Pituitary volumes in patients with adjustment disorder

The pituitary gland plays an important role in the stress response mechanism. Given the direct link between adjustment disorder and stress, we hypothesized that there might be changes in the pituitary gland in these patients. The study comprised a patient group of 19 individuals with adjustment disorder according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, and 18 healthy controls. The mean pituitary gland volumes of the patient group were not statistically significantly different from those of the healthy control group (80.81 ± 1.82 mm3 in patients with adjustment disorder vs. 81.10 ± 7.04 mm3 in healthy controls, with a statistically nonsignificant difference of P > 0.05). This finding is contrary to our previous findings in anxiety-related disorders. In this regard, adjustment disorder is not similar to anxiety-related disorders in terms of pituitary gland volumes. We should also clearly state that our study is a pioneering study and that studies with large samples are needed to support our findings. The limitations of our study can be attributed to the small sample size, the utilization of a cross-sectional design, and the inclusion of patients using psychotropic drugs.

Leptin, Nesfatin-1, Orexin-A, and Total Ghrelin Levels in Drug-Naive Panic Disorder

OBJECTIVE

This study aimed to examine the changes in serum nesfatin-1, leptin, orexin-A, and total ghrelin levels of patients diagnosed with drug-naive panic disorder (PD) before and after six weeks of the treatment and to compare the findings with the healthy subjects.

METHODS

The neuropeptides were measured in venous blood samples taken from 32 patients and 32 healthy subjects. The blood samples of the patients who used paroxetine 20 mg/day plus alprazolam 0.5 mg/day were retaken again after six weeks. Measurements were performed with the Enzyme-Linked Immunosorbent Assay (ELISA) method.

RESULTS

Serum nesfatin-1, leptin, orexin-A and total ghrelin levels of the patient group were found to be significantly lower than the control group (p<0.001, p<0.001, p<0.001, and p<0.001, respectively). When the serum nesfatin-1, leptin, orexin-A and total ghrelin levels of the patient group were compared before and after treatment, significant differences were found in terms of orexin-A and total ghrelin levels (p=0.046, p<0.001, respectively). However, no significant differences were found in terms of nesfatin-1and leptin levels (p=0.205, p=0.988, respectively).

CONCLUSION

This study reports that PD, like other anxiety disorders, may affect serum nesfatin-1, leptin, orexin-A, and total ghrelin levels, and there may be a relationship between PD treatment and the levels of these neuropeptides. The variability of this relationship among the neuropeptides examined indicates that various factors other than treatment play a role in this process.

Attitude towards seeking psychological help regarding psychiatric symptoms and stigma in patients with fibromyalgia

OBJECTIVE

The current study aimed to examine the psychiatric symptoms that can be seen in fibromyalgia (FM) patients, their attitudes toward seeking psychological help, and their concerns about stigma. Besides, it was investigated whether the stigma concerns that they may experience about receiving psychiatric treatment constitute an obstacle for patients to receive psychiatric treatment.

SUBJECTS AND METHODS

This cross-sectional descriptive study was conducted between February and July 2020. Various seeking help were measured with Attitude Towards Seeking Psychological Help Scale-Short Form (ATSPPH-SF), Self-Stigma in the Process of Seeking Psychological Help Scale (SSPSPHS), Intention to Seek Psychological Help Inventory (ISPHI), and Social Stigma Due to Seeking Psychological Help Scale (SSDSPHS). FM symptoms of patients were measured with The Symptom Screening Questionnaire, Revised 90 Items (SCL-90-R). Quality-of-life parameters were measured with Fibromyalgia Impact Questionnaire (FIQ).

RESULTS

Fibromyalgia patients had higher somatization (p=0.001), psychotism (p=0.045) and phobic anxiety (p=0.015) scores than controls. The ATSPPH-SF (p=0.002) and SSPSPHS (p=0.043) scale scores of the FM patients were higher than the controls. There was a significant positive correlation between FIQ and SSPSPHS (r=0.288, p=0.043) and SCL-90 overall (r=0.602, p<0.001) and all subscales scores. Patients with high active psychotic symptom levels had higher FM exposure scale scores and SCL-90 overall scores than those with low active psychotic symptom levels (p<0.001).

CONCLUSIONS

The findings of this study showed that fibromyalgia patients have more somatization symptoms than healthy individuals, and as psychiatric symptoms increase in these individuals, their level of being affected by FM increases.

Brain abscess incidence and microbial etiology in Turkey: a nationwide cross-sectional study

OBJECTIVE

Brain abscess, a localized purulent central nervous system infection, arises from a variety of microorganisms. Expedited diagnosis and formulation of effective treatment strategies are crucial for mitigating mortality risks in patients with brain abscesses. A nuanced understanding of potential microbial agents is pivotal for the development of empirical antibiotic therapies. This study aimed to explore the incidence and microbial etiology of brain abscesses.

PATIENTS AND METHODS

This study is a nationwide cross-sectional analysis of patients diagnosed with brain abscesses in Turkey, employing the ICD 10 diagnosis code from January 1, 2015, to December 31, 2021. Data pertaining to age, sex, comorbidities, and microorganisms isolated from central nervous system samples were meticulously recorded and analyzed.

RESULTS

This study included 11,536 patients diagnosed with brain abscesses. The incidence fluctuated between 0.98 and 3.68 during the review decrease post-2017, with a notable increase in male patients during time. Diabetes constituted 56.5% of the patients. The predominant isolated pathogens were Staphylococcus (37.6%), Streptococci (13.3%), and Klebsiella spp. (7.8%), Escherichia coli (6.4%), and Candida species (6.1%).

CONCLUSIONS

The incidence of brain abscesses is decreasing in Turkey. Although staphylococci remain the most isolated agents, the frequent occurrence of Gram-negative bacteria and Candida species warrants consideration during empirical antibiotic selection.

