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Aim: The sharing about an important public health problem, schizophrenia is increasing on Twitter, whiches user number multiplies day by day. Stigmatization can be usually met in the disorder of complex etiology. In this study, we aimed to investigate perspectives and attitudes of community toward schizophrenia, schizopherene, schizophrenic, and paranoiac on social media -Twitter- in Turkey. Material and Method: During about a month, totally 1200 Tweets that contain one of these -“schizophrenia, schizopherene, schizophrenic, paranoiac”- are analyzed and evaluated according to these words’ usage in a pilot sample. After establishing inter-rater reliability, they are evaluated in 5 main dimensions; a) mocking/humorous b) negative c) inappropriate d) anti-psychiatric e) medically appropriate. In addition, those who shared their age and gender were also recorded. Results: It was seen that these four words were usually used “mocking/ humorous” (39.2% and “negative” (26%). The usage of the words in non-medical was predominant. Most medically appropriate usage belonged to “schizophrenia” (26.7%). The most “negative” and “mocking/ humorous” usage belonged to “schizophrenic” (33.2% and 45.8%, respectively). In terms of gender, the four words were used mocking/ humorous mostly in both gender (39.5% and 38.8%). Medically appropriate use of women was greater (14.8% vs 7.5%). Conclusion: Our findings show that the presence of a great deal of misuse of schizophrenia and related words on Twitter. This misuse is quite a few pronounced by the adjective use of the disorder. At the time of the easiness of reaching information and social media usage the lack of knowledge, stigma and attitude problems toward schizophrenia is at an important level.

Jumping-to-conclusions (JTC) bias has been found to be associated with delusions. However, there is limited data about which other factors are related to JCT bias. The aim of the current study was ...

Background: Despite the diagnostic challenges in categorizing bipolar disorder subtypes, bipolar I and II disorders (BD-I and BD-II respectively) are valid indices for researchers. Subtle neurobiological differences may underlie clinical differences between mood disorder subtypes. The aims of this study were to investigate neurochemical differences between bipolar disorder subtypes. Methods: Euthymic BD-II patients (n = 21) are compared with BD-I (n = 28) and healthy comparison subjects (HCs, n = 30). Magnetic Resonance Imaging (MRI) and proton spectroscopy (1H MRS) were performed on a 3T Siemens Tim Trio system. MRS voxels were located in the left/right superior temporal cortices, and spectra acquired with the single voxel Point REsolved Spectroscopy Sequence (PRESS). The spectroscopic data were analyzed with LCModel (Version 6.3.0) software. Results: There were significant differences between groups in terms of glutamate [F = 6.27, p = 0.003], glutamate + glutamine [F = 6.08, p = 0.004], inositol containing compounds (Ino) (F = 9.25, p < 0.001), NAA [F = 7.63, p = 0.001] and creatine + phosphocreatine [F = 11.06, p < 0.001] in the left hemisphere and Ino [F = 5.65, p = 0.005] in the right hemisphere. Post-hoc comparisons showed that the BD-I disorder group had significantly lower metabolite levels in comparison to the BD-II and the HC groups. Limitations: This was a cross-sectional study with a small sample size. In addition, patients were on various psychotropic medications, which may have impacted the results. Conclusions: Neurochemical levels, in the superior temporal cortices, measured with 1H-MRS discriminated between BD-II and BD-I. Although further studies are needed, one may speculate that the superior temporal cortices (particularly left hemispheric) play a critical role, whose pathology may be related to subtyping bipolar disorder. The study was funded by Scientific Research Projects Committee of the Ankara Yıldırım Beyazıt University (Project Code: 803) and NIMH grant to CMM ( MH073998 ) and NIH grant to DO K24 ( MH104449 ). Dr. Phillips acknowledged the support of the Pittsburgh Foundation.

