Browsing by Author "Özmen, E"
Now showing 1 - 18 of 18
Results Per Page
Sort Options
Item Evaluation of serum microRNA expression profile in panic disorder patientsÇökmüs, FP; Özmen, E; Alkin, T; Batir, MB; Çam, FSItem The relationship between separation individuation and depression in first grade students of universityTaskin, EO; Yüksel, EG; Özmen, EObjective: The purpose of this study was to find out the relationship between separation individuation and depression in university students. Methods: The sample consisted of 1026 first grade students of Celal Bayar University consisted the sample of this research a Sociodemographic Form, The Separation Individuation Test of Adolescence (SITA) and Beck Depression Inventory (BDI) were used in this study. Statistical significance of the relationship between SITA subscale scores and BDI scores was assessed by Pearson correlation test and between SITA subscale scores and depression according to the cut-off values of BDI was assessed by using Student's Nest. Results: 20.6% of the students had depression according to the cut-off values of BDI. The mean score of the BDI was 10.98 +/- 9.02. There was a statistically significant negative correlation between the scores of SITA subscales 'peer enmeshment, 'practicing-mirroring' and 'healthy separation' which indicates positive separation individuation process and BDI scores when there was a statistically significant positive correlation between the scores of SITA subscales which indicates difficulties with separation individuation issues 'separation anxiety', 'engulfment anxiety, 'dependency denial' and 'rejection expectancy' and BDI scores. The scores of 'separation anxiety, 'engulfment anxiety, 'dependency denial' and 'rejection expectancy' subscales of SITA were significantly higher in the students with depression according to the cut-off values of BDI when healthy separation subscale scores were significantly higher in the students with depression according to the cut-off values of BDI. Conclusion: In this study, it has seen that there was a relationship between depression and separation-individuation process in adolescence. Difficulties with separation individuation issues in adolescence, in other words failure in achieve developmental tasks during adolescence could cause depression. (Anatolian Journal of Psychiatry 2009; 10:174480)Item INFLUENCE OF THE ERECTILE DYSFUNCTION ON QUALITY OF LIFE ACCOMPANYING DIABETES MELLITUS: A LONGITUDINAL, CONTROLLED STUDYOkur, M; Gümüs, B; Üçer, O; Karatas, TC; Özmen, E; Büyüksu, CIntroduction: Erectile dysfunction (ED) is one of the most common complications of Diabetes Mellitus (DM) in males and has a negative impact on the quality of life (QoL). The number of studies related with this subject is limited in the literature. QoL was evaluated and compared in diabetic patients with and without ED. Materials and Methods: Patients with ED who applied to our outpatient clinics (Celal Bayar University, Medical Faculty, Department of Urology) were included in the study. We interviewed 82 patients with DM+ED, 85 patients with ED and 65 normal (control) male subjects. All men (study and control groups) were asked to fill the IIEF (International Index of Erectile Function), CES-D (Center of Epidemiological StudiesDepression), BAI (Beck Anxiety Inventory), PIED (Pyschological Impact of Erectile Dysfunction) forms. Sildenafil citrate was administered as a medical treatment. Same forms were asked to be filled again in the 3th, 6th, 9th months of the therapy. Results: We observed that QoL of the patients with DM+ED and ED were affected negatively. ED was worse in the DM group compared to others. Significant improvements were detected in both QoL and ED in 3th and 6th months of the therapy. Conclusion: Our data show that treatment of ED significantly improves QoL in the patients with DM therefore, presence of ED has to be assessed in the patients with DM.Item Psychotic disorder secondary to systemic corticosteroidsÇökmüs, FP; Asçibasi, K; Sarikavak, T; Özmen, EThe discovery of corticosteroids in 1949, revolutionized the practise of medicine. Corticosteroids become the mainstay of therapy for a variety of acute and chronic diseases (e.g., endocrinopathies, cancer, inflammatory diseases, systemical lupus erythematosus, multiple sklerosis, and asthma). Corticosteroids often induce psychiatric syndromes, including depression, mania, psychosis, delirium, obsessive-compulsive symptoms, suicidality, catatonia and reversible dementia(1). In our case, we will discuss 67 years old male patient who developed psychotic disorder after receiving systemic corticosteroid treatment.Item THE RELATIONSHIP BETWEEN GENDER AND DEPRESSION, SELF-ESTEEM, HOPELESSNESS, SUBMISSIVE ACTS, GUILT, SHAME AND ANGER IN ADOLESCENTSÖzmen, E; Özmen, D; Çetinkaya, AÇ; Taskin, EO; Dündar, PELiterature Review and Objective: Although there were a number of research findings on gender differences in mental health problems, it is not known that it is a universal phenomenon or not. The purpose of this study was to investigate the relationship between gender and depression, self-esteem, hopelessness, submissive acts, guilt, shame and anger in Turkish adolescents. Methods: A cross-sectional survey of 1185 ninth-grade Turkish adolescents aged 14-19 was conducted. 