Decreased Nesfatin-1 Level in Overweight Depressed Patients.

BACKGROUND: Nesfatin-1 (NF-1) is a parameter that has been shown to have an important potential in the modulation of the emotional state such as depression. The study focused to investigate the relationship between the plasma NF-1 level and depression. SUBJECTS AND METHODS: Seventy-three patients who have a major depressive disorder (MDD) and 71 healthy individuals participated in the study. Plasma NF-1 was analyzed by Enzyme Linked Immunosorbent Assay (ELISA) and compared according to the groups. RESULTS: The mean NF-1 was lower in the patients with MDD than being in the healthy (p:0.019). Plasma NF-1 level was statistically significantly lower in the overweight MDD than in the non-overweight MDD (p:0.024). We observed a negative correlation between plasma NF-1 level and age (r:-0.178, p:0.033), BMI (r:-0.212, p:0.011), HAM-D scores (r:-0.185, p:0.026). However, there was no correlation for smoking status in both groups (r:0.095, p:0.259). CONCLUSION: This study demonstrated the relationship between plasma NF-1 level and MDD as well as overweight. Therefore, NF-1 might be related to certain nervous system pathologies as well as adipose tissue in the body.

Assessment of COVID-19 trauma responses. Who has been more traumatized during the pandemic?

Background and Objective: To evaluate the effect of cognitive and sociodemographic characteristics of healthcare and non-healthcare workers on their traumatic responses to the COVID-19 pandemic. Methods: Data were collected using an online survey between August-September 2020. The survey included the following scales: Beck Anxiety Inventory (BAI), Anxiety Sensitivity Index (ASI), and Impact of Event Scale-Revised (IES-R). Traumatic responses were categorized into three types: avoidance (IES-R_A), intrusion (IES-R_I), and hyperarousal (IES-R_H). Results: The study included a total of 672 participants, comprised of 399 (59.4%) men, and 273 (40.6%) women with a mean age of 39.25 ± 933 years. The results indicated that women had higher IES-R_I (r = .5.78, p < 0.001), IES-R_A (r = 4.47, p < 0.001), and IES-R_H (r = .5.20, p < 0.001) scores compared to men. Patients with a history of psychiatric diseases had significantly higher IES-R_I (r = -3.82, p < 0.001), IES-R_A (r = -2.00, p < 0.05), and IES-R_H (r = -4.06, p < 0.001) scores compared to patients with no history of psychiatric diseases. Non-healthcare workers had significantly higher IES-R_A (r = -2.69, p < 0.01) scores compared to healthcare workers. Conclusion: Female gender and a positive history of psychiatric diseases were found to lead to an increase in the frequency of all three traumatic responses to COVID-19. Contrary to expectation, being a healthcare worker was not found as a factor facilitating trauma response formation in our study.

Contexte et objectif: Évaluer l'effet des caractéristiques cognitives et sociodémographiques des travailleurs de la santé et des travailleurs non médicaux sur leurs réponses traumatiques à la pandémie de COVID-19. Méthodes: Les données ont été recueillies à l'aide d'une enquête en ligne entre août et septembre 2020. L'enquête comprenait les échelles suivantes : Inventaire d'anxiété de Beck (BAI), Indice de sensibilité à l'anxiété (ASI) et Échelle d'impact de l'événement - révisée (IES-R). Les réponses traumatiques ont été classées en trois types : évitement (IES-R_A), intrusion (IES-R_I) et hyperexcitation (IES-R_H). Résultats: L'étude a inclus un total de 672 participants, composés de 399 (59,4 %) hommes et 273 (40,6 %) femmes avec un âge moyen de 39,25 ± 933 ans. Les résultats ont indiqué que les femmes avaient des scores IES-R_I (r = 5,78, p < 0,001), IES-R_A (r = 4,47, p < 0,001) et IES-R_H (r = 5,20, p < 0,001) plus élevés que les hommes. Les patients ayant des antécédents de maladies psychiatriques présentaient des scores IES-R_I (r = −3,82, p < 0,001), IES-R_A (r = −2,00, p < 0,05) et IES-R_H (r = −4,06, p < 0,001) significativement plus élevés que les patients n'ayant aucun antécédent de maladies psychiatriques. Les travailleurs non médicaux avaient des scores IES-R_A (r = −2,69, p < 0,01) nettement plus élevés que les travailleurs de la santé. Conclusion: On a constaté une augmentation de la fréquence de trois réponses traumatiques à la COVID-19 chez les femmes et celles ayant des antécédents positifs de maladies psychiatriques. Contrairement aux attentes, le fait d'être un travailleur de la santé ne s'est pas avéré être un facteur facilitant la formation de réponses traumatiques dans notre étude.

