INTRODUCTION: Suicidal behavior remains a major clinical concern in bipolar disorder even during euthymic periods. This study aimed to compare interpersonal sensitivity, perceived cognitive failures, and affective symptoms in euthymic patients with bipolar disorder with and without a history of suicide attempts, and to examine whether perceived cognitive failures mediate the association between interpersonal sensitivity and suicidal behavior.
METHODS: This cross-sectional study included 68 euthymic patients with bipolar disorder. Participants were divided according to the presence of a history of suicide attempts. All participants were evaluated with the Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), Interpersonal Sensitivity Measure (IPSM), and Cognitive Failures Questionnaire (CFQ). Group comparisons, correlation analyses, and bootstrap mediation analyses were performed.
RESULTS: Patients with a history of suicide attempts had higher HAM-D (p=.008), CFQ (p=.005), and IPSM total scores (p=.033). The number of lifetime suicide attempts was positively correlated with perceived cognitive failures (r=.38, p<.01) and interpersonal sensitivity (r=.26, p<.05). In the bias-corrected bootstrap mediation model controlling for medical comorbidity, perceived cognitive failures statistically mediated the association between interpersonal sensitivity and the number of suicide attempts (β=.138, p=.019), whereas anxiety and depressive symptoms did not.
DISCUSSION AND CONCLUSION: Euthymic patients with bipolar disorder and a history of suicide attempts showed greater interpersonal sensitivity and subjective cognitive difficulties. Perceived cognitive failures may represent an important factor involved in the association between interpersonal sensitivity and suicidal behavior. Assessing interpersonal and cognitive factors in addition to mood symptoms may improve the clinical evaluation of suicide risk.

INTRODUCTION: Bipolar disorder and schizophrenia are severe disorders that often begin in adolescence and affect both youth and caregivers. Although interest in transdiagnostic psychosocial approaches has grown in recent years, few studies have examined the same structured family-based intervention across these diagnostic groups, particularly in non-Western settings. This single-arm pilot study evaluated the preliminary clinical and family-related outcomes of a brief, manual-based Family-Focused Therapy (FFT) program delivered in routine outpatient youth mental health care.
METHODS: Adolescents aged 15-19 years diagnosed with bipolar disorder (n=10) or schizophrenia (n=10), along with their caregivers, received a 9-session FFT program. Overall, 87% completed the intervention and were included in analyses. Primary outcomes included depressive symptoms, psychosocial functioning, and illness insight. Secondary outcomes included caregiver depressive symptoms, caregiver burden, and family functioning. Pre-post changes and exploratory group×time patterns were examined using within-group tests and repeated-measures models.
RESULTS: Depressive symptom severity decreased and psychosocial functioning improved in both diagnostic groups, with substantial within-group standardized mean change effects. Illness insight also showed pre-post improvement. Caregiver burden decreased in both groups, whereas caregiver depressive symptoms decreased only among parents of adolescents with bipolar disorder. Family functioning changes differed across diagnostic groups and informants.
DISCUSSION AND CONCLUSION: A brief transdiagnostic FFT program was associated with pre-post improvements across multiple clinical and family-related domains. Although conclusions are limited by the single-arm design, findings provide preliminary evidence suggesting the potential clinical relevance of FFT in routine outpatient care and warrant larger controlled trials of transdiagnostic family interventions in diverse clinical contexts.

INTRODUCTION: Social stigma toward schizophrenia is often perpetuated by inaccurate media portrayals. This study investigates how evidence-based psychoeducation influences the attitudes of graphic design students—future visual communicators—and how this knowledge shifts their creative output.
METHODS: Eighty graphic design students in Turkey participated in a 60-minute structured psychoeducation session led by psychiatrists. Participants created awareness posters before and after the intervention. Changes were measured using the Social Distance Scale (SDS), Survey on Knowledge about Schizophrenia, and Belief toward Mental Illness Scale (BMI). Qualitative shifts in visual metaphors and storytelling were also analyzed.
RESULTS: Post-intervention, both SDS and BMI scores decreased significantly (p < 0.05), indicating reduced stigma. While 85% of participants consistently supported professional medical help, the perception of schizophrenia as a purely social issue dropped from 23% to 20%. Critically, while technical design elements (color, typography) remained statistically constant, there was a significant evolution in narrative language, characterized by nuanced metaphors and sophisticated conceptual framing.
DISCUSSION AND CONCLUSION: Psychoeducation effectively improves theoretical knowledge and corrects misconceptions, though altering deeply rooted behavioral social distance remains a challenge. The intervention primarily influenced "conceptual depth" and "empathy-driven storytelling" rather than aesthetic choices, suggesting that education refines how designers think about a subject.
Conclusion: Integrating psychoeducation into design curricula fosters less-stigmatizing representations of mental illness. This interdisciplinary approach is vital for refining the visual metaphors used by communicators to reshape public perception.

