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OBJECTIVE: The molecular genetic of personality disorders has been investigated in several studies; however, the association of antisocial behaviours with synaptosomal-associated protein 25 (SNAP25) gene polymorphisms has not. This association is of interest as SNAP25 gene polymorphism has been associated with attention-deficit hyperactivity disorder and personality. METHODS: We compared the distribution of DdeI and MnII polymorphisms in 91 young male offenders and in 38 sex-matched healthy control subjects. We also investigated the association of SNAP25 gene polymorphisms with severity of psychopathy and with temperament traits: novelty seeking, harm avoidance, and reward dependence. RESULTS: The MnII T/T and DdeI T/T genotypes were more frequently present in male subjects with antisocial personality disorder (APD) than in sex-matched healthy control subjects. The association was stronger when the frequency of both DdeI and MnII T/T were taken into account. In the APD group, the genotype was not significantly associated with the Psychopathy Checklist-Revised scores, measuring the severity of psychopathy. However, the APD subjects with the MnII T/T genotype had higher novelty seeking scores; whereas, subjects with the DdeI T/T genotype had lower reward dependence scores. Again, the association between genotype and novelty seeking was stronger when both DdeI and MnII genotypes were taken into account. CONCLUSION: DdeI and MnII T/T genotypes may be a risk factor for antisocial behaviours. The association of the SNAP25 DdeI T/T and MnII T/T genotypes with lower reward dependence and higher novelty seeking suggested that SNAP25 genotype might influence other personality disorders, as well.
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Transtorno da Personalidade Antissocial/genética , Proteína 25 Associada a Sinaptossoma/genética , Temperamento/fisiologia , Adulto , Criminosos/psicologia , Comportamento Exploratório/fisiologia , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Testes Neuropsicológicos , Reação em Cadeia da Polimerase , Polimorfismo Genético , Fatores de Risco , Turquia , Adulto JovemRESUMO
BACKGROUND: Elevated blood levels of homocysteine (hCY) have been associated with schizophrenic male patients. However, controversy remains regarding the association between lowered plasma folate and vitamin B12, hyperhomocysteinemia, and schizophrenia. Sixty-six (66) male patients with chronic schizophrenia were investigated to test the hypotheses that alterations in Hcy, folate, and vitamin B12 levels might be related to the antipsychotic drug doses used in treatment. METHODS: Serum total homocysteine, folic acid, and vitamin B12 levels were determined by chemiluminescence methods in both patients and control subjects. The patients were grouped according to the antipsychotic drug doses used in their treatment. RESULTS: Patients had higher homocysteine levels but they did not differ from controls in terms of folate and vitamin B12 levels. On the other hand, only folate levels were negatively correlated in the patient group treated with higher therapeutic doses of chlorpromazine equivalents (> 400 mg/day) compared to the patient group with lower doses (< 400 mg/day). CONCLUSIONS: Our findings show that higher typical antipsychotic drugs may play a role as modifiying factor for folate metabolism in chronic schizoprenic male patients.
