Nazmiye Kaya

Axis I and Axis II psychiatric disorders in patients with fibromyalgia

OBJECTIVE To determine the current prevalence of Axis I and Axis II psychiatric disorders in patients with fibromyalgia. METHOD The study sample includes 103 patients with fibromyalgia and 83 control subjects. Axis I and Axis II disorders were determined by structured clinical interviews. RESULTS The rate of any Axis I psychiatric disorder (47.6% vs. 15.7%), major depression (14.6% vs. 4.8%), specific phobia (13.6% vs. 4.8%), any Axis II disorder (31.1% vs. 13.3%), obsessive-compulsive (23.3% vs. 3.6%) and avoidant (10.7% vs. 2.4%) personality disorders were significantly more common in the patient group compared to the control group. CONCLUSION Our results suggest that a considerable proportion of patients with fibromyalgia also present with Axis I and Axis II psychopathologies.

Quality of life, family burden and associated factors in relatives with obsessive–compulsive disorder

OBJECTIVE The aim of this study is to assess the quality of life (QoL), family burden and psychiatric disorders in first-degree relatives of patients with obsessive-compulsive disorder (OCD) and to compare them with healthy controls and their relatives. METHODS Forty patients with OCD and 47 of their first-degree relatives as well as 40 healthy subjects and 45 of their first-degree relatives were recruited in this study. OCD and comorbid anxiety or mood disorders were determined by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders. Comorbid Axis II disorders were diagnosed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition Personality Disorders. Type and severity of obsessive-compulsive symptoms were assessed with the Yale-Brown Obsessive-Compulsive Scale, and the disability of patients with OCD was evaluated with the WHO DAS II. Family burden and QoL in the relatives were evaluated with the Zarit Burden Interview (ZBI) protocol and the World Health Organization Quality of Life Assessment-Brief, respectively. RESULTS The mean ZBI score of family members of OCD patients was higher than the control relatives. Linear regression analysis indicated that the independent factors associated with ZBI were duration of OCD, comorbid major depressive disorder and poorer insight. Compared with those of control relatives, the QoL of relatives of patients with OCD was significantly lower in all domains. While the diagnosis of major depressive disorder in relatives of OCD patients was significantly higher than the control relatives, the diagnosis of any anxiety disorder did not differ. CONCLUSIONS Our study provides evidence that OCD not only affects the lives of patients but also their family members.

Maternal generalized anxiety disorder during pregnancy and fetal brain development: A comparative study on cord blood brain-derived neurotrophic factor levels

OBJECTIVES The study aimed to investigate whether maternal GAD during pregnancy affects fetal circulating brain-derived neurotrophic factor (BDNF), which plays important roles in neuronal development, by comparing cord blood BDNF levels in newborn infants of women with and without GAD. METHODS Study sample included 19 women with GAD and 25 women without any psychiatric disorder. GAD and other psychiatric diagnoses were screened by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The blood sample for the determination of BDNF level was obtained from the umbilical cord during delivery. RESULTS Cord blood BDNF levels in newborn infants of healthy women were approximately two-fold compared to newborn infants of women with GAD, and the difference was statistically significant. The duration of GAD during pregnancy was the only variable correlating with cord blood BDNF levels. CONCLUSIONS The study results imply that prolonged maternal GAD during pregnancy may negatively influence neurodevelopment of the fetus through lower levels of circulating BDNF.

One year follow-up of post-partum-onset depression: the role of depressive symptom severity and personality disorders

Objective. Long-term follow-up and risk factors of persistent post-partum depression (PPD) are fairly unknown compared with its prevalence in the developing countries. In this study, we did a follow-up measure of PPD and examined the factors, which were associated with PPD 1-year post-partum. Method. Our sample comprised of 34 women. Depressive symptoms were assessed by the Edinburgh post-natal depression scale (EPDS) 6 weeks post-partum, and women with scores >12 on this scale was categorised as depressed. Personality disorders were determined at the same occasion by means of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II). One year post-partum EPDS was completed. Results. The rate of PPD 1-year post-partum was 32.4%, and it was unrelated to age at assessment, primiparity, number of children, employment status, economical status and educational level. Women depressed 1-year post-partum had significantly higher basal scores of EPDS and more often also a diagnosis of any axis II disorder; and specifically dependent and obsessive-compulsive personality disorders. In our sample, the predictors of 1-year post-partum PPD were having higher basal score of EPDS and the existence of a personality disorder. Conclusion. This study suggests that women with PPD, scoring high in the EPDS scale 6 weeks post-partum and having a personality disorder, run a higher risk for depression at 1-year follow-up.

