Emre Bora

Dokuz Eylul University | DEÜ · Department of Psychiatry

Objective: Executive dysfunction is a common feature of schizophrenia and bipolar disorder (BP). While deficits in social cognitive abilities, including theory of mind (ToM), have been suggested to be specific to schizophrenia, available evidence suggests that there is also a significant overlap in social cognitive performances of both disorders....

In recent years there has been growing interest in early intervention in psychotic disorders and a number of clinical and research programmes have been developed. The clinical staging model has been an essential part of early intervention as it provides the rationale of existing programmes. In medicine, clinical staging is a valuable approach in di...

Background: Bipolar disorder (BD) is associated with significant cognitive heterogeneity. In recent years, a number of studies have investigated cognitive subgroups in BD using data-driven methods and found that BD includes several subgroups including a severely impaired and a neurocognitively intact cluster. Studies in offspring of BD (BDoff) are...

Background Schizophrenia is associated with significant cognitive impairment. However, the pathophysiological mechanisms underlying cognitive dysfunction in schizophrenia remain unclear. Brain-derived neurotrophic factor (BDNF) and C-reactive protein (CRP) are among the most commonly investigated peripheral markers of cognition in schizophrenia.Met...

Background It is widely accepted that borderline personality disorder (BPD) is associated with significant impairments in mentalization and theory of mind (ToM) which are considered as closely related concepts by many authors particularly in psychoanalytical circles. However, for understanding interpersonal difficulties in personality disorders, it...

Schizophrenia has long been thought to be a disconnection syndrome and several previous studies have reported widespread abnormalities in white matter tracts in individuals with schizophrenia. Furthermore, reductions in structural connectivity may also impair communication between anatomically unconnected pairs of brain regions, potentially impacti...

Both structural and functional alterations in the retina and the choroid of the eye, as parts of the central nervous system, have been shown in psychotic disorders, especially in schizophre-nia. In addition, genetic and imaging studies indicate vascular and angiogenesis anomalies in the psychosis spectrum disorders. In this ocular imaging study, ch...

Sleep disturbances and cognitive impairment are both persistent and common features of schizophrenia. Accumulating evidence indicates that sleep-dependent memory consolidation might be impaired in patients with schizophrenia compared to healthy controls. The current systematic review was performed in accordance with PRISMA guidelines. A random-effe...

Evidence suggests that neurocognitive dysfunction is a transdiagnostic feature of individuals across the continuum between schizophrenia and bipolar disorder. However, there is significant heterogeneity of neuropsychological and social-cognitive abilities in schizophrenia, schizoaffective disorder, and bipolar disorder. The current study aimed to i...

Minor physical anomalies (MPAs) are markers of abnormalities in early foetal development and are well established findings in schizophrenia. It has been suggested that neurodevelopmental abnormalities might play a role not only in schizophrenia but also in bipolar disorder (BD). Therefore, according to neurodevelopmental theory of BD, one might exp...

In all human languages, noun phrases (NPs) (e.g., ‘a field’, ‘the woman with a book’) are used to identify entities in discourse. Previous evidence has shown that the spontaneous speech of patients with schizophrenia (Sz) shows differences in the distribution of grammatically different types of NPs, which are in part specific to patients with forma...

Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts (obsessions) and compulsions and has been associated with psychosocial impairment. Indeed, a number of studies have highlighted impairments in both social cognitive functions and empathic skills in OCD, despite several inconsistencies. This study aimed to investigate social...

Negative symptoms, including avolition, anhedonia, asociality, blunted affect and alogia are associated with poor long-term outcome and functioning. However, treatment options for negative symptoms are limited and neurobiological mechanisms underlying negative symptoms in schizophrenia are still poorly understood. Diffusion-weighted magnetic resona...

The onset of schizophrenia is determined by biological and social risk factors operating predominantly during development. These result in subtle deviations in brain structure and cognitive function. Striatal dopamine dysregulation follows, causing abnormal salience and resultant psychotic symptoms. Most people diagnosed as having schizophrenia do...

The detection of individuals at clinical ultra-high risk for psychosis (CHR-P) may be a key limiting step for early interventions, and there is some uncertainty regarding the true clinical reliability of the CHR-P states. The aim of this study was to explore how practitioners who were in the direct treatment of children with psychiatric disorders [...

Objective Synthetic cannabinoids (SCs) have become increasingly popular in recent years, especially among adolescents. The first aim of the current study was to examine resting‐state functional connectivity (rsFC) in SC users compared to controls. Our second aim was to examine the influence of comorbid attention‐deficit/hyperactivity disorder (ADHD...

