High-sensitivity C-reactive protein and high mobility group box-1 levels in Parkinson's disease.

Various immunologic and inflammatory factors are contributed to pathogenesis of Parkinson's disease (PD). High mobility group box-1 (HMGB1) is a protein that plays certain roles in inflammation, DNA repair, transcription, somatic recombination, cell differentiation, cell migration, neuronal development, and neurodegeneration. The aim of the present study was to evaluate the serum levels of HMGB1 and high-sensitivity C-reactive protein (hs-CRP) among patients with Parkinson's disease and healthy controls. This study includes 30 patients with PD and 30 healthy controls, matched sex, age, body mass index, and smoking status. HMGB1 and hs-CRP serum levels were compared between the groups. The diagnostic performance of HMGB1 and hs-CRP was evaluated with receiver operating characteristic (ROC) curve analysis. HMGB1 levels were significantly higher in PD patients than in controls. Hs-CRP levels were significantly higher in PD patients than in controls There was a moderate correlation between hs-CRP and HMGB1 levels in the patient group. The cut-off value of HMGB1 level for the prediction of PD was determined as 32.8 ng/mL with 80% sensitivity and 60% specificity (p = 0.006). The cut-off value of hs-CRP level for the prediction of PD was determined as 0.63 mg/L with 66.7% sensitivity and 77.7% specificity (p = 0.007). This study demonstrates for the first time the association between HMGB1, hs-CRP, and PD. We found that HMGB1 and hs-CRP levels to be significantly higher in the PD patients than in the normal controls. As a result of the ROC curve analysis, HMGB1 and hs-CRP levels may be fair markers in the diagnosis of PD.

Customary practices, domestic violence, and psychosomatic pain among adolescent mothers in Turkey.

BACKGROUND: Adolescent motherhood is present in many societies worldwide, including Turkey. AIMS: We aimed to determine the demographical and cultural characteristics of adolescent mothers, lifetime domestic violence and history of miscarriage, and whether they suffer from any kind of medically unexplained (psychosomatic) pain in a study in south-eastern Turkey. METHODS: We included 501 mothers in this case-control study. The study group comprised 228 mothers who gave their first deliveries at or before 19 years of age, and the control group consisted of 273 mothers who first delivered after 19 years of age. The case-control study was conducted between February and April 2013 in Diyarbakir, Turkey. RESULTS: Adolescent mothers marry more frequently with their relatives. They have a higher prevalence of culture-bound customary applications such as bride price. They are less likely to be asked for their consent to marry and tend to have more children. They are more frequently victims of domestic violence and more often report medically unexplained psychosomatic pain. CONCLUSIONS: Adolescent motherhood is still a public health problem that seems to be related to certain culture-bound customary practices, continuing domestic violence across generations, increased number of children, and more prevalent psychosomatic pain.

Altered lipid peroxidation markers are related to post-traumatic stress disorder (PTSD) and not trauma itself in earthquake survivors.

The traumatic life events, including earthquakes, war, and interpersonal conflicts, cause a cascade of psychological and biological changes known as post-traumatic stress disorder (PTSD). Malondialdehyde (MDA) is a reliable marker of lipid peroxidation, and paraoxonase is a known antioxidant enzyme. The aims of this study were to investigate the relationship between earthquake trauma, PTSD effects on oxidative stress and the levels of serum paraoxonase 1 (PON1) enzyme activity, and levels of serum MDA. The study was carried out on three groups called: the PTSD group, the traumatized with earthquake exercise group, and healthy control group, which contained 32, 31, and 38 individuals, respectively. Serum MDA levels and PON1 enzyme activities from all participants were measured, and the results were compared across all groups. There were no significant differences between the PTSD patients and non-PTSD earthquake survivors in terms of the study variables. The mean PON1 enzyme activity from PTSD patients was significantly lower, while the mean MDA level was significantly higher than that of the healthy control group (p < 0.01 for both measurements). Similarly, earthquake survivors who did not develop PTSD showed higher MDA levels and lower PON1 activity when compared to healthy controls. However, the differences between these groups did not reach a statistically significant level. Increased MDA level and decreased PON1 activity measured in PTSD patients after earthquake and may suggest increased oxidative stress in these patients. The nonsignificant trends that are observed in lipid peroxidation markers of earthquake survivors may indicate higher impact of PTSD development on these markers than trauma itself. For example, PTSD diagnosis seems to add to the effect of trauma on serum MDA levels and PON1 enzyme activity. Thus, serum MDA levels and PON1 enzyme activity may serve as biochemical markers of PTSD diagnosis.

