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Trichotillomania (TTM) is a psychiatric disorder can be triggered by traumatic events characterized by recurrent hair pulling. The incidence of post-traumatic stress disorder (PTSD) in TTM patients was also significantly higher than in the normal population. It is estimated that serotonergic system, dopaminergic system, hypothalamic-pituitary-adrenal (HPA) axis genes may be related with PTSD and TTM co-occurrence. When the literature is reviewed it is seen that serotonergic system gene especially 5HT-2A gene polymorphism may play an important role as a com-mon possible genetic background in the etiology of posttraumatic stress disorder and trichotillomania. It was also observed that effective results were obtained when agents acting on 5HT-2A receptor were preferred in the treatment. Here, we report a 20-year-old male patient who was diagnosed with TTM and PTSD as a result of trau-matic life event a year ago and we also aimed to discuss a possible common genetic etiology which may cause this comorbidity.

Mega cisterna magna (MCM) is a cystic malformation of the posterior fossa and characterized by enlarged cisterna magna with an intact vermis and cerebellar hemispheres. The lesion is frequently seen as isolated however it may also constitute a part of Dandy-Walker complex. The concurrence of MCM and psychiatric disorders has already been documented but the possible pathophysiological associations still remain elusive. We present a 36 years-old male patient with incidentally detected isolated MCM, who previously had persecutory and reference delusions as a possible non-index case of shared psychotic disorder. Shared psychotic disorder (folie a deux) is a relatively rare mental condition develops between two affected individuals in a close relationship. In this entity, the index patient already has a psychotic disorder and transmits delusional beliefs on a healthy -secondary- individual. It is firmly suggested that abnormalities of cerebellar structures could involve the pathophysiology of psychotic disorders and based on this fact, we aimed to contribute to the regarding literature with discussing the predisposing role of cerebellar neurodevelopmental abnormalities in psychosis with presenting a possible shared psychosis case.

Objective: Bipolar disorder (BD) affects 1-4% of the population worldwide and presents with seasonal patterns with an incidence of 20-30%. Limited studies exist on seasonality, its relation to sociodemographic and clinical characteristics, and effects on treatment in BD in Turkey. Methods: This retrospective study included 174 patients with a major diagnosis of BD according to the DSM-IV. Comorbidities were determined using the SCID-I. The study was conducted using a semi-structured interview schedule and a mood monitoring chart. The patients were divided into two groups, those with and those without seasonal patterns, and their sociodemographic and clinical characteristics were compared. Results: We found that 36.2% of patients with BD had seasonal patterns. Regardless of type, first episodes were significantly more frequent in the non-seasonal group. With respect to first-episode types, the manic type was significantly more frequent in the seasonal group and the depressive type in the non-seasonal group. The number of patients with a comorbid anxiety disorder (NOS) or dysthymia was significantly higher in the seasonal group and the hospitalized non-seasonal group. The rate of response to lithium monotherapy, mean duration of the disease, mean total number of episodes, and mean total number of mixed episodes were significantly higher in the seasonal group. Conclusion: The rate of dysthymia was significantly higher in the seasonal group, suggesting that those with seasonality have more depressive aspects. These results indicate that the prognosis for seasonal bipolar patients is poorer than for non-seasonal patients. Another important finding was the presence of a correlation between seasonality and a positive response to lithium protection. It has been established that the first episode of the disorder was manifested in the seasonal pattern. The first episode of BD is known to often develop as a depressive episode. These results suggest that it may be a predictor of seasonality.