioral Therapy (CBT). When evaluated with DSM-5 diagnostic criteria in the case report, the client has been experiencing serious functional losses in his daily life, which have been increasing for 6 months, due to compulsive behaviors accompanying his obsessions based on symmetry, order and control. During the treatment process, based on the cognitive model of CBT, a structured school of psychotherapy, on the OCD level, techniques such as helping the client evaluate obsessions realistically, restructuring dysfunctional thought patterns, exposure, response inhibition and relaxation exercises were applied. During the process, a total of 8 sessions of 50 minutes were carried out once a week, and a significant decrease in the severity of the client's obsessions and compulsions and a correspondingly significant increase in his functionality were observed. In this case report, the treatment of OCD with the CBT school is emphasized. Key Words: Obsessive Compulsive Disorder, Cognitive Behavioral Therapy, Techniques

Contemporary Perspectives in Critical Care of Neuroleptic Malignant Syndrome.

Neuroleptic malignant syndrome (NMS) is a psychiatric-neurologic emergency that may require intensive care management. There is a paucity of information about NMS as a critical illness. We reviewed the Mayo Clinic experience. A comprehensive data extraction was completed within the Mayo Clinic system diagnosed with NMS using International Classification of Diseases, ninth revision (ICD-9); ICD-9, Clinical Modification; ICD-10; ICD-10, Clinical Modification; and Health Insurance Claim (HIC) codes between the years of 1995 and 2023. Major criteria included fever, rigidity, tachycardia, and exposure to a neuroleptic agent. Minor criteria included rhabdomyolysis and dysautonomia. Criteria for exclusion were Parkinson's disease, abrupt discontinuation of baclofen or levodopa, concomitant selective serotonin reuptake inhibitors use or serotonin syndrome, malignant catatonia, or a classic dystonic reaction. A total of 332 patients had diagnostic codes of NMS, but only 20 patients fulfilled DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision), diagnostic criteria. The average age was 48.2years (range 20-93years). Four patients received antipsychotics following postoperative acute agitation or delirium (20%). Previous psychiatric diagnoses were schizophrenia or schizoaffective disorder in six patients (33%), major depressive disorder in five patients (20%), and bipolar disorder in two patients (10%). Haloperidol was the sole inciting neuroleptic in five patients (25%), but the remainder was associated with atypical or second-generation antipsychotics. A total of nine patients (45%) required mechanical ventilation. The majority of patients had rhabdomyolysis, which led to acute kidney failure in nearly half of them, but none required hemodialysis. Most patients recovered promptly, and no fatalities were directly attributable to NMS; however, four patients (20%) died within 1month, and four patients died years from diagnosis and unrelated to NMS. Neuroleptic malignant syndrome can become a critical illness, but there is often rapid recovery. Mortality proximate to NMS was uncommon, but late mortality remained substantial. The overwhelming majority of cases coded as NMS did not meet DSM-5 diagnostic criteria. Stricter criteria should be applied when diagnosing NMS in critical care and emergency medicine settings.

Investigating the Prevalence of Neurological Soft Signs in Children with Autism Spectrum Disorder and their Siblings: A Cross-Sectional Study.

Autism is determined by children's inability to communicate with others through language. More studies have shown that neurological soft signs (NSS) can be one of the symptoms of psychiatric disorders, including schizophrenia. However, complete and proven evidence regarding the role of NSS in the pathogenesis of autism has not been determined. For this purpose, this research investigated the prevalence of NSS in children with autism spectrum and their siblings and compared it with the control group. The current study was cross-sectional. In this study, thirty-two children aged 7-17 who had been referred to the pediatric psychiatry clinics of Imam Hossein Hospital and the Autism Charitable Association in Tehran, Iran, were entered; they were diagnosed with an autism disorder by a child and adolescent psychiatrist based on the DSM-5 diagnostic criteria. Furthermore, thirty-two siblings of children with autism in the age group of 7-17 years who did not have any neurological and mental disorders were included; thirty-two healthy individuals (controls) who did not have any disorders were evaluated with the K-SADS checklist. Gilliam Autism Rating Scale 3rd Edition (GARS-3) was also used to confirm the diagnosis and severity of the disease. The results showed that the incidence of NSS in the patient group was higher than in the other two groups, which was statistically significant (p<0.05). Furthermore, the results indicated that these signs had a high diagnostic value in identifying patients from healthy people. In general, using the NSS score in patients with autism can be considered a prediction factor compared to their siblings. In addition, the score had no effect on the prediction between sibling and control subjects.

