Neslihan Akkisi Kumsar

Relationship Between Craving and Ghrelin, Adiponectin, and Resistin Levels in Patients with Alcoholism

BACKGROUND Alcoholism is a leading cause of mortality and morbidity. The most widely accepted hypothesis of its etiology is multidimensional and includes biological, psychological, and sociological factors. The biological factors have been the focus of investigation. In recent years, pathways related to nutrition and the relationship between alcohol addiction and craving have been studied. Our aim was to explore the relationship between the appetite hormones (adiponectin, ghrelin, and resistin) and alcohol craving. METHODS Blood samples were obtained from 107 male patients over a 7-day period. Levels of adiponectin, resistin, and ghrelin, the Obsessive Compulsive Drinking Scale (OCDS) score, and the Penn Alcohol Craving Scale (PACS) score were assessed on days 0 and 7. Adiponectin, resistin, and ghrelin levels were also tested in 83 healthy males in the control group. RESULTS The sample group consisted of 190 males (107 patients and 83 healthy controls). Comparison of alcohol craving scales with biological markers in the patient group showed a positive correlation between adiponectin levels and the OCDS compulsive subscale scores, and a positive correlation between ghrelin levels and the OCDS total and compulsive subscale scores and the PACS resistance subscale scores. Resistin levels were negatively correlated with the OCDS total, obsessive subscale, and compulsive subscale scores. CONCLUSIONS Although we did not observe a significant relationship between craving and any of the 3 biomarkers on day 0, craving was positively correlated with the levels of adiponectin and ghrelin and negatively correlated resistin levels on day 7. Our findings support the hypothesis that appetite hormones are trait markers for alcohol craving. Nevertheless, more conclusive results require future studies that evaluate the relationship between these hormones and withdrawal/detoxification period or long-term soberness.

Testosterone Levels and Sexual Function Disorders in Depressive Female Patients: Effects of Antidepressant Treatment

INTRODUCTION Women suffer from depression more frequently than men, which indicates that sex hormones might be involved in the etiology of this disease. AIMS The purpose of this study was to assess the relationship between testosterone and depression pathophysiology in depressive women along with sexual function. We also investigated whether antidepressant treatment causes any change in levels of this hormone or in sexual function. METHODS Premenopausal female patients aged 25-46 years (n = 52) with diagnosed major depression were included in this study as the patient group, and 25- to 46-year-old premenopausal women without depression (n = 30) were included as the control group. MAIN OUTCOME MEASURES Serum testosterone and sex hormone-binding globulin (SHBG) levels were measured twice, before and after the antidepressant treatment. Bioavailable testosterone (cBT) levels were calculated using the assay results for total testosterone (TT), SHBG, and albumin according to the formulas of Vermeulen et al. Depression severity was measured using the 17-item Hamilton Depression Rating Scale, and sexual function was evaluated with the Arizona Sexual Experience Scale. RESULTS The mean TT and cBT levels significantly increased in the patient group after the antidepressant treatment (P < 0.001). Pre-treatment TT and cBT levels were significantly lower in the patient group than in the control group (P < 0.001). Similar results were obtained for post-treatment serum TT and cBT levels in the patient and control groups (P > 0.05). There were no significant differences among the groups in terms of SHBG level. CONCLUSION The low testosterone levels in depressed women compared with women in the control group and the elevated levels post-pharmacotherapy suggest that testosterone may be involved in depression.

Impulsivity in bipolar and substance use disorders

BACKGROUND Bipolar disorder (BD) is commonly associated with increased impulsivity, particularly during manic and depressed episodes; also impulsivity remains elevated during euthymic phases. Impulsivity is also a factor in the initiation and maintenance of substance use disorders (SUD). Impulsivity can predispose to substance abuse or can result from it. Impulsivity appears to be relatively independent of mood state and is higher in individuals with past substance use. Thus, we wanted to compare the impulsivity of BD and SUD closely associated with impulsivity and identify potential differences. METHODS Impulsivity was evaluated by the Barratt Impulsiveness Scale (BIS-11A), in 35 bipolar interepisode disorder male patients without comorbid substance use disorder and 40 substance use disorder male patients. The BIS-11A mean scores for the two groups were compared through one-way between-groups ANOVA. RESULTS There was no difference between the BD and substance use disorder groups on total and subscale attentional, motor impulsivity measures. However, for the male patients there was difference on the nonplanning subscale. The male BD patient group scored higher than the male substance use disorder patient group regarding nonplanning impulsivity. CONCLUSIONS Our results replicate the findings that interepisode BD and substance use disorder patients both have increased total impulsivity; furthermore, the findings also indicate that trait impulsivity is not completely the same in subscales. Both groups were similar on attention and motor impulsivity subscales; however, on the nonplanning subscale, BD patients were more impulsive than the substance use disorder patients.

