Abdullah Akpinar

Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students

Background and Aims The usage of smartphones has increased rapidly in recent years, and this has brought about addiction. The aim of the current study was to investigate the relationship between smartphone use severity and sleep quality, depression, and anxiety in university students. Methods In total, 319 university students (203 females and 116 males; mean age = 20.5 ± 2.45) were included in the study. Participants were divided into the following three groups: a smartphone non-user group (n = 71, 22.3%), a low smartphone use group (n = 121, 37.9%), and a high smartphone use group (n = 127, 39.8%). All participants were evaluated using the Pittsburgh Sleep Quality Index, Beck Depression Inventory, Beck Anxiety Inventory; moreover, participants other than those in the smartphone non-user group were also assessed with the Smartphone Addiction Scale. Results The findings revealed that the Smartphone Addiction Scale scores of females were significantly higher than those of males. Depression, anxiety, and daytime dysfunction scores were higher in the high smartphone use group than in the low smartphone use group. Positive correlations were found between the Smartphone Addiction Scale scores and depression levels, anxiety levels, and some sleep quality scores. Conclusion The results indicate that depression, anxiety, and sleep quality may be associated with smartphone overuse. Such overuse may lead to depression and/or anxiety, which can in turn result in sleep problems. University students with high depression and anxiety scores should be carefully monitored for smartphone addiction.

Possible role of adrenomedullin and nitric oxide in major depression.

Adrenomedullin (ADM) and nitric oxide (NO) have been implicated in the pathogenesis of certain psychiatric disorders such as schizophrenia and bipolar disorder. ADM induces vasorelaxation by activating adenylate cyclase and stimulating the release of NO. These two molecules are known to influence cerebral activity. In this study, we aimed to examine the serum levels of ADM and NO in patients with major depression (MD). We enrolled 50 patients with MD and 50 healthy control subjects. The diagnosis of MD was established on the basis of a structured clinical interview using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). The severity of depressive symptoms was evaluated using Hamiltons 17-item Depression Rating Scale. The mean serum levels of ADM and NO in patients with MD were significantly higher than those in healthy subjects (p=0.001, for both). The severity of psychomotor retardation in patients with MD was significantly correlated with the ADM (r=0.37, p=0.007) and NO levels (r=0.29, p=0.038). The patients with obvious psychomotor retardation had significantly higher levels of ADM and NO than did the patients with no psychomotor retardation (p=0.025, p=0.030). A significantly positive correlation was found between ADM and NO levels in patients with MD (r=0.79, p=0.001). Serum levels of ADM and NO levels were not correlated with the severity or duration of depression or depressive symptoms (except psychomotor retardation). In conclusion, our study indicates that serum levels of ADM and NO are elevated in patients with MD and that increased serum levels of ADM and NO may be associated with psychomotor retardation. The ADM-NO system may serve as a new target in the treatment of patients with MD and psychomotor retardation.

The relationship between childhood trauma and type D personality in university students

Aim: There has been increasing evidence that childhood traumas are related to reduced health-related quality of life, neurobiological changes and long-term adverse effects, such as an increase in the likelihood of psychiatric disorders in adulthoods. The aim of this study was to investigate the relationships between childhood traumas and type D personality. Subjects and methods: In total, 187 university students (64 males and 123 females; mean age = 21.69 ± 2.00) were included in the study. All participants were evaluated using the Type D Personality Scale (DS-14), Childhood Trauma Questionnaire (CTQ-28) and Beck Depression Inventory (BDI). The participants were divided into the two groups according to the presence of type D personality. Then, statistical analyses were performed. Results: The frequency of type D personality in participants was 43.3% (n = 81). The emotional neglect, physical neglect, emotional abuse component of the CTQ-28, total CTQ-28 scores and BDI scores were higher in the group with type D personality than in the group without type D personality (p < .001, p = .003, p = .001, p < .001 and p < .001, respectively). There were significantly positive correlations between the type D personality scores and BDI scores, emotional neglect, physical neglect, emotional abuse and childhood trauma total scores (p < .05, for all). Linear regression analyses showed that the significant and independent predictors of the score of DS-14 were total score of CTQ-28 and BDI score. Conclusion: Childhood trauma may be associated with type D personality, and there is predictive value of the childhood trauma on the scores of type D personality.