Neuroinflammation in the fetus exposed to maternal obsessive–compulsive disorder during pregnancy: A comparative study on cord blood tumor necrosis factor-alpha levels

OBJECTIVE The relationship between maternal psychiatric disorders and fetal neurodevelopment is unclear. Obsessive-compulsive disorder (OCD) is relatively frequent during pregnancy. The study aimed to investigate whether maternal OCD during pregnancy affects fetal circulating tumor necrosis factor-alpha (TNF-α) levels, an important pro-inflammatory cytokine, by comparing cord blood TNF-α levels in newborn infants of women with and without OCD. METHODS The study sample included 7 women with OCD and 30 healthy women. OCD and other psychiatric diagnoses were screened by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The blood sample for the determination of TNF-α level was obtained from the umbilical cord during delivery. RESULTS Cord blood TNF-α levels in newborn infants exposed to maternal OCD were significantly higher compared to non-exposed infants. Maternal anxiety symptom level was found to positively correlate with cord blood TNF-α levels in newborn infants of women with OCD. CONCLUSION The study results imply that maternal OCD during pregnancy may lead to neuroinflammation in the developing fetal brain through higher levels of circulating TNF-α.

The roles of BDNF, S100B, and oxidative stress in interferon-induced depression and the effect of antidepressant treatment in patients with chronic viral hepatitis: A prospective study

OBJECTIVE The aim of the study was to research the relationship between interferon (IFN) induced depression and sociodemographic characteristics, neurotrophic factors and oxidative stress. METHODS Sixty four cases, 34 with Chronic Hepatitis B (CHB) and 30 with Chronic Hepatitis C (CHC), were included in the study. The patients were assessed with Structured Clinical Interview for DSM-IV (SCID-I), Hamilton Anxiety Rating Scale (HARS) and Hamilton Depression Rating Scale (HDRS) at baseline on the 2nd and 6th weeks of treatment. S100 calcium binding protein B (S100B), brain-derived neurotrophic factor (BDNF), total antioxidant status (TAS) and total oxidative stress (TOS) levels were measured at the same visits. RESULTS In total, 20 patients were diagnosed with major depression (MD) on the sixth week. A significant relationship was found between depression developed after IFN therapy and baseline HARS scores and the type of IFN-α. When the pretreatment levels of HDRS, HARS, S100B, BDNF, TAS, and TOS were compared to those after treatment on the 2nd week, there was a significant increase in HDRS and HARS levels and a significant decrease in the levels of S100B and BDNF. No significant change was determined for TAS and TOS levels. CONCLUSIONS Our study suggests that the pathogenesis of IFN induced depression may involve neurotrophic factors.

Psychiatric disorders in patients with Behçet's disease

Objective. In this study, we aimed to investigate current prevalence and related clinical factors of psychiatric disorders in Behçet patients. Methods. Seventy-three outpatients who applied to a Behçet clinic and whose diagnosis was Behçets disease according to criteria of the International Study Group for Behçets disease were recruited in this study. Psychiatric diagnoses were assessed with The Structured Clinical Interview for DSM-IV/Clinical Version (SCID-I/CV). Results. Thirty patients (41.1%) reported at least one current psychiatric disorder. Major depression (17.8%) was the most frequent psychiatric disorder. Specific phobia (16.4%), generalized anxiety disorder (15.1%) and social phobia (9.6%) were other frequent disorders. Prevalence rates of any psychiatric and anxiety disorder were significantly higher in females than males. There was no significant relationship between psychiatric morbidity and clinical characteristics of Behçets disease. Conclusion. Our study suggests that Behçet patients have high prevalence of psychiatric disorders. Therefore, psychiatric evaluation should be performed in all patients with Behçets disease.