Relationship Between Sleep Disorders and Attention Deficit- Hyperactivity Disorder Symptoms in University Students. / Üniversite Ögrencilerinde Uyku Bozuklugu ile Dikkat Eksikligi Hiperaktivite Bozuklugu Belirtileri Arasindaki Iliski.

OBJECTIVE: Sleep disorders increase the symptoms of attention deficit hyperactivity disorder (ADHD). The aim of this study was to investigate whether or not sleep related problems give rise to symptoms of attention deficit and hyperactivity-impulsivity in university students. METHODS: The 252 university students between the ages of 18-25 years included in the study were assessed on the Pittsburgh Sleep Quality Index (PSQI), the Adult Attention-Deficit Hyperactivity Disorder Scale, the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). RESULTS: The participants of the study comprised 38.5% males and 61.5% females with a mean age of 22.39 (±1.93) years. The mean score data were 5.78 (± 2.72) on the PSQI, 41.77 (± 20.38) on the Adult Attention-Deficit Hyperactivity Disorder Scale, 8.53 (± 6.97) on the BDI and 9.05 (± 7.92) on the BAI. The total score and the scores on the attention-deficit and the general problems subsections of the Adult Attention-Deficit Hyperactivity Disorder Scale were significantly higher in participants with poor sleep quality (P<0.001). The PSQI and the Adult Attention-Deficit Hyperactivity Disorder Scale scores were significantly above the cut-off values in the participants with depression and anxiety symptoms as compared to those without these symptoms (P<0.001). The PSQI total score positively correlated with the Adult Attention-Deficit Hyperactivity Disorder Scale total score (P<0.001). CONCLUSION: University students with sleep disorder have more ADHD symptoms and poor quality of sleep increase ADHD sypmtoms. Therefore it's important to evaluate quality of sleep in young people suffering from attention problems in terms of treatment approaches and interventions.

Blood levels of interleukin-1 beta, interleukin-6 and tumor necrosis factor-alpha and cognitive functions in patients with obsessive compulsive disorder.

BACKGROUND: Cognitive dysfunction and immune system disorders are two actual issues for the patients with Obsessive Compulsive Disorder (OCD). The cognitive dysfunctions have been considered to substantial part of clinical phenomenon of OCD but exploration of various etiopathogenesis of cognitive dysfunction is needed. Immune dysfuncion has been implicated to be important part of pathopysiology of OCD and different lines of evidence suggests immune abnormalities in OCD. But whether these immune changes are traits of disease or secondary to clinical burden of the disease such as cognitive dysfunctions has not been determined. Data regarding relation between the cognitive dysfunctions and immune system disorders in OCD is unsatisfied. In this study we aimed to investigate the relation of blood levels of interleukin 1-beta (IL-1ß), interleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α) with various neurocognitive functions in patients with OCD in comparison with its autogenous/reactive subtypes and healthy controls. Further exploration of the effects of various clinical variables on cognitive functioning in patients with OCD and additional investigation of whether the cognitive dysfunction associated with this disorder differs from or overlap with that in other anxiety disorders are needed. METHODS: Forty-two patient with OCD and 45 age, sex and educational level matched healthy control were enrolled in the study. The diagnosis of OCD was made with Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Yale- Brown Obsessive-Compulsive Scale, Beck Anxiety and Depression Inventory Scales were administered. Neuropsychological test battery including Wisconsin Card Sorting Test (WCST), Trail Making Test A and B (TMT-A, TMT-B) were used for evaluation of the patients and healthy control. The plasma of interleukin-1beta (IL-1ß), interleukin-6 (IL-6), Tumor Necrosis Factor-Alpha (TNF-α) of both groups were measured with ELISA kits. RESULTS: Blood levels of IL-1ß, IL-6 and TNF-α were significantly higher in patients with OCD than the healthy control. There was significant difference in IL-1ß, IL-6 but not in TNF-α between autogenous/reactive subtypes and healthy controls. TNF-α is positively correlated with TMT-A, TMT-B and Stroop Test Part 5, negatively correlated with immediate memory, verbal learning, interference effect, immediate recall, delayed recall and recognition in RAVLT. IL-1ß was positively correlated with TMT-A score. IL-6 was positively correlated with scores of TMT-A, TMT-B. IL-6 was negatively correlated with immediate memory, verbal learning, interference effect, immediate recall and delayed recall in RAVLT, positively correlated with number of perseverative error and negatively correlated with the number of categories completed in WCST. CONCLUSION: This is the first study that investigates the relation of IL- 1ß, IL-6 and TNF-α levels with cognitive functions in OCD. There may be a contribution to pathogenesis of OCD and subtypes then new choices for treatment might be developed. Moreover, uncovering the effect of cytokine blood levels on cognitive function of OCD, new data concerning etiopathogenesis and further treatment choices can be gained.

