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  • Yayın
    The comparison of psychological factors and executive functions of children with Attention Deficit Hyperactivity Disorder and Cognitive Disengagement Syndrome to ADHD and ADHD comorbid with Oppositional Defiant Disorder
    (SAGE Publications Inc., 2024-10) İnci İzmir, Sevim Berrin; Aktan, Zekeriya Deniz; Ercan, Eyüp Sabri
    Objective: The study aims to examine family functionality, emotion regulation difficulties, preference for loneliness, social exclusion, internalizing and externalizing disorders, and executive functions in children with Attention Deficit Hyperactivity Disorder (ADHD) and Cognitive Disengagement Syndrome (CDS) and compare with ADHD, and ADHD+ Oppositional Defiant Disorder (ODD). Method: This study included 842 children aged 8–12 years. The subjects were categorized according to DSM-V as ADHD (n = 246), ADHD + ODD (n = 212), ADHD + CDS (n = 176), and Control group (n = 207). The solitude and social exclusion, difficulties in emotion dysregulation and Barkley SCT scales, Child Behavior Checklist, family assessment device, and Central Vital Signs (CNSVS) test were used. Results: According to the study, children with ADHD + CDS had higher rates of internalizing disorders. They also preferred being alone and experienced more difficulty communicating with their parents and solving problems within the family. Additionally, these children had difficulty recognizing and understanding the emotional reactions of others. The ADHD + ODD group presented a poorer performance on CNSVS domain tests except for the psychomotor speed test than other groups. Also, ADHD + CDS children had the lowest psychomotor speed scores and lower scores on reaction time and cognitive flexibility than pure ADHD children. Conclusion: This study will contribute to the etiology, treatment, and clinical discrimination of ADHD + CDS.
  • Yayın
    The comparison of functional connectivity in Parkinson’s Disease patients with and without Parkin gene mutations
    (Turkish Neuropsychiatric Society, 2025-06-19) Çebi, Merve; Ay, Ulaş; Kıçik, Ani; Erdoğdu, Emel; Tepgeç, Fatih; Uyguner, Zehra Oya; Tüfekçioğlu, Zeynep; Samancı, Bedia; Bilgiç, Başar; Emre, Murat; Demiralp, Tamer; Hanağası, Haşmet Ayhan
    Introduction: Mapping the functional connectivity of brain regions became appealing in recent research in neurology. Accordingly, a growing body of evidence shows resting-state functional connectivity (rsFC) changes in neurodegenerative disorders including Parkinson’s Disease (PD). As characterised by extensive and progressive dopaminergic loss in the substantia nigra, PD emerges with serious motor and non-motor dysfunctions. In the literature, the minority of PD cases have been associated with certain genetic mutations. The aim of this study was to investigate the rsFC in a group of PD patients having Parkin gene mutation. Method: Twelve PD patients with Parkin mutation (PP-PD), 12 PD patients without Parkin mutation (PN-PD) and 12 healthy controls (HC) were included in the study. All participants underwent a resting-state functional magnetic resonance imaging as well as a neuropsychological assessment and clinical examination. Results: Results indicated that PP-PD had longer disease duration, a higher rate of dyskinesia and lower scores on complex visual perception tests. The resting state networks showed that all PD (consisting of PP-PD and PN-PD) and PP-PD groups had increased functional connectivity in the frontoparietal network as compared to the HC. In addition, the PP-PD group displayed decreased functional connectivity in the dorsal attention network compared to the PN-PD. Conclusion: In conclusion, our data suggests that PD with Parkin gene mutation might be emerging with distinct resting state functional connectivity changes in the brain.