708 (59.7 %) of the students were male and the mean age of students was 15.53+/-0.72. Hopelessness was measured by using Beck Hopelessness Scale (BHS), self-esteem was measured by using the Rosenberg Self-Esteem Scale (SES), depression was measured by using Children's Depression Inventory (CDI), guilt and shame was measured by using Guilt and Shame Scale (GSS), submissive acts was measured by using Submissive Acts Scale (SAS), anger was measured by using The State-Trait Anger Scale (STAS). Student's t-test was used to find out the relationship between gender and depression, self-esteem, hopelessness, submissive acts, guilt, shame and anger in adolescents. Results: The findings indicate that the mean score of the SAS and BHS, anger control subscale of STAS of the boys were higher than that of the girls and the mean score of the CDI, guilt subscale of GSS, shame subscale of GSS, SES, trait anger subscale of STAS, anger-in subscale of STAS and anger-out subscale of STAS of the girls were higher than that of the boys. While there were statistically significant associations between gender and the SAS, BHS, CDI, guilt subscale of GSS, shame subscale of GSS, trait anger subscale of STAS, anger-out subscale of STAS and anger control subscale of STAS mean scores; no relationship was found between gender and the anger-in subscale of STAS and SES mean scores. Conclusion: The results of this study point out that there are gender differences in hopelessness, depression, guilt, shame, submissive acts and anger levels but not in self-esteem levels in Turkish adolescents. The findings suggest that psychological gender differences are seen not only in individualistic societies, but also in collectivistic societies.Item Anxiety, depression, and nature of acne vulgaris in adolescentsAktan, S; Özmen, E; Sanli, BBackground The reported prevalence of acne in adolescence is variable; improved treatment may have modified its prevalence and severity; acne has been related to psychiatric morbidity for many years. Methods Two thousand six hundred and fifty-seven high school students were examined, and adolescents with acne were interviewed about the subject of acne vulgaris. The severity of acne was graded using the Global Acne Grading System (GAGS). The Hospital Anxiety and Depression (HAD) scale was evaluated for one of every two subjects with acne (n = 308) and for the same number of sex-matched control subjects (n = 308) to determine the prevalence of depression and anxiety. Results Six hundred and fifteen of the subjects (23.1%) were determined to have acne. Acne prevalence in girls and boys was 16.1% and 29.2%, respectively (P < 0.001). Two hundred and twenty-five (15.8%) of 1424 boys and only 109 (8.8%) of 1233 girls had moderate or severe/very severe acne (P < 0.001), but the GAGS scores in the groups of boys and girls with acne were not significantly different. The acne and control groups showed no significant differences in the HAD anxiety and depression subscale scores. The HAD anxiety subscale scores of girls were significantly higher than those of boys in the acne group. The severity of acne was not correlated with the HAD anxiety or depression subscale scores. Conclusions Acne results in higher anxiety in adolescent girls. Although acne and moderate/severe acne are more common in adolescent boys, the severity of acne was found to be similar in boys and girls with acne. Adolescent girls are more vulnerable than boys to the negative psychological effects of acne.Item Evaluation of serum MicroRNA expression profiles in patients with panic disorderÇökmüs, FP; Özmen, E; Alkin, T; Batir, MB; Çam, FSBACKGROUND: Studies on the role of microRNAs (miRNA) in anxiety disorders are limited. We aimed to determine the availability of miRNAs as biomarkers in serum and to demonstrate the changes of miRNAs expression in patients with panic disorder (PD). METHODS: Thirty-five patients with PD and 35 healthy controls (HC) were evaluated with Structured Clinical Interview for DSM Disorders-I (SCID-I) and Panic Disorder Severity Scale (PDSS). In each group miRNA expression analysis was performed in venous blood by the Real-time Polymerase Chain Reaction (RT-PCR) method for genetic evaluation. RESULTS: Compared with the HC group, eight miRNA expression levels were found different in the PD group. Five of them were upregulated and three of them were downregulated. There was no correlation between the levels of miRNA expression with PDSS total score and PDSS sub-items. However, miR-1297 and miR-4465 expression levels were significantly different between the two groups. LIMITATIONS: There are some limitations in this research. Firstly the number of samples is small. Another limitation of our study is that the presence of medical illness