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Öğe Assessing Psychological Resilience and Stress Symptoms in Health Care Workers Following the 2023 Kahramanmaraş Earthquake(Cambridge Univ Press, 2025) Polat, Hatice; Ugur, Kerim; Sun, TunahanObjectives The study was conducted to assess the psychological resilience and stress symptoms in health care workers following the 2023 Kahramanmara & scedil; earthquake.Methods The study was completed with a sample size of 313 health care workers who experienced the earthquake and was carried out in a descriptive and correlational design. The Sociodemographic Data Form, Brief Psychological Resilience Scale (BPRS), and Traumatic Stress Symptom Scale-5 (TSSS-5) were used.Results The study found that 39.6% of health care workers were diagnosed with post-traumatic stress disorder, 41.2% of participants considered leaving their jobs after the earthquake, and 79.9% reported a decrease in job motivation (slight or a lot). It was determined that there was a negative correlation between the participants' BPRS scores and TSSS-5 scores (r:-0.523, P = 0.00).Conclusions In accordance with the findings of our study, it can be posited that traumatic stress symptoms diminished as the level of psychological resilience increased in health care workers who experienced the earthquake.Öğe Association between attention deficit hyperactivity disorder and chronotype in adults with epilepsy(Cukurova Univ, Fac Medicine, 2025) Ugur, Kerim; Sun, Tunahan; Tasci, Irem; Kartal, FatmaPurpose: This study aimed to determine the chronotype characteristics in adults with epilepsy, examine the relationship between chronotype and Attention Deficit Hyperactivity Disorder (ADHD), and compare ADHD symptom levels between patients with epilepsy and healthy controls. Materials and Methods: The study included 90 patients with epilepsy and 70 healthy controls, aged between 18 and 65 years. Sociodemographic and clinical data (seizure status, EEG, and MRI findings) were collected from the participants. The Morningness-Eveningness Questionnaire (MEQ), Adult ADHD Diagnosis and Evaluation Inventory, and Adult ADHD Self-Report Scale (ASRS) were administered. Results: A higher proportion of intermediate chronotypes was observed in the epilepsy group (68.9%) than in the control group (51.4%). ADHD symptom scores were higher in patients than in controls. Among patients with epilepsy, individuals with intermediate and evening chronotypes had significantly higher ADHD symptoms than those with morning chronotype. Although individuals with an evening chronotype had higher ADHD symptom levels than those with an intermediate chronotype, this difference was not statistically significant. Conclusion: The findings suggest that ADHD symptoms become more pronounced in patients with epilepsy as chronotype characteristics shift toward eveningness. Circadian features should be considered in the evaluation and management of ADHD comorbidity in adult patients with epilepsy.Öğe Clinical Heterogeneity of Major Depressive Disorder: The Role of Trauma, Dissociation, and Sleep(Mdpi, 2026) Namli, Zeynep; Tamam, Lut; Demirkol, Mehmet Emin; Karaytug, Mahmut Onur; Yesiloglu, Caner; Cetin Demirtas, Sinem; Ugur, KerimBackground: Major depressive disorder (MDD) is a common mental disorder characterized by a wide range of symptoms and a substantial contribution to global disease burden. Our study aimed to examine the relationships between childhood trauma, sleep quality, dissociative symptoms, posttraumatic growth, and suicidality in patients diagnosed with MDD. Methods: Our sample consisted of 115 patients with MDD and 84 healthy controls. Participants were administered the Hamilton Depression Rating Scale (HDRS), Beck Scale for Suicidal Ideation (BSSI), Pittsburgh Sleep Quality Index (PSQI), Childhood Trauma Questionnaire (CTQ-33), Dissociative Experiences Scale (DES), and Posttraumatic Growth Inventory (PTGI). Group differences were analyzed, and associations among variables within the MDD group were examined using correlation and mediation analyses. Results: Compared to healthy controls, patients with MDD had significantly higher scores on all scales except the PTGI (p < 0.001 for each). Within the MDD group, individuals with a history of suicide attempts had significantly higher CTQ total scores, physical and sexual abuse subscale scores, and DES scores than those without previous attempts. Additionally, dissociative experiences had a partial mediating role in the relationship between depression severity and suicidal ideation, as well as in the relationship between childhood traumas and sleep quality. Conclusions: The findings highlight the clinical relevance of dissociative experiences and sleep disturbances in the heterogeneous presentation of MDD and their association with illness severity and suicidality. In the follow-up and treatment process of patients with MDD, risk and protective factors should be evaluated together, and individualized treatment programs should be targeted.