Fatma Özlem Orhan

Restless legs syndrome in hemodialysis patients: association with depression and quality of life.

PurposeThe prevalence of restless legs syndrome (RLS) ranging from 6.6% to 83% has been reported in different case series. The pathophysiology of RLS in uremia is still unclear. The aim of this study was to assess the frequency of RLS in the hemodialysis patients and to explore depression and associated detrimental impact on quality of life.MethodsThe diagnosis of RLS was made using the criteria of the International Restless Legs Study Group. The polyneuropathy was diagnosed according to clinical signs and symptoms. Each subject completed three questionnaires: Beck Depression Inventory, Short Form-36 Quality of Life Scale, and the Epworth Sleepiness Scale (ESS). Biochemical parameters including hemoglobin, serum ferritin, and Kt/V index were collected. The data of the patients with and without RLS or clinical polyneuropathy (PNP) were compared.ResultsThere were 41 male and 40 female patients. RLS, PNP, and high ESS scores were seen in 12%, 47%, and 7% of hemodialysis patients, respectively. Beck depression inventory scores were high in patients with RLS when compared to those without (28.9 ± 9, p = 0.007). General health score in the RLS patients, physical functioning score in the PNP patients were significantly lower (GH, 20.7; p = 0.036; PF, 10.5; p < 0.005). We did not observe any association between hemoglobin, ferritin levels, and Kt/V index in the RLS patients. However, Kt/V index in the PNP patients were low.ConclusionsThe frequency of RLS in hemodialysis patients was lower than that reported from similar studies in other countries. The presence of RLS and PNP in hemodialyzed patients negatively affects quality of life, and RLS contributes to occurrence of depression.

Combination therapy of imipramine and melatonin: additive antidepressant effect in mouse forced swimming test.

Although there are tools to treat depressive patients, a considerable amount of the cases remains to be untreated. These drug-resistant patients need new drugs or drug combinations to overcome this problem. Thus, the potential synergistic effect of melatonin on a classical drug, imipramine was evaluated in the present study. To test this hypothesis, porsolt swim test, a test predictive of antidepressant-like action, was conducted in mice. Imipramine at doses of 20 and 40 mg/kg caused no alteration and statistically significant reduction in the duration of immobility in forced swim test, respectively. While 5 mg/kg melatonin had no effect, 10 mg/kg melatonin slightly reduced the duration of immobility. When sub-effective doses of imipramine and melatonin (20 and 5 mg/kg, respectively) were co-administered, there was no alteration in responses compared with those of each drug alone. Likewise, the effective dose of melatonin (10 mg/kg) did not cause any increase in responses to 20 mg/kg imipramine. Although combination of imipramine (40 mg/kg) and melatonin (5 mg/kg) did not exert an antidepressant effect above that of imipramine alone, co-administration of the effective doses (10 and 40 mg/kg for melatonin and imipramine, respectively) displayed an additive effect. There were no significant differences between groups in relation with locomotor activity test. The results show that co-administration of imipramine and melatonin exhibits an additive effect and that there seems to be no interaction between the drugs.

Temperament and character profiles of male COPD patients

BACKGROUND Chronic obstructive pulmonary disease (COPD) is a respiratory disorder, and is characterized by persistent airflow obstruction. These patients are exposed to severe physical limitations and substantial psychosocial trouble. The aims of this study were to determine the temperament and character profiles of personality in patients with COPD and to compare the results with those of healthy controls. METHODS Thirty-nine male COPD patients and 67 age- and gender-matched healthy controls completed the self-administered 240-item temperament and character inventory (TCI) and 14-item hospital anxiety and depression scale. The relationships between temperament and character personality profiles and clinical factors such as severity of COPD, anxiety, and depression were evaluated. RESULTS COPD patients had significantly higher mean scores of Harm avoidance and lower mean score of Self-directedness than those of healthy controls. In the COPD patients, the anxiety score was significantly higher (P=0.03) and the depression score was found to be insignificantly higher than that of control group. The TCI profiles were not correlated with the severity of COPD. In COPD patients, Self-directedness and Cooperativeness traits of TCI character negatively correlated with anxiety, but any of traits did not correlate with depression. CONCLUSIONS The present study defined the Harm avoidance score was higher and Self-directedness was lower in COPD patients and the COPD severity did not correlate with any of the personality trait. We suggest that during evaluation of COPD patients for treatment, personality trait should also be considered in clinical practice.

