Ömer Faruk Demirel

Recognition of emotional facial expressions and broad autism phenotype in parents of children diagnosed with autistic spectrum disorder

OBJECTIVE Research findings debate about features of broad autism phenotype. In this study, we tested whether parents of children with autism have problems recognizing emotional facial expression and the contribution of such an impairment to the broad phenotype of autism. METHOD Seventy-two parents of children with autistic spectrum disorder and 38 parents of control group participated in the study. Broad autism features was measured with Autism Quotient (AQ). Recognition of Emotional Face Expression Test was assessed with the Emotion Recognition Test, consisting a set of photographs from Ekman & Friesens. RESULTS In a two-tailed analysis of variance of AQ, there was a significant difference for social skills (F(1, 106)=6.095; p<.05). Analyses of variance revealed significant difference in the recognition of happy, surprised and neutral expressions (F(1, 106)=4.068, p=.046; F(1, 106)=4.068, p=.046; F(1, 106)=6.064, p=.016). CONCLUSION According to our findings, social impairment could be considered a characteristic feature of BAP. ASD parents had difficulty recognizing neutral expressions, suggesting that ASD parents may have impaired recognition of ambiguous expressions as do autistic children.

Serum levels of glial fibrillary acidic protein and Nogo-A in children with autism spectrum disorders

Abstract Context: Improved biomarkers would facilitate the diagnosis and treatment of autism spectrum disorders (ASD). Objective: Our objective was to examine the levels of Nogo-A and glial fibrillary acidic protein (GFAP) in children with ASD. Materials and methods: Serum concentrations of GFAP and Nogo-A were determined by enzyme-linked immunosorbent assay. Results: In this preliminary study, we found that serum Nogo-A was not found significantly different between groups, while serum levels of GFAP were significantly lower in ASD than controls. Discussion and conclusions: It will be of great interest to determine other potential causes of elevated serum levels of GFAP, and whether this elevation has any phenotypic effect.

Neurological soft signs in antisocial men and relation with psychopathy

Neurological soft signs (NSS) were studied in some axis-I disorders like schizophrenia, obsessive compulsive disorder, bipolar disorder, alcohol and substance abuse disorder. Aim of this study is detection of neurological soft signs in antisocial personality disorder and relation of these signs with psychopathy. The study was included 41 antisocial men and 41 healthy control subjects. Sociodemographic form, neurological evaluation scale and Hare psychopathy checklist was applied to the antisocial subjects, whereas sociodemographic form and neurological evaluation scale were applied to the controls. Antisocial men exhibited significiantly more NSS in total score and subgroups scales (p<0.05). It was shown that there was a significant association with psychopathy scores and NSS sequencing complex motor tasks (r=0.309; p=0.049) and NSS other tests subgroup scores (r=0.328; p=0.037). Similar relation was also observed in comparison between psychopathy subgroups. NSS accepted as being endophenotypes in schizophrenia, were also detected in antisocial group significantly more than controls in our study. Significant relationship between psychopathy and NSS may also hint the role of genetic mechanisms in personality development, though new extended studies with larger sample size are needed for clarification of this relationship.

Relationship between temperament, character and the autistic trait in parents of children with autistic spectrum disorder

Abstract Objective. Previous studies have revealed distinct features of autism, with higher harm avoidance and lower reward dependence and novelty seeking. It is assumed that high harm avoidance, and low novelty seeking, reward dependence, cooperativeness, and self-directedness are related with the broad autism phenotype, as seen in autistic individuals. Method. This study examined the association between the Temperament and Character Inventory (TCI) and the Autism Spectrum Quotient (AQ), in parents of children with ASD. Result. There was significant correlation between total AQ and total harm avoidance, cooperativeness, and self-directedness (p < 0.05). In the stepwise analysis, self-directedness and education emerged significantly (F(2,67) = 19.71, p < .005). This model modestly explained 35% of variance (Adjusted R2 = .350). Conclusion. Our findings suggest that self-directedness may be an autistic trait.

Decreased Expression of α-Synuclein, Nogo-A and UCH-L1 in Patients with Schizophrenia: A Preliminary Serum Study

Objective α-synuclein, Nogo-A and Ubiquitin C-terminal hydrolase L1 (UCH-L1) have neuromodulatory roles for human brain. Therefore, abnormalities of these molecules are associated with neuropsychiatric disorders. Although some serum studies in the other disorders have been made, serum study of α-synuclein, Nogo-A and UCH-L1 is not present in patients with schizophrenia and healthy controls. Therefore, our aim was to compare serum levels of α-synuclein, Nogo-A and UCH-L1 of the patients with schizophrenia and healthy controls. Methods Forty-four patients with schizophrenia who is followed by psychotic disorders unit, and 40 healthy control were included in this study. Socio-demographic form and Positive and Negative Syndrome Scale (PANSS) was applied to patients, and sociodemographic form was applied to control group. Fasting bloods were collected and the serum levels of α-synuclein, Nogo-A and UCH-L1 were measured by ELISA method. Results Serum α-synuclein [patient: 12.73 (5.18–31.84) ng/mL; control: 41.77 (15.12–66.98) ng/mL], Nogo-A [patient: 33.58 (3.09–77.26) ng/mL; control: 286.05 (136.56–346.82) ng/mL] and UCH-L1 [patient: 5.26 (1.64–10.87) ng/mL; control: 20.48 (11.01–20.81) ng/mL] levels of the patients with schizophrenia were significianly lower than healthy controls (p<0.001). Conclusion Our study results added new evidence for explaining the etiopathogenesis of schizophrenia on the basis of neurochemical markers.

