Assessment of Sonographic Carotid Parameters in Autism Spectrum Disorder: A Comparative Case Control Study.

OBJECTIVE: To compare carotid intima-media thickness (cIMT), systolic and diastolic diameters (D), intima-media thickness/diameter ratio (IDR) values in children with ASD, and control groups, and to analyze the correlation of these parameters with the Childhood Autism Rating Scale (CARS) scores. METHODS: This prospective case-control study included 37 children diagnosed with ASD and 38 individuals without ASD in the control group. Correlation assessments of sonographic measurements with CARS scores in the ASD group were also performed. RESULTS: Diastolic diameters of the right (median of ASD group:5.5 mm, control group:5.1 mm) and left (median of ASD group: 5.5 mm, in control group: 5.1 mm) side were higher in the ASD group (p = .015 and p = .032 respectively). A statistically significant correlation was detected between CARS score and left cIMT, right cIMT, right cIMT/systolic D, right cIMT/diastolic D, left cIMT/systolic D, and left cIMT/diastolic D (p < .05). CONCLUSION: Vascular diameters, cIMT, and IDR values of children with ASD positively correlated with CARS scores, and these findings could be interpreted as a marker of early atherosclerosis in children with ASD.

Assessment of COVID-19 trauma responses. Who has been more traumatized during the pandemic?

Background and Objective: To evaluate the effect of cognitive and sociodemographic characteristics of healthcare and non-healthcare workers on their traumatic responses to the COVID-19 pandemic. Methods: Data were collected using an online survey between August-September 2020. The survey included the following scales: Beck Anxiety Inventory (BAI), Anxiety Sensitivity Index (ASI), and Impact of Event Scale-Revised (IES-R). Traumatic responses were categorized into three types: avoidance (IES-R_A), intrusion (IES-R_I), and hyperarousal (IES-R_H). Results: The study included a total of 672 participants, comprised of 399 (59.4%) men, and 273 (40.6%) women with a mean age of 39.25 ± 933 years. The results indicated that women had higher IES-R_I (r = .5.78, p < 0.001), IES-R_A (r = 4.47, p < 0.001), and IES-R_H (r = .5.20, p < 0.001) scores compared to men. Patients with a history of psychiatric diseases had significantly higher IES-R_I (r = -3.82, p < 0.001), IES-R_A (r = -2.00, p < 0.05), and IES-R_H (r = -4.06, p < 0.001) scores compared to patients with no history of psychiatric diseases. Non-healthcare workers had significantly higher IES-R_A (r = -2.69, p < 0.01) scores compared to healthcare workers. Conclusion: Female gender and a positive history of psychiatric diseases were found to lead to an increase in the frequency of all three traumatic responses to COVID-19. Contrary to expectation, being a healthcare worker was not found as a factor facilitating trauma response formation in our study.

Contexte et objectif: Évaluer l'effet des caractéristiques cognitives et sociodémographiques des travailleurs de la santé et des travailleurs non médicaux sur leurs réponses traumatiques à la pandémie de COVID-19. Méthodes: Les données ont été recueillies à l'aide d'une enquête en ligne entre août et septembre 2020. L'enquête comprenait les échelles suivantes : Inventaire d'anxiété de Beck (BAI), Indice de sensibilité à l'anxiété (ASI) et Échelle d'impact de l'événement - révisée (IES-R). Les réponses traumatiques ont été classées en trois types : évitement (IES-R_A), intrusion (IES-R_I) et hyperexcitation (IES-R_H). Résultats: L'étude a inclus un total de 672 participants, composés de 399 (59,4 %) hommes et 273 (40,6 %) femmes avec un âge moyen de 39,25 ± 933 ans. Les résultats ont indiqué que les femmes avaient des scores IES-R_I (r = 5,78, p < 0,001), IES-R_A (r = 4,47, p < 0,001) et IES-R_H (r = 5,20, p < 0,001) plus élevés que les hommes. Les patients ayant des antécédents de maladies psychiatriques présentaient des scores IES-R_I (r = −3,82, p < 0,001), IES-R_A (r = −2,00, p < 0,05) et IES-R_H (r = −4,06, p < 0,001) significativement plus élevés que les patients n'ayant aucun antécédent de maladies psychiatriques. Les travailleurs non médicaux avaient des scores IES-R_A (r = −2,69, p < 0,01) nettement plus élevés que les travailleurs de la santé. Conclusion: On a constaté une augmentation de la fréquence de trois réponses traumatiques à la COVID-19 chez les femmes et celles ayant des antécédents positifs de maladies psychiatriques. Contrairement aux attentes, le fait d'être un travailleur de la santé ne s'est pas avéré être un facteur facilitant la formation de réponses traumatiques dans notre étude.

