Artuner Deveci

The effect of chronic antidepressant treatment on serum brain-derived neurotrophic factor levels in depressed patients: a preliminary study.

Recent studies suggested a role of brain-derived neurotrophic factor (BDNF) in depression. While BDNF levels are lower in depressed patients, antidepressant treatment increases serum BDNF levels of depressed patients. Our study aims to test the effect of chronic venlafaxine treatment on serum BDNF levels in patients with a major depressive disorder. Ten patients diagnosed as major depressive disorder according to DSM-IV are included in the study. Two of the patients had their first episode and were drug-naive, the other eight patients were drug-free for at least 4 weeks. The severity of depression was assessed with Hamilton Depression Rating Scale (HDRS). The control group consisted of ten age- and sex-matched subjects without any psychiatric disorder. Blood samples were collected at the baseline and after 12 weeks of antidepressant treatment (during remission). At the baseline the mean serum BDNF level was 17.9+/-9.1 ng/ml and the mean HDRS score was 23.2+/-4.6. Serum BDNF levels of the study group were significantly lower than in the control group (31.6+/-8.6 ng/ml). At the end of the study, the mean serum BDNF level was 34.6+/-7.1 ng/ml whereas the mean HDRS score was 8.2+/-3.9. From the baseline to the remission after 12 weeks of treatment, the increase in serum BDNF level and the decrease in HDRS score were statistically significant, respectively. When we compared the serum BDNF level of depressed patients at remission to that of the controls, there was no statistically significant difference. This study shows that venlafaxine treatment of depression improves serum BDNF level which may be considered as a nonspecific peripheral marker of depression.

Postnatal depression in turkey: epidemiological and cultural aspects.

Background In some periods of a womans life the risk of depression increases and the postnatal period is one of these. The prevalence and the risk factors of postnatal depression are not systematically studied in Turkey. The aim of this study is to investigate the epidemiological aspects and the cultural factors that may affect postnatal depression in our country. Method According to the records of ten primary health care centres in Manisa, a city in western Turkey, there were 1,337 women who had given birth in the previous 6 months. A sample group of 317 mothers were randomised among these women and 257 (81.7 %) of the sample group could be reached. Data were collected by use of the Edinburgh Postnatal Depression Scale and a questionnaire on sociodemographic variables designed for this study. Results The mean depression score was found to be 7.54 ± 4.66. When the cut-off point was taken into consideration, 14 % of mothers had a syndromal depression. The factors which affected the prevalence of depression were the number of living children, living in a shanty, being an immigrant, serious health problems in the baby, previous psychiatric history, psychiatric disorder in the spouse, and having bad relations with the spouse and his parents. Conclusion These findings revealed that the prevalence of postnatal depression in the Manisa province and the factors affecting it were very similar to other studies; but the negative impact of bad relations of the mother with her family-in-law on postnatal depression seems to be a distinguishing aspect of Turkish culture.

Sexual dysfunction in patients with psoriasis

Psoriasis can have a significant impact upon sexual function. The aim of this study was to investigate sexual function in females and males with psoriasis and to evaluate whether coexistent depression has an additional negative effect on sexual function in these patients. A total of 66 female subjects (39 with psoriasis and 27 healthy volunteers as a control group) and 70 male subjects (39 with psoriasis and 31 healthy volunteers as a control group) were enrolled in the study. A Psoriasis Area and Severity Index (PASI) was used to determine the severity of psoriasis for the patient groups. The Female Sexual Function Index (FSFI) was used to assess female sexual function and the International Index of Erectile Function (IIEF) was used to evaluate male sexual function. Quality of life was assessed with the Dermatology Life Quality Index (DLQI). The diagnosis of depression was made according to the Structured Clinical Interview for DSM‐IV (SCID‐I) interview and Hamilton Depression Rate Scale (HDRS) was used for grading depression. FSFI total score was found to be significantly decreased in female psoriatic patients without depression and psoriatic patients plus depression compared with healthy controls (24.09 ± 5.33 vs. 24.25 ± 4.52 vs. 28.12 ± 3.48, respectively, p = 0.004). However, FSFI score was not significantly different between patients with psoriasis without depression and those with psoriasis plus depression (p > 0.05). IIEF total score was also found to be significantly decreased in male psoriasis without depression and psoriasis plus depression patients compared with healthy controls (54.21 ± 13.07 vs. 52.0 ± 14.73 vs. 61.69 ± 9.49, respectively, p = 0.023). The difference in IIEF scores between patients with psoriasis without depression and in those with psoriasis plus depression were not statistically significant (p > 0.05). The results of the study demonstrated that patients with psoriasis, especially females have distinct sexual dysfunction compared with healthy controls, and coexistent depression has no additional negative effect on sexual dysfunction in our patients. Patients with psoriasis should be evaluated in terms of sexual function in order to provide a better quality of life.