Evaluation of Arterial Stiffness in Depression Patients

Background

It has been known that there is a significant correlation between depression and cardiovascular diseases. However, the reasons behind this correlation that could affect mortality and morbidity were not fully identified. The present study aimed to analyze arterial stiffness diagnosed with ultrasonography, which could be associated with cardiovascular disease risks in depression patients, and to compare the findings with those of healthy controls.

Methods

The study was conducted with 35 depression patients and 35 healthy individuals. Routine complete blood and biochemistry tests were requested for all patients, and their weight and height, waist circumference, and diastolic and systolic arterial blood pressure were measured. Femoral and carotid artery intima-media thickness and other arterial stiffness parameters were determined with Doppler ultrasonography.

Results

It was determined that the systolic pressure (P = .028) was higher in the patient group (P = .028). Also, the carotid elastic modulus (P = .048) was significantly higher in the patient group. A negative and significant correlation was determined between femoral compliance and chlorpromazine equivalent dose (P = .021, r = -0.389).

Conclusion

It was determined that the systolic blood pressure and carotid elastic modulus arterial stiffness parameters were significantly higher in depression patients. Measurable arterial stiffness parameters should be investigated in depression patients as cardiovascular risk markers. Furthermore, the determination of the effects of psychotropic drugs employed in arterial stiffness treatment could play an important role in the determination of cardiovascular disease risk in these patients.

Cortical Thickness of the Orbitofrontal Cortex in Patients with Alcohol Use Disorder

Aims: In the present study, it was hypothesised that compared to healthy control subjects, significant differences in the cortical thickness of the orbitofrontal cortex (OFC) region of the brain, which is relevant to both impulsivity and decision making, would be identified. Methods: The subject groups included in the study were composed of 15 individuals who met the criteria for alcohol use disorder, according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM 5) diagnostic criteria based on the Structured Clinical Interview for DSM 5 (SCID), and were admitted to the Firat University School of Medicine Department of Psychiatry or were hospitalised, and 17 healthy control comparisons were made. The volumes of and cortical thickness of the OFC were measured in the subjects. Results: It was found that patients with alcohol use disorder had reduced volumes of the OFC bilaterally and a thinner cortical thickness of the same region bilaterally compared to those of the healthy control comparisons. Conclusions: Consequently, it is suggested that the OFC region of the brain appears to be statistically significantly smaller in patients with alcohol use disorder, both in terms of cortical thickness and volume, compared to healthy controls. Future research should focus on the status of these relationships longitudinally and should assess the causality of the association with the treatment response.

Monocyte/HDL Cholesterol Ratios as a New Inflammatory Marker in Patients with Schizophrenia

PURPOSE

Monocyte/HDL cholesterol ratio (MHR) is a novel inflammatory marker that is used as a prognostic factor for cardiovascular diseases and has been studied in many diseases. The aim of this study was to investigate the role of inflammatory factors in schizophrenia patients by examining MHR levels and to compare schizophrenia patients and healthy controls in terms of cardiovascular disease risk.

METHOD

A total of 135 participants between the ages of 18-65, 85 diagnosed with schizophrenia, and 50 healthy individuals in the control group were included in this cross-sectional study. Venous blood samples were taken from the participants and CBC parameters and lipid profiles were analyzed. The sociodemographic and clinical data form and positive and negative symptoms scale (PANSS) were administered to all participants.

RESULTS

Although monocyte levels were significantly higher in the patient group, HDL-C levels were lower at significant levels. MHR was found to be higher in the patient group compared to the control group at significant levels. When compared to the control group, total cholesterol, triglyceride, WBC, neutrophil, basophil, and platelet levels were higher in the patient group at significant levels, and RBC, hemoglobin, and hematocrit levels were significantly lower.

CONCLUSION

The elevated MHR in patients with schizophrenia may contribute to our understanding that inflammation plays important roles in the pathophysiology of schizophrenia. Additionally, knowing the levels of MHR and considering the recommendations, such as diet and exercise, in the treatment approaches made us think that it might be beneficial in protecting schizophrenia patients against cardiovascular diseases and early death.

Relationship between optical coherence tomography findings and clinical variables in patients with opiate use disorder

PURPOSE

This study aimed to examine optical coherence tomography findings in patients with opiate use disorder by comparing them with healthy controls.

METHODS

The study included 30 opiate use disorder patients and 30 controls. The participants' detailed biomicroscopic examinations, visual acuity, intraocular pressure, and both eye examinations were evaluated. A total of 120 eyes were evaluated using optical coherence tomography, measuring the central macular thickness, mean macular thickness, mean macular volume and retinal nerve fiber layer thickness. Moreover, all participants filled in the demographic data form and Barratt Impulsiveness Scale.

RESULTS

Upon examination of the optical coherence tomography findings, central macular thickness, mean macular thickness, and mean macular volume were thinner in both eyes in patients with opiate use disorder (p<0.01 in all measurements in both eyes). Similarly, the total values of the superior quadrant and retinal nerve fiber layer thickness were statistically significant in both eyes compared to that in the control group (p=0.007, p=0.002; p=0.049, p=0.007, in the right and left eyes, respectively). Only the left eye was positively correlated with retinal nerve fiber layer superior quadrant measurement and hospitalization (r=0.380, p=0.039).

CONCLUSION

Our results revealed that the patients' central macular thickness, mean macular thickness, and mean macular volume values were thinner. Increase in the retinal nerve fiber layer thickness superior quadrant thickness and total value was also observed. Further studies with larger sampling groups that evaluate neuroimaging findings should be conducted.

Stigmas and childhood traumas associated with psychological help-seeking in suicide attempted individuals

PURPOSE

The aim was to investigate the possible associations of suicide attempt with childhood trauma, social support, psychological support seeking, stigmatizations. The study was case-control study and included 100 participants (50 suicide, 50 controls).