Background Bipolar disorder (BD) might be associated in disturbances in brain networks. However, little is known about the abnormalities in structural brain connectivity which might be related to vulnerability to BD and predictive of the emergence of manic symptoms. No previous study has investigated the effect of subthreshold syndromes on structur...

Bipolar disorder (BD) is associated with cognitive deficits that persist in remission in multiple domains. There is significant heterogeneity of cognitive function in BD. Cognitive impairment in BD is clinically relevant, but the etiology of cognitive dysfunction in BD is currently unknown. Brain imaging studies suggest that cognitive impairment in...

Aims: Patients with bipolar disorder present milder cognitive impairment in comparison to patients with schizophrenia. Psychotic symptoms are associated with poorer cognitive functioning in both disorders. We aim to compare cognitive dysfunction between bipolar disorder and schizophrenia across symptomatic and remitted states. Methods: An extensive...

Peripheral inflammatory and neurotrophic biomarkers of cognitive impairment in schizophrenia: a meta-analysis — CORRIGENDUM - Emre Bora

Background Obsessive-compulsive disorder (OCD) has been associated with cognitive deficits, particularly with executive functions. These findings support fronto-striatal dysfunction in OCD. However, it is not certain whether these findings are trait features of OCD. In recent years, a number of studies have investigated cognitive functions in unaff...

Schizotypy is a multi-dimensional personality construct that putatively indicates an individual's liability to psychosis. Schizophrenia is associated with significant deficits in theory of mind (ToM). However, previous studies investigating the relationship between schizotypy and ToM provided inconsistent findings. Following the systematic review o...

Background Severe impairment in interpersonal functioning is a common feature of schizophrenia. Deficits in communicative abilities are likely to be among the important factors contributing to social dysfunction in schizophrenia. Difficulties in pragmatic language abilities including understanding intended meaning, beyond explicit and literal conte...

Background Evidence suggests that neurocognitive dysfunction is a transdiagnostic feature of individuals across continuum between schizophrenia and bipolar disorder. However, there is a significant heterogeneity of neuropsychological and social cognitive abilities in schizophrenia, schizoaffective disorder and bipolar disorder. In recent years, sev...

Background Current scales of formal thought disorder (FTD) in schizophrenia have been shown to hold considerable inadequacies: 1. The concept of FTD is usually limited to positive and negative symptoms of schizophrenia 2. There is no much consideration about pragmatic disturbances. 3. There are significant inconsistencies in measurements of posFTD...

Synthetic cannabinoids (SC) have become increasingly popular in the last few years, especially among adolescents. Given ADHD is overrepresented in patients with substance use across adolescents compared to the general population, the current study aims were two-fold: i) examine structural brain network topology in SC users compared to healthy contr...

This chapter considers treatment approaches in early psychosis and the possibility of prevention prior to the development of illness. The chapter first considers the various definitions of the pre-psychotic state, including prodrome, and the concept of clinical high-risk (CHR) groups. The CHR groups, including the ultra-high-risk (UHR) and basic sy...

The third edition of the textbook presents psychiatry as a medical specialty. The application of science has transformed much of medicine by providing an understanding of the mechanisms of pathology. The genetic basis of psychiatry guarantees a future for explanation by neuroscience. The book sets the scene for such development by explaining the ke...

This chapter reviews the evidence of neuroprogresssion in bipolar disorder (BD) based on available neurocognitive and neuroimaging studies. It discusses the alternative versions of neuroprogression in patients with BD, including pronounced and subtle forms of neurodegeneration and functional reorganization in brain activity. It reviews the evidence...

Bipolar disorder (BD) is associated with cognitive dysfunction which has also been reported in offspring of individuals with BD (BDoff). However, it remains unclear whether cognitive underperformance in BDoff is associated with the presence of history of subclinical syndromes associated with risk for BD. To address this knowledge gap we assessed ex...

Executive dysfunction and language impairment are the most prominent neuropsychological models of formal thought disorder (FTD) in schizophrenia. However, available studies have provided contradictory findings regarding the accuracy of these models. Furthermore, specific neurocognitive underpinnings of positive FTD (PosFTD) and negative FTD (NegFTD...

Prodromal symptoms of bipolar disorder (BD) and early onset schizophrenia spectrum disorder (EOSSD) overlap. To date, there has been no study directly comparing the prodromal stage of both disorders. Thus, the current study is aimed at determining which prodromal symptom clusters differentiate BD and EOSSD. One hundred twenty one adolescents (33 BD...