Depression and Anxiety in Hyperthyroidism

BACKGROUND Our objective was to determine symptomatology of depression and anxiety in patients with untreated hyperthyroidism and compare with euthyroid patients. METHODS Thirty-two patients with hyperthyroidism (high free T3 and free T4, and suppressed TSH) and 30 euthyroid (normal free T3, free T4, and TSH) controls attending the Endocrinology Out-Patient Department at Celal Bayar University Hospital in Manisa, Turkey were included in the study. Hormonal screening was performed by immunoassay and hemagglutination method. For psychiatric assessment, Hospital Anxiety and Depression Scale [HAD], Hamilton Depression Rating Scale [HAM-D], and Hamilton Anxiety Rating Scale [HAM-A] were used. There was no difference between the two groups in terms of demographic features. RESULTS Total scores obtained both from HAM-D and HAM-A were significantly greater in the hyperthyroidism group than that of the euthyroid group (p <0.05); there was no difference in terms of HAD. When compared in terms of symptomatology, early insomnia (HAM-D#6), work and activities (HAM-D#7), psychic anxiety (HAM-D#10), weight loss (HAM-D#16), insomnia (HAM-A#4), and cardiovascular symptoms (HAM-A#8) were significantly more frequent in the hyperthyroidism group. By Wilks lambda discriminant analysis, psychomotor agitation (HAM-D#9), weight loss (HAM-D#16), and insomnia (HAM-A#4) were found as the discriminating symptoms for the hyperthyroidism group, whereas somatic anxiety (HAM-A#11) and loss of interest (HAD#14) were distinguishing symptoms of the euthyroidism group. CONCLUSIONS Hyperthyroidism and syndromal depression-anxiety have overlapping features that can cause misdiagnosis during acute phase. For differential diagnosis, one should follow-up patients with hyperthyroidism with specific hormonal treatment and evaluate persisting symptoms thereafter. In addition to specific symptoms of hyperthyroidism, psychomotor retardation, guilt, muscle pain, energy loss, and fatigue seem to appear more frequently in patients with comorbid depression and hyperthyroidism; thus, presence of these symptoms should be a warning sign to nonpsychiatric professionals for the need for psychiatric consultation.

Serum BDNF Levels in Suicide Attempters Related to Psychosocial Stressors: A Comparative Study with Depression

