The Diagnostic Value of Malondialdehyde, Superoxide Dismutase and Catalase Activity in Drug Naïve, First Episode, Non-Smoker Generalized Anxiety Disorder Patients.

OBJECTIVE: Generalized anxiety disorder (GAD) is a common anxiety disorder. Although lots of research done to reveal neurobiological basis of GAD, it is still unclear. Diagnosis of GAD depends on subjective complaints of patients, thus the need for a biological marker is constantly emerging. In this study, we aimed to investigate diagnostic value of malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) in GAD. METHODS: We evaluated MDA, SOD, and CAT levels in peripheral blood of 46 patients and 45 controls. MDA was measured with Ohkawa's methods, SOD was measured with Fridovich method, and CAT was measured with Beutler's method. RESULTS: MDA was significantly increased in patients than controls, medians 4.05 nmol/mg and 1.71 nmol/mg respectively, p＜0.001; SOD and CAT activity was significantly decreased in patients than controls, medians of SOD were 159.07 U/mg and 301.87 U/mg, p＜0.001 respectively, medians for CAT were 138.47 U/mg and 160.60 U/mg respectively. We found high correlation between Hamilton Anxiety Rating Scale and SOD, MDA r values were 0.723 and 0.715 respectively, p＜0.001 for both. Receiver operator characteristic (ROC) curve analysis showed high diagnostic performance for MDA and SOD, low diagnostic performance for CAT, areas under curve were 1.0, 1.0, and 0.648 respectively. CONCLUSION: Our results reveal possible diagnostic value of MDA, less likely of SOD but not CAT. Future studies should investigate diagnostic value of oxidants and antioxidantn enzymes in larger samples and include diagnostic value of these parameters.

Increased Serum G Protein-coupled Estrogen Receptor 1 Levels and Its Diagnostic Value in Drug Naïve Patients with Major Depressive Disorder.

OBJECTIVE: The facts that depression is more prevalent in females than in males and females are exposed to depression more commonly during certain hormonal fluctuating periods indicate the role of sex hormones in physiopathology. Estrogen acts over estrogen receptors alpha and beta and recently identified G protein-coupled estrogen receptor 1 (GPER1). The present study aimed, for the first time, to evaluate serum GPER1 levels in drug-naïve major depressive disorder (MDD) patients. METHODS: The study included 56 newly diagnosed drug-naïve MDD patients aged between 18 and 50 years and 42 age- and gender-matched healthy volunteers. Medical history was obtained and physical examinations, laboratory tests, and the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) were performed. The serum GPER1 levels were measured. RESULTS: The HAM-D score was significantly higher in the MDD patients than in the controls. The GPER1 level was significantly higher in the MDD patients than in the controls. A positive correlation was found with GPER1 levels and depression scores. The receiver operating characteristic analysis revealed sensitivity, specificity, positive predictive value, and negative predictive value as 82.1%, 90.5%, 92.0%, and 79.2%, respectively, for the presence of depression, when the serum GPER1 value was ≥0.16. CONCLUSION: This study demonstrated significantly higher serum GPER1 levels in the MDD patients than in the controls, a positive correlation was found between GPER1 levels and depression scores and serum GPER1 level was valuable in predicting the presence of depression.

Evaluation of Malondialdehyde, Superoxide Dismutase and Catalase Activity in Fetal Cord Blood of Depressed Mothers.

OBJECTIVE: The umbilical cord consists of two arteries and one vein and it functions in the transport between the maternal and fetal circulation. Biochemical analysis of fetal cord blood (FCB) during delivery could be beneficial in terms of understanding the fetal environment. In this study, we aimed to investigate oxidative parameters like malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) levels in FCB during delivery. METHODS: We collected FCB samples during caesarean section. Our study included 33 depressed mothers and 37 healthy controls. We investigated MDA, SOD, and CAT levels in FCB samples. RESULTS: We found no significant difference between groups in terms of MDA (p=0.625), SOD (p=0.940), and CAT (p=0.413) levels. CONCLUSION: Our study reveals probable protective effects of the placenta from oxidative stress. Future studies should include larger samples.

Arterial Stiffness in Patients Taking Second-generation Antipsychotics.