Serum levels of carcinoembryonic antigen (CEA) in patients with bipolar disorder.

OBJECTIVE: Carcinoembryonic antigen (CEA) is an oncofetal glycoprotein that is widely used as a tumour marker in adenocarcinomas. However, several non-neoplastic conditions, including acute and chronic inflammation and other inflammation-related conditions, are characterised by increased CEA concentrations. Bipolar disorder (BD) ranks seventh among the worldwide burden of non-fatal diseases. Inflammatory biomarkers have been considered as one of the main key pillars of a multifactorial approach for prediction of BD in an at-risk population. BP is accompanied by activation of inflammatory, cell-mediated and negative immunoregulatory cytokines. METHODS: We measured the levels of CEA in serum samples from 44 individuals with euthymic BP out-patients and 45 healthy controls. Patients were diagnosed according to the DSM-IV criteria. CEA was measured by an electrochemiluminescence immunoassay. RESULTS: The mean serum CEA concentration was 2.36±1.52 and 1.77±0.98 µg/l in patients and controls, respectively. CEA levels were significantly increased in euthymic BP patients when compared with controls (p=0.031). CONCLUSIONS: This study suggests that CEA is increased in BD and supports a role for immune activation in the core pathological mechanisms of BP. CEA levels may be a secondary marker for diagnosing BP.

Serum total oxidant and antioxidant status in earthquake survivors with post-traumatic stress disorder.

OBJECTIVE: Oxidative stress has been shown to play an important role in the pathogenesis of post-traumatic stress disorder (PTSD). Although there are some studies on oxidative stress and PTSD, there is no report available on the serum total oxidant and antioxidant status in earthquake survivors with PTSD. Therefore, this study aimed to investigate the serum total oxidant and antioxidant status in earthquake survivors with chronic PTSD. MATERIAL AND METHODS: The study group included 45 earthquake survivors with PTSD and 40 earthquake survivors without PTSD. The oxidative status was determined using the total antioxidant status and total oxidant status (TOS) measurements and by calculating the oxidative stress index (OSI). RESULTS: There were no statistically significant differences in the total antioxidant status, TOS, or OSI when comparing individuals with and without PTSD (all, p>0.05). There were no correlations between Clinician-Administered PTSD Scale scores and oxidant and antioxidant stress markers (all, p>0.05). CONCLUSIONS: Our results suggest that the total oxidant and antioxidant status may not affect earthquake survivors with PTSD. This is the first study to evaluate the oxidative status in earthquake survivors with PTSD. Further studies are necessary to confirm these findings.

Latent class analysis of obsessive-compulsive symptoms in a clinical sample.

OBJECTIVE: Obsessive-compulsive disorder (OCD) is probably a heterogeneous condition. To date, research investigating the symptom structure of OCD has generally focused on variable-classification approaches, primarily factor analysis. Our aim was to use the latent class analysis, an advanced individual-classification method, in order to define homogeneous sub-groups based on the Yale-Brown Obsessive-Compulsive Scale Check List (Y-BOCS CL) assessments within 193 outpatients with OCD. METHOD: Latent class analysis of 13 obsessive-compulsive symptom-clusters measured by the Yale-Brown Obsessive-Compulsive Scale Check List was performed. Associations of demographic and clinical features with latent class membership were tested by using logistic regression models. Differences in severity of obsessive-compulsive symptoms, obsessive beliefs, and depressive symptomotology between latent classes were evaluated with the chi-square likelihood test. RESULTS: Latent class analysis models of best fit yielded 3 latent classes: "autogenous obsessions", "reactive obsessive-compulsive", and "reactive obsessions". Outpatients in reactive obsessive-compulsive group reported significantly higher scores on the Y-BOCS global, obsessions, and compulsions scales than outpatients in other two sub-groups. Participants in reactive obsessive-compulsive group were predominantly female, single, and had a history of family psychopathology; whereas autogenous and reactive obsessions groups were predominantly male. There were no differences in severity of depression and obsessive belief domains. CONCLUSIONS: The results provide support for the validity of autogenous/reactive distinction for OCD. These three classes may have important implications for research and clinical purposes.