Psychiatric disorders are characterized by an overlapping set of pathophysiological pathways that include monoamines but also neurotrophins, apoptotic and mitochondrial pathways, epigenetics, and dysregulation of immunity and redox balance, counterbalanced by cellular resilience and defence pathways and the effects of treatment. These conspire in a...

Objective:: To derive new criteria sets for defining manic and hypomanic episodes (and thus for defining the bipolar I and II disorders), an international Task Force was assembled and termed AREDOC reflecting its role of Assessment, Revision and Evaluation of DSM and other Operational Criteria. This paper reports on the first phase of its delibera...

Background Individuals with bipolar disorder (BD) have a higher prevalence of obesity and metabolic syndrome (MetS) compared with the general population. Obesity and MetS are associated with cognitive deficits and brain imaging abnormalities in the general population. Obesity and components of MetS might potentially associate with neuroimaging and...

Bipolar bozukluk, işlevselliği ciddi derecede etkileyen, yüksek oranda özkıyım girişimleri ve hastane yatışlarına sebep olan, madde kullanım bozukluğu ve diğer birçok komorbidite ile seyreden, kronik, tekrarlayıcı bir psikiyatrik bozukluktur. Son yirmi yılda, psikotik bozukluk için yüksek riske sahip bireylerle yapılan çalışmalar, bipolar bozukluğa...

Neurological soft signs (NSS) are subtle deficits in motor coordination, sensory integration, and sequencing of complex motor acts. Increased NSS is a well-established feature of patients with schizophrenia but a relatively smaller number of studies have investigated NSS in bipolar disorder (BD). Some authors but not others suggested that NSS can d...

In the last two decades, number of studies examining prevention and early intervention in bipolar and psychotic disorders has gradually increased. Prodromal symptoms of these disorders often occur during adolescence. Many retrospective studies have shown early and late prodromal symptoms before the first episode of bipolar and psychotic disorders....

Neurocognitive impairment is a well-established feature of first-episode psychosis (FEP). Neurotoxicity hypothesis of psychosis suggests that untreated psychosis before the initiation of first effective treatment is associated with loss of acquired cognitive abilities. However, the outcome of the studies investigating the relationship between durat...

Background Neurodevelopmental abnormalities are common in schizophrenia. Minor physical anomalies (MPAs) are associated with abnormalities in neural development. Previous studies clearly demonstrated that MPAs are significantly increased in schizophrenia. However, the available evidence in unaffected relatives of patients with schizophrenia is cont...

Background Previous literature comparing cognitive functioning between bipolar disorder (BD) and schizophrenia (Sch), particularly focused on remitted patients with BD (i.e. euthymics) and clinically stable patients with Sch; and suggested milder cognitive impairment in BD in comparison to Sch. Acute psychotic symptoms may lead poorer cognitive fun...

The relationship between cognitive impairment in schizophrenia and metabolic syndrome: a systematic review and meta-analysis – CORRIGENDUM - E. Bora, B. B. Akdede, K. Alptekin

Objective: The primary aim of the current study was to investigate different aspects of theory of mind (ToM), including social-cognitive (ToM-reasoning) and social-perceptual (ToM-decoding) in obsessive-compulsive disorder (OCD). We also aimed to investigate the relationship between ToM, neurocognition and a number of clinical variables including...

We aimed to examine the whole-brain white matter connectivity and local topology of reward system nodes in patients with alcohol use disorder (AUD) and unaffected siblings, relative to healthy comparison individuals. Diffusion-weighted magnetic resonance imaging scans were acquired from 18 patients with AUD, 15 unaffected siblings of AUD patients a...

Objective: There is a significant cognitive heterogeneity in bipolar disorder (BD). The aim of this systematic review was to examine the potential distinctive neuropsychological of features of clinical subgroups of BD. A literature search investigating cognitive differences between potential subtypes of BD was conducted. Methods: It was possible...

OBJECTIVE: Digit ratios may be accepted as an indicator of level of prenatal androgen exposure during the fetal developmental period. Female-typical digit ratios have been suggested to be associated with better mentalizing and empathic abilities in general population. Recently, a number of studies have investigated the ratio of hand’s second and fo...

Letter to the Editor: The half-alive concept of schizophrenia is still better than the spectrum of everything - E. Bora

Historically, formal thought disorder has been considered as one of the distinctive symptoms of schizophrenia. However, research in last few decades suggested that there is a considerable clinical and neurobiological overlap between schizophrenia and bipolar disorder (BP). We conducted a meta-analysis of studies comparing positive (PTD) and negativ...