and continuous drug use were not excluded when PD and HC groups were selected. CONCLUSIONS: Our research is the first miRNA expression study in patients with PD which excluded psychotropic use and additional psychiatric disorders. In the PD group, miR-1297 and miR-4465 expression was upregulated than compared to the HC group. miR-1297 and miR-4465 regulate the GABAA gene regions that affect GABA(A) receptor subtypes that thought to play a role in the aetiology of PD.Item Psychiatric disorders in patients attending a dermatology outpatient clinicAktan, S; Özmen, E; Sanli, BBackground: Psychiatric comorbidity in patients with skin disorders has been reported. Objective: To find out the prevalence of psychiatric disorders in dermatology outpatients and to investigate the factors that affect the psychiatric symptoms. Methods: 256 patients attending our dermatology outpatient clinic completed a 12-item General Health Questionnaire (GHQ) following their dermatologic examination. A standardized personal interview was performed to establish a psychiatric diagnosis in patients sampled by using a stratified random sampling method. Results: The prevalence of psychiatric disorders was found to be 33.3% in the study group. The mean of the total GHQ scores of the sample group (n = 256 patients) was 3.656. The duration of the dermatologic complaints, sex of the subjects, localization of the lesions, and dermatologic diagnosis did not affect the total GHQ scores of the patients. Conclusion: Psychiatric comorbidity in 33.4% of the dermatology outpatients indicates the need for considering emotional factors for an effective management of the cutaneous disorders.Item Attitudes of patients attending a psychiatric outpatient clinic towards depressionTaskin, EO; Yüksel, EG; Deveci, A; Özmen, EObjective: The aim of this study was to determine the knowledge and attitudes of patients attending a psychiatric outpatient clinic towards depression and factors that influenced them. Methods: This study is carried out on patients who attending Psychiatric Outpatient Clinic of Celal Bayar University Hospital. The study was carried out in 200 subjects who have been selected by systematic sampling method. In this study, a 32-item questionnaire designed for rating the attitudes toward depression by PAREM (Psychiatric Research and Education Centre) was used by adding one item to find out the attitudes toward depression. In addition, a 8-item sociodemographic questionnaire designed by authors and a 5-item questionnaire which was designed by authors and included the patients knowledge and opinions about their illness and illness characteristics of patients were applied. Results: Most of the subjects (83.5%) believed that depression due to social problems. Half of subjects stated that they would not get married with a person with depression (50.5%). Twenty-eight of subjects stated that patients with depression might be aggressive. The patients suffering from a depressive episode toward depression answered the items Mrs. F. has a somatic disease (p=0.030), Persons with depression don't recover completely (p=0.003) and persons with depression are aggressive (p=0.029) as I agree more than the patients not suffering from a depressive episode; but answered the items I can work with a person with depression (p=0.004) and I would get married to a person with depression as I agree less than the patients not suffering from a depressive episode. Conclusions: Psychiatric outpatients have more correct knowledge than lay people about depression and treatment of depression. Most of the patients believed that depression is associated with social problems. Attitudes of the psychiatric outpatients toward patient with depression are more positive and more tolerant than lay people. However, patients with depressive episode have more negative and discriminative attitudes toward patients with depression and desire for social distance from patients with depression. (Anatolian Journal of Psychiatry 2009; 10: 100-108)Item Validity and reliability of the Diabetes Obstacles Questionnaire in type-2 diabetic patientsKahraman, G; Tavsanli, NG; Baydur, H; Özmen, D; Özmen, EObjective: The Diabetes Obstacles Questionnaire (DOQ) helps to determine the problems encountered with their illness by type-2 diabetic patients in daily life and the purpose of this study was to adapt this questionnaire to Turkish and to perform validity and reliability analysis. Methods: This was a methodological study planned to adapt DOQ to the Turkish language and to carry out validity and reliability analysis. After obtaining the necessary permission and making the translation, the questionnaire was applied to 400 type 2 diabetes patients, who had been diagnosed at least one year previously, in the endocrinology polyclinic of Manisa Government Hospital and the endocrinology polyclinic of Hafsa Sultan Hospital in Celal Bayar University. The WHOQOL-8 quality of life questionnaire was applied along with the DOQ in order to examine the extent of correspondence with