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Antipsicóticos/administração & dosagem , Ácido Fólico/sangue , Homocisteína/sangue , Esquizofrenia/sangue , Esquizofrenia/tratamento farmacológico , Vitamina B 12/sangue , Adolescente , Adulto , Estudos de Casos e Controles , Clorpromazina/administração & dosagem , Doença Crônica , Relação Dose-Resposta a Droga , Humanos , Medições Luminescentes , Masculino , Pessoa de Meia-Idade , Estatísticas não ParamétricasRESUMO
OBJECTIVES: Several oxidants and antioxidants have been evaluated in schizophrenia. However, previous studies frequently focused on individual parameters. Determination of the total oxidant and antioxidant status may be more useful. Therefore, we aimed to evaluate both plasma total oxidant status (TOS) and total antioxidant status (TAS) together with the oxidative stress index (OSI) in schizophrenia patients for the first time in the literature. METHODS: A total of 60 schizophrenia patients and 40 healthy volunteers were included in the study. The Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression-severity scale (CGI-S) were used to evaluate the severity of schizophrenia in the patients. TOS and TAS were measured in plasma and the OSI was calculated for patients and controls. RESULTS: There was no difference between patients and controls with regard to TOS, but the patients' TAS and OSI were significantly lower and higher, respectively, than those of the controls. No difference was detected between the schizophrenia subtypes or between the patients on typical or atypical antipsychotic medications or a combination of the two with regard to oxidative parameters. There was a weak to moderately significant negative correlation between TAS and total, positive and general psychopathology PANSS scores. Finally, we found a weak to moderately significant negative correlation between the CGI-S score and TOS and between the CGI-S score and TAS. CONCLUSIONS: There is a defect in the antioxidant defense system in schizophrenia. Known oxidative stress that causes oxidative cell damage and thus contributes to the pathophysiology of schizophrenia may be mainly related to this defensive defect.
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Antioxidantes/metabolismo , Estresse Oxidativo/fisiologia , Esquizofrenia/fisiopatologia , Adulto , Antipsicóticos/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Esquizofrenia/sangue , Esquizofrenia/tratamento farmacológico , Esquizofrenia Paranoide/sangue , Esquizofrenia Paranoide/tratamento farmacológico , Esquizofrenia Paranoide/fisiopatologia , Fumar/sangue , Fumar/fisiopatologia , Adulto JovemRESUMO
Maintenance electroconvulsive therapy is used for refractory bipolar disorder. We present a middle-aged man with refractory bipolar disorder who was successfully treated with maintenance electroconvulsive therapy and long-acting risperidone.
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Antipsicóticos/uso terapêutico , Clozapina/uso terapêutico , Eletroconvulsoterapia , Esquizofrenia Paranoide/terapia , Antipsicóticos/administração & dosagem , Antipsicóticos/efeitos adversos , Clozapina/administração & dosagem , Clozapina/efeitos adversos , Terapia Combinada , Confusão/etiologia , Confusão/psicologia , Eletroconvulsoterapia/efeitos adversos , Humanos , Masculino , Transtornos da Memória/etiologia , Transtornos da Memória/psicologia , Escalas de Graduação Psiquiátrica , Esquizofrenia Paranoide/tratamento farmacológico , Esquizofrenia Paranoide/psicologia , Adulto JovemRESUMO
It is hypothesized that molecular components of dopaminergic system, especially the dopamine D3 receptor gene (DRD3), may play a crucial role in the pathophysiology of schizophrenia, because it is abundant in the limbic system of the brain and it binds antipsychotic drugs. Several groups attempted to find an association between a serine-to-glycine polymorphism of the DRD3 gene (Ser9Gly) and schizophrenia; however, the results were inconsistent. In this study, we aimed to investigate the relationship of the Serine/Glycine polymorphism of the DRD3 gene with therapeutic response to clozapine treatment between Turkish schizophrenia patients (N = 92) and healthy controls (N = 100). Genotype groups were comparable in BPRS, SAPS, SANS analysis of response to clozapine. Our results suggest that an association between the Ser/Gly polymorphism of DRD3 gene and response to clozapine in Turkish schizophrenia patients is unlikely to exist.
