Association of Orthorexic Tendencies with Obsessive-Compulsive Symptoms, Eating Attitudes and Exercise

PURPOSE

The term orthorexia nervosa is used to describe the pathological fixation associated with consuming healthy food. It is assumed that orthorexia nervosa shares some phenomenological features with anorexia nervosa, obsessive-compulsive disorder (OCD), and other mental disorders. Individuals with orthorexic tendencies may have high physical activity as well as a healthy diet. This study aimed to investigate the relationship of orthorexia nervosa with obsessive-compulsive symptoms, eating attitudes, and several sociodemographic features.

PATIENTS AND METHODS

We included 63 patients diagnosed with OCD, 63 healthy volunteers who perform physical exercises at least three days a week, at least 30 minutes a day, and 63 healthy volunteers who do not perform physical exercises regularly. Sociodemographic data form, Yale-Brown Obsessive Compulsive Scale, ORTO-11 Scale, Eating Attitude Test, Hamilton Anxiety Scale, and Structured Clinical Interview for DSM-5 Disorders (SCID-5 CV) were administered to all participants. OCD data form was also applied to patients with OCD diagnosis.

RESULTS

We found a statistically significant relationship between current order-symmetry obsessions and orthorexic tendencies in patients with OCD (p<0.05). There was no relationship between the severity of the disorder and orthorexia nervosa in patients with OCD (p>0.05). Orthorexic tendencies were found to increase as impaired eating attitudes increased in participants who regularly performed physical exercises and patients with OCD (p<0.05). The orthorexic tendencies of participants who regularly performed physical exercises were higher than those diagnosed with OCD and healthy individuals who did not perform physical exercises.

CONCLUSION

The absence of a significant relationship between disorder severity and orthorexia nervosa in patients diagnosed with OCD and the increase in orthorexic tendencies as the deterioration in eating attitudes increases in both patients with OCD and the participants who regularly perform physical exercises suggest that orthorexia nervosa may be closer to the eating disorders group than obsessive-compulsive spectrum. Studies with large samples and different diagnoses are needed to determine the place of orthorexia nervosa in diagnosis and classification systems.

Impact of Childhood Trauma and Adult Separation Anxiety Disorder on Quality of Life in Individuals with Schizophrenia

Background

Childhood trauma and anxiety disorders are common in individuals with schizophrenia. This study aimed to investigate the effects of childhood trauma and adult separation anxiety disorder on the quality of life of individuals with schizophrenia.

Methods

This cross-sectional study included 111 individuals with schizophrenia and 85 control subjects. The separation anxiety symptom inventory (SASI), adult separation anxiety questionnaire (ASAQ), Positive and Negative Syndrome Scale (PANSS), childhood trauma questionnaire (CTQ), and World Health Organization quality of life questionnaire (WHOQoL-BREF) were administered to the participants.

Results

More individuals with schizophrenia than control subjects were unemployed and single (p<0.05). Individuals with schizophrenia scored significantly higher on the SASI, ASAQ, and CTQ (p<0.05), whereas the control subjects scored significantly higher on the WHOQoL-BREF (p<0.05). ASAQ scores had mild positive correlations with total PANSS and PANSS subscale scores, and moderate positive correlations with total CTQ, CTQ emotional subscale scores, and CTQ physical abuse subscale scores. A negative moderate correlation was found between ASAQ and total WHOQoL-BREF scores. Mediation analysis revealed that CTQ scores significantly affected total WHOQoL-BREF and ASAQ scores. The model pathway for ASAQ scores showed a significant direct and indirect effect of CTQ on the total WHOQoL-BREF scores.

Conclusion

Childhood trauma predicts adult separation anxiety disorder, which partially mediates the impact of childhood trauma on quality of life in individuals with schizophrenia. Therapeutic interventions for adult separation anxiety disorder in individuals with schizophrenia and a history of childhood trauma may help increase their quality of life.

Associations Between the Suicidal Ideation and the Tolerance for Psychological Pain and Tolerance for Physical Pain in Patients Diagnosed with Major Depressive Disorder

Purpose

Patients with major depressive disorder (MDD) may experience more frequent and severe psychological and physical pain complaints compared to those without depression. As the tolerance to psychological pain decreases in patients with MDD, the severity of suicidal ideation tends to increase. Furthermore, the tolerance for physical pain (TPP) has been related with suicidal behavior. We aimed to demonstrate the impact of TPP on suicidal ideation in patients with MDD in the presence of psychological pain.

