Decreased serum allopregnanolone and progesterone levels in male patients with bipolar disorder and their effects on cognitive functions.

The progression of bipolar disorder (BD) is characterized by recurrent episodes of depression, mania, and hypomania, thus affecting the daily functionality of individuals. Previous studies have shown that a large proportion of patients diagnosed with BD who are in clinical remission experience significant functional disorders. The present study aimed to investigate the relationships between cognitive impairment and serum progesterone, allopregnanolone and BDNF levels in male bipolar disorder patients who are in the euthymic period. Our study included 41 euthymic male patients with bipolar disorder and 40 age, sex, body mass index (BMI) and smoking-matched male healthy control subjects. Neuropsychiatric tests such as the Stroop Test TBAG Form, Auditory Verbal Digit Span Test- Form B (VADS-B) and Cancellation Test were administered to all participants, and 5-7 ml of peripheral venous blood sample was taken from all participants. Serum allopregnanolone, progesterone and BDNF levels were also measured in all participants. Serum allopregnanolone and progesterone levels were found to be lower in bipolar patients, and it was observed that the serum level of allopregnanolone decreased as the disease duration increased. The serum BDNF levels were similar between groups. The cognitive functions assessed using the Stroop, VADS-B and cancellation tests were found to be better in healthy subjects. The neurocognitive test performances of all participants were strongly positively correlated with allopregnanolone levels. The present study supports the hypothesis that allopregnanolone acts as an endogenous mood stabilizer.

Long-lasting cognitive effects of COVID-19: is there a role of BDNF?

Coronavirus disease 2019 (COVID-19) affects numerous systems of the body during the illness, and there have been long-lasting effects. BDNF plays an important role in synaptic plasticity and synaptic communication. According to the inclusion and exclusion criteria, 54 patients who had COVID-19 infection participated in this study. Thirty-six age-, sex-, body mass index (BMI)-, education level- and smoking status-matched healthy controls were included in the present study. All participants were individually administered the Stroop test and Visual Aural Digit Span Test Form B (VADS-B). Serum BDNF levels were measured by ELISA. Stroop test word reading spontaneous correction number and reading time, word color saying wrong number, spontaneous correction number and reading time, box color speaking spontaneous correction number and reading time, Stroop interference and speed factor duration were significantly higher in the COVID-19 group than in the control group. All scores of the VADS-B test were found to be significantly lower in the COVID-19 group. The mean serum BDNF levels were found to be 10.9 ± 6.9 ng/ml in the COVID-19 group and 12.8 ± 6.4 ng/ml in the healthy control group. Two-way ANOVA showed that the serum mean BDNF level was significantly lower in the COVID-19 group than in the control group. Gender had a significant effect on BDNF levels (F = 12.21; p = 0.008). The present study is the first to demonstrate the association between the role of serum BDNF and cognitive decline in patients with COVID-19 infection. Additionally, there is a significant role of male gender in terms of lower BDNF level and cognitive decline.

Favorable Personality Traits in Women Who Have Undergone Cosmetic Breast Augmentation Surgery.

OBJECTIVE: Breast augmentation surgery is one of the most common cosmetic procedures among women. In the present study, we compared personality traits, self-esteem, and body perception between women who had undergone breast augmentation surgery and a control group of women who had not. We hypothesized that the personality traits of women who had vs those who had not undergone breast augmentation surgery would differ. MATERIALS AND METHODS: According to the inclusion and exclusion criteria, patients who had undergone breast augmentation surgery and age- and education-matched, healthy women were included in the present study. The breast augmentation group and control group were compared in terms of personality traits under the Basic Personality Traits Inventory. Additionally, self-esteem, which was assessed with the Rosenberg Self-Esteem Scale, and body perception, which was evaluated using the Body Cathexis Scale, were measured and compared between the two groups. RESULTS: When the patients (n = 80) and the control group (n = 100) were compared, the Body Cathexis Scale, extroversion, and openness scores were statistically significant and were found to be higher in the breast augmentation group (p<0.05). In regression analysis, it was found that age, openness, and the Rosenberg Self-Esteem Scale score had statistically significant effects on extroversion. CONCLUSION: We argue that there may be a presupposition, based on stigma, that women who undergo breast augmentation surgery are more neurotic than those who do not. Consequently, this may influence the outcomes of studies evaluating the personalities of these women. Our results indicate that women who had undergone breast augmentation had more positive personality traits than women in an un-operated control group.

