Death Anxiety and Related Factors in Schizophrenia Patients: Controlled Study.

The aim of the study was to investigate the level of death anxiety and related sociodemographic and clinical variables in schizophrenia patients. One hundred and ninety schizophrenia patients and 110 healthy controls were included the study. Death anxiety measured with Templer Death Anxiety Scale (TDAS). The patients were also evaluated with scales in terms of depression, anxiety, obsessive-compulsive symptoms, and suicide. The death anxiety level in patients with schizophrenia was significantly higher than the healthy controls. The severity of depressive and psychotic symptoms were related to the level of death anxiety. Patients with schizophrenia may need more protection and psychosocial interventions about death related themes.

White matter characteristics in the early and late stages of bipolar disorder: A diffusion tensor imaging study.

BACKGROUND: Bipolar disorder (BD) is characterized by recurrent mood episodes that may progress over time. Staging models may be used to follow the long-term course of BD. BD is associated with microstructural changes in white matter (WM). This study aims to compare the WM integrity within patients groups who are in different stages of BD and healthy controls and investigate whether WM integrity changes may be a biomarker that can be used in the clinical staging of BD. METHODS: The study sample included euthymic 54 patients diagnosed with BD according to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) and 27 healthy volunteers. Early-stage patients (n = 26) were determined as patients who have not had any mood episodes after the first manic episode, and late-stage patients (n = 28) determined as patients with recurrent mood episodes. MRI was performed using a 1.5 Tesla MR system and DTI sequences were acquired. RESULTS: Region of interest (ROI) analyses showed that late-stage patients had significantly reduced fractional anisotropy (FA) in the right sagittal stratum and genu of the corpus callosum compared with healthy controls and early-stage patients. Regression models show that corpus callosum genu and right sagittal stratum FA values are predictive for the late-stage patient group. LIMITATIONS: There are some limitations of the ROI method. The cross-sectional design is another limitation of this study. CONCLUSIONS: WM integrity of corpus callosum genu and right sagittal stratum may be a biomarker for clinical staging of BD. Identifying stage-specific biomarkers may help us predict the neuroprogressive course of BD. Longitudinal studies would be required to detect stage-specific biomarkers.

Neurotrophic Factor Levels and Cognitive Functions before and after the Repetitive Transcranial Magnetic Stimulation in Treatment Resistant Depression.

OBJECTIVE: To determine relationship between the therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) on cognitive impairment and brain derived neurotrophic factor (BDNF), glial cell derived neurotrophic factor (GDNF) levels in treatment resistant depression (TRD). STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Psychiatry Clinic of Konya Beyhekim Training and Research Hospital in Turkey, between June and November 2019. METHODOLOGY: The study included 33 TRD patients and 33 healthy subjects. Patients received a total of 20 sessions of rTMS treatment. Serum BDNF and GDNF levels were measured before and after rTMS treatment. Additionally, the severity of depression as well as cognitive functions were assessed at the baseline and after the treatment. RESULTS: The rTMS treatment significantly improved depressive and cognitive symptoms in patients with TRD. Although the level of serum BDNF and GDNF increased after rTMS treatment, it was associated with the improvement in symptoms, but not significantly. CONCLUSIONS: rTMS treatment contributes to the antidepressant effect by normalising serum BDNF and GDNF levels in patients with TRD. Adding rTMS to antidepressants is, therefore, an appropriate treatment option for depressive patients with cognitive impairment. Key Words: rTMS, BDNF, GDNF, Cognitive function.

Ganglion cell complex thickness changes in patients with different states of bipolar disorder.

OBJECTIVES: Neuroimaging studies in patients with bipolar disorder have suggested that a neuropathological process may be effective in this disease. Neurodegenerative changes in the retina can be followed by optical coherence tomography, a non-invasive imaging method that allows in vivo visualization of the retinal layers. The aim of this study was to investigate the possible differences in optical coherence tomography parameters during euthymic, manic, and depressive episodes in patients diagnosed with bipolar disorder. METHODS: A total of 150 patients with bipolar disorder were included in the study, divided into three groups (50 patients in a euthymic state, 50 patients in a manic state, and 50 patients in a depressive state) and compared with 50 healthy controls. Ganglion cell complex thickness was measured with automated macular segmentation software of spectral-domain optical coherence tomography. RESULTS: Ganglion cell complex thicknesses were thicker in all quadrants in patient groups than the control group but the differences were significant in perifoveal superior and perifoveal inferior quadrants (p < 0.001, p < 0.001). There were no differences in ganglion cell complex thickness among the patient groups (p > 0.05). CONCLUSION: The evaluation of ganglion cell complex thickness by spectral-domain optical coherence tomography may give a clue for monitoring neurodegenerative changes in patients with bipolar disorder.

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

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

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

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

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

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

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

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

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

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