A Cross-Sectional Measurement of Endogenous Oxidative Stress Marker Levels in Obsessive Compulsive Disorder.

Background: There is a correlation between the increase in reactive oxygen radicals and the presence of specific mental illnesses. In this context, the objective of this study is to investigate the relationship between obsessive-compulsive disorder and the variations in the levels of several endogenous oxidative stress markers. Methods: Thirty obsessive-compulsive disorder patients were included in the study as the patient group, and 30 healthy volunteers of matching demographic characteristics were included in the study as the control group. Accordingly, the patient group consisted of 10 females and 20 males with a mean age of 29.5 ± 6.1 years, and the control group consisted of 15 females and 15 males with a mean age of 31.9±5.6 years. The serum nicotinamide adenine dinucleotide phosphate oxidase-2, nicotinamide adenine dinucleotide phosphate oxidase-4, and malondialdehyde levels of the 2 groups were compared using the independent samples t-test. The relationships between the serum nicotinamide adenine dinucleotide phosphate oxidase-2, nicotinamide adenine dinucleotide phosphate oxidase-4, and malondialdehyde levels of the 2 groups were analyzed using the Pearson's correlation coefficient. Results: The serum nicotinamide adenine dinucleotide phosphate oxidase-2, nicotinamide adenine dinucleotide phosphate oxidase-4, and malondialdehyde levels of the patient group were statistically significantly higher than those of the control group (P < .001). Statistically significant positive correlations were detected between the serum nicotinamide adenine dinucleotide phosphate oxidase-2 and nicotinamide adenine dinucleotide phosphate oxidase-4 levels (r = 0.692, P = .001) and between the serum nicotinamide adenine dinucleotide phosphate oxidase-2 and malondialdehyde levels (r = 0.563, P = .001). Conclusion: The results of this study indicated that oxidative stress and lipid peroxidation levels were higher in obsessive-compulsive disorder patients. Based on this finding, NOX-2 and NOX-4 levels can be used as indicators of endogenous oxidative stress in obsessive-compulsive disorder patients.

[Validity and Reliability of the Parents Internalized Stigma of Mental Illness Scale]. / Ebeveynlerin Ruhsal Hastaliklarda Içsellestirilmis Damgalanma Ölçegi’nin Geçerlilik ve Güvenilirligi.

OBJECTIVE: The purpose of this study is to investigate the validity and reliability of PISMI-TR, the Parents Internalized Stigma of Mental Illness scale, which had been previously adapted to the Turkish. METHOD: The data of this methodological study were acquired between June 2017 and August 2018 from the parents of 281 individuals who were diagnosed with a mental disorder and followed up at the adult psychiatry polyclinics of a university hospital, by means of an Information Form, the PISMI-TR scale and the Beliefs toward Mental Illness (BMI) scale. SPSS 22.0 and LISREL 8.89 were used for data analysis. The content and the construct validities were determined for the scale validity and the internal consistency values were calculated for the reliability. RESULTS: The Cronbach's alpha coefficient was 0.87 for the total score of the scale, and it varied in the 0.69-0.81 range for the subscale scores. The confirmatory factor analysis validated a 5-factor structure for the PISMI-TR scale tested on the participants of this study; and the adaptive ad statistical values were at an acceptable level. The factor loading was found to range between 0.34 and 0.74. CONCLUSION: The validity and reliability analyses carried out indicated that the PISMI-TR scale is both valid and reliable. The scale can be used to evaluate the internalized stigma in parents, who play an important role in adherence to treatment of the mentally ill offspring.

Evaluation of Risk Factors for ADHD and Co-Morbid Psychiatric Disorders Among the Parents of Children With ADHD.