Are oxidative stress markers useful to distinguish schizoaffective disorder from schizophrenia and bipolar disorder?

OBJECTIVE: Schizoaffective disorder is a disease with both affective and psychotic symptoms. In this study, we aimed to compare oxidative metabolism markers of schizoaffective disorder, bipolar disorder and schizophrenic patients. Furthermore, we also aimed to investigate whether schizoaffective disorder could be differentiated from schizophrenia and bipolar disorder in terms of oxidative metabolism. METHODS: Total oxidant status (TOS) and total antioxidant status (TAS) were measured in the blood samples that were collected from schizoaffective patients (n = 30), bipolar disorder patients (n = 30) and schizophrenic patients (n = 30). Oxidative stress index (OSI) was calculated by dividing TOS by TAS. RESULTS: TOS and OSI were found to be higher in patients with schizoaffective disorder compared with those in schizophrenia and bipolar disorder patients. TAS was not significantly different between the groups. CONCLUSION: Schizoaffective disorder was found to be different from bipolar disorder and schizophrenia in terms of oxidative parameters. This result may indicate that schizoaffective disorder could differ from bipolar disorder and schizophrenia in terms of biochemical parameters. Increased TOS levels observed in schizoaffective disorder may suggest poor clinical course and may be an indicator of poor prognosis.

The relationship between oxidative stress markers and 1H-Magnetic resonance spectroscopy findings in obsessive compulsive disorder.

INTRODUCTION: The purpose of this study was to examine N-acetyl aspartate (NAA)/creatine (Cr) and glutamate, glutamine, and gamma-aminobutyric acid complex (Glx)/Cr levels in patients with obsessive compulsive disorder (OCD) and healthy controls' orbitofrontal cortex (OFC) and caudate nucleus (CN) by proton magnetic resonance spectroscopy (1H-MRS) method and to investigate their relationship with oxidative stress markers glutathione peroxidase (GPx) and superoxide dismutase (SOD). METHODS: This study included patients with OCD (n = 25) and healthy controls (n = 25) ranging in age from 18 to 65. We used the ELISA method to evaluate serum SOD and GPx levels. Levels of NAA/Cr and Glx/Cr in the orbitofrontal cortex and caudate nucleus were measured using the 1H-MRS method. RESULTS: Our study did not detect statistically significant differences in the orbitofrontal cortex Glx/Cr and NAA/Cr levels between the OCD patients and the control group. OCD patients exhibited a decrease in NAA/Cr levels, consistent with impaired neuronal integration, and an increase in Glx/Cr levels, consistent with hyperactivation, in the caudate nucleus compared to the control group. We observed a negative correlation between NAA/Cr levels in the caudate nucleus and the levels of SOD and GPx. CONCLUSIONS: Our study is the first to assess CN and OFC together in OCD patients using 3 T MR, investigating the relationship between neurometabolite concentrations and oxidative stress parameters. The negative correlation we observed between NAA/Cr levels and SOD and GPx in the caudate nucleus suggests that increased oxidative stress in this brain region in OCD patients may contribute to impaired neuronal integration and functionality.

Predictive value of obsessive compulsive symptoms involving the skin on quality of life in patients with acne vulgaris.