Öğe Coping with stress, psychological resilience and psychiatric symptoms in migraine patients(Bayrakol Medical Publisher, 2023) Emir, Burcu Sirlier; Yildiz, Sevler; Kilicaslan, Asli Kazgan; Dogan, Serpil; Kurt, Osman; Ugur, KerimAim: Migraine is a prevalent chronic disease with unknown etiopathogenesis that affects the quality of life. In the present study, we aimed to investigate anxiety, depression, coping with stress and psychological resilience of migraine patients. Material and Methods: The study was conducted with 40 patients and 40 healthy individuals. The study data were collected with a sociodemographic and clinical data form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Psychological Resilience Scale for Adults (RSA), and Inventory of Coping Strategies (ICS). Results: It was determined that the RSA-structural resilience, RSA-social competence, BDI, BAI, ICS-optimism and ICS-social support scores of the patients were significantly higher when compared to the control group, RSA-self-perception, RSA-future perception, RSA-familial conformity, RSA-social resources, RSA-total and ICS-safe approach scores were significantly lower in the patient group when compared to the controls. There were positive correlations between the number of migraine attacks and RSA-future perception, RSA-familial conformity, RSA-social resources and RSA-total scores of the patients; There was a significant negative correlation between the number of migraine attacks and ICS-optimism scores. Discussion: The incidence of anxiety and depression was significantly higher and psychological resilience was significantly lower in the patients when compared to the control group. It could be suggested that patients could prefer ineffective coping strategies and their psychological resilience could be low. The determination of the psychiatric complications associated with migraine could alter treatment interventions, and thus, the prognosis.Öğe Cyberchondria and Anxiety Sensitivity in Patients with Panic Disorder: A Case-Control Study(Mdpi, 2026) Orman, Kubra; Sun, Tunahan; Ugur, Kerim; Kizilkaya, FatmaBackground and Objectives: Cyberchondria (CYB) has been associated with health anxiety and anxiety sensitivity (AS); however, its role in panic disorder (PD) remains unclear. This study aimed to compare CYB and AS levels between patients with PD and healthy controls and to examine their associations with PD severity. Materials and Methods: This cross-sectional case-control study included 71 patients with PD and 69 age- and sex-matched healthy controls. Participants completed the Cyberchondria Severity Scale (CSS), Anxiety Sensitivity Index-3 (ASI-3), and Beck Anxiety Inventory (BAI). PD severity was assessed using the Panic Disorder Severity Scale (PDSS). Group comparisons were additionally conducted using analysis of covariance (ANCOVA), controlling for relevant sociodemographic and clinical variables. Pearson correlation and hierarchical multiple regression analyses were performed. Results: Patients with PD had significantly higher CSS (80.70 +/- 22.71 vs. 60.62 +/- 17.22) and ASI-3 total scores (35.66 +/- 17.87 vs. 12.25 +/- 10.18) than healthy controls. In the PD group, CYB was positively correlated with AS (r = 0.38, p < 0.01), whereas no significant association was found between CYB and PD severity (r = 0.09, p > 0.05). AS showed a moderate positive correlation with PD severity (r = 0.46, p < 0.01). In hierarchical regression analyses, CYB did not predict PD severity. Adding AS significantly increased the explained variance; however, in the final model, only general anxiety severity (BAI) remained a significant predictor of PD severity. Conclusions: Patients with PD exhibit elevated levels of CYB and AS, which are positively associated with each other. Nevertheless, PD severity appears to be primarily driven by general anxiety symptoms rather than CYB. These findings suggest that CYB may represent a parallel maladaptive coping behavior rather than a direct determinant of symptom severity, with potential implications for assessment and intervention. Longitudinal studies are warranted to clarify causal relationships.