Evaluation of Early Maladaptive Schemas and Adult Attachment Profiles in Patients Diagnosed with Major Depressive Disorder and Examination of Their Relationship with Disease Variables.

Background/Objectives: The study aimed to compare the early maladaptive schemas and adult attachment profiles of patients diagnosed with major depressive disorder with those of healthy controls. Another objective of our study was to investigate the potential relationships between disease-related variables-such as the type of depression, number of depressive episodes, history of hospitalization, and suicidal ideation or attempts-and schema and attachment characteristics in the group of patients with major depressive disorder. Methods: The study included 118 patients who presented to the Psychiatry outpatient clinic at Mersin University Faculty of Medicine Hospital between 1 April 2021 and 1 September 2021 and were diagnosed with major depressive disorder according to DSM-5 diagnostic criteria based on mental state examinations conducted by researchers, as well as 92 healthy volunteers with no history of mental disorders. A sociodemographic data form prepared by the researchers was used to inquire about characteristics such as gender, age, and educational status. Additionally, a clinical data form was designed and implemented by the researchers to gather information regarding DSM-5 specifiers and the patients' clinical histories. The Young Schema Questionnaire Short Form-3 was used to evaluate early maladaptive schemas, while adult attachment profiles were assessed using the Experiences in Close Relationships Inventory II. The severity of depression in the patient group was measured with the Beck Depression Inventory. Statistical analysis of the data was conducted using SPSS 21, with a p-value less than 0.05 considered statistically significant. Results: The study included 118 patients, 84 (71.2%) of whom were women and 34 (28.8%) men, along with 92 healthy volunteers, 60 (65.2%) of whom were women and 32 (34.8%) men. The mean age was 41.9 (±13.2) in the patient group and 40.8 (±11.9) in the control group (p > 0.05). The patient group had higher scores than the control group across all schema subtypes and attachment dimensions. Significant differences in certain schemas were observed between patients with chronic depression and those with recurrent depressive episodes, as well as between patients with a single hospitalization history and those with multiple hospitalizations, and between patients with a history of suicide attempts and those without any suicidal ideation or attempts. Positive significant correlations were found between the attachment and schema scores and the severity of depression in both patients and controls. Conclusions: Further research is needed to determine the role of schemas and attachment styles in the development of depression in more detail and to focus on schema and attachment-based therapies in treatment.

Review of DSM-5 Diagnostic Criteria for Anorexia Nervosa and Recommendations to Improve Inclusivity

Review of DSM-5 Diagnostic Criteria for Anorexia Nervosa and Recommendations to Improve Inclusivity

Perinatal emotional skills groups for women and birthing people with borderline personality disorder: outcomes from a feasibility randomised controlled trial.

There is no clear evidence about how to support people with borderline personality disorder (BPD) during the perinatal period. Perinatal emotional skills groups (ESGs) may be helpful, but their efficacy has not been tested. To test the feasibility of conducting a randomised controlled trial (RCT) of perinatal ESGs for women and birthing people with BPD. Two-arm parallel-group feasibility RCT. We recruited people from two centres, aged over 18 years, meeting DSM-5 diagnostic criteria for BPD, who were pregnant or within 12 months of a live birth. Eligible individuals were randomly allocated on a 1:1 ratio to ESGs + treatment as usual (TAU), or to TAU. Outcomes were assessed at 4 months post randomisation. A total of 100% of the pre-specified sample (n = 48) was recruited over 6 months, and we obtained 4-month outcome data on 92% of randomised participants. In all, 54% of participants allocated to perinatal ESGs attended 75% of the full group treatment (median number of sessions: 9 (interquartile range 6-11). At 4 months, levels of BPD symptoms (adjusted coefficient -2.0, 95% CI -6.2 to 2.1) and emotional distress (-2.4, 95% CI -6.2 to 1.5) were lower among those allocated to perinatal ESGs. The directionality of effect on well-being and social functioning also favoured the intervention. The cost of delivering perinatal ESGs was estimated to be £918 per person. Perinatal ESGs may represent an effective intervention for perinatal women and birthing people with BPD. Their efficacy should be tested in a fully powered RCT, and this is a feasible undertaking. ISRCTN80470632.

