Saliha Ozsoy

Serum oxytocin levels in patients with depression and the effects of gender and antidepressant treatment

Abnormalities in the neurohypophyseal system have been reported in depression. This study aimed to investigate serum oxytocin levels in patients with depression and the effects of gender and antidepressant treatment on these levels. Serum oxytocin levels were measured before and after treatment with antidepressant drugs or electroconvulsive therapy (ECT) in 40 inpatients (30 women, 10 men) who met the DSM-IV criteria for major depressive disorder (n=29) or bipolar affective disorder depressive episode (n=11), and in 32 healthy controls (20 women, 12 men). Serum oxytocin levels were decreased both pre-treatment and post-treatment in the patients compared with those in the controls. Serum oxytocin levels were not affected by antidepressant drug treatment or ECT. The female patients had significantly lower oxytocin levels than the control females, whereas no difference was found between the male patients and the male controls. We found no difference in serum levels of oxytocin between the unipolar and bipolar depressive patients. Our result shows reduced oxytocin in depression and a gender difference in oxytocin levels. Furthermore, antidepressant treatments appear to have no effect on serum oxytocin levels.

Effects of antidepressant treatment and of gender on serum leptin levels in patients with major depression.

Leptin is a product of the obese gene and plays an important role in the regulation of body weight and food intake. Weight and appetite are frequently altered in depression. So far, inconsistent results have been reported in terms of leptin levels in depression. Therefore, the authors investigated serum leptin levels in patients with depression and in healthy controls, and whether there was any alteration throughout antidepressant treatment. Female patients showed significantly higher leptin levels than those of the control females both before and after the response to antidepressant treatment, whereas no difference was found between the male patients and the male controls. The improvement from depression with antidepressant treatment caused a further elevation on the leptin levels, in both female and male patients. These findings confirm an increase in leptin levels in depressive patients and presence of a sexual dimorphism. Moreover, clinical response to antidepressant treatment seems to have an additional increasing effect on leptin levels.

The Effects of Electroconvulsive Therapy on GABAergic Function in Major Depressive Patients

Objectives: It has been proposed that major depression is associated with a dysfunction of the &ggr;-aminobutyric acid (GABA) system. This study was planned to investigate whether there are any alterations in GABAergic activities in major depressive patients and, if there are, whether electroconvulsive therapy (ECT) has any effect on these changes. Methods: Twenty-five depressed inpatients who responded to a course of ECT and 23 healthy subjects were included in the study. Serum GABA levels were measured 2 days before and 10 minutes after the first ECT and 3 days after the last ECT, and a baclofen challenge test was performed 2 days before the first ECT and 3 days after the last ECT in the patients. The same tests were carried out only once in the control group. Results: Depressive patients had lower serum GABA levels compared with healthy individuals, and ECT caused a significant increase in these levels. The acute effect of the one-ECT procedure was a huge increase in the baseline GABA levels. Although there was no difference in the maximum alteration in growth hormone with baclofen between the patients and controls before the therapeutic ECT course, it became significantly higher in the depressive patients than in the controls after the treatment. Conclusions: The findings of this study support the GABA deficit hypothesis of major depression because major depressive patients have lower levels of serum GABA that are increased by a completed ECT course. ECT seems to increase brain GABA levels as well as GABAB activity, and these effects may contribute to its mechanism of therapeutic effect.

Serum ghrelin and leptin levels in patients with depression and the effects of treatment.

Objective Ghrelin and leptin, appetite-regulating hormones, play a role in mood regulation. Current data about the relation between leptin/ghrelin and depression are still controversial. This study aimed to investigate serum leptin and ghrelin levels in patients with depression and the effects of treatment on these levels. Methods Serum ghrelin and leptin levels were measured before and after treatment with antidepressant drugs and/or electroconvulsive therapy in 28 patients with depression and once in 21 healthy controls. Results Serum ghrelin levels of the patients were high in the pre-treatment. After the treatment, ghrelin levels were not different from those of the controls. We found no difference in serum levels of leptin between the patients and controls and no change with treatment. body mass index of the patients increased after the treatment especially in the drug-treated group. Conclusion The present study found increased serum ghrelin levels in depressive patients and normalization with improving of depression but no alteration in leptin levels.

Assessment of Psychopathology and Quality of Life in Children and Adolescents With Migraine

Aim: The aims of this study were to investigate comorbid psychiatric disorders and to identify anxiety and depression levels and quality of life in children and adolescents with migraine; and to assess their relationship with migraine. Method: 35 patients aged 9-16 years were followed in our neurology clinic and their parents were included into the study. 35 age- and sex-matched patients were employed as the control group. In the subjects included, psychiatric disorders were assessed by using the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version. All children and adolescents were assessed by using the Children’s Depression Inventory, the State-Trait Anxiety Inventory and the Pediatric Quality of Life Inventory. In addition, the Pediatric Migraine Disability Assessment Tool and visual analog scale were used to identify the degree of disability and pain severity in patients with migraine. Findings: In the psychiatric assessment of children and adolescents with migraine, it was found that a psychiatric diagnosis was made in 40% of patients; and depression scale scores were significantly higher than those of controls. Quality of life was found to be poorer in patients with migraine compared to controls. It was found that quality of life was negatively correlated with pain severity and degree of disability; while it was positively correlated with depression scores. Discussion: In children and adolescents with migraine, treatment of psychiatric disorders in addition to migraine therapy can facilitate migraine management and may decrease the need for prophylactic therapy.