INTRODUCTION: This study examined whether postural instability in children with Specific Learning Disorder (SLD) is associated with cognitive-attentional processes or broader motor involvement.
METHODS: Seventy children aged 7–11 years participated in the study, including 41 children with SLD and 29 typically developing controls. Postural stability was assessed using the NeuroCom Balance Master and the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) across four conditions: hard surface eyes open (HSEO), hard surface eyes closed (HSEC), foam surface eyes open (FSEO), and foam surface eyes closed (FSEC). Attention was measured using the Swanson, Nolan, and Pelham Scale–IV (SNAP-IV), and cognitive performance was estimated using the Vocabulary and Block Design subtests of the Wechsler Intelligence Scale for Children–Revised (WISC-R). Parent-reported motor coordination difficulties were assessed using the Developmental Coordination Disorder Questionnaire–2007 (DCDQ’07). Group differences were examined using independent samples tests, followed by ANCOVA models adjusting for attentional symptoms, verbal ability, and parent-reported motor coordination difficulties. Hierarchical multiple regression analyses were conducted to identify predictors of postural performance.
RESULTS: Children with SLD demonstrated significantly greater postural sway across all balance conditions (all p <.001). Group differences remained significant after adjusting for attentional symptoms and verbal ability. Additional ANCOVA models including DCDQ’07 scores also indicated persistent group differences in postural control parameters. Hierarchical regression analyses showed that SLD diagnosis was significantly associated with postural instability across conditions, whereas BMI was associated only in the HSEO condition.
DISCUSSION AND CONCLUSION: Postural control difficulties were more frequently observed in children with SLD compared with typically developing peers, even after adjusting for attentional symptoms, verbal abilities, and parent-reported motor coordination difficulties. However, given the cross-sectional design and potential confounding factors, including ADHD comorbidity and socioeconomic differences, these findings should be interpreted cautiously. Overall, the results suggest that postural instability may be related to broader neurodevelopmental mechanisms involving sensorimotor integration.

INTRODUCTION: This study examined whether perceived problem-solving ability mediates the association between mentalization and resilience in non-clinical adults.
METHODS: A cross-sectional correlational design was used. The sample comprised 422 adults (222 women, 200 men; age range 18–55, M = 34.44, SD = 10.70). Data were collected with the Mentalization Scale (MentS), the Problem-Solving Inventory (PSI), and the Resilience Scale for Adults (RSA). The mediation model was tested with PROCESS Macro v5.0 (Model 4) using 5,000 bootstrap samples, and a sensitivity analysis controlling for age, gender, marital status, and income was also conducted. Higher PSI scores indicate lower perceived problem-solving ability.
RESULTS: Mentalization was positively correlated with resilience (r =.27, p <.001) and negatively with PSI scores (r = -.25, p <.001), indicating that individuals with stronger mentalization reported better perceived problem-solving ability. PSI scores were negatively associated with resilience (r = -.39, p <.001). The total association between mentalization and resilience was significant (B = 0.54, p <.001). When problem-solving ability was added, the direct association remained significant but decreased (B = 0.37, p <.001), and the indirect association was significant (B = 0.17, 95% CI [0.08, 0.29]). The model explained 18% of the variance (R² =.18), and the pattern remained stable after demographic adjustment (R² =.197).
DISCUSSION AND CONCLUSION: Perceived problem-solving ability partially mediates the association between mentalization and resilience within a cross-sectional statistical model. Intervention programs aimed at strengthening resilience may benefit from addressing both mentalization and problem-solving.