Acne is one of the most common dermatological diseases, and obsessive compulsive disorder is among the most frequent psychiatric conditions seen in dermatology clinics. Comorbidity of these conditions may therefore be expected. The aim of this study was to measure obsessive compulsive symptoms and quality of life in patients with acne vulgaris, compare them with those of healthy control subjects, and determine whether there is any predictive value of obsessive compulsive symptoms for quality of life in patients with acne. Obsessive compulsive symptoms and quality of life measurements of 146 patients with acne vulgaris and 94 healthy control subjects were made using the Maudsley Obsessive Compulsive Questionnaire and Short Form-36 in a cross-sectional design. Patients with acne vulgaris had lower scores for physical functioning, physical role dysfunction, general health perception, vitality, and emotional role dysfunction. They also had higher scores for checking, slowness, and rumination. The only predictor of physical functioning and vitality dimensions of health-related quality of life in these patients was rumination score. Obsessive compulsive symptoms in patients with acne vulgaris are higher than in controls, and this may correlate with both disease severity and quality of life for patients.

Electroconvulsive therapy for mood disorders in pregnancy.

Electroconvulsive therapy (ECT) offers a treatment option for mood disorders during pregnancy. We retrospectively examined 12 pregnant patients who were treated with ECT for their mood disorders. The mean ± SD age of the patients was 28.1 ± 4.8 years. The mean ± SD number of ECTs performed was 9.8 ± 4.5. The mean ± SD Clinical Global Impression score was decreased from 6 to 2.6 ± 0.7 with ECT. No significant adverse events were observed other than early delivery in one patient and pes ekinovarus deformity in a newborn that was most probably not related to ECT causally. Electroconvulsive therapy seems to be an effective and safe treatment option in pregnant patients with mood disorders.

Development and Verification of Problematic Cryptocurrency Trading Scale.

Aim: Cryptocurrency trading is similar to problematic gambling behavior, with its high-risk factors and its methods of use. In this sense, it can become addictive. The aim of this study is to develop a valid and reliable scale to measure Problematic Cryptocurrency Trading among individuals who trade cryptocurrency. Method: First, the theoretical framework of the study was discussed to lay a basis for the motives of this study. Then, with the help of the DSM-5 diagnostic criteria and internet addiction scales, a 16-item scale was designed. The study was carried out on 2 different sample groups. The results were reported under the titles Study 1 and Study 2. The sample size of Study 1 was 1314. The data were collected through TrueFeedBack BlackStar, a survey platform that provides survey participation by awarding its participants with cryptocurrency. For this data set, item analyses, the t-test, reliability analysis, and the explanatory factor analysis were performed for 27% of the lower and upper groups. The Kaiser-Meyer-Olkin (KMO) test and Bartlett's test of sphericity to determine the suitability for the factor analysis, the principal component analysis for factorization, and the promax method for factor rotations were used. The SPSS Statistics 22 software package was used for the analyses. The sample size of Study 2 was 353. The data were collected from people known to be trading cryptocurrencies. The confirmatory factor analysis was performed for the model, the factor structure of which was determined in Study 1. For the goodness of fit of the model, root mean square error of approximation (RMSEA), incremental fit index (IFI), goodness of fit index (GFI), and chi-Square Test (χ 2) goodness of fit criteria were used. The Amos 23 software package was used for the data analysis. Results: As a result of the exploratory factor analysis, a two-factor structure was obtained. For the total scores of the scale, Cronbach's alpha reliability value was found to be 0.913, and for the sub-factors, Cronbach's alpha values were found to be 0.897 and 0.866. The factor loadings of items varied between 0.786 and 0.597 for the first sub-factor and between 0.869 and 0.683 for the second sub-factor. The confirmatory factor analysis confirmed the two-factor structure of the scale, and the goodness of fit criteria were found to be at acceptable levels. Conclusion: It was determined that the Problematic Cryptocurrency Trading Scale is a valid and reliable scale.

Premedication with dexmedetomidine and midazolam attenuates agitation after electroconvulsive therapy.

