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Antidepressant-induced hypomania/mania is a complex issue that can be seen in mood disorders but is not clarified. There are case reports in the literature regarding vortioxetine-induced mania and hypomania; however, there is insufficient data. Here, we aim to present a case of vortioxetine-induced hypomania in a major depressive disorder patient who previously used various antidepressants but did not experience hypomania or mania. Our case is expected to contribute to the literature.

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OBJECTIVES: Myofascial Pain Syndrome (MPS) is known as a chronic pain syndrome, which is often associated with decreased life quality, depressive, and anxiety disorders. Affective temperament characteristics are mental illness signs that may assist in anticipating and detecting a tendency to depression and anxiety in MPS. The properties and impacts of affective temperament on pain, disability, life quality, depressive, and anxiety disorders in MPS patients were intended to explore by this study. PATIENTS AND METHODS: This case-control study was carried out in the physical medicine and rehabilitation clinic of a university hospital, Turkey, from October 2018 to January 2019 with 51 MPS patients and 47 healthy controls (HC). Physical examination, clinical history, visual analog scale (VAS), neck disability index (NDI), Short Form (36) Health Survey (SF-36), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego- Autoquestionnaire (TEMPS-A) scale were performed for all volunteers. RESULTS: TEMPS-A depressive, cyclothymic, and anxious scores were remarkably higher in MPS patients than in the HC group. In MPS patients, SF 36 physical and mental health summary scores were remarkably lower than the control group. Additionally, BDI and BAI scores were significantly higher in patients with MPS than in the control group. There was a significant positive correlation between depressive and anxious temperament scores and NDI. Moreover, a negative correlation was found between the SF36 physical health summary score and depressive and anxious temperament scores. Also, the mental health summary score was negatively correlated with depressive, cyclothymic, and anxious temperament scores. CONCLUSION: This research assesses for the first time of the affective temperament characteristics of MPS patients.KEY POINTSMyofascial pain syndrome patients have distinct temperaments than the control group.Myofascial pain syndrome patients had remarkably higher TEMPS-A depressive, cyclothymic, and anxious scores than the healthy control group.Life quality, clinical severity, and courses can be affected by differences in temperament.Clinicians can readily apply the TEMPS-A temperament scale in patient application to demonstrate these differences.The anticipation of a psychiatric situation plays a more significant role in evaluating the higher mood symptom rates and their effect on life quality.

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PURPOSE: To assess whether adolescent athletes were affected or not in terms of mental health by the long duration at home linked to isolation enforced during the COVID-19 pandemic. METHOD: The study included 940 team athletes, 274 individual athletes, and 131 nonathlete controls aged 12-17 years. Demographic data were obtained with a form including questions about age, sex, sports type, and physical activity status (type, duration, and frequency) during the isolation period. Participants completed the Children's Revised Impact of Event Scale-13, Center for Epidemiological Studies Depression Scale for Children, and State-Trait Anxiety Inventory for Children. RESULTS: Among participants, 88% did not meet the physical activity recommendations for children and adolescents, while 42.8% felt depressed. Depressive symptoms were present in 38.1% of boys and 59.7% of girls, with girls (6.4%) having higher posttraumatic stress symptoms than boys (3.5%). Among athletes, depressive and anxiety symptoms were lower compared with nonathlete controls (P < .01). Posttraumatic stress symptoms were lower among athletes than nonathlete controls for girls (team vs control, P = .006; individual vs control, P = .002) but similar for boys (P > .05). The depression (P = .518), state (P = .866), and trait anxiety (P = .507) symptoms were similar between team athletes and individual athletes. CONCLUSION: Though adolescent athletes' depression, anxiety, and posttraumatic stress symptoms were significantly lower than nonathlete controls, athletes also had high depression levels. These findings show the need to take precautions to protect the psychological health of not only nonathletes, but also athletes in the pandemic period.

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OBJECTIVE: Cognitive development is susceptible to environmental distress, leading to cognitive distortions. Cognitive distortions may affect clinical course of psychiatric disorders. We aimed to assess whether childhood maltreatment and emotion dysregulation impair automatic thoughts (ATs) and meta-cognitions (MCs) in Bipolar Disorder (BD) and Major Depressive Disorder - Recurrent (MDB-RE) in this study. METHOD: 85 patients with BD, 81 MDD-RE in remission and 86 healthy participants were enrolled. Automatic Thoughts Scale (ATS), Metacognition Questionnaire (MCQ-30), Childhood Trauma Questionnaire (CTQ- 28), Difficulties in Emotion Regulation Strategies Scale (DERS) were the measures used. RESULTS: ATs were determined by CTQ physical abuse (ß=0.34, p<0.01), DERS goals (ß=-0.37, p<0.01), impulse (ß=0.53, p<0.01) and non-accept (ß=0.23, p<0.05) subscales in BD (F=21.08, p<0.01) and CTQ emotional neglect (ß=0.22, p<0.05), DERS strategies (ß=0.39, p<0.05) in MDD-RE (F=9.97, p<0.05). MCs were predicted by sexual abuse (ß=0.46, p<0.01) in BD (F=4.88, p<0.01), and emotional abuse (B=-0.30, p<0.05) in MDD-RE (F= 7.02, p<0.01). CONCLUSION: These results suggest that emotion dysregulation and childhood adversities are associated with cognitive processes such as MCs and ATs in MDD-RE and BD. Cognitive processes can cause various clinical manifestations and emotion dysregulation and childhood traumas should be considered as psychopathological components that can affect the course of mood disorders via various components. Further follow-up studies and larger samples are needed to better understand the effects of these components.

