The Effect of Dream Anxiety on Sleep Quality in Inflammatory Bowel Diseases.

INTRODUCTION: Declining sleep quality is a well-known issue in inflammatory bowel disease (IBD), but dream characteristics of patients with IBD and their role in sleep quality are unknown. In this study, we aimed to examine whether and how patients with ulcerative colitis (UC) and Crohn's disease (CD) differ on sleep quality, sleepiness level, and dream anxiety (DA) level compared to healthy controls (HC), controlling for their depressive and anxious tendencies. METHODS: Patients and HCs were enrolled prospectively into the study. The Van DA Scale, Pittsburg Sleep Quality Index, Epworth Sleepiness Scale, Beck Depression Index, and State-Trait Anxiety Inventories were used to assess DA, sleep quality, sleepiness, depression, and anxiety, respectively. RESULTS: Patients with IBD had significantly lower depression (p = 0.004), state anxiety (p = 0.0001), trait anxiety (p = 0.004), and DA (p = 0.0001) than HCs. Although no statistically significant difference in sleep quality was found (p = 0.99), daytime sleepiness was more common in HCs than in IBD patients (p = 0.0001). No statistically significant difference was seen in depression, state anxiety, trait anxiety, DA, sleep quality, and daytime sleepiness between patients with CD and those with UC. No correlation was found between disease activity indices and psychological parameters. CONCLUSION: In contrast to previous studies, this study found lower anxiety and depression levels in patients with IBD than in HCs. Moreover, DA score was higher in HCs. For the first time, we revealed that DA may be one of the factors leading to sleep disturbance in patients with IBD.

Hippocampal Subfield Volumes Predict Disengagement from Maintenance Treatment in First Episode Schizophrenia.

OBJECTIVES: Disengagement from treatment is common in first episode schizophrenia (FES) and is associated with poor outcomes. Our aim was to determine whether hippocampal subfield volumes predict disengagement during maintenance treatment of FES. METHODS: FES patients were recruited from sites in Boston, New York, Shanghai, and Changsha. After stabilization on antipsychotic medication, participants were randomized to add-on citalopram or placebo and followed for 12 months. Demographic, clinical and cognitive factors at baseline were compared between completers and disengagers in addition to volumes of hippocampal subfields. RESULTS: Baseline data were available for 95 randomized participants. Disengagers (n = 38, 40%) differed from completers (n = 57, 60%) by race (more likely Black; less likely Asian) and in more alcohol use, parkinsonism, negative symptoms and more impairment in visual learning and working memory. Bilateral dentate gyrus (DG), CA1, CA2/3 and whole hippocampal volumes were significantly smaller in disengagers compared to completers. When all the eight volumes were entered into the model simultaneously, only left DG volume significantly predicted disengagement status and remained significant after adjusting for age, sex, race, intracranial volume, antipsychotic dose, duration of untreated psychosis, citalopram status, alcohol status, and smoking status (P < .01). Left DG volume predicted disengagement with 57% sensitivity and 83% specificity. CONCLUSIONS: Smaller left DG was significantly associated with disengagement status over 12 months of maintenance treatment in patients with FES participating in a randomized clinical trial. If replicated, these findings may provide a biomarker to identify patients at risk for disengagement and a potential target for interventions.

Impact of expectant mother's knowledge level about fetal anomaly scan on their state anxiety prior to antenatal ultrasound screening.

OBJECTIVE: We aimed to investigate the role of expectant mothers' background antenatal ultrasound knowledge on their state anxiety when they apply for the ultrasound examination. MATERIALS AND METHODS: A cross-sectional study was conducted in perinatology outpatient clinic of a university hospital. Expectant mothers who applied for the first trimester ultrasound scan and second trimester anomaly scan were recruited to the study. A self-report form was applied to participants to assess the sociodemographic characteristics, obstetric history, knowledge and attitudes toward antenatal ultrasound. Expectant mothers' state anxiety prior to ultrasound scan was measured with the state sub-scale of State-Trait Anxiety Inventory. RESULTS: A total of 500 expectant mothers (220 in the first trimester and 280 in the second trimester) were included to the study. We found a negative correlation between the participants' age and state anxiety level (r = -0.118, p < .01). Also, participants' education level had a significant effect on their state anxiety level (F (2, 497)=5.91, p < .01). Participant's age significantly predicted lower state anxiety level (ß = -0.10, t = -2.09, p < .05). We did not find any significant relationship between the mean knowledge level of mothers and state anxiety levels of mothers (r = -0.07, p > .05). CONCLUSION: Age was the only affecting factor on anxiety levels before ultrasound scan in pregnant participants. There was no significant effect of background knowledge on state anxiety.

Cognitive Psychophysiological Substrates of Affective Temperaments.