INTRODUCTION: The Special Needs Report for Children (SNRC; Çocuklar İçin Özel Gereksinim Değerlendirmesi Raporu, ÇÖZGER), introduced in Turkey in 2019, restructured pediatric disability evaluation. Whether it facilitates linkage to child mental health services remains underexamined. This study evaluated the characteristics of children receiving SNRC, post-report psychiatric linkage to care, and its predictors.
METHODS: Records of 2363 children and adolescents who received SNRC at a single tertiary center between February 20, 2019 and December 31, 2025 were retrospectively reviewed. Pre-report follow-up was defined as ≥2 non-SNRC outpatient visits within 12 months, and post-report linkage as ≥1 non-SNRC psychiatric visit. Predictors were examined using binary logistic regression.
RESULTS: Of 2363 cases, 60.9% were male and the mean age at first presentation was 8.4 ± 4.7 years. Overall, 59.4% had no psychiatric diagnosis, with neurological, endocrine, and genetic comorbidities prominent in this group. Among 960 patients with a psychiatric diagnosis, the most frequent were intellectual disability, language/speech disorders, specific learning disorder, and autism spectrum disorder. Post-report linkage occurred in 35.1% of the full sample and 46.5% of the psychiatric subgroup. Positive predictors were psychiatric comorbidity count (OR=3.77; 95% CI: 2.63–5.40), number of reports (OR=2.84; 2.48–3.26), prior follow-up (OR=2.58; 2.17–3.07), autism spectrum disorder (OR=1.84; 1.33–2.53), and male sex (OR=1.20; 1.01–1.43); out-of-province residence was the only negative predictor (OR=0.43; 0.35–0.53).
DISCUSSION AND CONCLUSION: The modest post-report linkage rate suggests that the SNRC process functions only partially as a gateway to ongoing care. These findings support reconceptualizing SNRC not merely as a reporting procedure but as a structural opportunity for linkage to child mental health services.

Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia, yet its use is limited by interindividual variability in metabolism, efficacy, and adverse effects. This review examines the contribution of pharmacogenetics to these differences.
A comprehensive literature review was conducted focusing on genetic determinants of clozapine pharmacokinetics, pharmacodynamics, treatment response, and adverse effects. Key cytochrome P450 enzymes, regulatory loci, and neurotransmitter receptor gene variants were evaluated.
CYP1A2 polymorphisms and emerging loci such as NFIB significantly influence clozapine metabolism. Genetic variants in neurotransmitter receptor genes modulate efficacy and the risk of adverse effects, including weight gain and hematological abnormalities. Pharmacogenetic testing can complement therapeutic drug monitoring to optimize treatment outcomes.
Pharmacogenetics enhances understanding of interindividual variability in clozapine response, but current evidence does not support routine genotype-based dosing. Personalized therapy integrating pharmacogenetic data, therapeutic drug monitoring, and clinical assessment remains the most promising approach. Further research is needed to implement these strategies in routine clinical practice.

Bipolar disorder (BD) is characterized by a complex interplay between genetic vulnerability and environmental stressors. During adolescence, heightened neurobiological sensitivity renders individuals more susceptible to the disruptive effects of digital stimuli. This case report describes a 16-year-old male who experienced his first manic episode following intensive emotional engagement with an artificial intelligence (AI)-based chatbot. The case illustrates how an asymmetric relationship with AI—occurring in the context of post-surgical social withdrawal—may be associated with manic delusions and clinical escalation through sleep deprivation, cognitive overstimulation, and the 'echo chamber' effect. Given the scarcity of empirical data on AI-induced psychopathology, this case provides a unique perspective on how generative AI models may be associated with the reinforcement of maladaptive beliefs as a psychosocial context in reward-sensitive adolescents. Clinical assessment in the digital age must evolve beyond monitoring screen time to qualitatively evaluating human-AI interactions, recognizing AI as a novel environmental factor warranting clinical attention in the management of adolescent bipolar disorder.

Valproic acid is a mood stabilizer and antiepileptic drug that acts through GABA and glutamate. Glutamatergic and GABAergic dysfunction is thought to be a common mechanism in the pathophysiology of autism spectrum disorder and obsessive-compulsive disorder. The use of valproic acid may be effective in treatment-resistant cases of obsessive-compulsive disorder associated with autism.
A 15-year-old male with autism was administered 2 types of SSRIs in appropriate doses and duration separately for OCD. Aripiprazole was added to the treatment of the patient whose obsessive-compulsive disorder symptoms did not decrease. The patient who responded partially to augmentation was started on valproic acid.
The patient's obsessive-compulsive disorder complaints decreased significantly after valproic acid treatment, and his functionality improved. The valproic acid blood level was 68 mg/L. While the Children's Yale Brown Obsessive Compulsive Scale score was 36 points before valproic acid treatment, the score decreased to 19 points after 2 months of valproic acid treatment.
GABAergic agents such as valproic acid may be considered for treatment-resistant obsessive-compulsive disorder in autism.