Investigation of Cognitive Distortions in Panic Disorder, Generalized Anxiety Disorder and Social Anxiety Disorder.

The aim of this study was to determine the main cognitive distortions observed in panic disorder (PD), generalized anxiety disorder (GAD) and social anxiety disorder (SAD) and to investigate the impact of cognitive distortions on diagnoses, depression levels, disorder type and severity of anxiety. This study consisted of 150 clinical (50 PD, 50 GAD, 50 SAD) and 91 healthy control participants. A sociodemographic data form, the Beck Depression Inventory (BDI), the Dysfunctional Attitudes Scale (DAS), the Cognitive Distortions Scale (CDS) and the State-Trait Anxiety Inventory (STAI) scales were administered to all participants. It was found that cognitive distortions were higher in individuals with PD, GAD and SAD. The PD, SAD and GAD groups were similar for "catastrophizing", "mindreading", "all or nothing thinking", "overgeneralization", "should statements" and "emotional reasoning". "Personalization", "labeling" and "minimizing or disqualifying the positive" were observed at a higher severity in the SAD group compared to the PD group, and "mental filter" was observed at a higher severity in the GAD group compared to the PD group. Our findings emphasize the need to address cognitive distortions in PD, GAD and SAD treatment. The evaluation of cognitive distortions specific to anxiety disorders is significant in guiding therapy goals and pioneering new research.

A Neuroleptic Malignant Syndrome Without Rigidity.

Neuroleptic malignant syndrome (NMS) is an uncommon but potentially lethal idiosyncratic reaction which may emerge in the aftermath of the treatments with neuroleptics demonstrating itself with the symptoms of altered consciousness, high fever, impaired autonomic functions, and muscle rigidity. Although various risk factors have been identified for NMS, its etiology is not completely known. The mortality and morbidity related with NMS could be reduced by early diagnosis, interruption of the neuroleptics used within a short period and aggressive treatment. Our case is different from general NMS cases due to lack of rigidity. A NMS case which developed within a short time in the aftermath of multiple antipsychotic use and wherein no rigidity was observed shall be discussed in this case report.

The relationship between theory of mind and insight in obsessive-compulsive disorder.

BACKGROUND: It is known that obsessive-compulsive disorder (OCD) patients with poor insight display more severe neuropsychological impairments than other patients with OCD. There are limited studies of OCD and theory of mind (ToM). AIM: To investigate ToM skills in patients with OCD and the relationship between insight and ToM skills by comparing OCD patients with good and poor insight. METHODS: Eighty patients with OCD and 80 healthy controls completed the structured clinical interview for DSM-IV axis I disorders, the Yale Brown Obsessive-Compulsive Scale, the Beck Anxiety and Beck Depression Inventories, and the Brown Assessment of Beliefs Scale. To assess ToM skills, first- and second-order false-belief tests, a hinting test, a faux pas test, a reading the mind in the eyes test, and a double-bluff test were administered. RESULTS: Patients with OCD had poorer ToM abilities than healthy controls. All ToM scores were significantly lower in the poor insight group than in the good insight group (p < .001). A significant negative correlation was found between the BABS-total scores and all the ToM test mean scores (p < .05). CONCLUSIONS: The finding of significantly lower ToM skills in OCD with poor insight than in OCD with good insight may contribute to the idea of OCD with poor insight being a subtype with different clinical and neuropsychological characteristics.

The role of alpha1-adrenoceptor and arachidonate pathways in increased tone of demucosalized bladder tissue.

PURPOSE: We investigated the role of the alpha1-adrenoceptor system, and cyclooxygenase and lipoxygenase pathways in increased contractile reactivity of demucosalized bladder tissues. MATERIALS AND METHODS: A total of 20 male Sprague-Dawley rats were used. From each bladder 2 tissue strips were prepared. One strip was demucosalized, while the other was kept intact. Isometric tension studies were done at baseline tone with contractile responses assessed to 120 mM potassium, electrical field stimulation (1 to 40 Hz) and carbachol (10(-9) to 10(-4) M). Relaxation responses to electrical field stimulation, isoproterenol (10(-9) to 10(-4) M), papaverine (10(-4) M) and sodium nitroprusside (10(-4) M) were recorded in carbachol precontracted strips. The effects of doxazosin, the cyclooxygenase inhibitor indomethacin and the lipoxygenase inhibitor REV5901 (each 3 x 10(-5) M) on these responses were investigated. RESULTS: Carbachol and electrical field stimulation induced significantly greater contractions in demucosalized strips. All contractile responses were significantly decreased in the presence of doxazosin, indomethacin and REV5901 in intact and demucosalized tissues. Indomethacin augmented the effect of doxazosin on demucosalized tissue contractions compared to results obtained with doxazosin alone. In carbachol precontracted tissues relaxation responses to isoproterenol and electrical field stimulation were significantly lower in demucosalized tissues. These responses were significantly decreased with doxazosin or indomethacin independent of mucosa. CONCLUSIONS: Bladder mucosa is a determinant of rat bladder tissue contractility. Doxazosin, and cyclooxygenase and lipoxygenase pathways significantly affect rat bladder tissue contractility independent of mucosa. However, the effect of doxazosin is significantly amplified by cyclooxygenase inhibition in the absence of bladder mucosa. These findings may have important clinical implications regarding the single and combined use of doxazosin with cyclooxygenase inhibitors.

Determining the relation between N-acetyltransferase-2 acetylator phenotype and antituberculosis drug induced hepatitis by molecular biologic tests.

Tuberculosis is treated with a group of drugs that need to be used over a long period of time and isoniazid is the major drug in this group. Antituberculosis drug-induced hepatitis is the most serious problem in tuberculosis treatment. The enzyme N-acetyltransferase-2 (NAT-2) metabolizes isoniazid in the liver so it is considered to cause hepatotoxicity. The association of polymorphic NAT acetylator status and antituberculosis drug-induced hepatitis is discussed. To determine whether acetylator status is a risk factor for antituberculosis drug-induced hepatitis, we genotyped NAT2*5A, NAT2*6A, NAT2*7A/B and NAT2*14A polymorphisms in 100 patients diagnosed with tuberculosis. 70 patients who did not develop hepatotoxicity were classified as the control group, and 30 patients who were diagnosed with antituberculosis drug-induced hepatitis were classified as the study group. NAT2 polymorphisms were divided into three phenotypic groups according to the analytical results obtained. Among the 70 patients constituting the control group; 14 (20%), 37 (52.9%), 19 (27.10%) patients were rapid, intermediate and slow acetylators respectively. In contrast, among the patients constituting the study group; 3 (10%), 4 (13.3%), 23 (76.7%) patients were rapid, intermediate and slow acetylators. The difference was statistically significant when the control and study groups were compared for their acetylator status. The proportion of slow acetylators was much higher in the study group. In conclusion, NAT2 acetylator phenotype analysis by molecular biology methods prior to medical treatment for tuberculosis, can be used both for determining the high-risk group of patients who may develop hepatotoxicity and for closer follow-up during treatment period.