Hemsley and Garety described the "jumping to conclusions bias" in which patients with delusions may reach unreasonable results with insufficient information. In this study patients with bipolar disorder and healthy volunteers were compared in terms of jumping to conclusions bias using the beads in the jar task.37 patients with DSM-5 diagnosis of bipolar disorder and 30 healthy controls were tested with the Beads Task (BT), Tower of London Test (ToL) and Barrat Impulsiveness Scale (BIS).In the BT, the mean score of DtD (draws to decision) and JTC (jumping to conclusions) scores were not statistically different between the two groups. In the ToL test, the duration of the total execution and the total time were significantly longer in the bipolar group than the control group. BIS scores were significantly higher in the bipolar group. YMRS (Young Mania Rating Scale) scores were not correlated with BT.This study is the first clinical study to assess the jumping to conclusions bias in patients with bipolar disorder. No JTC bias was detected in bipolar disorder. Further studies may assess JTC in larger samples to determine the effects of clinical state changes, psychotic symptoms, medication and impulsivity.

Objective: Several types of evidence have shown that auditory networks are dysfunctional in schizophrenia (Sch) and bipolar disorders (BD). Auditory cortices show abnormalities in hallucinations or during remission. This study aimed to assess resting-state connectivity of auditory cortices in Sch and BD. Method: Patients with BD-1 (n=28), BD-2 (n=21), Sch (n=30), and healthy controls (HC, n=30) were enrolled into the study. A 3 Tesla whole-body magnetic resonance imaging (MRI) system with a 32-channel phase-array head coil was used to acquire the MRI data. T1-weighted anatomical and gradient-echo based Echoplanar Imaging sequences were used. MATLAB and Freesurfer software packages were used for data analyses. Connectivity alterations within the auditory network guided our further seedbased connectivity analysis. Results: The left angular gyrus volume was decreased in Sch and BD-2 groups. The supramarginal gyrus had hyperconnectivity with the medial prefrontal cortices and decreased connectivity with the medial superior temporal gyrus (STG) in the BD-1 and BD-2 groups. The left superior temporal sulcus (STS) had increased connectivity with the bilateral posterior cingulate cortex in BD-1 and BD-2 and increased connectivity with the dorsal prefrontal cortices in the Sch group. The STS had increased connectivity with the medial STG in the BD-1 and Sch groups, whereas connectivity decreased in the BD-2 group. Conclusion: These findings suggest that functional connectivity of resting-state networks are altered in BD and Sch. Auditory network alterations may predispose to dysfunctional auditory information processing. Further studies are needed to determine the relationship between symptoms and auditory network dysfunction.

Objective: The aim of this study was to evaluate the dynamic thiol-disulphide homeostasis as a novel oxidative stress parameter in newly diagnosed and medication-naive general anxiety disorder (GAD) and panic disorder (PD) patients. Method: Medication-naive patients with GAD (n=21) or PD (n=23) and healthy individuals (n=23) were enrolled. Patients were administered a sociodemographic form, Beck Depression Inventory, and Beck Anxiety Inventory. Routine biochemical parameters, native thiol, total thiol, and disulphide parameters were measured in all patients and healthy individuals. Results: The native thiol levels of the GAD and PD groups were found significantly lower than those of the control group (p

