Research Article
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Year 2026, Issue: Advanced Online Publication, 8 - 18, 28.01.2026
https://doi.org/10.31832/smj.1782990

Abstract

References

  • Wang Q, Qin Z, Xing X, Zhu H, Jia Z. Prevalence of cannabis use around the world: a systematic review and meta-analysis, 2000-2024. China CDC Wkly. Jun 21 2024;6(25):597-604. doi:10.46234/ccdcw2024.116
  • Hasin D, Walsh C. Trends over time in adult cannabis use: a review of recent findings. Curr Opin Psychol. Apr 2021;38:80-85. doi:10.1016/j.copsyc.2021.03.005
  • Turkey Country Drug Report 2019. European Monitoring Centre for Drugs and Drug Addiction. Accessed July 30, 2025. https://www.euda.europa.eu/system/files/publications/11356/turkey-cdr-2019.pdf
  • Kurt Tunagur EM, Yazici AB, Guzel D, et al. Investigating associations between appetite-regulating hormones, aggression and craving in males with cannabis use disorder. Drug Alcohol Depend. Sep 1 2022;238:109577. doi:10.1016/j.drugalcdep.2022.109577
  • Ganzer F, Broning S, Kraft S, Sack PM, Thomasius R. Weighing the evidence: a systematic review on long-term neurocognitive effects of cannabis use in abstinent adolescents and adults. Neuropsychol Rev. Jun 2016;26(2):186-222. doi:10.1007/s11065-016-9316-2
  • Kroon E, Kuhns L, Hoch E, Cousijn J. Heavy cannabis use, dependence and the brain: a clinical perspective. Addiction. Mar 2020;115(3):559-572. doi:10.1111/add.14776
  • Urits I, Gress K, Charipova K, et al. Cannabis use and its association with psychological disorders. Psychopharmacol Bull. May 19 2020;50(2):56-67.
  • Hindley G, Beck K, Borgan F, et al. Psychiatric symptoms caused by cannabis constituents: a systematic review and meta-analysis. Lancet Psychiatry. Apr 2020;7(4):344-353. doi:10.1016/S2215-0366(20)30074-2
  • Arseneault L, Cannon M, Poulton R, Murray R, Caspi A, Moffitt TE. Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ. Nov 23 2002;325(7374):1212-3. doi:10.1136/bmj.325.7374.1212
  • Tunagür MT, Sarıgedik E. One-Year retrospective analysis of adolescent substance use treatment clinic cases. Sakarya Tıp Dergisi. September 2025;15(3):239-248. doi:10.31832/smj.1740901
  • Hengartner MP, Angst J, Ajdacic-Gross V, Rossler W. Cannabis use during adolescence and the occurrence of depression, suicidality and anxiety disorder across adulthood: findings from a longitudinal cohort study over 30 years. J Affect Disord. Jul 1 2020;272:98-103. doi:10.1016/j.jad.2020.03.126
  • Fattore L. Synthetic Cannabinoids-further evidence supporting the relationship between cannabinoids and psychosis. Biol Psychiatry. Apr 1 2016;79(7):539-48. doi:10.1016/j.biopsych.2016.02.001
  • Maggu G, Choudhary S, Jaishy R, Chaudhury S, Saldanha D, Borasi M. Cannabis use and its relationship with bipolar disorder: a systematic review and meta-analysis. Ind Psychiatry J. Jul-Dec 2023;32(2):202-214. doi:10.4103/ipj.ipj_43_23
  • Onaemo VN, Fawehinmi TO, D'Arcy C. Comorbid cannabis use disorder with major depression and generalized anxiety disorder: a systematic review with meta-analysis of nationally representative epidemiological surveys. J Affect Disord. Feb 15 2021;281:467-475. doi:10.1016/j.jad.2020.12.043
  • Soule EK, Maloney SF, Guy MC, Eissenberg T, Fagan P. User identified positive outcome expectancies of electronic cigarette use: a concept mapping study. Psychol Addict Behav. May 2017;31(3):343-353. doi:10.1037/adb0000263
  • Ricci V, De Berardis D, Martinotti G, Maina G. Effects of persistent cannabis use on depression, psychosis, and suicidality following cannabis-induced psychosis: a longitudinal study. Am J Addict. May 14 2025. doi:10.1111/ajad.70048
  • Ogel K, Evren C, Karadağ F, Gürol DT. Bağımlılık profil indeksi'nin (BAPİ) geliştirilmesi, geçerlik ve güvenilirliği. Türk Psikiyatri Dergisi. 2012;23(4):264-273. IBM SPSS Statistics for Windows. Version 27.0. IBM Corp.; 2020.
  • Blanco C, Hasin DS, Wall MM, et al. Cannabis use and risk of psychiatric disorders: prospective evidence from a US national longitudinal study. JAMA Psychiatry. Apr 2016;73(4):388-95. doi:10.1001/jamapsychiatry.2015.3229
  • Krawczyk N, Feder KA, Saloner B, Crum RM, Kealhofer M, Mojtabai R. The association of psychiatric comorbidity with treatment completion among clients admitted to substance use treatment programs in a U.S. national sample. Drug Alcohol Depend. Jun 1 2017;175:157-163. doi:10.1016/j.drugalcdep.2017.02.006
  • Hunt GE, Siegfried N, Morley K, Sitharthan T, Cleary M. Psychosocial interventions for people with both severe mental illness and substance misuse. Cochrane Database Syst Rev. Oct 3 2013;(10):CD001088. doi:10.1002/14651858.CD001088.pub3
  • Priester MA, Browne T, Iachini A, Clone S, DeHart D, Seay KD. Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: an integrative literature review. J Subst Abuse Treat. Feb 2016;61:47-59. doi:10.1016/j.jsat.2015.09.006
  • Mahmood Z, Vella L, Maye JE, et al. Rates of cognitive and functional ımpairments among sheltered adults experiencing homelessness. Psychiatr Serv. Mar 1 2021;72(3):333-337. doi:10.1176/appi.ps.202000065
  • Fazel S, Bains P, Doll H. Substance abuse and dependence in prisoners: a systematic review. Addiction. Feb 2006;101(2):181-91. doi:10.1111/j.1360-0443.2006.01316.x
  • Pycroft A, Green A. Challenging the Cultural determinants of dual diagnosis in the criminal justice system. In: Winstone J, ed. Mental Health, Crime and Criminal Justice: Responses and Reforms. Palgrave Macmillan UK; 2016:147-166.
  • Alves VL, Goncalves JL, Aguiar J, Teixeira HM, Camara JS. The synthetic cannabinoids phenomenon: from structure to toxicological properties. A review. Crit Rev Toxicol. May 2020;50(5):359-382. doi:10.1080/10408444.2020.1762539
  • Trecki J, Gerona RR, Schwartz MD. Synthetic cannabinoid-related illnesses and deaths. N Engl J Med. Jul 9 2015;373(2):103-7. doi:10.1056/NEJMp1505328
  • Lindquist-Grantz R, Mallow P, Dean L, Lydenberg M, Chubinski J. Diversion programs for individuals who use substances: a review of the literature. Journal of Drug Issues. 2021;51(3):483-503. doi:10.1177/00220426211000330
  • Virtanen S, Aaltonen M, Latvala A, Forsman M, Lichtenstein P, Chang Z. Effectiveness of substance use disorder treatment as an alternative to imprisonment. BMC Psychiatry. Apr 9 2024;24(1):260. doi:10.1186/s12888-024-05734-y