Öğe Evaluation of Optical Coherence Tomography Findings in Antisocial Personality Disorder Patients(Aves, 2023) Emir, Burcu Sirlier; Yildiz, Sevler; Kilicaslan, Asli Kazgan; Kurt, Osman; Keser, Sinem; Ugur, KerimBackground: Antisocial personality disorder is a frequently studied personality disorder, and its etiopathogenesis is still investigated. Neuroimaging demonstrated that certain regions of the brain could be associated with this disorder, and in the present study, we aimed to investigate the changes in retina, which could be considered an extension of the brain in antisocial personality disorder patients with optical coherence tomography. Methods: The study was conducted with 35 patients and 35 healthy controls. The study data were collected with the Sociodemographic and Clinical Data Form, Beck Anxiety Inventory, Beck Depression Inventory, and Barratt Impulsivity Scale-Short Form. Retinal nerve fiber layer thickness, choroidal thickness, and macular thickness were analyzed based on optical coherence tomography. Results: The Beck Depression Inventory (P =.044), Beck Anxiety Inventory (P =.005), Barratt Impulsivity Scale-motor (P <.001), Barratt Impulsivity Scale-non-planning dimension (P <.001), and Barratt Impulsivity Scale-total scores (P <.001) of the patients were significantly higher when compared to the controls. The superior (P =.013) and inferior retinal nerve fiber layer thickness (P <.001) of the patients were significantly lower when compared to the control group. Conclusion: Retinal nerve fiber layer thickness was significantly lower in the patient group when compared to healthy controls, which suggested that it could be associated with the pathophysiology of antisocial personality disorder.Öğe Inflammation Markers in Patients with Bipolar Disorder Who Have Committed Offenses and Their Relationship with Criminal Behavior(Mdpi, 2023) Sirlier Emir, Burcu; Yildiz, Sevler; Kazgan Kilicaslan, Asli; Kurt, Osman; Ugur, Kerim; Tabara, Muhammed Fatih; Aydin, SueleymanBackground and Objectives: This study aimed to examine the function of various inflammation parameters and their interactions in the pathology of Bipolar disorder (BD) and to assess whether they could be biomarkers in the relationship between criminal behavior and BD. Materials and Methods: Overall, 1029 participants, including 343 patients with BD who have committed offenses, 343 nonoffending patients with BD, and 343 healthy controls, were included in this retrospective study. Neutrophil, lymphocyte, monocyte, and platelet counts; high-density lipoprotein (HDL-c) levels; systemic immune-inflammatory index (SII), systemic inflammatory response index (SIRI), neutrophil to high-density lipoprotein ratio (NHR), lymphocyte to high-density lipoprotein ratio (LHR), monocyte to high-density lipoprotein ratio (MHR), platelet to high-density lipoprotein ratio (PHR) were measured. Results: Significant differences were observed between the groups in terms of SII, SIRI, NHR, LHR, MHR, PHR, neutrophil, and monocyte values (p < 0.001). The lymphocyte counts were significantly higher in the patients with BD who committed offenses (p = 0.04). The platelet counts were significantly lower in the patients with BD who committed offenses compared to nonoffending patients with BD (p = 0.015). The HDL-c levels were significantly lower in the patients with BD who have committed offenses than those of nonoffending patients with BD (p < 0.001). Bipolar disorder, not receiving active psychiatric treatment, having a diagnosis of bipolar manic episodes, and having low platelet and HDL values constitute a risk of involvement in crime. Conclusions: The present study emphasizes the role of systemic inflammation in the pathophysiology of patients with BD with and without criminal offenses and the relationship between inflammation and criminal behavior.Öğe Inflammation markers in patients with psychotic disorder who have committed offenses and their relationship with criminal behavior(Routledge Journals, Taylor & Francis Ltd, 2025) Yildiz, Sevler; Emir, Burcu Sirlier; Kilicaslan, Asli Kazgan; Kurt, Osman; Ugur, Kerim; Sehlikoglu, Seyma; Atmaca, MuradThe role of inflammation in the etiology of psychotic disorders (PD) is well-established. This study aimed to identify inflammation parameters in patients diagnosed with PD, assess their potential as biomarkers, and examine their relationship with criminal behavior. This retrospective study comprised three groups: 530 patients diagnosed with PD who had committed crimes (offenders with PD), 530 patients with PD who had