Abdurrahman Altindag

Post-traumatic stress disorder among Syrian refugees in Turkey: a cross-sectional study.

Abstract Objective. Refugees have had major challenges to meet their health care needs throughout history especially in war zones and natural disaster times. The health care needs of Syrian refugees have been becoming an increasingly important issue. We aimed to examine the prevalence of post-traumatic stress disorder (PTSD) and explore its relation with various socioeconomic variables among Syrian refugees, who sought asylum in Turkey. Methods. This cross-sectional study was conducted in a tent city. Sample size calculation yielded 352 and the participants of the study were determined randomly. Experienced and native Arabic speaking, psychiatrist evaluated the participants. Results. The frequency of PTSD was 33.5%. Through the binary logistic regression analysis, we calculated that the probability of having PTSD among Syrian refugees in our sample was 71%, if they had the following features: with female gender; being diagnosed with psychiatric disorder in the past; having a family history of psychiatric disorder; and experiencing 2 or more traumas. Conclusions. The findings of our study suggest that PTSD among Syrian refugees in Turkey might be an important mental health issue in refugee camps especially among female refugees, who were exposed to 2 or more traumatic events and had a personal or family history of psychiatric disorder.

Beneficial effects of N-acetylcysteine in treatment resistant schizophrenia

Poor response to antipsychotics is still an important problem in the treatment of many schizophrenia patients. N-Acetylcysteine (NAC) is a compound that exerts anti-oxidant and scavenging actions against reactive oxygen species. This paper reports a case of poorly responsive schizophrenia patient who improved considerably with add-on NAC 600 mg/day. The NAC might work through activating cysteine-glutamate antiporters or reducing in nitric oxide (NO) metabolites, free radicals and cytokines or through both of these mechanisms.

A Defect in the Antioxidant Defense System in Schizophrenia

Objectives: Several oxidants and antioxidants have been evaluated in schizophrenia. However, previous studies frequently focused on individual parameters. Determination of the total oxidant and antioxidant status may be more useful. Therefore, we aimed to evaluate both plasma total oxidant status (TOS) and total antioxidant status (TAS) together with the oxidative stress index (OSI) in schizophrenia patients for the first time in the literature. Methods: A total of 60 schizophrenia patients and 40 healthy volunteers were included in the study. The Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression-severity scale (CGI-S) were used to evaluate the severity of schizophrenia in the patients. TOS and TAS were measured in plasma and the OSI was calculated for patients and controls. Results: There was no difference between patients and controls with regard to TOS, but the patients’ TAS and OSI were significantly lower and higher, respectively, than those of the controls. No difference was detected between the schizophrenia subtypes or between the patients on typical or atypical antipsychotic medications or a combination of the two with regard to oxidative parameters. There was a weak to moderately significant negative correlation between TAS and total, positive and general psychopathology PANSS scores. Finally, we found a weak to moderately significant negative correlation between the CGI-S score and TOS and between the CGI-S score and TAS. Conclusions: There is a defect in the antioxidant defense system in schizophrenia. Known oxidative stress that causes oxidative cell damage and thus contributes to the pathophysiology of schizophrenia may be mainly related to this defensive defect.

Childhood traumatic events and dissociation in university students

Objective. The purpose of this study was to determine the frequency of childhood traumatic events, to investigate its relationship with dissociation and other psychiatric symptoms and to examine the potential effect of family functioning on dissociative symptoms and general psychopathology in a Turkish university student sample. Methods. All participant completed Brief Physical and Sexual Abuse Questionnaire, Symptom Checklist-90-Revised (SCL-90-R), Dissociative Experiences Scale (DES) and Family Assessment Device (FAD). Results. The most frequent childhood trauma type was separation from caretaker (46.1%). Witnessing violence (33.1%), harsh punishment (21.2%) and substance abuse in family (10.5%) followed. Sexual abuse of incest type was seen in 6.3%. Students who reported childhood traumatic events had higher DES and SCL-90-R scores compared to those who did not. There were fair relationships between SCL-90-R and FAD scores. Conclusion. A history of childhood traumatic events may be related to increased level of dissociation and general psychopathology in university students. Other pathogenic family factors also may contribute to the development of psychiatric symptoms.

Oxidative markers of Myeloperoxidase and Catalase and their diagnostic performance in bipolar disorder

BACKGROUND Recent researches suggest oxidative stress and generalized inflammatory state to be associated with bipolar I disorder (BID). Our aim is to evaluate Myeloperoxidase (MPO) and Catalase (CAT) activities in BID. METHODS 73 BID patients and 73 healthy controls were enrolled. Patients were classified into manic, depressive and euthymic state. Serum MPO and CAT were measured in both patients and controls. RESULTS CAT activity was significantly lower in controls than manic, depressive and euthymics (p<0.001). MPO activity was significantly higher in controls compared to euthymics (p=0.007) and it was significantly higher in depressives compared to euthymics (p=0.023). CAT was negatively and MPO was positively correlated with disease duration in overall the patients. Positive Predictive Value was 94.5% and Negative Predictive Value was 100% above the cutoff point for CAT activity. CONCLUSION MPO and CAT activities are impaired in BID, which may be associated with oxidative stress and inflammation.