a scale which measures similar concepts. In order to assess the reliability of the scale, the coefficient of internal consistence (Cronbach's alpha value) was examined and in order to evaluate the relation of each item to dimension, the item-total correlations and the internal consistence coefficients when items were deleted were evaluated. Also, the items of the questionnaire were applied again to 30 people after a gap of at most two weeks and test-retest analysis as performed. When this was done, intraclass correlation coefficients were examined. Results: The DOQ consists of eight scales and a total of 78 questions. Ten of these questions were excluded in our study as they were not applicable to Turkish society. Conclusion: The study was similar to the original study from the aspect of factors produced in the dimensions.Item Communication of patient-physician in patients with chronic obstructive pulmonary disease with acute exacerbationBulut, H; Ozan, E; Özmen, E; Çimen, PPurpose The aim of this study was to investigate the patient-physician communication of patients with chronic obstructive pulmonary disease (COPD) who were hospitalized due to acute exacerbation. Materials and Methods: The study was carried out in the department of pulmonology in a training and Research Hospital in Izmir with COPD patients who were hospitalized due to acute exacerbation. 400 patients who were able to communicate and literate in the 18-65 age group, were selected with simple random sampling the study. In the collection of research data, Patient Identification Form and Satisfaction Scale of Communication of Physicians were used. Results: The total score of the Physicians' Communication Form Satisfaction Scale was 100.10 +/- 17.79. The mean scores of the sub-dimensions of Body Language, Speech-Listening, Caring and Giving information were 11.03 +/- 2.83, 39.03 +/- 7.20, 42.06 +/- 9.40 and 7.98 +/- 3.05. A significant relationship was found between the communication characteristics of the patients, such as knowing the name of the physician, asking the physician questions and answering the questions during the daily interview duration about the disease and treatment. Conclusion: In general, patients reported satisfaction with the total average score of satisfaction from the communication style of physicians.Item The effect of locus of control on attitudes towards depression and schizophreniaÖzmen, E; Özmen, D; Deveci, A; Taskin, EOObjective: There is no consensus about the effects of personality traits on attitudes toward mental illness. The purpose of this study was to determine the effect of locus of control on attitudes toward depression and schizophrenia. Methods: A cross-sectional survey of 196 university students was conducted. Attitudes toward depression and schizophrenia were assessed by a questionnaire designed by the authors and locus of control was measured by using Internal-External Locus of Control Scale developed by Rotter. Results: The items of the attitudes questionnaire were analyzed one by one to find out the effect of locus of control to attitudes toward mental disorders. There is a statistically significant difference between the participants who answered the item as 'I agree' and 'I don't agree' in one out of 15 items of depression part and two out of 15 items of schizophrenia part of the questionnaire. Discussion: Although many studies have shown that an individual's belief about locus of control has an important influence on his/her attitudes and behaviors, in this study it was seen that locus of control had no or minimal effect on attitudes toward depression and schizophrenia. But there is a need to implement new studies to illuminate the subject.Item Hopelessness and factors affecting hopelessness in high school studentsÖzmen, D; Dündar, PE; Çetinkaya, AC; Taskin, O; Özmen, EObjective: The purpose of this study was to determine the level of hopelessness and to examine the effects of socio-demographic features, depression, self-esteem on hopelessness in a high school population. Methods: A cross-sectional survey was conducted among 1185 ninth-grade Turkish adolescents aged between 14 and 19. Hopelessness, sef esteem and depression levels were measured with Beck Hopelessness Scale, the Rosenberg Self-Esteem Scale and Children's Depression Inventory respectively. Student's t-test and analysis of variance were used to examine relationships among the variables. Results: Being male, lower income, lower education levels in parents, perception of family status as low, depression, lower self esteem, perception of quality of life as low were positively correlated with the mean score of Beck Hopelessness Scale. On the other hand only 16.6% of the students responded as 'yes' to item 'my future seems dark to me' and 12.8% of the students responded as 'no' to item 'I look forward to the future with hope and enthusiasm.' Conclusion: The results of this study suggest that school-based adolescents in urban part of Turkey have hope for the future. But the prevalence of