Altered Affective Temperaments in Women With Vaginismus.

OBJECTIVE: Vaginismus is one of the most frequently occurring genito-pelvic pain disorders in women. Sexual dysfunction commonly presents with comorbid psychiatric disorders, and many patients suffering from the former exhibit the latter. The objective of this study was to investigate the affective temperaments of women with vaginismus compared to healthy controls. METHODS: Forty-eight women with vaginismus and 42 age-matched healthy women were recruited and compared in terms of their scores on the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire and a sociodemographic instrument. RESULTS: Except for the scores for hyperthymic temperament, those for depressive, cyclothymic, irritable, and anxious temperaments were significantly higher in the vaginismus group than in the healthy controls (P<.05). The analysis of covariance indicated that the anxious temperament was significantly associated with covariants. CONCLUSIONS: On the basis of the preliminary results, women with vaginismus may be candidates for bipolar disorder. This population should therefore be screened more carefully in terms of the development of the disorder. Bipolar disorder should also be considered when treatments for comorbid psychiatric disorders are needed.

Increased serum BDNF and ProBDNF levels in children with irritable bowel syndrome.

OBJECTIVE: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders among the pediatric population. Recently, neurotrophins have been suggested to be etiological factors or causes of symptoms of IBS. In the present study, the aim was to research the serum brain-derived neurotrophic factor (BDNF) and proBDNF levels in children with IBS. METHODS: The study group was selected from pediatric gastroenterology outpatient clinic and control group was recruited from healthy children outpatient clinic. Based on the inclusion and exclusion criteria, 29 children with IBS and 55 healthy children were included in the study. The data were obtained from all participants, and if needed, from their parents. All participants were assessed in terms of anthropometric measurements. The serum (BDNF) and proBDNF levels were compared between the groups. RESULTS: The proBDNF levels in IBS patients were higher compared with the control group in covariance analysis (IBS patients group mean 492.4, SD 534.1; control group mean 332.8, SD 406.7) (p = 0.02; Cohen's d = 0.45). The serum BDNF levels of IBS patients were also higher compared with the control group (IBS patients group mean 3.1, SD 4.3; control group mean 1.7, SD 2.7) (p = 0.02; Cohen's d = 0.51). CONCLUSIONS: The present study is the first to demonstrate that there is a higher level of serum BDNF in children with IBS. Moreover, it is the first to demonstrate an increased level of proBDNF in IBS. Additional research is needed to confirm the preliminary results.

Beneficial Effects of Ibuprofen on Pentylenetetrazol-induced Convulsion.

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that is commonly used as an anti-inflammatory, anti-pyretic, and analgesic. Although some studies have focused on the anti-inflammatory and anti-pyretic properties of ibuprofen during febrile convulsions, only one has investigated its antiepileptic effects. In the present study, we aimed to investigate the effects of ibuprofen in rats exposed to pentylenetetrazol (PTZ)-induced seizures. In total, 48 rats were randomly divided in two groups: Group A for electroencephalography (EEG) recordings and Group B for behavioral assessment. All EEG recordings and behavioral assessment protocols were performed. In addition, groups were compared in terms of prostaglandin F2 alfa (PGF2α) levels in the brain. We demonstrated the beneficial effects of the administration of ibuprofen in PTZ-induced seizures in rats via the following findings: spike percentages and Racine convulsion scale values were significantly lower and first myoclonic jerk (FMJ) onset times were significantly higher in the ibuprofen-administered groups. Moreover, PGF2α levels in the brain were significantly higher in the saline and PTZ 70 mg/kg group than in the control and PTZ 70 mg/kg and 400 mg/kg ibuprofen groups. Our study is the first to demonstrate the beneficial effects of ibuprofen on seizures through behavioral, EEG, and PGF2α brain assessments. Ibuprofen can be used for epilepsy and febrile seizures safely and without inducing seizures. However, further experimental and clinical studies are needed to confirm our results.