not committed crimes (non-offenders with PD), and 530 healthy controls, totaling 1,590 participants. Routine hematological tests were used to measure neutrophil, lymphocyte, monocyte, and platelet counts, high-density lipoprotein (HDL), systemic inflammatory response index (SIRI), systemic immune-inflammatory index (SII), and neutrophil/HDL (NHR), lymphocyte/HDL, platelet/HDL (PHR), and monocyte/HDL (MHR) ratios. Offenders with PD exhibited significantly higher levels of SII, SIRI, PHR, NHR, LHR, neutrophils, and monocytes compared to non-offenders with PD and healthy controls (p < 0.001). The criminal group had lower HDL and lymphocyte levels than the remaining two groups (p < 0.001). Among those treated in forensic psychiatry units, patients with two or more treatments showed significantly higher SIRI values compared to those with only one treatment (p = 0.045). Non-offenders with PD had higher platelet values than the remaining two groups (p < 0.001). This study underscores the role of systemic inflammation in the pathophysiology of psychotic disorders through a comparison of patients who have and have not committed crimes, highlighting the relationship between inflammation and lipid metabolism. Further research is required to clarify these findings.Öğe Investigation of Optic Nerve Sheath Diameter, Intraocular Pressure, and Dry Eye in Patients with Borderline Personality Disorder: The Role of Childhood Trauma(Mdpi, 2025) Sun, Tunahan; Cakar, Demet Dursun; Yesiloglu, Caner; Demirkol, Mehmet Emin; Tamam, Lut; Ugur, Kerim; Polat, HaticeBackground/Objectives: Borderline personality disorder (BPD) is a psychiatric disorder characterized by emotional instability, impulsive behavior, and impaired interpersonal relationships. It is associated with a high prevalence of childhood trauma and neurobiological changes. This study aimed to compare ophthalmologic parameters, namely, optic nerve sheath diameter, intraocular pressure, and dry eye, in patients with BPD with healthy controls and to investigate the relations between these parameters and childhood trauma. Methods: This study included 51 female patients with BPD between the ages of 18 and 35 years, who were not using psychotropic medication, and 51 healthy controls matched for age and educational level. Optic nerve sheath diameter, intraocular pressure, and tear break-up time were measured, and trauma history was evaluated using the Childhood Trauma Questionnaire-Short Form. Independent t-test and Pearson correlation analysis were used in statistical analyses. Results: Patients with BPD were found to have significantly higher mean optic nerve sheath diameter scores (left: 3.94 +/- 0.43, right: 3.97 +/- 0.47) compared with healthy controls (left: 3.76 +/- 0.44, right: 3.78 +/- 0.45) (p < 0.05). The groups showed no significant difference in intraocular pressure and dry eye parameters (p > 0.05). A significant positive correlation was noted between emotional abuse scores and the optic nerve sheath diameter of the left eye in patients with BPD (p < 0.05; r = 0.364). Conclusions: An increased optic nerve sheath diameter may be a potential peripheral biomarker reflecting chronic stress or changes in intracranial physiology in patients with BPD. This increase is particularly associated with a history of emotional abuse. Ophthalmological parameters may contribute to understanding the neurobiological basis of BPD and serve as peripheral biomarkers or indicators of neurobiological changes.Öğe Investigation of the relationship between forensic psychiatry patients' violent behaviors and levels of treatment adherence and hope(Ugur, Kerim, 2021) Polat, Hatice; Ugur, KerimINTRODUCTION: This study was conducted to examine the relationship between violent behaviors of forensic psychiatry patients and their adherence to treatment and level of hope. METHODS: This study used a descriptive and correlational research design. July 2020 October 2020 data of the study was collected and a total of 134 patients participated in the study. A personal information form, Morisky Adherence Scale, Taylor crime violence Rating Scale and Herth Hope Scale were used for data collection. RESULTS: It was determined that 40.3% of the patients participating in the study exhibited moderate violent behavior, 63.4% had low levels of adherence to treatment and hope levels were 40.14±21.80. It was determined that there was a negative significant relationship between the levels of hope and treatment adherence of violent behavior of patients (p<0.05). DISCUSSION AND CONCLUSION: It was determined that most forensic psychiatry patients had low adherence treatment and moderate violent behavior, and that there was a negative association between patients ' violent behavior and their level of hope and adherence to treatment.