Effectiveness of ultra-rapid dose titration of clozapine for treatment-resistant bipolar mania: case series

Treatment of severe and refractory manic episodes in hospital settings can occasionally be very difficult. In particular, severely excited patients showing aggressive, hostile, impulsive behaviours frequently require physical restraint and seclusion, high doses of antipsychotics and benzodiazepines, and sometimes, electroconvulsive therapy. Hospital stay is generally prolonged and such patients cause great emotional distress for other patients in the ward and clinical staff involved in their care. Here we report on three patients with a diagnosis of bipolar disorder and one patient with a diagnosis of schizoaffective disorder bipolar subtype, all of whom were hospitalized for severe manic episodes with psychotic features. These patients were extremely difficult to manage in the ward as no response could be obtained in the first week of treatment despite high doses of antipsychotics and benzodiazepine administration. The introduction and rapid titration of clozapine proved remarkably effective and was well tolerated in the acute management of these patients. We observed that clozapine had a superior and fast mood stabilization effect with rapid titration and could be extremely helpful in the management of such patients.

Increased serum levels of spectrin degradation products in patients with schizophrenia

Abstract Objective: Under various patho-physiological and physiological conditions, spectrin breakdown reactions generate several spectrin breakdown products of 120 kDa (SBDP120) and 145 kDa (SBDP145). Previous studies indicating that there is the existence of a raised breakdown of α-spectrin in schizophrenic left superior temporal cortices. In this study, we aimed to investigate serum levels of SBDP120 and SBDP145, which has not been previously examined, and investigate their relationships with clinical parameters in patients with schizophrenia. Methods: Forty-four patients with schizophrenia, followed by psychotic disorders unit, and 44 healthy controls, age and gender-matched volunteers with no psychiatric history, were included in this study. Sociodemographic form was applied to both groups. Turkish version of positive and negative syndrome scale (PANSS) were implemented to the patients. Serum SBDP120 and SBDP145 levels were determined by Enzyme-Linked Immuno Sorbent Assay. Results: Serum SBDP120 ng/mL and SBDP145 ng/mL levels of the patients with schizophrenia were significantly higher than healthy controls. Even more important, serum SBDP120 levels were positively correlated with PANSS scores in patients with schizophrenia. Conclusions: These findings may provide evidence for disturbance of neuroplasticity, membrane/cytoskeleton stability, dynamics, and remodelling in schizophrenia patients and support the neurogenerative theories for explaining the etiology of schizophrenia.

Total Tau and Phosphorylated Tau Protein Serum Levels in Patients with Schizophrenia Compared with Controls

Tau protein is located in the axons of neurons and in Alzheimer Disease, is abnormally phosphorylated and aggregates into paired helical filaments (neurofibrillary tangles) reflecting the degree of neurofibrillary pathology and neurodegeneration. Although tau and phosphorylated tau (p-Tau) pathology is a hallmark for dementia, few studies were performed in patients of schizophrenia. This preliminary serum study was designed to compare serum total tau and p-Tau levels of schizophrenia patients with healthy controls. The study was included 42 patients diagnosed with schizophrenia and 42 healthy control subjects. Sociodemographic form was applied to both groups and PANSS was applied to patient group. Serum total tau and p-Tau levels were measured by ELISA method. Total tau and p-Tau levels of patients were significantly lower than healthy controls. There was a positive correlation between amount of past electroconvulsive therapies and total tau level. However total tau and p-Tau levels were positively correlated. Our study results showed that serum total tau and p-Tau levels of patients with schizophrenia were significantly lower than healthy controls.

Do Low Serum UCH-L1 and TDP-43 Levels Indicate Disturbed Ubiquitin- Proteosome System in Autism Spectrum Disorder?

INTRODUCTION The mechanism of ubiquitination-related abnormalities causing neural development problems is still unclear. We examined the association between autism and serum transactive response DNA-binding protein-43 (TDP-43) and ubiquitin c-terminal hydrolase-L1 (UCH-L1) levels, both of which are members of the ubiquitin-proteosome system. METHODS We measured serum levels of TDP-43 and UCH-L1 in 24 children with autism and 24 healthy children. Childhood Autism Rating Scale (CARS) was used to assess symptom severity at admission. RESULTS The mean serum TDP-43 and UCH-L1 levels in children with autism spectrum disorder (ASD) were found to decrease compared to healthy controls (p<0.001, 506.21±780.97 ng/L and 1245.80±996.76 ng/L, respectively; 3.08±5.44 ng/mL and 8.64±6.67 ng/mL, respectively). A positive correlation between serum TDP-43 levels and UCH-L1 levels was found in the ASD group (r=0.947, n=24, p<0.001). The CARS score of children with ASD was 48.91 points (standard deviation [SD]: 5.82). CONCLUSION Low serum levels of UCH-L1 and TDP-43 may reflect disturbed ubiquitination in autism.

Postpartum depression in mothers of babies with infantile colic

Objective: Postpartum depression leads to mother-child relationship problems, impairment of maternal caregiving and parenting skills in both mother and child. Infantile colic (IC) is one of the important problems in early childhood. In this study we investigated the relationship between postpartum depression and IC. Method: In our study, mothers of infants younger than 3 months (n=102) were evaluated with Edinburgh Post Partum Depression Scale (EPDS). Results: EPDS mean scores of IC (n=55) group were significantly higher than those without IC (n=47) group (respectively, 12,7±4,8; 8,44±5,62) (p