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Antipsicóticos/uso terapêutico , Clozapina/uso terapêutico , Glicina/genética , Polimorfismo Genético , Receptores de Dopamina D3/genética , Esquizofrenia/tratamento farmacológico , Serina/genética , Sequência de Bases , Estudos de Casos e Controles , Primers do DNA , Esquizofrenia/genética , TurquiaRESUMO
BACKGROUND: Alterations in ceruloplasmin are currently assumed as one of the mechanisms underlying the development of a number of neurodegenerative disorders. Several studies indicate that elevated serum ceruloplasmin levels may play a role in schizophrenia by exacerbating or perpetuating dopaminergic dysregulation. No study investigating the relationship between ceruloplasmin and obsessive-compulsive disorder (OCD) has been published to date. Nowadays OCD is increasingly speculated to be a different disorder than other anxiety disorders, and rather is considered to be more similar to psychotic disorders. The objective of this study to explore whether there is an association of ceruloplasmin with OCD as in schizophrenia. METHOD: 26 pure OCD and 9 co-morbid OCD patients from Gaziantep University Sahinbey Research Hospital, Psychiatry Clinics, diagnosed according to the DSM IV and 40 healthy controls were included in the study. Blood samples were collected; ceruloplasmin levels were measured. RESULTS: The mean ceruloplasmin level in pure OCD patients, co-morbid OCD patients, and control group persons were 544.46 +/- 26.53, 424.43 +/- 31.50 and 222.35 +/- 8.88 U/L respectively. Results of all 3 groups differ significantly. Positive predictive value of ceruloplasmin for that cut-off point is 31/31 (100%) and negative predictive value is 40/44 (91%) in our group. CONCLUSION: Although the nature of relationship is not clear there was an association between ceruloplasmin levels and OCD in our study.
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OBJECTIVES: Various psychological, social, genetic, biochemical, factors are to be involved in the etiology of OCD. Some molecules of free radicals are also found to play role in OCD. To the best of our knowledge, there has been no study, regarding the role of free radicals in the pathogenesis of OCD, from a general antioxidant aspect of view. Therefore, in this present cross-sectional study, we aimed to assess whether antioxidant-oxidant status is associated with OCD and can be used or not as a biological marker regarding that disorder. METHODS: 37 OCD patients diagnosed according to DSM-IV and as control group forty healthy subjects were included to the study. Venous blood samples were collected once. The total oxidant status, antioxidant status and oxidative stress index of the plasma were measured using a novel automated colorimetric measurement method. RESULTS: There was not a significant difference between only OCD and all patients in all measures (TOS: Z = - 1.453, p = 0.521; TAS: Z = - 0.151, p = 0.880; OSI: Z = - 0.679 p = 0.497). TAS levels were both higher than controls in only OCD groups and all patients (Z = - 5.538, p < 0.001 and Z = - 6.394, p < 0.001 respectively). TOS and OSI of both patient groups were significantly lower than controls (TOS: Z = - 5.131, p < 0.001; OSI: Z = - 5.105, p < 0.001 and TOS: Z = - 5.979, p < 0.001; OSI: Z = - 5.862, p < 0.001). In only OCD group, illness duration was correlated with TOS and OSI (r(0) = 0.44, p = 0.023, n = 26 and r(0) = 0.44, p = 0.026, n = 26 respectively) but not with TAS. CONCLUSION: Our study found an overall oxidative imbalance shifted towards antioxidant side in OCD which may be due to either a rebound phenomenon or chronicity of the condition.
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Antioxidantes/análise , Transtorno Obsessivo-Compulsivo/sangue , Oxidantes/sangue , Estresse Oxidativo/fisiologia , Adulto , Biomarcadores/sangue , Colorimetria , Grupos Controle , Estudos Transversais , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Radicais Livres/sangue , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico , Escalas de Graduação Psiquiátrica/estatística & dados numéricosRESUMO
Free radicals have been implicated in some psychiatric disorders. This study aimed to investigate the role of oxidative and antioxidative parameters in etiopathogenesis and prognosis of panic disorder (PD), using novel methods for measurement of total oxidant and antioxidant statuses. Nineteen PD patients and 40 healthy subjects were recruited. Both total antioxidant status and oxidative stress index, and ceruloplasmin levels of PD patients were significantly higher in PD patients. Total oxidant status and oxidative stress index decreased after treatment. This study suggests an oxidative imbalance in PD and treatment can reverse overall oxidative imbalance.