hopelessness was not rare in school-based adolescents and it was more common in the children of families with low socio-economical level. Hopelessness may be one of the important indicators of low subjective well-being that should be recognized by the health care personnel.Item The prevalence of suicide ideation and suicide attempts in Manisa city centreDeveci, A; Taskin, EO; Dündar, PE; Demet, MM; Kaya, E; Özmen, E; Dinç, GObjective: Suicide attempts are a major public health problem. This study aimed to investigate the lifetime prevalence of suicide ideation and suicide attempts in Manisa city centre. Risk factors related to suicide ideations and attempts were also studied. Method: This study was carried out in Manisa city centre. Using cluster and systematic samples, data were collected from 1086 persons 15-65 years old. Separate questions were asked about the lifetime occurrence of suicide ideation (Have you ever seriously thought about committing suicide?), and suicide attempts (Have you ever attempted suicide?). A form for suicide attempters was used to determine the characteristics of the attempts. Results: The lifetime prevalences of suicide ideation and suicide attempts were 6.6% (n=72) and 2.3% (n=25), respectively. Marital problems were the most common stressor in suicide attempts (44%, n=11). Approximately two thirds of the suicide attempters used a drug overdose for suicide. Of all the suicide attempters, 24% (n=6) had made previous attempts. The essential risk factors for suicide ideation were being female (p=0.012), smoking (p=0.001), consuming alcohol (p=0.028), having a previous psychiatric disorder (p < 0.0001), and a family history of psychiatric disorders (p=0.021). The essential risk factors for suicide attempts were smoking (p=0.005), having a previous psychiatric disorder (p < 0.0001), and a family history of psychiatric disorders (p=0.029). Conclusion: The results of the present study suggest that suicide attempts must be carefully evaluated in subjects with previous psychiatric disorders, previous suicide attempts and a family history of psychiatric disorders. It is necessary to know the clinical and demographic features related to suicide attempts.Item Trait anger and anger expression styles in adolescentsÖzmen, D; Özmen, E; Çetinkaya, A; Akil, IÖObjective: The aim of this study was to investigate the trait anger levels and anger expression styles of students in the second stage of primary education and the factors affecting them. Methods: The study was carried out on students in the second stage of primary education (classes 6, 7 and 8th) at three schools in the center of the city of Manisa in an area with inhabitants at various socioeconomic levels. A sociodemographic form, the State-Trait Anxiety Scale for Children, and the State Trait Anger Scale were applied to the students. Variables affecting students' trait anger and anger expression styles were examined using multiple linear regression analysis. Results: It was observed that levels of trait anger in the adolescents remained at the level of 'a little', that they did not express out their anger and that they tended to control their anger moderately, and that the levels of suppressed anger were not high. The factors which most affected levels of trait anger and anger expression styles in the adolescents were anxiety, gender and family type. A positive correlation was found between anxiety and trait anger, suppressed anger and expressed anger, while a negative correlation was found between anxiety and anger which was kept under control. Male students had a higher level of trait anger and expressed their anger more often, while female students controlled their anger more. The levels of trait anger, expressed anger and suppressed anger were higher in adolescents living in split-up families, and their anger was less controlled. Discussion: The results of this study suggest that adolescents in Turkey are not prone to experiencing anger and they tend to control their anger; when they get angry; they do not suppress it or bear grudges, they are not prone to argue with others; and when they get angry they do not express it in words or behavior. Because of the reduction of anxiety levels increase the ability to control the anger level, reduction of anxiety should definitely be placed in anger control training programs and therapeutic attempts in adolescents.Item Attitudes of Resident Physicians Working in a University Hospital Towards SchizophreniaTaskin, EO; Ascibasi, K; Cokmus, FP; Özmen, EObjective: To evaluate the attitudes of resident physicians working in a university hospital (future specialists) towards schizophrenia. Methods: The data of 170 resident physicians who completed the questionnaires in full were included in the research. The data collection procedure was completed in 6 months by two resident psychiatrists using the sealed envelope method for the questionnaires (an 11-item socio-demographic and an 8-item professional information form and a 32-item attitude towards schizophrenia