CONCLUSION

BDI, BAI scores were higher in the patient (p < 0.001). While scores of all-subscales of Childhood-Trauma-Questionnaire were higher (p < 0.05) in the patients, scores of Perceived-Social-Support were lower (p < 0.001). Repeating suicide attempts has higher Stigma-Scale-for-Receiving-Psychological-Help scores than the patients who attempted to the first time (p = 0.045).

PRACTICE IMPLICATION

Suicide is relationship with more childhood traumas, less social support. Repeating suicide attempts, individuals felt public stigma for receiving psychological help.

The clinicopathological features and survival of Castleman disease: a multicenter Turkish study

OBJECTIVE

In this study, we aimed to investigate the clinicopathological features and survival of CD, which is quite rare and has many unknowns.

PATIENTS AND METHODS

This study was conducted by retrospectively evaluating patients diagnosed with CD in six different centers in Turkey.

RESULTS

The median age of 33 patients included in the study was 49 and 51.5% (n = 17) of these patients were women. 18 (54.5%) patients were in the hyaline vascular subtype and most of the patients were UCD (n = 20, 60.6%). The most common involvement region was head and neck (n = 19, 57.5%). The UCD group was younger than the MCD group (p=0.027). Visceral lymph node involvement was higher in MCD than in UCD (p=0.001). Similarly, it was observed that there was more hepatomegaly (p=0.035) and splenomegaly (p=0.013) in the MCD group. During the median 19.5 months follow-up period, there were no patients who died.

CONCLUSIONS

It was observed that UCD and MCD are different clinical entities. Promising survival times can be achieved with surgical and systemic treatments in both subtypes of this extremely rare disease. However, this result should be supported by well-designed prospective comprehensive studies.

Insula volumes in patients with schizoaffective disorder

We aimed to investigate insula volumes in patients with schizoaffective disorder with the motivation that schizoaffective disorder has strong resemblance of clinical presentaion with schizophrenia and bipolar disorder and that there have been studies on insula volumes in patients with schizophrenia and bipolar disorder but not in patients with schizoaffective disorder.

Suicidal Ideation, Self-esteem, and Hopelessness in Patients With Pulmonary Arterial Hypertension

Objective: To investigate the frequency of suicidal ideation and its correlation with other clinical variables in patients with pulmonary arterial hypertension.

Methods: Fifty patients with pulmonary arterial hypertension who presented to the cardiology department between 2018 and 2019 and 50 healthy controls were included in the study. A sociodemographic and clinical data form was completed by both the patients and controls, and the Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), Rosenberg Self-Esteem Scale (RSE), and Suicide Probability Scale (SPS) were administered. SPSS version 22 software was used in the statistical analysis.

Results: The mean ± SD systolic pulmonary pressure of the patients was 47.48 ± 18.86 and the pulmonary artery pressure was 33.32 ± 19.69. BHS, BDI, and SPS total scores were statistically significantly higher in the patient group compared to the control group (P < .001, P = .001, P = .026, respectively). RSE scores were also higher in the patient group compared to the control group (P = .017).

Conclusions: It is important to identify pulmonary arterial hypertension patients with intense feelings of hopelessness and depressive symptoms and to provide psychiatric treatment and psychotherapeutic interventions to improve their self-esteem.

Superior Temporal Gyrus Volumes in Patients With Social Anxiety Disorder

Objective: To determine if superior temporal gyrus volumes are altered in patients with a social anxiety disorder.

Methods: Magnetic resonance imaging (MRI) was utilized to determine the superior temporal gyrus volume in 21 patients with a social anxiety disorder and 20 control subjects without a social anxiety disorder. The superior temporal gyrus volumes were measured by manual tracing method. The study was conducted between September 2019 and April 2020.

Results: The mean superior temporal gyrus volume for both sides was statistically significantly smaller than that of control subjects (left side: 11.38 ± 0.85 cm³ for patients and 12.73 ± 0.86 cm³ for controls, t=-5.064, P < .001; right side: 11.42 ± 0.84 mm³ for patients and 12.92 ± 0.85 cm³ for controls, t=-5.574, P < .001). Moreover, when comparing volumetric measurements for subregions, we detected that volumes of all subregions were also statistically significantly smaller than those of healthy comparisons (for both sides of the Heschl's gyrus and planum temporale).

Conclusions: The study findings suggest that patients with social anxiety disorder seem to have smaller superior temporal gyrus volumes compared to healthy control subjects, although we do not know whether these results were in accordance with functional changes of the same region.

Clinical characteristics, quality of life and risk factors for severity in palmoplantar pustulosis: a cross-sectional, multicentre study of 263 patients

BACKGROUND

Palmoplantar pustulosis (PPP) is a rare, chronic, inflammatory skin disease characterized by sterile pustules on palmar or plantar areas. Data on PPP are scarce.

AIM

To investigate the clinical characteristics and risk factors for disease severity in a large cohort of Turkish patients with PPP.

METHODS

We conducted a cross-sectional, multicentre study of patients with PPP recruited from 21 tertiary centres across Turkey.

RESULTS

In total, 263 patients (165 women, 98 men) were evaluated. Most patients (75.6%) were former or current smokers. The mean Palmoplantar Pustulosis Area and Severity Index (PPPASI) was 8.70 ± 8.06 and the mean Dermatology Life Quality Index (DLQI) score was 6.87 ± 6.08, and these scores were significantly correlated (r = 0.52, P < 0.001). Regression analysis showed that current smoking was significantly associated with increased PPPASI (P = 0.03). Coexisting psoriasis vulgaris (PsV) was reported by 70 (26.6%) patients. Male sex prevalence, PPP onset incidence, disease duration, DLQI, and prevalence of nail involvement and psoriatic arthritis (PsA) were significantly increased among patients with PPP with PsV. Of the 263 patients, 18 (6.8%) had paradoxical PPP induced by biologic therapy, and these patients had significantly increased mean DLQI and prevalence of PsA (r = 0.03, P = 0.001).