18 F-FDG metabolic abnormalities precede perfusion and atrophic changes in diagnosis of early frontotemporal dementia: study from a tertiary care university hospital.

Diagnosis of early onset dementia is critical for initiating management. Although structural MRI is an established procedure for dementia evaluation, early cases may be missed. Neurodegenerative diseases lead to reductions in glucose consumption and grey matter volume loss. Our primary aim was to establish whether metabolic changes precede perfusion abnormalities in early cases of dementia especially, frontotemporal dementia (FTD). Secondly to study if cerebral atrophy using Pasquier visual rating scales can be used reliably to correlate with hypometabolism in this group of patients. A total of 56 patients (M:F = 39:17) with memory loss as per the DSM-5 diagnostic criteria were clinically and neurologically examined and referred for 18 F-Fluorodeoxyglucose (FDG) PET brain imaging. A few patients who had a prior (recent, <1 week) MR brain underwent brain 18 F-FDG PET-CT, and all others were considered for simultaneous 18 F-FDG PETMR imaging of brain. T2-weighted images were used to report Pasquier rating scales in all our patients as per recommendation. Cognitive assessments were analysed along with neuroimaging findings. Highest diagnostic performance was obtained with 18 F-FDG PET for identifying early FTD in our series of patients. Sensitivity, specificity and accuracy of FDG and arterial spin labeling (ASL) using simultaneous PETMR were found to be 96.34%/90.1%/89 : 53.57%/62.12%/78, respectively. Cerebral atrophy rated using Pasquier visual scales showed the lowest diagnostic performance. Our study showed that the earliest phase of cognitive decline was found to be associated with specific patterns of hypometabolism, even in the absence of atrophy, which are currently considered diagnostic biomarkers. Metabolic derangements indeed precede perfusion changes and cerebral atrophy in the setting of early dementia. Simultaneous FDG PETMR is being recommended as the investigation of choice for the evaluation of early FTD. This pilot study shows that FDG PET outperforms cognitive assessments and anatomical imaging modalities in early dementia evaluation. Although ASL can detect perfusion deficits in dementia, compared with FDG PET, its sensitivity and specificity for discerning early onset dementia from controls remain inferior to FDG PET. Pasquier scales, although easy to implement, cannot replace FDG PET metabolic findings, which start very early in the neuronal disease process.

Predictors of Sexual Dysfunction, Associated Distress, and Sexual Satisfaction Among Male and Female Patients Living with Anxiety Disorders in Denmark

ABSTRACT Although previous studies have established links between anxiety disorders, sexual dysfunctions, and sexual satisfaction, there is relatively little research on the specific factors associated with living with an anxiety disorder that might contribute to these sexual health disparities. This study assessed the associations between anxiety, cognitive distractions, biased expectancies, and 1) sexual dysfunction (DSM-5 diagnostic criteria) 2) associated distress, and 3) sexual satisfaction while considering the role of pharmacological treatment-related sexual side effects and comorbid depressive symptoms. A large clinical population (N = 207) of people with anxiety diagnoses seeking treatment at 11 outpatient anxiety clinics in Denmark participated. Higher cognitive distraction levels were linked with a greater risk of sexual dysfunction, more sexual dysfunction-associated distress, and lower sexual satisfaction. Higher sexuality and anxiety biased expectancies were associated with an increased risk of sexual dysfunctions and associated distress and decreased sexual satisfaction. Higher anxiety symptom severity was only associated with lower sexual satisfaction among female respondents. Higher anxiety sensitivity was linked to a higher risk of sexual dysfunction, associated distress, and lower sexual satisfaction among female participants only.