Acute dystonia following epileptic seizure after bupropion intoxication.

Bupropion is an effective treatment for major depressive disorder and smoking cessation. In this paper, we present a case report about dystonia in the head and the neck after epileptic seizures due to 4200 mg of extended-release bupropion intake, and we aim to take attention to the rare neuropsychiatric side effects that may occur after the use of high doses of bupropion.

Is Childhood Trauma a Risk Factor for Resistant Epilepsy?

Childhood traumas have been considered risk factors for many psychiatric disorders. Recent studies demonstrated that childhood traumas can also be considered risk factors for neurological diseases. In this context, the objective of this study is to investigate the effects of childhood traumas on treatment resistance in patients with epilepsy. The study sample consisted of 85 epilepsy patients, 40 male and 45 female, who were diagnosed and followed up by a neurologist. Of these patients, 45 were being followed up with the diagnosis of refractory epilepsy, and 40 were being followed up with the diagnosis of treatment-responsive epilepsy. Cranial magnetic resonance imaging and electroencephalography were performed on all patients. In addition, all patients were administered childhood trauma questionnaire (CTQ) and Hamilton depression rating scale (HAM-D). Epilepsy patients included in the study were divided into refractory epilepsy and treatment-responsive epilepsy groups. There was no significant difference between the groups in sociodemographic characteristics. On the other hand, total CTQ and all CTQ subscale scores and HAM-D scores were significantly higher in the refractory epilepsy group than in the treatment-responsive epilepsy group. This study demonstrates that childhood traumas may contribute to treatment resistance in epilepsy patients. Therefore, it is recommended that a history of childhood traumas be routinely queried in the treatment of epilepsy patients.

A New Hope in Alzheimer's Disease Psychosis: Pimavanserin.

Alzheimer's disease (AD) ranks first among the causes of dementia worldwide. AD can develop a psychotic manifest at a significant rate. AD prognosis worsens by added psychosis clinic. There is no treatment approved by the United States Food and Drug Administration (FDA) among antipsychotics for Alzheimer's disease Psychosis (ADP). However, pimavanserine, an atypical antipsychotic, has been approved by the FDA for Parkinson's psychosis. It is predicted that pimavanserin, a new antipsychotic, will fill an important gap in this area. In clinical trials, it appears to be effective in the treatment of delusions and hallucinations at psychosis in both Parkinson's and AD. In this systematic review, we evaluated the analysis of current literature data on pimavanserin used in ADP. We searched the existing literature on clinical studies on pimavanserin therapy used in ADP. Data were determined by systematically searching PubMed, MEDLINE, EMBASE, and Google Scholar until December 2022. A total of 35 citations were found and uploaded on the Mendeley program. Abstracts and full texts of literature data were examined. Pimavanserin was observed, and satisfactory results were obtained in treating ADP. Pimavanserin has a unique mechanism of action. Pimavanserin, an atypical antipsychotic drug, has a low affinity for 5-HT2C receptors and has selective 5-HT2A reverse agonist/antagonist action. Pimavanserin has no clinically significant affinity for dopaminergic, histaminergic, muscarinic or adrenergic receptors. This agent may also achieve significant positive results in resistant psychosis treatments.

Vortioxetine-Induced Amenorrhea: A Case Report.