CONCLUSION

Our data suggest that smoking is a risk factor for both PPP development and disease severity. Patients with PPP with PsV present distinct clinical features and patients with biologic therapy-induced paradoxical PPP have reduced quality of life and are more likely to have PsA.

Insula volumes are altered in patients with social anxiety disorder

OBJECTIVE

In the present study, we aimed at examining the volumes of the insula in more pure patients with a social anxiety disorder.

METHODS

We examined twenty-one patients with social anxiety disorder according to DSM-IV and twenty healthy controls. All patients and controls were applied to magnetic resonance imaging (MRI). Insula volumes were measured by using the manual tracing method in accordance with the standard anatomical atlases and related previous studies on insula volumes.

RESULTS

We found that the mean posterior and anterior insula volumes for both sides of patients were statistically significantly reduced compared to those of healthy control subjects.

CONCLUSION

Consequently, in the present study, we found that patients with a social anxiety disorder had reduced insula volumes compared to those of healthy control subjects. However, to get strong this finding, novel studies with a larger sample size are required.

The anxiety levels, quality of sleep and life and problem-solving skills in healthcare workers employed in COVID-19 services

OBJECTIVE

The present study aims to investigate the level of anxiety experienced by healthcare workers employed in COVID-19 services, the effects of anxiety on sleep quality and quality of life and, the relationship between these variables and problem-solving skills of the healthcare workers.

MATERIAL AND METHOD

The study was conducted in two healthcare facilities which serve as pandemic hospitals. 140 healthcare workers, who were employed in the COVID-19 outpatient clinics or emergency departments, participated in the present study. All participants were submitted to the Pittsburgh Sleep Quality Index (PSQI), Problem Solving Inventory (PSI), World Health Organization Quality of Life-BREF (WHOQOL-BREF), Beck Anxiety Inventory (BAI).

FINDINGS

The number of participants without anxiety was 41(29%), with mild anxiety was 53(38%). Clinically significant anxiety findings were found in only 33% of the participants. A positive correlation was found between the participants' BAI scores and PSQI, PSI scores, and a negative correlation with the WHOQOL-BREF scores. PSQI and PSI scores of nurses were statistically higher when compared to those of physicians and staff. WHOQOL-BREF scores were found to be lower.

CONCLUSION

Healthcare workers might develop psychiatric symptoms such as anxiety and sleep disturbance. Such symptoms could adversely affect the problem-solving skills of healthcare workers and cause a deterioration in their quality of life.

Analysis of Childhood Traumas and Defense Styles in Patients With Tension Headache

Objective

Studies indicate that patients tend to develop chronic tension headache as a response to stress. The present study investigated the relationship between headache and the events that caused childhood traumas and defense styles, which could be considered as a significant source of stress in individuals with tension headache.

Methods

Fifty patients between the ages of 18 and 65 years diagnosed with tension headache were included in the present study. The control group included 50 healthy participants. All study participants completed a sociodemographic data form prepared by the researchers and the Childhood Trauma Questionnaire and Defense Style Questionnaire.

Results

Traumatic experiences (emotional abuse, physical abuse, emotional neglect, physical neglect, and sexual abuse) were significantly higher in the patient group compared to the control group. The total score of immature and neurotic defense styles was higher in the patient group than in the control group (P < .001, P < .001). The mature defense styles total score was significantly higher in the control group than in the patient group (P = .006). A positive correlation was found between the childhood trauma scores and immature and neurotic defense style scores.

Conclusion

The findings indicate that traumatic experiences during childhood were more frequent in patients with tension headache compared to healthy individuals. Furthermore, these individuals had difficulty coping with stress, and inappropriate defense styles were employed as a response to stress.

Self-Esteem and Defense Mechanisms in HIV-Positive and AIDS Patients

Objective

To investigate the self-esteem and defense mechanisms in patients diagnosed with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS).

Methods

This prospective, cross-sectional study included 29 patients diagnosed with HIV/AIDS admitted to inpatient or outpatient clinics between March 2018 and January 2019 and 29 healthy subjects. Participants were assessed using a sociodemographic and clinical data form, the Rosenberg Self-Esteem Inventory (RSEI), the Defense Style Questionnaire (DSQ), and the Beck Anxiety Inventory (BAI).

Results

Patients with HIV/AIDS had significantly higher scores on the fantasy, psychosomatic symptoms, and parental interest subscales of the RSEI. There was no significant difference between the groups on the other subscales, including the self-esteem subscale. There was no correlation between the duration of the disease and self-esteem. The neurotic defense mechanism and immature defense mechanism subscale scores of the DSQ were significantly higher in the HIV/AIDS group compared to the control group (P < .01). Undoing and reaction formation scores in neurotic defense mechanisms and projection, devaluation, autistic fantasy, and splitting scores in immature defense mechanisms were significantly higher in the HIV/AIDS group compared to controls (P < .05). There was no significant difference between the groups based on the mature defense mechanisms subscale scores.

Conclusions

No difference was found in the self-esteem scores of the HIV/AIDS and control groups, and this finding could be associated with the stability of the self-esteem concept. It was also determined that patient group members utilized neurotic and immature defense mechanisms more often compared to the healthy group, and there was no difference between the groups based on mature defense mechanisms.

QT Wave Dispersion in Patients With Major Depressive Disorder

Objective

A limited number of studies have investigated QT wave dispersion (QTd) in depressive disorder. The objective of this study was to investigate whether QTd differed in patients diagnosed with depression compared to a control group and whether the difference correlated with the depression and anxiety scores.

Methods

Forty patients diagnosed with major depressive disorder (DSM-5 criteria) who did not receive their first treatment after the first episode were included in the study. Forty healthy individuals with similar sociodemographic characteristics were included in the control group. A sociodemographic and clinical data form, the Beck Depression Inventory, and the Beck Anxiety Inventory were given to all patients. Electrocardiograms were evaluated in a single-blind setting by the same cardiologist. The longest QT interval (QTmax) and the shortest QT interval (QTmin) were calculated. Heart rate-corrected QTmax (QTcmax) and QTmin (QTcmin) were calculated using the Bazett formula (QT[ms]/√R-R). The difference between QTcmax and QTcmin was accepted as the corrected QT dispersion (QTcd). The study was conducted from December 2018-March 2019.

