Omer Ozbulut

Ghrelin and leptin levels in patients with obsessive–compulsive disorder

To examine the importance of ghrelin and leptin in the pathogenesis of obsessive-compulsive disorder (OCD), we measured serum ghrelin and leptin levels, lipid profile and body mass index (BMI) in 43 patients with OCD and 20 healthy controls. The patients were divided into two subgroups according to whether DSM-IV OCD was accompanied with major depressive disorder (MDD) (OCD+MDD) or not (OCD-MDD). There was no statistically significant difference in ghrelin and leptin levels between groups. The OCD+MDD group had a trend of higher ghrelin levels and lower leptin levels than the OCD-MDD and control groups. There was a negative correlation between change in serum ghrelin and leptin levels only in the OCD+MDD group. Neither ghrelin nor leptin showed any correlation with severity of MDD and OCD. In conclusion, our results suggest that OCD is not associated with leptin or ghrelin levels. More comprehensive and detailed studies are needed to decipher the exact role of ghrelin and leptin in OCD.

Temperament and character profile in patients with essential hyperhidrosis.

Background/Aims: The main debates on hyperhidrosis are whether there are some personality features such as anxiety or stress, or whether the psychological symptoms are due to negative social feedback from early life. We aimed to investigate the temperament and character dimensions with a psychobiological inventory. Methods: We recruited patients with hyperhidrosis (n = 26) and chronic renal failure (n = 44) as well as healthy subjects (n = 22) from dermatology and nephrology clinics and the general population in Afyonkarahisar. All subjects were required to perform a temperament and character inventory. Results: The total novelty seeking score in hyperhidrosis was significantly lower than in controls. There was no significance in total harm avoidance scores between hyperhidrosis patients and controls. The total reward dependence and persistence scores were significantly higher in hyperhidrosis patients. The fear of uncertainty in the harm avoidance scale was found to be significantly greater in hyperhidrosis patients. Regarding character dimensions, the total score in each of the subscales self-directedness, cooperativeness and self-transcendence was found to be higher in hyperhidrosis patients. Conclusion: The higher scores of all subscales of character dimensions in hyperhidrosis patients suggest that hyperhidrosis is not related with social phobia or personality disorder.

Evaluation of physical fitness parameters in patients with schizophrenia

The aims of this study were to compare aerobic and anaerobic exercise capacities, pulmonary functions, body composition and fat distribution parameters in patients with schizophrenia and healthy controls and to investigate the associations among these parameters. Sixty (30 male, 30 female) patients with schizophrenia and 60 (30 male, 30 female) healthy controls were included in the study. Maximal aerobic capacity was estimated with the Astrand submaximal exercise protocol, and anaerobic performance was determined with a Wingate test. Body composition was established with a bioelectrical impedance analyzer. Pulmonary function tests, skinfold thickness and body circumference measurements were also carried out. Maximal aerobic capacity, maximal anaerobic power, anaerobic capacity and pulmonary function tests (forced vital capacity and maximal voluntary ventilation) were found to be lower in male and female schizophrenic groups as compared to the controls. Body fat percentage, waist and abdomen circumferences, and waist to hip ratio were found to be higher in female schizophrenic patients than in controls. We suggest that maximal aerobic capacity, maximal anaerobic power, and anaerobic capacity are poor in the schizophrenia patients as compared to healthy controls. Low cardiorespiratory fitness is related to reduced pulmonary function and impaired body composition in schizophrenia patients.

The prevalence of panic disorder in pregnant women during the third trimester of pregnancy

OBJECTIVE The principal aim of this study was to assess the current prevalence rate of panic disorder (PD) in pregnant women during the third trimester of pregnancy. The second aim of the present study was to investigate the clinical characteristics of PD in pregnant and nonpregnant women. METHOD The study data were gathered from 512 consecutive women in the third trimester of pregnancy who were admitted to the obstetric outpatient clinics of 2 university research centers. The diagnosis of PD was determined by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I disorders in the third trimester of pregnancy. Within the same period, the Panic and Agoraphobia Scale was used to determine the severity of PD. In addition, we compared the clinical characteristics of PD in gravid subjects (n = 13) with their control group. A control group was composed of 19 consecutive nonpregnant female outpatients diagnosed with PD who presented to the psychiatric outpatient clinics of the same hospitals. RESULTS The prevalence rate of PD was found to be 2.5% (n = 13) among the subjects in the third trimester of pregnancy. Of these 13 pregnant, 7 subjects reported that PD developed during the 6th to 28th weeks of their gestation, and the number of subjects who experienced PD symptoms before pregnancy was 6. In addition, there was no statistically difference between gravid and nongravid PD cases with regard to the severity of panic symptoms. CONCLUSION Our study suggests that PD may be common among pregnant females during the third trimester of pregnancy and seems to be associated with similar clinical features during gestation and nongestation.

Association analyses of depression, anxiety, and physical fitness parameters in Turkish obese adults.