Automatic screening for posttraumatic stress disorder in early adolescents following the Ya'an earthquake using text mining techniques.

Self-narratives about traumatic experiences and symptoms are informative for early identification of potential patients; however, their use in clinical screening is limited. This study aimed to develop an automated screening method that analyzes self-narratives of early adolescent earthquake survivors to screen for PTSD in a timely and effective manner. An inquiry-based questionnaire consisting of a series of open-ended questions about trauma history and psychological symptoms, was designed to simulate the clinical structured interviews based on the DSM-5 diagnostic criteria, and was used to collect self-narratives from 430 survivors who experienced the Ya'an earthquake in Sichuan Province, China. Meanwhile, participants completed the PTSD Checklist for DSM-5 (PCL-5). Text classification models were constructed using three supervised learning algorithms (BERT, SVM, and KNN) to identify PTSD symptoms and their corresponding behavioral indicators in each sentence of the self-narratives. The prediction accuracy for symptom-level classification reached 73.2%, and 67.2% for behavioral indicator classification, with the BERT performing the best. These findings demonstrate that self-narratives combined with text mining techniques provide a promising approach for automated, rapid, and accurate PTSD screening. Moreover, by conducting screenings in community and school settings, this approach equips clinicians and psychiatrists with evidence of PTSD symptoms and associated behavioral indicators, improving the effectiveness of early detection and treatment planning.

Unveiling Severity Indicators for Anorexia and Bulimia Nervosa Treatment Success: DSM-5 Versus ICD-11 Versus Drive for Thinness.

This study aimed to compare treatment outcomes associated with three severity indicators-DSM-5 for anorexia nervosa (AN) and bulimia nervosa (BN), ICD-11 for AN, and drive for thinness (DT) for AN and BN-within a treatment-seeking population. A total of 628 female participants diagnosed with either AN (n=266; mean age=26.71) or BN (n=362; mean age=29.49) were recruited from an ED unit. Upon admission, participants were classified based on DSM-5 (AN and BN) and ICD-11 severity categories. They underwent CBT-E comprehensive manualised programs, according to ED subtype, and were categorised into 'full remission', 'partial remission', 'non-remission' or 'drop-out' based on DSM-5 diagnostic criteria at discharge. Significant associations were found only for ICD-11 AN severity groups (p=0.03, Cramer's V=0.18), with 'dangerously low BMI' associated with poorer outcomes than 'significantly low BMI'. No other significant relationships were found with DSM-5 or DT severity groups. This study reveals the limitation of using a single severity indicator and emphasises the necessity of a comprehensive assessment to capture the complexities of AN and BN. Future research should also evaluate the validity of these severity measures across various factors, including biological correlates and psychopathology.

Neuroinflammation, Stress-Related Suicidal Ideation, and Negative Mood in Depression