Five-Year Naturalistic Follow-Up of Patients with Cannabis Use Disorder: Psychiatric Outcomes

Year 2026, Issue: Advanced Online Publication, 8 - 18, 28.01.2026
https://doi.org/10.31832/smj.1782990

Abstract

Objective: Cannabis use disorder (CUD) is increasingly prevalent and often co-occurs with psychiatric and legal complications. While cross-sectional associations between CUD and mental illness are well-documented, longitudinal data on the clinical and forensic trajectories of affected individuals remain limited, particularly in real-world settings.
Methods: This naturalistic follow-up study tracked 51 male patients diagnosed with CUD over a five-year period. Data were collected via structured telephone interviews and hospital records, assessing substance use patterns, psychiatric diagnoses, Alcohol and Substance Addiction Treatment Center (AMATEM) admissions, and legal outcomes. Psychiatric comorbidities were evaluated using medical records, and substance use severity was assessed using the Addiction Profile Index (API).
Results: Over five years, 82.4% of participants continued substance use, with synthetic cannabinoids being the most frequently used substance (76.5%). More than half (64.7%) developed a psychiatric diagnosis, most commonly depression and anxiety. Synthetic cannabinoid use was significantly different in individuals with psychiatric comorbidity (p = .033). AMATEM admissions declined over time but remained higher in patients with psychiatric diagnoses (Year × Diagnosis interaction: F = 2.600, p = .037). Nearly half experienced judicial psychiatric evaluations, and 23.5% had a history of incarceration.
Conclusion: CUD is associated with persistent substance use, high rates of psychiatric comorbidity, and substantial legal-system involvement. Synthetic cannabinoids appear to exacerbate psychiatric outcomes. Long-term, integrated interventions are needed to address dual-diagnosis and reduce forensic burden.

Ethical Statement

The study was approved by the Scientific Research Ethics Committee of Sakarya University Faculty of Health Sciences on June 27, 2024 (Approval No: 2024/193).

