How Do Cannabis and Synthetic Cannabinoids Affect Neurocognitive Functions? / Esrar ve Sentetik Kannabinoidler Nörobilissel Islevleri Nasil Etkiler?

OBJECTIVE: In this study, the losses of neurocognitive function caused by the use of cannabis and synthetic cannabinoid were studied on specific cognitive areas (attention and working memory, executive functions, visuospatial perception, learning and memory, planning and problem solving, word naming) and were described in comparision with healthy controls (control group). METHOD: In this study, while 52 participants who applied to Ege University Faculty of Medicine Department of Mental Health and Mental Disorders Drug Addiction Treatment Center Clinic between March 2015 - February 2017 and used cannabis at least for one year in the past and 51 participants who used synthetic cannabinoids for at least one year in the past were participant groups with a history of substance use; 57 staff/student of Ege University with no history of any substance use were participants of the control group. The research sample consisted of 160 participants. The sample group consisted of 160 men aged 18-35, and also 16 participants aged 36-54 were involved in the study in order to observe neuropsychological functions that changed with age. Stroop Test for attention area, Raven Standart Progressive Matrices Test for executive functions area, Line Orientation Test and Cancellation Test for visuospatial perception area, Serial Digit Learning Test and Öktem Verbal Memory Progresses Scale for learning and memory area, The Tower of London Test for planning and problem solving skill, Boston Naming Test for word naming area were used. RESULTS: In this study, while the lowest perfomance on the ability of focused attention, visuospatial cognition, visual scanning, orientation, sustained attention, general ability, short-term memory, learning, long-term memory, word naming was shown by the participants with a history of synthetic cannabis use, the participants with a history of cannabis use had the lowest performance on the ability of response rate, perseveration, conceptualizing, abstract thinking, changing sets, recognition. Participants' history of substance use did not affect the ability of planning and problem solving. CONCLUSION: In conclusion, this study suggests that the addition of cognitive rehabilitation programs to medical and psychosocial improvement studies carried out in the field of addiction will increase the success.

HBsAg, Anti-HCV and Anti-HIV Seroprevalance Among Drug Users: a Retrospective Assessment.

INTRODUCTION: Drug abuse and co-occurring infections are associated with significant morbidity and mortality. In regions with high rates of drug usage, infections like hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are highly prevalent. Epidemiological studies on HBV, HCV and HIV infections among users of illicit drugs are scarce in Turkey. The primary aim of this cross-sectional and retrospective study was to determine the hepatitis B surface antigen (HBsAg), anti-HCV antibody (anti-HCV) and anti-HIV antibody (anti-HIV) seroprevalences in drug users who applied to a psychiatric outpatient clinic of drug addiction of a university hospital. Secondarily, the assessment of HBsAg, anti-HCV and anti-HIV parameters among intravenous drug users was aimed. METHODS: Serum samples of all patients on probation who applied to a psychiatric outpatient clinic of drug addiction of a university hospital between 2013-2017 and sent to the department of medical microbiology for routine serologic testing were included in the study. The serologic results were obtained retrospectively from laboratory records. For the statistical analysis of the data IBM SPSS 20.0 program was used. RESULTS: Among the studied individuals, the ELISA results demonstrated the existence of HBsAg, anti-HCV and anti-HIV in 94 out of 4357 patients (2.2%), 27 out of 4451 patients (0.6%) and 10 (0.2%) out of 4464 patients, respectively. According to the records, 17 of the patients reported intravenous drug usage. Among this patient group, three patients were found to be anti-HCV positive and one patient was found to be anti-HIV positive. CONCLUSION: In our study, the prevalence of HCV and HIV was increased in patients with intravenous drug usage, whereas in non-intravenous drug users the prevalence is similar to the normal population. In order to plan prevention and harm reduction services for this high-risk population, more national data is needed on HBV, HCV and HIV rates among this group.

[Severity of Alcohol Dependence Questionnaire: Validity and Reliability of the Turkish Version]. / Alkol Bagimliligi Siddeti Ölçegi: Türkçe Formunun Geçerlik ve Güvenirligi.