Schizophrenia and Bipolar Affective Disorder: a Dimensional Approach.

AIM: Schizophrenia (SCH) and bipolar affective disorder (BAD) are currently classified separately according to the DSM (The Diagnostic and Statistical Manual of Mental Disorders) and ICD (International Statistical Classification of Diseases and Related Health Problems) standardized diagnostic guidelines. However, the validity of this categorical approach is controversial because psychotic symptoms may be observed in both diagnoses. The purpose of this study was to compare the clinical and social characteristics in a sample group consisting of patients diagnosed with SCH or BAD to help demonstrate the basic difficulty in the current classification of SCH and BAD as two etiologically distinct diseases. SUBJECTS AND METHODS: The study sample group consisted of 102 patients diagnosed with SCH and 92 patients diagnosed with BAD. All of the participants were evaluated by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition with regard to beginning symptoms of the disease, the symptoms and signs of active disease period within total disease duration, continuining residual symptoms in intermediate period. The patients were administered the Positive and Negative Syndrome Scale, the Quality of Life Enjoyment and Satisfaction Questionnaire and the Social Functioning Scale. RESULTS: The SCH and BAD groups in this study were statistically similar in terms of sex, length of education, age at disease onset, attempted suicide, quality of life and social functioning. CONCLUSION: Our study findings indicated that the course of disease in patients with BAD-1, in which psychotic features predominate and which exhibits a recurring course, shares various characteristics with SCH. It can be concluded that further phenomenological and neurobiological evaluations are required for intermediate cases with similiar clinical characteristics with schizophrenia and bipolar disorders.

A retrospective analysis of cases with neuroleptic malignant syndrome and an evaluation of risk factors for mortality.

OBJECTIVE: Neuroleptic malignant syndrome (NMS) is a neurological emergency rarely encountered in clinical practice but with a high mortality rate. Cases associated with atypical antipsychotic use or termination of dopamine agonists have been seen in recent years. The purpose of this study was to assess the presence of risk factors for mortality by investigating all clinical and laboratory characteristics of cases with NMS. MATERIAL AND METHODS: This descriptive, cross-sectional study retrospectively investigated all clinical and laboratory characteristics by scanning the ICD-10 codes of patients presenting to the XXXX Faculty of Medicine Emergency Department and diagnosed with NMS between 2006 and 2016. Patients were divided into surviving and non-surviving groups, and the data elicited were subjected to statistical comparisons. RESULTS: The mean age of the 18 patients diagnosed with NMS was 46.9 ± 4.8 years, and 50% were women. In addition to antipsychotics among the drugs leading to NMS, the syndrome also developed as a result of levodopa withdrawal in three patients and metoclopramide use in one patient. Statistically significant differences were determined between the surviving and non-surviving patients in terms of blood pressure, blood urea nitrogen (BUN), creatine kinase (CK) and mean platelet volume (MPV) values (p ≤ 0.05). CONCLUSION: In this study the most common agent that cause NMS was atypical antipsychotics. Also advanced age, increased blood pressure and serum CK, BUN and MPV values were identified as potential risk factors for mortality in NMS.