Social cognitive abilities are impaired in Alzheimer disease and other dementias. Recent studies suggested that social cognitive abilities might be also impaired in mild cognitive impairment (MCI). Current meta-analysis aimed to summarize available evidence for deficits in theory of mind (ToM) and emotion recognition in MCI. In this meta-analysis o...

Objective Cognitive impairment is a familial and heritable aspect of major psychoses and might be a shared vulnerability marker for schizophrenia and BP. However, it is not clear whether some aspects of cognitive deficits are uniquely associated with risk for specific diagnoses. Methods A novel meta-analysis of cognitive functions in first-degree...

Background Bipolar disorder (BP) is associated with significant cognitive impairment. Recent evidence suggests that cognitive deficits are already evident after first-episode mania. However, it is not clear whether BP is associated with further decline in cognitive functions in individuals with established illness. Aim of this meta-analytic review...

Background: Most studies suggested that patients with deficit schizophrenia have more severe impairment compared with patients with non-deficit schizophrenia. However, it is not clear whether deficit and non-deficit schizophrenia are associated with differential neurocognitive profiles. Methods: The aim of this meta-analytic review was to compar...

Historically, formal thought disorder has been considered as one of the distinctive symptoms of schizophrenia. However, research in last few decades suggested that there is a considerable clinical and neurobiological overlap between schizophrenia and bipolar disorder (BP). We conducted a meta-analysis of studies comparing positive (PTD) and negativ...

Objective: Neuropsychological impairment, including deficits in social cognition is evident in subjects at genetic high-risk for psychosis. However, findings in youth at genetic risk to bipolar disorder (BP) have been suggested to be less supportive of premorbid deficits. We aimed to conduct a meta-analysis of cognitive deficits in youth with fami...

It has been suggested that reversal learning deficits might be an endophenotype of OCD. To investigate this hypothesis, we administered a probabilistic reversal learning task (ProbRev) to OCD patients, their unaffected first-degree relatives, and healthy controls. Although the relatives had a performance in between OCDs and controls at the early ph...

Cognitive impairment is evident euthymic patients with bipolar disorder (BP) and in their first-degree relatives (BP-Rel). Increasing evidence suggests that BP is also associated with social cognitive impairment. It is important to establish whether social cognitive impairment is also evident in BP-Rel. A novel meta-analysis of theory of mind (ToM)...

Poor insight in schizophrenia has been associated with executive dysfunction and deficits in general cognitive ability. The overall outcome of available neurocognitive studies suggests that there is a significant but modest relationship between cognitive deficits and poor insight in schizophrenia. However, social cognitive abilities, particularly,...

Background: Historically, formal thought disorder has been considered as one of the distinctive symptoms of schizophrenia. However, research in last few decades suggested that there is a considerable clinical and neurobiological overlap between schizophrenia and bipolar disorder (BP). Methods: We conducted a meta-analysis of studies comparing posit...

Background Individuals with schizophrenia are at greater risk for metabolic syndrome (MetS) which is associated with cognitive deficits in the general population. MetS might be potentially an important contributing factor to cognitive impairment in schizophrenia. Method In the current systematic review and meta-analysis, the findings of 18 studies...

Amyotrophic lateral sclerosis (ALS) is associated with executive dysfunction and behavioral impairment. Recent studies suggested that social cognitive deficits might also be a prominent feature of ALS. Current meta-analysis aimed to summarize available evidence for deficits in social cognition including theory of mind (ToM) and emotion recognition...

Synthetic cannabinoids have become increasingly popular in the last few years especially among adolescents and young adults. However, no previous studies have assessed the effects of synthetic cannabinoids on the structure of the human brain. Understanding the harms of synthetic cannabinoid use on brain structure is therefore crucial given its incr...

Findings of surface-based morphometry studies in major depressive disorder (MDD) are still inconsistent. Given that cigarette smoking is highly prevalent in MDD and has documented negative effects on the brain, it is possible that some of the inconsistencies may be partly explained by cigarette use. The aim of the current study was to examine the i...

Objective: There is increasing evidence suggesting that social cognitive abilities are impaired in temporal lobe epilepsy (TLE), the most common form of focal epilepsies. Methods: In this meta-analysis, 31 studies investigating theory of mind (ToM) and facial emotion recognition performances of 1356 patients with TLE (351 postsurgery) and 859 he...

Clinical diagnosis of autism spectrum disorder (ASD) can be conceptualized as the extreme end of the distribution of subclinical autistic traits related to genetic susceptibility factors (broad autism phenotype (BAP)) in the general population. Subclinical autistic traits are significantly more common among unaffected first-degree relatives of prob...