Assessment of Temperament and Character Profile with Anxiety and Depression in Patients with Acne

BACKGROUND Acne is the most common skin disease, affecting nearly 85% of the population as well as their lives. Acne can severely affect social and psychological functioning. Patients with acne may have anxiety, depression, decreased self-esteem, interpersonal difficulties, unemployment, social withdrawal, and even suicidal intent. AIMS The aim of this study was to evaluate the temperament and character inventory (TCI) of patients with acne and to compare the results with those of healthy controls. STUDY DESIGN Case-control study. METHODS The study population consisted of 47 patients with acne, and 40 healthy control subjects. All participants were instructed to complete a self-administered 240-item TCI and the Hospital Anxiety and Depression Scale. RESULTS In this study, the scores for the temperament properties Worry and pessimism (HA1) and Dependence (RD4) and the character properties Social acceptance (C1) and Integrated conscience (C5) were found to be higher in acne patients than in healthy controls (p<0.05). Compared to the controls, depression and anxiety scores were found to be markedly higher in the patients with acne. Acne type correlated positively with the Disorderliness (NS4) subscale of Novelty seeking (NS) and anxiety. Additionally, acne type correlated negatively with the Attachment (RD3) subscale of Reward Dependence (RD), with the Transpersonal identification (ST2) and Spiritual acceptance (ST3) subscales of Self-Trancendence (ST), and with the Compassion (C4) sub-scale of Cooperativeness (C). CONCLUSION Studies in this area may lead to the development of specific and focused interventions for TCI in patients with acne vulgaris. We suggest that the evaluation and treatment of acne should also include psychosomatic approaches in clinical practice.

Sociodemographic Variables and Depression in Turkish Women From Polygamous Versus Monogamous Families

In this study, we aimed to determine the different sociodemographic variables of polygamous and monogamous wives, and the relationship between depression and polygamous marriage. Seventy-nine polygamous wives and 73 monogamous wives from Kahramanmaras, located in southern Turkey, were interviewed. After reviewing the data, we suggest that there is a statistically significant difference between polygamous wives and monogamous wives in terms of Beck Depression Inventory (BDI) scores. The results highlighted many implications for clinical practice and for future research. Additional research needs to be conducted in order to investigate the effects of polygamy on womens mental health.

Evaluation of Anxiety and Levels of Serum B12, Folate, TSH, Ferritin, and Zinc in Telogen Alopecia Patients with Trichodynia

Background: Trichodynia refers to pain, discomfort, and/or paresthesia of the scalp. Trichodynia may be associated with anxiety. Aim: To assess serum vitamin B12, folate, thyroid stimulating hormone (TSH), ferritin, and zinc levels, and to investigate anxiety in telogen alopecia patients with trichodynia. Materials and Methods: The study included 31 telogen alopecia patients who complained of trichodynia and 30 telogen alopecia patients without trichodynia. Their serum vitamin B12, folate, TSH, ferritin, and zinc levels were assessed and their anxiety levels were scored using the Beck Anxiety Inventory (BAI) and the State-Trait Anxiety Inventory (STAI). Results: No significant difference was found in the serum levels of vitamin B12, folate, TSH, ferritin, and zinc in the patient and control groups. The anxiety scores in both groups were similar. Conclusion: Our data provide no evidence for the association of serum vitamin B12, folate, TSH, ferritin, and zinc levels or anxiety scores with trichodynia.

Maras Powder Usage Among Turkish Psychiatric Outpatients

A kind of smokeless tobacco known as Maras powder, which is used in the southeastern region of Turkey, causes nicotine dependence. The aim of this study was to determine the usage of Maras powder among psychiatric outpatients and nonpsychiatric controls. The study group consisted of 276 psychiatric patients and 283 nonpsychiatric patients from psychiatry and family medicine outpatient clinics. A socio-demographic form, the Fagerström Test for Nicotine Dependence, and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders–4th Edition were given to the participants. The rates of Maras powder usage in the patient group (10.1%) were significantly higher than those in the control group (5.6%). Men were found to use Maras powder at a higher rate in both groups. The rates of Maras powder usage according to the psychiatric diagnosis were evaluated. This is the first study estimating Maras powder usage rates among psychiatric patients in Turkey. The studys limitations are noted.