OBJECTIVE This study aims to investigate the associations among depression, anxiety, aerobic exercise capacity, body fat percentage, sum of skinfolds, abdomen circumference, and waist to hip ratio on the basis of body mass index (BMI) in adults. METHODS The subjects of the study were 60 obese participants (30 women, 30 men) with BMIs over 30 kg/m{2}and 60 healthy controls (30 women, 30 men) with BMIs of 18-25 kg/m{2}. Body fat percentage was calculated from the skinfold thicknesses using the formula. Body circumference measurements were performed using a tape measure. Maximal aerobic capacity (VO(2)max) was determined by Astrand submaximal exercise protocol. Two self-reported questionnaires, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), were administered to all participants. RESULTS BMI, body fat percentage, sum of skinfolds, abdomen circumference, and waist to hip ratio were found to be higher in obese groups as compared to the controls, while VO(2)max (ml/kg/min) values were lower in both genders. In males, BAI scores and mild-level anxiety percentage values were higher in the obese group than in the control group. There was no significant difference for BDI scores and levels between the obese and control groups in both genders. There was also no significant difference in BAI scores and levels between the obese and control groups in women. CONCLUSION The fact that physical fitness being found poor in obese shows the existence of a condition that might constitute an increased tendency for obesity-related disorders. In addition, it was suggested that, in Turkey, attitudes toward obesity change depending on gender.

Phenomenology of Delusions and Hallucinations in Patients with Schizophrenia

ABSTRACTBackground: The aim of this study is to investigate the influence of living in different geographic regions of the same country on the phenomenology of schizophrenic delusions and hallucinations in two groups of schizophrenic patients.Methods: A total of 373 schizophrenic patients hospitalized in three different psychiatric hospitals in Turkey were recruited, and their delusions were classified by using the classification system developed by Huber and Gross. Patients were categorized with respect to regions in which they lived. Group 1 represented the Western region of Turkey, and group 2 represented the Central region of Turkey.Results: Delusions of persecution and reference were detected frequently in both genders and groups. Delusions of poisoning and erotomania were more prevalent in females than in males. The most frequent auditory hallucinations included hearing voices conversing and voices commenting. Seeing goblins was the most prevalent theme in visual hallucinations.Conclusions: The resu...

The impact of obsessive-compulsive disorder in pregnancy on quality of life

Aim. To examine the effects of obsessive-compulsive disorder (OCD) on quality of life in pregnant women. Material and method. Twenty-five pregnant women diagnosed as OCD in two university outpatient clinics were included for the study. Twenty-five pregnant women with no mental disorders and the same sociodemographic properties were taken as the control group. The diagnosis of OCD was confirmed with the DSM-IV Axis-I Disorders Structured Clinic Interview Diagnosis/Clinic Version (SCID-I/CV). In order to measure the severity of OCD Yale-Brown Obsession and Compulsion Scale was performed. Quality of life was evaluated by WHO (World Health Organisation) Life Quality Scale – Short Form (WHOQOL-Brief). Results. The whole subgroup of points of WHOQOL-Brief was significantly lower in OCD patients compared to control group (in all subgroups P<0.01). There was a negative correlation between the Y-BOCS obsession and compulsion subpoints and total points with the physical health (P <0.05), psychological health (P <0.001) and social relationship (P <0.01) of WHOQOL-Brief. No significant association was found with enviromental areas. Besides, there was a negative correlation between the duration of OCD and WHOQOL-Brief psychological health subarea (P <0.05). Conclusion. OCD negatively effects the quality of life in pregnant women and is correlated with the severity of the disorder.

Is valproate promising in cardiac fatal arrhythmias? Comparison of P- and Q-wave dispersion in bipolar affective patients on valproate or lithium–valproate maintenance therapy with healthy controls

Autonomic nerve system is considered to be involved in bipolar affective disorder (BAD) or to be influenced by valproate monotherapy or valproate plus lithium combination. We planned to assess the effects of medication on atrial and ventricular conduction. The electrocardiography records were performed with eligible 15 patients with valproate, 20 patients with lithium–valproate combination use in euthymic phases of BAD and 20 healthy participants. The blood valproate and lithium concentrations in groups were in normal range. The difference in P maximum, P minimum, maximum QTc were statistically insignificant. Minimum QTc (F = 6.36; df = 2; P = 0.003) and QT dispersion (QTD) (F = 5.57; df = 2; P = 0.006) were statistically significant among the groups. There were no significant differences between patient groups among ECG parameters. Minimum QTc was significantly longer in combination group than healthy controls, whereas the QTD values in both patient groups were significantly lower than controls’. Valproate might have some preventive effects on ventricular electrical conduction because of lower QTD in both patient groups. Thus, valproate seems to have cardiac conduction stabilizing effect beside its mood stabilizing aspect. However, this finding needs replication and further corroboration in well-designed studies.

Frequency of body dysmorphic disorder among patients with complaints of hair loss

Body dysmorphic disorder (BDD) is a psychiatric condition in which a disabling preoccupation with a non‐existent or slight defect in appearance is the main symptom. Hair concerns are frequent in patients with BDD.

Tardive dyskinesia with ziprasidone and citalopram use in an elderly female patient

Tardive dyskinesia (TD) is occasionally an irreversible condition caused by antipsychotic treatment. Second‐generation antipsychotics are considered to have less extrapyramidal effects, including causing TD. Herein, we present a case of TD following ziprasidone use. A 67 year‐old woman started to hear voices and ‘see’ people speaking to her, especially while praying. She presented to our clinic with anxiety, anhedonia, dysphoria, and auditory hallucinations. She was admitted with a diagnosis of depressive disorder with psychotic features. Citalopram 20 mg/day and ziprasidone 40 mg b.i.d. were started. After her symptoms had been relieved, the patient was was discharged and with monthly follow up. At her first visit 1 month after discharge, orofacial dyskinesia was found on physical examination. Ziprasidone may be associated with TD, even in someone who has never been exposed to a traditional neuroleptic. However, concomittant treatment with a serotonin reuptake inhibitor in the present case may have favored the appearance of TD.