Although many studies have examined the neurobiological aspects of suicide, the molecular mechanisms and pathophysiologic mechanisms associated with suicide remain unclear. In this study, it is aimed to investigate whether there is a difference in serum brain-derived neurotrophic factor (BDNF) levels among suicide attempters without a major psychiatric disorder, compared to major depressive disorder patients and healthy subjects. It was undertaken with the hypothesis that suicide per se lowers serum BDNF levels, since it is a source of stress. The study was carried out in Celal Bayar University Hospital, Manisa, Turkey. Ten suicide attempters, 24 patients with major depressive disorder and 26 subjects without any psychiatric diagnosis and any psychiatric treatment were included in the study. All subjects were asked to give their written consent. Blood samples were collected at the baseline. Serum BDNF was kept at –70°C before testing, and assayed with an ELISA kit (Promega; Madison, Wisc., USA) after dilution with the block and sample solution provided with the kit. The data were subjected to the Kruskal-Wallis test for nonparametric analysis of variance. Mean serum BDNF levels were significantly lower in the suicide group (21.2 ± 12.4 ng/ml) and the major depressive disorder group (21.2 ± 11.3 ng/ml) than the control group (31.4 ± 8.8 ng/ml; p = 0.004). These results suggest that BDNF may play an important role in the neurobiology of suicidal behavior. BDNF levels may be a biological marker for suicidal behavior. To investigate the role of BDNF in suicide, further studies with a wider sample size and a variety of psychiatric diagnoses accompanying suicide attempt are needed.

Risk factors for delaying treatment seeking in obsessive-compulsive disorder

BACKGROUND Despite the multiple alternatives of treatment, it is well known that patients with obsessive-compulsive disorder (OCD) delay seeking treatment. In this study, the aim was to determine the risk factors for delaying treatment seeking in OCD patients. METHODS The sample consisted of 132 OCD who completed the Yale-Brown Obsessive-Compulsive Scale, Yale-Brown Obsessive-Compulsive Scale Symptom Checklist, and Beck Depression Inventory. RESULTS In univariate analyses with risk evaluation, income level, being single or divorced, having a history of psychiatric treatment, poor insight for the symptoms, and obsessions of hoarding were the variables that were found to be significant. In the regression model, history of psychiatric treatment and duration of OCD were the 2 variables that remained statistically significant. CONCLUSION This was the first study wherein the sample included patients who were recruited from a nonpsychiatric department: the dermatology clinic. Application to dermatology has not been determined as a risk factor for delaying treatment seeking in OCD patients.

Serum brain-derived neurotrophic factor levels in conversion disorder: Comparative study with depression.

Abstract  The aim of the present study was to compare serum brain‐derived neurotrophic factor (BDNF) levels of patients with major depressive disorder (MDD) and conversion disorder (CD). Serum BDNF levels were measured in the following three groups: 15 CD patients without any comorbid diagnosis of psychiatric disorder, 24 patients with MDD, and 26 healthy subjects without any psychiatric diagnosis or psychiatric treatment. The serum BDNF level of the healthy control group (31.4 ± 8.8 ng/mL) was statistically higher than the level of the MDD group (21.2 ± 11.3 ng/mL) and the CD group (24.3 ± 9.0 ng/mL; P = 0.008). This suggests that BDNF level may play a similar role in the pathophysiology of MDD and CD.

Sexual dysfunction in female patients with neurodermatitis.

Neurodermatitis is a chronic disease affecting the patients psychosocial status and quality of life. It is associated with a variety of psychologic problems, including demoralization, depression, anxiety, obsessive-compulsive disorder, and sleep disturbances. Coexistence of sexual dysfunction, especially in women, with several systemic diseases has gained interest in recent years. In this study, we evaluated sexual function in female patients with neurodermatitis. We enrolled 89 women (43 patients, 46 controls) in the study. Quality of life was assessed with the Dermatology Life Quality Index (DLQI), and the Female Sexual Function Index (FSFI) was used to determine sexual function. Individuals with psychiatric disorders and/or those using antidepressants were excluded. The total DLQI score was 11.95 ± 5.65 in patients with neurodermatitis. The total FSFI score was significantly lower in patients compared with healthy controls (22.76 ± 5.31 and 28.83 ± 3.50, respectively; P = .001). Domain scores of FSFI (desire, arousal, lubrication, orgasm, and satisfaction) except pain were significantly lower in patients with neurodermatitis (P = .001). The pain score was also lower in patients than controls, but the difference was not statistically significant (P = .073). Neurodermatitis may be associated with sexual dysfunction, and patients with neurodermatitis should be evaluated with regard to sexual function to provide a better quality of life.