Paliperidone regulates intracellular redox system in rat brain: Role of purine mechanism

Abstract Objective The treatment of schizophrenia is multifactorial, with antipsychotic medications comprising a major part of treatment. Paliperidone is a newly commercialized antipsychotic whose formulation includes the principal active metabolite risperidone, 9-hydroxyrisperidone. Ever since the relationship between schizophrenia and oxidative stress was first demonstrated, many studies have been conducted in order to probe the potential protective effects of antipsychotic drugs on the oxidant–antioxidant system and lipid peroxidation. The basic aim of this study is to determine the effects of the newly marketed drug paliperidone on the activities of the enzymes adenosine deaminase (ADA), xanthine oxidase (XO), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) as well as on malondialdehyde (MDA) and nitric oxide (NO) levels in rat brain tissues. Methods Twenty male Sprague-Dawley rats were used for the study, which were divided into two equal groups. The first was the control group (n = 10) and the second was the paliperidone group (n = 10). Saline was administered once daily for 14 days in the control group. In the paliperidone group, paliperidone was administered once daily with a dose of 1 mg/kg for 14 days. All rats were sacrificed at the end of the fourteenth day. Brain samples were collected and then analyzed. Results Our results demonstrated that paliperidone significantly decreased the activities of ADA (P = 0.015), XO (P = 0.0001), and CAT (P = 0.004) while insignificantly increasing the activity of SOD (P = 0.49), MDA (P = 0.71), and NO (P = 0.26) levels in rat brain tissues. In addition, paliperidone insignificantly decreased the activity of GSH-Px (P = 0.30) compared to the control group in rat brain tissues. Discussion In conclusion, the data obtained in this study suggest that paliperidone can positively alter antioxidant status and, accordingly, can offer positive outcomes in the treatment of schizophrenia by reducing activity in the enzymes ADA and XO, which are associated with purine metabolism. We believe that such a comprehensive approach used with other antipsychotic drugs warrants further study.

Could Recurrent Anxiety be a New Surgical Indication for Patients with Spontaneous Pneumothorax

DOI: 10.4328/JCAM.2074 Received: 30.09.2013 Accepted: 01.10.2013 Printed: 01.01.2015 Corresponding Author: İsa Döngel, Süleyman Demirel Üniversitesi Tıp Fakültesi Göğüs Cerrahisi Anabilim Dalı, Isparta, Türkiye. T.: +902462119251 GSM: +905052228388 F.: +902462112830 E-Mail: drdongel@hotmail.com Editör için: Yazkan R. ve ark. tarafından yapılan “Tekrarlama Anksiyetesi Spontan Pnömotorakslı Hastalar için Yeni Bir Cerrahi Endikasyon Olabilir mi?” başlıklı çalışmayı spontan pnömotoraks klinik tablosuna farklı bir bakış açısı ortaya koyması nedeniyle ilgiyle okudum. Spontan pnömotoraks plevra yaprakları arasında hava birikmesi ve buna sekonder gelişen akciğer kollapsı olarak tanımlanmaktadır ve göğüs cerrahisi kliniklerinde sık karşılaşılan hastalıklardan birisidir [1,2]. Anksiyete ise hoş olmayan özellikleri ile diğer duygulanım şekillerinden ayrılan korku ve endişe duygusudur. Anksiyeteli hasta fizyolojik ve psikolojik olarak çarpıntı, nefes almada zorluk, hızlı hızlı nefes alma, ellerde ve ayaklarda titreme, aşırı terleme, sıkıntı, heyecan, aniden çok kötü bir şey olacakmış hissi ve korkusunu taşır [3]. Yayınladığınız çalışma spontan pnömotorakslı hastalarda tekrarlama anksiyetesinin yeni bir cerrahi endikasyon oluşturup oluşturmadığını irdelemekte ve bu konuda yapılmış nadir çalışmalardan biri olma özelliğini taşımaktadır. Spontan pnömotoraks tedavisinde amaç, kliniğin düzeltilmesi, pnömotoraksın boşaltılarak akciğerin tekrar ekspansiyonunun sağlanması ve pnömotoraksın tekrarının önlenmesidir [1,2]. Anksiyete ve spontan pnömotoraksın klinik bulgularında benzer özellikler mevcut olup, spontan pnömotorakslı hastaların hastalıkları konusunda tatmin edici düzeyde bilgilendirilmesi hastaları tekrarlama anksiyetesinden korur. Dolayısıyla bu yazının yeni bir cerrahi endikasyondan çok, tekrarlama anksiyetesi yönünden hastaların ve doktorların uyanık olması ve bu konuda hastaların detaylı bilgilendirilmesini hatırlatması yönüyle daha anlamlı olduğunu düşünüyorum. Primer spontan pnömotoraks gelişen hastaların %25-30 oranında konservatif tedavi yöntemlerine cevap vermemekte ve cerrahi tedavi gerekebilmektedir [2,4]. Bu nedenle hastalara ilk atakta cerrahi yapmanın uygun olmadığını, mutlaka konservatif yöntemler denendikten sonra, başarılı olunamıyorsa cerrahinin daha uygun olduğunu düşünüyorum. Ayrıca nonkardiyak göğüs ağrısı nedeniyle acil servise başvuran hastalarda Hastane Anksiyete ve Depresyon Skalası (HADS) kullanılarak yapılan çalışmalarda, HADS skoru yüksek saptanan hastalarda anksiyete ve/veya depresyon tanısı alma oranı %73,3 bulunmuştur [5]. Yani bu tür hastaların bir kısmının anksiyete ve/veya depresyona yatkın oldukları anlamını taşımaktadır. Dolayısıyla tekrarlama anksiyetesi nedeniyle yapılan cerrahi sonrası, hastaların bir kısmının yine anksiyete ve/veya depresyon geçirme riski taşıyacağı aşikârdır. Bu nedenle spontan pnömotoraks geçiren hastaların ilk atakta konservatif tedavi edilmesi şayet hasta tekrarlama anksiyetesi riski taşıyorsa psikiyatri ile konsülte edilerek yakın takip edilmesinin daha uygun bir yaklaşım olduğu kanaatindeyim.

