MicroRNA dysregulation in manic and euthymic patients with bipolar disorder.

BACKGROUND: Bipolar disorder (BPD) is a major psychiatric disorder with an unclear pathophysiology. Peripheral blood samples are easily drawn, making them are good candidates for diagnosing diseases. MicroRNAs are small non-coding RNA transcripts that regulate gene expression by binding to the 3'- UTR of mRNAs and directing their degradation. The aim of this study was to use blood plasma to investigate microRNA dysregulations in bipolar manic and euthymic patients. SUBJECTS AND METHODS: Blood samples were collected from 58 patients with bipolar I disorder (19 manic, 39 euthymic) and 51 healthy controls. RESULTS: Four microRNAs (miR-29a-3p, p = 0.035; miR-106b-5p, p = 0.014; miR-107, p = 0.011; and miR-125a-3p, p = 0.014) were upregulated in the entire bipolar group, compared to the healthy controls. Seven microRNAs (miR-9-5p, p = 0.032; miR-29a-3p, p = 0.001; miR-106a-5p, p = 0.034; miR-106b-5p, p = 0.003; miR-107, p < 0.001; miR-125a-3p, p = 0.016; and miR-125b-5p, p = 0.004) were more upregulated in bipolar manic patients compared to the healthy controls, and two microRNAs (miR-106a-5p, p = 0.013, and miR-107, p = 0.021) showed statistically significant upregulation in the manic patients compared to the euthymic patients. CONCLUSIONS: Our results showed greater miRNA dysregulation in the manic patients than in the euthymic patients. Two microRNAs could be more selective for bipolar manic episodes. Future studies should include depressive patients along with euthymic and manic patients.

Increased Neutrophil-lymphocyte and Platelet-lymphocyte Ratios in Male Heroin Addicts: A Prospective Controlled Study.

OBJECTIVE: The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are markers that can determine the presence of systemic inflammatory response. In this study, we examined the NLR and PLR levels in patients with heroin dependence compared to healthy controls. METHODS: The study sample included 90 male patients with heroin dependence aged 18 to 45 years and 60 healthy subjects who had similar socio-demographic characteristics as the patient group. The diagnoses of heroin dependence and other Axis I psychiatric disorders in the patient and control groups were screened with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I). The extent of heroin addiction was assessed with the Addiction Severity Index (ASI). RESULTS: The mean NLR and PLR levels of patients with heroin dependence were significantly higher than the control subjects (p=0.031 and p<0.001, respectively). Positive correlations were found between NLR, PLR and duration of the disorder. CONCLUSION: Our results indicate that inflammatory processes may play a role in the pathophysiology of heroin dependence.

Evaluation of Oxidant/Antioxidant Status and Cytokine Levels in Patients with Cannabis Use Disorder.

OBJECTIVE: Cannabis is the most commonly used illegal drug in the world and it has several adverse effects such as anxiety, panic reactions and psychotic symptoms. In this study, we aimed to evaluate oxidant, anti-oxidant status and cytokine levels in individuals with cannabis use disorder. METHODS: Thirty-four patients with cannabis use disorder and 34 healthy controls were enrolled to the study. Serum total antioxidant status, total oxidant status and cytokine levels were investigated in patients with cannabis use disorder and healthy controls. RESULTS: We found increased levels of total oxidant status, oxidative stress index and interleukin (IL) 1ß, IL-6, IL-8, and tumor necrosis factor (TNF) α in individuals with cannabis dependency compared to healthy people. When we compared total antioxidant status, IL-12, and interferon (IFN) γ levels, there were no differences in both groups. There was positive correlation between IL-6 and total oxidant status, oxidative stress index levels. CONCLUSION: The oxidative balance of individuals with cannabis use disorder was impaired and they had higher levels of IL-1ß, IL-6, IL-8, and TNF-α, which is a pro-inflammatory cytokine and indicates increased inflammation compared to healthy controls. Thus, these findings suggest that cannabis increased inflammation and impaired the oxidative balance.

Bilateral Pretibial Edema Associated with Paliperidone Palmitate Long-acting Injectable: A Case Report.

Peripheral edema is observed as an adverse effect of the usage of antipsychotics in the literature. This case report describes a 36-year-old female patient with the diagnosis of paranoid schizophrenia who presented with pretibial edema following initiation of long-acting injectable paliperidone palmitate. Pretibial edema developed within the second week of treatment and completely disappeared after its discontinuation.