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Antioxidantes/metabolismo , Encéfalo/metabolismo , Estresse Oxidativo/fisiologia , Transtorno de Pânico/metabolismo , Adulto , Biomarcadores/análise , Biomarcadores/metabolismo , Encéfalo/fisiopatologia , Química Encefálica/fisiologia , Ceruloplasmina/análise , Ceruloplasmina/metabolismo , Metabolismo Energético/fisiologia , Feminino , Radicais Livres/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Oxidantes/metabolismo , Transtorno de Pânico/genética , Transtorno de Pânico/fisiopatologia , Prognóstico , Compostos de Enxofre/metabolismo , Regulação para Cima/fisiologiaRESUMO
The aims of this study are to investigate the contribution effect of oxidative stress in MK-801-induced experimental psychosis model, and to show that prevention of oxidative stress may improve prognosis. Because oxidative damage has been suggested in the neuropathophysiology of schizophrenia, the possible protecting agents against lipid peroxidation are potential target for the studies in this field. For this purpose, Wistar Albino rats were divided into three groups: the first group was used as control, MK-801 was given to the rats in the second group and MK-801+omega-3 essential fatty acids (EFA) was given to the third group. MK-801 was given intraperitoneally at the dose of 0.5mg/(kgday) once a day for 5 days in experimental psychosis group. In the second group, 0.8g/(kgday), omega-3 FA (eicosapentaenoic acid, 18%, docosahexaenoic acid, 12%) was given to the rats while exposed MK-801. In control group, saline was given intraperitoneally at the same time. After 7 days, rats were killed by decapitation. Prefrontal brain area was removed for histological and biochemical analyses. As a result, malondialdehyde (MDA), as an indicator of lipid peroxidation, protein carbonyl (PC), as an indicator of protein oxidation, nitric oxide (NO) levels and superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activities as antioxidant enzymes, and xanthine oxidase (XO) and adenosine deaminase (AD) activities as an indicator of DNA oxidation was found to be increased significantly in prefrontal cortex (PFC) of MK-801 group (P<0.0001) compared to control group. In omega-3 FA treated rats, prefrontal tissue MDA, PC and NO levels as well as SOD, GSH-Px, XO, and AD enzyme activities were significantly decreased when compared to MK-801 groups (P<0.0001) whereas catalase (CAT) enzyme activity was not changed. Moreover, in the light of microscopic examination of MK-801 groups, a great number of apoptotic cells were observed. omega-3 FA supplementation decreased the apoptotic cell count in PFC. The results of this study revealed that oxidative stress and apoptotic changes in PFC may play an important role in the pathogenesis of MK-801-induced neuronal toxicity. This experimental study also provides some evidences for the protective effects of omega-3 FA on MK-801-induced changes in PFC of rats.
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Maleato de Dizocilpina/toxicidade , Animais , Masculino , RatosRESUMO
BACKGROUND: Several lines of evidence suggest that clozapine is more effective than both first- and second-generation antipsychotic drugs in treatment-resistant schizophrenia (TRS). However, clinicians appear to be hesitant to prescribe this drug. It would therefore be extremely valuable if predictors of response to clozapine could be identified. The aim of this study was to evaluate the predictive factors of clinical responses to clozapine in a group of Turkish patients with TRS. METHODS: This was a 16-week uncontrolled open study carried out among 97 TRS patients (80 males and 17 females; DSM-IV diagnosis). All patients fulfilled the criteria for refractory schizophrenia according to the UK guidelines for the National Institute of Clinical Excellence (NICE). After all previous antipsychotic medications had run their course, the patients were started on clozapine according to a standardized titration and dosage schedule. Psychopathology was evaluated before the initiation of clozapine therapy and once every 4 weeks using the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment for Positive Symptoms, and the Scale for the Assessment of Negative Symptoms. RESULTS: Of the TRS patients on clozapine, 55.7% achieved a clinical response, defined as at least a 20% decrease in BPRS. We observed a favorable effect of clozapine on both positive and negative symptoms. Logistic regression analysis showed that a good clozapine response was more likely when schizophrenia began at a later age, when negative symptoms were severe, and when patients had an early response at 4 weeks. CONCLUSION: A combination of demographic, baseline clinical, and acute treatment response variables may accurately predict response to clozapine in TRS. Priority should be given to initiating clozapine at the earliest phase of TRS, especially for patients with evident negative symptoms.