PURPOSE: This study was designed to compare the effects of premedication with dexmedetomidine and midazolam on post-electroconvulsive therapy (ECT) agitation (which patients had experienced previously and had been resistant to treatment). In addition, we aimed to evaluate the duration of convulsion, the propofol requirement, the recovery time, and patients' satisfaction during and after ECT. METHODS: Fifteen patients with depressive episodes of bipolar disorder and nonbipolar recurrent depression and patients who underwent a series of three consecutive ECT treatments were studied as a crossover design. In this double-blind and placebo-controlled study, patients were randomly allocated to receive either dexmedetomidine, 0.5 microg x kg(-1) (group Dex), midazolam, 0.025 mg x kg(-1) (group Dor), or saline (group C) in a total volume of 20 ml given intravenously 10 min before the induction of anesthesia. Propofol was administered until the patients did not respond to a verbal command. RESULTS: The mean duration of convulsive activity was longer in group Dex than in group C and group Dor (P < 0.05). The total dose of propofol requirement in group Dor and group Dex was lower than that in group C (P < 0.05). Agitation scores in both groups Dor and Dex were significantly lower than scores in group C (P < 0.05) at 10 and 15 min after ECT. CONCLUSION: Premedication with low-dose intravenous dexmedetomidine, 0.5 microg x kg(-1) or midazolam, 0.025 mg x kg(-1) before ECT may be useful in managing treatment-resistant agitation after ECT, without adverse effects.

Evaluation of serum inflammatory markers in treatment-resistant manic patients and adequate responder manic patients.

Mania is accompanied with immune activation as indicated by increased pro-inflammatory cytokines, acute phase proteins; and carcinoembryonic antigen (CEA) is known to accompany signs of immune-inflammatory responses in bipolar disorder (BD) and medical disorders. In this study, it was aimed to compare high sensitivity C-reactive protein (hsCRP), CEA levels and white blood cells (WBCs) counts in the treatment-resistant BD (Group 3), the treatment-responsive BD patients (Group 2), and the healthy control group (Group 1). The sociodemographic data form, the Young Mania Rating Scale (YMRS), the Hamilton Depression Rating Scale (HDRS), and the Clinical Global Impression Severity of Illness (CGI-S) Scale were applied to the patients. In Group 3, the WBCs counts, and CEA levels were significantly higher than the other two groups. There was a positive correlation between WBCs counts and YMRS and CGI-S scores in all manic patients. There was a positive correlation between CEA levels and YMRS, HDRS and CGI-S in manic patients. This study shows that there is an activation of the immune-inflammatory response system in treatment resistant manic patients; and, WBCs counts and CEA levels are associated with severity of disease in manic patients.

Evaluation of Risk Factors for ADHD and Co-Morbid Psychiatric Disorders Among the Parents of Children With ADHD.

OBJECTIVE: The aim of this study is to investigate the presence of ADHD and other psychiatric disorders among parents with at least one child with ADHD relative to parents with children who do not have ADHD. METHOD: Eighty five parents of children with ADHD with 68 control parents who had healthy children without ADHD were interviewed for participation in present study. Each parent was evaluated for co-existing psychiatric disorders using the Structured Clinical Interview for the DSM IV Axis I Disorders (SCID I). RESULTS: We found that ADHD and co-morbid psychiatric symptoms were increased in the parents of children with ADHD in comparison with the healthy control group. CONCLUSION: Psychiatric co-morbidity was more common among the parents of patients with inattentive and combined presentations. Adult ADHD is associated with psychiatric co-morbidities including anxiety disorders, mood disorders, and somatoform disorders as well as substantial role impairment.

High ceruloplasmin levels are associated with obsessive compulsive disorder: a case control study.

BACKGROUND: Alterations in ceruloplasmin are currently assumed as one of the mechanisms underlying the development of a number of neurodegenerative disorders. Several studies indicate that elevated serum ceruloplasmin levels may play a role in schizophrenia by exacerbating or perpetuating dopaminergic dysregulation. No study investigating the relationship between ceruloplasmin and obsessive-compulsive disorder (OCD) has been published to date. Nowadays OCD is increasingly speculated to be a different disorder than other anxiety disorders, and rather is considered to be more similar to psychotic disorders. The objective of this study to explore whether there is an association of ceruloplasmin with OCD as in schizophrenia. METHOD: 26 pure OCD and 9 co-morbid OCD patients from Gaziantep University Sahinbey Research Hospital, Psychiatry Clinics, diagnosed according to the DSM IV and 40 healthy controls were included in the study. Blood samples were collected; ceruloplasmin levels were measured. RESULTS: The mean ceruloplasmin level in pure OCD patients, co-morbid OCD patients, and control group persons were 544.46 +/- 26.53, 424.43 +/- 31.50 and 222.35 +/- 8.88 U/L respectively. Results of all 3 groups differ significantly. Positive predictive value of ceruloplasmin for that cut-off point is 31/31 (100%) and negative predictive value is 40/44 (91%) in our group. CONCLUSION: Although the nature of relationship is not clear there was an association between ceruloplasmin levels and OCD in our study.