Amaç: Bu çalışmanın amacı, üreme çağındaki kadınlarda demir eksikliği anemisinin bilişselfonksiyonlar, fiziksel fonksiyonellik, psikiyatrik morbidite, yorgunluk ve yaşam kalitesi üzerindekietkilerini incelemekti.Materyal ve Metot: Yaşları 18‐50 arasında değişen ve demir eksikliği anemisi olan 33 kadın ve anemisiolmayan 32 sağlıklı kadın çalışmaya dahil edildi. Laboratuvar analizi, nöropsikolojik testler, BeckDepresyon Ölçeği, Beck Anksiyete Ölçeği, VAS yorgunluk, Sağlık Değerlendirme Anketi ve Kısa Form‐36değerlendirildi.Bulgular: Gruplar arasında demografik özellikler açısından anlamlı fark saptanmadı. Demir eksikliğiAnemisi olan grupta Digit Forward/Backward, Digit Span Total, Sağlık Değerlendirme Anketi, BeckDepresyon Ölçeği, Beck Anksiyete Ölçeği, Kısa Form‐36 ve yorgunluk skorları kontrol grubuna goreanlamlı olarak daha düşüktü. Korelasyon analizinde eğitim, serum demir, ferritin ve hemoglobindüzeyleri ile bilişsel test skorları ve yorgunluk arasında anlamlı ilişkili bulundu. Serum demir, ferritin vehemoglobin düzeyleri ile Sağlık Değerlendirme Anketi, Beck Depresyon Ölçeği, Beck Anksiyete Ölçeğive Kısa Form‐36 skorları arasında anlamlı ilişki bulundu.Sonuç: Demir eksikliği anemisi üreme çağındaki kadınlarda bilişsel fonksiyonları, fizikselfonksiyonelliği, yaşam kalitesini, yorgunluğu, anksiyete ve depresyon semptomlarını negative yöndeetkilemektedir., Objectives: The aim of the study was to determine whether irondeficiency anemia (IDA) in reproductive-age women affects cognitivefunctioning, physical functioning, psychiatric morbidity, fatigue and qualityof life. Materials and Methods: Thirty-three women aged between 18-50years with IDA and 32 non-anemic healthy women were included in the study.Laboratory analyses, neuropsychological tests, Beck Depression Inventory (BDI),Beck Anxiety Inventory (BAI), VAS fatigue, Health Assessment Questionnaire (HAQ-DI)and Short Form-36 (SF-36) were assessed. Results: There was nosignificant difference in demographic characteristics of the patients betweengroups. Digit Forward/Backward, Digit Span Total, HAQ-DI, BAI, BDI, SF-36,fatigue scores in IDA group were significantly lower than the controls.Correlation analysis revealed that education, serum iron, ferritin, andhemoglobin levels were associated with cognitive test scores and fatigue. Serumiron, ferritin, and hemoglobin levels were found to be associated with HAQ-DI,BAI, BDI, and SF-36 scores. Coclusion: IDA negativelyaffects cognition, physical functioning, quality of life, fatigue, symptoms ofanxiety and depression in reproductive-age women.

Constipation is a side effect of antipsychotic drugs that have high affinity for muscarinic cholinergic receptors. In addition, ileus is an important side effect of antipsychotic treatment, with potentially morbid and mortal consequences if early detection fails. In this report, a colonic ileus case is described in a patient with schizophrenia under the treatment of paliperidone palmitate. Consequently, complete physical examination and close screening of side effects are recommended when antipsychotics are prescribed.

Dear Editor, Chewing, coughing, breathing, typing are activities that produce low level sounds and these audible activities are frequently encountered in the society. These background sounds are usually ignored in public places or at home. Some people may not ignore and perceive these sounds and become disgusted. Reasons of disgust are distraction and anger. Tension might be followed by anger which may then generate urge to leave the environment or intercept the background noise. Sensitivity to the group of background noise is called misophonia. 1-3 The term consists of two words: misos (strong hate or disgust) and phonia (sound) and was introduced by Margaret and Pavel Jastreboff in 2001. 4 It was aimed to present and discuss two cases of misophonia in this letter to the editor. The first case was a young man with generalized anxiety disorder. He was also suffering from misophonia and misophonia triggered anger. He reported that particularly his family life was devastated because of his anger. The second patient was suffering from obsessive compulsive disorder and misophonia. She reported that she was counting to ten, breathing slowly or leaving the environment as soon as possible, if she cannot relax. She was frequently listening music with headphones in public places to avoid from disgusting sounds. Both patients reported that they could not express themselves during their disgust, because of inhibiting themselves due to the fear of being called crazy. Misophonia is defined as immediate negative psychological responses to certain sounds that most people do not notice. 1-3 This novel psychopathology is proposed to be involved with dysregulation of emotional processing with a neurobiological basis. 5 Current classification systems have not defined misophonia yet and it is not clear whether it is a distinct entity or a dimension or symptom domain which accompany other disorders. 3 Post-traumatic stress disorder was the most frequently accompanying disorder in a recent large-scale study. 6 Accordingly, other psychopathologies may trigger or enhance the responses and therefore misophonia might be a dimensional concept. Misophonia may deteriorate quality of life and social functioning and thus should be further investigated. 1-3,5 A Google search with the key words “misophonia treatment” retrieved 217 results in the date of January 12th. 8 of the web pages’ name was including the term “misophonia”. Increased awareness of this problem would be useful in order to develop better treatments. 7,8