survey that was prepared by the Psychiatric Research and Training Center). The effect of the sociodemographic and occupational variables on the responses to the questionnaire items was tested using logistic regression analysis. Results: The mean age of the participants was 28.07 +/- 2.40 (min=24-max=42) years. Approximately 98.8% (n=168) described schizophrenia as a 'disorder' and 78.2% (n=133) as a 'psychiatric disorder.' Some 64.1% (n=109) of the participants stated that schizophrenia was a congenital disease, 81.2% (n=138) said it was a curable disease, 85.9% (n=145) though that it could be treated with medication, 60% (n=102) believed that the medications used for treating schizophrenia would cause dependence, and 81.8% (n=139) stated that the medications used would involve serious adverse effects. Nearly 70.6% (n=120) of the participants stated that they could work with someone with schizophrenia and 45.9% (n=78) said that they could marry someone with schizophrenia. The presence of psychiatric diagnoses in a close friend (social acceptance of patients) was found to be an influential variable. Conclusions: The resident physicians had high-level knowledge of schizophrenia as a psychiatric disorder, but their knowledge on the effects and adverse effects of the medication was insufficient or incorrect. The sample's social acceptance of patients was generally good, despite putting social distance in situations requiring more personal intimacy. Based on these results, to treat schizophrenia more successfully, we need to either revise psychiatry curriculum in medical education or provide targeted skill training for non-psychiatric physicians in order to adopt more positive attitudes towards patients with schizophrenia and refer them appropriately to psychiatrists when needed.Item Left Atrial Coupling Index Predicts Heart Failure in Patients with End Stage Renal DiseaseDemir, FA; Bingöl, G; Uçar, M; Özden,Ö; Özmen, E; Tüner, H; Nasifov, M; Ünlü, SBackground and Objectives: We aimed to ascertain the predictive power of the left atrial coupling index (LACI) in patients with end stage renal disease (ESRD) for heart failure with preserved ejection fraction (HFpEF). Materials and Methods: This is a retrospective study including 100 subjects between 18 and 65 years of age with ESRD and not on dialysis treatment. Patients were divided into groups with and without HFpEF. The LACI was defined as the ratio of the left atrial volume index (LAVI) to the a ' wave in tissue Doppler imaging (TDI). Statistical analyses were performed, including univariate and multivariate regression analyses. Results: The mean age of the participants was 47 +/- 13.3 years. Individuals with HFpEF exhibited a higher LACI. Univariate and multivariate regression analyses demonstrated that the predictive capacity of the LACI for HFpEF was considerably higher than that of the LAVI and other echocardiographic parameters. Conclusions: Higher LACI levels were consistently related to the presence of HFpEF in ESRD patients. The LACI can be easily obtained in daily practice using conventional Doppler echocardiographic measurements during left atrial functional assessments.Item The role of predominant polarity on cognitive dysfunctions in patients with bipolar disorderAtay, E; Ermis, C; Atay, ING; Aydemir, Ö; Özmen, EBackgroundCognitive impairment is frequently observed in bipolar disorder (BD). Previous findings indicated that predominant polarity could have an effect on cognitive deficits. This study aimed to examine the association between predominant polarity and cognitive impairments in BD.Materials and methodsEuthymic BD patients with manic (MPP, n = 31), depressive (DPP, n = 25), undetermined predominant polarity (UPP, n = 28), and healthy controls (HC, n = 27) participated in the study. A battery of neurocognitive and social cognitive tests was implemented. Neurocognitive domains were identified via principal component analysis.ResultsThe MPP group performed worse in the Controlled Oral Word Association Test (COWAT), Reading the Mind in the Eyes Test (RMET), and Hinting Test (HT) compared to the DPP group and reasoning/problem-solving skills compared to the UPP group. Both MPP and UPP groups showed impairments in processing speed compared to HC. Among patient groups, there was no significant difference in working memory, attention, processing speed, verbal, and visual domain scores. The MPP group had poorer scores compared to controls in most of the social cognitive and neurocognitive domains in the study, while the overall cognitive impairment in the DPP group was relatively milder.ConclusionsAlthough our sample size was relatively small, the MPP group yielded more severe cognitive impairment in verbal fluency and social cognition tests compared to DPP. Patients with MPP are particularly vulnerable to cognitive impairment, making them a priority for cognitive enhancement interventions. Future studies should focus on the outcomes of cognitive and pharmacological interventions in these polarity subgroups.