Efficacy of Transcranial Photobiomodulation on Depressive Symptoms: A Meta-Analysis.

Background: Transcranial photobiomodulation (tPBM) is a novel, noninvasive, device-based intervention, which has been tested as a possible treatment for various neurological and psychiatric conditions. Recently, it has been investigated as an innovative treatment for major depressive disorder (MDD). There have been several animal and clinical studies that evaluated the underlying mechanism and the efficacy of its antidepressant effects, but results have been conflicting. Objective: Thus, we conducted the first meta-analysis on effects of tPBM on depressive symptoms. Materials and methods: Thirty original articles on tPBM were retrieved, eight of them met criteria for inclusion to a random effects meta-analysis. Results: tPBM appeared effective in decreasing depressive symptom severity regardless of diagnosis (Hedges' g = 1.415, p < 0.001, k = 8), but a significant heterogeneity has been found. The meta-analysis of single-arm studies (baseline to endpoint changes) limited to participants with MDD has supported the significant effect of tPBM in reducing the depression severity, without a significant heterogeneity (Hedges' g = 1.142, 95% confidence interval = 0.780-1.504, z = 6.19, p < 0.001, k = 5). However, the meta-analysis of the few double-blind, sham-controlled studies in MDD has not supported the statistically significant superiority of tPBM over sham (Hedges' g = 0.499, p = 0.211, k = 3), although a sample size bias is likely present. Conclusions: Overall, this meta-analysis provides weak support for the promising role of tPBM in the treatment of depressive symptoms. Dose finding studies to determine optimal tPBM parameters followed by larger, randomized, sham-controlled studies will be needed to fully demonstrate the antidepressant efficacy of tPBM.

Adiponectin in anorexia nervosa and its modifiers: A meta-regression study.

OBJECTIVE: Adiponectin, which is secreted from adipose tissue, is a protein hormone. Although a large body of studies have found that circulating adiponectin levels increase in anorexia nervosa (AN) and caloric restriction, the effect of subtypes of AN and modifiers of adiponectin in AN are not yet known. METHODS: A systematic search of electronic databases was performed using the search terms "adiponectin," "anorexia nervosa," and "eating disorder" up to January 2021. All studies published in peer-reviewed journals, which included cases and control groups, were selected. The main outcome was the pooled standardized mean difference (SMD) in adiponectin levels between cases and controls, using the random-effects model. Modifiers of SMD were tested via meta-regression. Heterogeneity and publication bias were evaluated. RESULTS: Thirty-four studies met all eligibility criteria. The total sample of AN participants (Hedges' g = .765, p < .0001), and specifically the binge-eating/purging (Hedges' g = 1.211, p < .00001) and restrictive subtypes (Hedges' g = .913, p < .00001) of AN have increased adiponectin plasma levels compared with healthy controls. Meta-regression determined that insulin, IGF-1, BMI, triglyceride, resistin, glucose, IL-6 levels are significant modifiers of adiponectin levels. DISCUSSION: Compared with controls, adiponectin levels are higher in AN overall, and specifically in the binge-eating/purging and the restrictive AN subtypes. Many of metabolic parameters of glucose metabolism and pro-inflammatory molecules modify the relationship between AN and adiponectin levels. Adipose tissue is important to maintain metabolic stability. PUBLIC SIGNIFICANCE: Anorexia nervosa is a psychiatric disorder associated with a severe decrease in body weight and multiple metabolic abnormalities, including an increase in the hormone adiponectin. In this paper, we used meta-analysis, a powerful statistical method, to aggregate data from 34 rigorously selected research reports. This enabled us to understand the value of adiponectin to differentiate clinical subtypes of anorexia nervosa and the relations between adiponectin and other important metabolic parameters.

OBJETIVO: La adiponectina, que es secretada del tejido adiposo, es una hormona proteica. Aunque una gran cantidad de estudios han encontrado que los niveles circulantes de adiponectina aumentan en la anorexia nerviosa (AN) y la restricción calórica, el efecto de los subtipos de AN y los modificadores de la adiponectina en la AN aún no se conocen. MÉTODOS: Se realizó una búsqueda sistemática en bases de datos electrónicas utilizando los términos de búsqueda "adiponectina", "anorexia nerviosa" y "trastorno de la conducta alimentaria" hasta enero de 2021. Se seleccionaron todos los estudios publicados en revistas revisadas por pares, que incluían casos y grupos de control. El resultado principal fue la diferencia de medias estandarizada (DME) agrupada en los niveles de adiponectina entre los casos y los controles, mediante el modelo de efectos aleatorios. Los modificadores de DME se probaron mediante metarregresión. Se evaluaron la heterogeneidad y el sesgo de publicación. RESULTADOS: Treinta y cuatro estudios cumplieron todos los criterios de elegibilidad. La muestra total de sujetos con AN (g de Hedges = 0.765, p < 0.0001), y específicamente los subtipos de atracones/purgaciones (g = 1,211 de Hedges, p < 0.00001) y restrictivos (g = 0.913, p < 0.00001) de AN tienen incrementados los niveles plasmáticos de adiponectina en comparación con los controles sanos. La metarregresión determinó que los niveles de insulina, IGF-1, IMC, triglicéridos, resistina, glucosa, IL-6 son modificadores significativos de los niveles de adiponectina. DISCUSIÓN: En comparación con los controles, los niveles de adiponectina son más altos en la AN en general, y específicamente en los subtipos de atracones/purgaciones y AN restrictiva. Muchos de los parámetros metabólicos del metabolismo de la glucosa y las moléculas proinflamatorias modifican la relación entre los niveles de AN y adiponectina. El tejido adiposo es importante para mantener la estabilidad metabólica.