  • Yayın
    Investigation of symptom-specific functional connectivity patterns in Parkinson’s disease
    (Springer-Verlag Italia S.R.L., 2025-06-14) Kıçik, Ani; Bayram, Ali; Erdoğdu, Emel; Kurt, Elif; Sarıdede, Dilek Betül; Cengiz, Sevim; Bilgiç, Başar; Hanağası, Haşmet; Öztürk Işık, Esin; Gürvit, Hakan; Tüzün, Erdem; Demiralp, Tamer
    Parkinson’s disease (PD) is a complex neurodegenerative disease, characterized by pronounced heterogeneity in symptoms. This study investigates the functional connectivity (FC) patterns associated with distinct symptom clusters, aiming to elucidate the heterogeneity in PD and uncover the neural mechanisms underlying its motor and cognitive symptoms. Resting-state functional MRI (rs-fMRI) data from 55 non-demented PD patients and 24 healthy controls (HC) were used to perform seed-to-seed FC analyses. A clustering algorithm was applied to the cognitive and motor scores of all PD patients to generate relatively homogeneous symptomatic subgroups. PD patients exhibited a general decrease in FC within a network comprising the sensorimotor network (SMN) and the visual network (VN) regions. Symptom-based clustering revealed three relatively homogeneous subgroups, exhibiting a gradient pattern: patients with greater motor deficits showed significant disconnection within the SMN, whereas patients with greater visuospatial deficits exhibited reduced FC in an extended subnetwork, with pronounced disconnections between the VN and SMN areas. Our study demonstrated a notable disconnection between the SMN and VN, indicating impaired visual-motor integration in PD. Stronger disconnection within the SMN was associated with greater motor dysfunction, and stronger visual-sensorimotor disconnections were associated with greater visuospatial deficits. These findings suggest that at least two separate routes of functional disconnection may be responsible for the inhomogeneous symptom distribution in PD.
  • Yayın
    Treatment and long-term outcome of mental disorders: The grim picture from a quasi-epidemiological investigation in 54,826 subjects from 40 countries
    (Elsevier Ireland Ltd, 2025-06) Fountoulakis, Konstantinos N.; Karakatsoulis, Gregory; Abraham, Seri; Adorjan, Kristina; Uddin Ahmed, Helal; Alarcòn, Renato Daniel; Arai, Kiyomi; Auwal, Sani Salihu; Berk, Michael; Levaj, Sarah; Yılmaz Kafalı, Helin
    Introduction: This study registered rates of specific treatment options for mental disorders as well as their long-term outcome. Material and methods: The history of mental disorders was used as a proxy for diagnosis. The data came from the COMET-G study (40 countries; 54,826 subjects, 64.73 % females, 35.45±13.51 years old). The analysis included descriptive statistics, Risk Ratios, t-tests, and ANCOVA's. Results: 24.14 % reported a history of any mental disorder (depression >12 %, non-affective psychosis and Bipolar disorder 1 % each, >20 % self-injury, >10 % had attempted suicide, 7.17 % illegal substance abuse). Most patients were not under any kind of treatment (59.44 %) and most were not receiving treatment as recommended (e.g. 90 % of Bipolar and 2/3 of psychotic patients). No treatment at all and psychotherapy as monotherapy were consistently related to poorer outcomes. In anxiety or depression, only antidepressant monotherapy and benzodiazepines, in Bipolar disorder only antipsychotic monotherapy in males and antidepressant monotherapy in females and in non-affective psychosis antipsychotics and psychotherapy in females only, were related to good outcomes. No treatment modality was related to a good outcome in those with a history of self-harm, suicidal attempts, or illegal substance use. Only depression and treatment with antidepressants were related to metabolic syndrome. Discussion: In the community, the overwhelming majority of mental patients do not receive appropriate treatment or, even worse, no treatment at all. The outcome is unfavourable for the majority and only a few selective treatment options seem to make a difference.
  • Yayın
    Analyzing language ability in first-episode psychosis and their unaffected siblings: a diffusion tensor imaging tract-based spatial statistics analysis study
    (Elsevier Ltd, 2024-11) Çabuk, Tuğçe; Şahin Çevik, Didenur; Çakmak, Işık Batuhan; Yılmaz Kafalı, Helin; Şenol, Bedirhan; Avcı, Hanife; Karlı Oğuz, Kader; Toulopoulou, Timothea
    Schizophrenia (SZ) is a highly heritable mental disorder, and language dysfunctions play a crucial role in diagnosing it. Although language-related symptoms such as disorganized speech were predicted by the polygenic risk for SZ which emphasized the common genetic liability for the disease, few studies investigated possible white matter integrity abnormalities in the language-related tracts in those at familial high-risk for SZ. Also, their results are not consistent. In this current study, we examined possible aberrations in language-related white matter tracts in patients with first-episode psychosis (FEP, N = 20), their siblings (SIB, N = 20), and healthy controls (CON, N = 20) by applying whole-brain Tract-Based Spatial Statistics and region-of-interest analyses. We also assessed language ability by Thought and Language Index (TLI) using Thematic Apperception Test (TAT) pictures and verbal fluency to see whether the scores of these language tests would predict the differences in these tracts. We found significant alterations in language-related tracts such as inferior longitudinal fasciculus (ILF) and uncinate fasciculus (UF) among three groups and between SIB and CON. We also proved partly their relationship with the language test as indicated by the significant correlation detected between TLI Impoverished thought/language sub-scale and ILF. We could not find any difference between FEP and CON. These results showed that the abnormalities, especially in the ILF and UF, could be important pathophysiological vulnerability indexes of schizophrenia. Further studies are required to understand better the role of language as a possible endophenotype in schizophrenia with larger samples.
