Erdem Deveci

Relationship of Asymmetrical Dimethylarginine, Nitric Oxide, and Sustained Attention during Attack in Patients with Major Depressive Disorder

We investigated the relationship of serum nitric oxide (NO) and asymmetrical dimethylarginine (ADMA) levels with cognitive functioning in patients with major depressive disorder (MDD). 41 MDD patients (Beck depression scale scores >16) and 44 controls were included in the study. Rey verbal learning and memory test, auditory consonant trigram test, digit span test, Wisconsin card sorting test, continuous performance task (TOVA), and Stroop test scores were found to be impaired in patients with major depressive disorder when compared to healthy controls. There was no significant difference between patient and control groups in terms of serum NO and ADMA. Serum NO levels were correlated with TOVA test error scores and Stroop test time scores, whereas serum ADMA levels were negatively correlated with TOVA test error scores. Metabolic detriments especially in relation to NO metabolism in frontal cortex and hypothalamus, psychomotor retardation, or loss of motivation may explain these deficits.

Psychological Evaluation of Patients Seeking Rhinoplasty.

OBJECTIVE The aim of this study was to evaluate different determinants of the patients psychosocial functioning that might possibly affect the outcome of rhinoplastic surgery. MATERIALS AND METHODS Forty-one patients undergoing rhinoplasty, consecutively admitted to and operated upon at the Department of Otolaryngology, Erzurum Regional Training and Research Hospital, Turkey, were studied with regard to their psychological characteristics. RESULTS In the patient group, Liebowitz anxiety, Liebowitz/avoidance, and Liebowitz/total scores were significantly higher than the control group (p<0.001). No significant differences were found between the patient and control groups according to Rosenberg self-esteem scale and The Hospital Anxiety and Depression Scale. In the Quality of Life SF-36 results, significant differences were found between the patient and control groups apart from SF-36 scores of pain (p<0.05), vitality (p<0.05), social functioning (p<0.05) and emotional role difficulties (p<0.05). CONCLUSION Patient selection must be done very carefully to obviate not only physical, but also psychological postoperative complications. The SF-36 questionnaire may be of value in screening-patients for psychological problems prior to rhinoplasty.

Development of Hyperprolactinemia Induced by the Addition of Bupropion to Venlafaxine XR Treatment

Hyperprolactinemia is characterized by abnormally increased serum prolactin levels. Menstrual irregularities and hyperprolactinemia can be caused by a variety of medical conditions as well as due to the use of some psychopharmacological drugs, namely antipsychotics; it can also develop during antidepressant treatment. Bupropion is an antidepressant functioning via the inhibition of noradrenaline and dopamine reuptake. The endocrine and sexual adverse events of this agent are rare. In the literature, only one case reporting hyperprolactinemia or galactorrhea caused by bupropion use is available. Here, we present the case of a patient diagnosed with depressive disorder and receiving venlafaxine, who developed hyperprolactinemia and oligomenorrhea after the addition of bupropion the ongoing treatment and showed serum prolactin levels decreased to normal ranges shortly after the discontinuation of bupropion.

Early Maladaptive Schemas in the Patients with Somatoform Disorders

Objective: Somatoform disorders are characterized by physical symptoms that suggest a medical condition but that are not fully explained by a medical condition. A number of studies have suggested the efficacy of cognitive behavioral therapy for somatoform disorders. But, while it is clear that somatoform disorders are closely related to a number of cognitive factors, the precise nature of these relationships have not been elucidated yet. The aim of the present study was to determine the relationships between DSM-IV hypochondriasis and somatoform disorder diagnoses and the early maladaptive schemas which have been proposed by Young as the core of psychological problems. Method: We investigated a total of 28 patients aged 18-65 years, were diagnosed as Hypochondriasis or Somatization Disorder according to DSM-IV and 30 healthy controls. All participitans were assessed with The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-1). Data were obtained by using a Sociodemographic Questionnaire and Young Schema Questionnaire-Short Form 3. Results: The main age of patients was 36,71 ± 10.39. Most of the patients were female, married and housewives. All early maladaptive schema scores of patients with somatoform disorders were higher than healthy controls. Conclusion: All early maladaptive schemas have been found to be related to somatoform disorders in this study. The role of not a specific one but a total of maladaptive schemas in etiology may reflect the unspecific general sources of the tendency to somatoform disorders.

PW05-03 Bipolar disorder (BD) and obsessive compulsive disorder (OCD) comorbidty or varied episodes in the same disorder

Previous studies have suggested that OCD has comorbidity with bipolar disorder (BD) (1,2). We evaluated the three bipolar OCD cases. C1: Because of the OCD symptoms Chlomipramine was started. Her OCD symptoms improved in several days but manic symptoms was apeeared, switched to Lithium Carbonate. In her out patient exams, manic and obsessive compulsive symptoms were almost never observed simultaneously at the course. C2: In 2003, her complaints started as combined OCD and Manic symptoms, Risperidon and Lithium carbonate were started, manic and OCD symptoms improved. In 2005, OCD and Depressive symptoms appeared together. She got improved with Lithium Carbonate and Chlomipramine. She had one episode with obsessive and manic symptoms or obsessive and depressive symptoms every year till now. Her uncle had Depression and her aunt had Bipolar disorder. C3: Because of his OCD symptoms we prescribed SSRI and lower dose antipsychotic. At that time he hospitalized for his manic symptoms, his OCD was partially remitted. His manic symptoms improved with Lithium carbonate1200p/d. He had resistant obsessive compulsive symptoms and episodic manic symptoms. His father had M. Depressive episodes. Conclusion Our cases suggest that bipolar OCD has episodic course, treatment resistant symtomatology, high family loading and high frequency of recurrence.