Social Media Addiction Among Individuals Who Underwent Rhinoplasty: Myth or Reality?

Background: Social media addiction is currently a common problem worldwide. Studies have suggested that individuals who underwent rhinoplasty are susceptible to the aforementioned condition, but no evidence-based research has been conducted to derive a definitive conclusion to this issue. Objective: This study was aimed at comparing the self-esteem, body perception, and social media use of individuals with and without a history of rhinoplasty. Design, Setting, and Participants: The study was conducted at two treatment centers. Rhinoplasty patients were selected from those who sought treatment in the private clinic of one of the researchers, whereas the control cohort participants were chosen from among employees of a university hospital. After the implementation of inclusion and exclusion criteria, 100 patients and 102 healthy unmatched control subjects were enrolled in the research. Main Measures and Outcomes: The collected sociodemographic data covered age, gender, years of education, and type of social media use. Social media addiction was measured using the social media addiction scale, self-esteem was ascertained with the Rosenberg self-esteem scale, and body perception was assessed using the body perception scale. The independent samples t-test was conducted twice to compare the mean scores of the participants, and mediation analysis was carried out to determine the effects of body image and self-esteem scores on social media addiction scores. Two-sided p-values were calculated, and differences were considered significant at the 0.1, 0.05, and 0.001 levels. Results: The groups obtained similar body image and self-esteem scores, but the difference in the social media addiction scores of the rhinoplasty patients and control participants was statistically significant at the 0.05 level, with the former having higher addiction scores. On the basis of the cutoff for social media addiction, 8 and 10 participants from the rhinoplasty and control groups, respectively, exhibited signs of dependency on Web-based social networks and similar innovations. The self-esteem scores (X) and body image scores (M) predicted the social media addiction scores (Y). The coefficient of the body image scores was statistically significant, but that of the self-esteem scores was not. The X + M → Y model indicated statistically significant effects. Conclusion and Relevance: We compared the social media usage of rhinoplasty patients and control participants. Our findings indicated no evidentiary support for the view of rhinoplasty patients as social media addicts and suggested that such a perception is a form of stigmatization.

Distinct temperament and character traits in patients with hyperemesis gravidarum.

Hyperemesis gravidarum (HG) is an extreme form of vomiting during pregnancy and is characterized with excessive vomiting and nausea and ketonuria, electrolyte imbalance, dehydration and severe nurtition deficiency. The etiology of HG is considered as multifactorial. Altough there is a great interest to HG in terms of psychiatric conditions, there have been limited numbers of studies that researched personality traits in patients with HG. In present study, we aimed to compare temperament and character traits between pregnant women with and without HG by Temperament and Character Inventory. 48 pregnant women with HG and 64 healthy pregnant women were included to study. The HG groups and control group were compared in terms of temperament and character traits and anxiety levels. The temperament scores of novelty seeking, harm avoidance and reward dependence were found to be similar between groups while the score of persistence was significantly lower in HG group compared with control group (p = .021). All character scores in HG group as cooperativeness, self-directedness, and self-transcendence were significantly lower compared with control groups (respectively; p = .002, p = .018 and p = .029). The scores of STAI-1 was higher in HG group compared with control group (p = .027) whereas the score of STAI-2 was found to be similar between groups. Present study is the first to demonstrate different temperament and character traits in patients with HG. We argue that our results support the psychiatric background of HG; however further studies are needed to confirm our results.

A Report of Rabbit Syndrome Who Benefited from Sigma 1 Agonist Fluvoxamine.

Rabbit Syndrome is an uncommon side effect of antipsychotic treatment. Although it is usually associated with typical antipsychotics, it can also be related to atypical antipsychotics. Anticholinergics are the most accepted treatment approach in treating Rabbit Syndrome. Fluvoxamine is a member of selective serotonin reuptake inhibitors and it is a potent agonist of sigma 1 receptors. In this article, we report a Rabbit Syndrome case who has benefited from fluvoxamine, in terms of both depressive disorder and Rabbit Syndrome; and present the data on the effects of sigma 1 agonist fluvoxamine on numerous movement disorders.