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Antipsicóticos/uso terapêutico , Clozapina/uso terapêutico , Esquizofrenia/tratamento farmacológico , Adulto , Resistência a Medicamentos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Probabilidade , Escalas de Graduação Psiquiátrica , Esquizofrenia/fisiopatologia , Resultado do Tratamento , TurquiaRESUMO
BACKGROUND: There has been much evidence in recent years that free oxygen radicals and nitric oxide (NO) may play an important role in the pathophysiology of neuropsychiatric disorders. In this study, we aimed to investigate whether NO, xanthine oxidase (XO), superoxide dismutase (SOD), and adenosine deaminase (ADA) levels are associated with major depression (MD) and to evaluate the impact of antidepressant treatments on NO, SOD, ADA and XO levels in MD. METHODS: Thirty-six patients who were diagnosed as MD according to DSM-IV criteria and 20 healthy controls were included. The serum levels of NO, XO, SOD, and ADA were measured by spectrophotometric methods both in patients and controls. Patients were treated with antidepressant drugs for 8 weeks. All patients were assessed by Hamilton Depression Rating Scale (HDRS) both before and after antidepressant treatment. RESULTS: ADA and XO levels of the patients were significantly higher than the controls. SOD level of the patients was significantly lower than the controls. Although NO levels of the patients were higher than the controls, the difference was not statistically significant. There was no correlation between HDRS and the parameters studied (SOD, ADA, XO, and NO) of the patients. After 8 weeks of antidepressant treatment, ADA and SOD activities were increased, whereas NO and, XO levels decreased significantly. CONCLUSIONS: ADA, XO, and SOD activity may have a pathophysiological role in MD and may predict prognosis of MD. Activity of these enzymes may be used to monitor effects of the antidepressant treatment.
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Adenosina Desaminase/análise , Antidepressivos/uso terapêutico , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/tratamento farmacológico , Óxido Nítrico/análise , Superóxido Dismutase/análise , Xantina Oxidase/análise , Adolescente , Adulto , Transtorno Depressivo Maior/enzimologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PrognósticoRESUMO
Neuroleptic malignant syndrome (NMS) is the rarest and most serious of the neuroleptic-induced movement disorders. We describe a case of neuroleptic malignant syndrome (NMS) associated with the use of ziprasidone. Although conventional neuroleptics are more frequently associated with NMS, atypical antipsychotic drugs like ziprasidone may also be a cause. The patient is a 24-year-old male with a history of schizophrenia who developed signs and symptoms of NMS after 2 days of treatment with an 80-mg/day dose of orally administrated ziprasidone. This case is the earliest (second day of treatment) NMS due to ziprasidone reported in the literature.
