Salih Selek

Elevated serum nitric oxide and superoxide dismutase in euthymic bipolar patients: impact of past episodes.

Nitric oxide (NO) has been implicated to play a role in the pathogenesis of many neuropsychiatric disorders. NO level was found high in acute manic inpatients. In this study, we aimed to assess NO level and activity of the antioxidant enzyme, superoxide dismutase (SOD), in euthymic bipolar patients. Twenty-seven patients with bipolar disorder (BD) in euthymic phase, and 20 healthy volunteers were included in this study. A semi-structured form was used to note social, demographic and clinical parameters of the patients. NO level and SOD activity were studied in the serum samples obtained from the patients and controls. The mean serum NO level in BD was significantly higher than in controls. Mean serum SOD activity was found to be elevated in patients with BD compared to controls. Total number of the manic episodes correlated with NO levels, but not with SOD activity. In conclusion, the number of manic episodes is positively associated with NO levels. NO and SOD appear to have a pathophysiological role in BD, especially in Type I euthymic phase, and may be considered an available trait marker for BD.

Oxidative imbalance in obsessive compulsive disorder patients: A total evaluation of oxidant–antioxidant status

OBJECTIVES Various psychological, social, genetic, biochemical, factors are to be involved in the etiology of OCD. Some molecules of free radicals are also found to play role in OCD. To the best of our knowledge, there has been no study, regarding the role of free radicals in the pathogenesis of OCD, from a general antioxidant aspect of view. Therefore, in this present cross-sectional study, we aimed to assess whether antioxidant-oxidant status is associated with OCD and can be used or not as a biological marker regarding that disorder. METHODS 37 OCD patients diagnosed according to DSM-IV and as control group forty healthy subjects were included to the study. Venous blood samples were collected once. The total oxidant status, antioxidant status and oxidative stress index of the plasma were measured using a novel automated colorimetric measurement method. RESULTS There was not a significant difference between only OCD and all patients in all measures (TOS: Z = - 1.453, p = 0.521; TAS: Z = - 0.151, p = 0.880; OSI: Z = - 0.679 p = 0.497). TAS levels were both higher than controls in only OCD groups and all patients (Z = - 5.538, p < 0.001 and Z = - 6.394, p < 0.001 respectively). TOS and OSI of both patient groups were significantly lower than controls (TOS: Z = - 5.131, p < 0.001; OSI: Z = - 5.105, p < 0.001 and TOS: Z = - 5.979, p < 0.001; OSI: Z = - 5.862, p < 0.001). In only OCD group, illness duration was correlated with TOS and OSI (r(0) = 0.44, p = 0.023, n = 26 and r(0) = 0.44, p = 0.026, n = 26 respectively) but not with TAS. CONCLUSION Our study found an overall oxidative imbalance shifted towards antioxidant side in OCD which may be due to either a rebound phenomenon or chronicity of the condition.

Oxidative imbalance in adult attention deficit/hyperactivity disorder.

OBJECTIVE There are few studies evaluating the biochemical basis of adult attention deficit/hyperactivity disorder (A-ADHD). In the present study, we evaluated whether nitric oxide (NO), an oxidant, level and superoxide dismutase (SOD), an antioxidant, activity are associated with A-ADHD or not. METHODS Twenty A-ADHD patients from Gaziantep University Sahinbey Research Hospital, Psychiatry Clinic, diagnosed according to The Turkish version of Adult ADD/ADHD DSM IV-Based Diagnostic Screening and Rating Scale by two psychiatrists (H.A.S. and S.S.), and twenty-one healthy volunteer controls were included. Blood samples were collected; NO levels and SOD activities were measured. RESULTS The mean NO levels in patients were significantly higher than those of controls and SOD activity of patients was significantly lower than controls. CONCLUSIONS Remarkable high levels of oxidant NO, and low SOD activities suggest an oxidative imbalance in A-ADHD. This is the first study evaluating the oxidative metabolism in A-ADHD.

Role of Oxidative and Antioxidative Parameters in Etiopathogenesis and Prognosis of Panic Disorder

Free radicals have been implicated in some psychiatric disorders. This study aimed to investigate the role of oxidative and antioxidative parameters in etiopathogenesis and prognosis of panic disorder (PD), using novel methods for measurement of total oxidant and antioxidant statuses. Nineteen PD patients and 40 healthy subjects were recruited. Both total antioxidant status and oxidative stress index, and ceruloplasmin levels of PD patients were significantly higher in PD patients. Total oxidant status and oxidative stress index decreased after treatment. This study suggests an oxidative imbalance in PD and treatment can reverse overall oxidative imbalance.

Reduced PON1 enzymatic activity and increased lipid hydroperoxide levels that point out oxidative stress in generalized anxiety disorder.

In recent years, there has been an increasing focus on generalized anxiety disorder (GAD) which is one of the most prevalent mental disorders in general population. Psychological, genetic, neurobiological, and neurochemical factors are believed to play role in the etiopathogenesis of GAD. The role of oxidative stress, as a neurochemical cause, in various anxiety disorders has been studied in recent years; however, it has not been thoroughly studied in GAD, yet. In this paper, we aimed to evaluate the serum levels of lipid hydroperoxide (LOOH), paraoxonase, and arylesterase in GAD patients without any co-morbid psychiatric disorders and investigate their diagnostic performance. Blood samples were collected from 40 GAD patients and 40 healthy control subjects to measure their serum LOOH levels, arylesterase and paraoxonase activities. Obtained results have been compared between groups and receiver operating characteristic (ROC) curve has been drawn for diagnostic performance of measured biochemical markers. Positive and negative predictive values have been estimated where appropriate. Mean LOOH level of the GAD patients was significantly higher than that of control subjects (t=-5.49, p<0.001), whereas, mean paraoxonase activity was lower in these patients (t=3.056, p=0.03). GAD could be predicted for LOOH level over 7.740 μmol/l with 92.5% positive predictive value and 92% negative predictive value. Increased LOOH level and decreased paraoxonase activity of GAD patients may suggest increased lipid peroxidation and oxidative stress in these patients. LOOH levels may be a state marker for diagnosing GAD.