Oxidative imbalance in obsessive compulsive disorder patients: a total evaluation of oxidant-antioxidant status.

OBJECTIVES: Various psychological, social, genetic, biochemical, factors are to be involved in the etiology of OCD. Some molecules of free radicals are also found to play role in OCD. To the best of our knowledge, there has been no study, regarding the role of free radicals in the pathogenesis of OCD, from a general antioxidant aspect of view. Therefore, in this present cross-sectional study, we aimed to assess whether antioxidant-oxidant status is associated with OCD and can be used or not as a biological marker regarding that disorder. METHODS: 37 OCD patients diagnosed according to DSM-IV and as control group forty healthy subjects were included to the study. Venous blood samples were collected once. The total oxidant status, antioxidant status and oxidative stress index of the plasma were measured using a novel automated colorimetric measurement method. RESULTS: There was not a significant difference between only OCD and all patients in all measures (TOS: Z = - 1.453, p = 0.521; TAS: Z = - 0.151, p = 0.880; OSI: Z = - 0.679 p = 0.497). TAS levels were both higher than controls in only OCD groups and all patients (Z = - 5.538, p < 0.001 and Z = - 6.394, p < 0.001 respectively). TOS and OSI of both patient groups were significantly lower than controls (TOS: Z = - 5.131, p < 0.001; OSI: Z = - 5.105, p < 0.001 and TOS: Z = - 5.979, p < 0.001; OSI: Z = - 5.862, p < 0.001). In only OCD group, illness duration was correlated with TOS and OSI (r(0) = 0.44, p = 0.023, n = 26 and r(0) = 0.44, p = 0.026, n = 26 respectively) but not with TAS. CONCLUSION: Our study found an overall oxidative imbalance shifted towards antioxidant side in OCD which may be due to either a rebound phenomenon or chronicity of the condition.

Adenosine deaminase, nitric oxide, superoxide dismutase, and xanthine oxidase in patients with major depression: impact of antidepressant treatment.

BACKGROUND: There has been much evidence in recent years that free oxygen radicals and nitric oxide (NO) may play an important role in the pathophysiology of neuropsychiatric disorders. In this study, we aimed to investigate whether NO, xanthine oxidase (XO), superoxide dismutase (SOD), and adenosine deaminase (ADA) levels are associated with major depression (MD) and to evaluate the impact of antidepressant treatments on NO, SOD, ADA and XO levels in MD. METHODS: Thirty-six patients who were diagnosed as MD according to DSM-IV criteria and 20 healthy controls were included. The serum levels of NO, XO, SOD, and ADA were measured by spectrophotometric methods both in patients and controls. Patients were treated with antidepressant drugs for 8 weeks. All patients were assessed by Hamilton Depression Rating Scale (HDRS) both before and after antidepressant treatment. RESULTS: ADA and XO levels of the patients were significantly higher than the controls. SOD level of the patients was significantly lower than the controls. Although NO levels of the patients were higher than the controls, the difference was not statistically significant. There was no correlation between HDRS and the parameters studied (SOD, ADA, XO, and NO) of the patients. After 8 weeks of antidepressant treatment, ADA and SOD activities were increased, whereas NO and, XO levels decreased significantly. CONCLUSIONS: ADA, XO, and SOD activity may have a pathophysiological role in MD and may predict prognosis of MD. Activity of these enzymes may be used to monitor effects of the antidepressant treatment.

The investigation of factors related to suicide attempts in Southeastern Turkey.