Patients and Methods

We included 123 patients with MDD and 114 healthy volunteers who had no previous psychiatric diagnosis. Sociodemographic data form, Psychache Scale (PS) and Tolerance for Mental Pain Scale (TMPS) were used to assess psychological pain. Beck Scale for Suicide Ideation (BSIS) and Beck Depression Inventory (BDI) were administered to participants. To assess the TPP, we used a device based on the principle of electronic dynamometry.

Results

The mean BDI, BSIS, PS, and TPP scores in the MDD group were higher, and the mean TMPS score was lower than those in the control group (p < 0.001 for each, p = 0.03 for TPP). We found statistically significant correlations between BDI, TMPS, BSIS, PS, and TPP scores (p < 0.05 for each). TPP was a partial mediator in the relationship between TMPS and BSIS scores (β = -1.814; p < 0.001).

Conclusion

We found that tolerance of psychological pain was a strong predictor of suicidal ideation, and TPP was mediating this relationship. These findings suggest that considering both tolerance to psychological pain and TPP may be beneficial when assessing the risk of suicide in individuals with MDD.

Assessing orthorexic behaviors in a clinical sample: validity and reliability study of the Turkish version of the Düsseldorf orthorexia scale

BACKGROUND

Orthorexia nervosa (ON) is defined as a pathological fixation on eating healthy and pure food. In this study, it was aimed to evaluate the psychometric properties of the Turkish version of the Düsseldorf orthorexia scale (DOS) in a clinical sample.

METHODS

A total of 385 individuals, 117 with generalized anxiety disorder (GAD), 108 with major depressive disorder (MDD), 56 with obsessive-compulsive disorder (OCD) and 104 healthy controls, participated in the study. Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Eating Attitude Test (EAT-40), Orthorexia Nervosa Inventory (ONI) and Düsseldorf Orthorexia Scale (DOS) were applied to all participants.

RESULTS

The DOS demonstrated high internal consistency (Cronbach's alpha = 0.87) and good construct validity. Confirmatory factor analysis supported a one-factor structure, explaining a significant portion of variance among responses. In the analyses performed to test the convergent validity of DOS, a positive correlation was found with ONI and EAT scores (p < 0.001 for each). There was no significant correlation between DOS and HAM-D and HAM-A scores (p > 0.05 for each). The severity of orthorexic symptoms measured by DOS was similar between each patient group and healthy control group. DOS was applied to 70 more participants two weeks apart and the test-retest reliability was determined as 0.99.

CONCLUSIONS

This study shows that the Turkish version of DOS is valid and reliable in clinical samples and healthy individuals, is largely consistent with ONI, and that this scale can be used in studies investigating ON.

Validity and Reliability Study of the Turkish Version of the Unbearable Psychache Scale

Background

: Suicide is a significant public health issue globally, and psychological pain (psychache) is one of the principal risk factors for suicide. It is suggested that when psychache becomes intolerable, suicide attempts are made to get rid of the pain. This study aims to investigate the reliability and validity of the Turkish version of the Unbearable Psychache Scale, which assesses psychache quickly.

Methods:

In this study, we included 136 patients with depression, 45 (33.09%) of whom had previous suicide attempts, and 120 healthy controls. The participants filled out the Unbearable Psychache Scale, Beck Depression Inventory, Beck Suicidal Ideation Scale, Beck Hopelessness Scale, Psychache Scale, and Mee-Bunney Psychological Pain Assessment Scale.

Results:

The Beck Depression Inventory, Beck Hopelessness Scale, Beck Suicidal Ideation Scale, Psychache Scale, Mee-Bunney Psychological Pain Assessment Scale, and Unbearable Psychache Scale mean scores were significantly higher in the patients than healthy controls (P < .001 for each). The Cronbach’s alpha coefficient of the Unbearable Psychache Scale was 0.96 in the internal consistency analysis. The item-total score values were between 0.96 and 0.97. The exploratory factor analysis demonstrated that the Unbearable Psychache Scale was loaded under 1 factor with an eigenvalue above 1 and explained 89.80% of the total variance. The factor loads were between 0.94 and 0.96. There was a significant correlation between the Unbearable Psychache Scale and the Beck Depression Inventory, Beck Hopelessness Scale, Beck Suicidal Ideation Scale, Psychache Scale, and Mee-Bunney Psychological Pain Assessment Scale (P < .001 for each). The Unbearable Psychache Scale differentiated 82% of the patients from the control group and 66.90% of the patients with suicidal attempts from those without suicide attempts.