Evaluation of several micro RNA (miRNA) levels in children and adolescents with attention deficit hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent childhood disorders, although disorders etiology and pathogenesis remains unknown, several theories about ADHD development have been proposed and many researchers believe that it is caused by both genetic and environmental factors. In this study we evaluated miR18a-5p, miR22-3p, miR24-3p, miR106b-5p, miR107, miR125b-5p and miR155a-5p levels in child and adolescent ADHD patients. The research sample consisted a group of 52 ADHD patients, and 52 healthy volunteer controls. There was no significant difference in age and sex between the two groups (p>0.05). miRNA 18a-5p, 22-3p, 24-3p, 106b-5p and 107 levels were statistically significantly decreased in ADHD patients(p<0.05). miRNA 155a-5p levels were increased in patients group (p<0.05). The positive predictive value (PPV) and negative predictive value of miR107 was estimated for the cutoff point of 0.4480. PPV was 70% and NPV was 86.5% for the taken cut off point. There could be a close relationship between levels of circulating miRNAs and ADHD. If we could understand how the signaling pathways arranged by miRNAs, impact on CNS development, function and pathology this can improve our knowledge about ADHD etiology and treatment.

Lipid peroxidation markers in adult attention deficit hyperactivity disorder: new findings for oxidative stress.

Malondialdehyde (MDA) is a reliable marker of lipid peroxidation where paraoxonase and arylesterase are two enzymes against it. Although increased MDA has been previously shown in adults with attention deficit/hyperactivity disorder (A-ADHD), levels of paraoxonase and arylesterase enzymes have not been studied yet. We aimed to determine the status of both MDA level and paraoxonase and arylesterase enzyme activities in A-ADHD patients. A total of 35 adults with ADHD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) criteria and 29 healthy volunteers were included in the study. Serum MDA, paraoxonase and arylesterase levels of the participants were measured. The disease severity of the patients was determined by using Turgays Adult Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD) DSM IV Based Diagnostic Screening and Rating Scale. The serum MDA level of patients was significantly higher than that of healthy control subjects, whereas their paraoxonase and arylesterase levels were significantly lower. There was no correlation between the levels of biochemical parameters (MDA, paraoxonase and arylesterase) and the disease severity. Sub-types of A-ADHD were similar in terms of these biochemical parameters. Increased lipid peroxidation, a part of oxidative stress, in adults with ADHD appears to be unbuffered by antioxidant enzymes, namely paraoxonase and arylesterase.

Improvement of restless legs syndrome and trichotillomania with aripiprazole

The case report describes a 39‐year‐old woman with restless legs syndrome (RLS) and trichotillomania (TTM). She was treated with venlafaxine and clonazepam with partial remission of RLS and no response for TTM. When aripiprazole was added to the clonazepam both RLS and TTM fully remitted. We suggest that aripiprazole might be worth investigating for treatment of these disorders.

High ceruloplasmin levels are associated with obsessive compulsive disorder: a case control study

BackgroundAlterations in ceruloplasmin are currently assumed as one of the mechanisms underlying the development of a number of neurodegenerative disorders. Several studies indicate that elevated serum ceruloplasmin levels may play a role in schizophrenia by exacerbating or perpetuating dopaminergic dysregulation. No study investigating the relationship between ceruloplasmin and obsessive-compulsive disorder (OCD) has been published to date. Nowadays OCD is increasingly speculated to be a different disorder than other anxiety disorders, and rather is considered to be more similar to psychotic disorders. The objective of this study to explore whether there is an association of ceruloplasmin with OCD as in schizophrenia.Method26 pure OCD and 9 co-morbid OCD patients from Gaziantep University Sahinbey Research Hospital, Psychiatry Clinics, diagnosed according to the DSM IV and 40 healthy controls were included in the study. Blood samples were collected; ceruloplasmin levels were measured.ResultsThe mean ceruloplasmin level in pure OCD patients, co-morbid OCD patients, and control group persons were 544.46 ± 26.53, 424.43 ± 31.50 and 222.35 ± 8.88 U/L respectively. Results of all 3 groups differ significantly. Positive predictive value of ceruloplasmin for that cut-off point is 31/31 (100%) and negative predictive value is 40/44 (91%) in our group.ConclusionAlthough the nature of relationship is not clear there was an association between ceruloplasmin levels and OCD in our study.

Oxidative markers of Myeloperoxidase and Catalase and their diagnostic performance in bipolar disorder

BACKGROUND Recent researches suggest oxidative stress and generalized inflammatory state to be associated with bipolar I disorder (BID). Our aim is to evaluate Myeloperoxidase (MPO) and Catalase (CAT) activities in BID. METHODS 73 BID patients and 73 healthy controls were enrolled. Patients were classified into manic, depressive and euthymic state. Serum MPO and CAT were measured in both patients and controls. RESULTS CAT activity was significantly lower in controls than manic, depressive and euthymics (p<0.001). MPO activity was significantly higher in controls compared to euthymics (p=0.007) and it was significantly higher in depressives compared to euthymics (p=0.023). CAT was negatively and MPO was positively correlated with disease duration in overall the patients. Positive Predictive Value was 94.5% and Negative Predictive Value was 100% above the cutoff point for CAT activity. CONCLUSION MPO and CAT activities are impaired in BID, which may be associated with oxidative stress and inflammation.