Öğe Psychological rigidity, alexithymia and treatment motivation in individuals diagnosed with substance use disorder(Taylor & Francis Inc, 2024) Polat, Hatice; Ugur, Kerim; Yildiz, SevlerObjective: In this study, we examined the relationship between psychological rigidity, alexithymia, and treatment motivation in individuals diagnosed with substance use disorder (SUD). Methods: 164 patients diagnosed with SUD who were admitted to Alcohol and substance addiction treatment outpatient clinic were included in the study. Sociodemographic data form, Acceptance and Action Questionnaire-II (AAQ-II), Toronto Alexithymia Scale (TAS-20), Treatment Motivation Questionnaire (TMQ) were applied to all participants. Results: A significant positive relationship was found between the TAS total dimension and all its sub-dimensions and the AAQ-II total score (p < 0.01). A statistically significant difference was found between both TMQ total scores and AAQ-II total scores, depending on the participants' alexithymia status (p < 0.05). Conclusions: It was determined that individuals with SUD who participated in this study were prone to alexithymia and had moderate levels of psychological rigidity and treatment motivation.Öğe The Effect of Alexithymia, Metacognitive Beliefs and Self-Efficacy on Disability in Patients With Schizophrenia: A Cross-Sectional Study(Wiley, 2026) Polat, Hatice; Ugur, Kerim; Sun, TunahanIntroduction Schizophrenia is a chronic mental disorder and one of the leading causes of disability worldwide, with greater levels of disability being associated with lower general self-efficacy. Reducing disability and enhancing self-sufficiency in individuals diagnosed with schizophrenia are among the primary goals of treatment and care. Aim This study aimed to examine the effects of alexithymia and metacognitive beliefs on self-efficacy levels and disability in individuals diagnosed with schizophrenia. Methods The study was conducted with 145 individuals under the age of 30 (67 individuals diagnosed with schizophrenia and 78 healthy controls) using a descriptive and correlational design. Data were collected using a sociodemographic data form, the Toronto Alexithymia Scale (TAS-20), the Metacognition Questionnaire (MCQ-30), the General Self-Efficacy Scale (GSES) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Results Compared to the control group, the patient group demonstrated significantly higher TAS-20, MCQ-30 and WHODAS 2.0 scores, and significantly lower GSES scores (p < 0.05). The patients' total MCQ-30 scores were significantly associated with both WHODAS 2.0 and GSES scores (p < 0.05); however, TAS-20 did not mediate the relationship between MCQ-30 and WHODAS 2.0 (p > 0.05), whereas it showed a significant mediating effect in the relationship between MCQ-30 and GSES (p < 0.05). Discussion Patients exhibited higher disability and lower general self-efficacy than the control group. Cognitive-behavioural and metacognitive therapeutic approaches targeting alexithymia may contribute to improved functioning and reduced disability in individuals with schizophrenia. Implications for Practice The findings improve understanding of factors related to disability and diminished general self-efficacy in individuals with schizophrenia and may inform the development of targeted psychosocial interventions. Relevance Statement Self-efficacy and disability are key determinants of recovery in schizophrenia. By demonstrating the roles of alexithymia and metacognitive beliefs, this study provides a conceptual framework to guide clinical practice and supportive care strategies.Öğe The effect of functional remission and cognitive insight on criminal behavior in patients with schizophrenia(W B Saunders Co-Elsevier Inc, 2023) Polat, Hatice; Ugur, Kerim; Aslanoglu, Eren; Yildiz, Sevler; Yagin, Fatma HilalObjective: This study was planned to determine the relationship of functional remission with a criminal history and determine its effect on criminal behavior in patients with schizophrenia.Methods: This cross-sectional study was conducted with 132 patients with schizophrenia (66 with and 66 without a criminal history). Data were collected between November 2020 and April 2021 using a personal information form, the Functional Remission of General Schizophrenia (FROGS), the Taylor Crime Violence Rating Scale, the Beck Cognitive Insight