Misophonia is a condition characterized by extreme emotional reactions, such as irritation or anger, triggered by specific sounds. Despite its prevalence, there is a lack of evidence-based treatment methods for misophonia.

This case report aims to explore the effectiveness of combining psychoeducation with Cognitive Behavioral Therapy (CBT) in the treatment of a misophonic patient. The focus is on reducing the patient’s emotional distress and improving their quality of life.

The patient is a 28-year-old woman employed as a salesperson in a busy city. Mouth smacking, gum chewing and clock ticking are the sounds that bother her the most. She has never used any medications or attempted any methods to alleviate her misophonia. Neither she, nor her family has a history of a psychiatric disorder.

The therapeutic intervention spanned eight sessions, each lasting around half an hour. The first two sessions, a patient history was taken and Mısophonia Interview Scale (MIS) was conducted. MIS comprised the Misophonia Checklist (MCL), which involved reading fifty misophonic sounds to the patient one by one. She then rated her discomfort in response to each sound on a four-point Likert-type scale. From the MCL responses, a total severity score (Misophonia Total Score - MTS), was calculated.

The treatment commenced with a psychoeducational component focused on enhancing the patient’s comprehension of misophonia. This phase aimed to elucidate the neurobiological underpinnings of the condition, common triggers, and the emotional reactions associated with it.

Then, CBT was employed to identify and challenge the patient’s negative automatic thoughts (NATs) linked to her misophonia. Three sessions primarily concentrated on identifying and managing NATs associated with her misophonia. These sessions equipped the patient with the skills to recognize and confront NATs through structured discussions and practical assignments.

The last three sessions centered on exposure therapy, with the goal of reducing emotional and physiological responses to triggers. Homework assignments during this phase encouraged the patient to independently practice exposure exercises.

The initial MTS was 54, indicating significant distress. After the interventions, the final MTS decreased to 35 and the impact of misophonic symptoms on her life decreased from severe to moderate.

Misophonia is a challenging disorder to treat due to its limited evidence-based interventions. This case report demonstrates that a combination of psychoeducation and CBT methods may hold promise in managing misophonic symptoms. However, it is essential to acknowledge the need for further research in this area, as misophonia’s treatment strategies require more robust empirical support. This case highlights the potential benefits of psychoeducation and CBT, emphasizing the need to explore and develop effective treatments for this debilitating condition.

None Declared

Interoception encompasses processes that involve receiving, processing, and integrating bodily signals with external stimuli, ultimately influencing ongoing motivated behaviors. Disruptions in these interoceptive processes are believed to contribute to the development and progression of alcohol use disorder (AUD). Interoceptive accuracy (IAc), the objective dimension of interoception, has been shown to be decreased in patients with AUD. Traits linked to substance use vulnerability, such as personality dimensions and alexithymia, may be associated with decreased IAc.

Our objective was to compare the heartbeat perception (HBP) scores, as a measure of IAc, between abstinent inpatients with AUD and healthy controls. Additionally, we aimed to investigate potential associations between IAc and variables such as alcohol craving, personality dimensions, and alexithymia.

The study comprised 48 abstinent inpatients with AUD and 68 healthy control subjects. All participants completed a heart rate tracking task, serving as an objective physiological measure of IAc. In addition to the IAc task, several assessments were administered to the patient group, including the Alcohol Use Disorders Identification Test (AUDIT), the Penn Alcohol Craving Scale (PACS), the Temperament and Character Inventory (TCI), and the Toronto Alexithymia Scale (TAS-20). Patients were recruited for a 28-day abstinence-based inpatient treatment program, and all assessments were conducted during the final week of hospitalization at the Alcohol and Substance Addiction Treatment Center in Trakya University School of Medicine (Edirne, Türkiye).

Patients’ HBP scores (mean ± standard deviation: 0.59±0.21) were significantly lower than those of healthy control subjects (0.74±0.15) (t=-4.469, p<0.001). The patients’ HBP scores showed significant negative correlations with AUDIT (r=-0.312, p=0.035), PACS (r=-0.361, p=0.019), and TAS-20 scores (r=-0.406, p=0.004). Additionally, there was a significant positive correlation between patients’ HBP scores and TCI self-directedness scores (r=0.371, p=0.009), and a near-significant correlation with TCI persistence scores (r=0.282, p=0.052). TCI novelty seeking, harm avoidance, reward dependence, cooperativeness, and self-transcendence scores did not significantly correlate with patients’ HBP scores (p>0.05).

Our findings may support the hypothesis that interoceptive processes play a role in AUD, and that certain traits linked to vulnerability to alcohol use are associated with decreased IAc.