Objectives This study aims to the effects of kinesiophobia on lymphedema, upper extremity function, depression/anxiety, and quality of life in breast cancer survivors. Patients and methods Between January 2015 and January 2016, a total of 81 breast cancer survivors (mean age 54.1±10.8 years; range 44 to 70 years) were included. Lymphedema was evaluated based on the circumference measurements. The Tampa Scale for Kinesiophobia (TSK), the Quick Disabilities of Arm, Shoulder, and Hand (Q-DASH) Questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Short Form-36 (SF-36) were applied to all patients. Results We found a significantly higher rate of lymphedema in the patients with kinesiophobia. Kinesiophobic patients had also significantly higher mean scores of TSK, Q-DASH, HADS-A, and HADS-D and lower mean scores of the SF-36 physical scores. Correlation analysis demonstrated that presence of lymphedema, Q-DASH, HADS-A, and HADS-D scores were significantly associated with the TSK scores. Conclusion Kinesiophobia increases the risk for lymphedema, depression/anxiety, and decreased upper extremity functioning in breast cancer survivors. Identifying kinesiophobia in breast cancer survivors, psychosocial providers may help to prevent undesirable effects of kinesiophobia.

Background/aim: The aim of this study was to investigate the relationship between familial Mediterranean fever and female sexual dysfunction and premenstrual syndrome. Materials and methods: This study included 36 patients with familial Mediterranean fever and 33 healthy volunteers. Familial Mediterranean fever was diagnosed according to the Tel Hashomer criteria and familial Mediterranean fever mutations were identified in all of the patients. The patients and healthy volunteers were compared in terms of anxiety, depression, sexual dysfunction, and premenstrual syndrome, and a model was created that describes the relationships among these variables. Results: We found statistically significant differences between the groups in terms of anxiety, premenstrual syndrome, and Golombok Rust Inventory of Sexual Satisfaction frequency and vaginismus subscale scores. There was no difference in depression scores between the groups. Conclusion: Familial Mediterranean fever is a rheumatic disease that predisposes patients to sexual dysfunction and premenstrual syndrome, which emerges as direct and indirect psychological factors.

The comorbidity of structural or genetic diseases with schizophrenia is seen as an opportunity to understand the formation of schizophrenia. This case report presents a patient with comorbidity of schizophrenia, tetralogy of Fallot (TOF) and total situs inversus. TOF is a cyanotic heart disease, which can be linked to 22q11 deletion and trisomy 21. Situs inversus totalis (SIT) is a congenital condition in which the major visceral organs, including the heart, are positioned in a mirror image from normal conditions. The comorbidity of TOF and SIT is quite rare. In our case report, schizophrenia is added to this rare comorbidity. This case report discussed the comorbidity and probable causal relationships. Furthermore, the research method of how transposition in internal organs is reflected in brain lateralization is also presented.

Objective: We aimed to investigate the effects of Maras powder (smokeless tobacco) on treatment outcomes of patients with anxiety.Method: Patients between 18 and 65 years old diagnosed as generalized anxiety disorder and anxiety disorder not otherwise specified were enrolled. The patients were categorized into two groups: Maras powder using group (30 patients) and Maras powder free group (30 patients). All the participants were administered the Turkish version of Hospital Anxiety and Depression Scale (HADS) at baseline and the 1 and 2 months after the treatment. All patients were given standard pharmacological treatments for their psychiatric diagnosis.Results: There was a significant decrease of HADS scores within the groups after treatment. The mean baseline HADS scores of both groups were not significantly different. However, mean HADS scores of the groups were significantly different at the first and second months after the treatment.Conclusion: Maras powder use may negatively affect the treat...