Brain translocator protein 18k Da (TSPO) binding, a putative marker of neuroinflammatory processes (eg, gliosis), is associated with stress and elevated in depressed and suicidal populations. However, it is unclear whether neuroinflammation moderates the impact of daily life stress on suicidal ideation and negative affect, thereby increasing risk for suicidal behavior. To examine the association of TSPO binding in participants with depression with real-world daily experiences of acute stress-related suicidal ideation and negative affect, as well as history of suicidal behavior and clinician-rated suicidal ideation. Data for this cross-sectional study were collected from June 2019 through July 2023. Procedures were conducted at a hospital-based research center in New York, New York. Participants were recruited via clinical referrals, the Columbia University research subject web portal, and from responses to internet advertisements. Of 148 participants who signed informed consent for study protocols, 53 adults aged 18 to 60 years who met DSM-5 diagnostic criteria for current major depressive disorder completed procedures with approved data and were enrolled. Participants were free of schizophrenia spectrum disorders, active physical illness, cognitive impairment, and substance intoxication or withdrawal at the time of scan. All participants underwent positron emission tomography imaging of TSPO binding with 11C-ER176 and concurrent arterial blood sampling. A weighted average of 11C-ER176 total distribution volume (VT) was computed across 11 a priori brain regions and made up the primary outcome measure. Clinician-rated suicidal ideation was measured via the Beck Scale for Suicidal Ideation (BSS). A subset of participants (n = 21) completed 7 days of ecological momentary assessment (EMA), reporting daily on suicidal ideation, negative affect, and stressors. In the overall sample of 53 participants (mean [SD] age, 29.5 [9.8] years; 37 [69.8%] female and 16 [30.2%] male), 11C-ER176 VT was associated at trend levels with clinician-rated suicidal ideation severity (β, 0.19; 95% CI, -0.03 to 0.39; P = .09) and did not differ by suicide attempt history (n = 15; β, 0.18; 95% CI, -0.04 to 0.37; P = .11). Exploratory analyses indicated that presence of suicidal ideation (on BSS or EMA) was associated with higher 11C-ER176 VT (β, 0.21; 95% CI, 0.01 to 0.98; P = .045). In 21 participants who completed EMA, 11C-ER176 VT was associated with greater suicidal ideation and negative affect during EMA periods with stressors compared with nonstress periods (β, 0.12; SE, 0.06; 95% CI, 0.01 to 0.23; P = .03 and β, 0.19; SE, 0.06; 95% CI, 0.08 to 0.30; P < .001, respectively). TSPO binding in individuals with depression may be a marker of vulnerability to acute stress-related increases in suicidal ideation and negative affect. Continued study is needed to determine the causal direction of TSPO binding and stress-related suicidal ideation or negative affect and whether targeting neuroinflammation may improve resilience to life stress in patients with depression.

Pre- and postsynaptic signatures in the prelimbic cortex associated with "alcohol use disorder" in the rat.

The transition to alcohol use disorder (AUD) involves persistent neuroadaptations in executive control functions primarily regulated by the medial prefrontal cortex. However, the neurophysiological correlates to behavioral manifestations of AUD are not fully defined. The association between cortical neuroadaptations and behavioral manifestations of addiction was studied using a multi-symptomatic operant model based on the DSM-5 diagnostic criteria for AUD. This model aimed to characterize an AUD-vulnerable and AUD-resistant subpopulation of outbred male Wistar rats and was combined with electrophysiological measurements in the prelimbic cortex (PL). Mirroring clinical observations, rats exhibited individual variability in their vulnerability to develop AUD-like behavior, including motivation to seek for alcohol (crit 1), increased effort to obtain the substance (crit 2), and continued drinking despite negative consequences (crit 3). Only a small subset of rats met all the aforementioned AUD criteria (3 crit, AUD-vulnerable), while a larger fraction was considered AUD-resilient (0 crit). The development of AUD-like behavior was characterized by disruptions in glutamatergic synaptic activity, involving decreased frequency of spontaneous excitatory postsynaptic currents (sEPSCs) and heightened intrinsic excitability in layers 2/3 PL pyramidal neurons. These alterations were concomitant with a significant impairment in the ability of mGlu2/3 receptors to negatively regulate glutamate release in the PL but not in downstream regions like the basolateral amygdala or nucleus accumbens core. In conclusion alterations in PL synaptic activity were strongly associated with individual addiction scores, indicating their role as potential markers of the behavioral manifestations linked to AUD psychopathology.

Birth satisfaction and symptoms of childbirth related PTSD among women in Iceland: A population-based study

