The Relationship between Cognition and Asymmetric Dimethyl Arginine, Symmetric Dimethyl Arginine, Nitric Oxide Levels and Total Antioxidant Capacity in Euthymic Bipolar Disorder Patients

ABSTRACT Objective: This study investigates the relationship between serum nitric oxide, asymmetrical dimethylarginine and symmetrical dimethylarginine levels and Total Antioxidant Capacity, and cognitive function in patients with bipolar disorder. Method: The study included 42 bipolar patients, diagnosed and assessed according to the DSM-V criteria, and 30 healthy controls. The Sociodemographic Questionnaire was used for the collection of data, and a bivariate Pearson correlation analysis was carried out. Results: The patient scores from a Rey Auditory Verbal Learning Test (RAVLT), Auditory Consonant Trigram (ACT), Digit Span Test (DST), Wisconsin Card Sorting Test (WCST), Trail Making-B (TMT-B) and Stroop Tests (ST) were found to be impaired in patients with BD when compared to the healthy controls. The SDMA level of the patient group was significantly higher in the control group, while the ADMA level was lower. The SDMA value was found to be positively correlated with ST-1,2,5 duration; and the NO value was positively correlated with ST-3 duration. Conclusions: The presence of neurobiological markers may serve to predict the severity of neurocognitive deficits, and can provide information about the progress of the disease.

Homocysteine, chronotype and clinical course in bipolar disorder patients.

Purpose: Higher homocysteine (HHcy) levels have been detected in bipolar disorder (BD) patients, and BD patients show circadian rhythm disorders even during remission. Here, we determined the homocysteine (Hcy) levels and chronotype of patients with BD during remission and investigated whether this was related to the clinical course of the disease. Materials and methods: In total, 80 BD outpatients were included. Clinical evaluation was conducted using the Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), Pittsburgh Sleep Quality Index (PSQI) and the Morningness-Eveningness Questionnaire (MEQ). Hcy, folic acid, vitamin B12 levels and protein consumption the day before clinical evaluation were measured.Results and conclusions: HHcy was found in 11 patients (8.8%), most of whom were males (n = 8, 72.7%). During the course of BD, patients with HHcy had significantly more mixed episodes than patients without HHcy (p = .007, z = -2696). In addition, patients with HHcy had significantly lower MEQ scores than patients without HHcy (p = .04, t = 2018). There was no significant difference in chronotype between patients with and without HHcy. The HHcy group had significantly lower levels of vitamin B12 (p = .003, t = 2870). There were no statistically significant differences in daily protein intake and folic acid levels between HHcy and non-HHcy groups. Our study showed a significant relationship between the number of mixed episodes and HHcy. In terms of potential confounds, patients who abused alcohol were excluded, but alcohol consumption was not evaluated. This result should be considered in BD and should be evaluated in larger samples of BD patients.

The Relationships between Prenatal Attachment, Basic Personality Traits, Styles of Coping with Stress, Depression, and Anxiety, and Marital Adjustment Among Women in the Third Trimester of Pregnancy.

OBJECTIVE: The importance of prenatal attachment, probably as the initial attachment of a pregnant woman to the fetus and which turn into the maternal-baby attachment after birth, for the well-being of the newborn and mother is well known. The aim of the present study was to explore the possible socio-demographic and clinical factors (personality features, styles used in coping with stress, depression, and situational anxiety levels, and marital adjustment) affecting maternal-fetal attachment. MATERIALS AND METHODS: Eighty women on their third trimesters of pregnancy were included in the study. After examination by a psychiatrist, a detailed socio-demographic form and scales including Prenatal Attachment Inventory, Basic Personality Traits Scale, Coping with Stress Attitudes Inventory, State-Trait Anxiety Inventory-1, Beck Depression Inventory (BDI), and Marital Adjustment Scale were applied. RESULTS: Educational level, marital adjustment, social support, and turning to religion as a coping mechanism with stress were found to be positively correlated with prenatal attachment scores. The duration of marriage and number of giving births and the avoidance/disengagement subscale of Coping with Stress Scale and BDI scores were negatively correlated with prenatal attachment scores. A BDI score of ≥17 (this score suggests moderate and/or severe symptoms of depression) was found to be an independent and a negative variable on prenatal attachment. CONCLUSION: We suggest that the detection of symptoms of depression and other factors that may affect prenatal attachment, may help shed light to the interventions to be performed to improve the quality of maternal-fetal attachment by society and governments.

Levels of nitric oxide, asymmetric dimethyl arginine, symmetric dimethyl arginine,and L-arginine in patients with obsessive-compulsive disorder.