Vareniklin Kullanımı Sonrası İleri Yaş Başlangıçlı Mani: Bir Olgu Sunumu

Late-life onset manic attacks generally occur secondary to general medical conditions or drug use. Varenicline is an α4β2 nicotinic acetylcholine receptor partial agonist, used for the cessation of smoking. In this case report, we present a 67-year-old male patient with a new-onset manic episode following varenicline treatment. The patients manic symptoms started on the seventh day of varenicline treatment. His symptoms started on the 7th day of treatment. He was admitted to the psychiatric outpatient clinic since his symptoms did not improve despite discontinuing varenicline treatment. In the initial mental status examination, he scored 35/60 on the Young Mania Rating Scale (YMRS). On the twenty-fifth day of the hospitalization, the patient was discharged since his YMRS score improved (5/60). Varenicline may cause manic episodes in patients with bipolar disorder and in healthy individuals. An increasing number of serious psychiatric disorders are being reported due to varenicline treatment. Mental state examination before and during varenicline treatment seems necessary.

The Investigation of Symptoms and Diagnoses of Adult-Attention Deficit/ Hyperactivity Disorder in Women with Iron Deficiency Anemia

INTRODUCTION The aim of this study was to investigate symptoms and diagnoses of Adult-Attention Deficit/Hyperactivity Disorder (ADHD) in women with iron deficiency anemia, to evaluate relationship between ADHD with clinical features and to compare with the women without iron deficiency anemia. METHODS Eighty-three newly diagnosed iron deficiency anemia patients and 70 healthy controls were included in this study. All participants were assessed using a sociodemographic form, Structured Clinical Interview I (SCID-I), Wender Utah Rating Scale (WURS); Moreover, participants having WURS scores 36 and above were also assessed using the Adult ADD/ADHD Evaluation Scale and interviewed according to DSM-5 criteria. RESULTS In the study, 22.9% of patients with iron deficiency anemia and 12.9% of healthy controls were found to have WURS scores 36 and above. Fifteen patients (18.1%) in iron deficiency anemia group and two patients (2.9%) in control group had adult ADHD, when they were evaluated with Adult ADD/ADHD Evaluation Scale and interviewed according to DSM-5 criteria (p=0.007). The patients with iron deficiency anemia had significantly higher WURS scores compared to controls (p=0.002). The levels of iron and ferritin had negative correlation (r=-0.166, p<0.05; r=-0.255, p<0.01, respectively) and the levels of serum iron binding capacity had positive correlation (r=0.255, p<0.01) with the scores of WURS. CONCLUSION The prevalence of adult ADHD is higher than those reported for general population in patients with iron deficiency anemia. Early diagnose and treatment of adult ADHD may positively contribute to the patients with iron deficiency anemia.

Yatarak tedavi gören bipolar bozukluk hastalarında dissosiyatif bozukluk eştanısı olan ve olmayan hasta gruplarının karşılaştırılması

