Comparative evaluation of craving, sleep quality, sexual function and quality of life in opioid use disorder patients in remission with buprenorphine/naloxone maintenance treatment.

AIM: To compare opioid use disorder (OUD) patients who continue to use opioids and are in remission with buprenorphine-naloxone (B/N) in terms of some parameters and to evaluate the relationship between B/N dose and these parameters. METHOD: We included 141 OUD patients in remission with B/N maintenance treatment for at least 6 months, 141 who still used opioids, and 141 healthy volunteers. Substance Craving Scale (SCS), Pittsburgh Sleep Quality Index (PSQI), Arizona Sexual Experiences Scale (ASEX), and Short Form 36 (SF-36) were administered. RESULTS: PSQI scores and ASEX scores were higher in those who continued to use opiates than in OUD in remission, and in OUD in remission compared to controls. OUD patients with current opioid use also had lower SF-36 scores compared to both patients in remission and healthy controls. SCS, PSQI, ASEX, and SF-36 scores were similar when the three groups were examined based on the dosage of B/N (below 8, 8-15, and 16 mg/day and above) use in OUD in remission. CONCLUSIONS: Quality of life, craving, sleep and sexual functions improved significantly with B/N; however, these effects are not dependent on B/N dosage.

Bruxism and Sleep Disorders in Patients Diagnosed With Depressive Disorder and Anxiety Disorder Using Antidepressants.

OBJECTIVE: To investigate the frequency of bruxism, factors associated with bruxism and sleep disorders in patients diagnosed with depressive disorder and anxiety disorder who use antidepressants. METHODS: A total of 273 patients diagnosed with anxiety disorder or depression who had been using antidepressants for at least 1 month were included, along with 273 healthy control groups. The patient and control groups completed a sociodemographic data form, Epworth Daytime Sleepiness Scale (EDSS), Pittsburgh Sleep Quality Index (PSQI) and a bruxism questionnaire. Additionally, the clinician confirmed the diagnosis of bruxism through a clinical interview. RESULTS: Bruxism was detected in 73.3% of the patient group and 28.2% of the control group (p < 0.001). The most commonly used antidepressants among patients were selective serotonin reuptake inhibitors (SSRIs) such as escitalopram and sertraline. Within the patient group, individuals with bruxism had higher family history rates of teeth grinding (p = 0.034), PSQI scores (p < 0.001) and EDSS scores (p < 0.001) compared to those without bruxism. Positive correlations were found between the presence of bruxism and PSQI (p < 0.001) scores as well as EDSS scores (p < 0.001) in both the patient group and all participants. Regression analysis conducted on the entire sample revealed that family history rates of teeth grinding (p < 0.001), antidepressant use (p < 0.001) and PSQI score (p = 0.004) were associated with bruxism. CONCLUSION: The findings from this study suggest that a majority of patients diagnosed with depressive or anxiety disorders may experience bruxism, particularly those using SSRI-type antidepressants. Furthermore, individuals with bruxism may have poor sleep quality and excessive daytime sleepiness tendencies.

CHILDHOOD TRAUMAS, LOVE ATTITUDES, RELATIONSHIP SATISFACTION, AND SEXUAL FUNCTIONS IN EUTHYMIC DEPRESSIVE DISORDER PATIENTS.

BACKGROUND: It was aimed to compare childhood traumas, relationship satisfaction, sexual functions, and love attitudes in depressive disorder (DD) patients with healthy volunteers. SUBJECTS AND METHODS: The study included 100 DD patients, who were in remission and had no drug side effects, and 100 healthy volunteers. A sociodemographic data form, the Childhood Trauma Questionnaire (CTQ), the Love Attitudes Scale (LAS), the Relationship Assessment Scale (RAS), and the Arizona Sexual Experiences Scale (ASEX) were administered to all participants. In addition, the Hamilton Depression Rating Scale and the UKU Side Effect Rating Scale were applied to DD patients. RESULTS: CTQ physical abuse scores were higher in the DD group compared to the healthy volunteers (p<0.001). CTQ sexual abuse scores were higher in the DD group than those in healthy volunteers (p=0.020). CTQ emotional abuse scores were higher in the DD group than those in healthy volunteers (p<0.001). RAS scores were lower in the DD group compared to the healthy volunteers (p<0.001). ASEX scores in women were higher in the DD group compared to healthy volunteers (p=0.009). LAS passionate love scores were lower in the DD group than those in the healthy volunteers (p<.0.001). LAS friendship love scores were lower in the DD group than those in healthy volunteers (p=0.005). CONCLUSION: It can be said that DD patients have more history of abuse, less relationship satisfaction, and less passion for love. Female DD patients may experience more sexual problems.