OBJECTIVE: That treatment with second-generation antipsychotics (SGAs) causes metabolic side effects and atherosclerosis in patients with schizophrenia and bipolar disorder (BD) is well-known. Increased arterial stiffness is an important marker of arteriosclerosis and has been identified as an independent risk factor for cardiovascular diseases. We measured pulse wave velocity (PWV) as a marker of arteriosclerosis in patients with schizophrenia and BD who use SGAs. METHODS: Patients and controls were collected from our psychiatry outpatient clinics or family medicine. Mental illness was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Mean age, gender, systolic and diastolic blood pressure, body mass index, Framingham risk score (FRS), etc. were determined. Simultaneous electrocardiography and pulse wave were recorded with an electromyography device. The photo-plethysmographic method was used to record the pulse wave. Inclusion criteria included use of SGAs for at least the last six months. Patients with diseases that are known to cause stiffness and the use of typical antipsychotics were excluded. RESULTS: Ninety-six subject (56 patients, 40 controls) were included in our study. There were 49 females, 47 males. Patients had schizophrenia (n=17) and BD (n=39). Their treatments were quetiapine (n=15), risperidone (n=13), olanzapine (n=15), and aripiprazole (n=13). Although differences in mean age, gender, and FRS in the patient and control groups were not statistically significant (p=1), PWV was greater in patients in the antipsychotic group (p=0.048). CONCLUSION: This study supported the liability to stiffness in patients with schizophrenia and BD. Using SGAs may contribute to arterial stiffness in these patients.

Serum levels of G protein-coupled estrogen receptor 1 (GPER1) in drug-naive patients with generalized anxiety disorder.

Sex hormones, particularly estrogen, are suggested to play a role in the physiopathology of generalized anxiety disorder (GAD). Estrogen functions through the estrogen receptors alpha and beta and the recently discovered G protein-coupled estrogen receptor 1 (GPER1). This study aimed, for the first time, to evaluate serum GPER1 levels in drug-naive patients with GAD. This study included 40 newly diagnosed drug-naive patients with GAD aged between 18 and 50 years and 40 age- and gender-matched healthy controls. Medical histories were obtained, and physical examinations and laboratory tests were conducted; the Hamilton Anxiety Rating Scale (HAM-A) was also used for all participants. Serum GPER1 levels were measured. The serum GPER1 level was significantly higher in the patients with GAD than in the controls. A positive significant correlation was observed between the GPER1 level and the HAM-A score. The receiver operating characteristic analysis revealed a sensitivity, specificity, positive predictive value, and negative predictive value of 85.0%, 82.5%, 82.9%, and 84.6%, respectively, for the presence of anxiety when the serum GPER1 value was ≥0.14 (the area under the curve was 0.904.). In conclusion, this study demonstrated that GPER1 levels were associated with the anxiety levels of patients, and that the serum GPER1 level was a valuable predictor of the presence of anxiety independent of gender.

Depression in pregnancy is associated with decreased glutathione peroxidase activity in fetal cord blood.

The investigation of fetal cord blood (FCB) during child delivery has created a novel topic in the field of psychiatric research. The umbilical vein receives nutrients and oxygen from the mother's circulation and transports them to the fetal circulation. Investigating fetal cord blood during delivery is beneficial for understanding the fetal environment. Depression in pregnancy is associated with medical and emotional burdens. In this study, we aimed to investigate glutathione peroxidase (Gpx) and myeloperoxidase (MPO) activity in the FCB of depressed mothers and healthy controls. Our study included 45 depressed mothers and 59 healthy controls. The FCB samples were collected from the umbilical vein during delivery. We found that Gpx levels were significantly decreased in the FCB of depressed mothers than healthy controls, medians were 0.14 U/ml and 0.16 U/ml respectively, Z: -3.567 and p < 0.001. MPO levels were similar in both groups, medians were 1.0 U/L and 1.2 U/L respectively, Z: -1.837 and p:0.066. Depression in pregnancy may be associated with decreased antioxidant levels, and this condition may cause an oxidative load, which may lead to improper brain development. Future studies should be performed in larger samples to clarify our preliminary results.

Pineal gland volume in schizophrenia and mood disorders.

BACKGROUND: The majority of patients with schizophrenia and mood disorders have disruptions in sleep and circadian rhythm. Melatonin, which is secreted by the human pineal gland, plays an important role in sleep and circadian rhythm. The aim of the present study was to evaluate and compare pineal gland volumes in patients with schizophrenia and mood disorders. SUBJECTS AND METHODS: We retrospectively evaluated the pineal gland volumes of 80 cases, including 16 cases of unipolar depression, 17 cases of bipolar disorder, 17 cases of schizophrenia, and 30 controls. The total pineal gland volume of all cases was measured via magnetic resonance images, and the total mean pineal volume of each group was compared. RESULTS: The mean pineal volumes of patients with schizophrenia, bipolar disorder, unipolar depression, and the controls were 83.55±10.11 mm(3), 93.62±11.00 mm(3), 95.19±11.61 mm(3) and 99.73±12.03 mm(3), respectively. The mean pineal gland volume of the patients with schizophrenia was significantly smaller than those of the other groups. CONCLUSIONS: Our data show that patients with schizophrenia have smaller pineal gland volumes, and this deviation in pineal gland morphology is not seen in those with mood disorders. We hypothesize that volumetric changes in the pineal gland of patients with schizophrenia may be involved in the pathophysiology of this illness.