Results

No statistically significant difference was found between patient and control groups on the basis of age, sex, body mass index, or smoking. Beck Anxiety Inventory and Beck Depression Inventory scores of the patient group (28.48 ± 12.39 and 32.2 ± 11.58, respectively) were significantly higher compared to the control group (2.7 ± 3.41 and 2.75 ± 3.2, respectively). The patient group QTcmax (419.8 ± 24.46) and QTcd (42.55 ± 17.47) values were significantly higher compared to the QTcmax (405.2 ± 24.54) and QTcd (30.48 ± 9.25) values of the control group. There was a positive correlation between QTcd, QTcmax, and anxiety and depression scores.

Conclusions

QTcd values of depressed patients were higher than those of the healthy controls, and there was a positive correlation between QTcd and depression and anxiety scores.

Smaller Pituitary Volumes in Patients with Delusional Disorder

Introduction:

Delusional disorder shares some clinical characteristics of OCD and hypochondriasis. Delusions compared to obsessions in the OCD and compared to bodily preoccupations in the hypochondriasis are more established beliefs.

Aim:

To measure pituitary volumes in patients with delusional disorder and hypothesized that volumes would be reduced in those patients by a mechanism that we could not account for before for patients with OCD and hypochondriasis.

Methods:

Eighteen patients with delusional disorder and healthy controls were included into the study. Pituitary gland volumes were measured.

Results:

When using independent t test, the mean total pituitary volume was 777.22±241.28 mm³ in healthy controls, while it was 532.11±125.65 mm³ in patients with delusional disorder. The differences in regard to pituitary gland volumes between patients with delusional disorder and healthy control subjects were statistically meaningful (p<0.01), as supported by ANCOVA, with the covariates of age, gender and total brain volumes as covariates.

Conclusion:

We determined that patients with delusional disorder had smaller pituitary volumes compared to those of healthy control subjects.

Evaluation of oxidative stress in patients with recalcitrant warts

BACKGROUND

Warts are benign conditions of the skin and mucosa caused by human papilloma viruses (HPV) that affect many people worldwide.

OBJECTIVE

The aim of this study was to evaluate OS by TOS/TAS, levels of 8-hydroxy-2-deoxyguanosine (8-OHdG) an indicator of DNA damage, and also protein oxidation levels by determining the dynamic serum thiol/disulphide homeostasis in patients with warts. We also aimed to investigate whether there is a relationship between thiol/disulphide homeostasis, recalcitrance of warts and DNA damage.

METHODS

Forty patients of age ≥18 years, having recalcitrant genital and/or non-genital warts that persisted for more than 2 years, 40 patients with warts that persisted for <2 years and 40 healthy controls were enrolled in the study. Blood TAS, TOS, OSI, 8-OHdG and dynamic thiol/disulphide homeostasis were evaluated.

RESULTS

Significant differences were detected between the groups in the levels of 8-OHdG, TOS, OSI, total thiol, native thiol, reduced thiol, as well as native thiol/total thiol ratio, disulphide/total thiol ratio and disulphide/native thiol ratio. Compared with the controls, patients with recalcitrant warts had significantly higher levels of 8-OHdG, TOS and OSI levels. Total thiol and native thiol levels were significantly lower in patients with recalcitrant warts compared with patients with warts that persisted for <2 years. Disulphide levels were significantly higher in the latter group of patients compared with patients with recalcitrant warts and controls. Native thiol/total thiol ratio was significantly higher in both patient groups compared with controls whereas disulphide/total thiol and disulphide/native thiol ratios were significantly lower in both patient groups than in controls.

CONCLUSION

Our findings suggest that impairment of thiol disulphide homeostasis in patients with recalcitrant warts may lead to increased OS and DNA damage. Thus, antioxidant administration with thiol containing proteins may help in the regression of warts and thereby prevent carcinogenesis.

Should patients be informed about the side effects of psychotropic drugs? According to us: Yes

BACKGROUND

In our daily clinical practice, we observe that patients who were informed about the probable side effects of any medication experience less side effects. For this reason, we decided to examine this in a systematic investigation.

METHODS

We divided patients into two groups, the informed and uninformed one about side effects of the drugs. During the control examination, tolerability of the drugs given was questioned in detail.

RESULTS

At the end of one month, the mean total UKU score was statistically significantly lower in patients from the informed group compared to that of the uninformed one (p < 0.05). The proportion of patients who discontinued the drug during the one month-period was statistically significantly higher in the uninformed group compared to informed group 9% in the informed group vs. 25% in the uninformed group) (p < 0.05).

CONCLUSIONS

Finally, we found that giving information about the side effects of a psychopharmacological agent seems to be useful and to provide beneficial effects on the tolerability of the drug, independent of the kind of psychotropic agent.

Psychiatric symptoms in migraine patients and their attitudes towards psychological support on stigmatization

OBJECTIVE

Although migraine patients experience more psychological problems when compared to the general population, they are usually not treated. The reasons for non-treatment of these problems are not clear. The anxiety and concern of migraine patients about stigmatization may also prevent them to express psychological symptoms. The present study aimed to investigate the attitudes and behavior of migraine patients about receiving psychological help and their concerns about stigmatization.

MATERIAL AND METHOD

The study group included 50 18-49 years old patients diagnosed with migraine in the neurology clinic and the control group included 50 healthy individuals with similar age, gender socio demographic characteristics with the study group. Attitude Scale Towards Seeking Professional Help (ASPH-SF), Self-Stigma in Seeking Professional Help Scale (SSPHS), Intentions to Seek Psychological Help Scale (ISHP), Stigma Scale for Receiving Psychological Help (SSRPH) and Symptom Checklist (SCL-90-R) were applied to all participants.

