Rıfat Karlıdağ

Total antioxidant capacity and total oxidant status in patients with major depression : impact of antidepressant treatment

Aim:  The purpose of the present study was to investigate whether total antioxidant capacity (TAC) and total oxidant status (TOS) are associated with major depressive disorder (MDD) and to evaluate the impact of antidepressant treatment on TAC and TOS in MDD.

Is there any role of Toxoplasma gondii in the etiology of obsessive-compulsive disorder?

Obsessive-compulsive disorder (OCD) is a common psychiatric illness. Although the aetiology of OCD is still unknown, the family-genetic data show that familial forms of OCD may be associated with a specific genetic susceptibility. Recent investigations have associated development of OCD with infectious illness. Toxoplasmic encephalitis (TE) is a common presentation of Toxoplasma gondii infection of the central nervous system (CNS). The most commonly affected CNS region in TE is the cerebral hemisphere, followed by the basal ganglia, cerebellum and brain stem. The basal ganglia has been implicated in the development of OCD. Therefore, in this study, it was aimed to investigate a possible association between Toxoplasma infection and OCD. We selected 42 patients with OCD and 100 healthy volunteers, and investigated the sero-positivity rate for anti-Toxoplasma IgG antibodies by Enzyme Linked Immunosorbent Assay (ELISA). The sero-positivity rate for anti-T. gondii IgG antibodies among OCD patients (47.62%) was found to be significantly higher than the rate in healthy volunteers (19%). This is the first report to examine a potential association between Toxoplasma infection and OCD. The main finding of the present study is an increased level of IgG antibodies to T. gondii in OCD patients when compared with the level in healthy controls. There might be a causal relationship between chronic toxoplasmosis and the aetiology of OCD.

Reduced P50 auditory sensory gating response in professional musicians.

Evoked potential studies have demonstrated that musicians have the ability to distinguish musical sounds preattentively and automatically at the temporal, spectral, and spatial levels in more detail. It is however not known whether there is a difference in the early processes of auditory data processing of musicians. The most emphasized and studied early process, especially for neuropsychiatric purposes, is sensory gating. The suppression percentage of the midlatency auditory evoked potential P50, and rarely the N100, wave is used for sensory gating studies. Our aim in this study was to investigate whether there was a difference in the auditory P50 and N100 suppression of control subjects who were professional musicians with no psychiatric problems. 34 professional musicians and 19 non-musicians (the control group) were included in this study. P50 and N100 measurements were taken, the suppression percentage of P50 and N100 was calculated and the results compared. Musicians showed significantly less P50 suppression when compared to non-musicians. There was no significant difference for N100 suppression. What the decreased P50 suppression in musicians when compared to non-musician subjects means, when we also take into account that N100 suppression is not decreased, and how it may contribute to the music perception and production processes of these persons is discussed.

The Effect of Agoraphobia on Oxidative Stress in Panic Disorder

We aimed to investigate whether agoraphobia (A) in panic disorder (PD) has any effects on oxidative and anti-oxidative parameters. We measured total antioxidant capacity (TAC), paraoxonase (PON), arylesterase (ARE) antioxidant and malondialdehyde (MDA) oxidant levels using blood samples from a total of 31 PD patients with A, 22 PD patients without A and 53 control group subjects. There was a significant difference between the TAC, PON, ARE and MDA levels of the three groups consisting of PD with A, PD without A and the control group. The two-way comparison to clarify the group creating the difference showed that the TAC, PON, and ARE antioxidants were significantly lower in the PD with A group compared to the control group while the MDA oxidant was significantly higher. There was no significant difference between the PD without A and control groups for TAC, PON, ARE and MDA levels. We clearly demonstrated that the oxidative stress and damage to the anti-oxidative mechanism are significantly higher in the PD group with A. These findings suggest that oxidative/anti-oxidative mechanisms may play a more important role on the pathogenesis of PB with A.

The changes in tear film parameters and impression cytology in heavily drinking men.

Purpose: To evaluate the tear film function and ocular surface changes in heavily drinking men. Methods: This prospective case–control study involved 35 male subjects with heavy alcohol consumption (group 1) and 35 age- and sex-matched control subjects (group 2). Best-corrected visual acuity measurement, slit-lamp examination, Schirmer I test, tear film break-up time (BUT) measurement, and conjunctival impression cytology were performed in all subjects. The results were compared between the 2 groups. Results: The mean Schirmer I test results in group 1 and group 2 were 8.31 ± 3.56 mm and 13.17 ± 5.71 mm, respectively, and the mean BUT values were 9.22 ± 3.10 seconds and 13.20 ± 4.04 seconds, respectively. The mean Schirmer I and BUT results were statistically lower in group 1 than in group 2 (P < 0.0001). The mean impression cytology scores in group 1 and group 2 were 2.08 ± 0.78 and 1.37 ± 0.94, respectively. A statistically significant difference was noted between the study and control groups for the grading of cytological changes (P = 0.001). Conclusions: Our data showed that heavily drinking men have decreased tear production, tear film instability, and significant degeneration of the ocular surface epithelium when compared with normal subjects.