None Declared

Severe mental disorders as bipolar disorder and schizophrenia often co-occur with chronic medical illnesses, especially cardiovascular disease and diabetes. Our aim was to estimate the prevalence of physical health problems in hospitalized patients and to determine the sociodemographic and clinical factors associated with physical comorbidity.

The medical records of all inpatients followed up between September 2007 and September 2009 were reviewed retrospectively.

144 patients were evaluted of which 59 (%41) had schizophrenia, 31(%21.5) had bipolar disorder and 54 (%37.5) had other disorders. 43 (%29.9) patients had at least one medical illness, hypertension being the most common (%30) followed by thyroid disorders (%16) and diabetes mellitus (%11). Diabetes Mellitus was detected only in bipolar patients (p=0.005). Females were affected more than males regarding physical comorbidity (p=0.009). Patients with physical comorbidity were older (42.9 vs 35.54 yrs) and had a longer duration of illness (16.2 vs 10.0 yrs). Their hemoglobin levels were lower, blood glucose, urea, thyroid stimulating hormone levels were higher than the patients with no physical illness and the differences were all statistically significant (p=0.05). There was no difference regarding length of hospital stay, drug compliance, previous neuroleptic use, family history for medical and mental illness.

Conclusions: Although it is generally accepted that many physical conditions have been associated with serious mental disorders, the exact nature of the relationship between them is still unclear. Further research is required to identify medical comorbidity risk factors in order to improve the physical health of these patients.

Most previous studies investigating the relationship between visual perception and anxiety have found that anxiety-provoking stimuli are perceived as relatively larger in size. Thus, the present study used neutral stimuli to investigate the relationships among anxiety, anxiety sensitivity (AS), and visual perception in a group of male and female university students.

The Visual Size Perception Assessment Test (V-SPAT), which requires subjects to define a neutral figure in a dichotomous manner (i.e., tall/short, large/small, wide/narrow, crowded/deserted) was administered to all participants (n = 76). Additionally, the anxiety level and AS of each participant was determined using the Beck Anxiety Inventory (BAI) and the Anxiety Sensitivity Index-3 (ASI-3), respectively.

The BAI and ASI-3 total and cognitive scores of female participants were correlated with perceptions of 'deserted”, whereas their ASI-3 social scores were correlated with perceptions of 'short”. The ASI-3 cognitive scores of male participants were correlated with perceptions of 'crowded”, and their ASI-3 physical scores were correlated with perceptions of 'tall”.

The present findings indicate that the visual perception of neutral objects is correlated with anxiety and AS. Furthermore, these data revealed sex differences in the relationship between AS and visual perception in that males perceived the objects as larger and females perceived them as smaller.

Otitis media with effusion is a clinical manifestation characterised by inflammation of middle-ear mucosa. This study investigated the therapeutic effect of erythromycin, clarithromycin, azithromycin and roxithromycin on a histamine-induced animal model of otitis media with effusion.

The animals were divided into five groups, receiving erythromycin, clarithromycin, azithromycin, roxithromycin or saline solution. The guinea pigs in the study groups received erythromycin (40 mg/kg/day), clarithromycin (15 mg/kg/day), azithromycin (10 mg/kg/day) or roxithromycin (10 mg/kg/day) for 3 days by gastric tube. Four hours after the end of the administration, histamine solution was injected into the right middle ear.

The lowest neutrophil density value obtained using stereological techniques was in the azithromycin group (0.86 ± 0.25 × 10−5/μm3), while the highest value was observed in the control group (6.68 ± 3.12 × 10−5/μm3). The anti-inflammatory properties of clarithromycin, azithromycin and roxithromycin were similar to one another, but better than that of erythromycin.

The use of macrolide antibiotics is recommended, as they show antibacterial and anti-inflammatory efficacy in otitis media with effusion.

To investigate the effects of different suture materials in the nasal cavity on encrustation and micro-organism colonisation.

Four different suture materials were used to suture the nasal septum. The effects of suture materials on intranasal encrustation were evaluated with anterior rhinoscopy. The sutures were removed and evaluated in terms of micro-organism colonisation on the 7th and 21st post-operative days.

Monofilament sutures were found to cause less encrustation and micro-organism colonisation. There was increased late-stage encrustation if an absorbable monofilament suture remained in place for a long time. The removal of a non-absorbable monofilament suture in the early or late post-operative period made no difference in terms of micro-organism growth on the suture.

The material and physical characteristics of sutures placed inside the nose may indirectly affect the healing process. It may be more appropriate to use different materials depending on the length of time the suture is to remain in place.