The comparison in temperament and character features in pre- and post-treatment of the patients with first episode major depression

Aim: In this study, the association between temperament and character inventory (TCI) subscores and depression scores, and possible changes in temperament dimensions after treatment were explored. Methods: 54 major depressive patients diagnosed according to DSM-IV criteria were enrolled and naturalistic antidepressant treatments were prescribed to the patients. Hamilton Depression Rating Scale (HDRS) and TCI were administered during enrollment and after three months of treatment. Patient group was composed of 31 remitted patients and compared with 75 healthy controls. Results: Comparison of TCI scores of pre-treatment patient group and the control group demonstrated that harm avoidance, self-directedness, and cooperation subscale scores of patients were significantly different from controls (p=0.001, p=0.001 and p=0.001 respectively). The difference between patients and controls persisted even after the treatment. There was no significant difference between pre-treatment and post-treatment TCI outcomes of the patient group (P>0.05). Conclusion: Our findings indicate that harm avoidance, cooperativeness, and self directedness dimensions are not state-related in MDD patients.

Serum levels of GPER -1 in euthymic bipolar patients

Introduction Estrogen and its receptors have been suggested as playing a role in the pathogenesis of bipolar disorder (BD). Estrogen functions through the estrogen receptors alpha and beta and the recently discovered G-protein–coupled estrogen receptor-1 (GPER-1). The aim of this study was to evaluate serum GPER-1 levels in euthymic BD patients. Patients and methods The study population consisted of 38 euthymic outpatients meeting the criteria for BD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and 35 age- and gender-matched healthy controls. Medical histories were obtained and physical examinations and laboratory tests conducted. Results Serum GPER-1 levels were measured in both patients and controls and found to be significantly higher in the BD patients than in controls. These results were not influenced by the medications in use. Conclusion The results of this study demonstrated that GPER-1 may play a role in BD pathophysiology.

The effects of Maras powder use on patients with migraine

Background It is accepted that smoking often triggers migraine. However, studies evaluating the relationship between the use of smokeless tobacco and migraine are limited, and there is no clear consensus on the subject. In this study, it was aimed to evaluate the relationship between migraine and Maras powder, which is the most common smokeless tobacco in Turkey. Subjects and methods The study included a total of 600 subjects, consisting of 300 patients (aged >18 years) diagnosed with a migraine according to the International Headache Society (IHS-ICHD-3 Beta) criteria after presenting at Sütçü Imam University Medical Faculty Neurology Policlinic with the complaint of headache between July 2016 and December 2016 and a control group of 300 individuals with similar features of age, gender, and educational level. A questionnaire was administered to each patient to record the status of smoking or using Maras powder. Results In the migraine patient group, 16.4% smoked and 9.7% used Maras powder. In the control group, the rate of smoking was 8.5% and the rate of Maras powder use was 11.86%. In males diagnosed with a migraine, the use of Maras powder was found to be at a higher rate than smoking (p<0.001). The Visual Pain Score and the headache frequency values were higher in those who smoked or used Maras powder than in non-users (p<0.001). The Fagerström Test for Nicotine Dependence Smokeless Tobacco results of the patients diagnosed with migraine and who used Maras powder were found to be higher than of those who smoked (Fagerström Test for Nicotine Dependence; p<0.001). When patients were evaluated according to the Migraine Disability Assessment Scale, the majority of migraine patients were seen to be at stages 1 and 2, and one in every three patients who used Maras powder cigarette and one in every two patients who smoked had headaches of a severity which affected their daily activities (p<0.001). Conclusion Smoking or the use of Maras powder increases the frequency and severity of migraines in a similar way. Therefore, Maras powder must be included in the scope of the fight against tobacco and people should be warned about this issue.