BACKGROUND: Vortioxetine is a novel multimodal antidepressant for the treatment of major depressive disorders and is widely used in clinical practice. Vortioxetine has a safe profile. However, there are case reports of other adverse effects in the literature. In this article, a case of amenorrhea due to vortioxetine is presented. CASE: The patient is 36 years old, married, female, and is an anesthesiologist. She applied to the psychiatric outpatient clinic with symptoms of major depression. Vortioxetine was initiated at 10 mg/d and then gradually increased to 20 mg/d. She had regular menstruation until now. However, she did not menstruate after taking vortioxetine. The patient used vortioxetine for 3 months and never had a period. Pregnancy test and other tests to investigate organic etiology were normal. Two weeks after discontinuation of vortioxetine, the patient had a menstrual period. CONCLUSIONS: Further research is needed on the relationship and possible mechanisms between vortioxetine and amenorrhea.

The Evaluation of Thiol/Disulfide Homeostasis and Oxidative DNA Damage in Patients with Obsessive Compulsive Disorder.

Objective: In this study, we aimed to examine thiol/disulfide homeostasis and oxidative DNA damage in patients with OCD and compare them with healthy controls. Methods: Thirty-five patients previously diagnosed with OCD in Van Yuzuncu Yil University Department of Psychiatry and thirty-three healthy volunteers were included in the study. The severity of the symptoms was measured using the Yale-Brown Obsessive-Compulsive Scale. Five ml of blood samples were taken from the patient and control groups. The samples were stored at appropriate conditions until use. Leukocyte DNA was isolated and the levels of 8-hydroxy-2-deoxyguanosine (8-OHdG) and deoxyguanosine were detected to assess the oxidative DNA damage. The level of oxidative DNA damage was expressed as 8-OHdG/106dG. Total thiol/native thiol levels were measured for thiol/disulfide homeostasis. The level of disulfide was determined by subtracting the native thiol value from the total thiol value and the result was divided by two. Results: were given as percentages. Results: The total and native thiol levels in patients with OCD were significantly lower, and the disulfide levels were significantly higher in patients with OCD than healthy control subjects. In addition, 8-OHdG, an indicator of DNA damage, was significantly lower in the control group compared to the patient group. Conclusion: Increased levels of disulfide/native thiol and disulfide/total thiol in patients with OCD show that levels of oxidative stress were elevated and therefore, higher 8-OHdG levels in patients with OCD is a marker of oxidative DNA damage.

A Cross-Sectional Measurement of Endogenous Oxidative Stress Marker Levels in Obsessive Compulsive Disorder.

Background: There is a correlation between the increase in reactive oxygen radicals and the presence of specific mental illnesses. In this context, the objective of this study is to investigate the relationship between obsessive-compulsive disorder and the variations in the levels of several endogenous oxidative stress markers. Methods: Thirty obsessive-compulsive disorder patients were included in the study as the patient group, and 30 healthy volunteers of matching demographic characteristics were included in the study as the control group. Accordingly, the patient group consisted of 10 females and 20 males with a mean age of 29.5 ± 6.1 years, and the control group consisted of 15 females and 15 males with a mean age of 31.9±5.6 years. The serum nicotinamide adenine dinucleotide phosphate oxidase-2, nicotinamide adenine dinucleotide phosphate oxidase-4, and malondialdehyde levels of the 2 groups were compared using the independent samples t-test. The relationships between the serum nicotinamide adenine dinucleotide phosphate oxidase-2, nicotinamide adenine dinucleotide phosphate oxidase-4, and malondialdehyde levels of the 2 groups were analyzed using the Pearson's correlation coefficient. Results: The serum nicotinamide adenine dinucleotide phosphate oxidase-2, nicotinamide adenine dinucleotide phosphate oxidase-4, and malondialdehyde levels of the patient group were statistically significantly higher than those of the control group (P < .001). Statistically significant positive correlations were detected between the serum nicotinamide adenine dinucleotide phosphate oxidase-2 and nicotinamide adenine dinucleotide phosphate oxidase-4 levels (r = 0.692, P = .001) and between the serum nicotinamide adenine dinucleotide phosphate oxidase-2 and malondialdehyde levels (r = 0.563, P = .001). Conclusion: The results of this study indicated that oxidative stress and lipid peroxidation levels were higher in obsessive-compulsive disorder patients. Based on this finding, NOX-2 and NOX-4 levels can be used as indicators of endogenous oxidative stress in obsessive-compulsive disorder patients.