Homocysteine Levels and Oxidative Stress Parameters in Patients With Adult ADHD.

OBJECTIVE: In our study, we aimed to evaluate the plasma homocysteine levels and oxidative stress parameters in patients with adult ADHD (A-ADHD). METHOD: Blood samples were taken from 32 A-ADHD patients and 32 controls enrolled in the study and plasma homocysteine, serum folate, vitamin B12, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were determined. Results were compared between the groups. RESULTS: Patients' plasma homocysteine level was significantly lower and serum folate level was significantly higher than the controls. The means of plasma homocysteine and folate levels were statistically significantly different between the groups ( p < .05). However, a statistically significant difference was not detected between groups for mean serum vitamin B12, TAS, TOS, and OSI levels ( p > .05). CONCLUSION: Our study suggests that oxidative balance is not impaired in A-ADHD, and contrary to other psychiatric disorders, homocysteine levels were found to be lower.

Investigation of Dysregulation of Several MicroRNAs in Peripheral Blood of Schizophrenia Patients.

OBJECTIVE: The prevalence of schizophrenia is 1%, and it is a debilitating disorder that often results in a shortened lifespan. Peripheral blood samples are good candidates to investigate because they can be easily drawn, and they are widely studied in psychiatric disorders. MicroRNAs are small non-coding RNA transcripts. They regulate the expression of genes by binding to the 3'-untranslated region (UTR) of mRNAs and pointing them to degrade. In this study, we aimed to investigate the expression of miR-9-5p, miR-29a-3p, miR-106-5p, miR-106b-5p, miR-107, miR-125a-3p, and miR-125b-3p in schizophrenia patients and healthy controls. METHODS: We collected blood samples from 16 patients with schizophrenia and 16 healthy controls. MicroRNAs were measured with reverse transcriptase polymerase chain reaction. RESULTS: Schizophrenia patients showed statistically significant upregulation of five microRNAs: miR9-5p (p=0.002), miR29a-3p (p＜0.001), miR106b-5p (p=0.002), miR125a-3p (p＜0.001), and miR125b-3p (p=0.018). CONCLUSION: Our results increased the value of the miR106 and miR29 families as potentially and consistently dysregulated in psychiatric disorders. Our results should be considered preliminary, and they need confirmation in future studies with larger sample sizes.

Quality of life in patients with chronic venous disease in Turkey: influence of different treatment modalities at 6-month follow-up.

PURPOSE: The main purpose of this study was to evaluate the influence of any of the four domains of the QoL score in CVD patients of classes C0-C4 and to analyze the correlation between the QoL and types of treatment modalities, and an additional aim of the present study was to compare QoL levels of patients with CVD and healthy participants and was to examine the factors associated with QoL in CVD patients. METHODS: The sample was composed of 501 patients with primary superficial venous reflux (28.5 % male and 71.5 % female) who answered 100 % of the questions in the World Health Organization Quality of Life (WHOQoL-BREF) questionnaire. After a clinical and duplex examination, the patients were categorized as C0-C4, according to the CEAP classification. The relationships between WHOQoL-BREF domains and gender, age, occupation, BMI, the clinical classes of the CEAP classification and four different treatment modalities according to guideline were analyzed. RESULTS: For the WHOQOL-BREF test battery, the patients with CVD had worse values, as compared with the control group participants. The differences were significant for the physical (77.81 ± 12.75 vs. 59.18 ± 12.90, p < 0.001), the psychological (74.78 ± 11.37 vs. 60.21 ± 14.70, p < 0.001), the social relationships (76.56 ± 13.56 vs. 63.07 ± 21.37, p < 0.001) and the environmental (70.27 ± 13.36 vs. 50.16 ± 11.39, p < 0.001) health scores. The patients with CVD had worse WHOQOL-BREF scores at initial, compared with the 6-month follow-up scores. CONCLUSION: This study shows that in spite of undergoing therapy, the subsequent QoL scores did not improve significantly, indicating that CVD continued to negatively affect the patient's life.

Increased S100B Levels in Cannabis Use Disorder.