OBJECTIVE: The aim of this study is to investigate the presence of ADHD and other psychiatric disorders among parents with at least one child with ADHD relative to parents with children who do not have ADHD. METHOD: Eighty five parents of children with ADHD with 68 control parents who had healthy children without ADHD were interviewed for participation in present study. Each parent was evaluated for co-existing psychiatric disorders using the Structured Clinical Interview for the DSM IV Axis I Disorders (SCID I). RESULTS: We found that ADHD and co-morbid psychiatric symptoms were increased in the parents of children with ADHD in comparison with the healthy control group. CONCLUSION: Psychiatric co-morbidity was more common among the parents of patients with inattentive and combined presentations. Adult ADHD is associated with psychiatric co-morbidities including anxiety disorders, mood disorders, and somatoform disorders as well as substantial role impairment.

Evaluation of Paraoxonase, Arylesterase and Malondialdehyde Levels in Schizophrenia Patients Taking Typical, Atypical and Combined Antipsychotic Treatment.

OBJECTIVE: Human serum paraoxonase (PON1) prevents lipids from peroxidation and functions as an antioxidant mechanism. Malonyldialdehyde (MDA) is the final product of lipid peroxidation and can be used as an indicator of oxidative stress. The aim of this study was to investigate PON1, MDA, and arylesterase (ARY) levels in schizophrenic patients who are taking typical, atypical, or combined (typical and atypical) antipsychotic drug treatment, with respect to those of healthy controls. METHODS: We evaluated 41 patients (11 taking typical antipsychotics, 19 taking atypical antipsychotics, 11 taking combined antipsychotics) and 43 healthy controls. RESULTS: MDA levels were higher in schizophrenic patients taking typical antipsychotics compared with healthy controls (p=0.001). ARY levels were higher in patients taking atypical antipsychotics compared with healthy controls (p=0.005). PON1 activity was similar in all groups. CONCLUSION: Our results indicate that treatment with typical antipsychotic drugs could be related to increased MDA levels; and antipsychotic medication may increase PON1 levels in schizophrenic patients.

Decreased Prolidase Activity in Patients with Posttraumatic Stress Disorder.

OBJECTIVE: Many neurochemical systems have been implicated in the development of Posttraumatic Stress Disorder (PTSD). The prolidase enzyme is a cytosolic exopeptidase that detaches proline or hydroxyproline from the carboxyl terminal position of dipeptides. Prolidase has important biological effects, and to date, its role in the etiology of PTSD has not been studied. In the present study, we aimed to evaluate prolidase activity in patients with PTSD. METHODS: The study group consisted of patients who were diagnosed with PTSD after the earthquake that occurred in the province of Van in Turkey in 2011 (n=25); the first control group consisted of patients who experienced the earthquake but did not show PTSD symptoms (n=26) and the second control group consisted of patients who have never been exposed to a traumatic event (n=25). Prolidase activities in the patients and the control groups were determined by the ELISA method using commercial kits. RESULTS: Prolidase activity in the patient group was significantly lower when compared to the control groups. Prolidase activity was also significantly lower in the traumatized healthy subjects compared to the other healthy group (p<0.01). CONCLUSION: The findings of the present study suggest that the decrease in prolidase activity may have neuroprotective effects in patients with PTSD.

The investigation of factors related to suicide attempts in Southeastern Turkey.