References

  • Wang Q, Qin Z, Xing X, Zhu H, Jia Z. Prevalence of cannabis use around the world: a systematic review and meta-analysis, 2000-2024. China CDC Wkly. Jun 21 2024;6(25):597-604. doi:10.46234/ccdcw2024.116
  • Hasin D, Walsh C. Trends over time in adult cannabis use: a review of recent findings. Curr Opin Psychol. Apr 2021;38:80-85. doi:10.1016/j.copsyc.2021.03.005
  • Turkey Country Drug Report 2019. European Monitoring Centre for Drugs and Drug Addiction. Accessed July 30, 2025. https://www.euda.europa.eu/system/files/publications/11356/turkey-cdr-2019.pdf
  • Kurt Tunagur EM, Yazici AB, Guzel D, et al. Investigating associations between appetite-regulating hormones, aggression and craving in males with cannabis use disorder. Drug Alcohol Depend. Sep 1 2022;238:109577. doi:10.1016/j.drugalcdep.2022.109577
  • Ganzer F, Broning S, Kraft S, Sack PM, Thomasius R. Weighing the evidence: a systematic review on long-term neurocognitive effects of cannabis use in abstinent adolescents and adults. Neuropsychol Rev. Jun 2016;26(2):186-222. doi:10.1007/s11065-016-9316-2
  • Kroon E, Kuhns L, Hoch E, Cousijn J. Heavy cannabis use, dependence and the brain: a clinical perspective. Addiction. Mar 2020;115(3):559-572. doi:10.1111/add.14776
  • Urits I, Gress K, Charipova K, et al. Cannabis use and its association with psychological disorders. Psychopharmacol Bull. May 19 2020;50(2):56-67.
  • Hindley G, Beck K, Borgan F, et al. Psychiatric symptoms caused by cannabis constituents: a systematic review and meta-analysis. Lancet Psychiatry. Apr 2020;7(4):344-353. doi:10.1016/S2215-0366(20)30074-2
  • Arseneault L, Cannon M, Poulton R, Murray R, Caspi A, Moffitt TE. Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ. Nov 23 2002;325(7374):1212-3. doi:10.1136/bmj.325.7374.1212
  • Tunagür MT, Sarıgedik E. One-Year retrospective analysis of adolescent substance use treatment clinic cases. Sakarya Tıp Dergisi. September 2025;15(3):239-248. doi:10.31832/smj.1740901
  • Hengartner MP, Angst J, Ajdacic-Gross V, Rossler W. Cannabis use during adolescence and the occurrence of depression, suicidality and anxiety disorder across adulthood: findings from a longitudinal cohort study over 30 years. J Affect Disord. Jul 1 2020;272:98-103. doi:10.1016/j.jad.2020.03.126
  • Fattore L. Synthetic Cannabinoids-further evidence supporting the relationship between cannabinoids and psychosis. Biol Psychiatry. Apr 1 2016;79(7):539-48. doi:10.1016/j.biopsych.2016.02.001
  • Maggu G, Choudhary S, Jaishy R, Chaudhury S, Saldanha D, Borasi M. Cannabis use and its relationship with bipolar disorder: a systematic review and meta-analysis. Ind Psychiatry J. Jul-Dec 2023;32(2):202-214. doi:10.4103/ipj.ipj_43_23
  • Onaemo VN, Fawehinmi TO, D'Arcy C. Comorbid cannabis use disorder with major depression and generalized anxiety disorder: a systematic review with meta-analysis of nationally representative epidemiological surveys. J Affect Disord. Feb 15 2021;281:467-475. doi:10.1016/j.jad.2020.12.043
  • Soule EK, Maloney SF, Guy MC, Eissenberg T, Fagan P. User identified positive outcome expectancies of electronic cigarette use: a concept mapping study. Psychol Addict Behav. May 2017;31(3):343-353. doi:10.1037/adb0000263
  • Ricci V, De Berardis D, Martinotti G, Maina G. Effects of persistent cannabis use on depression, psychosis, and suicidality following cannabis-induced psychosis: a longitudinal study. Am J Addict. May 14 2025. doi:10.1111/ajad.70048
  • Ogel K, Evren C, Karadağ F, Gürol DT. Bağımlılık profil indeksi'nin (BAPİ) geliştirilmesi, geçerlik ve güvenilirliği. Türk Psikiyatri Dergisi. 2012;23(4):264-273. IBM SPSS Statistics for Windows. Version 27.0. IBM Corp.; 2020.
  • Blanco C, Hasin DS, Wall MM, et al. Cannabis use and risk of psychiatric disorders: prospective evidence from a US national longitudinal study. JAMA Psychiatry. Apr 2016;73(4):388-95. doi:10.1001/jamapsychiatry.2015.3229
  • Krawczyk N, Feder KA, Saloner B, Crum RM, Kealhofer M, Mojtabai R. The association of psychiatric comorbidity with treatment completion among clients admitted to substance use treatment programs in a U.S. national sample. Drug Alcohol Depend. Jun 1 2017;175:157-163. doi:10.1016/j.drugalcdep.2017.02.006
  • Hunt GE, Siegfried N, Morley K, Sitharthan T, Cleary M. Psychosocial interventions for people with both severe mental illness and substance misuse. Cochrane Database Syst Rev. Oct 3 2013;(10):CD001088. doi:10.1002/14651858.CD001088.pub3
  • Priester MA, Browne T, Iachini A, Clone S, DeHart D, Seay KD. Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: an integrative literature review. J Subst Abuse Treat. Feb 2016;61:47-59. doi:10.1016/j.jsat.2015.09.006
  • Mahmood Z, Vella L, Maye JE, et al. Rates of cognitive and functional ımpairments among sheltered adults experiencing homelessness. Psychiatr Serv. Mar 1 2021;72(3):333-337. doi:10.1176/appi.ps.202000065
  • Fazel S, Bains P, Doll H. Substance abuse and dependence in prisoners: a systematic review. Addiction. Feb 2006;101(2):181-91. doi:10.1111/j.1360-0443.2006.01316.x
  • Pycroft A, Green A. Challenging the Cultural determinants of dual diagnosis in the criminal justice system. In: Winstone J, ed. Mental Health, Crime and Criminal Justice: Responses and Reforms. Palgrave Macmillan UK; 2016:147-166.
  • Alves VL, Goncalves JL, Aguiar J, Teixeira HM, Camara JS. The synthetic cannabinoids phenomenon: from structure to toxicological properties. A review. Crit Rev Toxicol. May 2020;50(5):359-382. doi:10.1080/10408444.2020.1762539
  • Trecki J, Gerona RR, Schwartz MD. Synthetic cannabinoid-related illnesses and deaths. N Engl J Med. Jul 9 2015;373(2):103-7. doi:10.1056/NEJMp1505328
  • Lindquist-Grantz R, Mallow P, Dean L, Lydenberg M, Chubinski J. Diversion programs for individuals who use substances: a review of the literature. Journal of Drug Issues. 2021;51(3):483-503. doi:10.1177/00220426211000330
  • Virtanen S, Aaltonen M, Latvala A, Forsman M, Lichtenstein P, Chang Z. Effectiveness of substance use disorder treatment as an alternative to imprisonment. BMC Psychiatry. Apr 9 2024;24(1):260. doi:10.1186/s12888-024-05734-y
There are 28 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Research Article
Authors