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OBJECTIVE: We aimed to explore whether the mental health status of professional athletes was affected by the isolation period in which organized sports were suspended due to the COVID-19 pandemic. METHODS: A total of 612 volunteers between the ages of 18-38 enrolled in the study, 418 of them were athletes engaged in team sports or individual sports and 194 of them were non-athletes. Participants completed the Depression - Anxiety - Stress Scale 21 (DASS-21), the Impact of Events Scale-Revised (IES-R) and International Physical Activity Questionnaires (IPAQ). Non-parametric methods were used for comparisons between groups. The presence of a linear relationship was tested with the Spearman Correlation Test. A value of p < 0.05 was accepted statistically significant. RESULTS: A total of 571 participants, 372 males and 199 females, completed the study. Depression and anxiety symptoms were lower in athletes compared to non-athletes (p < 0.05). Depression, anxiety and stress symptoms were similar in team athletes and individual athletes (p = 0.232, p = 0.444, p = 0.116; respectively). The post-traumatic stress symptoms were lower in male team athletes than female team athletes (p = 0.020) and non-athletes (p < 0.001). Depression, anxiety and stress symptoms were found to be similar in men and women (p > 0.05). There was a negative correlation between physical activity level and mental health symptoms (p < 0.05). CONCLUSION: The mental health status of athletes was better than non-athletes, and the positive effect of sport, which was done until the break due to the isolation period, on mental health continued. These findings show that physical activity may help to protect mental health.

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OBJECTIVE: Activity of the paraoxonase 1 (PON1) enzyme varies prominently according to the PON1 Q192R genotype. The arginine (R) genotype hydrolyzes peroxided lipids more quickly and efficiently than the glutamine (Q) genotype. The Q phenotype suggests greater liability to neurodegenerative processes, cardiovascular and malignancy risks than the R phenotype. Stimulated PON/ARES ratio is associated with the PON1 Q192R polymorphism. This study aimes to assess the Q192R phenotype in schizophrenia, bipolar disorder and depression. METHOD: Patients with schizophrenia (37), bipolar disorder (n=50), depression (n=43) and healthy volunteers (n=43) were enrolled. Serum PON1, stimulated paraoxonase (sPON) and aryl esterase (ARES) levels were assessed with an automatic analyzer. Clusters of sPON/ARES ratio were detected with frequency analysis in PON1. QQ, QR and RR variant groups. RESULTS: There were significant differences between the bipolar disorder, depression, schizophrenia and healthy volunteer groups in terms of phenotype frequencies in groups (Fisher's Exact Coefficient=18.96, p=0.003). A higher prevalence of the PON1 RR variant was found in bipolar disorder whereas the PON1 QQ variant had a higher prevalence in depression and schizophrenia as compared to others. Serum PON1 activity correlated with number of episodes in the bipolar disorder group and with SANS, SAPS scores in the schizophrenia group. CONCLUSION: Difference between bipolar disorder, schizophrenia and depression in PON1 activity and PON1 phenotype might be suggestive of different liability to lipid peroxidation and neurodegeneration between the diagnostic groups. Longitudinal studies may identify long term differences between PON1 Q192R polymorphisms in clinical outcomes and neuropathology.

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17-α-hydroxylase enzyme has a crucial role in the steroid biosynthesis and, deficiency of this enzyme is an autosomal recessive monogenic disorder which is one of the two hypertensive form of congenital adrenal hyperplasia. It is characterized with the deficiency in glucocorticoid, adrenal androgen, and sex steroid synthesis with concomitant mineralocorticoid excess due to genetic defect in steroid biosynthesis. The relationship of hormone system physiology with psychiatric signs and syndromes are complex. Any problem in the hypothalamo-pituitary axis may cause psychiatric syndromes. On the other hand, many psychiatric disorders, such as mood-anxiety symptoms, depression, mania, psychosis, and delirium can be seen secondary to the treatment of hormone deficiency. We present the case of a male patient with pseudohermaphroditism who has been followed and treated in Rasit Tahsin Mood Clinic with the diagnosis of mood disorder not otherwise specified and was diagnosed with 46, XY karyotype and 17-α-hydroxylase deficiency after referring to a hospital with delayed puberty. Considering the medical literature, 17-α-hydroxylase deficiency has been evaluated from the aspects of gender-related behavioral disorders, psychological developmental and anxiety disorders. To the best of our knowledge, in the medical literature, this is the first case of 17-α-hydroxylase deficiency associated with mood disorder. Here, the relationship between mood disorders and hypothalamo-pituitary axis is discussed in the light of the literature.