Conclusion:

This study demonstrated that the Turkish version of the Unbearable Psychache Scale was valid and reliable and can be used in depressive patients and healthy individuals.

The relationship of coping skills with psychache in patients with depressive disorder

Suicide is a leading cause of death and disability worldwide. Psychache (psychological pain) and diminished tolerance of psychaches are important risk factors for suicide. People experiencing psychaches of similar severity may not demonstrate the same levels of tolerance because of various coping skills. This study aimed to determine the relationship between psychache, tolerance for psychache, and coping skills in individuals with depression and healthy controls. We included 73 patients with depressive disorders without comorbid mental disorders and 65 healthy controls. We applied beck depression inventory, beck hopelessness scale, beck suicidal ideation scale, psychache scale, tolerance for mental pain scale (TMPS), and coping attitudes evaluation scale (COPE) to all participants. People with depression had significantly higher COPE dysfunction scores than those in the control group did. Patients who had previously attempted suicide attempt(s) previously had significantly higher beck hopelessness scale, beck depression inventory, COPE dysfunction, and psychache scale scores, and lower TMPS-10 scores than those who did not attempt suicide. Mediation analyses revealed that dysfunctional coping skills played a partial mediating role in the relationship between psychache and the TMPS. The study revealed that dysfunctional coping skills were related to suicidal ideation and previous suicide attempts. These findings suggest that improving coping skills could help reduce the severity of suicidal ideation.

Psychiatric Disorders and Their Impact on Herpes Zoster Incidence: Five Years of Data from Turkiye

Background/Objectives: This study investigates the relationship between psychiatric disorders and herpes zoster (HZ). Emergency and outpatient admissions to Kırşehir Education and Research Hospital between 2019 and 2023 were examined. Psychiatric disorders are known in the literature as one of the factors that weaken the immune system, thereby increasing the risk of infection. Methods: In our study, the past diagnoses and sociodemographic data of all individuals over the age of 18 who applied to the Kırşehir Education and Research Hospital between 2019 and 2023 were obtained from hospital system records. Patients receiving immunosuppressive treatment or those with diseases that could affect immune system function were excluded from the study. The sample was divided into two groups: those with and without psychiatric disorders diagnosed with HZ. Sociodemographic features, change of HZ frequency over the years, and differences among psychiatric diagnosis subgroups were examined between the groups. Results: Individuals with psychiatric diseases had a significantly higher frequency of HZ compared to those without psychiatric diseases (0.0040% vs. 0.0016%, p < 0.001). No significant difference was found in the frequency of HZ among different types of psychiatric disorders (p = 0.60). Additionally, no statistically significant difference was found in the median age between the groups (p = 0.11). In terms of gender distribution, it was determined that women were more frequently diagnosed with HZ compared to men. Conclusions: The frequency of HZ was found to be higher in individuals with psychiatric disorders. However, further research is needed to explore the association between specific psychiatric diagnoses and HZ frequency.

Validity and Reliability Study of the Turkish Version of the Orbach Mikulincer Mental Pain Scale-8 in a Clinical Population

Purpose

Suicide is a growing public health issue for all societies; identifying suicide risk is crucial. This study aims to evaluate the psychometric properties of the Turkish version of the Orbach and Mikulincer Mental Pain Scale-8 (OMMP-8), which enables the assessment of suicidality in a short time.

Patients and Methods

We conducted this study with 148 individuals diagnosed with major depressive disorder and 130 healthy controls. We administered the Hamilton Depression Scale (HDRS), Beck Hopelessness Scale (BHS), Beck Scale for Suicidal Ideation (BSIS), and Mee Bunney Psychological Pain Assessment Scale (MBPPAS) to all participants.

Results

Cronbach's alpha values were 0.96, 0.97, and 0.98 for Factors 1, 2, and 3, respectively, and 0.92 for the entire scale. Exploratory (EFA) and confirmatory factor analyses (CFA) proved the 3-factor structure of the scale. The OMMP-8 total score and HDRS (r = 0.851), BSIS (r = 0.836), BHS (r = 0.825), and MBPPAS (r = 0.881) total scores were statistically significantly correlated, indicating convergent and concurrent validity of the scale. The scale successfully discriminated between depression and control groups (89.6%) and participants with and without suicide attempts in the depression group (82.4%).

Conclusion

This study demonstrates that the Turkish version of the OMMP-8 scale is valid and reliable for both individuals with depression and healthy controls and can be used in studies investigating suicide risk.