  • Yayın
    Reliability of direct-to-home teleneuropsychological assessment: a within-subject design study
    (Routledge, 2025-07-04) Yıldırım, Elif; Soncu Büyükişcan, Ezgi; Akça Kalem, Şükriye; Gürvit, Hakan
    Objective: During the COVID-19 pandemic, the need to continue diagnosis and treatment processes, in addition to scientific research, led to a rapid shift towards direct-to-home tele-neuropsychology administrations, the reliability and validity of which had not been clearly established then. This study, therefore, aimed to examine the reliability of direct-to-home tele-neuropsychological assessment (TNP). Method: The sample included 105 cognitively healthy individuals aged between 50–83 years, and 47 patients diagnosed with neurocognitive disorders (mild cognitive impairment and early-stage Alzheimer’s type dementia). All participants underwent both face-to-face and teleneuropsychological assessments in a counterbalanced order. Results: The results revealed that performances across measures of attention, working memory, verbal fluency, verbal and visual memory, and visual perception were comparable across assessment modalities. Intraclass correlation coefficients of the tests ranged from.54 to.92. Conclusions: The findings of the study provide support for direct-to-home teleneuropsychological assessment among patients with neurocognitive disorders. Neuropsychological tests relying on verbal administration and independent of motor performance may represent a reliable alternative for this patient group when administered in settings where external distractions or technological limitations are controlled. For cognitively healthy individuals, on the other hand, the reliability of the TNP application is more questionable for memory and some executive function tests and therefore needs further exploration.
  • Yayın
    Efficacy, all-cause discontinuation, and safety of serotonergic psychedelics and MDMA to treat mental disorders: a living systematic review with meta-analysis
    (Elsevier B.V., 2025-12) Højlund, Mikkel; Yılmaz Kafalı, Helin; Kırmızı, Begüm; Fusar-Poli, Paolo; Correll, Christoph U.; Cortese, Samuele; Sabé, Michel; Fiedorowicz, Jess; Saraf, Gayatri; Zein, Josephine; Berk, Michael; Husain, Muhammad I.; Rosenblat, Joshua D.; Rubaiyat, Ruby; Corace, Kim; Wong, Stanley; Hatcher, Simon; Kaluzienski, Mark; Yatham, Lakshmi N.; Cipriani, Andrea; Gosling, Corentin J.; Carhart-Harris, Robin; Tanuseputro, Peter; Myran, Daniel T.; Fabiano, Nicholas; Moher, David; Mayo, Leah M.; Nicholls, Stuart G.; White, Tracy; Prisco, Michele De; Radua, Joaquim; Vieta, Eduard; Ladha, Karim S.; Katz, Jay; Veroniki, Areti A.; Solmi, Marco
    Serotonergic psychedelics and 3,4-methylendioxtmethamphetamine (MDMA) are promising treatments for mental disorders with a continuously evolving evidence base. We searched Pubmed/Scopus/clinical trial registries up to 08july2025 for double-blind randomized controlled trials (RCTs) testing MDMA or serotonergic psychedelics in patients with mental disorders. Primary outcomes were change in disease-specific symptoms and all-cause discontinuation. Standardized mean differences (SMD) and relative risk (RR) were estimated using random-effects meta-analysis. Risk of bias (RoB) was assessed with Cochrane’s RoB-tool version 2 and certainty of evidence with GRADE. The review is maintained as living systematic review ( https://ebipsyche-database.org/ ). We included 30 RCTs (1480 participants; female=45.8 %; with psychological support=83.3 %; high RoB=83.3 %). In post-traumatic stress disorder (PTSD), MDMA reduced PTSD symptoms compared to any