Elif Merve Kurt Tunagür 0000-0002-7883-4190

Submission Date September 13, 2025
Acceptance Date November 17, 2025
Early Pub Date January 28, 2026
Publication Date January 28, 2026
Published in Issue Year 2026 Issue: Advanced Online Publication

Cite

APA Kurt Tunagür, E. M. (2026). Five-Year Naturalistic Follow-Up of Patients with Cannabis Use Disorder: Psychiatric Outcomes. Sakarya Medical Journal(Advanced Online Publication), 8-18. https://doi.org/10.31832/smj.1782990
AMA Kurt Tunagür EM. Five-Year Naturalistic Follow-Up of Patients with Cannabis Use Disorder: Psychiatric Outcomes. Sakarya Medical Journal. January 2026;(Advanced Online Publication):8-18. doi:10.31832/smj.1782990
Chicago Kurt Tunagür, Elif Merve. “Five-Year Naturalistic Follow-Up of Patients With Cannabis Use Disorder: Psychiatric Outcomes”. Sakarya Medical Journal, no. Advanced Online Publication (January 2026): 8-18. https://doi.org/10.31832/smj.1782990.
EndNote Kurt Tunagür EM (January 1, 2026) Five-Year Naturalistic Follow-Up of Patients with Cannabis Use Disorder: Psychiatric Outcomes. Sakarya Medical Journal Advanced Online Publication 8–18.
IEEE E. M. Kurt Tunagür, “Five-Year Naturalistic Follow-Up of Patients with Cannabis Use Disorder: Psychiatric Outcomes”, Sakarya Medical Journal, no. Advanced Online Publication, pp. 8–18, January2026, doi: 10.31832/smj.1782990.
ISNAD Kurt Tunagür, Elif Merve. “Five-Year Naturalistic Follow-Up of Patients With Cannabis Use Disorder: Psychiatric Outcomes”. Sakarya Medical Journal Advanced Online Publication (January2026), 8-18. https://doi.org/10.31832/smj.1782990.
JAMA Kurt Tunagür EM. Five-Year Naturalistic Follow-Up of Patients with Cannabis Use Disorder: Psychiatric Outcomes. Sakarya Medical Journal. 2026;:8–18.
MLA Kurt Tunagür, Elif Merve. “Five-Year Naturalistic Follow-Up of Patients With Cannabis Use Disorder: Psychiatric Outcomes”. Sakarya Medical Journal, no. Advanced Online Publication, 2026, pp. 8-18, doi:10.31832/smj.1782990.
Vancouver Kurt Tunagür EM. Five-Year Naturalistic Follow-Up of Patients with Cannabis Use Disorder: Psychiatric Outcomes. Sakarya Medical Journal. 2026(Advanced Online Publication):8-18.