BACKGROUND: Suicide is an important health problem in Turkey as it is in all regions of the world. Suicidal behavior has multiple causes, which are broadly divided into those related to proximal stressors and those due to predisposition. Suicide statistics may be associated with mental health disorders, which are among the foremost predictors of suicide attempts. More than 90% of patients who commit suicide have a diagnosable psychiatric disorder, usually a major depressive disorder. Other major risk factors for suicide attempts are history of suicide attempts in the family, stressful life events, sleep disturbances, poor income, unemployment, severity of symptoms of depression, and anxiety. Sleep is a complex phenomenon. Sleep disturbances can therefore be contributed to the emergence of suicidal behavior allowing for the possibility of predicting future suicides. METHODS: We evaluated 106 patients who were admitted after suicide attempts to the Department of Psychiatry at Dicle University Faculty of Medicine. The recruited subjects were assessed by Structured Clinical Interview for DSM-IV Axis I disorders, and the intensity of symptoms was evaluated using the Beck Anxiety Inventory, Hamilton Depression Rating Scale, and Pittsburgh Sleep Quality Index. The mean values of the subjects attempting multiple and single suicides were compared using appropriate inferential statistical tests. RESULTS: Most suicide attempts are believed to be preventable. Our results revealed that a great variety of risk factors are associated with an increased risk for multiple suicide attempts. Most of these attempts appeared to be spontaneous and impulsive rather than planned. In particular, this study highlights the importance of previous suicide attempts, history of suicide in the family, history of stressful life events in the previous 6 months, poor income, unemployment, sleep disturbances, severe hopelessness with depression, and coexisting symptoms of anxiety as risk factors. CONCLUSION: The first step in prevention of suicides is doubtlessly strong and reliable communication, due to the fact that the majority of subjects who commit suicide have had contact with a health professional during the month before the suicide.

Diagnostic performance of increased prolidase activity in schizophrenia.

We investigated whether prolidase activity has a diagnostic test value in schizophrenia and assessed the relation between prolidase activity and sociodemographic-clinical characteristics of patients with schizophrenia. Fifty patients with schizophrenia (diagnosed as schizophrenia according to DSM-V criteria) and 50 healthy volunteers were included in this study. Case and control groups had a similar distribution in age, sex, body mass index (BMI), and smoking status. Serum prolidase activity was measured in both groups and was determined to be significantly higher in the patient group (509.706±41.918) compared to the control group (335.4±13.6; t=6.231; p=0.0001). A cut-off point of 392.65U/L prolidase was determined for diagnostic measures from the plotted ROC curve. The area under the ROC curve was 1.000, which was significant (p<0.0001). Higher values were assigned as the disease state. Both positive predictive value (PPV) and negative predictive value (NPV) were 100% at the cut-off point of 392.650U/L. The prolidase levels of the control group were all below the cut-off point. There were no statistically significant differences between the two groups with regard to age, gender, or BMI (p>0.05), and no correlation was found between mean prolidase activity and age of onset of the disease, family history, disease duration, number of hospitalizations, subtypes of schizophrenia, PANSS scores or sub-scores, CGI-S scores, S-A scale scores, and the antipsychotic treatment (p>0.05). The results of this study indicate that serum prolidase activity may be a useful diagnostic test for schizophrenia; however, further studies are needed to verify this.

Altered lipid peroxidation markers are related to post-traumatic stress disorder (PTSD) and not trauma itself in earthquake survivors.

The traumatic life events, including earthquakes, war, and interpersonal conflicts, cause a cascade of psychological and biological changes known as post-traumatic stress disorder (PTSD). Malondialdehyde (MDA) is a reliable marker of lipid peroxidation, and paraoxonase is a known antioxidant enzyme. The aims of this study were to investigate the relationship between earthquake trauma, PTSD effects on oxidative stress and the levels of serum paraoxonase 1 (PON1) enzyme activity, and levels of serum MDA. The study was carried out on three groups called: the PTSD group, the traumatized with earthquake exercise group, and healthy control group, which contained 32, 31, and 38 individuals, respectively. Serum MDA levels and PON1 enzyme activities from all participants were measured, and the results were compared across all groups. There were no significant differences between the PTSD patients and non-PTSD earthquake survivors in terms of the study variables. The mean PON1 enzyme activity from PTSD patients was significantly lower, while the mean MDA level was significantly higher than that of the healthy control group (p < 0.01 for both measurements). Similarly, earthquake survivors who did not develop PTSD showed higher MDA levels and lower PON1 activity when compared to healthy controls. However, the differences between these groups did not reach a statistically significant level. Increased MDA level and decreased PON1 activity measured in PTSD patients after earthquake and may suggest increased oxidative stress in these patients. The nonsignificant trends that are observed in lipid peroxidation markers of earthquake survivors may indicate higher impact of PTSD development on these markers than trauma itself. For example, PTSD diagnosis seems to add to the effect of trauma on serum MDA levels and PON1 enzyme activity. Thus, serum MDA levels and PON1 enzyme activity may serve as biochemical markers of PTSD diagnosis.