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Antipsicóticos/efeitos adversos , Síndrome Maligna Neuroléptica/etiologia , Piperazinas/efeitos adversos , Esquizofrenia/tratamento farmacológico , Tiazóis/efeitos adversos , Adulto , Antipsicóticos/administração & dosagem , Biperideno/administração & dosagem , Diagnóstico Diferencial , Diazepam/administração & dosagem , Quimioterapia Combinada , Humanos , Infusões Intravenosas , Masculino , Síndrome Maligna Neuroléptica/tratamento farmacológico , Exame Neurológico/efeitos dos fármacos , Transtornos Parkinsonianos/induzido quimicamente , Transtornos Parkinsonianos/diagnóstico , Transtornos Parkinsonianos/tratamento farmacológico , Piperazinas/administração & dosagem , Esquizofrenia/diagnóstico , Tiazóis/administração & dosagemRESUMO
OBJECTIVE: To determine the significance of the A218C polymorphism of the tryptophan hydroxylase (TPH) gene in migraine. METHODS: Fifty-nine migraineurs and 62 healthy controls were included in the study, and polymerase chain reaction - restriction fragment length polymorphism assays were used to determine TPH A218C polymorphism. RESULTS: There was no association between TPH gene polymorphism and gender, family history of migraine and epilepsy, or aura. There was no significant difference between the allele frequencies of both groups (p>0.05). A significant difference was found between the genotypes of the migraineurs and controls regarding the AA genotype. Homozygosity for the C allele or heterozygosity for the A or C was not associated with the occurrence of migraine (p>0.05), but homozygosity for the A allele was less frequent in the migraineurs (p=0.02). CONCLUSION: Since it is unlikely that TPH polymorphism alters serotonin biosynthesis, its association with migraine may be attributed to linkage disequilibrium with a functional variant within the TPH gene or a nearby gene.
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Transtornos de Enxaqueca/genética , Polimorfismo Genético , Triptofano Hidroxilase/genética , Adulto , Feminino , Genótipo , Heterozigoto , Homozigoto , Humanos , Desequilíbrio de Ligação , Masculino , Pessoa de Meia-Idade , Serotonina/biossíntese , Triptofano Hidroxilase/metabolismoRESUMO
OBJECTIVE: A prospective randomized study was undertaken to assess the effectiveness and side effect profiles of nicotine patch and bupropion therapies for smoking cessation. METHODS: Three hundred and fifty patients were referred to our smoking cessation program in the Department of Pulmonary Diseases, Gaziantep University between September 2002 and July 2003. Of these, only 131 patients fulfilled the trial criteria. We randomized the patients into nicotine patch (n=50), bupropion (n=50) and control groups (n=31). Cases were followed up for 24 weeks. Questionnaires including the Fagerstrom test for nicotine dependence and Beck Depression Inventory were carried out at initial evaluation. Declaration of quitting and exhaled carbon monoxide level less than 10 ppm was accepted as success criteria. RESULTS: Success rates were 26% for nicotine patch group, 26% for bupropion and 16% for control group at the end of the 24th week (p=0.56). Beck depression inventory scores did not differ significantly between the groups, however none of the cases with scores greater than 13 succeeded regardless of the group. Mean body weight at baseline and change at 6 months did not differ significantly between the groups. Sleep disturbance was significantly more common in nicotine patch and bupropion groups than the control group (p=0.008). CONCLUSION: The present study reinforces the role of medical doctors and importance of close follow up in smoking cessation, and directed counseling is quite as effective as pharmacologic therapy and is the sole approach without any adverse effects.
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Bupropiona/uso terapêutico , Motivação , Nicotina/administração & dosagem , Abandono do Hábito de Fumar/métodos , Adulto , Feminino , Humanos , Masculino , Estudos Prospectivos , Abandono do Hábito de Fumar/psicologiaRESUMO
OBJECTIVE: Electroconvulsive therapy (ECT) is used in the treatment of many psychiatric diseases and this therapy may be effective on antioxidant defence system. In this study, we aimed to evaluate the effects of ECT on oxidative stress. METHODS: Fourteen major depression, 11 schizophrenia and 8 bipolar affective disorder patients diagnosed and received ECT treatment, and 37 healthy volunteers enrolled in the study. ECT was applied to all patients. Before ECT, after the first and last ECTs, serum samples were obtained. Serum total antioxidant status (TAS), total oxidant status (TOS), and calculated oxidative stress index (OSI) were measured in patients before and after ECTs. RESULTS: TOS values before ECT were higher in major depression (p=0.005) and schizophrenia (p=0.001) groups compared to the control group. TAS values were lower in major depression (p=0.0001), schizophrenia (p=0.004), bipolar affective disorder (p=0.004) groups compared to the controls. Also OSI values were higher in major depression (p=0.0001), schizophrenia (p=0.001), bipolar affective disorder (p=0.009) groups compared to healthy group. After the last ECT, TOS values were significantly lower compared to TOS values before ECT in major depression (p=0.004) and schizophrenia patients (p=0.004). TAS values after the first ECT were higher compared to values before ECT in major depression patients (p=0.004). After last ECT, OSI values were significantly lower compared to before ECT in schizophrenia patients (p=0.006). CONCLUSION: As a result, it can be said that ECT did not increase oxidative stress. However, further studies with more patients are needed.