Decreased serum orexin A levels in drug-naive children with attention deficit and hyperactivity disorder.

Attention deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders of childhood and characterized by inattention, hyperactivity, and impulsivity. ADHD is a neurodevelopmental disorder, and its etiology has not yet been determined precisely. Orexin A is thought to play an important role in different forms of learning, memory, and attention. Despite its importance in attention and learning, no study has investigated serum orexin levels in patients with ADHD. In the present study, we aimed to compare serum orexigenic neuropeptides such as orexin A and orexin B, neuropeptide Y, and ghrelin between drug naive children with ADHD and healthy children. Fifty-six drug-naive children with ADHD and 40 healthy controls were enrolled in the study. After comparison of serum orexin A and orexin B, neuropeptide Y, and ghrelin, we found that serum orexin A levels were significantly lower in the ADHD group (p = 0.001). Furthermore, serum orexin A levels were compared between ADHD subgroups. Orexin A levels were significantly lower in the inattentive subtype compared with the hyperactive subtype and combined subtype (p = 0.009). Our results indicate that orexin A might be a neurobiological etiological factor in ADHD, particularly associated with attention symptoms. The present study is the first to demonstrate decreased serum orexin A levels in drug-naive children with ADHD. Further studies are needed to confirm our results and to show the effects of treatments involving orexin A in patients with ADHD.

Altered methyltetrahydrofolate reductase gene polymorphism in mothers of children with attention deficit and hyperactivity disorder.

Attention Deficit and Hyperactivity Disorder (ADHD) is one of the most common psychiatric disorders in childhood and causes significant functional impairments in children. Behavioral genetic and molecular genetic studies have provided significant evidence in terms of highlighting the etiology of ADHD. Folate deficiency during pregnancy is an established risk factor for ADHD. Polymorphisms in the Methyltetrahydrofolate Reductase (MTHFR) encoding gene, such as A1298C and C667T, are associated with the decreased bioavailability of folate, and this condition can act like folate deficiency. In the literature, no study has investigated MTHFR polymorphisms in mothers of children with ADHD. Sixty-four children diagnosed with ADHD and their mothers as well as 40 healthy children and their mothers participated in this study. MTHFR polymorphisms were investigated in all participants. Comparison of the C677C and A1298C MTHFR polymorphisms in children with and without ADHD revealed no significant differences. We found that the maternal C677C_CT genotype counts, both observed and expected values, were significantly different from those based on Hardy-Weinberg Principle Analysis in the ADHD group. The most important result of this study was that maternal C677C MTHFR gene polymorphisms are significant risk factors in for ADHD, and we argue that children with ADHD are exposed to folate deficiency, even if their mothers received a sufficient amount of folate during pregnancy. This result also highlights one of the genetic factors of ADHD. Further studies should be performed to confirm this finding.

Increased serum G72 protein levels in patients with schizophrenia: a potential candidate biomarker.

OBJECTIVE: The product of the G72 gene is an activator of d-amino acid oxidase and has been suggested to play a role in the pathogenesis of schizophrenia. Increased G72 protein levels may be associated with disturbed glutamatergic transmission and increased reactive oxygen species. Only one pilot study by Lin et al. has investigated the potential role of serum G72 protein levels as a biomarker for schizophrenia. In this study, we aimed to compare serum G72 protein levels between patients with schizophrenia and healthy controls, and to retest the results of the previous pilot study. Materials and methods In total, 107 patients with a diagnosis of schizophrenia according to the inclusion and exclusion criteria and 60 age-sex-matched healthy controls were included in the study. The groups were compared regarding serum G72 protein levels. RESULTS: The mean serum G72 protein values were 495.90±152.03 pg/ml in the schizophrenia group and 346.10±102.08 pg/ml in the healthy control group. The mean serum G72 protein level was significantly increased in the schizophrenia group compared with the healthy control group (t=-3.89, p<0.001). A receiver operating characteristics analysis was performed to compare the schizophrenia and healthy control groups. It was determined that the cut-off value was 141.51 pg/ml with a sensitivity of 0.991 and a specificity of 0.821. CONCLUSION: We suggest that serum G72 protein levels may represent a candidate biomarker for schizophrenia and have confirmed the results of the previous preliminary study. Additional studies with larger sample sizes and the inclusion of first episode schizophrenia patients are required to clarify the reliability and validity of serum G72 protein levels as a biomarker for schizophrenia.

