Mustafa Gulec

Cognitive functions and serum levels of brain-derived neurotrophic factor in patients with major depressive disorder.

OBJECTIVE We assessed major cognitive domains in major depressive disorder (MDD) compared to a healthy control group using neurocognitive tests. We hypothesized that lower serum brain-derived neurotrophic factor (BDNF) levels would be associated with poorer neurocognitive performance in patients with major depression and that these associations would be shown in healthy controls as well. METHOD Executive functions, sustaining and focusing of attention, memory functions, and verbal fluency were assessed in this study using the Trail-Making Test (TMT), Stroop Color Word Interference Test-TBAG Form (SCWT), Wisconsin Card Sorting Test (WCST), Test of Variables of Attention (TOVA), Auditory Consonant Trigram test (ACTT), Digit Span subtest of the Wechsler Memory Scale (DST), Rey Auditory Verbal Learning Test (RAVLT), and Controlled Oral Word Association Test (COWAT). RESULTS The MDD group showed significantly poorer performance than the control group in cognitive functions; they also had lower levels of BDNF than the control group. However, there was no correlation between cognitive performances and BDNF levels except in the TMT, Part B. CONCLUSIONS The current understanding of the importance of neurocognitive assessment and related biological markers in depression is improving. Further studies with larger sample sizes evaluating neurocognitive functions with molecular analyses of BDNF levels may reveal a novel marker for predicting and monitoring neurocognitive deficits in depression.

Oxidative stress in patients with primary insomnia

OBJECTIVE Many physiological and pathological processes, such as infections, environmental toxins, and ionizing radiation increase bodily concentrations of oxidizing substances, known as free radicals, which lead to neurodegenerative disorders. Sleep is one of the most important factors contributing to health; however, insomnia is among the most prevalent health complaints. METHODS In this study, for the first time in the literature, we investigated the effects of primary insomnia on certain oxidative stress biomarkers. For this purpose, glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and myeloperoxidase (MPO) activities and levels of reduced glutathione (GSH) and malondialdehyde (MDA) were measured in 30 patients with primary insomnia and 30 healthy volunteers RESULTS Our results show that the patients with primary insomnia had significantly lower GSH-Px activity and higher MDA levels compared with the controls. CONCLUSION These results may indicate the important role of sleep in attenuating oxidative stress.

Ongoing or re-emerging subjective insomnia symptoms after full/partial remission or recovery of major depressive disorder mainly with the selective serotonin reuptake inhibitors and risk of relapse or recurrence: A 52-week follow-up study

BACKGROUND Many patients who remit fully/partially or recover from an episode of major depression continue to suffer from sleep problems, mainly insomnia. Our study assesses the frequency and types of ongoing or re-emerging subjective insomnia symptoms and their relationship to subsequent depressive relapse or recurrence in a group of full/partial remitters or recoverers. METHOD Sixty patients, 18 to 65 years of age, with current MDD defined using DSM-IV-TR criteria were participated in the study. They began a 24-week course of open-label acute plus continuation phase treatment mainly with SSRIs. Maintenance treatment was not planned for not affecting natural relapse or recurrence rates. All participants were evaluated by CGI-S, BDI, HAMD-17, PSQI, and ISI at weeks 0, 4, 12, 24, and 52. RESULTS Majority of the participants (83.33%) had subjective sleep disturbance, insomnia prior to relapse or recurrence. Repeated measures ANOVA was used to evaluate changes in scores of depression and sleep scales over time between recurred (N = 12) and non-recurred groups (N = 48). Differences between means were calculated with post hoc Bonferroni comparison test. The changes in scores of entire clinical scales over time between recurred and non-recurred groups were statistically significant. LIMITATIONS The limitations of this study include the use of a relatively small, mostly young female sample and the lack of an objective sleep measure to corroborate self-report scales. CONCLUSIONS Early recognition and treatment of disturbances of the sleep-wake cycle may be important for treatment and prevention of recurrence of depression.