Objective: Determining the type of personality traits in substance abusers may play an important role in the treatment compliance. The aims of the study were to assess the personality traits of substance abusers and to compare them with the healthy controls.Methods: Eighty-seven male substance abusers and 50 healthy male volunteers referred to Manisa Military Hospital between February 2010 and October 2010 were enrolled in the study. Participants filled out the Temperament and Character Inventory.Results: Significantly higher scores for novelty seeking (NS) and harm avoidance (HA), and significantly lower scores for persistence (P), self-directedness (SD), and cooperativeness (C) were detected in substance abusers than in the controls.Conclusion: Substance abusers have distinctive temperament and character dimensions compared with the healthy controls. Further studies with larger samples are required to confirm the results of the present study.

Sjogren Sendromu toplumda % 2-3 oraninda gorulen kronik otoimmun bir hastaliktir. Santral sinir sistemi tutulumu olan Sjogren Sendromunda psikiyatrik ve norolojik bulgularin varligi bildirilmistir. OLGU. 35 yasinda kadin hasta, insanlarin kendisi hakkinda konustugunu dusunme, izlendiginden suphelenme, ev islerini yapamama, karamsarlik, uykusuzluk, cocuklarina karsi zarar verme dusuncesi, ozbakimda azalma sikayetleriyle klinigimize basvurmus ve yatisi yapilmistir. Hastanin oykusunden dort senedir paranoid sizofreni tanisi ile takip edildigi ogrenilmistir.Hastanin yatis sonrasi cekilen Beyin MRG’sinin vaskuler lezyonlar ve vaskulit ile uyumlu olabilecegi raporlanmistir. Hastaya minor tukruk bezi biyopsisi yapilmis, patoloji raporu Chisholm Mason siniflandirmasina gore Grade 3 olarak raporlanmistir. Hastaya uygulanan Schimmer testi pozitif bulunmustur. AECCC kriterlerine gore hastaya primer Sjogren Sendromu tanisi konmus, hastaya hidroksiklorokin 200 mg/ gun tedavisi baslanmistir. Tartisma: Sjogren Sendromunda santral sinir sistemi tutulumu psikiyatrik bozukluklara neden olabilir. Sjogren Sendromu ile birlikte en sik atipik duygudurum bozukluklari gorulmekle birlikte (3) psikoz, somatizasyon, panik bozukluk, kisilik bozukluklari da bildirilmistir. Psikiyatrik ve norolojik bulgularin vaskulit tarafindan meydana gelen iskemik hasar nedeniyle meydana geldigi iddia edilmektedir. Sundugumuz vakada santral sinir sistemi tutulumu olan Sjogren Sendromu olan hastanin sizofreni tanisi ile takip edildigi dikkati cekmektedir. Sjogren Sendromu ve psikiyatrik hastaliklar arasindaki iliskiyi anlamak icin ileri arastirmalar yapilmalidir. Romatolojik hastaliklarin psikiyatrik bulgular ile ortaya cikabilecegi goz ardi edilmemeli, ayirici tanida dusunulmelidir. Tedavide endike psikotropik ilaclarin yaninda altta yatan otoimmun hastalik icin gerekli immunsupresif ajanlarin da psikiyatrik semptomlarda hizli iyilesme sagladigi bilinmektedir.

