Personality traits in acromegalic patients: Comparison with patients with non-functioning adenomas and healthy controls

OBJECTIVES

Pituitary diseases may cause psychiatric and personality alterations. We aimed to compare the personality traits of acromegalic patients with those of patients with non-functioning pituitary adenomas and a healthy control group.

DESIGN

Fifty-eight acromegalic patients, 45 patients with non-functioning adenoma, and 40 healthy subjects were enrolled in the study. Cloninger's Temperament and Character Inventory (TCI), Beck Depression Inventory, Beck Anxiety Inventory, and Rosenberg Self-Esteem Scale (RSES) were used to assess personality, depression, anxiety, and self-esteem.

RESULTS

Depression score was higher in acromegaly and non-functioning adenoma groups than healthy controls. RSES scores were similar among the three groups. Regarding the scales of TCI, only novelty-seeking was significantly reduced in acromegaly and non-functioning adenoma than the control group. Pairwise comparisons revealed that the difference was due to the difference between acromegalic patients and controls. Scales of TCI were correlated with depression and anxiety in patients with acromegaly and non-functioning adenoma but not in healthy controls.

CONCLUSION

This study showed that novelty-seeking was reduced in patients with acromegaly. Both the hormonal lack and excess and structural changes can lead to cognitive and personality changes in acromegaly. More studies are needed to be carried out about personality characteristics in pituitary diseases.

For whom the circadian clock ticks? Investigation of PERIOD and CLOCK gene variants in bipolar disorder

Clock genes play significant roles in the regulation of circadian rhythms, which are thought to be involved in the pathophysiology of neurodegenerative and psychiatric diseases. We aimed to investigate the association of five gene polymorphisms (PER3 VNTR (rs57875989), PER2 rs2304672, CLOCK rs1801260, CLOCK rs10462028, CLOCK rs11932595) with PCR-based methods as potential risk factors in bipolar disorder (BD). We used a multiple testing methodology in BD patients (n = 121) and healthy control individuals (n = 121) of Turkish descent to analyze the effects of these gene variants both as risk factors for the disorder and for the evaluation of these variants in the patient group with multiple subscales. We evaluated the circadian rhythm disturbances and seasonal variations in mood and behavior in BD patients using the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) and Seasonal Pattern Assessment Questionnaire (SPAQ) to enlighten the possible links between these scores and the studied circadian gene variants. The results of our study revealed significant associations: PER3 VNTR (rs57875989) 5/5 repeat genotype displayed a protective effect against BD when compared with 4/4 repeat genotype. Moreover, patients with PER3 VNTR 5/5 repeat genotype displayed a higher ratio of hypomania. PER2 rs2304672 G allele frequency increased the risk for BD. There was no association in terms of genotype/allele frequency comparisons between patients and controls for CLOCK gene variants. However, significant associations were found in patients in terms of clinical and behavioral patterns such as mean age at disease onset and BRIAN total scores enabling some risk stratifications for patients. Our results indicate the significance of circadian gene variants in BD, which need to be confirmed in different studies with larger samples. Thus, the possible endophenotypes of BD can be enlightened and advanced chronotherapeutics approaches can be manipulated in the future for clinical benefit.

Frequency of retrotransposon human endogenous retrovirus-K113 and a preliminary analysis of some microbial clues in bipolar disorder

Aim: The aim of our study was to investigate whether the retrotransposon human endogenous retrovirus (HERV)-K113 could be related with bipolar disorder or not. As a second and a preliminary aim, we also conducted bacterial screening in whole blood in a limited number of samples. Patients & methods: Three separate PCR reactions including the preintegration sites and sites within the viral sequences were performed for HERV-K113 detection. Bacterial screening was performed with SSCP/sequencing analysis. Results & conclusion: No difference was observed in terms of the frequency of retrotransposon HERV-K113 in Turkish bipolar disorder patients and healthy controls. SSCP/sequencing and alignment analysis for bacterial screening reflected the possible presence of different bacteria. We strongly recommend the broadened retrotransposon and microbial diversity analyses in bipolar disorder for future studies.

THU0488 PSYCHIATRIC SYMPTOMS, TEMPERAMENT PROFILE, STRESS PERCEPTION AND SLEEP QUALITY IN THE PATIENTS WITH CHRONIC SHOULDER PAIN: RELATIONSHIP WITH PAIN, DISABILITY, AND FUNCTIONAL CAPACITY

Background:

Shoulder pain is very common in general population. Psychiatric symptoms and poor sleep quality related with chronic pain and disability may be present in these patients.

Objectives:

The aim of this study was to investigate the psychiatric symptoms, perceived stress, temperament profile and sleep disturbance in the patients with chronic shoulder pain (CSP) and also to evaluate the relationship with pain, disability, and functional capacity.