control ( k = 11; SMD=-0.85 [-1.09; -0.60]; I2=0 %; GRADE=low). In major depressive disorder (MDD), psilocybin/ayahuasca/LSD reduced depressive symptoms ( k = 8; SMD=-0.62 [-0.97; -0.28]; I2=55 %; GRADE=very low). In anxiety disorders, both MDMA and serotonergic psychedelics reduced anxiety symptoms (SMDMDMA=-1.18 [-2.04; -0.32]; I2=0 %; k = 2; GRADE=low and SMDserotonergic=-0.88 [-1.70; -0.06]; I2=54 %; k = 5; GRADE=very low). In alcohol use disorder, neither psilocybin nor LSD reduced abstinence rates ( k = 6; RR=1.42 [0.89; 2.26]; I2=7 %; GRADE=very low). In attention-deficit hyperactivity disorder (ADHD), LSD did not reduce ADHD symptoms ( k = 1; SMD=0.22 [-0.32; 0.76]; GRADE=very low). Moderate certainty in evidence was only found for MDMA on PTSD symptoms when compared to placebo. MDMA/serotonergic psychedelics were not associated with higher risk of all-cause discontinuation (RRMDMA=0.74 [0.32; 1.72]; RRserotonergic=0.81 [0.56; 1.15]). Overall, MDMA/serotonergic psychedelics are promising for the treatment of PTSD, MDD, and anxiety disorders with moderate to large effect sizes. Pragmatic trials, long-term, head-to-head trials exploring the role of psychological support, aiming to identify predictors of response, and accounting for expectancy and functional unblinding are needed. Studies addressing these limitations will likely be required for regulatory approval of psychedelic drugs.
  • Yayın
    Ebeveyn tutumları ve çocuk davranış problemleri arasındaki ilişkide ebeveyn mükemmeliyetçiliğinin aracı rolü
    (Galenos Publishing House, 2025-11-11) İnce, Merve; Akçınar, Berna; Yılmaz, Simay
    Amaç: Bu çalışma, annelerin mükemmeliyetçiliğinin, annelerin ebeveynlik stilleri ile çocukların içselleştirme ve dışsallaştırma davranış problemleri arasındaki ilişkide aracılık rolünü incelemeyi amaçlamaktadır. Gereç ve Yöntem: Örneklem, 3-6 yaş arası çocukları olan 271 anneden oluşmaktadır. Katılımcılardan sosyodemografik bilgi formu, Ebeveyn Tutum Ölçeği, Hacettepe Ruhsal Uyum Ölçeği ve Çok Boyutlu Mükemmeliyetçilik Ölçeğini doldurmaları istenmiş ve veriler çevrimiçi olarak toplanmıştır. Bulgular: Çalışmanın ana hipotezini test etmek için yapılan analiz bulgularına göre demokratik ebeveynlik, içselleştirme (b=-0,117, p<0,05) ve dışsallaştırma (b=-0,076, p<0,05) davranış problemlerini negatif yönde yordamıştır. Bu ilişkilerde annenin kendine yönelik mükemmeliyetçiliği (KYM) ve sosyal olarak belirlenen mükemmeliyetçilik (SBM) aracılık etmemiştir. Otoriter ebeveynlik, içselleştirme (b=0,046, p<0,05) ve dışsallaştırma (b=0,049, p<0,05) davranış problemleriyle pozitif yönde ilişkilendirilmiş ve bu problemler üzerindeki etkilerinde KYM ve SBM aracılık rolü üstlenmemiştir. Buna karşın, aşırı korumacı ve izin verici tutumlar bu davranış problemlerini anlamlı bir şekilde yordamamıştır. Ayrıca, annelerin KYM’nin, aşırı korumacı ve izin verici ebeveynlik tutumları ile içselleştirme ve dışsallaştırma davranış problemleri arasındaki ilişkide aracılık etkisi olmadığı bulunmuş; ancak SBM’nin aşırı koruyucu ebeveyn tutumu ile içselleştirme [b=0,017, standart hata (SH)=0,009, güven aralığı (GA): (0,003, 0,038)] ve dışsallaştırma [b=0,012, SH=0,007, GA: (0,001, 0,029)] davranış problemlerinde ve izin verici ebeveyn tutumu ile içselleştirme davranış problemi [b=0,013, SH=0,008, GA: (0,000, 0,033)] arasında aracılık etkisinde bulunduğu görülmüştür. Sonuç: Bu çalışma, ebeveynlik tutumları ve özelliklerinin çocukların ruh sağlığı üzerindeki önemli rolünü vurgulamakta, ebeveynlerin etkili ve olumlu ebeveynlik yaklaşımlarını benimsemeleri için pratik müdahalelerin gerekliliğini belirtmektedir.