Ultrasonically determined thyroid volume and thyroid functions in lithium-naïve and lithium-treated patients with bipolar disorder: a cross-sectional and longitudinal study

This study investigated thyroid volume, hormone levels and antibodies in long‐term lithium‐treated and lithium‐naïve bipolar patients, some of whom underwent prospective follow‐up evaluations.

The Effects of Antidepressants on Neuropeptide Y in Patients with Depression and Anxiety.

INTRODUCTION This study aimed to investigate the neuropeptide Y (NPY) levels in patients with anxiety and depression and also the effects of antidepressants on this neuropeptide. MATERIALS AND METHODS The study included 40 outpatients who presented with depressive and anxiety symptoms, and 32 healthy controls. The patients received antidepressant treatment for 6 months. Serum levels of neuropeptide Y were measured before treatment in 40 patients, after 8 weeks of treatment in 32 patients, after 6 months in 10 patients, and once in the controls. RESULTS Serum NPY levels were lower in the patients than in the controls. NPY levels were increased and normalized by antidepressant treatment. While there was no change in NPY levels in the patients using fluoxetine and sertraline for 8 weeks, an increase was found in patients using escitalopram and venlafaxine. Serum NPY levels were increased by treatment for 8 weeks in the patients with depression, but not in the patients with anxiety. DISCUSSION The findings suggest that NPY may be related to pathophysiology in depression and anxiety, and antidepressants influence NPY levels.

Association of Gingival Crevicular Fluid Cortisol/Dehydroepiandrosterone Levels With Periodontal Status

BACKGROUND The aim of the present study is to examine whether anxiety and depression scale scores change with regard to clinical periodontal status and to investigate the association between the levels of stress-related hormones in gingival crevicular fluid (GCF) and extent/severity of periodontal disease. METHODS One hundred twenty participants who fulfilled the study inclusion criteria were chosen. Patients with chronic periodontitis (CP) and those with healthy periodontal tissues/mild gingivitis were included. The clinical examinations were performed on the day after the psychologic evaluations which included anxiety and depression measurements. GCF sampling was undertaken the following day. Commercially available enzyme-linked immunosorbent assay kits were used to determine GCF cortisol and dehydroepiandrosterone (DHEA) levels. Study groups were assigned as follows: group 1, non-periodontitis; group 2, localized CP; and group 3, generalized CP. RESULTS There were no significant differences with respect to age, sex, education, income level, occupation, or smoking history among the groups (P >0.05). There were no significant differences between the non-periodontitis and CP groups for any of the psychosocial scales (P >0.05). Group 3 had significantly higher mean DHEA scores compared with group 1 (P <0.05); however, the median cortisol scores showed no statistically significant differences among the three groups (P >0.05). CONCLUSIONS Anxiety/depression scores and GCF cortisol levels did not show any difference with regard to clinical periodontal status. However, a significant association was found between elevated levels of GCF DHEA and the severity of periodontitis.

The association between depression, weight loss and leptin/ghrelin levels in male patients with head and neck cancer undergoing radiotherapy

OBJECTIVE This study investigated the relationship between weight loss, depression and anxiety, and appetite hormones, leptin and ghrelin levels in patients with head and neck cancer (HNC), as well as the effect of radiotherapy and antidepressant treatment on weight and these hormones. METHODS Forty male patients with HNC and twenty physically and mentally healthy male controls were recruited for the study. Psychiatric status was evaluated with clinical interview and psychometric tests. All patients received radiotherapy and antidepressant treatment with mirtazapine that was given to patients with psychiatric disorders. Serum leptin and ghrelin levels were measured pre- and post-treatment in the patients and once in the controls. RESULTS There was no significant difference between the serum leptin and ghrelin levels of patients and controls. The leptin levels of the patients were decreased by radiotherapy. Eleven patients were diagnosed with major depressive disorder and adjustment disorder and were classed as depressive patients. Depressive patients were affected more by radiotherapy with respect to weight loss. The basal leptin levels of depressive patients were also lower than non-depressive patients and controls. CONCLUSION It seems that depression aggravated weight loss and, in addition, decreased leptin levels in cancer patients. Detection and treatment of psychiatric disorders may improve prognosis by preventing weight loss as well as by providing psychiatric treatment in cancer patients.

Hypothalamic-Pituitary-Adrenal Axis Response to Oral Naltrexone in Alcoholics during Early Withdrawal

INTRODUCTION It is thought that naltrexone may play a significant role in the regulation of the hypothalamic-pituitary-adrenal (HPA) axis response to stress. We investigated the HPA axis response following single-dose oral naltrexone administration in the early phase of alcohol withdrawal. METHODS Cortisol and adrenocorticotrophic hormone (ACTH) responses to naltrexone were measured in alcohol-dependent males (n=23) and in healthy males (n=20). Blood samples were collected for cortisol and ACTH measurements before administering (0 min) 50 mg naltrexone at 08.00 in the morning, and at 60, 90, 120 and 180 min after administering naltrexone. RESULTS Naltrexone administration resulted in a significant ACTH response in the patients while cortisol and ACTH responses were found to be significant in the controls. Cortisol response was not large enough to reach significance in the patients. ACTH level changes as a response to naltrexone in the patients were lower than that in the controls. DISCUSSION The study revealed blunted cortisol and attenuated ACTH responses to naltrexone in early alcohol withdrawal. This study may have shown impairment in adrenal and pituitary levels during alcohol withdrawal.