Increased serum levels of apoptosis in deficit syndrome schizophrenia patients: a preliminary study.

BACKGROUND: Schizophrenia is a chronic and debilitating disorder, the etiology of which remains unclear. Apoptosis is a programmed cell death mechanism that might be implicated in neuropsychiatric disorders, including schizophrenia. In this study, we aimed to compare the serum levels of apoptosis among deficit schizophrenia (DS) syndrome patients, nondeficit schizophrenia (NDS) patients, and healthy controls (HCs). PATIENTS AND METHODS: After the inclusion and exclusion criteria were applied, 23 DS patients, 46 NDS patients, and 33 HCs were included in the study. The serum apoptosis levels were measured using a quantitative sandwich enzyme immunoassay with human monoclonal antibodies directed against DNA and histones. RESULTS: There was a significant difference among the three groups in terms of the levels of apoptosis (F 2,96=16.58; P<0.001). The serum apoptosis levels in the DS and NDS groups were significantly higher than those in the HC group. Furthermore, the serum apoptosis levels in the DS group were significantly higher than the levels in the NDS group. CONCLUSION: This study suggests that increased levels of apoptosis may be implicated in the pathophysiology of DS syndrome. However, further studies are needed to support the role of apoptosis in DS.

Neurological soft signs might be endophenotype candidates for patients with deficit syndrome schizophrenia.

BACKGROUND: Schizophrenia is a chronic, disabling, disorder that affects approximately 1% of the population. The nature of schizophrenia is heterogeneous, and unsuccessful efforts to subtype this disorder have been made. Deficit syndrome schizophrenia (DS) is a clinical diagnosis that has not been placed in main diagnostic manuals. In this study, we aimed to investigate and compare neurological soft signs (NSS) in DS patients, non-deficit schizophrenia (NDS) patients, and healthy controls (HCs). We suggest that NSS might be an endophenotype candidate for DS patients. METHODS: Sixty-six patients with schizophrenia and 30 HCs were enrolled in accordance with our inclusion and exclusion criteria. The patients were sub-typed as DS (n=24) and NDS (n=42) according to the Schedule for the Deficit Syndrome. The three groups were compared in terms of sociodemographic and clinical variables and total scores and subscores on the Physical and Neurological Examination for Soft Signs (PANESS). Following the comparison, a regression analysis was performed for predictability of total PANESS score and its subscales in the diagnosis of DS and NDS. RESULTS: The groups were similar in terms of age, sex, and smoking status. The results of our study indicated that the total PANESS score was significantly higher in the DS group compared to the NDS and HC groups, and all PANESS subscales were significantly higher in the DS group than in the HC group. The diagnosis of DS was predicted significantly by total PANESS score (P<0.001, odds ratio =9.48, 95% confidence interval: 0.00-4.56); the synergy, graphesthesia, stereognosis, motor tasks, and ability to maintain posture subscales were found to be significant predictors. CONCLUSION: This study confirms that NSS were higher in patients with DS. In addition, we suggest that our results might support the notion of DS as a different and distinct type of schizophrenia. NSS might also be a promising candidate as an endophenotype for DS. However, large sampled, multicentric studies are needed to clarify the place of NSS as an endophenotype in DS.

Decreased serum levels of brain-derived neurotrophic factor in schizophrenic patients with deficit syndrome.

