Abdullah Bolu

Mitochondrial complex I and III gene mRNA levels in schizophrenia, and their relationship with clinical features.

BackgroundThe etiology of schizophrenia is not precisely known; however, mitochondrial function and cerebral energy metabolism abnormalities were determined to be possible factors associated with the etiology of schizophrenia. Impaired mitochondrial function negatively affects neuronal plasticity, and can cause cognitive deficits and behavioral abnormalities observed during the clinical course of schizophrenia. The present study aimed to investigate the relationship between the clinical features of schizophrenia, and mitochondrial complex activation, based on measurement of mRNA levels in the NDUFV1, NDUFV2, NDUFS1, and UQCR10 genes involved in the peripheral mitochondrial complex.MethodsThe study included 138 schizophrenia patients and 42 healthy controls. The schizophrenia group was divided into a chronic schizophrenia subgroup (n = 84) and a first-episode schizophrenia subgroup (n = 54). The symptoms profile and severity of disorder were evaluated using the Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), and Brief Psychiatric Rating Scale (BPRS).ResultsThe level of mRNA expression of NDUFV1, NDUFV2, and NDUFS1 was significantly higher in the schizophrenia group than in the control group. The mRNA level of NDUFV2 was positively correlated with BPRS and SAPS scores in the first-episode schizophrenia subgroup.ConclusionThe findings showed that there was a positive correlation between gene mRNA levels and psychotic symptomatology, especially positive symptoms. Our results suggest that mRNA levels of the NDUFV1, NUDFV2, and NDUFS1 genes of complex I of the mitochondrial electron transport chain might become a possible peripheral marker for the diagnosis of schizophrenia.

Low-dose Clozapine-induced Seizure: A Case Report

Seizures are believed to be a dose-dependent side effect of clozapine. In this case report, we describe a patient who had tonic-clonic seizures after using a low dose clozapine who did not have any seizure risk. The 29-year-old male patient had been followed-up with a diagnosis of schizophrenia for about 5 years. When using clozapine 200 mg/day he had a tonic-clonic seizure with bilateral diffuse epileptic activity in electroencephalography (EEG). In the literature, there are a few case reports about low-dose clozapine-induced seizure. Seizures were observed in our case with a low dose of clozapine (200 mg/day) making this case remarkable. EEG monitoring at regular intervals and examination of plasma levels of clozapine could be useful in preventing the development of seizures.

Reliability and Validity of the Intensive Care Delirium Screening Checklist in Turkish.

PURPOSE The aim was to investigate and evaluate validity and reliability of the Intensive Care Delirium Screening Checklist (ICDSC) in Turkey. METHODS A cross-sectional study design was used. Fifty-nine patients in an intensive care unit for longer than 24 hr were included in this study. RESULTS Cronbachs alpha coefficient indicated that the ICDSC was a reliable test with high internal consistency (specialist nurse min: 0.720, max: 0.855; primary nurse min: 0.728, max: 0.830). The sensitivity and specificity were high. CONCLUSION The findings showed that the sensitivity and specificity of the ICDSC are high for Turkish patients. IMPLICATIONS FOR NURSING PRACTICE The ICDSC provides fast and effective evaluations of the patients for delirium. So, ICDSC may be easily integrated into routine nursing practice.

Hyperammonemic encephalopathy without hepatic dysfunction due to treatment with valproate: four cases and a mini review

ABSTRACT Divalproex sodium/valproic acid (VPA) is an antiepileptic drug which is frequently prescribed in neurology and psychiatric clinics. Common side effects of VPA are side effects of the digestive system, weight gain, tremor, sedation, hematologic side effects and hair loss. Valproate-induced hyperammonemia is almost seen in 50% of patients treated with VPA, some of which may develop encephalopathy. Valproate-induced hyperammonemic encephalopathy (NE) is a well-known subject and there are numerous publications in the current literature. Although there is substantial evidence for this side effect in patients with neurological disorders, the data in the psychiatric area are limited. When we look at publications, it seems that VHE is seen more often because it starts earlier in psychiatric patients, but we think that it is often missed. Here, we presented five cases in which we followed up and treated with VHE diagnosis in our clinic within one year and other reports published previously in a table.

The Relationship between the Number of Manic Episodes and Oxidative Stress Indicators in Bipolar Disorder

Objective Bipolar disorder (BD) is a chronic mood disorder characterized by recurrent episodes that has a lifetime prevalence of 0.4–5.5%. The neurochemical mechanism of BD is not fully understood. Oxidative stress in neurons causes lipid peroxidation in proteins associated with neuronal membranes and intracellular enzymes and it may lead to dysfunction in neurotransmitter reuptake and enzyme activities. These pathological processes are thought to occur in brain regions associated with affective functions and emotions in BD. The relationship between the number of manic episodes and total oxidant-antioxidant capacity was investigated in this study. Methods Eighty-two BD patients hospitalized due to manic symptoms and with no episodes of depression were enrolled in the study. Thirty of the 82 patients had had their first episode of mania, and the other 52 patients had had two or more manic episodes. The control group included 45 socio-demographically matched healthy individuals. Serum total antioxidant capacity (TAC) and total oxidant capacity (TOC) measurements of the participants were performed. The oxidative stress index (OSI) was calculated by TOC/TAC. Results There were no significant differences in OSI scores between BD patients with first-episode mania and BD patients with more than one manic episode. However, OSI scores in both groups were significantly higher than in the control group. TOC levels of BD patients with first-episode mania were found to be significantly higher than TOC levels of BD patients with more than one manic episode and healthy controls. There were no significant differences in TAC levels between BD patients with first-episode mania and BD patients with more than one manic episode. TAC levels in both groups were significantly higher than in the control group. Conclusion Significant changes in oxidative stress indicators were observed in this study, confirming previous studies. Increased levels of oxidants were shown with increased disease severity rather than with the number of manic episodes. Systematic studies, including of each period of the disorder, are needed for using the findings indicating deterioration of oxidative parameters.