Methods:

We prospectively evaluated 150 patients (M/F=41/109) (60.46±10.59 years) who have had shoulder pain for at least 3 months and 120 healthy controls (M/F=35/85) (58.35±8.52 years). Pain was evaluated with Visual Analog Scale (VAS), disability with Shoulder Disability Questionnaire (SDQ), functionality with The University of California-Los Angeles (UCLA) Shoulder Scale and range of shoulder motion, temperament profiles with TEMPS-A, stress perception with Perceived stress scale (PSS), psychiatric symptoms with Symptom Checklist-90-R (SCL-90R), Rosenberg self esteem with Self-Esteem Scale (RSES) and sleep disturbance with Pittsburgh sleep quality index (PSQI).

Results:

The mean VAS pain score, SDQ score, and UCLA score of the patients with shoulder pain were 4.34±1.79, 61.98±26.88, and 58.90±17.78, respectively. SCL-90-R total and all subscale scores except interpersonal sensitivity, psychoticism, paranoid, and phobia were significantly higher in the patient group than the control group (p<0.05). Also PSQI total and sleep quality and latency subscale scores were significantly higher in the patient group (p<0.05). There was no significant difference between the patient and control groups in terms of RSES and PSS. The study identified 28 depressive temperament in the patient group which was statistically different from the control group (p<0.05). There were no significant differences between two groups in terms of cyclothymic, irritable, anxious, and hyperthymic temperaments (p>0.05). When the patient group is evaluated according to functionality, the patients having fair/poor shoulder function had more psychiatric symptoms except hostility, poor sleep quality, decreased self-esteem and increased stress perception. Also, anxious and depressive temperaments were found more common in the patients with fair/poor shoulder function. Psychiatric symptoms (somatization, obsessive-compulsive, interpersonal-sensitivity, depression and anxiety) and total PSQI were positively correlated with SDQ (p<0.05). There was positive correlation between PSS and SDQ (p>0.05).SCL90R total score, subscale of depression and anxiety, total PSQI and PSS were significantly correlated with VAS score (p<0.05).

Conclusion:

We found psychiatric symptoms such as obsessive-compulsive besides somatization, anxiety, depression, hostility and sleep disturbances higher in the patients with CSP. Additionally, psychiatric symptoms, anxious and depressive temperaments were more common in the patients with fair/poor shoulder function. Self-esteem was not related with the pain. All these findings indicate the importance of psychological health in the patients with CSP. In order to reach treatment goals, psychiatric symptoms and temperament profiles of these patients also should be considered.

Disclosure of Interests: :

None declared

Perceived stress, life events, fatigue and temperament in patients with psoriasis

Objective

To evaluate the perceived stress, life events, fatigue and temperament profile in patients with psoriasis and to investigate the relationship between these factors.

Methods

This cross-sectional study included patients with psoriasis and healthy control subjects. The two groups were compared regarding the number of life events, Perceived Stress Scale (PSS) and Multidimensional Assessment of Fatigue scores. The Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire was used to evaluate the personality traits among the two groups.

Results

A total of 75 patients with psoriasis (mean ± SD age, 44.94 ± 13.62 years) and 75 healthy controls (mean ± SD age, 41.10 ± 8.89 years) were included in the study. A statistically significant difference was found between the two groups in terms of the presence of life events, PSS score, fatigue and temperament profiles. Patients with psoriasis with depressive, cyclothymic and anxious temperament profiles were found to have higher PSS scores. In the psoriasis group, the PSS scores were positively correlated with the number of life events.

Conclusions

Stress and life events were found to be correlated with psoriasis. In the patients with psoriasis, depressive, cyclothymic and anxious temperament profiles seemed to be associated with higher perceived stress.

Prevalence of metabolic syndrome among inpatients with schizophrenia

OBJECTIVE

Cardiovascular disease is one of the most prevalent factors responsible for excess mortality in schizophrenia. Metabolic syndrome (MetS) is associated with the development of coronary heart disease and diabetes mellitus. The aim in this cross-sectional study was to assess the prevalence of MetS in schizophrenic Turkish inpatients.

METHOD

The study was conducted from January 2006 to June 2006, and included 231 patients with schizophrenia. All participants were enrolled from inpatients attending the Samsun Mental Health Hospital psychiatry clinic. All subjects were aged between 18 and 65 and met the DSM IV criteria for schizophrenia. MetS was taken as central obesity (defined as waist circumference: men > or = 94 cm, women > or = 80 cm) and meeting > or = 2 of the following abnormalities described by the International Diabetes Federation (IDF): a serum triglyceride level > 150 mg/dL, high-density lipoprotein (HDL) cholesterol < 40 mg/dL in men and < 50 mg/dL in women, blood pressure > or = 130/85 mm Hg, and a fasting serum glucose level > or = 100 mg/d/L.