BACKGROUND: Brain-derived neurotrophic factor (BDNF) is a well-established neurotrophin that plays a role in the pathophysiology of numerous psychiatric disorders. Many studies have investigated the serum BDNF levels in patients with schizophrenia. However, there are restricted data in the literature that compare the serum BDNF levels in patients with deficit and nondeficit syndromes. In this study, we aimed to compare the serum BDNF levels between schizophrenic patients with deficit or nondeficit syndrome and healthy controls. METHODS: After fulfilling the inclusion and exclusion criteria, 58 patients with schizophrenia and 36 healthy controls were included in the study. The patients were grouped as deficit syndrome (N=23) and nondeficit syndrome (N=35) according to the Schedule for the Deficit Syndrome. Three groups were compared in terms of the sociodemographic and clinical variants and serum BDNF levels. RESULTS: The groups were similar in terms of age, sex, body mass index, and smoking status. The serum BDNF levels in patients with deficit syndrome were significantly lower than those in healthy controls. In contrast, the serum BDNF levels in patients with nondeficit syndrome were similar to those in healthy controls. CONCLUSION: This study suggests that decreased BDNF levels may play a role in the pathophysiology of schizophrenic patients with deficit syndrome. Nonetheless, additional studies using a larger patient sample size are needed to investigate the serum BDNF levels in schizophrenic patients with deficit syndrome.

Increased serum dehydroepiandrosterone sulfate in the first episode but not in subsequent episodes in male patients with schizophrenia.

BACKGROUND: Many studies have investigated the relationship between blood levels of dehydroepiandrosterone (DHEA) and its sulfate ester (DHEA-S), cortisol, progesterone, and testosterone and the onset, prognosis, symptom severity, and treatment response of schizophrenia. In the present study, we assessed potential differences in blood levels of neurosteroids between drug-naïve first-episode patients with schizophrenia (FES), and drug-free patients with schizophrenia who were not in the first episode but were in a phase of acute exacerbation (DFP). MATERIALS AND METHODS: The present study included 32 male FES, 28 male DFP, and 24 male healthy controls (HC). Groups were compared in terms of blood levels of adrenocorticotropic hormone (ACTH), cortisol, testosterone, progesterone, and DHEA-S. RESULTS: Blood levels of ACTH, cortisol, testosterone, and progesterone were similar among the groups. The mean value of serum DHEA-S was significantly different among the groups (P<0.001). The value of serum DHEA-S was higher in the FES group than in the DFP and HC groups (both P<0.001). The mean values of serum DHEA-S in the HC and DFP groups were found to be similar (P=0.33). CONCLUSION: We suggest that higher values of DHEA-S in the FES group compared with both the DFP and HC groups indicate that this neurosteroid response is unique to first-episode schizophrenia patients. Further studies are needed to investigate the difference in blood levels of neurosteroids in different groups in terms of age of diagnosis.

Increased serum prolactin levels in drug-naive first-episode male patients with schizophrenia.

BACKGROUND: Prolactin is a hormone receiving considerable attention in psychiatry. Increased serum prolactin level is frequently associated with dopamine blocking antipsychotics. Furthermore, decreased prolactin level was considered a reflector of the effect of antipsychotics. However, there is restricted numbers of investigations that researched baseline prolactin levels in first-episode patients with schizophrenia. AIMS: We purpose to investigate serum baseline prolactin levels in drug-naive first-episode patients with schizophrenia (FES) and to explore the differences in serum prolactin levels between FES, drug-free schizophrenic patients (DFS) and healthy controls (HC). MATERIAL AND METHODS: The study was conducted in the Departments of Psychiatry, Gölbasi Hasvak and Kirklareli State Hospitals, Turkey. Thirty male FES, 41 male DFS and 32 male HC were included in study. All participants were clinically examined and individually interviewed. Before initiating any pharmacological treatment, 5 ml of venous blood was collected to measure serum prolactin levels between 08:00 and 10:00 h, which was determined by radioimmunoassay (RIA). Prolactin levels were also collected from the consenting HC using the same assay. RESULTS: The mean age was higher in the DFS group. The mean score of Brief Psychiatric Rating Scale was higher in the FES group and mean score of Scale for the Assessment of Negative Symptoms was higher in the DFS group. The mean value of prolactin was higher in the FES group (34.1 ± 19.9 ng/dl) compared with DFS (17.9 ± 6.5 ng/dl) and HC (9.7 ± 2.3 ng/dl) (F = 35.5, P < 0.001). Additionally, the mean value of serum prolactin is higher in the DFS group compared with HC (P < 0.001). CONCLUSION: To our knowledge, this study is the first to demonstrate higher serum prolactin levels in male FES compared with male DFS and male HC. Prolactin might act as a protective factor while first episode of schizophrenia is experienced. Future studies are needed to provide the role of prolactin in schizophrenia.