BACKGROUND: It has been determined that cannabis has adverse effects on brain tissue, and that increased S100 calcium binding protein B (S100B) blood levels are markers of neuronal damage. Therefore, the aim of this study was to evaluate the S100B levels in cannabis use disorder. METHOD: Thirty-two patients with cannabis use disorder and 31 matched healthy controls were enrolled in this study. Appropriate blood samples were taken from the enrolled subjects, and the serum S100B protein levels were measured with an electrochemiluminescence immunoassay for the quantification of the protein. FINDINGS: We found significantly increased S100B protein levels in patients with cannabis use disorder. The mean serum concentration of S100B was 0.081 ± 0.018 µg/l in patients with cannabis use disorder, and 0.069 ± 0.018 µg/l in the control group (p = 0.008). INTERPRETATION: Our data suggest that elevated S100B protein levels might indicate neuronal damage in the brains of people with cannabis use disorder.

Burden of care and quality of life in relatives of opioid dependent male subjects.

BACKGROUND: The aim of this study was to compare the quality of life (QoL) and family burden in relatives of patients with heroin dependence with that of healthy controls. SUBJECTS AND METHODS: A total of 50 heroin dependent patients and 50 of their relatives and 50 healthy subjects and 50 of their relatives were included in the study. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID-I) was used to determine the heroin dependence and other Axis I psychiatric disorders. Family burden and QoL levels in the relatives were assessed with the Zarit Burden Interview (ZBI) protocol and the World Health Organization Quality of Life Assessment-Brief (WHOQOL-BREF), respectively. RESULTS: There were no significant differences in demographic characteristics between the groups. When compared with healthy controls, family members of heroin dependence patients had significantly higher ZBI scores and significantly lower all subscale scores of the WHOQOL-BREF. ZBI score was positively correlated with duration of the illness. All WHOQOL-BREF subscale scores were negatively correlated with duration of the illness. CONCLUSIONS: The study suggests that heroin dependence not only affects the lives of patients but also the lives of their family members. Heroin dependence leads to high burden on the family and also impairs the QoL of relatives.

Quality of life in rheumatological patients: The impact of personality disorders.

OBJECTIVE: Rheumatological diseases are associated with lower quality of life (QoL) levels. Psychiatric disturbances are frequently observed in these patients. This study examined the impact of personality disorders on the QoL of patients with rheumatological diseases. METHOD: The study sample consisted of 142 participants including patients suffering from rheumatological disease with a personality disorder (n = 30), without any personality disorder (n = 112), and healthy control participants without physical or psychiatric disorders (n = 60). The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I) and the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders (SCID-II) were used to determine Axis I and Axis II psychiatric disorders, respectively. QoL levels were assessed by means of the World Health Organization QoL Assessment-Brief. RESULTS: The subscale scores of physical health, psychological health, and social relationships were significantly lower in patients with rheumatological disease regardless of the existence of personality disorder compared with the control participants. Rheumatological patients with a personality disorder had significantly lower subscale scores of psychological health (p = 0.003) and social relationships (p < 0.003) compared with patients without any personality disorder. CONCLUSIONS: Personality disorders seem to be a relevant factor that maybe associated with QoL in patients suffering from rheumatological disease.

Pregnancy-Onset Panic Disorder: Incidence, Comorbidity and Associated Factors.

INTRODUCTION: The present study aimed to investigate the incidence rate of pregnancy-onset panic disorder (POPD) among Turkish pregnant women using a diagnostic interview. Additionally, we examined whether the independent socio-demographic or clinical risk factors were associated with the risk of panic disorder in these women. METHODS: The study sample comprised 1475 consecutive pregnant women who presented to the obstetric outpatient clinics of two research centers. The rate of POPD in these participants was 1.3% (Group 1, n=20). The 20 women with POPD were compared with 250 pregnant women without pregnancy-onset depression or anxiety (Group 2; controls). Panic disorder and other anxiety or mood disorders were determined by means of the Structured Clinical Interview for DSM-IV. Comorbid Axis II disorders were diagnosed with the Structured Clinical Interview for DSM-III-R Personality Disorders. RESULTS: The incidence rate of panic disorder was 1.3% (n=20). In group 1, 55% (n=11) of the women with POPD had an additional mood or anxiety disorder. In addition, the prevalence rate of any cluster C personality disorder, including avoidant, passive-aggressive and obsessive-compulsive personality disorders, were significantly greater in the group 1 women with POPD than the control pregnant women without a panic disorder (group 2). CONCLUSION: The women with POPD were more likely than the controls to have a cluster C Axis II disorder and a history of a pre-existing anxiety or mood disorder.