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The Sakarya University Sakarya Medical Journal expects all its parties to take on the following ethical responsibilities as part of the publication ethics.

The ethical duties and responsibilities listed below are based on the guidelines and policies published as open access by the Committee on Publication Ethics (COPE).

The publication of an article in a peer-reviewed journal is essential for the development of a coherent and respected knowledge network. Peer-reviewed articles support and develop scientific methods. Therefore, it is important for all relevant parties involved in the publishing process, including authors, journal editors, reviewers, and publishing agencies, to agree on the expected ethical behaviors and standards.


1. Ethical Principles

1. Authorship of the Paper:
Authorship should be limited to those who have made a significant contribution to the conception, design, execution, or interpretation of the reported study. All those who have made significant contributions should be listed as co-authors. Where there are others who have participated in certain substantive aspects of the research project, they should be acknowledged or listed as contributors. The corresponding author should ensure that all appropriate co-authors and no inappropriate co-authors are included in the paper and that all co-authors have seen and approved the final version of the paper and have agreed to its submission for publication.

2. Conflicts of Interest:
Authors: All authors should disclose in their manuscript any financial or other substantive conflict of interest that might be construed to influence the results or interpretation of their manuscript. All sources of financial support for the project should be disclosed.
Reviewers: Referees should inform the journal editor about the evaluation process if they suspect any conflict of interest in the article they are evaluating, and refuse article evaluation if necessary. In order to prevent conflict of interest, people in the institutions where the article authors are working cannot referee the article.
Editors: Editors should not have personal or financial conflicts of interest with articles.

3. Data Access and Retention:
Authors are asked to provide the raw data in connection with a paper for editorial review, and should be prepared to provide public access to such data, if practicable, and should in any event be prepared to retain such data for a reasonable time after publication.

4. Data Fabrication and Falsification:

Fabrication and/or falsified experimental results, including the manipulation of images.

5. Duplicate / Multiple Submission(s):
Manuscripts that are either found to have been submitted elsewhere or published elsewhere. If authors have used their own work, either previously submitted or published, as the basis for a submitted manuscript, they are required to cite the previous work. They also need to indicate how novel contributions are offered in their submitted manuscript, over and above those of the previous work.

6. Intellectual Property
• Authors certify that their submitted manuscript (and any supporting items) are their own intellectual property, and the copyright has not been transferred to others.
• Authors certify that the manuscript contains no plagiarism, no fabrication, no falsification, no manipulated citations and that the manuscript conforms to JSS authorship policies.
• All manuscripts, revisions, drafts, and galleys remain the intellectual property of the author(s). Except as stated in the agreed license, the author(s) retain the copyright to their work.
• Authors, reviewers, and editors agree to keep all communications, comments, or reports from reviewers or editors confidential.
• Reviewers and editors agree to keep all manuscripts, revisions, and drafts confidential, with the exception of the final published galley(s).

7. Correction, Retraction, Expression of Concern
• Editors may make corrections if they detect minor errors in the published article that do not affect the findings, interpretations, or results.
• Editors may retract the article in case of major errors/violations that invalidate the findings and results.
• Editors may issue a statement of concern if there is a possibility of abusive research or publication by the authors, if there is evidence that the findings are unreliable and the authors' institutions have not investigated the incident, or if the potential investigation seems unfair or inconclusive. The COPE guideline is taken into account with regard to the correction, retraction, and expression of concern.

8. Publication of Studies Based on Surveys and Interviews
Aiming to establish ethical assurance in scientific periodicals, Sakarya Medical Journal adopts the principles of the "Code of Conduct and Best Practice Guidelines for Journal Editors" and the "Code of Conduct for Journal Publishers" published by the Committee on Publication Ethics (COPE). In this scope, the following aspects should be adhered to in the studies submitted to the journal:
• Ethics committee approval should be obtained for research conducted in all the disciplines that require ethics committee approval, and this approval should be stated and documented in the article.
• In studies that require ethics committee approval, information about the approval (committee name, date, and issue number) may be included in the method section of the study. However, in the case of reports, information about the informed consent and the signed consent form should be included in the Article Information Form at the end of the article.
The studies that require ethics committee approval are as follows:
• All kinds of research conducted with qualitative or quantitative approaches that require data collection from participants through surveys, interviews, focus group works, observations, experiments, and other interview techniques.
• Use of humans and animals (including material/data) for experimental or other scientific purposes,
• Clinical studies conducted on humans,
• Studies conducted on animals,
• Retrospective studies in accordance with the law on the protection of personal data,
Also;
• A statement confirming that an "informed consent form" has been received in case reports,
• Obtaining permission from the owners for the use of scales, surveys or photographs belonging to others,
• A statement confirming that copyright regulations are met for the intellectual and artistic works used.