Relationships between nicotine craving, orexin-leptin levels and temperament character traits among non-treatment seeking health professionals

ABSTRACT BACKGROUND: Repeated cigarette use in individuals generally occurs due to the craving for smoking. Orexin-leptin hormones and temperament character traits are thought to be important factors affecting nicotine craving. OBJECTIVE: The aims of this study were to determine orexin-leptin blood levels, which appear in nicotine deprivation, in health professionals who were diagnosed as having tobacco use disorder in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) and to assess the temperament-character traits of the same group and to provide biologic and psychotherapeutic data for the treatment of tobacco abuse. METHODS: The study sample consisted of faculty of medicine students and resident physicians who were smokers (n = 40). The control group comprised medical students and resident physicians who were non-smokers (n = 40). The Sociodemographic and Clinical Information Form, DSM-IV SCID-I Clinical Version, and Temperament and Character Inventory (TCI) were applied to both groups. Substance Craving Scale (SCS) and Fagerstrom Test for Nicotine Dependence were applied only smoking group. Blood samples were taken for plasma orexin and serum leptin levels for both groups. RESULTS: The plasma orexin levels were lower in the smokers group (p < .001). No statistically significant relations were determined between the SCS and plasma orexin and serum leptin levels in the smoking group. No significant differences were determined between the leptin (U = 119.5, p = .33) and orexin (U = 99, p = .11) levels of the heavy and very heavy smokers. The total points of novelty seeking (NS), and NS3 and NS4 subscale points in the TCI of the smoking group (p = .003, p = .003, p = .002), and the self-directedness (SD) SD2 and SD5 (p = .02, p = .01) subscale points, and total cooperativeness points (TC), and C4 and C5 subscale points (p = .001, p = .002, p = .001) of the non-smoking group were found as high. CONCLUSIONS/IMPORTANCE: Differences were detected between the smokers and non-smokers in TCI scale subgroups and in terms of orexin levels. These results will greatly assist in the fight against craving that appears as a result of smoking cessation. Orexin appears to be more specific for nicotine craving than leptin. It seems more likely that the quest for the treatment of craving will continue through orexin. Temperament and personality traits are important for determining psychotherapeutic and supportive approaches to the release of tobacco and tobacco products. A number of studies investigating monoaminergic mechanisms indirectly related to orexin and leptin are required to research temperament, which has a greater genetic burden.

Evidence of associations between brain-derived neurotrophic factor (BDNF) serum levels and gene polymorphisms with tinnitus

Background: Brain-derived neurotrophic factor (BDNF) gene polymorphisms are associated with abnormalities in regulation of BDNF secretion. Studies also linked BDNF polymorphisms with changes in brainstem auditory-evoked response test results. Furthermore, BDNF levels are reduced in tinnitus, psychiatric disorders, depression, dysthymic disorder that may be associated with stress, conversion disorder, and suicide attempts due to crises of life. For this purpose, we investigated whether there is any role of BDNF changes in the pathophysiology of tinnitus. Materials and Methods: In this study, we examined the possible effects of BDNF variants in individuals diagnosed with tinnitus for more than 3 months. Fifty-two tinnitus subjects between the ages of 18 and 55, and 42 years healthy control subjects in the same age group, who were free of any otorhinolaryngology and systemic disease, were selected for examination. The intensity of tinnitus and depression was measured using the tinnitus handicap inventory, and the differential diagnosis of psychiatric diagnoses made using the Structured Clinical Interview for Fourth Edition of Mental Disorders. BDNF gene polymorphism was analyzed in the genomic deoxyribonucleic acid (DNA) samples extracted from the venous blood, and the serum levels of BDNF were measured. One-way analysis of variance and Chi-squared tests were applied. Results: Serum BDNF level was found lower in the tinnitus patients than controls, and it appeared that there is no correlation between BDNF gene polymorphism and tinnitus. Conclusions: This study suggests neurotrophic factors such as BDNF may have a role in tinnitus etiology. Future studies with larger sample size may be required to further confirm our results.