RESUMO
Methamphetamine, one of the most frequently used illicit drugs worldwide, can induce psychosis in a large fraction of abusers and it is becoming a major problem for the health care institutions. There is some evidence that genetic and epigenetic factors may play roles in methamphetamine psychosis. In this study, we examined methamphetamine-induced epigenetic and expression changes of several key genes involved in psychosis. RNA and DNA extracted from the saliva samples of patients with methamphetamine dependency with and without psychosis as well as control subjects (each group 25) were analyzed for expression and promoter DNA methylation status of DRD1, DRD2, DRD3, DRD4, MB-COMT, GAD1, and AKT1 using qRT-PCR and q-MSP, respectively. We found statistically significant DNA hypomethylation of the promoter regions of DRD3 (P = 0.032), DRD4 (P = 0.05), MB-COMT (P = 0.009), and AKT1 (P = 0.0008) associated with increased expression of the corresponding genes in patients with methamphetamine psychosis (P = 0.022, P = 0.034, P = 0.035, P = 0.038, respectively), and to a lesser degree in some of the candidate genes in non-psychotic patients versus the control subjects. In general, methamphetamine dependency is associated with reduced DNA methylation and corresponding increase in expression of several key genes involved in the pathogenesis of psychotic disorders. While these epigenetic changes can be useful diagnostic biomarkers for psychosis in methamphetamine abusers, it is also consistent with the use of methyl rich diet for prevention or suppression of psychosis in these patients. However, this needs to be confirmed in future studies. © 2016 Wiley Periodicals, Inc.
Assuntos
Metilação de DNA/efeitos dos fármacos , Transtornos Psicóticos/genética , Adulto , Transtornos Relacionados ao Uso de Anfetaminas/genética , Estudos de Casos e Controles , Catecol O-Metiltransferase/genética , Metilação de DNA/genética , Dopamina , Epigenômica , Feminino , Predisposição Genética para Doença/genética , Humanos , Masculino , Metanfetamina/efeitos adversos , Regiões Promotoras Genéticas/efeitos dos fármacos , Regiões Promotoras Genéticas/genética , Proteínas Proto-Oncogênicas c-akt/genética , Transtornos Psicóticos/metabolismo , Receptores de Dopamina D3/genética , Receptores de Dopamina D4/genética , Saliva , TranscriptomaRESUMO
Bipolar I disorder (BID) and its treatments have shown to be associated with deep impacts on patients' subjective feelings and quality of life (QOL). There are also some comments about impact of these feelings on course and outcome of patients with BID. This study was aimed to evaluate quality of life in patients with BID and to assess its relationship with course of disorder. Fifty patients with BID were recruited based on the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) from May 2008 and followed for 12 months. Quality of life and mood disorder recurrence were assessed through World Health Organization Quality of Life and SCID-I tools respectively at baseline and after 6 and 12 months. Repeated measures analysis and logistic regression were used to analyze the independent effect of QOL and demographic factors on BID recurrence. Fifty patients (66% male; 48% never married; 48% in primary school level) with mean ± SE age and age of BID onset 33.8±1.5 and 26.6±1.1 years were studied. They had 3.4±0.6 episodes already. Twenty eight percent suffered from recurrences during the follow-up. The QOL scores at baseline, after 6 and 12 months were 70±1.8, 69.6±1.1 and 73±1.3 respectively. There were no significant change in QOL and its sub-domains during the follow-up (P=0.37). QOL showed no independent relationship with BID recurrences (P>0.1). No change in the QOL during the follow-up could denote lack of effectiveness of routine interventions on this factor. Also, short-term follow-up might be concerned as the possible reason. Of prime importance is to consider quality of life independently in treating patients with bipolar disorder.
Assuntos
Transtorno Bipolar/psicologia , Qualidade de Vida , Adulto , Transtorno Bipolar/diagnóstico , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Recidiva , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Bipolar disorder is strongly associated with suicidal ideations, attempts and commissions. Although several studies have been conducted on suicide risk factors in patients with bipolar disorder worldwide, a comprehensive study has not been reported from Iran. METHODS: Patients with bipolar disorder type I, hospitalized in Iran Hospital of Psychiatry since May 2008 to August 2011 were sequentially enrolled. Patients were evaluated using Demographic and Clinical Variables Questionnaire, the Structured Clinical Interview for DSM-IV axis I disorders (SCID-I), Young-Mania Rating Scale (Y-MRS), and Hamilton Depressive Rating Scale-7 (HDRS-7). One hundred patients were followed for 2 to 42 months (mean: 20.6 ± 12.5 months). RESULTS: Only one patient attempted suicide during the follow-up period. 33% of the patients had history of previous suicide attempts. Female gender, divorce, and early age at onset of the disease were independently correlated with suicide attempt. CONCLUSION: Suicide attempts rarely occur during systematic follow-up of patients with bipolar disorder type I. Larger samples and longer follow-ups are needed to confirm this finding. DECLARATION OF INTEREST: None.
