Emre Aydemir

The ratios of 2nd to 4th digit may be a predictor of schizophrenia in male patients

The production of androgens (mostly testosterone) during the early fetal stage is essential for the differentiation of the male brain. Some authors have suggested a relationship between androgen exposure during the prenatal period and schizophrenia. These two separate relationships suggest that digit length ratios are associated with schizophrenia in males. The study was performed in a university hospital between October 2012 and May 2013. One hundred and three male patients diagnosed with schizophrenia according to DSM‐IV using SCID‐I, and 100 matched healthy males, were admitted to the study. Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS) and Brief Psychiatric Rating Scale (BPRS) were used to assess schizophrenia symptoms. The second digit (2D) and fourth digit (4D) asymmetry index (AI), and the right‐ and left‐hand 2D:4D ratios were calculated. All parametric data in the groups were compared using an independent t‐test. The predictive power of the AI was estimated by receiver operating characteristics analysis. The 2D:4D AI was statistically significantly lower in the patient group than the healthy control comparison group. There were significant differences between the schizophrenia and the control groups in respect of left 2D:4D and right 2D:4D. There was no correlation between AI, left, or right 2D:4D, BPRS, or SAPS in the schizophrenia group. However, there was a negative correlation between left 2nd digit (L2D):4D and the SANS score. Our findings support the view that the 2D:4D AI can be used as a moderate indicator of schizophrenia. Even more simply, the right or left 2D:4D can be used as an indicator. L2D:4D could indicate the severity of negative symptoms. Clin. Anat. 28:551–556, 2015.

Evaluation of peer effects on eating behaviors: a cluster analysis approach

ABSTRACT Objectives: In this study, we aimed to determine the effects of socio-demographic characteristics and the peer groups on the eating attitude and body mass index (BMI) of students at a medical school in Turkey. Methods: This cross-sectional study was conducted with the participation of the students of Gulhane Military Medical Academy (GMMA). Ethical permissions of the study were obtained from the GMMA Ethics Committee. The target population of the study consisted of 703 students, 533 of whom (75.8%) agreed to participate in the study. The Eating Attitudes Test (EAT) was administered to the participants and their BMI was noted. The EAT consists of 10 questions that measure the socio-demographic characteristics of the participants and 40 questions that evaluate eating habits. In order to determine the peer groups of the students, each student was asked to provide the numbers of their three closest friends. Three peer groups were generated for each grade by applying cluster analysis and as a result 18 peer clusters were examined. Results: In this study, the average EAT score was 12.5 ± 6.9, and the mean BMI was 23.1 ± 2.4. It was found that the EAT score of 2.4% of the students was equal to or exceeding 30; 0.4% were obese; 21.0% were overweight; and 2.1% were slim. There was a significant difference between the grade level of the students and sport habits (p values respectively; p < .001, p = .015) in terms of the comparison of the EAT score to socio-demographic characteristics. In the analysis of variance between 18 clusters generated according to the cluster analysis, a statistically significant difference was found in terms of both BMI and the EAT (p values <.001, <.001, respectively). This suggests that students with similar eating habits and similar BMI levels have a tendency to cluster among similar peer groups. The variables that effect the EAT scores and BMI levels of the students were evaluated by the analysis of covariance. It was found that students’ smoking status (p = .039) had a statistically significant effect on BMI after it was adjusted according to peer group and grade. Also, it was found that the grade (p = .011) and peer cluster (p = .021) had a statistically significant effect on eating habits. Conclusions: The peer groups may affect both eating attitudes and BMIs. In medical literature several studies exist that support these findings. But it is a novel approach to identify peer groups by using clustering algorithms and our study has been able to demonstrate the relationship of peer group and eating habits with this method.

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.

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.

Possible relationship between amino acids, aggression and psychopathy.

Abstract Objective: Aggressive behaviour is associated with reduced serotonin metabolism in the brain, but there is not enough knowledge on potential changes of the serotonin precursor levels among violent offenders. In this study, we aimed to evaluate the relationships among the tendency of psychopathy, anger and the basic amino acids. Methods: Fifty-two young adult male patients with antisocial personality disorder (APD) and 30 healthy men included the study. Serum amino acid levels were measured by HPLC method. Aggression questionnaire and Hare Psychopathology Scale were used for all participants. Results: Blood levels of phosphoserine, aspartic acid, glutamic acid, aminoadipic acid and 1-methylhistidine in group of patients with APD were significantly higher than the control group. Blood levels of TRP, asparagine, citrulline, cystine, isoleucine, tyrosine, histidine, hydroxylysine, lysine, ethanolamine and arginine in the group of patients were found lower than the control group. A significant positive correlation between anger scores and histidine, methionine and GABA was found. GABA and methionine showed a significant correlation with the indirect aggression score. Conclusion: Our study showed a relationship between serum amino acid levels and the scores of aggression and psychopathy. We think that this is a productive research area for understanding the relationship among biochemical factors, aggression and psychopathy.

The relationship between the level of aggression and the sleep quality in patients with posttraumatic stress disorder

Subject: Sleep disorders are common problems in post-traumatic stress disorder (PTSD) patients. The main symptoms associated with sleep disorders were reported as a reduction in total sleep time, prolonged sleep latency, increase in the number wakefulness, low sleep efficiency and a reduction in the percentage of deep sleep stages. A relation between sleep disorders and increased levels of aggression was determined. In this study, we aimed to examine the relationship between the quality of sleep and the level of aggression in patients with Post Traumatic Stress Disorder. Method: The study was included 48 patients with a diagnosis of PTSD who were hospitalized. Data were collected using post-traumatic stress disorder questionnaire scale, Pittsburgh sleep quality scale and the Buss-Perry Aggression Scale applied by the clinician. Data analysis was made using SPSS 15.0 package program. Descriptive statistics and Pearson’s correlation test were used in statistical analysis. Results: The average age of the cases was 32.33 ± 7.93, the average of the symptoms of post-traumatic stress disorder was 56.23 ± 11.14, the average of sleep quality was 22.08 ± 6.67 and the average of aggression levels was 51.67 ± 7.48. There was a high level deterioration in sleep quality and aggression levels were medium/medium-high levels. It was determined that Buss-Perry Aggression Scale scores were positively correlated with Pittsburgh sleep quality and posttraumatic stress disorder total and hyper arousal subscale scores. Conclusion: In this study, it is stated that increase in overstimulation symptoms and degradation of sleep in PTSD patients cause increase in agression levels. Degradation of sleep is determined as an indicator of agression that is observed in TSSB patients. Associatively, in PTSD patients, use of interventions to improve the quality of sleep oriented agressive behaviours gain value

A RELATIONSHIP BETWEEN THE AGGRESIVE BEHAVIOR AND DISSOCIATION IN POSTTRAUMATIC STRESS DISORDER

Aggression is associated with the hyper arousal symptoms in Post-Traumatic Stress Disorder (PTSD). Biological and psychological factors play a role in the etiology of aggressive behavior. In this study, we aimed to investigate the relationship between dissociation and aggressive behavior in patients with PTSD. 42 patients with a diagnosis of PTSD according to DSM-IV criteria and 41 healthy subjects were enrolled to the study. Socio-demographic data form, the Clinician-Administered PTSD Scale (CAPS), Dissociative Experiences Scale (DES) and the Buss Perry Aggression Scale tests were administered to the participitants. DES scores, CAPS hyper arousal scores and number of experienced trauma were higher in the PTSD patients with high levels of aggression than the PTSD patients with low levels of aggression. The results suggested that dissociative symptoms should be screened carefully in PTSD patients who had aggressive behaviours prominently.