BACKGROUND: Suicide is an important health problem in Turkey as it is in all regions of the world. Suicidal behavior has multiple causes, which are broadly divided into those related to proximal stressors and those due to predisposition. Suicide statistics may be associated with mental health disorders, which are among the foremost predictors of suicide attempts. More than 90% of patients who commit suicide have a diagnosable psychiatric disorder, usually a major depressive disorder. Other major risk factors for suicide attempts are history of suicide attempts in the family, stressful life events, sleep disturbances, poor income, unemployment, severity of symptoms of depression, and anxiety. Sleep is a complex phenomenon. Sleep disturbances can therefore be contributed to the emergence of suicidal behavior allowing for the possibility of predicting future suicides. METHODS: We evaluated 106 patients who were admitted after suicide attempts to the Department of Psychiatry at Dicle University Faculty of Medicine. The recruited subjects were assessed by Structured Clinical Interview for DSM-IV Axis I disorders, and the intensity of symptoms was evaluated using the Beck Anxiety Inventory, Hamilton Depression Rating Scale, and Pittsburgh Sleep Quality Index. The mean values of the subjects attempting multiple and single suicides were compared using appropriate inferential statistical tests. RESULTS: Most suicide attempts are believed to be preventable. Our results revealed that a great variety of risk factors are associated with an increased risk for multiple suicide attempts. Most of these attempts appeared to be spontaneous and impulsive rather than planned. In particular, this study highlights the importance of previous suicide attempts, history of suicide in the family, history of stressful life events in the previous 6 months, poor income, unemployment, sleep disturbances, severe hopelessness with depression, and coexisting symptoms of anxiety as risk factors. CONCLUSION: The first step in prevention of suicides is doubtlessly strong and reliable communication, due to the fact that the majority of subjects who commit suicide have had contact with a health professional during the month before the suicide.

Somatosensory Amplification, Anxiety, and Depression in Patients With Hepatitis B: Impact on Functionality.

In the present study, we aimed to determine the differences in body image along with anxiety and depression levels, and also to evaluate their impact on disability parameters in patients with hepatitis B.Our study comprised 77 patients with hepatitis B (n = 41, chronic active patients; n = 36, patients with inactive hepatitis B) and 53 healthy individuals (control group). Enrolled patients responded to several questionnaires, including a sociodemographic form, Sheehan Disability Scale (SDS), Hospital Anxiety and Depression Scale (HADS), and Somatosensory Amplification Scale.Patients with chronic active hepatitis B (CAHB) had higher levels of somatosensory perception than patients with inactive hepatitis B (IHB) and control group (P < 0.001, P = 0.001, respectively). Patients with CAHB had high scores on all the 3 domains of SDS (work/school, P < 0.001; social life, P < 0.001; and family life, P < 0.001). Also, patients with CAHB had a significantly higher HADS total score, HADS anxiety score, and HADS depression score than control group (P < 0.001, P < 0.001, P < 0.001, respectively). No significant difference was noted between patients with CAHB and patients with IHB with regard to HADS depression score; however, HADS anxiety and HADS total scores were significantly higher in the CAHB group (NS, P = 0.027, P = 0.035, respectively). Moreover, the IHB group exhibited higher scores for the work/school and social life domains of SDS than those of the control group (P = 0.008, P = 0.047).Although patients with CAHB may present with somatosensory amplification, anxiety, and depression, patients with IHB do not exhibit such symptoms. However, functionality is affected in both carrier and active patient groups. We believe that routine health checks of patients with hepatitis B should include psychiatric evaluation, psychiatric examination, and follow-up.

A Case of Skin Picking Disorder of a Patient with a History of Childhood Abuse.

Skin picking (excoriation) disorder is the recurrent excoriation of one's own skin, resulting in noticeable skin damage. People pick their skin for different reasons. For the majority of patients, first skin picking is associated with a history of childhood abuse and personal problems. Subjects who moderately to severely cause injurious self-harm are more likely to have a history of exposure to domestic violence and childhood abuse than those who do not self-harm. At the same time, these conditions could be related to the etiology for majority of other psychiatric disorders. We report herein, a case of a patient with skin picking disorder who had a history of childhood physical and emotional abuse with borderline personality disorder.