FINDINGS

The comparison of the patient and control groups based on SCL-90-R findings demonstrated that the patient group scores in somatization, anxiety (p = 0.000), depression (p = 0.003), anger (p = 0.02), interpersonal sensitivity (p = 0.006), phobia (p = 0.001), paranoid thoughts (p = 0.012), psychosis (p = 0.031) subscales and additional subscale (p = 0.014) and general symptom index (p = 0.001) scores were higher. Based on SCL 90, it was found that patients with higher levels of symptoms had higher social stigma scores when compared to patients with lower symptom levels (p = 0.007). Migraine patients with high symptom levels were found to have significantly lower rates of seeking psychiatric help (14% vs 33%) when compared to the control group. There was no difference between the patient and control groups based on ASPH-SF, SSPHS, ISPH and SSRPH scale scores.

CONCLUSION

Although migraine patients exhibit higher levels of psychiatric symptoms when compared to healthy individuals, it was determined that only a minority of these patients receive psychiatric treatment. Especially patients with high level of psychiatric symptoms could have sought less psychiatric help due to the concerns of stigmatization.

Orbito-frontal cortex and thalamus volumes in the patients with obsessive-compulsive disorder before and after cognitive behavioral therapy

Background The effect of a variety of treatment modalities including psychopharmacological and cognitive behavioral therapy on the brain volumes and neurochemicals have not been investigated enough in the patients with obsessive-compulsive disorder. Therefore, in the present study, we aimed to investigate the effect of cognitive behavioral therapy on the volumes of the orbito-frontal cortex and thalamus regions which seem to be abnormal in the patients with obsessive-compulsive disorder. We hypothesized that there would be change in the volumes of the orbito-frontal cortex and thalamus. Methods Twelve patients with obsessive-compulsive disorder and same number of healthy controls were included into the study. At the beginning of the study, the volumes of the orbito-frontal cortex and thalamus were compared by using magnetic resonance imaging. In addition, volumes of these regions were measured before and after the cognitive behavioral therapy treatment in the patient group. Results The patients with obsessive-compulsive disorder had greater left and right thalamus volumes and smaller left and right orbito-frontal cortex volumes compared to those of healthy control subjects at the beginning of the study. When we compared baseline volumes of the patients with posttreatment ones, we detected that thalamus volumes significantly decreased throughout the period for both sides and that the orbito-frontal cortex volumes significantly increased throughout the period for only left side. Conclusions In summary, we found that cognitive behavioral therapy might volumetrically affect the key brain regions involved in the neuroanatomy of obsessive-compulsive disorder. However, future studies with larger sample are required.

Is Cytomegalovirus Surveillance Necessary for Patients With Low Reactivation Risk in an Autologous Hematopoietic Cell Transplantation Setting?

BACKGROUND

In an autologous hematopoietic cell transplantation (AHCT) setting, routine cytomegalovirus (CMV) surveillance is not indicated except in high-risk situations. On the other hand, some studies reported increased CMV reactivation in AHCT setting as a result of incorporation of novel agents into treatment algorithms, such as bortezomib and rituximab. We retrospectively analyzed CMV reactivation and infection rates in patients with no high-risk features, who were treated with AHCT.

METHODS

During January 2010 to November 2015, all consecutive, CMV-seropositive patients were included. The viral copy numbers were measured twice a week from the start of the conditioning regimen until engraftment, once a week for the remaining time period until day 30 after AHCT and once weekly only for patients who had been diagnosed with CMV reactivation before and who developed primary/secondary engraftment failure during 31 to 60 days after AHCT.

RESULTS

One hundred one (61.6%) men and 63 (38.4%) women were included in the study. The median age of study cohort was 51 years (range, 16-71 years). The indications for AHCT were Hodgkin lymphoma, non-Hodgkin lymphoma, and multiple myeloma in 44 (26.8%), 41 (25%), and 79 (48.2%) patients, respectively. CMV reactivation occurred in 60 (37%) patients, and 13 patients (8%) received pre-emptive ganciclovir treatment.

CONCLUSIONS

On the basis of our results, it might be stated that CMV surveillance may be recommended during 40 days after AHCT in countries with a high CMV prevalence, even in patients without high-risk features regarding reactivation. Additionally, the risky conditions necessitating CMV screening after AHCT must be re-defined in the era of novel agents.

The Relationship between Ghrelin and Copeptin Levels, and Anxiety and Depression Levels in Suicide Attempts

Objective

It was aimed to detect acylated ghrelin (AG), unacylated ghrelin (UG) and copeptin levels in patients with suicide attempts and to determine if these biomarkers are risk factors for suicide attempts.

Methods

Serum copeptin, AG and GU levels were screened in 128 patients who were admitted to emergency department with suicide attempts and 59 healthy controls. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were applied simultaneously, and the data were compared statistically.

Results

AG, UG and copeptin levels were higher in the patient group compared with the healthy control group. BAI scores of patients were found to be positively correlated with BDI scores. While there was a significant difference (p=0.0064) between psychiatric and non-psychiatric patients with suicide attempts in terms of BAI scores, there were no differences in BDI scores and levels of biomarkers. We found significantly increased BDI and BAI scores and increased levels of AG, UG and copeptin in psychiatric and non-psychiatric patients compared with healthy individuals. The specificities yielded by receiver operating characteristic curve analysis in patients with suicide attempts were as follows: 91.53% for AG, 72.88% for UG and 94.92% for copeptin.

Conclusion

Serum levels of AG, UG and copeptin increase with increasing anxiety and depression in patients with suicide attempts. Increased levels of AG, UG and copeptin could be considered a risk factor for suicide attempts.

Protective effect of thymoquinone against cyclophosphamide-induced genotoxic damage in human lymphocytes

OBJECTIVE

Protective effect of thymoquinone (TQ) against the cytotoxic and genotoxic effects of cyclophosphamide (CP) was assessed in human peripheral blood lymphocyte culture.