OBJECTIVE: The aim of the study is to determine the validity and reliability of Turkish version of Severity of Alcohol Dependence Questionnaire (SADQ) developed by Tim Stockwell and colleagues in 1983 for the purpose of evaluating the severity of dependence in people with alcohol use disorder. METHOD: The present study was conducted with an adult sample of 200 participants with alcohol use disorder according to DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) who applied to Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science. Regarding validity analysis, item-total score correlation coefficients and principal component analysis were calculated. The scale was compared with Michigan Alcoholism Screening Test (MAST). Reliability analysis was performed with internal consistency reliability and test-retest reliability. RESULTS: Considering the internal consistency reliability of scale, Cronbach's Alpha Reliability Coefficient was found to be α=0.914. Item and Total Score Correlation Coefficients of the scale items were found between 0.309 and 0.730 (p<0.01). The mean test-retest scores of the scale and its sub-dimensions were calculated with t-test for dependent groups and the difference was not statistically significant. Testretest correlation coefficient of the scale was found 0.855 (p<0.01). Exploratory factor analysis explained 70.5% of the total variance and four sub-dimensions were identified. Factor loadings of these sub-dimensions were estimated between 0.49-0.91. The correlation between SADQ and MAST was statistically significant (r=0.557, p<0.01). CONCLUSION: The results of this study suggest that the Turkish version of the SADQ with four sub-dimensions is a reliable and valid instrument in determining severity of alcohol dependence.

TPH1 A218 allele is associated with suicidal behavior in Turkish population.

BACKGROUND: Serotonergic dysfunction is implicated in depression, psychiatric disorders and suicidal behaviors. The first and rate-limiting step in the synthesis of serotonin is catalyzed by tryptophan hydroxylase (TPH) which is encoded by TPH1 and THP2 genes. Genetic association studies have revealed contradictory results about the effect of the TPH1 A218C (rs1800532) polymorphism on suicidal behavior in different populations. MATERIAL AND METHOD: In this study, we investigated A218C polymorphism in 109 suicide attempters and 98 healthy controls. Socio-demographic characteristics of participants were obtained through questionnaire. DNA was extracted from peripheral blood and genotyping was performed by Real Time PCR. Fisher's exact test was used to evaluate the significance of the difference among the independent variables. Hardy-Weinberg equilibrium was tested using Pearson's goodness-of-fit chi-squared test. RESULTS: The frequency of A allele was significantly higher in suicide attempters than controls (46.33% vs. 35.71%, p=0.0357). However, there were no differences in genotype frequencies of this locus between participants having attempted suicide and controls (p>0.05). Among males, frequencies of CC genotype and C allele were found to be significantly higher in controls (p=0.0125, p=0.0298). With regard to the female subjects and female controls, no significant association was detected between suicidal behavior and genotype/allele frequencies (p>0.05). CONCLUSION: Our results provide evidence that A allele of TPH1 A218C polymorphism may be associated with suicidal behavior in Turkish population.

[Pregabalin Dependence: A Case Report]. / Pregabalin Bagimliligi: Olgu Sunumu.

Pregabalin is a new generation antiepileptic that exerts its effect by decreasing the release of such neurotransmitters as glutamate, noradrenaline, and substance P. Pregabalin can be prescribed in Turkey at 150-600 mg to treat neuropathic pain, generalized anxiety disorder, and fibromyalgia, and as concomitant therapy in adult patients with partial epilepsy. Experimental studies have shown that pregabalin could be beneficial in the treatment of benzodiazepine dependence and withdrawal, as well as for relapse prevention in patients with alcohol dependence. Nonetheless, the number of case reports on the abuse potential of pregabalin has increased. Herein we present a patient with pregabalin dependence. The patient’s underlying alcohol and polysubstance dependence, and symptoms of generalized anxiety were thought to contribute to the development of pregabalin dependence. The patient reported that he had experienced severe withdrawal symptoms when he tried to stop using pregabalin. Bupropion and low-dose quetiapine were added to his paroxetine treatment, and pregabalin was discontinued gradually. Following this treatment the patient had not exhibited any signs of pregabalin dependence for one month. Although pregabalin is a promising drug for various psychiatric disorders, it should be used carefully in patients with a history of substance dependence.