Scale, and the Positive and Negative Syndrome Scale (PANSS) was used to collect data.Results: In terms of all scale variables, there were significant differences between the groups with and without a criminal history (p < 0.05). These differences were mostly clearly observed in the FROGS-social functionality (effect size: 16.79), PANSS-positive (effect size: 2.62) and FROGS-health and treatment (effect size: 2) subscales. Conclusions: In this study, it was determined that as the symptoms of the illness increased in schizophrenia, the patients' functional remission and insight decreased, and their tendency to commit crimes increased. Psychiatric nurses can plan therapeutic interventions to increase the functionality and insight levels of patients with schizophrenia.Öğe The impact of post-earthquake anxiety and depression on erectile dysfunction: A cross-sectional study after the February 6, 2023 Earthquakes in Turkiye(Kare Publ, 2026) Bugday, Muhammet Serdar; Akdemir, Ender; Ugur, Kerim; Cakmak, Battal Selcuk; Akbulut, Mehmet Levent; Polat, HaticeOBJECTIVE: This study aimed to evaluate the effects of the February 6, 2023, earthquakes in Turkiye on anxiety and depression levels and their impact on erectile dysfunction (ED). METHODS: A total of 164 men aged 25-55 were enrolled between July 15, 2024, and January 15, 2025. Ninety-seven patients who presented with ED after the earthquakes were included as the study group, and 67 healthy individuals without ED were enrolled as controls. All participants completed the Arizona Sexual Experiences Scale (ASEX), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), World Health Organization Quality of Life-BREF (WHO-QOL-BREF), and International Index of Erectile Function (IIEF-5). Statistical analyses were conducted using chi-square, t-tests, and ANOVA. RESULTS: There were no significant differences between the groups regarding age and marital status. Patients with ED had significantly higher ASEX, HAM-A, and HAM-D scores and significantly lower WHOQOL-BREF scores compared to controls (p=0.001). Among ED patients, 52 (53.6%) had severe ED, 40 (41.2%) had moderate, and 5 (5.2%) had mild symptoms. ASEX scores were significantly higher (p=0.01), and WHOQOL-BREF general health scores were significantly lower in patients with severe ED compared to those with milder forms (p=0.001). CONCLUSION: The February 6 earthquakes were associated with increased anxiety and depression and decreased quality of life in men, which significantly contributed to the prevalence and severity of ED. These findings highlight the importance of addressing sexual health as part of post-disaster psychosocial support.Öğe The Relationship among Dyadic Adjustment and Disease Burden in Patients with Bipolar Disorder and Their Spouses(Mdpi, 2023) Namli, Zeynep; Tamam, Lut; Demirkol, Mehmet Emin; Karaytug, Mahmut Onur; Yesiloglu, Caner; Ugur, Kerim(1) Background: Spouses of individuals with bipolar disorder (BD) experience significant burdens, and the perception of the burden may affect dyadic adjustment. We aimed to investigate the sexual functions, alexithymic traits, marital satisfaction, and burden in patients with BD and their spouses. We also aimed to assess the mediating role of sexual functions and alexithymia in the relationship between burden and dyadic adjustment. (2) Methods: We included 81 patients with BD type 1 (40.69 +/- 8.55 years, 65.4% female, and 34.6% male) and their healthy spouses (40.95 +/- 7.30 years, 34.6% female, and 65.4% male) and 78 healthy controls (38.90 +/- 5.88, 48.7% female, and 51.3% male). The participants were evaluated using the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), Dyadic Adjustment Scale (DAS), Hamilton Depression Rating Scale (HDRS), Toronto Alexithymia Scale-20 (TAS-20), and Burden Assessment Scale (BAS). (3) Results: The GRISS scores of the control group were significantly lower than the spouses and BD groups. The DAS total score of the control group was significantly higher than that of the spouses and BD groups. Regression analyses revealed that TAS, GRISS, and HDRS scores were associated with DAS scores in the BD group. In the spouse group, TAS and BAS scores were associated with DAS scores. The GRISS scores partially mediated the relationship between dyadic adjustment and burden in the spouses of patients with BD. (4) Conclusions: Mental health professionals should regularly scan caregivers' perceptions of burden. Appropriate psychosocial interventions could help spouses of patients with BD to cope better with the burden and improve dyadic adjustment.