9. Policy of Publishing Additional or Special Issues
A special issue can be published in our journal once a year upon the request of the Editorial Board. The publication processes of the articles sent to be included in the special issue are the same as the standard processes.

1. Additional or Special issue: An issue published in addition to the regular issues of a periodically published journal. It may consist of conference papers or a series of articles focusing on a specific topic.
2. Page numbering in the additional or special issue is different from the regular issues.
3. The print run of the additional or special issue cannot be more than one-third of the regular issue. The special issues containing conference paper abstracts are not included in this scope.
4. Ratios of case reports, compilations, and research articles (excluding conference paper abstracts) published in the additional or special issue will be included in the ratios of articles published in other issues.
5. The issues published as a tribute are not accepted as additional or special issues. Their page numbering and organization are the same as the regular issues.

10. Journal Policies on Data Sharing and Reproducibility
Sakarya University Sakarya Medical Journal strongly recommends author(s) submit supplementary material and data sets that illustrate the results shown in their papers. If any restrictions exist on the side of the author(s), these concerns should be shared with the editorial team during the submission of scientific papers.

Sakarya Medical Journal encourages author(s) to share data and make them publicly available if they do not violate human rights or other privacy issues. Cited data sets, apart from whether they are created by the author(s) or not, should be written in the reference lists of papers. Authors are also recommended to include a data availability statement.

Sakarya Medical Journal encourages all authors to make their data available to share publicly.

Actions that violate scientific research and publication ethics are as follows:

Plagiarism: Showing others' original ideas, methods, data, or works as their own work, partially or completely, without reference to scientific rules,
Forgery: Using data that does not actually exist or has been falsified in scientific research,
Distortion: Falsifying the research records or data obtained, displaying the equipment or materials not used in the research as if used, distorting or shaping the results of the research in the interests of the people and organizations that provide support,
Republishing: Presenting repetitive publications as separate publications in academic appointments and promotions,
Slicing: Dividing the results of research into pieces in an improper way or in a way that disrupts the integrity of the research and publishing each one separately to increase the total publication count for academic appointments and promotions,
Unfair Authorship: Including non-contributors in the author list or not including those who have contributed, changing the author's order in an unjustified and inappropriate manner, removing the names of contributors from the work in subsequent editions, using influence to include names among the authors despite not being contributors,

Other ethical violations include:
a) Not specifying the supporting individuals, institutions or organizations and their contributions in the publications made as a result of research conducted with support.
b) Using theses or studies that have not yet been submitted or have not been accepted as a source without the permission of the owner,
c) Not complying with ethical rules in research on humans and animals, not respecting patients' rights in publications,
ç) Violating the provisions of the relevant legislation in biomedical research and other clinical research related to humans,
d) Sharing the information in a work that has been assigned for review with others before it is published without the explicit consent of the author,
e) Misusing resources, spaces, facilities and equipment provided or allocated for scientific research,
f) Deliberately making a false and ungrounded allegation about ethical violation,
g) Publishing the data obtained from surveys conducted as part of a scientific study without the explicit consent of the participants, or without the permission of the relevant institution if the study is conducted in an institution,
h) Harming animal health and ecological balance in research and experiments,
ı) Failing to obtain written permissions from authorities that are required for starting research activities or experiments,
i) Conducting research activities or experiments in violation of the related legislation or the provisions on research and experiments in the international conventions to which Turkey is a party,
j) Disregarding the obligation to inform and warn the relevant authorities about possible harmful practices related to the scientific research.
k) Not using the data and information obtained from other individuals or institutions in scientific studies to the extent and as permitted, not respecting the confidentiality of this information and not ensuring its protection,
l) Making false or misleading statements regarding scientific research and publications in academic appointments and promotions.

Ethical Guidelines for Authors
• Studies must be original and based on research.
• It must be ensured that all the persons mentioned as authors/co-authors have contributed to the article. It is against scientific ethics to show persons who have not made any academic contribution as additional authors or to rank the authors by non-scientific criteria such as title, age, and gender, regardless of the order of contribution.
• In the articles with multiple authors, it should be clearly stated to what extent the authors have contributed to which stage of the article.
• The article should not be sent to different journals at the same time and should not have been sent to another journal before. If it is found to have been sent to another journal, the publication process will be canceled.
• It is assumed that the authors who submit articles to the journal have read and accepted the publication and writing principles of the journal, and the authors are deemed to have committed to these principles.
• The citations and bibliography should be complete.
• Plagiarism and fake data should be avoided.
• The similarity rate obtained as a result of the similarity checks should not exceed 30% in order to initiate the peer review process.
• An article may be included in a maximum of 2 PRE-REVIEW processes. The article will be rejected if the feedback conveyed to the author is not revised.
• The corresponding author must inform the journal editor in case of any conflict of interest.
This issue can be referred to WAME.