BACKGROUND/AIM: We aimed to investigate and compare to healthy controls the variations in the levels of nitric oxide (NO), asymmetric dimethyl arginine (ADMA), symmetric dimethyl arginine (SDMA), and L-arginine levels in patients with obsessive-compulsive disorder (OCD). MATERIALS AND METHODS: We enrolled 30 patients with OCD and 30 healthy controls in the study consecutively. Diagnostic interviews of all participants were conducted with the Structured Clinical Interview for Axis I Disorders (SCID-I), and sociodemographic data of the participants were recorded. Patients scoring 10 points or more on the Yale-Brown Obsessive-Compulsive Scale were enrolled in the study. RESULTS: The NO levels of patients with OCD were increased compared to the control group, but the increase was not statistically significant (P > 0.05). However, patients with OCD had significantly lower levels of ADMA, SDMA, and L-arginine compared with the controls (P < 0.001). CONCLUSION: We found a significant decrease in ADMA, SDMA, and L-arginine as NO inhibitors between the groups, possibly because of an increase in NO. However, the insignificant increase in NO suggests that ADMA, SDMA, and L-arginine play direct and potentially important roles in OCD biology.

Pain perception: predictive value of sex, depression, anxiety, somatosensory amplification, obesity, and age.

OBJECTIVE: Factors affecting pain sensation are still being investigated. In this study, we aimed to examine the effects of sex, age, body mass index (BMI), somatosensory amplification, anxiety, and depression on the perception of pain. METHODS: Venipuncture was performed on 140 healthy individuals. All the cases completed a sociodemographic data form, visual analog scale (VAS), Beck Anxiety Inventory (BAI), Beck Depression Inventory, and Somatosensory Amplification Scale. Height and weight were also measured. RESULTS: When both the sexes were compared, there was no difference in terms of VAS, BMI, age, and Beck Depression Inventory, but Somatosensory Amplification Scale and BAI were found to be higher in females. A correlation was found among VAS points, BAI, and BMI. The results of a regression analysis show that the BAI score is a predictor for the VAS score. CONCLUSION: These results indicate that anxiety may be a predictor of pain, whereas sex, depression, somatosensory amplification, age, and weight do not appear to influence the perception of pain.

Diffuse Hair Loss Induced by Sertraline Use.

Hair loss is a rare side effect of psychotropic drugs. The most related drug class with this side effect is the mood stabilizers. Studies reporting the sertraline-induced alopecia are limited in number. Sertraline is a potent antidepressant which inhibits the serotonin reuptake from the presynaptic terminals selectively. The reason for hair loss could not be elucidated completely. Psychotropic drugs are usually considered to lead to hair loss through influencing the telogen phase of hair follicle. This paper reports a 21-year-old male with diffuse hair loss induced by sertraline use and improved by quitting the drug. To the best of our knowledge, there are no other case reports on sertraline-induced alopecia within 2 weeks.

Synthetic cannabis-induced mania.

Synthetic cannabinoids (SC), cannabinoid 1 and cannabinoid 2 receptors agonists, are the psychoactive substances. SC was originally produced to treat medical conditions. Compared to other narcotics, SC is easier to obtain, cheap, and highly potent and has a long half-life. In addition, routine analysis does not detect SC, which has led to widespread use. A case is presented that manic episode was developed with the use of SC. Hospitalization and admission to psychiatric units depending on SC use have been observed mostly with psychosis. Although SC-induced affective symptoms were mentioned in the literature, mania has not been reported before. We aimed to discuss the psychiatric conditions induced by widespread use of SC via our case.

[Internalized stigmatization in bipolar patients: relationship with clinical properties, quality of life and treatment compliance]. / Iki uçlu bozuklukta içsellestirilmis damgalanma: klinik özellikler, yasam kalitesi ve tedaviye uyum ile iliskisi.

OBJECTIVE: This study aimed to investigate the impact of the internalized stigmatization on bipolar disorder (BD) patients. MATERIALS AND METHODS: The study included 100 BD patients that provided written informed consent to participate. Diagnosis of the BD patients that were in remission and receiving outpatient treatment was performed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and patient data were recorded using SKIP-TURK. In addition, the patients were administered the Internalized Stigma of Mental Illness Scale (ISMI), Mood Stabilizer Compliance Questionnaire (MSQC), and World Health Organization Quality of Life Assessment, abbreviated form (WHOQOL-BREF). RESULTS: Internalized stigmatization was observed in 46% of the BD patients; these patients had higher functionality scores, shorter regression periods, and more depressive episodes than those without internalized stigmatization. Although internalized stigmatization occurred more frequently in seasonal and rapid cycling patients, both attributes were prodrome of internalized stigmatization. Internalized stigmatization was observed more frequently in patients with low socioeconomic status, low level of education, rural residence, lack of work, and more children. There was a strong correlation between ISMI score, and WHOQOL-BREF and MSQC scores. CONCLUSION: The clinical features of the BD and internalized stigmatization were observed to affect each other. Furthermore, stigmatization affected treatment compliance and quality of life.