METHODS

Mitotic indices were determined as endpoints of cytotoxicity, while sister chromatid exchanges (SCE) served as endpoints of genotoxicity. Firstly, the genotoxic effect of 0.16 µg/ml of CP was tested and CP was detected as genotoxic. In the second set, CP group was treated with 20 µM and 40 µM TQ.

RESULTS

TQ reduced the SCE frequencies, suggesting its protective action on human lymphocytes in vitro against the CP induced genotoxic damage.

CONCLUSIONS

Our results suggest that TQ produces a protective mechanism against CP-induced genetic damage, and suggest a role of DNA strand breaks in the genotoxicity (Tab. 1, Fig. 1, Ref. 19).

Illicit substance use among persons admitted to probation polyclinic of a regional mental hospital in the Eastern Anatolia, Turkey

OBJECTIVES

To investigate the illicit substance use trends by gender and year in Eastern Turkey, Elazığ.  

METHODS

This is a retrospective study designed to assess the drug use prevalence in persons who admitted to the Probation Policlinic of Elazig Mental Health Hospital between January 2011 and December 2014 in Eastern Turkey, Elazığ. Laboratory screening tests for drugs were studied using the cloned enzyme donor immunoassay technique in urine.  

RESULTS

The study consisted of 10267 males (95.3%)  and 510 females (4.7%), with a mean age of 30.42±10.83 years. Overall prevalence was 32.1% for cannabis, 3.8% for opiate, 0.35% for cocaine and 1.2% for polydrug usage. The prevalence of cannabis was significantly higher in males (32.7%, p=0.000). The prevalence of cannabis use was the lowest in the age group of 50-59 while it was significantly higher in the age groups of 20-29 and 30-39 (p=0.000). The prevalence of opiate use showed a significant difference among the years (p=0.000).There was a significant difference in the prevalence of cocaine use among the years (p=0.02). The prevalence of polysubstance use showed a significant difference among years (p=0.000). 

CONCLUSION

Cannabis was the most common illicit drug in the east of the Turkey. Further studies are required for comparing the results of various regions of the country and developing early interventions and treatment facilities.

Determination of health anxiety, anxiety, and somatosensory amplification levels in individuals with normal coronary angiography

The objective of the present study is to determine the somatosensory amplification, anxiety, and depression levels in patients with normal coronary arteries. Thirty-five patients with normal coronary arteries and 35 healthy individuals of similar age and gender as the patient group were included in the study. Somatosensory Amplification Scale (SSAS), Health Anxiety Inventory (HAI-18), Penn State Anxiety Scale (PSWQ), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) were applied to all participants. Comparison of the patient group with the control group demonstrated that SSAS (22.7±8.2; 18.5±5.98; p=0.018), BAI (15.4±9.43; 9.4±7.3; p=0.004), BDI (24.9±13.5; 13.7±7.5; p<0.001), PSWQ (55.3±13.7; 33.8±6.7; p<0.001), and HAI-18 (18.8±8.7; 12.3±7.1; p=0.001) scores were statistically significantly higher in the patient group. Furthermore, a positive correlation was found between SSAS, BAI, BDI, PSWQ, and HAI-18 scores. It was found that concerns about disease prevailed in patients having normal coronary arteries, the patients continued to amplify their somatic sensations, and their anxiety and depression scores were higher than those of healthy individuals. Thus, the necessity of these interventions should be assessed in detail in the future.

Evidence for the changes of pituitary volumes in patients with post-traumatic stress disorder

In pubertal and postpubertal patients with post-traumatic stress disorder (PTSD), significantly greater pituitary gland volumes have been reported. Moving from this point, in the present study, we aimed to investigate pituitary gland volumes in patients with PTSD and hypothesized that volumes of the gland would be structurally changed. Volumetric magnetic resonance imaging of the pituitary gland was performed among sixteen patients with PTSD and fifteen healthy control subjects. We found that the mean volume of the pituitary gland was statistically significant and smaller than that of healthy subjects (0.69±0.08cm³ for patient group and 0.83±0.21 for control subjects). Consequently, in the present study, we found that patients with PTSD had smaller pituitary gland volumes than those of healthy controls like other anxiety disorders. It is important to provide support for this finding in future longitudinal investigations.

Copeptin levels and blood lipid profile in borderline patients with or without self-mutilation

Purpose

Self-mutilation, known as self-harming behaviour of an individual without the intention of suicide, is commonly observed in individuals with borderline personality disorder. The objective of this study is to compare copeptin levels that are known to be related to aggressive behaviour and blood lipid profiles in borderline patients with and without self-mutilation.

Methods

Twenty patients with self-mutilation [SM(+)] and 20 patients without self-mutilation [SM(−)] between the ages of 18 and 49, diagnosed with borderline personality disorder based on DSM-IV-TR(8) diagnostic criteria and attended to by Fırat University Psychiatry Polyclinic, participated in the study. Socio-demographic and clinical data form, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale (HAMA) and Barrat Impulsivity Scale (BIS) were applied to all participants. Copeptin levels and plasma lipid levels were studied in the blood samples taken from the participants.

Results

Mean copeptin level found in SM(+) group (37.54 ± 18.8 ng/mL) was statistically significantly higher than SM(−) group (18.53 ± 16.6 ng/mL) (p = 0.002). A negative correlation was found between mean copeptin and mean total cholesterol levels (r = −0.436; p = 0.005), and between copeptin and low-density lipoprotein cholesterol (LDL) levels (r = −0.403; p = 0.01) in both SM(+) and SM(−) patient groups. HAMA mean score for SM(+) group was found as 36.45 ± 13.2, and for SM(−) group, it was found as 35.7 ± 12.9. There was a statistically significant difference between the depression points achieved by the two groups (p = 0.046). BIS total points average for SM(+) group was determined as 71 ± 9.71, whereas it was determined as 66.8 ± 7.92 in SM(−) group. There was no statistically significant difference between the groups based on anxiety points. Barrat planning, Barrat motor and Barrat attention points for SM(+) group were higher than the SM(−) group. However, the difference was not statistically significant (p > 0.05).

