Mehmet Cemal Kaya

Role of Oxidative and Antioxidative Parameters in Etiopathogenesis and Prognosis of Panic Disorder

Free radicals have been implicated in some psychiatric disorders. This study aimed to investigate the role of oxidative and antioxidative parameters in etiopathogenesis and prognosis of panic disorder (PD), using novel methods for measurement of total oxidant and antioxidant statuses. Nineteen PD patients and 40 healthy subjects were recruited. Both total antioxidant status and oxidative stress index, and ceruloplasmin levels of PD patients were significantly higher in PD patients. Total oxidant status and oxidative stress index decreased after treatment. This study suggests an oxidative imbalance in PD and treatment can reverse overall oxidative imbalance.

Reduced PON1 enzymatic activity and increased lipid hydroperoxide levels that point out oxidative stress in generalized anxiety disorder.

In recent years, there has been an increasing focus on generalized anxiety disorder (GAD) which is one of the most prevalent mental disorders in general population. Psychological, genetic, neurobiological, and neurochemical factors are believed to play role in the etiopathogenesis of GAD. The role of oxidative stress, as a neurochemical cause, in various anxiety disorders has been studied in recent years; however, it has not been thoroughly studied in GAD, yet. In this paper, we aimed to evaluate the serum levels of lipid hydroperoxide (LOOH), paraoxonase, and arylesterase in GAD patients without any co-morbid psychiatric disorders and investigate their diagnostic performance. Blood samples were collected from 40 GAD patients and 40 healthy control subjects to measure their serum LOOH levels, arylesterase and paraoxonase activities. Obtained results have been compared between groups and receiver operating characteristic (ROC) curve has been drawn for diagnostic performance of measured biochemical markers. Positive and negative predictive values have been estimated where appropriate. Mean LOOH level of the GAD patients was significantly higher than that of control subjects (t=-5.49, p<0.001), whereas, mean paraoxonase activity was lower in these patients (t=3.056, p=0.03). GAD could be predicted for LOOH level over 7.740 μmol/l with 92.5% positive predictive value and 92% negative predictive value. Increased LOOH level and decreased paraoxonase activity of GAD patients may suggest increased lipid peroxidation and oxidative stress in these patients. LOOH levels may be a state marker for diagnosing GAD.

Neutrophil-lymphocyte ratio in patients with major depressive disorder undergoing no pharmacological therapy

Studies attempting to clarify the relationship between major depressive disorder (MDD) and the immune system have been increasing in recent years. It was reported that increased production of the main proinflammatory cytokines, such as interleukin-1, interleukin-6, and tumor necrosis factor-alpha, and that of acute phase reactants may play a role in the etiopathogenesis of depression. Stress and depression were reported to increase leukocyte and neutrophil counts and to decrease lymphocyte count. Biological determinants affecting the diagnosis, therapy, and prognosis of depression are quite limited. Therefore, new etiological models are needed to explain the pathophysiology of depression. In recent years, neutrophil–lymphocyte ratio (NLR) was determined to be a good indicator of inflammatory status. There is no study in the literature investigating NLR in MDD. This study aims to examine the role of inflammation in the etiology of depression based on the NLR in MDD patients who are undergoing no pharmacological therapy. A total of 41 patients diagnosed with MDD, who received no antidepressant therapy within the past 1 month, were included in the study, which took place between January and March 2015. The control group consisted of 47 healthy subjects with no psychiatric disorders. A sociodemographic information form and a Beck Depression Scale were administered, and the blood was taken for biochemical analysis. Significant differences were identified in the NLR, neutrophil count, lymphocyte percentage, and leukocyte values of the patient group when compared with the control group (P<0.05). Our study is the first in which NLR was investigated in MDD. The findings of the study reveal that NLR tends to be higher in patients with MDD, and a high NLR value supports the view that inflammation is a critical factor in the etiology of MDD.

Psychological Distress and Poor Quality of Life in Patients with Central Serous Chorioretinopathy

Abstract Purpose: We aimed to compare the mental health and quality of life (QoL) between central serous chorioretinopathy (CSCR) patients and the control subjects. Methods: Thirty consecutive patients presenting with CSCR and age-gender-matched 30 healthy control subjects filled in the following standardized questionnaires: Symptom Checklist 90-R (SCL 90-R) and Short Form 36 (SF-36). Age, gender, and ocular clinical findings were recorded. Results: According to SCL-90-R, all scores were significantly higher in the CSCR group when compared to the control group. The patients with CSCR reported significantly lower levels of QoL, except bodily pain. Conclusion: Our results indicated that CSCR patients have poorer QoL and more psychological problems. CSCR patients may benefit from psychosocial support and interventions.

High social phobia frequency and related disability in patients with acne vulgaris

Acne is an easily recognizable abnormality which may cause some adverse psychosocial consequences. We aimed to determine the social phobia frequency, social anxiety level, and disease related disability in a group of acne vulgaris patients. One-hundred and forty acne vulgaris patients and 98 healthy control subjects were included in the study. Acne severity was determined by the Global Acne Grading System (GAGS). A psychiatrist interviewed each participant and the Liebowitz Social Anxiety Scale (LSAS) was administered to all participants, who also completed the Hospital Anxiety and Depression Scale (HADS) and Sheehan Disability Scale (SDS). Social phobia was diagnosed in 45.7% of acne vulgaris patients and in 18.4% of control subjects. Acne vulgaris patients demonstrated higher performance avoidance and total avoidance scores in LSAS than controls. Acne vulgaris patients without social phobia had higher scores in HADS and LSAS than the acne vulgaris patients with social phobia. They were more disabled in their occupational, social, and familial lives. Social phobia diagnosis predicted disability at work, whereas education level predicted the disability in family life of acne vulgaris patients. Social phobia seems to be a common psychiatric comorbidity which may give rise to some additional disability among acne vulgaris patients.