A Case of Skin Picking Disorder of a Patient with a History of Childhood Abuse.

Skin picking (excoriation) disorder is the recurrent excoriation of one's own skin, resulting in noticeable skin damage. People pick their skin for different reasons. For the majority of patients, first skin picking is associated with a history of childhood abuse and personal problems. Subjects who moderately to severely cause injurious self-harm are more likely to have a history of exposure to domestic violence and childhood abuse than those who do not self-harm. At the same time, these conditions could be related to the etiology for majority of other psychiatric disorders. We report herein, a case of a patient with skin picking disorder who had a history of childhood physical and emotional abuse with borderline personality disorder.

Family History in Patients with Bipolar Disorder.

INTRODUCTION: In this study, we aimed to better understand the genetic transmission of bipolar disorder by examining the family history of patients. METHODS: Sixty-three patients with bipolar disorder and their families were included. The final sample comprised 156 bipolar patients and their family members. An inclusion criterion was the presence of bipolar disorder history in the family. The diagnosis of other family members was confirmed by analyzing their files, hospital records, and by calling them to the hospital. RESULTS: Sixty-five patients were women (41.6%) and 91 were men (58.3%) (ratio of men/women: 1.40). When analyzing the results in terms of the transition of disease from the mother's or father's side, similar results were obtained: 25 patients were from the mother's side and 25 patients were from the father's side in 63 cases. CONCLUSION: The results of our study support the fact that a significant relationship exists between the degree of kinship and the heritability of bipolar disorder and, furthermore, that the effect of the maternal and paternal sides is similar on the transmission of genetic susceptibility.

Neutrophil-lymphocyte ratio in patients with major depressive disorder undergoing no pharmacological therapy.

Studies attempting to clarify the relationship between major depressive disorder (MDD) and the immune system have been increasing in recent years. It was reported that increased production of the main proinflammatory cytokines, such as interleukin-1, interleukin-6, and tumor necrosis factor-alpha, and that of acute phase reactants may play a role in the etiopathogenesis of depression. Stress and depression were reported to increase leukocyte and neutrophil counts and to decrease lymphocyte count. Biological determinants affecting the diagnosis, therapy, and prognosis of depression are quite limited. Therefore, new etiological models are needed to explain the pathophysiology of depression. In recent years, neutrophil-lymphocyte ratio (NLR) was determined to be a good indicator of inflammatory status. There is no study in the literature investigating NLR in MDD. This study aims to examine the role of inflammation in the etiology of depression based on the NLR in MDD patients who are undergoing no pharmacological therapy. A total of 41 patients diagnosed with MDD, who received no antidepressant therapy within the past 1 month, were included in the study, which took place between January and March 2015. The control group consisted of 47 healthy subjects with no psychiatric disorders. A sociodemographic information form and a Beck Depression Scale were administered, and the blood was taken for biochemical analysis. Significant differences were identified in the NLR, neutrophil count, lymphocyte percentage, and leukocyte values of the patient group when compared with the control group (P<0.05). Our study is the first in which NLR was investigated in MDD. The findings of the study reveal that NLR tends to be higher in patients with MDD, and a high NLR value supports the view that inflammation is a critical factor in the etiology of MDD.

Serum levels of carcinoembryonic antigen (CEA) in patients with bipolar disorder.

OBJECTIVE: Carcinoembryonic antigen (CEA) is an oncofetal glycoprotein that is widely used as a tumour marker in adenocarcinomas. However, several non-neoplastic conditions, including acute and chronic inflammation and other inflammation-related conditions, are characterised by increased CEA concentrations. Bipolar disorder (BD) ranks seventh among the worldwide burden of non-fatal diseases. Inflammatory biomarkers have been considered as one of the main key pillars of a multifactorial approach for prediction of BD in an at-risk population. BP is accompanied by activation of inflammatory, cell-mediated and negative immunoregulatory cytokines. METHODS: We measured the levels of CEA in serum samples from 44 individuals with euthymic BP out-patients and 45 healthy controls. Patients were diagnosed according to the DSM-IV criteria. CEA was measured by an electrochemiluminescence immunoassay. RESULTS: The mean serum CEA concentration was 2.36±1.52 and 1.77±0.98 µg/l in patients and controls, respectively. CEA levels were significantly increased in euthymic BP patients when compared with controls (p=0.031). CONCLUSIONS: This study suggests that CEA is increased in BD and supports a role for immune activation in the core pathological mechanisms of BP. CEA levels may be a secondary marker for diagnosing BP.