Conclusion

Findings of the study demonstrated that as cholesterol and LDL levels decreased, copeptin levels increased, and that could be related to the self-mutilation behaviour.

Assessment of left ventricle systolic and diastolic functions in schizophrenia patients

The objective of the study was to scrutinize in detail the changes that occur in left ventricle (LV) systolic and diastolic functions using echocardiography in patients with at least 5 years of history and 40 healthy volunteers matching the patients in age and gender, who were enrolled in a cross-sectional study. All cases were examined with Tei Index, an index that could assess LV systolic and diastolic functions in conjuction, and with LV ejection fraction (LVEF) that assesses systolic function. In addition, Mitral E and A wave velocities, Isovolemic relaxation time (IVRT), Tissue Doppler Em (peak early motion) and Am (peak after motion) waves, which evaluate diastolic functions were measured. Tei Index was calculated as 0.61±0.19 in the patient group, and as 0.39±0.10 in the control group and the difference was statistically significant (p<0.001). LVEF was measured as 58%±5 in the patient group, and as 62%±3 in the control group and the difference was statistically significant (p<0.001). Also the IVRT values were significantly different between the tissue Doppler Em and Em/Am ratio among the groups (p<0.001). Echocardiographic myocardial performance, LV systolic and diastolic functions in schizophrenia patients was found to be worse than those of the control group.

Hippocampus and amygdala volumes in patients with vaginismus

AIM: To compare hippocampus and amygdala volumes of patients with vaginismus with those of healthy control subjects.

METHODS: Magnetic resonance imaging was performed on ten patients with vaginismus and ten control subjects matched for age and gender. Volumes of the hippocampus and amygdala were blindly measured.

RESULTS: We found that the mean right amygdala volume of patients with vaginismus were smaller than that of the healthy controls. With regard to hippocampus volumes, the mean left and right hippocampus volumes were smaller than those of the healthy controls.

CONCLUSION: Our present findings suggest that there have been hippocampus and amygdala structural abnormalities in patients with vaginismus. These changes provide the notion that vaginismus may be a fear-related condition.

Subcutaneous Adipose Tissue Type II Deiodinase Gene Expression Reduced in Obese Individuals with Metabolic Syndrome

The present study aimed to evaluate the role of subcutaneous adipose tissue (SAT) type II deiodinase enzyme gene (DIO2) expression in developing metabolic syndrome (MetS). A total of 51 obese patients with MetS and without MetS and 13 healthy subjects enrolled in the study. Body mass index (BMI), waist circumference (WC), waist-to-hip circumference ratio (WHR), hip circumference, and systolic (SBP) and diastolic blood pressures (DBP) of all subjects were recorded. Fasting plasma glucose (FPG), fasting plasma insulin, high density lipoprotein- cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC) and triglyceride (TG) of all subjects were analyzed. Expression of the DIO2 gene in adipose tissue was determined by reverse transcription polymerase chain reaction (qRT-PCR). BMI, WC and WHR were not significantly difference between obese with and without MetS. SBP, DBP, FPG and TG were significantly higher in obese with MetS group than obese without MetS group. While the free triiodothyronine (T3) level was in the normal range in all group, it was significantly lower in the obese with MetS than both obese without MetS and control group. DIO2 expression was significantly lower in the obese with MetS group compared to the control. In correlation analysis, DIO2 expression was negatively correlated with DBP, TG and homeostasis model assessment of insulin resistance (HOMA-IR) levels and positively correlated with free T3. In conclusion, the reduction of SAT DIO2 expression is negatively correlated with DBP and TG levels that are associated with the MetS. This might have an effect on developing MetS. We believe that DIO2 gene may be an important molecular target for future studies in developing targeted treatment options for obese people with MetS.

Association between sociodemographic characteristics and anxiety levels of violence-exposed patients admitted to emergency clinic

BACKGROUND

Here we aimed to investigate sociodemographic characteristics, psychiatric history, and association between sociodemographic characteristics and anxiety levels of violence-exposed patients admitted to emergency clinic.

METHODS

This study consists of 73 violence-exposed patients admitted to emergency clinic who were literate and agreed to participate in the study. A sociodemographic data form created by us to investigate alcohol-substance abuse, suicide attempt, previous history of trauma, self and family history of psychiatric disorders and Beck Anxiety Inventory was given to the patients.

RESULTS

Of the patients exposed to violence 63% (n=46) were female and 27% (n=27) were male. Of these patients, 68.5% (n=50) were married, 43.8% (n=25) were workers, 34.2% were housewives, 11% were unemployed, and 11% were civil servants. Of the violence-exposed patients, 56.2% (n=41) were primary school, 21.9% (n=16) were high school, and 21.9% (n=16) were university graduates. Smoking and alcohol use rates were 54.8% (n=40) and 17.8% (n=13), respectively. The most common trauma type was assault using physical force with a ratio of 78.1% (n=57). In addition, anxiety scores were high in 42.5% (n=31) and moderate in 9.6% (n=7) of the patients. Mentioned psychiatric disorder was present in 17.8% (n=13) of the patients and 19.2% (n=14) of the patients' relatives. The correlation between sociodemographic characteristics and anxiety scores revealed that married patients had higher anxiety scores (P<0.01) and patients assaulted by their parents had lower anxiety scores (P<0.00).

CONCLUSION

A total of 63% of the violence-exposed patients admitted to emergency room were females, 56.2% were primary school graduates, and 43.8% were factory workers; this result shows that low socioeconomical status and education level affect exposure to trauma especially in females. In addition, ~20% of the patients and patients' relatives had a psychiatric disorder and 53.4% of perpetrators were parents, spouses, and children; this result shows that psychiatric history and family relations are one of the issues that should be taken into account and treated.