Given its complexity, childbirth can elicit both positive and negative psychological reactions and, in some cases, women may experience symptoms of childbirth-related post-traumatic stress disorder (CB-PTSD). Several risk factors for CB-PTSD have been identified previously, including history of mental health issues and childbirth related complications. The aim of our study was to explore the role of satisfaction with care in CB-PTSD symptoms. CB-PTSD was measured with the City Birth Trauma Scale (CityBiTS), a questionnaire with 29 items distributed according to DSM-5 diagnostic criteria. A CityBiTS score>28 points was defined as CB-PTSD symptoms. Birth satisfaction was measured with the Birth Satisfaction Scale-Revised (BSS-R), a self-report questionnaire. Logistic-regression was used to calculate odds ratios and 95% confidence intervals for the association between birth satisfaction and CB-PTSD, adjusted for age, relationship status, education, income, parity, mode of birth, postpartum depression and maternal and infant health-related problems during pregnancy and birth. Of 600 participants, 34 (5.7 %) indicated symptoms of CB-PTSD. When adjusted for socio-demographic and pregnancy and birth-related factors, birth satisfaction was independently associated with symptoms of CB-PTSD. For each additional point on the BSS-R, the odds of having CB-PTSD symptoms decreased by 16%. Support during labor and birth, effective communication and shared decision making were factors significantly associated with CB-PTSD symptoms. Increased satisfaction with care was strongly associated with less symptoms of CB-PTSD. Emphasizing sense of control with support, effective communication and shared decision making may significantly improve the overall experience for women and possibly reduce CB-PTSD symptoms.

How accurately can supervised machine learning model predict a targeted psychiatric disorder?

BackgroundHoarding disorder (HD) is characterized by a compulsion to collect belongings, and to experience significant distress when parting from them. HD is often misdiagnosed for several reasons. These include patient and family lack of recognition that it is a psychiatric disorder and professionals’ lack of relevant expertise with it. This study evaluates the ability of a supervised machine learning (ML) model to match the diagnostic skills of psychiatrists when presented with equivalent information pertinent to symptoms of HD.MethodsFive hundred online participants were randomly recruited and completed the Hoarding Rating Scale-Self Report (HRS-SR) and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Responses to the questionnaires were read by an ML model. Responses to the HRS-SR were then converted into anonymized, random-equivalent texts. Each of these individual texts was presented in random order to two experienced psychiatrists who were independently asked for a provisional diagnosis - e.g.; the presence or absence of HD. In case of disagreement between the two assessors, a third psychiatrist broke the tie. A decision tree classification model was employed to predict clinical HD using self-report data from two psychological tests, the HRS-SR and GAD-7. The target variable was whether a participant had clinical HD, while the predictive variables were the continuous scores from the HRS-SR and GAD-7 tests. The model’s performance was evaluated using a confusion matrix, which compared the observed diagnoses with the predicted diagnoses to assess accuracy.ResultsAccording to the psychiatrists, approximately 10% of the participants fulfilled DSM-5 diagnostic criteria for HD. 93% of the clinician-identified cases were identified by the ML model based on HRS-SR and GAD-7 scores. A decision tree plot model demonstrated that about 60% of the cases could be detected by the HRS-SR alone while the rest required a combination of HRS-SR and GAD-7 scores. ML evaluation metrics showed satisfactory performance, with a Matthews Correlation Coefficient of 55%; Area Under Curve (AUC), 79%; a Negative Predictive Value of 76%; and a False Negative Rate of 24%.ConclusionsStudy findings strongly suggest that ML can, in the future, play a significant role in the risk assessment of psychiatric disorders prior to face-to-face consultation. By using AI to scan big data questionnaire responses, wait time for seriously ill patients can be substantially cut, and prognoses substantially improved.

Taking a Deeper Dive Into OSFED Subtypes: A Meta-Analysis and Systematic Review.

To compare all other specified feeding or eating disorders (OSFED) groups (atypical anorexia nervosa [AN], purging disorder [PD], night eating syndrome [NES], subthreshold bulimia nervosa [sub-BN], and subthreshold binge-eating disorder [sub-BED]) to threshold eating disorders (EDs [AN, BN, and BED]) and control groups (CGs) on measures of eating and general psychopathology. We conducted a comprehensive search in PsycINFO, Medline, Embase, and CINAHL on all published studies from January 2013 to February 2024 using DSM-5 diagnostic criteria via clinical interviews or well-established diagnostic tools. We also undertook a quality appraisal using an adapted version of the Downs and Black criteria and registered the review with PROSPERO (ID: CRD42022314495). Overall, our meta-analyses (n = 33 eligible studies) indicated that the combined OSFED and several specific OSFED subtypes displayed comparable levels of eating psychopathology to full-threshold EDs. Our systematic review (n = 33 eligible studies) found individuals with OSFED to have comparable levels of eating and general psychopathology to full-threshold EDs, but higher levels of eating and general psychopathology than CGs. These findings were specifically attributed to atypical AN and NES. There was a lack of evidence available for sub-BN and sub-BED. Studies mainly met the quality appraisal criteria. The main limitations identified in the included studies were insufficient reporting of their statistical power (78%) and no adjusting for potential confounding factors (67%). Findings support the conceptualization of atypical AN, and NES as clinically significant EDs with similar severity to full-threshold EDs.