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OBJECTIVE: We investigated the relationship between serum bilirubin levels and metabolic syndrome (MetS), and the longitudinal effects of baseline serum bilirubin concentrations on MetS in patients with schizophrenia spectrum disorders undergoing atypical antipsychotics. METHODS: The sample of this study consisted of 131 patients with schizophrenia spectrum disorders. Waist circumference, blood pressure, and levels of triglycerides, high-density lipoprotein cholesterol, fasting glucose, and insulin were evaluated at baseline and at month six. Serum bilirubin levels were measured at baseline. Serum bilirubin levels of the patients with and without MetS criteria were compared. We also compared patients with high and low bilirubin levels (upper and lower 50th percentiles of serum bilirubin levels) in terms of MetS criteria, MetS frequency, and course of MetS. RESULTS: Serum direct bilirubin levels were more consistently related to MetS and MetS-related variables. The waist circumference and triglyceride criteria for MetS were significantly related to low serum direct bilirubin at baseline; waist circumference and fasting glucose criteria, and insulin resistance were associated with low serum direct bilirubin at follow-up. MetS diagnosis and the presence of the waist circumference criterion were more frequent at the baseline and the follow-up in low bilirubin group. At the end of the follow-up period, the rate of reverse MetS was significantly higher in the high bilirubin group. CONCLUSION: Our results have suggested that serum direct bilirubin levels showed a more reliable and stable relationship with abdominal obesity for MetS components.in patients with schizophrenia spectrum disorders using antipsychotics. Further studies are required.
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Nitric oxide (NO) has been implicated to play a role in the pathogenesis of many neuropsychiatric disorders. NO level was found high in acute manic inpatients. In this study, we aimed to assess NO level and activity of the antioxidant enzyme, superoxide dismutase (SOD), in euthymic bipolar patients. Twenty-seven patients with bipolar disorder (BD) in euthymic phase, and 20 healthy volunteers were included in this study. A semi-structured form was used to note social, demographic and clinical parameters of the patients. NO level and SOD activity were studied in the serum samples obtained from the patients and controls. The mean serum NO level in BD was significantly higher than in controls. Mean serum SOD activity was found to be elevated in patients with BD compared to controls. Total number of the manic episodes correlated with NO levels, but not with SOD activity. In conclusion, the number of manic episodes is positively associated with NO levels. NO and SOD appear to have a pathophysiological role in BD, especially in Type I euthymic phase, and may be considered an available trait marker for BD.
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Transtorno Bipolar , Óxido Nítrico/sangue , Superóxido Dismutase/sangue , Adolescente , Adulto , Idoso , Antioxidantes/fisiologia , Transtorno Bipolar/sangue , Transtorno Bipolar/fisiopatologia , Transtorno Bipolar/psicologia , Demografia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Seguimentos , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo/fisiologia , Índice de Gravidade de Doença , Fatores de TempoRESUMO
OBJECTIVE: Electroconvulsive therapy (ECT) can be given as the form of acute, continuation or maintenance ECT according to the process of administration. We report our 7 years' observation with acute and maintenance ECT in a university hospital in Turkey. METHODS: The medical records of the hospitalized patients treated with acute or maintenance ECT between the years 2007 and 2013 was retrospectively analyzed. The sociodemographic characteristics, diagnosis, data of ECT and the co-administered psychotropic drugs were recorded. The frequency of ECT was calculated by identifying the total number of the hospitalized patients during the study period from the hospital records. RESULTS: A total number of 1,432 female and 1,141 male patients hospitalized in a period of 7 years, with a total number of 111 patients treated with ECT. The ratio of ECT was 4%, maintenance/acute ECT 11%. For acute ECT, affective disorders (65.3%) and psychotic disorders (21.6%) were among the leading diagnoses. Maintenance ECT, the diagnosis was; 6 affective disorders, 4 psychotic disorders and 1 obsessive compulsive disorder. There was a significant difference between the patients receiving acute and maintenance ECT in terms of age, duration of illness, and number of previous hospitalizations and ECTs. CONCLUSION: The percentage of patients treated with acute ECT is lower in our institution than that in many other institutions from our country. Acute and maintenance ECT should be considered as an important treatment option particularly for patients with long disease duration, a high number of hospitalizations and a history of benefiting from previous ECTs.