Relationship between SSRIs and Metabolic Syndrome Abnormalities in Patients with Generalized Anxiety Disorder: A Prospective Study.

OBJECTIVE: SSRIs are some of the most widely prescribed medications in the world. In addition to their effectiveness, SSRIs were reported to be associated with the side effects of weight gain, sexual dysfunction, drug interactions, extrapyramidal symptoms and discontinuation symptoms. However, the effects of SSRIs on metabolic parameters are poorly understood. METHODS: This study aims to describe the effects of SSRIs on the metabolic parameters of drug-naive first episode patients with generalized anxiety disorder. Ninety-seven female patients aged 20-41 years without any metabolic or psychiatric comorbidity were included in the study. Fluoxetine, sertraline, paroxetine, citalopram and escitalopram were randomly given to the patients. Metabolic parameters, including BMI, waist circumference and the levels of fasting glucose, total cholesterol, triglyceride, HDL, LDL and blood pressure, were measured before and after 16 weeks of treatment. RESULTS: In the paroxetine group, there was a significant increase in the parameters of weight, BMI, waist circumference, fasting glucose, total cholesterol, LDL and triglyceride after 16 weeks of treatment. There were significant increases in the levels of triglyceride in the citalopram and escitalopram groups. In the sertraline group, the total cholesterol level increased after treatment. In the fluoxetine group, there were significant reductions in the parameters of weight, total cholesterol and triglyceride. CONCLUSION: To our knowledge, this study is the first to prospectively describe metabolic syndrome abnormalities in patients with first episode generalized anxiety disorder. Although the effectiveness of the different SSRIs is similar, clinicians should be more careful when prescribing SSRIs to patients who have cardiac risk factors. Larger and lengthier controlled clinical trials are needed to explore the associations between SSRI use and metabolic syndrome.

Reduced total antioxidant level and increased oxidative stress in patients with deficit schizophrenia: a preliminary study.

INTRODUCTION: Deficit schizophrenia (DS) is defined for identifying a relatively homogeneous subgroup of patients with diagnosis of schizophrenia, characterized by the presence of primary and enduring negative symptoms. There have been several studies which investigated the status of oxidative stress and total antioxidant level in patients with schizophrenia. However, there is not any study which researched differences between DS and nondeficit schizophrenia (NDS) in terms of status of oxidative stress and antioxidant level. We hypothesized that patients with DS would have different status of oxidative stress and antioxidant levels compared with patients with NDS. METHODS: Twenty-three patients with DS, 42 patients with NDS and 31 age, sex and smoking status matched healthy controls (HC) were included to study. Five milliliters of blood was drawn from control subjects and patients for assessing total antioxidant potential (TAOP) and total peroxide levels (TPEROX). The ratio of TPEROX to TAOP is referred as oxidative stress index (OSI). RESULTS: We noticed that serum TAOP level was significantly lower in DS group compared with NDS and HC groups. The OSI was also found to be higher in DS group compared with NDS and HC groups. Furthermore, serum TAOP level and status of OSI were similar between NDS and HC groups. CONCLUSION: Our study is the first to demonstrate differences between DS and NDS in terms of status of oxidative stress and serum total antioxidant level. We suggest that our study represents novel and important results in terms of supporting provides and hypothesis which considered DS as a different disease entity with respect to NDS. Further studies are needed for investigating the status of antioxidants and oxidative stress and their clinical implications in deficit schizophrenia.