Psychological status and patient-assessed health instruments in ankylosing spondylitis.

BACKGROUND: Determination of the relationships between disease and psychological status in ankylosing spondylitis (AS) is needed for clinical assessment and management, as well as selection and monitoring of AS patients for biological therapy. OBJECTIVE: The study aimed to describe associations between self-reported health status and psychological factors in AS patients and to compare the Symptom Checklist 90-Revised (SCL-90-R) profiles of the AS patients and the control subjects. METHODS: Disease status was determined through the Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and the Bath AS Metrology Index (BASMI). Psychological status was measured using the SCL-90-R. RESULTS: BASDAI and BASFI scores correlated with somatization, anxiety, obsessive-compulsive, depression, and hostility subscales of SCL-90-R (P ≤ 0.05). BASFI scores were significantly correlated with interpersonal sensitivity and phobic anxiety subscales of SCL-90-R (P < 0.05), whereas no correlation was observed between BASDAI and interpersonal sensitivity and phobic anxiety subscales. BASMI scores were significantly correlated with somatization and interpersonal sensitivity subscales (P < 0.05). After age and sex adjustments, a statistically significant difference was determined between the somatization scores of the AS patients and control subjects (P = 0.005). CONCLUSION: AS is a chronic disease, which causes deformities and workforce decline. This, in turn, might lead to psychological distress. There is a need to assess the mood of patients with AS. Completion of self-report assessment tools are potentially confounded by reporting biases that result from psychological factors. Some patients may overreport symptoms or disability because of a tendency to somatize. Thus, during interpretation of these tools, psychological status should be taken into account especially deciding the treatment regimen including biologic therapies.

Risperidone and liver function tests in children and adolescents: a short-term prospective study.

OBJECTIVE: Revealing of unknown adverse effects of atypical antipsychotics on pediatric population may take a long period of time. The purpose of this prospective study is to document changes in the liver function tests (LFTs) associated with risperidone usage in a group of children and adolescents. METHOD: Study subjects consist of 120 youths with ages ranging from 3-17 years. For this study, patients' baseline and follow-up weight and hepatobiliary function tests including alanine aminotransferases(ALT) and aspartat aminotransferases (AST), gamma gluatamyl transerase (GGT), alkaline phosphatase (ALP) and serum bilirubin levels were measured before and after the treatment period of one month. RESULTS: Only one male patient's ALT levels increased up to three-fold and AST levels increased up to two-fold of the basal levels. First month mean levels of liver enzymes and billuribin of the patients were significantly higher than the baseline. Sixty-three patients (52.5%) showed an asymptomatic increase in the liver enzymes and/or billuribin levels of the first month of this study. Weight gain was observed in 58 patients (57.4%). There was no significant association between changes in weight and liver enzymes and billuribin levels. CONCLUSION: We found clinically non significant liver function test abnormalities mostly in the form of ALP elevation in 52.5% and marked liver enzymes elevation in 0.8% of risperidone-treated subjects. However use of concomitant medications and variations in age are the limitations of this study. These findings suggest that risperidone treatment in the short term may lead to liver function changes in children and adolescents.

Resistance to macrolides in Group A streptococci from the European section of Turkey: genetic and phenotypic characterization.

The aim of this study was to determine the susceptibilities to macrolides of Group A streptococcal isolates from the European section of Turkey. In the case of resistant isolates, the patterns and genetic mechanisms of erythromycin resistance were studied. Seven (2.7%) of the 260 isolates were resistant to erythromycin. Four of them showed the M phenotype and harboured mefA genes whereas three isolates showed the inducible macrolide, lincosamide and streptogramin B resistance phenotype and harboured ermTR genes. In the European section of Turkey, the current resistance rate of Group A streptococci to macrolides remains low.

Pain perception in patients with bipolar disorder and schizophrenia.

OBJECTIVE: Pain perception is reported to be altered in patients with depression and schizophrenia. However, few studies have investigated the pain perception in patients with bipolar disorders. We therefore aimed to compare pain sensitivity between patients with bipolar disorder, schizophrenia and controls. METHODS: Study groups consisted of 30 patients with bipolar disorder, and control groups consisted of 27 patients with schizophrenia and 59 healthy subjects. Pain perception was assessed with cold pressor test (CPT) by exposure to ice-water. RESULTS: Patients with schizophrenia had significantly higher pain thresholds (PTh) than patients with bipolar disorder. There were no differences between the PTh of patients with schizophrenia and healthy control subjects. However, patients with bipolar disorder had significantly lower pain tolerance (PT) in the CPT than patients with schizophrenia and corresponding healthy control subjects. CONCLUSIONS: The higher PTh in the schizophrenia group compared with the bipolar group found in this study supports further investigation of a potential difference in the pain perception between patients with schizophrenia and bipolar disorder. Theoretical implications of these findings and possible relevant behavioural and neurochemical mechanisms are discussed.