Comparison of naltrexone implant and oral buprenorphine-naloxone in the treatment of opiate use disorder.

OBJECTIVE: We aimed to compare the effectiveness of extended-release naltrexone (XR-NTX) implant and sublingual buprenorphine-naloxone (BUP-NX) in relapse prevention in opiate use disorder (OUD). METHODS: Medical records of 400 patients who were treated for OUD between 2016 and 2020 were retrospectively evaluated concerning sociodemographic and clinical characteristics and abstinence duration with either BUP-NX (192 patients) or XR-NTX (208 patients) as maintenance treatments. RESULTS: The median age of patients using BUP-NX was 25.00, and the median age of patients using XR-NTX was 25.50 (p = .785). The ratio of female patients in the BUP-NX group and the XR-NTX group was 7.3% (n = 14) and 6.7% (n = 14), respectively. A significantly higher abstinence time was observed in the BUP-NX group (median = 4 months) than in the XR-NTX group (median = 3 months) (p = .015). Liver function tests were within the normal ranges at the three time points, which were just before the beginning and in the first and third months of treatment. CONCLUSIONS: These findings suggest that BUP-NX might be more effective than XR-NTX in preventing relapse in OUD and both drugs are safe for the liver. Prospective randomized studies are needed to replicate our results.

HCV Genotype Distribution Among People Who Inject Drug in Turkey: Findings from Multicenter and Cross-Sectional Study.

Background: Hepatitis C virus (HCV) infection is very common in people who inject drugs (PWID). Studies about the prevalence and genotype distribution of the HCV among PWID are very crucial for developing strategies to manage HCV infection. This study's objective is to map the distribution of HCV genotypes among PWID from various regions of Turkey. Method: This prospective, multicenter, cross-sectional study involved 197 PWID who tested positive for anti-HCV antibodies from 4 different addiction treatment facilities in Turkey. Interviews were done with people who had anti-HCV antibodies, and blood samples were taken to check the HCV RNA viremia load and genotyping. Results: This study was conducted on 197 individuals with a mean age of 30.3 ± 8.6 years. 9.1% (136/197 patients) had a detectable HCV-RNA viral load. Genotype 3 was the most commonly observed genotype by 44.1%, followed by genotype 1a by 41.9%, genotype 2 by 5.1%, genotype 4 by 4.4%, and genotype 1b by 4.4%. Whereas genotype 3 was dominant with 44.4% at the central Anatolia region of Turkey, the frequencies of genotypes 1a and 3, which were predominantly detected in the south and northwest regions of Turkey, were very close to each other. Conclusion: Although genotype 3 is the predominant genotype in the PWID population in Turkey, the prevalence of HCV genotype varied across the country. To eliminate HCV infection in the PWID, treatment and screening strategies that differ by genotype are essentially required. Especially identification of genotypes will be useful in developing individualized treatments and determining national prevention strategies.

The role of anxiety and emotional stress as a risk factor in treatment-resistant hypertension.

Depression and anxiety are both known to be co-morbid with coronary heart disease. Given the high prevalence of coronary heart disease today, specifically the aspect of hypertension, it seems more important than ever to investigate whether or not treatment of these co-morbidities can have an effect on reducing hypertension. This article summarizes the limited amount of literature that has been published in this area and highlights what we believe to be a missing key element that will guide our own future research in this area.

Depression and coronary heart disease.

Depression and coronary heart disease (CHD) are significant contributors to the burden of disease in both developed and developing countries. Although depression seems to be a marker of increased risk after the diagnosis of CHD, it is currently unclear whether depression can be considered as an independent risk factor and whether its treatment lowers the risk. We review the data from prominent trials and recent analyses in regard to the association of depression with CHD. We also review some of the mechanisms that might contribute to this association.

