Pınar Güzel Özdemir

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.

The comparison of aripiprazole and risperidone augmentation in selective serotonin reuptake inhibitor‐refractory obsessive‐compulsive disorder: a single‐blind, randomised study

To investigate the comparative efficacy of aripiprazole and risperidone as augmenting agents in the treatment of obsessive‐compulsive disorder (OCD) patients who did not show a ≥35% decrease in the Yale‐Brown Obsessive‐Compulsive Scale (Y‐BOCS) after 12‐week monotherapy with selective serotonin reuptake inhibitors (SSRIs).

Assessment of the effects of antihistamine drugs on mood, sleep quality, sleepiness, and dream anxiety

Abstract Objective. There are limited comparative studies on classic and new-generation antihistamines that affect sleep quality and mood. The purpose of this study was to determine and compare the effects of classic and new-generation antihistamines on sleep quality, daytime sleepiness, dream anxiety, and mood. Methods. Ninety-two patients with chronic pruritus completed study in the dermatology outpatient clinic. Treatments with regular recommended therapeutic doses were administered. The effects of antihistaminic drugs on mood, daytime sleepiness, dream anxiety, and sleep quality were assessed on the first day and 1 month after. Results. Outpatients who received cetirizine and hydroxyzine treatments reported higher scores on the depression, anxiety, and fatigue sub-scales than those who received desloratadine, levocetirizine, and rupatadine. Pheniramine and rupatadine were found to be associated with daytime sleepiness and better sleep quality. UKU side effects scale scores were significantly elevated among outpatients receiving pheniramine. Classic antihistamines increased daytime sleepiness and decreased the sleep quality scores. New-generation antihistamines reduced sleep latency and dream anxiety, and increased daytime sleepiness and sleep quality. Conclusion. Both antihistamines, significantly increased daytime sleepiness and nocturnal sleep quality. Daytime sleepiness was significantly predicted by rupadatine and pheniramine treatment. Cetirizine and hydroxyzine, seem to have negative influences on mood states. Given the extensive use of antihistamines in clinical settings, these results should be more elaborately examined in further studies.

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.

Relationships between posttraumatic stress disorder (PTSD), dissociation, quality of life, hopelessness, and suicidal ideation among earthquake survivors

Researches have demonstrated that Posttraumatic stress disorder (PTSD) is one of the most common stress reactions in the face of disasters and significantly associated with a broad range of trauma-induced sequelaes including anxiety, depression, suicidality as well as functional impairments. To date, though many aspects of risk factors with respect to the development and maintenance of PTSD have been addressed, mediating role of dissociation has received relatively less attention. In the present study, we examined relations of PTSD with quality of life, hopelessness, suicidal ideation, and mediational effect of pathological dissociation in these connections. 583 subjects most of whom experienced a severe earthquake participated in the study after two years of the disaster. We found that being female, being single, earthquake exposure, and having greater suicidal ideation were significant predictors of PTSD symptom severity. Role-Physical, Bodily-Pain, General Health and Role-Emotional subscales of the SF-36 were inversely associated with PTSD symptom severity. Pathological dissociation significantly mediated the substantial associations between predictors and PTSD symptom clusters. Chronic dissociation appears to put trauma exposed individuals in jeopardy of prolonged posttraumatic reactions by mediating the negative influences of risk factors in the face of experienced earthquake.

Psychometric properties of the Turkish version of the Sleep Hygiene Index in clinical and non-clinical samples

OBJECTIVE Sleep is one of the most significant of human behaviors, occupying roughly one third of human life. Sleep is a process the brain requires for proper functioning. Sleep hygiene can be described as practices to ease sleep and to avoid factors which decrease sleep quality. Inadequate sleep hygiene generally results in disturbance of daily life activities due to inability to sustain sleep quality and daytime wakefulness. Therefore, the importance of development and utilization of measures of sleep hygiene increases. The aim of the study was to assess psychometric properties of the Sleep Hygiene Index (SHI) in clinical and non-clinical Turkish samples. METHOD Data were collected from 106 patients with major depression consecutively admitted to the psychiatry clinic of Yüzüncü Yıl University School of Medicine and 200 were volunteers recruited from community sample who were enrolled at the university. The SHI, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) were administered to the subjects. Factor structure of the SHI was evaluated with explanatory and multi-sample confirmatory factor analyses. Pearson product-moment correlation coefficients of the SHI with the PSQI, ISI and ESS were computed. Item analyses, internal consistency coefficients and intra-class correlations between two repeated applications in both patient and healthy subjects were calculated. RESULTS The SHI revealed a unidimensional factor structure. Significant strong partial associations of the SHI with depression, insomnia and poor sleep quality and a modest partial association with sleepiness were detected. Cronbachs alphas for the SHI in community sample and patients with major depression were 0.70 and 0.71, respectively. Additionally, we found acceptable three-week temporal reliability in terms of intra-correlation coefficients of r=0.62, p<0.01 for the community sample and of r=0.67, p<0.01 among patients with major depression. CONCLUSION The SHI revealed adequate validity and reliability to be used by researchers in Turkish sample. Current results were discussed in light of previous findings and theoretical considerations.