Lack of pain in schizophrenia: a patient whose arm was burned and amputated

Diminished pain sensitivity or loss of pain sensation in schizophrenic patients has previously been reported. We report an interesting case of a schizophrenia patient who had the disease for 20 years and who had his forearm amputated below the elbow level due to severe burn injury to his muscles, tendons, nerve fibers and bone tissue, caused by direct exposure to flames from a liquefied petroleum gas cylinder, in an attempt to make himself warm during a medicine-free period with active symptoms and without pain sensation.

Are oxidative stress markers useful to distinguish schizoaffective disorder from schizophrenia and bipolar disorder

Objective Schizoaffective disorder is a disease with both affective and psychotic symptoms. In this study, we aimed to compare oxidative metabolism markers of schizoaffective disorder, bipolar disorder and schizophrenic patients. Furthermore, we also aimed to investigate whether schizoaffective disorder could be differentiated from schizophrenia and bipolar disorder in terms of oxidative metabolism. Methods Total oxidant status (TOS) and total antioxidant status (TAS) were measured in the blood samples that were collected from schizoaffective patients (n = 30), bipolar disorder patients (n = 30) and schizophrenic patients (n = 30). Oxidative stress index (OSI) was calculated by dividing TOS by TAS. Results TOS and OSI were found to be higher in patients with schizoaffective disorder compared with those in schizophrenia and bipolar disorder patients. TAS was not significantly different between the groups. Conclusion Schizoaffective disorder was found to be different from bipolar disorder and schizophrenia in terms of oxidative parameters. This result may indicate that schizoaffective disorder could differ from bipolar disorder and schizophrenia in terms of biochemical parameters. Increased TOS levels observed in schizoaffective disorder may suggest poor clinical course and may be an indicator of poor prognosis.

Evaluation of oxidative metabolism and oxidative DNA damage in patients with obsessive–compulsive disorder

There are limited published data about the role of oxidative stress in the pathophysiology of obsessive–compulsive disorder (OCD). In addition, oxidative stress and oxidative DNA damage have not been investigated together in OCD. In this study, we aimed to evaluate oxidative stress and oxidative DNA damage in patients with OCD.

The prevalence of comorbid anxiety disorders in outpatients with schizophrenia

Objective. The purpose of this study was to determine the prevalence of lifetime anxiety disorders in patients with schizophrenia in Sanliurfa, Turkey, and to assess the association between comorbidity and several demographic and clinical variables. Methods. Eighty-two outpatients diagnosed with schizophrenia were recruited for the study. They were assessed by means of the Structured Clinical Interview for DSM-IV axis I Disorders-Clinician Version (SCID-I-CV), Anxiety Disorder Module, the Positive and Negative Syndrome Scale (PANSS), the Hamilton Anxiety Rating Scale (HARS), and the Global Assessment of Functioning Scale (GAF). Results. Fifty-five (67.1%) were diagnosed with at least one lifetime comorbid anxiety disorder. The most common anxiety disorder was obsessive-compulsive disorder (39.0%), followed by social phobia (13.4%). We found patients with a diagnosis of schizophrenia with comorbid anxiety disorders had shorter duration of illness than those without such comorbid conditions. Atypical antipsychotics were more commonly prescribed to treat these patients. Conclusion. As comorbidity of anxiety disorders is relatively prevalent among patients with a diagnosis of schizophrenia, special attention to this issue should be paid when interviewing these patients.

Oxidative metabolism may be associated with negative symptoms in schizophrenia

ABSTRACT Objective: In the present study, we aimed to examine the relationship between the oxidative metabolism with disease severity, sociodemographic, and clinical characteristics in the patients with schizophrenia. Methods: Seventy-one patients with schizophrenia and 76 healthy volunteers were included in the study. Plasma total antioxidant level (TAL) and total oxidant level (TOL) were analyzed, and oxidative stress index (OSI) was calculated. Results: There was a statistically significant increase in TOL and OSI and decrease in TAL in the patients with schizophrenia compared to the controls (p < .05). There were positive, mild, statistically significant correlations between TOL, OSI, and Positive and Negative Syndrome Scale-Total scores (p = .01, p = .01, respectively), Positive and Negative Syndrome Scale-Negative scores (p = .002, p = .001, respectively), Positive and Negative Syndrome Scale Global Psychopathology scores (p = .03, p = .03, respectively), and Clinical Global Impression-Severity Scale scores (p = .008, p = .009 respectively). OSI levels were significantly lower in the patients who were on treatment with atypical antipsychotics (AAP) compared to the patients who were on typical antipsychotics (TAP) and combined antipsychotic (CAP) agents (p = .032). Conclusions: Oxidative stress was higher in schizophrenia patients. The increased severity of negative symptoms was in line with the disruption in oxidative balance. Oxidative stress is quite lower in AAP users compared to the TAP and CAP users. One of the mechanisms underlying the fact that AAPs are more effective on negative symptoms than typical agents may be the positive effect on the oxidative stress.