Intravenous buprenorphine/naloxone and concomitant oral pregabalin misuse: a case report.

Opioid misuse and dependence are major medical and social concerns worldwide. Buprenorphine/naloxone combination (BNC) is a drug that has misuse potential and is used to treat opioid dependence, including buprenorphine and naloxone. Buprenorphine shows its pharmacological effects by binding to opioid receptors. Buprenorphine is a partial agonist and has smaller maximal effects compared to those of full agonists (heroin, methadone). Naloxone is a non-selective opiate antagonist added to buprenorphine for the prevention of intravenous diversion. BNC is used in the treatment of opioid dependence for detoxification and maintenance. The drug should be used as a sublingual film tablet. Pregabalin is used in the treatment of neuropathic pain, epilepsy and anxiety disorders. It is increasingly being reported as possessing a potential for misuse. In this article, we present a case of intravenous BNC and concomitant oral pregabalin misuse that developed in a monitored and treated patient for the reason of opioid dependence.

[Case report: comorbid anorexia nervosa and schizophrenia in a male patient]. / Olgu Sunumu: Bir Erkek Hastada Anoreksiya Nervoza ve Sizofreni Eshastalanimi

Anorexia nervosa is a rare psychiatric disorder and epidemiological studies have shown a female to male ratio of 10:1, suggesting it is a disorder predominantly seen among females. The prevalence of anorexia nervosa comorbid with other psychiatric disorders has been reported to be quite high. Whereas depression and anxiety disorders are the most common comorbid diagnoses in anorexic patients, the dual-diagnosis of anorexia and schizophrenia is a relatively rare condition. Based generally on the observations from single case reports or case series, several explanations have been made about the co-occurrence of anorexia and schizophrenia. Herein, we present a male patient who developed schizophrenia after an anorexic period of 4 years that began when he was 14 years old with the decision to lose weight, which then progressed to a pattern of disordered eating and body image. This case is rare because the patient is male and has a comorbid diagnosis of anorexia nervosa and schizophrenia. To the best of our knowledge, there is only one previous case report in the literature describing a male anorexic patient with comorbid schizophrenia. In this case presentation, the diagnosis of anorexia nervosa in males is addressed, the definition and significance of sub-threshold cases are discussed, and the comorbidity of anorexia nervosa and schizophrenia are reviewed in light of the literature.

Relationship between neutrophil/lymphocyte ratio with oxidative stress and psychopathology in patients with schizophrenia.

INTRODUCTION: The aim of our study was to evaluate the relationship between neutrophil/lymphocyte ratio (NLR) and total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index (OSI), paraoxonase, and total thiol (T.thl) in schizophrenic patients compared to healthy control group and investigate the relationship between these parameters and psychopathological symptoms. METHODS: The study population consisted of 61 healthy control subjects and 64 volunteer patients monitored in the outpatient clinics of psychiatry of Antalya Education and Research Hospital. Hemograms were determined by using a fully automated hematology analyzer (Beckman Coulter LH780). Serum TOS, TAS, paraoxonase, and T.thl were measured using a novel automated colorimetric measurement method developed by Erel. Sociodemographic data forms were completed by the participants. The Positive and Negative Syndrome Scale (PANSS) was used to assess the patients. RESULTS: Neutrophils, NLR, TAS, and TOS significantly increased, whereas lymphocytes, T.thl, and T.thl/OSI ratio were significantly lower in the schizophrenia patient group compared to the control group. A statistically significant positive relationship was found between PANSS positive subscale with leukocytes and significantly negative relationships were found between PANSS positive subscale with lymphocytes and T.thl/OSI ratio. Significant positive relationships were found between PANSS total subscale with leukocytes and NLR. Statistically significant negative relationships were found between PANSS total subscale with lymphocytes and T.thl/OSI ratio. In the group of patients with schizophrenia, a significant negative correlation was found between NLR with T.thl/OSI. In the group of patients with schizophrenia, a significant positive correlation was found between NLR with TOS and OSI. CONCLUSION: By measuring NLR, which is simple, inexpensive, and suitable for routine use, we can obtain information about oxidative stress and psychopathological symptoms in patients with schizophrenia. Inflammation and oxidative stress are important in the pathogenesis of schizophrenia and are closely related with the patients' clinical symptoms.