Relationship between sleep quality and depression among elderly nursing home residents in Turkey.

OBJECTIVES: Epidemiological studies indicate that more than half of the elderly population suffers from chronic sleep disturbances. Therefore, this descriptive study was conducted to examine sleep quality, excessive daytime sleepiness, daytime napping, and depression among a population of nursing home residents. METHODS: The study's sample included 73 elderly people living in a nursing home in Turkey. Geriatric Depression Scale, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and a sleep diary were used. RESULTS: The participants' mean age was 74.0 years (standard deviation (SD) = 6.7). Forty-four of the individuals had a poor sleep quality prevalence of 60.3%; and the mean global PSQI score was 6.6 (SD = 3.6). Their mean ESS score was 5.9 (SD = 4.6) and 14 participants (19.2%) had daytime sleepiness. The mean daytime napping duration was 1.0 h (SD = 1.3) according to the participants' sleep diaries. The study found that 60.3% of the participants were depressed, furthermore the mean depression score was 15.9 (SD = 7.0). There was a significant correlation between the PSQI subscores; subjective sleep quality, the sleep latency, and sleep disturbances scores and depression scores. Also, daytime napping frequency and daytime napping duration, according to the sleep diary, were correlated positively with depression scores. CONCLUSIONS: The current study's results confirm the previously reported high prevalence of poor sleep quality and depression in this nursing home population. Clinicians need to assess patients appropriately to identify high prevalence of sleep problems and depression in nursing home patients and initiate appropriate referrals and interventions.

Night eating syndrome among patients with depression.

OBJECTIVE: The purpose of this study was to identify the rate of night eating syndrome (NES) in a depressed population. METHOD: The study sample was composed of 162 depressed patients and 172 healthy control participants. RESULTS: The rates of night eating in our sample with depression (35.2%) was higher as compared with healthy control participants (19.2%) (p less than 0.05). In addition, in the depression group, the rate of NES-positive patients did not differ in accordance with body mass index (BMI) classification (p more than 0.05). However, in the control group, the rate of NES-positive patients was significantly different with regard to BMI classification, and NES diagnosis was highest in the obese members of the control group (p less than 0.05). Multiple logistic regression analysis was then used to evaluate the relationships of four variables: depression, gender, education status and BMI with the diagnosis of NES. Results showed that significant independent predictors of NES were depression, gender, and a BMI of 25 or greater. DISCUSSION: This is the first study to find that depressed patients are at a significantly greater risk for NES. Depression, male gender and BMI may account for the high rate of NES found in this population.

Maras powder usage among Turkish psychiatric outpatients.

A kind of smokeless tobacco known as Maras powder, which is used in the southeastern region of Turkey, causes nicotine dependence. The aim of this study was to determine the usage of Maras powder among psychiatric outpatients and nonpsychiatric controls. The study group consisted of 276 psychiatric patients and 283 nonpsychiatric patients from psychiatry and family medicine outpatient clinics. A socio-demographic form, the Fagerström Test for Nicotine Dependence, and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders?4th Edition were given to the participants. The rates of Maras powder usage in the patient group (10.1%) were significantly higher than those in the control group (5.6%). Men were found to use Maras powder at a higher rate in both groups. The rates of Maras powder usage according to the psychiatric diagnosis were evaluated. This is the first study estimating Maras powder usage rates among psychiatric patients in Turkey. The study's limitations are noted.

Combination therapy of imipramine and melatonin: additive antidepressant effect in mouse forced swimming test.

Although there are tools to treat depressive patients, a considerable amount of the cases remains to be untreated. These drug-resistant patients need new drugs or drug combinations to overcome this problem. Thus, the potential synergistic effect of melatonin on a classical drug, imipramine was evaluated in the present study. To test this hypothesis, porsolt swim test, a test predictive of antidepressant-like action, was conducted in mice. Imipramine at doses of 20 and 40 mg/kg caused no alteration and statistically significant reduction in the duration of immobility in forced swim test, respectively. While 5 mg/kg melatonin had no effect, 10 mg/kg melatonin slightly reduced the duration of immobility. When sub-effective doses of imipramine and melatonin (20 and 5 mg/kg, respectively) were co-administered, there was no alteration in responses compared with those of each drug alone. Likewise, the effective dose of melatonin (10 mg/kg) did not cause any increase in responses to 20 mg/kg imipramine. Although combination of imipramine (40 mg/kg) and melatonin (5 mg/kg) did not exert an antidepressant effect above that of imipramine alone, co-administration of the effective doses (10 and 40 mg/kg for melatonin and imipramine, respectively) displayed an additive effect. There were no significant differences between groups in relation with locomotor activity test. The results show that co-administration of imipramine and melatonin exhibits an additive effect and that there seems to be no interaction between the drugs.