Ethical Guidelines for Peer Reviewers
• Peer reviewers should be aware that they play a critical role in the academic quality of the article to be published in the journal, and they should engage in the peer review process with the responsibility of improving academic quality.
• Peer reviewers should only accept to review articles for which they have the expertise to make an appropriate assessment. They should also respect the confidentiality of the blind peer review process and keep the details of the article confidential at all costs.
• After the review process, any information about the reviewed article should not be shared with others under any circumstances.
• Peer reviewers should only evaluate the accuracy of the content of the articles and their compliance with academic criteria. Any difference of opinions between the article's argument and the peer reviewer should not affect the review process.
• Peer review reports should be objective and measurable. Libelous, derogatory, or accusatory expressions should definitely be avoided.
• Peer reviewers should avoid superficial or inaccurate statements in their peer review reports. In reviews with negative results, a complete justification should be presented on the aspects that led to the negative result.
• Peer reviewers should review the articles within the time period allotted to them. If they are not going to review the article, they should notify the journal within a reasonable time.
• Peer reviewers should identify relevant published work that has not been cited by the authors. Any statement that an observation, derivation, or argument had been previously reported should be accompanied by the relevant citation. A reviewer should also call to the editor's attention any substantial similarity or overlap between the manuscript under consideration and any other published paper of which they have personal knowledge.

Ethical Guidelines for Editors
• Editors should accept articles that will contribute to the relevant areas specified in the journal policy.
• Editors should not have any conflict of interest with accepted or rejected articles.
• Editors have full responsibility and authority to accept or reject an article.
• It is editors' responsibility to keep the names of peer reviewers and authors mutually confidential.
• Only the articles that will contribute to the relevant field should be accepted.
• If an error is detected, editors should support the correction or retraction of the error.
• It is the duty of editors to complete the pre-review, peer review, editing and publishing processes of the articles submitted to the journal in a timely and appropriate manner.
• Editors should not assign people who do not contribute to the journal as editorial board members or associate editors.

2. Publication Policy

Any manuscript that is considered to be published in Sakarya Medical Journal must meet the following criteria:
• Originality
• Not containing ethical violations
• Having clear messages for the scientific community
• Expressing the extent of the article's contributions to researchers in the field and its relevance to social sciences
• Current fields and topics drawing the interest of researchers in the field of health sciences
• Having structural and logical integrity
• Research results that are based on scientific evidence
• Coherence of the scientific method

Review of the Articles
Articles can be submitted to the Sakarya Medical Journal by registering in the "Article Management System" on https://dergipark.org.tr/en/journal/630/submission/step/manuscript/new
Articles sent by e-mail will not be taken into consideration.

Pre-Review and Plagiarism Checking
The journal's compliance with the writing rules is examined and a similarity check is made to prevent plagiarism. Similarity software is used in the checking process. The overall similarity rate should be less than 30%. If the similarity rate is more than 30%, the study is either rejected or sent back to the author to reduce the similarity rate. The pre-review is completed within a maximum of 30 days.

Editor/Field Editor Review
After the study passes the stages of pre-review and similarity checking, it is reviewed by the relevant editor/field editor in terms of subject, scope, language use, and academic competence. This review is completed within a maximum of 30 days.

Peer Review Process (Double-Blind Peer Review)
Studies that pass the pre-review and editorial review undergo a confidential double-blind peer review process. Within the double-blind strategy, the identity of the peer reviewer is concealed from the author submitting publications to the journal. Similarly, the peer reviewers do not know who wrote the article they are reviewing. In other words, the peer review process is conducted by keeping both authors and peer reviewers anonymous to each other. The reports are also stored in the Article Management System.

Author's Revision
Authors take into account the feedback, criticisms, and recommendations of the reviewer and the Editorial Board. In case of any disagreement, they have the right to appeal with their justifications. Authors edit the article as per the reports and upload the final version of the article to the system.

Field Editor Review
The field editor checks whether the author has made the requested corrections in the text. If there is a “Major Revision” requirement in the peer review reports, they send the article to the relevant peer reviewer. If there is an "Acceptance" or "Minor Revision" requirement and the revisions are completed, they can submit the article for language checks (The checking process is completed within a maximum of 7 days.). If they detect that the corrections have not been made, they re-send the article to the author. They may reject the article if the author does not make the corrections again. Articles that are not accepted for publication are not deleted from the system. Their processes and files are stored in the system.

English Language Checks
The checking process is completed within 15 days at the latest.

Editorial Board Review
The articles that pass technical, academic, and linguistic reviews are examined by the Editorial Board, and the final publication status is determined. In case of any objection from the members, the Board decides by a majority of votes.

Typesetting and Layout Process
The journal undertakes the typesetting and layout processes of the studies decided to be published by the Editorial Board.