The roles of BDNF, S100B, and oxidative stress in interferon-induced depression and the effect of antidepressant treatment in patients with chronic viral hepatitis: a prospective study.

OBJECTIVE: The aim of the study was to research the relationship between interferon (IFN) induced depression and sociodemographic characteristics, neurotrophic factors and oxidative stress. METHODS: Sixty four cases, 34 with Chronic Hepatitis B (CHB) and 30 with Chronic Hepatitis C (CHC), were included in the study. The patients were assessed with Structured Clinical Interview for DSM-IV (SCID-I), Hamilton Anxiety Rating Scale (HARS) and Hamilton Depression Rating Scale (HDRS) at baseline on the 2nd and 6th weeks of treatment. S100 calcium binding protein B (S100B), brain-derived neurotrophic factor (BDNF), total antioxidant status (TAS) and total oxidative stress (TOS) levels were measured at the same visits. RESULTS: In total, 20 patients were diagnosed with major depression (MD) on the sixth week. A significant relationship was found between depression developed after IFN therapy and baseline HARS scores and the type of IFN-α. When the pretreatment levels of HDRS, HARS, S100B, BDNF, TAS, and TOS were compared to those after treatment on the 2nd week, there was a significant increase in HDRS and HARS levels and a significant decrease in the levels of S100B and BDNF. No significant change was determined for TAS and TOS levels. CONCLUSIONS: Our study suggests that the pathogenesis of IFN induced depression may involve neurotrophic factors.

Mood and anxiety disorders among inpatients of a university hospital in Turkey.

OBJECTIVE: The aim of the study was to assess the prevalence of mood and anxiety disorders among inpatients and the relationship between sociodemographic factors, medical illnesses and treatments. METHODS: In the present study, we selected 650 inpatients from all clinics except psychiatry and pediatrics in a general hospital by a simple random sampling method. Based on the exclusion criteria, 57 patients were excluded. Mood and anxiety disorders were determined by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. RESULTS: Of the participants, 226 (37.5%) had a psychiatric disorder, 87 (14.4) had a mood disorder and 146 (24.2%) had an anxiety disorder. The most common specific diagnoses were not otherwise specified as anxiety disorder (9.5%), major depression (8.6%) and generalized anxiety disorder (7.6%). While the overall prevalence was highest in the hematology clinic (60.0%), it was lowest in the clinic of infectious diseases (22.7%). Logistic regression analysis indicated that the independent factors associated with psychiatric disorders were being of the female gender and a personal history of psychiatric disorders. CONCLUSIONS: In conclusion, results of the present study suggest that mood and anxiety disorders were frequently observed among inpatients, particularly in female patients and those with an individual history of psychiatric disorder. Successful treatment of these disorders may positively contribute to the course of the disease in inpatients. However, this assumption should be confirmed by further studies.

Quality of life, family burden and associated factors in relatives with obsessive-compulsive disorder.

OBJECTIVE: The aim of this study is to assess the quality of life (QoL), family burden and psychiatric disorders in first-degree relatives of patients with obsessive-compulsive disorder (OCD) and to compare them with healthy controls and their relatives. METHODS: Forty patients with OCD and 47 of their first-degree relatives as well as 40 healthy subjects and 45 of their first-degree relatives were recruited in this study. OCD and comorbid anxiety or mood disorders were determined by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders. Comorbid Axis II disorders were diagnosed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition Personality Disorders. Type and severity of obsessive-compulsive symptoms were assessed with the Yale-Brown Obsessive-Compulsive Scale, and the disability of patients with OCD was evaluated with the WHO DAS II. Family burden and QoL in the relatives were evaluated with the Zarit Burden Interview (ZBI) protocol and the World Health Organization Quality of Life Assessment-Brief, respectively. RESULTS: The mean ZBI score of family members of OCD patients was higher than the control relatives. Linear regression analysis indicated that the independent factors associated with ZBI were duration of OCD, comorbid major depressive disorder and poorer insight. Compared with those of control relatives, the QoL of relatives of patients with OCD was significantly lower in all domains. While the diagnosis of major depressive disorder in relatives of OCD patients was significantly higher than the control relatives, the diagnosis of any anxiety disorder did not differ. CONCLUSIONS: Our study provides evidence that OCD not only affects the lives of patients but also their family members.

Mood, anxiety and personality disorders in patients with systemic lupus erythematosus.