Dynamic Thiol/Disulfide Homeostasis and Oxidative DNA Damage in Adult Attention Deficit Hyperactivity Disorder.

OBJECTIVE: Insufficient number of oxidative stress studies have been conducted in patients with adult attention deficit hyperactivity disorder (ADHD). The objective of the current study is to examine the thiol/disulfide homeostasis as well as oxidative DNA damage levels in adult ADHD patients and to compare them with the results of healthy control subjects. METHODS: The study was inclusive of forty-nine patients who were diagnosed with adult ADHD, as well as thirty-three healthy volunteers to be used as the control group. The diagnosis of the patients was conducted according to the DSM-5 diagnostic criteria. Blood were stored under appropriate laboratory conditions. For the purpose of detecting the oxidative DNA damage level, an extraction of genomic DNA from leukocytes was carried out, and furthermore the levels of 8-hydroxy-2-deoxyguanosine (8-OHdG), apart from deoxyguanosine, were measured accordingly. RESULTS: Total thiol and the native thiol levels were observed to be statistically lower in adult ADHD patients as compared to the subjects in the healthy control group (p = 0.001). It was observed that the disulfide levels were higher in adult ADHD patients as compared to the healthy control subjects (p = 0.001). In addition, the levels of 8-OHdG, which are considered as a marker for assessing DNA damage, were found to be significantly lower in the control group as compared to the adult ADHD patients (p = 0.001). CONCLUSION: It was observed that the thiol/disulfide homeostasis had shifted towards disulfide, and 8-OHdG levels were increased in adult ADHD patients.

Isotretinoin Induced Psychotic Mania: A Case Report. / Izotretinoin ile Iliskili Psikotik Mani Atagi: Olgu Sunumu.

Biological, genetic and psychosocial factors may play a role in the aetiology of bipolar mood disorder (BPD). BPD episodes might be triggered by isotretinoin, a retinoid derivative of vitamin A with a role in cellular proliferation and differentiation. Due to its association with depression, suicidal ideation and suicide attempts, American Food and Drug Administration (FDA) issued a placement of a label warning for isotretionin. Personal or family history of psychiatric disorders was emphasized in the literature for the risk of mood episodes following isotretionin treatment. Here we aim to present the case of an 18- year old young male adult, without personal or family history of a psychiatric disorder, who developed psychotic mania within the first week of isoretinoin which was prescribed for acne vulgaris. Psychotic mania symptoms receded within one week after starting olanzapine (10 mg/day). We believe this case is significant in demonstrating the occurence of a manic episode after isoretinoin in individuals lacking a personal or family history of psychiatric diagnoses.

[Hair Loss Associated with Paroxetine Use: A Case Report]. / Paroksetin Kullanimina Bagli Saç Dökülmesi: Bir Olgu Sunumu2.

Diverse dermatological side effects in relation to using psychotropic agents, include the serious outcomes as hypersensitivity and StevensJohnson syndrome as well as milder forms as ecchymosis and hair loss. Whereas hair loss is frequently associated with mood stabilizers, rarely ,it is also attributed to antidepressants. Selective serotonin reuptake inhibitors (SSRIs) which are the first choice treatment for depression, anxiety disorders and obsessive-compulsive spectrum disorders, are the most commonly used antidepressant drugs. Psychiatric comorbidities have been known in many dermatological diseases and their treatment have positive effects on the course and outcome as well as on the adaptation process to the disease. Due to their favorable side effect profile, for comorbid cases SSRIs are frequently used. Here we present a case of hair loss during paroxetine in a 24-year-old male with social anxiety disorder. In this case the hair loss improved after discontinuing and recurred after resuming paroxetine. After replacing paroxetine with sertraline, another SSRI, alopecia did not recur.

Isotretinoin Induced Psychotic Mania: A Case Report. / Izotretinoin ile Iliskili Psikotik Mani Atagi: Olgu Sunumu.