Amac: Genel kabul edilen goruse gore, psikiyatri literaturunde, icsel bir anksiyete egilimini gosteren anksiyete duyarliligi ile, kisilik ozellikleri ve intihar arasindaki iliski hakkinda yeterli bilgi bulunmamaktadir. Bu calisma yuksek anksiyete duyarliliginin intihar acisindan onleyici bir faktor olup olmadigini arastirmak icin planlanmistir. Materyal ve Metot: Bu calismada hastalar iki gruba ayrildi. Bir grup DSM-IV-TR’ye gore unipolar depresyon tanisi alan, hic intihara kalkismamis ve halen intihar dusuncesi olmayan 31 hastadan olusuyordu. Diger grup ise intihar girisimi nedeniyle Ankara Ataturk Egitim ve Arastirma Hastanesi Psikiyatri Poliklinigi’ne veya Ankara Ataturk Egitim ve Arastirma Hastanesi Acil Servisi’ne basvuran ve DSM-IV-TR’ye gore unipolar depresyon tanisi alan 28 hastadan olusmaktaydi. Hastalara Anksiyete Duyarlilik Indeksi-3 (ADI-3), Intihar Olasiligi Olcegi (IOO), Beck Depresyon Olcegi (BDO) ve Beck Anksiyete Olcegi (BAO) uygulandi. Ek olarak ADI-3’un 3 alt olcegi olan sosyal, bilissel ve fiziksel alt olcekler de bireysel olarak degerlendirildi. Bulgular: Intihar oykusu olan depresyonlu 28 hasta grup 1 ve intihar oykusu olmayan depresyonlu 31 hasta ise grup 2 olarak degerlendirildi. Yas, egitim, cinsiyet ve medeni durum acisindan gruplar arasinda fark saptanmadi. ADI-3 total skoru (M group1 = 27,2 ± 16,9; M group2 = 35,9 ± 15,2; t = 2,045; p =0,045), ADI-3 fiziksel alt olcek skoru (Mdn group1 = 5,5; Mdn group2 = 10, Z = -1,989; p = 0,047) ve BDO skoru acisindan iki grup arasinda anlamli fark saptandi. ADI-3 sosyal ve bilissel alt olcekleri, BAO ve IOO skorlari acisindan gruplar arasinda anlamli fark saptanmadi. Sonuc: ADI-3, depresyonlu hastalarda intihar riskini degerlendirmede kisa zamanda olculebilir bir skala olarak klinik kullanim icin onerilebilir.

Background: Superior temporal cortices include brain regions dedicated to auditory processing and several lines of evidence suggest structural and functional abnormalities in both schizophrenia and bipolar disorder within this brain region. However, possible glutamatergic dysfunction within this region has not been investigated in adult patients. Methods: Thirty patients with schizophrenia (38.67 ± 12.46. years of age), 28 euthymic patients with bipolar I disorder (35.32 ± 9.12. years of age), and 30 age-, gender- and education-matched healthy controls were enrolled. Proton magnetic resonance spectroscopy data were acquired using a 3.0. T Siemens MAGNETOM TIM Trio MR system and single voxel Point REsolved Spectroscopy Sequence (PRESS) in order to quantify brain metabolites within the left and right Heschl's gyrus and planum temporale of superior temporal cortices. Results: There were significant abnormalities in glutamate (Glu) (F(2,78) = 8.52, p < 0.0001), N-acetyl aspartate (tNAA) (F(2,81) = 5.73, p = 0.005), creatine (tCr) (F(2,83) = 5.91, p = 0.004) and inositol (Ins) (F(2,82) = 8.49, p < 0.0001) concentrations in the left superior temporal cortex. In general, metabolite levels were lower for bipolar disorder patients when compared to healthy participants. Moreover, patients with bipolar disorder exhibited significantly lower tCr and Ins concentrations when compared to schizophrenia patients. In addition, we have found significant correlations between the superior temporal cortex metabolites and clinical measures. Conclusion: As the left auditory cortices are associated with language and speech, left hemisphere specific abnormalities may have clinical significance. Our findings are suggestive of shared glutamatergic abnormalities in schizophrenia and bipolar disorder. © 2013 Elsevier B.V.

Chorea consists of random, involuntary, continous, abrupt, short, jerky movements with different severity that can pass through one part of the body to the other parts. Hemichorea mostly occurs after the contralateral thalamic stroke, but may also occur in lesions involving the basal ganglia, white matter tracts, and the pons. Case. A 60 year old, married, primary school educated, housewife, female patient was refered to our clinic. In 1993, she had the complaints of being followed, crying, decreased self-esteem and aggression. With the diagnosis of bipolar disorder mixed episode, sertraline 50 mg/day and risperidone 4 mg/day treatment was initiated and used about 12 years for this treatment. In that time, exacerbation was not observed. In 2009, she had the complaints of tremors on the left side, involuntary movements of the arms and legs, speech disorders and balance disorders. Brain magnetic resonance imaging showed ischemia in the basal ganglia. Due to hemichorea (involuntary movements of the arms and legs), haloperidol 10 mg/day treatment was started. Nearly 4 years later, she emerged the symptoms of tardive dyskinesia.When haloperidol treatment was decreased gradually hemichorea symptoms increased whereas increasing the dose of haloperidol treatment symptoms of tardive dyskinesia increased. In this article, the difficulties in diagnosis and treatment of tardive dyskinesia and hemichorea in a bipolar patient were discussed.