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There are some studies in attention deficit hyperactivity disorder (ADHD) which note altered circadian rhythms, suggesting abnormalities in melatonin physiology. In order to better characterize the possible melatonin alteration in ADHD, in this study we aimed to detect daytime, nighttime and 24 h levels of 6-hydroxymelatoninsulfate (6-OH MS) in the patients diagnosed with ADHD. Twenty-seven patients between 6 and 16 years-old, who had been diagnosed initially with ADHD, but without other physical and psychiatric disease history and who had not taken psychotropic pharmacotherapy for six months, plus 28 healthy volunteer controls, were included in the study. Urine samples were collected during the whole 24 h cycle, daytime and nighttime separately to assess the time-dependent excretion of the 6-OH MS, which is the main urine metabolite of melatonin. The Enzyme-Linked Immunosorbent Assay (ELISA) method was used for measuring the urine 6-OH MS level. Daytime (15.4 (8.9-24.8) ng/ml vs 6.9 (2.5-15.9) ng/ml, p=0.002), nighttime (102.9 (65.3-197.7) ng/ml vs 61.5 (37.2-114.4) ng/ml, p=0.012) and 24 h (54.1 (34.6-83.9) ng/ml vs 27.3 (14.3-48.9) ng/ml, p=0.000) 6-OH MS levels median (25p-75p) were found to be significantly higher in the ADHD group. After adjustment for age and sex, there was a statistically significant difference between the ADHD group (59.8 ± 4.9) and control group (33.8 ± 4.8) in 24-h 6-OH MS levels (F(1, 51)=13.673, p=.001, partial η2=.211). There was no relationship between 6-OH MS levels and Conners Parent Rating Scale short form subscale scores for the ADHD group. These findings indicate that melatonin production is increased in ADHD cases. Further research is needed to determine and thereby understand the mechanisms underlying the higher melatonin production, to assess the impact of altered melatonin on the pathophysiology of ADHD.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/urina , Melatonina/análogos & derivados , Adolescente , Estudos de Casos e Controles , Criança , Ritmo Circadiano , Feminino , Humanos , Masculino , Melatonina/urinaRESUMO
The aim of the study was to determine the differences between expression levels of certain miRNAs, as their association with schizophrenia has been well presented in the literature, and to investigate their relation to treatment resistance in schizophrenic patients. Three groups were formed: 1) treatment-resistant group, 2) treatment responsive group and 3) healthy control group. Expression levels of miRNAs from peripheric blood samples were determined by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). We investigated the roles of 29 schizophrenia-related miRNAs in schizophrenia treatment and their potentials to be considered as indicators. Among these miRNAs, only miR-181b-5p, miR-195-5p and miR-301a-3p expressions were found to be significantly different between the treatment-resistant group and the group responding well to the treatment. miRNAs may cause resistance by silencing the receptor genes of the drugs used for schizophrenia treatment. miR-181b-5p, miR-195-5p and miR-301a-3p may be candidate indicators that can be used to reveal resistance against schizophrenia treatment.