Affective temperaments are the subclinical manifestations or phenotypes of mood states and hypothetically represent one healthy end of the mood disorder spectrum. However, there is a scarcity of studies investigating the neurobiological basis of affective temperaments. One fundamental aspect of temperament is the behavioral reactivity to environmental stimuli, which can be effectively evaluated by use of cognitive event-related potentials (ERPs) reflecting the diversity of information processing. The aim of the present study is to explore the associations between P300 and the affective temperamental traits in healthy individuals. We recorded the P300 ERP waves using an auditory oddball paradigm in 50 medical student volunteers (23 females, 27 males). Participants' affective temperaments were evaluated using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-auto questionnaire version (TEMPS-A). In bivariate analyses, depressive temperament score was significantly correlated with P300 latency ( rs = 0.37, P < .01). In a multiple linear regression analysis, P300 latency showed a significant positive correlation with scores of depressive temperament (ß = 0.40, P < .01) and a significant negative one with scores of cyclothymic temperament (ß = -0.29, P = .03). Affective temperament scores were not associated with P300 amplitude and reaction times. These results indicate that affective temperaments are related to information processing in the brain. Depressive temperament may be characterized by decreased physiological arousal and slower information processing, while the opposite was observed for cyclothymic temperament.

[Sociodemographic and Clinical Characteristics of Transsexual Individuals who Applied to a Psychiatry Clinic for Sex Reassignment Surgery]. / Cinsiyet Degistirme Ameliyati Için Psikiyatri Klinigine Basvuran Transseksüel Bireylerin Sosyodemografik ve Klinik Özellikleri.

OBJECTIVE: The aim of the study was to investigate sociodemographic and clinical characteristics of people with gender dysphoria and differences of sociodemographic and clinical characteristics between female-to-male (FtM) and male-to-female (MtF) transsexual individuals. METHOD: This study examined retrospectively sociodemographic and clinical characteristics of 139 cases with the diagnosis of gender dysphoria who were willing to undergo sex reassignment surgery and were referred to the Cerrahpasa Medical Faculty between 2007-2013. RESULTS: Among 139 patients with gender dysphoria 102 were MtF (73,4%), and 37 patients were FtM (26,6%). In MtFs, rates of working in jobs which do not require high education level, unemployment, being a sex worker (p < 0,001), drug use (p = 0,017), and not having the health insurance (p < 0,001) were found to be significantly higher than FtMs. Rates of receiving psychotherapy for gender dysphoria (p = 0,001) and starting hormone therapy under the supervision of a doctor (p < 0,001) were significantly higher in FtMs, however higher rates of taking hormone therapy (p < 0,001) and undergoing surgery for sex reassignment (p < 0,001) were observed in the MtFs. CONCLUSION: There are significant differences both in sociodemographic characteristics and clinical characteristics between MtFs and FtMs. However further studies would be needed to identify underlying causes.

Genetic Polymorphism of the Serotonin Transporter Gene, SLC6A4 rs16965628, Is Associated with Obsessive Compulsive Disorder.

Obsessive compulsive disorder (OCD) is a psychiatric disorder characterized by obsessive ideas and compulsive behaviors. Genetic studies have centered on candidate genes involved in OCD etiology related to serotonergic and dopaminergic systems. In this study, the relationship between cathechol-O-methyltransferase (COMT) -287A/G (rs2097063), serotonin transporters 5-HTTLPR I/D, and SLC6A4 rs16965628 polymorphisms in 80 OCD patients and 100 healthy controls was determined. Patients and controls were genotyped for COMT rs2097063 and SLC6A4 rs16965628 polymorphisms by real-time polymerase chain reaction (PCR). The 5-HTTLPR I/D polymorphism was genotyped using PCR and agarose gel electrophoresis. Severity of symptoms was checked with a Yale-Brown Obsession Compulsion Scale (Y-BOCS). When the OCD group and controls were compared, no significant difference was found between COMT -287A/G (rs2097063), 5-HTTLPR I/D polymorphisms, and OCD. However, a significant difference was found between 5-HTT rs16965628 polymorphism and OCD (p=0.025, OR=3.43, 95% CI 1.41-10.35). In addition, the G allele frequency was found to be higher for rs16965628 in the OCD group. No significant difference was observed between COMT -287A/G (rs2097063), SLC6A4 rs16965628, and 5-HTTLPR I/D polymorphisms and Y-BOCS scores (p>0.05). There was also lack of correlation between Yale-Brown scores and gender of OCD patients. On the other hand, combined genotypes of SLC6A4 rs16965628 GG+GC were found to be risk factors for OCD development (p=0.02, OR=3.464; 95% CI 1.214-9.883) in logistic regression analysis adjusted for age and gender. Our findings suggest that subjects carrying the G allele of rs16965628 have genetic susceptibility to OCD. These data are the first to suggest that polymorphism in serotonin transporter (rs16965628) is associated with the development of OCD in the Turkish population.