Lipid peroxidation markers in adult attention deficit hyperactivity disorder: new findings for oxidative stress.

Malondialdehyde (MDA) is a reliable marker of lipid peroxidation where paraoxonase and arylesterase are two enzymes against it. Although increased MDA has been previously shown in adults with attention deficit/hyperactivity disorder (A-ADHD), levels of paraoxonase and arylesterase enzymes have not been studied yet. We aimed to determine the status of both MDA level and paraoxonase and arylesterase enzyme activities in A-ADHD patients. A total of 35 adults with ADHD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) criteria and 29 healthy volunteers were included in the study. Serum MDA, paraoxonase and arylesterase levels of the participants were measured. The disease severity of the patients was determined by using Turgays Adult Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD) DSM IV Based Diagnostic Screening and Rating Scale. The serum MDA level of patients was significantly higher than that of healthy control subjects, whereas their paraoxonase and arylesterase levels were significantly lower. There was no correlation between the levels of biochemical parameters (MDA, paraoxonase and arylesterase) and the disease severity. Sub-types of A-ADHD were similar in terms of these biochemical parameters. Increased lipid peroxidation, a part of oxidative stress, in adults with ADHD appears to be unbuffered by antioxidant enzymes, namely paraoxonase and arylesterase.

Effects of isotretinoin on obsessive compulsive symptoms, depression, and anxiety in patients with acne vulgaris

Abstract Background: Depression, anxiety, and obsessive compulsive symptoms are known to be common among patients with acne vulgaris. In contrast to earlier reports, a number of recent studies suggested isotretinoin to be beneficial for depression and anxiety symptoms in acne patients. Moreover, its effects on obsessive compulsive symptomatology are still widely unknown. Objectives:To examine the effects of isotretinoin treatment on obsessive compulsive symptoms, depression, and anxiety in acne vulgaris patients. Methods: The Hospital Anxiety and Depression Scale, Maudsley Obsessive Compulsive Questionnaire, and Sheehan Disability Scale were administered to 43 patients with acne vulgaris who accepted isotretinoin treatment and agreed to participate in the study. Severity of acne was evaluated with Global Acne Grading System. Thirty-three patients completed 6 months treatment with oral isotretinoin at 0.5–1.0 mg/kg daily doses. Measurements were repeated at the end of 6 months. Results:Depression, anxiety, and obsessive rumination symptoms were significantly improved after isotretinoin treatment. On the other hand, obsessive doubting of acne patients was worse at the end of the treatment. There was no significant change in disease related disability of patients. Conclusion:Besides worsening of obsessive doubting, successful treatment with oral isotretinoin seems to be related with improvement in depression, anxiety, and obsessive rumination symptoms in acne vulgaris patients. These changes were not reflected in the disability level that acne patients have reported.

Electroconvulsive therapy for mood disorders in pregnancy.

Abstract Electroconvulsive therapy (ECT) offers a treatment option for mood disorders during pregnancy. We retrospectively examined 12 pregnant patients who were treated with ECT for their mood disorders. The mean ± SD age of the patients was 28.1 ± 4.8 years. The mean ± SD number of ECTs performed was 9.8 ± 4.5. The mean ± SD Clinical Global Impression score was decreased from 6 to 2.6 ± 0.7 with ECT. No significant adverse events were observed other than early delivery in one patient and pes ekinovarus deformity in a newborn that was most probably not related to ECT causally. Electroconvulsive therapy seems to be an effective and safe treatment option in pregnant patients with mood disorders.

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.

Diagnostic performance of increased prolidase activity in schizophrenia.

We investigated whether prolidase activity has a diagnostic test value in schizophrenia and assessed the relation between prolidase activity and sociodemographic-clinical characteristics of patients with schizophrenia. Fifty patients with schizophrenia (diagnosed as schizophrenia according to DSM-V criteria) and 50 healthy volunteers were included in this study. Case and control groups had a similar distribution in age, sex, body mass index (BMI), and smoking status. Serum prolidase activity was measured in both groups and was determined to be significantly higher in the patient group (509.706±41.918) compared to the control group (335.4±13.6; t=6.231; p=0.0001). A cut-off point of 392.65U/L prolidase was determined for diagnostic measures from the plotted ROC curve. The area under the ROC curve was 1.000, which was significant (p<0.0001). Higher values were assigned as the disease state. Both positive predictive value (PPV) and negative predictive value (NPV) were 100% at the cut-off point of 392.650U/L. The prolidase levels of the control group were all below the cut-off point. There were no statistically significant differences between the two groups with regard to age, gender, or BMI (p>0.05), and no correlation was found between mean prolidase activity and age of onset of the disease, family history, disease duration, number of hospitalizations, subtypes of schizophrenia, PANSS scores or sub-scores, CGI-S scores, S-A scale scores, and the antipsychotic treatment (p>0.05). The results of this study indicate that serum prolidase activity may be a useful diagnostic test for schizophrenia; however, further studies are needed to verify this.