Coping strategies and mood profiles in patients with multiple sclerosis

OBJECTIVE The aim of the present study was to investigate the coping strategies, mood characteristics and the association between these aspects in patients diagnosed with multiple sclerosis and healthy subjects. METHOD Fifty consecutive patients who were diagnosed with multiple sclerosis according to McDonald criteria and thirty-one healthy subjects were included in the study. In addition to the sociodemographic form, Expanded Disability Status Scale (EDSS), Coping Orientation for Problem Experiences Scale (COPE), and Profile of Mood States (POMS) tests were applied to the participants. RESULTS Non-functional coping strategies were significantly higher in the secondary-progressive type (p≤0.05). Depression-dejection, fatigue-inertia and total POMS scores were significantly higher in the secondary-progressive type (p≤0.05). CONCLUSION The results of our study demonstrate the importance of rehabilitation programs that encourage exercise among patients with multiple sclerosis to increase vigor-activity levels.

Chronotypes and oxidative stress: is there an association?

Human studies suggest that free radicals and antioxidant enzymes can alter according to age, lifestyle, environment, and habits. Individuals having a marked circadian preference, that is, morning type or evening type, differ on a number of psychological, behavioral, and biological variables. The aim of this study was to determine whether chronotype impacts some parameters of oxidant and antioxidant status. For this purpose, glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and myeloperoxidase (MPO) activities and the levels of reduced glutathione (GSH) and malondialdehyde (MDA) were measured in 96 healthy volunteers (including 32 morning-type, 32 intermediate-type, and 32 evening-type individuals), aged between 21 and 26 years. There were no significant relationships between the chronotypes with regard to oxidant and antioxidant parameters. Our results indicated that the levels of GSH and MDA as well as the activities of GSH-Px, MPO, and SOD were not influenced by the individual circadian differences in our sample. These results were discussed using the theoretical concepts of age-related factors, and suggestions for further research presented.

Migren ve gerilim tipi başağrısı olan bayan hastalarda kişilik özellikleri ve baş etme yöntemleri

Amaç: Stres ve anksiyete baş ağrılarının en sık tetikleyicileridir. Kişilik özellikleri ve başa çıkma yöntemleri bireylerin strese verdiği yanıtı etkiler. Yapılan çalışmalarda kaygılı ve depresif kişilik özelliklerinin başağrısına yatkınlık oluşturabileceğini, başağrısı olan hastaların işlevsel olmayan başa çıkma yöntemlerini daha sık kullandıklarını göstermiştir. Bu çalışmada migren ve gerilim tipi başağrısı olan bayan hastalarda başa çıkma yöntemlerinin ve kişilik özelliklerinin incelenmesini amaçlamıştır. Yöntem: Çalışmaya 45 migren, 45 gerilim tipi baş ağrısı olmak üzere toplam 90 hasta ve 42 sağlıklı gönüllü alınmıştır. Katılımcılara Görsel Analog Skala, Başa Çıkma Tutumlarını Değerlendirme Ölçeği (COPE), Eysenck kişilik anket / Revize Kısaltılmış Formu, Beck Depresyon Ölçeğive Beck Anksiyete ölçeği uygulanmıştır. Bulgular: Migren ve gerilim tipi baş ağrısı olan hastalarda sağlıklı bireylere kıyasla anksiyete ve depresyon düzeylerinin daha yüksek olduğu bulundu. Ayrıca, bu hastaların kontrol grubuna göre daha yüksek nörotizm puanlarına sahip olduğu tespit edildi. Migren hastalarında COPE alt ölçeklerinden yararlı sosyal destek kullanımı puanlarının kontrol grubuna kıyasla daha düşük, dini olarak başa çıkma düzeylerinin daha yüksek olduğu bulundu. Gerilim tipi baş ağrısı olan hastalarda ise aktif başa çıkma puanlarının kontrol grubuna göre daha düşük olduğu bulundu. Sonuç: Bu sonuçlar migren ve gerilim tipi baş ağrısı olan hastaların sağlıklı bireylerle karşılaştırıldığında aktif başa çıkma yöntemleri daha az kullandıklarını, daha fazla nevrotik kişilik özelliklerine sahip olduklarını, ayrıca daha yüksek depresyon ve anksiyete düzeylerine sahip olduklarını göstermektedir. Sözkonusu etkenler başağrılarının başlamasında, tetiklenmesinde ve şiddetinde önem taşıyabilir.

The relationship between atypical depression and insülin resistance in patients with polycystic ovary syndrome and major depression

In this study, we aimed to examine the relationship between atypical depression and insulin resistance (IR) in patients with polycystic ovary syndrome (PCOS) and major depression. A total of 176 subjects (69 patients with PCOS, 58 patients with depression, and 49 healthy controls) were included in the study. The Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Beck Hopelessness Scale (BHS), and the Scale for Suicide Ideation (SSI) were administered. Data concerning their height, weight, fasting a.m. serum levels of insulin, glucose level, and total testosterone level were collected from all participants. The body mass index (BMI) and the Homeostasis Model Assessment Insulin Resistance index (HOMA-IR) were both calculated. 34 (49.3%) of the PCOS patients met the criteria for depression. 26 (76.5%) of them had atypical depression, 8 (23.5%) had non-atypical depression. 27 (46.6%) of the 58 depressed patients had atypical depression. Insulin resistance was higher in the PCOS patients than in the control subjects and the depression patients. There was no association between atypical depression and IR in patients with PCOS and depression. We concluded that there is no relationship between IR and atypical depression.