Investigation of Clinical Features and Comorbid Psychopathologies of Children with Sleep Terrors

Aim: In this study, it was aimed to investigate the clinical characteristics of children diagnosed with sleep terrors, including sleep environment and sleep habits, clinical features and comorbid psychiatric disorders. Method: Between 2020 and 2024, 51 children who were diagnosed with sleep terror according to DSM-5 diagnostic criteria in 3 different Child and Adolescent Psychiatry clinics were included in the study. The sociodemographic and clinical characteristics of the cases were examined retrospectively through the files. Results: Of the 51 participants, 30 (58.8%) were male, 21 (41.2%) were female and the mean age at the time of admission was 6.76±1.45 years. It was determined that 15 (29.4%) of the cases slept in a noisy environment and 41 (80.4%) of the cases had their sleep interrupted except for sleep terror attacks. At least one psychiatric disorder was detected in 17 (33.3%) patients, and the most common (9.8%) comorbid psychiatric disorder was attention deficit hyperactivity disorder. It was found that complete retrograde amnesia was significantly higher in preschoolers, and motor activity during the attack, physical injury and/or material damage, and full awakening during the attack were significantly higher in school-age children. It was determined that 64.7% of the parents intervened incorrectly during the episode, and in 29.4% of the cases, the wrong medication was applied in the treatment history. Conclusion: In sleep terrors, identification of triggering factors and comorbid psychiatric disorders during the diagnostic evaluation process, psychoeducation of parents in treatment, and selection of appropriate medication for medication are very important.

The growing definition of Autism

ABSTRACT The definition of autism continually changes over time in line with the growth of autism studies and the influences of the neurodiversity movement. The current paper aims to present the ongoing changes in the definition and diagnostic criteria of Autism as well as to introduce the autistic and neurodiversity movement happening globally. It traces back histories of Autism from myths and legends, cases in history possibly related to autism, Kanner’s and Asperger’s pioneered works on autism, and the ongoing transformation of Autism diagnostic criteria presented by all versions of DSM. The contribution of adults with Autism organisations to the DSM-5 diagnostic criteria is highlighted and future studies aimed to confirm the effectiveness of the newly revised criteria of DSM-5-TR are suggested. Subsequently, the current paper also discusses the brief history and principles of the autistic and neurodiversity movements that are growing globally and reviews the evolving definition of autism. The possible impact caused by the changes in the definition on the well-being of individuals with Autism is presented as well as future predictions of Autism’s definition are discussed.

Sosyal Kaygı Bozukluğunda Bilişsel Davranışçı Terapi Olgu Sunumu

In this study, the client's symptoms were characterized as social anxiety disorder based on dsm5 diagnostic criteria. The client is a 24-year-old female university student. The client stated that she had fears of failing, being stupid and being disgraced and mentioned physical symptoms such as hand and voice tremors, nausea and heart palpitations due to these fears. The client, who has beliefs such as inadequate, worthless and I must be successful, shows excessive anxiety and avoidance behaviors in situations such as eating in front of people, speaking in public, making presentations and mixing with people. The client realized that his academic success was jeopardized and his functionality was decreasing and applied for therapy. Cognitive behavioral therapy was used with the client. First, the client was psychoeducated about the therapy and its progress and a therapeutic relationship was developed. In the first stage of the treatment, cognitive processes were emphasized, automatic negative thoughts and core beliefs were identified and questioned, and cognitive restructuring was performed. Then behavioral techniques were practiced. Key words: Social anxiety disorder, anxiety, cognitive behavioral therapy.