Relations between childhood traumatic experiences, dissociation, and cognitive models in obsessive compulsive disorder

Abstract Objective. Previous studies have indicated that obsessive compulsive disorder (OCD) is associated with childhood traumatic experiences and higher levels of dissociation. Dissociative tendency may arise when individual attempt to incorporate adverse experiences into cognitive schema. Methods. We investigated the possible links among childhood trauma, dissociation, and cognitive processes. We evaluated 95 patients with OCD using the Beck Depression Inventory (BDI), Thought-Action Fusion Scale (TAFS), Metacognitions Questionnaire (MCQ-30), White Bear Suppression Inventory (WBSI), Dissociative Experiences Scale (DES), and Childhood Trauma Questionnaire (CTQ-28). Results. The CTQ-28 total scores were not associated with Y-BOCS total, Y-BOCS insight, BDI, TAFS, MCQ-30, and WBSI scores. The TAFS Total, MCQ-30, WBSI, and BDI scores were significantly associated with DES scores. Regression analysis revealed that MCQ-30 and WBSI scores significantly predicted the DES scores. Conclusions. These results suggest that in spite of pathological connotation of dissociative experiences, dissociation may primarily constitute a cognitive trait which is strongly associated with cognitive processes.

Mirtazapine protects against cisplatin-induced oxidative stress and DNA damage in the rat brain.

Cisplatin chemotherapy is associated with neurotoxicity, and oxidative stress might play an important role in the pathogenesis. Mirtazapine may be a preventative agent via its less‐known antioxidant properties. The aim of this study was to examine the potential chemoprotective effects of mirtazapine against cisplatin‐induced oxidative stress and DNA damage.

Seasonality of self-destructive behaviour: Seasonal variations in demographic and suicidal characteristics in Van, Turkey

Abstract Objective. Seasonality is one of the most interesting but still elusive issue in suicide research. Linkages of seasonality in suicides to possible contributors such as gender, type of method used, and climatic factors have received attention in different cultures. We aimed at evaluating seasonal trends in suicidal behaviour according to demographic characteristics, reasons for self-destructive behaviour and means preferred in suicide. Methods. Our aim was to assess the seasonal variation in self-destructive behaviour in terms of completed and attempted suicides in a 3-year time period from 2008 to 2010 in Van, Turkey. A total of 1448 cases were registered over a 3-year time period in the city. Seasonal deviations in demographic characteristics, reasons for suicide, and methods of suicide were evaluated. Results. Seasonal distribution of both completed and attempted suicides by gender did not significantly deviate. On the other hand, we found a significant decline in self-destructive behaviours among those who were single and student in the spring. We found a peak in self-destructive behaviours in the autumn among Individuals who suffer from psychological problems. Conclusions. Subjects with psychological difficulties were more prone to commit suicide in autumn. Seasonal differences in methods of suicide used by suicidal subjects were not significant.

Psychometric properties of the Turkish version of the Internet Addiction Test (IAT)

OBJECTIVE Of many instruments developed to assess Internet addiction, the Internet Addiction Test (IAT), an expanded version of the Internet Addiction Diagnostic Questionnaire (IADQ), has been the most widely used scale in English and non-English speaking populations. In this study, our aim was to investigate the psychometric properties of short and expanded versions of the IAT in a Turkish undergraduate sample. METHOD Overall, 455 undergraduate students from Turkey aged between 18 and 30 participated in the study (63.53% were females). Explanatory and confirmatory factor analytic procedures investigated factor structures of the IADQ and IAT. The Internet Addiction Scale (IAS), Coping Inventory for Stressful Situations (CISS), Obsessive Compulsive Inventory-Revised (OCI-R) and Dissociative Experiences Scale (DES) were administered to assess convergent and divergent validities of the IADQ and IAT. Internal consistency and 15-day test-retest reliability were computed. RESULTS In the factorial analytic investigation, we found a unidimensional factor structure for each measure fit the current data best. Significant but weak to moderate correlations of the IADQ and the IAT with the CISS, OCI-R and DES provided empirical evidence for divergent validity, whereas strong associations with the subscales of the IAS pointed to the convergent validity of Youngs Internet addiction construct. Internal consistency of the IADQ was weak (α=0.67) and of the IAT was high (α=0.93). Temporal reliability of both instruments was very high (α=0.81 and α=0.87; respectively). CONCLUSION The IAT revealed promising and sound psychometric properties in a Turkish sample.