Psychiatric comorbidity and childhood trauma in fibromyalgia syndrome.

OBJECTIVES: In this study, we aimed to compare patients with fibromyalgia syndrome (FMS) and those with myofascial pain syndrome (MPS) and healthy women and to investigate the prevalence of childhood traumatic experiences (CTEs) in relation to comorbid mood and anxiety disorders. PATIENTS AND METHODS: Between February 2014 and May 2014, a total of 136 women including 52 with FMS, 35 with MPS, and 49 healthy controls were included in the study. The Sociodemographic Data Form, Mood and Anxiety Disorders Modules of Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) Axis I Disorders (SCID-I), Fibromyalgia- related Symptom Scale (FSS), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), and Childhood Trauma Questionnaire-28 (CTQ-28) were applied to participants. RESULTS: As a result of the semi-structured clinical interview conducted by a psychiatrist experienced in psychological trauma, the prevalence of any mood or anxiety disorder were found to be significantly more common in the FMS group. Childhood traumatic experiences, not only in general, but also with all subtypes, were also reported to be significantly more in FMS patients. Besides, only in patients with FMS, a significant relationship was found between the psychiatric diagnoses and the presence of CTEs. Furthermore, the CTQ-28 scores were correlated positively with the FSS scores as well as HDRS and HARS. Among the symptoms screened by the FSS, only crying and over-reacting to incidents were significantly associated with CTEs in FMS group. CONCLUSION: Based on our study results, CTEs may play a critical role in the development of fibromyalgia and may be related with comorbid mood and anxiety disorders in FMS patients. Associating psychological symptoms such as crying or over-reacting to incidents in FMS patients should be, therefore, alerting for psychiatric consultation.

Clinical and pharmacologic risk factors for neuroleptic malignant syndrome and their association with death.

AIM: The aim of the present study was to evaluate demographics, clinical features, psychiatric diagnoses and prognosis of neuroleptic malignant syndrome (NMS) reported in Turkey, and to assess their association with mortality. METHODS: Data on all reported cases of NMS in the Turkish Psychiatric Index between 1985 and 2005 were collected. The type, dosage and administration period of neuroleptics, the clinical and laboratory findings; and prognosis were compared in terms of mortality. RESULTS: Thirty-six patients with a mean age of 33.67 +/- 16.98 years were identified. Fifteen (41.7%) were diagnosed as having schizophrenia or other psychotic disorders and the same number were diagnosed as having affective disorder. Remaining five (13.9%) were diagnosed with other psychiatric disorders and 1 (2.7%) had no psychiatric diagnosis. Twenty-two (61.1%) of the NMS cases were associated with high potency typical neuroleptics. Association between an atypical antipsychotic and NMS has been reported in one case. NMS appeared within 7 days after initiation of the antipsychotic medication in the majority of samples (n = 19, 52.8%). Several combinations of rescue treatments were used in the majority of cases (n = 19, 52.8%), although bromocriptine (n = 22, 61.1%) was the most frequently preferred rescue treatment for NMS. Benzodiazepines were significantly better than the other treatment options in preventing mortality. Five out of the 36 patients (13.9%) with NMS had died. Age was the only significant independent factor that was associated with mortality. CONCLUSIONS: Benzodiazepines may be included in the treatment of NMS. The mortality rate due to NMS in Turkey was lower than the previously reported rates from other developing countries.

[Smoking and schizophrenia: where is the biological connection?]. / Sizofreni ve Sigara Içimi: Biyolojik Baglanti Nerede?

OBJECTIVE: Patients with psychiatric disorders have a higher incidence of smoking than the general population. In particular, the rate of smoking among patients with schizophrenia has been found to be between two and three times in the general population in western countries. This paper reviews the biological factors that might be contributing to the high rate of smoking among patients with schizophrenia and examines the interaction between nicotine and neurobiological disturbances observed in schizophrenia. METHOD: Papers assessing the possible biological causes of smoking in patients with schizophrenia and the physiological effects of nicotine were reviewed by using the key words "nicotine, schizophrenia, smoking and cigarette" in Pubmed, Turk Medline, and the Turkish Psychiatric Index. RESULTS: Studies conducted in humans and animals show that nicotine can directly increase dopaminergic transmission in the central nervous system, enhance cognitive performance and improve sensory gating deficits observed in patients with schizophrenia. Moreover, smoking diminishes the efficacy of most antipsychotic drugs via an increased hepatic metabolism. CONCLUSION: Studies suggest a link between the physiological effects of nicotine and the neurobiological disturbances in schizophrenia. Disturbances in the cholinergic transmission may be responsible for some symptoms of schizophrenia. The harmful effects of smoking vastly outweigh any possible benefits, but, nevertheless, further investigation may lead to important insights regarding the etiology of schizophrenia at a molecular level.