OBJECTIVE: This study presents the current prevalence of mood, anxiety and personality disorders and factors associated with the existence of psychiatric disorders in patients with systemic lupus erythematosus (SLE). METHODS: The study sample was comprised of 45 patients with SLE and 60 control subjects. Mood and anxiety disorders were ascertained by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition/Clinical Version. Personality disorders were diagnosed with the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders. The disease activity was assessed with SLE Disease Activity Index. RESULTS: Of the 45 patients, 21 (46.7%) had at least one mood or anxiety disorder, and 16 (35.6%) had at least one personality disorder. The most common Axis I and Axis II diagnoses in the patient group were major depression (22.2%) and obsessive-compulsive personality disorder (20.0%), respectively. Specifically, major depression, generalized anxiety disorder and obsessive-compulsive personality disorder were more prevalent in the SLE group compared to the control group. The existence of Axis I disorders was associated with a more severe disease activity of SLE. CONCLUSION: Mood and anxiety disorders, particularly major depression and generalized anxiety disorder, are frequently observed in patients with SLE.

Is hyperemesis gravidarum associated with mood, anxiety and personality disorders: a case-control study.

OBJECTIVE: Intractable nausea and vomiting, known as hyperemesis gravidarum (HG), are relatively common medical problems among pregnant women. Although there are some studies based on psychiatric symptom scales, the relationship between HG and psychiatric disorders, particularly anxiety and personality disorders, is unclear. In this study, we aimed to investigate whether there is a difference among women with and without HG with respect to frequency of mood, anxiety and personality disorders. METHODS: The study sample was composed of 52 patients with HG and 90 control pregnant women. Mood and anxiety disorders were ascertained by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Personality disorders were assessed with the Structured Clinical Interview for DSM, Revised Third Edition, Personality Disorders (SCID-II). RESULTS: The prevalence of any mood disorder and any anxiety disorder in women with HG was 15.4% and 36.5%, respectively. In addition, 19 (36.5%) of the patients with HG had at least one personality disorder. According to reports collected from the participants in the study, most of the mood or anxiety disorders occurred before the pregnancy in women with HG. The prevalence of major depression, generalized anxiety disorder, avoidant personality disorder and obsessive-compulsive personality disorder was significantly higher in women with HG compared to the control subjects. CONCLUSIONS: The results of the present study suggest that mood and anxiety disorders, and personality disturbances are frequently observed among women with HG and that there is a potential relationship between these psychiatric disorders and HG during pregnancy.

Clinical correlates of worsening in obsessive-compulsive symptoms during pregnancy.

This study examined clinical factors related to worsening of obsessive-compulsive disorder (OCD) in pregnant women. For comorbid diagnoses at the onset of pregnancy and frequency of several obsessive-compulsive symptoms, there was a significant difference between women whose OCD worsened during the pregnancy and those in whom the OCD did not worsen.

Delirium following acute myocardial infarction: incidence, clinical profiles, and predictors.

PURPOSE: To examine the incidence, clinical profile, and predictors of delirium following acute myocardial infarction (MI). DESIGN AND METHODS: The study sample included 212 consecutive patients with acute MI who were admitted to the coronary intensive care unit of a university hospital. FINDINGS: Delirium was found to occur in 5.7% of the patients. The predictors of delirium were advanced age, higher level of serum potassium at admission, and experience of cardiac arrest during MI. PRACTICE IMPLICATIONS: Delirium is reasonably prevalent in patients with acute MI. We propose that patients with the risk factors that have been delineated in this study should be evaluated carefully.

Axis I and Axis II psychiatric disorders in patients with fibromyalgia.

OBJECTIVE: To determine the current prevalence of Axis I and Axis II psychiatric disorders in patients with fibromyalgia. METHOD: The study sample includes 103 patients with fibromyalgia and 83 control subjects. Axis I and Axis II disorders were determined by structured clinical interviews. RESULTS: The rate of any Axis I psychiatric disorder (47.6% vs. 15.7%), major depression (14.6% vs. 4.8%), specific phobia (13.6% vs. 4.8%), any Axis II disorder (31.1% vs. 13.3%), obsessive-compulsive (23.3% vs. 3.6%) and avoidant (10.7% vs. 2.4%) personality disorders were significantly more common in the patient group compared to the control group. CONCLUSION: Our results suggest that a considerable proportion of patients with fibromyalgia also present with Axis I and Axis II psychopathologies.