Language
Sakarya Medical Journal publishes articles written in English.

Change of Authorship
Sakarya Medical Journal accepts article authors according to the statement on the Title Page of the article. Therefore, it is the responsibility of the authors to submit the final version of the full author list. Requests for any change of authorship after the submission of the article (e.g removal/addition of authors, change of order, etc.) are subject to editorial approval. The Editorial Board will investigate such cases and act according to the COPE flowcharts.

Requests for a change of authorship should be conveyed to the Editor with an official letter stating the reasons for the change. The letter should be signed by all the authors and include their confirmation of the change of authorship. If the request is approved by the Editorial Board, the authors are required to submit a new Copyright Agreement Form according to the final author list.

Disclaimer
The opinions expressed in the articles published in the journal are those of the author(s). They do not purport to reflect the opinions or views of the Sakarya Medical Journal and its Editor-In-Chief, Editorial Board or Publisher. The Editor-in-Chief, Editorial Board, and Publisher assume no responsibility or liability for such cases. The sole responsibility for the published content lies with the authors.

Complaints and Appeals
Sakarya Medical Journal handles complaints and appeals by following the below procedure. Complaints, including but not limited to the long delays in handling studies and publication ethics, are initially handled by the Editor-in-Chief of Sakarya Medical Journal. The Editor-in-Chief examines complaints and appeals together with Area Editors and Editorial Board if applicable. If anything occurs about complaints and appeals please contact sakaryatipdergisi@sakarya.edu.tr.

Complaints about the Content of a Paper
The Editor-in-Chief examines the complaints of the author(s) and the reports of reviewers and make a decision about:
• The confirmation of the rejection of the paper,
• The appeal of the author should be considered,
• A fresh opinion from an independent reviewer is needed.
The final decision of the editor-in-chief is to notify the author(s). The explanation of the consequences of the appeal is shared with the author(s) if necessary. This is the final decision of Sakarya Medical Journal.

Complaints about Processes
The complaints about processes are handled by the Editor-in-Chief. Long delays in handling studies are examined by editors of Sakarya Medical Journal, and any necessary issues are shared with the Editor-in-Chief. The Editor-in-Chief evaluates the complaints, and when necessary, information is shared with the authors.

Complaints about Ethics
The Editor-in-Chief considers complaints about publication ethics of the author’s or reviewer’s conduct. The editor-in-chief follows the publication ethics on the Sakarya Medical Journal website. The editorial board of Sakarya Medical Journal examines the concerns of complainants or reviewers. The details and progress of the examination are clearly shared with the complainant(s). The Editor-in-Chief or Assistant Editors provide feedback to the complainant(s) on the manner of action and the final decision.

• Sakarya Medical Journal does not request any fees for article submission, reviewing and editing processes, page layout, and publication (page or color fees).
• Sakarya Medical Journal does not pay any fees to authors, reviewers, editors, and editorial board members.
• All papers in Sakarya Medical Journal are free to read and download.
• Sakarya Medical Journal signed on to the Budapest Open Access Initiative (BOAI), which promotes free access to research literature and has adopted the Open Access Principles that are clarified in this initiative.
• All papers in Sakarya Medical Journal are archived with the LOCKSS (Lots Of Copies Keep Stuff Safe) system through TUBITAK ULAKBİM DergiPark.
• Sakarya Medical Journal does not accept announcements, advertisements, sponsorships, etc. due to its publication policy.
• All expenses of Sakarya Medical Journal are covered by Sakarya University.

Baş Editör

Chest Diseases, Health Sciences

Editör Kurulu

Orthopaedics, Health Sciences
Toxicology, Cardiology, ​Internal Diseases, Nanotoxicology, Health and Safety
Clinical Sciences (Other), Neurology and Neuromuscular Diseases, Medical Education
Sociology of Health, Qualitative Methods in Sociology, Clinical Midwifery, Nursing (Other), Medical Education
Central Nervous System, Neurology and Neuromuscular Diseases
Cardiovascular Surgery
Neurology and Neuromuscular Diseases
Optical Technology, Autoimmunity, Computational Neuroscience, Neurology and Neuromuscular Diseases
Paediatrics (Other)
Central Nervous System

Mizanpaj Editörü

Public Administration
Information Systems Organisation and Management, Business Process Management, Architecture for Disaster Relief, Natural Hazards
Information Systems Education, Data Analysis

Yazım ve Dil Editörü

Health Sciences, Public Health

Ingilizce Dil Editörü

Chest Diseases, Health Sciences

Biyoistatistik Editörü

Nutrition and Dietetics, Dentistry, Pharmacology and Pharmaceutical Sciences, ​Internal Diseases, Statistics, Biostatistics, Health Sciences, Sports Science and Exercise, Nursing, Veterinary Sciences

INDEXING & ABSTRACTING & ARCHIVING


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30703 The published articles in SMJ are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.