Objective: Deficits in theory of mind (ToM), ability to infer mental states of others, can play a significant role in interpersonal difficulties and/or unawareness of illness observed in AN and other eating disorders including bulimia Nervosa (BN). Method: Current meta-analysis aimed to summarize available evidence for deficits in ToM in AN and...

Background and aims: Deficits in social cognitive abilities including emotion recognition and theory of mind (ToM) can play a significant role in interpersonal difficulties observed in alcohol use disorder (AUD). This meta-analysis aims to estimate mean effect sizes of deficits in social cognition in AUD and examines the effects of demographic and...

Multiple sclerosis (MS) is associated with cognitive decline and impairment in social functioning. Accumulating evidence suggests that patients with MS are impaired in social cognition, including theory of mind (ToM) and emotion recognition. In this meta-analysis of 24 studies, facial emotion recognition and ToM performances of 989 patients with MS...

Schizophrenia is associated with significant cognitive impairment. Bipolar disorder (BP) also presents with cognitive deficits that are similar to, albeit less severe than those reported in schizophrenia. There has been controversy over whether selective deficits in social cognition or developmental trajectory of cognitive deficits can distinguish...

Objective: Cognitive dysfunction is a common characteristic of both schizophrenia and bipolar disorder (BP). While these deficits are more severe in schizophrenia, there is a significant overlap between conditions. However, it was hypothesized that social cognitive deficits might be more specific to schizophrenia. Methods: We conducted a meta-an...

Behavioral disturbances and lack of empathy are distinctive clinical features of behavioral variant frontotemporal dementia (bvFTD) in comparison to Alzheimer disease (AD). The aim of this meta-analytic review was to compare facial emotion recognition performances of bvFTD with healthy controls and AD. The current meta-analysis included a total of...

Bipolar disorder (BP), at the group level, is associated with significant but modest cognitive deficits, including executive dysfunction. Among executive functions, response inhibition deficits have been suggested to be particularly relevant to BP. However, BP is associated with significant heterogeneity in neurocognitive performance and level of f...

Background: Impairment in social cognition is an established finding in autism spectrum disorders (ASD). Emerging evidence suggests that attention-deficit/hyperactivity disorder (ADHD) might be also associated with deficits in theory of mind (ToM) and emotion recognition. However, there are inconsistent findings, and it has been debatable whether...

Objective: Social cognitive deficits can contribute to risk for depression and to psychosocial impairment during depression. However, available evidence suggests that emotion recognition is only marginally impaired in major depressive disorder (MDD). Recent studies have investigated theory of mind (ToM) abilities, a cognitively more demanding aspe...

Background: Theory of mind (ToM) dysfunction is prominent in a number of psychiatric disorders, in particular, autism and schizophrenia, and can play a significant role in poor functioning. There is now emerging evidence suggesting that ToM abilities are also impaired in bipolar disorder (BP); however, the relationship between ToM deficits and moo...

Neurocognitive impairment in Huntington’s disease (HD) frequently includes deficits in emotion recognition, and recent studies have also provided evidence for deficits in theory of mind (ToM). There have been conflicting reports regarding the extent of emotion recognition and ToM deficits before the onset of motor symptoms in HD. In this meta-analy...

Non-motor symptoms of Parkinson's disease (PD) include cognitive deficits and impairment in the recognition of emotions. Recently, a number of studies have investigated theory of mind (ToM) deficits in PD. In this meta-analysis of 18 studies, the ToM performance of 487 non-demented individuals with Parkinson's disease (PD) was compared with 459 hea...

Background: Whether there are differential effects of first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) on the brain is currently debated. Although some studies report that FGAs reduce grey matter more than SGAs, others do not, and research to date is limited by a focus on schizophrenia spectrum disorders. To addre...

Neurocognitive deficits are evident both in established schizophrenia and bipolar disorder (BP). However, it has been suggested that schizophrenia, but not BP, is characterized by neurodevelopmental abnormalities that can lead to cognitive deficits at the earliest stages of the illness. The aim of this meta-analytic review was to compare neurocogni...

Current evidence suggests that neurocognitive testing has limited practical benefit in distinguishing behavioural-variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD). In this meta-analysis of 30 studies, theory of mind (ToM) performances of 784 individuals with bvFTD (n=273) and AD (n=511) were compared with 671 healthy controls. T...

Current evidence suggests that neurocognitive testing has limited practical benefit in distinguishing behavioural-variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD). In this meta-analysis of 30 studies, theory of mind (ToM) performances of 784 individuals with bvFTD (n=273) and AD (n=511) were compared with 671 healthy controls. T...