Biological, genetic and psychosocial factors may play a role in the aetiology of bipolar mood disorder (BPD). BPD episodes might be triggered by isotretinoin, a retinoid derivative of vitamin A with a role in cellular proliferation and differentiation. Due to its association with depression, suicidal ideation and suicide attempts, American Food and Drug Administration (FDA) issued a placement of a label warning for isotretionin. Personal or family history of psychiatric disorders was emphasized in the literature for the risk of mood episodes following isotretionin treatment. Here we aim to present the case of an 18- year old young male adult, without personal or family history of a psychiatric disorder, who developed psychotic mania within the first week of isoretinoin which was prescribed for acne vulgaris. Psychotic mania symptoms receded within one week after starting olanzapine (10 mg/day). We believe this case is significant in demonstrating the occurence of a manic episode after isoretinoin in individuals lacking a personal or family history of psychiatric diagnoses.

Investigation of Thiol/Disulfide Balance and Oxidative DNA Damage in Patients Experiencing Avalanche Disaster and with a Diagnosis of Post-Traumatic Stress Disorder.

Objective: There are few studies on oxidative stress in patients with post-traumatic stress disorder (PTSD). The thiol/disulfide homeostasis is a new marker of oxidative stress. This study aimed to examine the oxidative DNA damage and thiol/disulfide homeostasis after 6 months in patients who developed PTSD after an avalanche disaster and to compare them with healthy controls. Methods: A total of 31 patients who developed PTSD after 2 consecutive avalanche disasters that occurred in Van on February 4 and 5, 2020, resulting in 42 deaths, and 33 healthy volunteers were included in the study. The patients were followed up by a psychiatrist within the framework of psychosocial intervention during their admission to Yüzüncü Yil University Medical Faculty Emergency Service. The patients monitored for a long time were diagnosed according to DSM-5 diagnostic criteria. The clinical follow-up was evaluated with the post-traumatic stress disorder self-assessment (PTSD-KD) and the impact of events scale. To determine oxidative DNA damage, 8-hydroxy-2-deoxyguanosine (8-OHdG) and deoxyguanosine (dG) levels were determined by isolating leukocyte DNA. Oxidative DNA damage was given as a ratio of 8-OHdG/106dG. Total thiol/native thiol levels were also determined. Disulfide levels were calculated by subtracting native thiol results from the total thiol results and dividing them by 2. Results: It was determined that total thiol and native thiol levels in patients with PTSD were statistically significantly lower than in the healthy control group (P = .001), and the disulfide levels were higher in the PTSD group compared with that in the healthy control group (P = .001). In addition, 8-OHdG, an indicator of DNA damage, was found to be significantly lower in the control group than in the patient group (P = .001). Conclusion: In our study, thiol/disulfide homeostasis was observed to shift toward disulfide in patients with PTSD when compared with healthy controls. The level of 8-OHdG, the indicator of DNA damage, was observed to increase in patients with PTSD. This result indicates that thiol/disulfide homeostasis can be significant in the pathophysiology of oxidative stress in these patients.

Anxiety, depression and quality of life in patients with beta thalassemia major and their caregivers.

Mental health and health related quality of life is commonly affected in patients with chronic problems and their caregivers. In the present study, it was aimed to assess depression and anxiety in patients with beta thalassemia major (BTM) and in their caregivers; and to evaluate effects of these disorders on quality of life. The study was carried out in a district Hereditary Hemoglobinopathy Center and included 88 patients with BTM and 63 of their caregivers. All subjects were assessed using Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Short Form-36 (SF-36) by a trained psychiatry resident via face-to-face interview. The BDI scores were 17 or above in 20.5% of the patients with BTM and 28.6% of their caregivers (P = 0.248). Of the patients with BTM, there were mild anxiety symptoms in 19.3%, while moderate and severe anxiety symptoms in 14.8% and 4.5%, respectively. Anxiety levels were similar between the patients with BTM and their caregivers (P = 0.878). It was found that BDI and BAI scores were negatively correlated to scores of physical health and mental health components of SF-36 in patients with BTM and their caregivers. In linear regression analysis, it was seen that depression affected physical and mental health of the patients with BTM and their caregivers regardless from anxiety. BTM leads an increase in the frequency of depression and anxiety in both patients and their caregivers, and affects negatively physical and mental components of quality of life.