Addiction profile in probation practices in Turkey: 5-year data analysis.

Introduction While drug addiction is a global problem, it is important for every region to know the general features of its own addicts in order to develop effective treatment programs. This study presents sociodemographic data of the individuals diagnosed with drug addiction. Methods In this study, data of the patients between the years of 2009 and 2014 were retrospectively analyzed. The patients were assessed at psychiatry polyclinics according to probation practices of drug abuse. The study involved 513 patients in whom drug positivity was detected in urine analysis at least once and whose diagnoses were confirmed with a clinical interview. Results According to this study, a majority of the addicts were detected in 2013. Males made up 98.2% of the sample population, their average age was 32.12±10.21 years, and minimum and maximum ages for the first drug use were 7 years and 45 years, respectively. Marijuana use was found in 90.8% of the patients, 90% of them were living with their families, and 59.6% of them held a regular job. Treatment response was related with age of first use of drugs, duration of use drugs, and prior treatment anamnesis of the patients. Conclusion In this study, it was determined that the drug which was most frequently was used marijuana. The risk of drug addiction can affect any individual in society, regardless of their education, occupation, or social support levels. Alternative treatment models, especially for chronic and long-term users, should be researched.

Relation of addiction with dopamine 2 receptor (DRD2) TaqIA polymorphism in heroin addicts

Objective: To understand the etiologic reasons of heroin addiction will make an important contribution to the prevention and treatment of this disease. It is thought that DRD2 TaqIA gene polymorphism affects the reward system by causing hyperdopaminergic activity and thereby might also lead to the development of substance addiction. The purpose of this study is to examine the possible relation between TaqIA polymorphism and heroin addiction. Methods: One hundred patients, who applied to Ankara Numune Hospital Alcohol and Substance Treatment and Training Centre for treatment and were diagnosed with heroin addiction as a result of the clinical evaluation that was conducted in accordance with DSM-IV were included in this study. One hundred healthy volunteers, who accepted to participate in the study as the control group and were matched with the patient group in terms of age and gender, were involved. Results: There was no statistically significant difference between the patient and control groups in terms of A1 allele carrier. As a result of the evaluation that was performed by dividing the patient group into two groups according to A1 allele carrier, no statistically significant relation was determined between the substance-use features and A1 allele. Conclusion: DRD2 TaqIA polymorphism, which is known to be associated with reward pathways, cannot be a genetic factor that is effective on the development of heroin addiction alone and it is required to consider different genes and gene-gene interactions in broader sample groups in order to determine the genetic factors causing the addiction.

Erişkin başlangıçlı hallervorden-spatz sendromunun psikiyatrik yönleri: İki olgu sunumu

Psychiatric aspects of adult-onset hallervorden-spatz syndrome: a report of two cases Hallervorden-Spatz Syndrome (HSS) is a rare, familial, progressive, and ultimately fatal disorder characterized by extrapyramidal rigidity, dysarthria, pyramidal tract involvement, and dementia, with pathological evidence of iron deposition in the globus pallidus and substantia nigra. The diagnosis is usually made using magnetic resonance imaging (MRI), where bilateral high signal intensity in the globus pallidus surrounded by low signal intensity areas is found. This is called an “eye-of-the-tiger” appearance and is considered specific to this disorder. Psychiatric aspects of this syndrome are common and include cognitive decline, personality changes with impulsivity and violent outbursts, depression and emotional

Clozapine-Induced Febrile Neutropenia and Cellulitis

SUMMARY Clozapine is one of the atypical antipsychotics and is frequently prescribed to patients with treatment-resistant schizophrenia. Agranulocytosis is a major side effect that may lead to death, which limits its use. This is a case report of a patient that developed febrile neutropenia and cellulitis after treatment with clozapine for 20 weeks.