Serum total oxidant and antioxidant status in earthquake survivors with post-traumatic stress disorder.

OBJECTIVE: Oxidative stress has been shown to play an important role in the pathogenesis of post-traumatic stress disorder (PTSD). Although there are some studies on oxidative stress and PTSD, there is no report available on the serum total oxidant and antioxidant status in earthquake survivors with PTSD. Therefore, this study aimed to investigate the serum total oxidant and antioxidant status in earthquake survivors with chronic PTSD. MATERIAL AND METHODS: The study group included 45 earthquake survivors with PTSD and 40 earthquake survivors without PTSD. The oxidative status was determined using the total antioxidant status and total oxidant status (TOS) measurements and by calculating the oxidative stress index (OSI). RESULTS: There were no statistically significant differences in the total antioxidant status, TOS, or OSI when comparing individuals with and without PTSD (all, p>0.05). There were no correlations between Clinician-Administered PTSD Scale scores and oxidant and antioxidant stress markers (all, p>0.05). CONCLUSIONS: Our results suggest that the total oxidant and antioxidant status may not affect earthquake survivors with PTSD. This is the first study to evaluate the oxidative status in earthquake survivors with PTSD. Further studies are necessary to confirm these findings.

Relations between mood characteristics, circadian preferences, and functionality in multiple sclerosis.

OBJECTIVE: Multiple sclerosis (MS) is a progressive disorder that results in demyelinization of the nerve fibers of the central nervous system. We aimed to determine chronobiological and mood features in patients with MS. METHODS: The sample comprised 75 patients with MS (54 women and 21 men) and 50 healthy individuals (38 women and 12 men). Sixty-three patients were relapsing-remitting MS and twelve patients had secondary progressive-type MS. Mood characteristics were assessed using subscales of the Profile of Mood States (POMS). Chronotypical characteristics were determined by the Morningness-Eveningness Questionnaire (MEQ). Univariate and structural equation modeling was applied to untangle the possible connections between variables. RESULTS: Both relapsing-remitting and secondary progressive patients scored higher on the depression-dejection and fatigue-inertia scales of the POMS than healthy individuals. Circadian preferences did not differ significantly between these groups. Patients using glatiramer acetate and other types of drugs had greater severity of functional impairment measured relative to interferon-beta treatment group. Glatiramer acetate had more negative effects on mood than interferon-beta therapy. This finding may be the result of significantly higher duration of disease and higher symptom severity scores in glatiramer acetate group. CONCLUSIONS: In the structural equation model, gender was found to be predictive for characteristics of mood.

Magnetic resonance imaging in children under anesthesia: the relationship between the degree of information provided to parents and parents' anxiety scores.

BACKGROUND: We aimed to investigate the correlation between the anxiety scores of parents whose children are administered anesthesia for magnetic resonance imaging (MRI) and the level of information provided to them before the MRI. The study included 146 children and their parents. The demographic information of the children and their parents was recorded. The parents were divided into two groups. In Group I, the patient's medical history and physical exam findings were recorded on a standard consultation form by an anesthesiologist. In Group II, the parents were additionally provided with more detailed information on how the anesthesia would be administered and the drugs to be used and their side effects and complications. The anxiety scores of the parents were found to be lower in Group II. A higher level of education was associated with higher anxiety scores. Intergroup comparison detected lower anxiety scores for Group II parents whose education levels were up to high school. However, no change upon receiving detailed information was detected in the anxiety scores of parents with higher education levels. In conclusion, this may lower the anxiety scores in parents informed about details of anesthesia administration and may raise parents' sense of confidence in the doctor.

Latent class analysis of obsessive-compulsive symptoms in a clinical sample.