RESULTS

The study group consisted of 174 male and 57 female patients. Mean age was 38.5 +/- 10.5 and mean duration of illness was 15.76 +/- 9.95 years. The overall prevalence of MetS diagnosed according to the IDF criteria was 32.0% (n = 74) and was higher in females (61.4%) than in males (22.4%; p = 0.0001). In logistic regression analysis the last step of the regression model was gender (B = 1.70, p = 0.0001, OR = 5.50, 95% CI = 2.90-10.45).

CONCLUSION

This study shows that the prevalence of MetS in Turkish patients with schizophrenia is similar to that of the general population, but lower than in other reports regarding the schizophrenia population.

Schizophrenia in Turkish newspapers : retrospective scanning study

The attitude of mass media is a strong determinant for stigmatisation since the majority of the society gets exposed to psychiatric disorders via either written or visual media. In this study we explored to demonstrate the meaning attributed to the word schizophrenia in Turkish written printed media. We screened the online sites of 12 national newspapers which allow word scanning between the dates January 1, 2001 and May 1, 2006. The searched terms appeared in a total of 878 texts. In all twelve newspapers, the terms "Schizophrenia", "Schizophrene", or "Schizophrenic" appeared once every 2.2 days. While a positive referral appeared once in every 12.2 days, a negative referral or metaphoric use was seen once every 3.1 days. Among the 878 texts scanned, in 491(55.9%) the searched terms appeared with reference to the disease and in 387 (44.1%) the searched terms were used metaphorically. Considering the assumption the negative reporting may have a stronger impact than positive reporting, it is possible to suggest that Turkish newspapers are raising stigmatisation. It is meaningful that the name of a disease is used almost with equal frequency as a metaphoric term. In our study, higher rates of metaphoric use observed can be explained with the fact that in Turkey the word Schizophrenia is attributed with strong negative perception.

Conversion and somatization disorders; dissociative symptoms and other characteristics

OBJECTIVE

There is a difference in classification of conversion disorder in ICD-10 and DSM-IV. Conversion disorder is included in dissociative disorders in ICD-10. In view of this, we aimed to clarify this discrepancy in the classification of this diagnosis.

METHODS

We assessed 87 patients with conversion disorder and 71 patients with somatization disorder for sociodemographic characteristics, suicide ideation, psychiatric symptoms and dissociative symptoms using the Patient Information Form, the Dissociative Experience Scale (DES), the Symptom Check List (SCL-90-R) and the Suicide Ideation Scale.

RESULTS

The number of the high school graduates, singles and students with conversion disorders was higher than the number of patients with the same characteristics who have somatization disorder. In conversion disorder, the SCL-90-R total score and the score in paranoid ideation, psychoticism subgroups were higher than the scores in somatization disorders. There were no statistical differences in suicide ideation and the total score of dissociative symptoms between the two disorders. The number of patients whose total DES score of 30 and above was higher in conversion disorders.

DISCUSSION

As a result of this present study, we concluded that to enlighten the concepts of conversion, further somatization and dissociation studies are necessary.

Psychiatric symptoms in Turkish infertile women

The aims of this study were to determine the psychiatric symptoms which may develop because of infertility in Turkish women and to find out the precipitating factors. Fifty women with primary infertility and 50 health controls were evaluated using the Beck Depression Inventory, Spielberger Stait-Trait Anxiety Inventory, Rosenberg self-esteem scale and Symptom Checklist scale. They were also asked to describe the reactions received from their husband, husbands' families and social group because of infertility. Psychiatric symptoms were not significantly different between the two groups. However, within the infertile group, depression and anxiety were more frequent in the women who received negative reactions from their husband, their husbands' families and social group. Depression, anxiety and self-esteem were improved in the infertile women as age and the duration of infertility increased. In conclusion, our findings indicate that the reactions the infertile women are faced with play an important role in the development of certain psychiatric symptoms.

Conversion disorder and its subtypes: a need for a reclassification

Four subtypes of conversion disorder were described in DSM-IV. There are few publications concerning studies aimed at separating the subtypes of the conversion disorder. Usually, pseudoseizures are in focus and attempts are made to differentiate these seizures from other disorders. The aim of the present study has been to investigate differences between the four subtypes of the conversion disorder and to discuss the possibilities for a reclassification. Ninety-five patients were seen by two researchers and diagnosed as conversion disorders. The subtypes were determined according to DSM-IV criteria. All completed the Patients Information Form, developed by the researchers, and the Dissociative Experience Scale (DES). Twenty-four (25.2%) of the patients had motor symptoms or deficits (Type 1), 5 (5.2%) sensory symptoms or deficits (Type 2), 23 (24.2%) seizures or convulsions (Type 3) and 43 (47.3%) had mixed presentations (Type 4). There were statistically significant differences between the subtypes as concerns occupation, family history of psychiatric disorders, hospitalizations and place of settlement. Furthermore, the DES scores were statistically different between the groups of patients with different subtypes of conversion disorder.