Plasma Indolamine 2,3 dioxygenase and serum neopterin levels in patients with first episode major depressive disorder and recurrent major depressive disorder

Objective: The aims of this study were to determine whether the plasma Indolamine 2,3 dioxygenase and neopterin levels in patients with major depression differ from a healthy control group and to investigate the relationship between previous major depression episodes and plasma indolamine 2,3 dioxygenase and serum neopterin levels. Methods: Thirty eight first episode major depression patients, sixty four recurrent major depression patients and forty one healthy control participant included the study. Plasma indolamine 2,3 dioxygenase and serum neopterin levels compared in these three groups. Results: Plasma indolamine 2,3 dioxygenase and serum neopterin levels in recurrent major depression group were statistically higher than first episode major depression and healthy control group. There was a positive correlation between plasma IDO levels and number of depressive episodes in major depression group (rho=0.36, p<0.001). Conclusion: According to these findings previous major depression episodes can promote response of the immune system associated with proinflamatuar cytokine activity. This sensitizing effect of previous depressive episodes may increase the recurrence risk of depression.

Identification of anger and self-esteem in psoriasis patients in a consultation-liaison psychiatry setting: a case control study

ABSTRACT Objective: Psoriasis is one of the most common chronic skin diseases, which has a negative impact on the interpersonal relationship and psychosocial well-being. Therefore, psoriasis may lead to a decrease in the self-esteem of the patients. Increased level of anger often accompanies patients with psoriasis. Our aim is to investigate the relationship of anger, anger expression style and level of self-esteem in patients with psoriasis and to determine whether duration and severity of disease affects anger, anger expression style and level of self-esteem. In addition, we aimed to compare the level of self-esteem in patients with early and late onset of psoriasis. Methods: Eighty-five patients with psoriasis and 86 healthy controls were included in the study. Severity of disease was calculated with Psoriasis Area and Severity Index (PASI). The patients were classified as early-onset (age < 20 years) and late-onset psoriasis (age ≥ 20 years). Duration of disease and socio-demographic characteristics were recorded. State-Trait Expression Inventory for Anger (STAXI) and Roserberg Self-esteem Scale (RSES) were used for determining anger, anger expression style and self-esteem. Results: Trait anger, state anger and anger-in scores were statistically significantly higher in patients with psoriasis (p < .05). Anger-out and anger-control scores were similar in both groups. RSES scores were statistically significantly higher in the psoriasis group (p < .05). There was a negative weak statistically significant correlation between RSES and anger-control scores (r = −0.246, p = .027). A positive, weak, statistically significant correlation was found between RSES scores and anger-out scores (r = 0.224, p = .045). A positive, mild, statistically significant correlation between duration of the disease and anger-in scores (r = 0.277, p = .027) was detected in patients with psoriasis whereas no statistically significant correlation between the other parameters and duration and severity of the disease was detected. No significant difference was detected when patients with early- and late-onset psoriasis were compared in terms of self-esteem (p = .722). A positive, mild, statistically significant correlation between duration of the disease and anger-in scores (r = 0.277, p = .027) was detected in patients with psoriasis whereas no statistically significant correlation between the other parameters and duration and severity of the disease was detected. Conclusion: Reduced self-esteem and increased anger levels are remarkable in psoriasis patients. While evaluating and arranging treatment of psoriasis patients, it should be considered that psoriasis is not only a dermatological disease, but also a disease resulting in reduced self-esteem and increased anger level; therefore dermatologic and psychiatric approaches should be taken with the patients.

Cortical Excitability and Agressive Behavior in Post-Traumatic Stress Disorder

INTRODUCTION Hyperarousal and alertness play an important role in the clinical presentation of Post-traumatic stress disorder (PTSD). Strenuous effort has been made to shed light on the mechanisms that cause these symptoms of patients. Based on the claim that there is a relationship between some subtypes of hyperarousal symptoms and aggression in patients with PTSD, we aimed to examine the relationship between electrophysiological measurements that was measured through transcranial magnetic stimulation (TMS) and aggression scale scores of PTSD patients in this study. METHODS The study included 37 patients with a diagnosis of PTSD according to DSM-IV criteria and 25 healthy volunteers. Electrophysiological measurements of participants were made with TMS. The Buss Perry Aggression Questionnaires was administered to patients and control group. RESULTS In the patient group, a positive correlation was found between scores of aggression and arousal symptoms. Motor excitability threshold, one of TMS measurements, which is a sign of cortical excitability, was significantly lower in the patient group than the control group. There was a negative correlation between aggression scale scores and the parameters of motor excitability threshold and cortical silent period which both shows cortical excitability of the patients. CONCLUSION We concluded that there was an increase in cortical excitability in PTSD patients and we suggest that this increase might be associated with hyperarousal symptoms and aggressive behavior.