* Correspondence: miatagun@ybu.edu.tr To the Editor Blood cells in circulation could be disturbed both qualitatively and quantitatively in psychiatric disorders. Previous studies have reported alterations in the number (1,2) and function (3) of blood cells in psychiatric disorders. Alterations might be related to different etiologies in different psychiatric disorders (1) and medications (4,5). After the reversal of these mechanisms by successful treatment with escitalopram, the platelet volumes were normalized in first episode, medication-naive patients with major depressive disorder (6). In bipolar disorder, mood stabilizers seem to be the major reason for the changes in blood cells (4,5). In patients with psychotic spectrum disorders, the mean platelet volume (MPV) is increased, especially in patients on atypical antipsychotics (7). We have analyzed the blood cell counts of outpatients in our clinic between 1 January, 2012 and 31 December, 2014. Major depressive disorder (n = 338), bipolar disorder (n = 389), and psychotic spectrum disorders (n = 227) were the diagnostic groups examined in our analysis. The results of the comparison between the groups are presented in Table 1. These results confirm the previous study results, which reported increased leukocytes and decreased erythrocytes and platelets in bipolar disorder. Lithium (Li) increases the number of leukocytes in circulation (4,8–10). We further compared hematological parameters in patients on Li (n = 124), patients on valproate (VPA) (n = 203), and patients not taking a mood stabilizer (n = 51) in the bipolar disorder group (Table 2). Since Li and VPA have similar mechanisms of action, we proposed that VPA might also have effects similar to those of Li. However, there were differences in the platelet distribution width (which was higher in VPA-treated patients than in mood stabilizer-free patients with bipolar disorder, P = 0.006), platelet counts (which were lower in VPA-treated patients than in Li-treated patients (P = 0.000002) and mood stabilizer-free patients with bipolar disorder (P = 0.040)), WBCs (which were lower in VPA-treated patients than in Li-treated patients, P = 0.000076), and red blood cell counts (which were lower in VPA-treated patients Received: 30.05.2015 Accepted/Published Online: 13.09.2015 Final Version: 23.06.2016 Letter to the Editor

5. Madrigal JL, Olivenza R, Moro MA, Lizasoain I, Lorenzo P, Rodrigo J, Leza JC. Glutathione depletion, lipid peroxidation and mitochondrial dysfunction are induced by chronic stress in rat brain. Neuropsychopharmacology 2001;24:420-9

Suicide is one of the major public health problems worldwide. Ingestion of the drugs is commonly used for suicide; however, injection of chemicals is a rare method (Guz et al., 2010). Especially, thinner injection is an unusual method and is used for suicide in a few cases. Thinner is one of the abused inhalants which are formed by toluene, ethyl acetate, and isobutanol, and are widely used in industry (Carabez-T et al., 1998). These toxic agents are usually taken in through inhalation. This report aims to inform about an unusual case attempted suicide by thinner injection into left subcutaneous tissue of neck.

Cerebellum is known to play an important role in coordination and motor functions. In some resent studies it is also considered to be involved in modulation of mood, cognition and psychiatric disorders. Dandy Walker Malformation is a congenital malformation that is characterized by hypoplasia or aplasia of the cerebellar vermis, cystic dilatation of the fourth ventricle and enlargement of the posterior fossa. When the volume of posterior fossa is normal, the malformation is called Dandy Walker Variant. Case is a 32 year old male with a 12 year history of Bipolar I Disorder presented with manic and depresive symptoms, including dysphoric and depressive affect, anhedonia, suicidal thoughts and behaviours, thoughts of fear about future, overtalkativeness and graphomania, increased energy, irregular sleep, loss of appetite, increased immersion in projects, irritability, agressive behavior, impulsivity. Cranial Magnetic Resonance Imaging was compatible to the morphological features of Dandy Walker Variant.