OBJECTIVE: Obsessive-compulsive disorder (OCD) is probably a heterogeneous condition. To date, research investigating the symptom structure of OCD has generally focused on variable-classification approaches, primarily factor analysis. Our aim was to use the latent class analysis, an advanced individual-classification method, in order to define homogeneous sub-groups based on the Yale-Brown Obsessive-Compulsive Scale Check List (Y-BOCS CL) assessments within 193 outpatients with OCD. METHOD: Latent class analysis of 13 obsessive-compulsive symptom-clusters measured by the Yale-Brown Obsessive-Compulsive Scale Check List was performed. Associations of demographic and clinical features with latent class membership were tested by using logistic regression models. Differences in severity of obsessive-compulsive symptoms, obsessive beliefs, and depressive symptomotology between latent classes were evaluated with the chi-square likelihood test. RESULTS: Latent class analysis models of best fit yielded 3 latent classes: "autogenous obsessions", "reactive obsessive-compulsive", and "reactive obsessions". Outpatients in reactive obsessive-compulsive group reported significantly higher scores on the Y-BOCS global, obsessions, and compulsions scales than outpatients in other two sub-groups. Participants in reactive obsessive-compulsive group were predominantly female, single, and had a history of family psychopathology; whereas autogenous and reactive obsessions groups were predominantly male. There were no differences in severity of depression and obsessive belief domains. CONCLUSIONS: The results provide support for the validity of autogenous/reactive distinction for OCD. These three classes may have important implications for research and clinical purposes.

Decreased serum sulphydryl levels as a sign of increased oxidative stress in generalized anxiety disorder.

OBJECTIVE: In recent years, many published studies have focused on the relationship between oxidative stress and psychiatric disorders. However, studies in generalized anxiety disorder (GAD) are few despite relatively high prevalence rates. In an attempt to fill this gap in the literature we aimed to measure serum levels of free sulphydryl, an important member of antioxidant defense mechanisms, of the patients with GAD. METHODS: A total of 35 (23 female, 12 male) GAD patients without any other co-morbid medical or psychiatric disorder and 35 (23 female, 12 male) healthy controls have been included in the study. Disease severity of the patients were quantified by using the Hamilton Anxiety Rating Scale (HAM-A). Serum free sulphydryl group levels of patients and healthy controls were measured in an appropriate way. RESULTS: Mean level of serum sulphydryl groups was significantly lower in the patient group. There was a negative correlation between their level and the disease duration. However, they did not show any significant correlation with the disease severity. CONCLUSION: Decreased serum sulphydryl level observed in pure GAD patients suggests an increased oxidative stress in these patients. Well designed future researches are needed to replicate our findings and to test the implications of the present study.

Mood and metabolic consequences of sleep deprivation as a potential endophenotype' in bipolar disorder.

It has been commonly recognized that circadian rhythm and sleep/wake cycle are causally involved in bipolar disorder. There has been a paucity of systematic research considering the relations between sleep and mood states in bipolar disorder. The current study examines the possible influences of sleep deprivation on mood states and endocrine functions among first-degree relatives of patients with bipolar disorder and healthy controls. Blood samples were taken at two time points in the consecutive mornings at predeprivation and postdeprivation periods. Participants simultaneously completed the Profiles of Mood States at two time points after giving blood samples. Plasma T3 and TSH levels increased after total sleep deprivation in both groups. Sleep deprivation induced TSH levels were reversely associated with depression-dejection among healthy controls. A paradoxical effect was detected for only the first-degree relatives of the patients that changes in plasma cortisol levels negatively linked to depression-dejection and anger-hostility scores after total sleep deprivation. Plasma DHEA levels became correlated with vigor-activity scores after sleep deprivation among first-degree relatives of bipolar patients. On the contrary, significant associations of depression-dejection, anger-hostility, and confusion-bewilderment with the baseline plasma DHEA levels became statistically trivial in the postdeprivation period. Findings suggested that first-degree relatives of patients with bipolar disorder had completely distinct characteristics with respect to sleep deprivation induced responses in terms of associations between endocrine functions and mood states as compared to individuals whose relatives had no psychiatric problems. Considering the relationships between endocrine functions and mood states among relatives of the patients, it appears like sleep deprivation changes the receptor sensitivity which probably plays a pivotal role on mood outcomes among the first-degree relatives of patients with bipolar disorder.