Chronotype effects on general well-being and psychopathology levels in healthy young adults

Variations in diurnal preferences for activity and sleep have long been classified as morning and evening chronotypes. Although morning and evening-types do not differ in sleep architecture, earlier studies have revealed the association between eveningness and psychopathology. However, most of these works had been conducted only with patient samples. Additionally, previous research has also discovered that morning-types have a healthier lifestyle than evening-types. Therefore, the aim of the present study was to assess the associations between chronotypes and general well-being and psychopathology levels in practically healthy young adults, whose physical and mental health were both examined precisely prior to the research, for the first time in the literature. We found that morning-type individuals have significantly better health conditions than evening-types. And, participants exhibiting a tendency to evening-type were more prone to develop psychological symptoms than subjects exhibiting morning-type chronobiological characteristics. Mental health professionals should be aware that eveningness may be a risk factor for mental and physical health even in currently well young adults.

Psychometric Evaluation of the Turkish Language Version of the Profile of Mood States (POMS)

Amaç: Duygudurum Profili (DP) kısa süreli duygudurum değişikliklerini değerlendirmek için geliştirilmiş olup 65 sıfat ve 6 alt ölçekten oluşmuştur. Çalışmanın amacı DP’nin Türkçe Formunun çeviri yeterliğini değerlendirmek ve yöntemsel hataların üstesinden gelinmesindeki karar alma süreçlerini bildirmekti. Yöntem: İngilizce Form Türkçeye uzman ekip yaklaşımı ile çevrildi. Geri çeviri, iki dilli öznelerin kullanımı ve eş zamanlı geçerlik için diğer ölçekler ile bağıntı gibi diğer tekniklere ilaveten yapı geçerliği için ağırlıklı olarak faktör analizi kullanıldı. Bulgular: Elli sekiz maddelik Türkçe formun son hali uygun psikometrik özelliklere sahipti. Türk katılımcıların verilerine dayanan bulgularımız 6 faktörlü orijinal çözümü tekrarladı (“çökkünlük-keyifsizlik”-15, “gerginlik-sıkıntı”-9, “öfke-saldırganlık”-12, “şaşkınlık-şaşırmışlık ”-7, “yorgunluk-durgunluk ”-7 ve “dinçlik-aktiflik”-8). Uygun bir kalıba ulaşmak için hiçbir faktöre uymayan 7 maddeyi dışlamak gerekti. Bu sonuçları sağlama örneklemi üzerinde doğrulayıcı bir faktör analizi yürüterek ve karşılaştırılabilir bir kalıp ve yine karşılaştırılabilir faktör yükleri elde ederek sınadık. Bu formun eş zamanlı geçerliği DP alt ölçek puanları ile anksiyete ve depresyon ölçek puanları arasındaki bağıntılar aracılığıyla kanıtlandı. Sonuçlar: Çalışma geçerli psikometrik özellikler göstermesine karşın ölçeğin duyarlığını değerlendirmek için çeşitli topluluklarda yapılmış daha ileri çalışmalara ihtiyaç vardır.

Dream Anxiety is an Emotional Trigger for Acute Myocardial Infarction

OBJECTIVE The aim of the present study was to investigate the relationship between nightmares and acute myocardial infarction (AMI) occurring during sleep, and also to evaluate the influence of several related factors. METHOD The sample comprised AMI patients who had been admitted to the coronary care unit. The patients were grouped into two categories; the asleep-AMI group consisted of 36 patients who had the onset of symptoms of AMI during sleep, and the awake-AMI group included 183 patients who had AMI while they were awake. The sleep quality and dream anxiety for the 1-month interval before AMI were assessed with Pittsburgh Sleep Quality Index (PSQI) and Van Dream Anxiety Scale (VDAS), respectively. RESULTS Asleep-AMI patients reported significantly poorer subjective sleep quality, significantly higher global PSQI scores, and displayed significantly higher nightmare frequency, difficulty in falling asleep after a nightmare, higher autonomic hyperactivity, dream recall frequency, daytime anxiety, psychological problems, and higher global dream anxiety scores than awake-AMI patients. CONCLUSION The present study suggests that sleep anxiety and related emotions are associated with AMI during sleep.