Evaluation of sexual function in patients presenting with Behçet’s disease with or without depression

Aim  Sexual dysfunction has been found in many disorders that are chronic or disabling. The aim of this study was to evaluate the sexual satisfaction levels, sexual function and their relationship with the mental state in a group of patients being followed‐up with a diagnosis of Behçet’s disease (BD).

Recurrent priapism during quetiapine treatment

Priapism is defined as prolonged penile erection without sexual desire or stimulation. Since it is a urological emergency, serious consequences can occur if neglected. Different etiological factors including hemotopoetic disorders, malignancies, various drugs, perineal trauma, etc. can cause priapism. Drug induced priapism can occur during treatment with antispychotic medications. This report discusses a case of priapism, which occurred when the dose of quetiapine was increased.

Sympathetic skin response in premenstrual syndrome

Premenstrual syndrome is a term which includes a broad group of emotional, behavioral and physical symptoms that occur for several days before menses and subside following the menstrual period. Many women experience premenstrual syndrome symptoms, particularly physical ones such as breast tenderness and swelling. Approximately 5–10% women suffer from severe premenstrual syndrome and another 30–40% have moderate symptoms. Premenstrual syndrome continues to be an unsolved problem.In this study, we evaluated 24 premenstrual syndrome patients and 20 healthy women in the control group. The ages of the women were 22–34 years (mean ± SD: 25±3) for the premenstrual syndrome group and 23–34 (25±3) for the control group. The sympathetic skin response was recorded from the palms, soles and genital regions by using electrical stimuli to the median nerve at the wrist.The sympathetic skin response was recorded twice, in the follicular and late luteal phases of menstruation.The follicular and late luteal phase sympathetic skin response of the two groups were compared. The amplitudes and latency values of the late luteal and follicular phase sympathetic skin response from the premenstrual syndrome group and control group women were statistically similar. We also did not find any latency or amplitude difference in the sympathetic skin response obtained from the three regions of the premenstrual syndrome patients and the control group.We checked sympathetic skin response in the symptomatic (late luteal phase) and asymptomatic (follicular phase) periods of patients with premenstrual syndrome, a disorder known to have many autonomic symptoms, to determine whether there was sudomotor sympathetic involvement.The results of our PMS patients indicate at the very least that there is no difference with the control subjects as regards peripheral sudomotor functions.

The effect of body mass index on the sexual functions of morbidly obese female patients

The effect of body mass index on the sexual functions of morbidly obese female patients Objective: The aim of this study is to investigate whether morbidly obese female patients are suffering sexual dysfunction, in addition to analyzing the effect of body mass index (BMI) on sexual functions. Method: A total of 72 morbidly obese women admitted to the Endocrinology Department, whose BMI scores were 40 or over, and 28 healthy women age-matched with the morbidly obese group, whose BMI scores were under 30 were included in this study. Considering the effects on sexual functioning, the patients and the control group were evaluated by a psychiatric specialist. women with a psychiatric disorder according to DSM-5, taking medicines that could affect sexual functions, and those with a chronic physical or any neurological disease or being pregnant or breastfeeding were excluded from the study. A sociodemographic data form and the Arizona Sexual Experiences Scale (ASEX) were administered to both the treatment and control group. Results: Statistical analyses revealed that morbidly obese female patients more frequently suffered from sexual dysfunction compared to the control group. The Arizona Sexual Experiences Scale (ASEX) and all subscale scores except the sexual satisfaction rate were significantly higher in morbidly obese female patients than in the control group. There was no correlation found between the BMI and sexual function in the analyses conducted. Conclusion: In our study, morbidly obese female patients were found to show more impairments in all areas of sexual functions except sexual satisfaction rate when compared to the control group. Previous studies have suggested that obesity is the cause of sexual dysfunction in men; however, the same relationship could not be demonstrated in women. In a limited study of female patients, conflicting results were attributed to the inability to control variables. The fact that variables such as depression, anxiety, and chronic physical illness, which may affect sexual function, had been assessed in our study is important for accurately interpreting the findings. The data in our study reveals the importance of investigating sexual functions in morbidly obese female patients.

P50 sensory gating in patients with vaginismus

Objective: P50 sensory gating was investigated in patients with primary vaginismus (PV) with the hypothesis that interpreting coping capacities as a stress factor during sexual intercourse by perceiving unrelated stimuli and an impairment of the sensory information processing may be associated with fear/anxiety related to a possible pain in vulvovagina. Methods: A total of 35 patients who were diagnosed with PV and 29 healthy volunteers matched for age and gender underwent P50 recording in the neurophysiology laboratory and the results were compared. Results: The PV groups P50 gating ratio and S1 amplitude were statistically significantly lower than in the control group. Conclusion: Sensory gating is required for filtering the stimuli coming to the brain and developing an appropriate behavioral response. The reduced formation of an appropriate behavioral response in the PV group can lead to a perception of excessive and unrelated stimuli coming from internal and external environments and interpreting these as a stress factor exceeding the capacity to cope. Our study is the first to evaluate sensory gating in PV patients and new studies with larger patient groups are required.