Giris: Bu calismada dissosiyatif bozukluk (DB) estanisi olan ve olmayan bipolar bozukluk (BB) hastalarinin sosyodemografik karakteristiklerinin karsilastirilmasi ve estani varliginin tedaviye etkisinin degerlendirilmesi amaclanmistir. Yontem: BB tanisi ile Şisli Etfal Hastanesi Psikiyatri Klinigi’nde 2010-2011 yillari arasinda yatisi yapilan ardisik 149 hasta calismaya alinmistir. Hastalara SCID-D uygulanarak DB tanisi, SCID-I ile BB tanisi konmus, sosyodemografik karakteristikleri, YMDO, HAM-D, KPDO, DYO puanlari ve hastanede yatis sure ve sayilari incelenmistir. Bulgular: 23 hastada (%15,4) baska turlu adlandirilamayan dissosiyatif bozukluk, 4 hastada (% 2,6) dissosiyatif kimlik bozuklugu, 1 hastada (%0,6) dissosiyatif amnezi tespit edildi. DB estanisi olan BB hastalarinin daha genc ve daha fazla oranda kadin oldugu belirlendi (sirasiyla p=0,002, p=0,015). DB estanili BB hastalarinin DYO toplam puaninin BB hastalarin daha yuksek oldugu tespit edildi (p<0,001). Tum orneklemde DYO toplam puani ile hastanede kalis suresi arasinda korelasyon bulunmustur (p=0,001, Spearman r=0.336). Basvuru sirasinda toplam HDO puani estanili grupta anlamli olarak daha yuksek (p=0,027), intihar maddesi hem basvuru hem taburculukta anlamli olarak yuksek bulunmustur (p<0,001 ve p=0,035). Basvuru esnasinda KPDO puanlarindan, halusinatuar davranis maddesi estanili grupta yuksek bulunmustur (p=0,019). YMDO puanlarindan konusma hiz ve miktari hem basvuru hem taburculukta (sirasiyla p=0,027, p=0,006), icgoru maddesi ise basvuru esnasinda estaninin olmadigi bipolar hasta grubunda yuksek bulunmustur (p=0,018). Sonuc: BB hastalarinda DB estanisi sorgulanmalidir. DB estanili hastalarin daha cok kadin cinsiyette ve daha genc yasta oldugu, daha fazla depresyon puanlarina sahip oldugu; daha uzun sureli hastanede kalis suresine sahip oldugu bulunmustur. Dissosiyasyon estanisi varliginda, intihar girisim sayisi ve halusinatuar davranislarda artis gorulebilir.

Evaluation of Eating Attitude in Patients with Migraine

INTRODUCTION This study aimed to investigate the eating attitudes in patients with migraine. METHODS Fifty-nine patients (mean age: 32.54±8.47 years) diagnosed with migraine according to the International Classification of Headache Disorder, 2004, and 47 age-, gender- and education-matched healthy controls (mean age: 31.85±7.14 years) were enrolled for this study. Sociodemographic data were recorded, and the body mass index was calculated as kilograms per meter squared. Data regarding the duration of illness and attack, frequency of migraine attacks, and the presence of aura were recorded. Migraine severity was assessed by Migraine Disability Assessment Score (MIDAS). Eating Attitudes Test (EAT), Beck Depression Inventory (BDI), and Beck Anxiety Inventory were applied to all participants. RESULTS The patients with migraine had significantly higher EAT scores, levels of anxiety, and depression than controls (p<.01). Furthermore, 11.9% of patients with migraine had an EAT score of 30 or higher, which is suggestive of a disordered eating attitude, whereas this rate was 2.1% in healthy controls (p<.05). The scores of EAT and BDI had positive correlation with the scores of MIDAS in patients with migraine (r=.298, p<.05; r=.332, p=.01, respectively). CONCLUSION In our study, disordered eating attitudes and the levels of anxiety and depression were high in patients with migraine than controls. Our study is important to demonstrate the connection between migraine and disordered eating attitudes.

The Polymorphisms of Ser49Gly and Gly389Arg in Beta-1-Adrenergic Receptor Gene in Major Depression

INTRODUCTION It was reported that the genetic susceptibility of major depressive disorder (MDD) is related with genetic polymorphisms. The aim of this study was to investigate the possible association of the genotype and allele frequencies of Ser49Gly and Arg389Gly polymorphisms in MDD by comparing them with healthy subjects. METHODS A total of 144 patients with MDD diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and 105 healthy controls were included in the study. Polymerase chain reaction (PCR) with restriction fragment length polymorphism (RFLP) was used for genotyping. RESULTS Of the 144 participants in the MDD group, 77 (53.5%) had homozygous wild type (AA), 57 (39.6%) had heterozygous type (AG), and 10 (6.9%) had mutant (GG) genotype for Ser49Gly, whereas 75 (52.1%) had homozygous wild type (GG), 59 (41.0%) had heterozygous (GC) type, and 10 (6.9%) had mutant homozygous (CC) genotype for Gly386Arg. There were no significant difference in the allele and genotype frequencies of the beta-1-adrenergic receptor (ADRB1) gene for Ser49Gly and Arg389Gly polymorphisms after comparing with healthy controls (p=0.626; p=0.863 and p=0.625; p=0.914). CONCLUSION The results of our study did not reveal a major effect of the polymorphism of Ser49Gly and Gly389Arg in the ADRB1 gene in MDD. Further studies with larger sample size are required to elucidate the role of other beta-1 adrenergic gene polymorphisms in MDD.