Selçuk Aslan

Detection of oxidative DNA damage in lymphocytes of patients with Alzheimer's disease

Oxidative damage to DNA may play an important role in both normal ageing and in neurodegenerative diseases. The deleterious consequences of excessive oxidations and the pathophysiological role of reactive oxygen species have been intensively studied in Alzheimers disease. Although the role of oxidative stress in the aetiology of Alzheimers disease is still not clear, the detection of an increased damage status in the cells of patients could have important therapeutic implications. The levels of oxidative damage in peripheral lymphocytes of 24 Alzheimers disease patients and of 21 age-matched controls were determined by comet assay applied to freshly isolated blood samples with oxidative lesion-specific DNA repair endonucleases (endonuclease III for oxidized pyrimidines, formamidopyrimidine glycosylase for oxidized purines). It was demonstrated that Alzheimers disease is associated with elevated levels of oxidized pyrimidines and purines (p<0.0001) as compared with age-matched control subjects. It was also demonstrated that the comet assay is useful as a biomarker of oxidative DNA damage when used with oxidative lesion-specific enzymes.

A possible relationship between Toxoplasma gondii and schizophrenia: A seroprevalence study

Objective. Schizophrenia is a pervasive neuropsychiatric disease of uncertain etiology. We aimed to investigate a possible association between Toxoplasma gondii infection and schizophrenia in this study. Method. We selected individuals with schizophrenia (n=88) and tested them with commercially available enzyme-linked immunosorbent assay (ELISA) for anti-Toxoplasma IgG and IgM antibodies and compared these seropositivity rate to those of controls without psychiatric disease (n=88). Results. The rate of IgG antibody in the schizophrenia patients (47.7%) was higher than the control groups (20.4%) (P<0.001). We did not find any anti-Toxoplasma IgM seropositivity in both schizophrenia patients and control group. In schizophrenic patients with and without anti-Toxoplasma IgG groups statistical analysis did not reveal any correlation between demographic variables and Toxoplasma infection. Conclusion. Our findings supported previous studies indicate that T.gondii may play a role in etiopathogenesis in some cases of schizophrenia.

Prevalence of insomnia symptoms: results from an urban district in Ankara, Turkey

Objective. Characteristics of insomnia symptoms in Turkey are not well established. The goal of this study was to determine the prevalence of insomnia and related symptoms in an urban district of Turkey. Method. The study was carried out in Ankara, in an urban district with a population of 2665. Out of the 1332 people in the sample, 1034 in the 15–65 age range were included in the study. Interviews were conducted according to the “Sleep Disorders Assessment Questionnaire” developed by the researchers. The Insomnia Severity Index (ISI) was also given to the subjects with a sleep problem to measure the subjective quality and quantity of insomnia symptoms. Results and conclusion. A total of 29.4% of all participants reported a sleep problem, out of which 23.7% defined one or more of the insomnia symptoms which included difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), non-restorative sleep (NRS) and sleep deprivation (SD). Insomnia risk was found to be significantly increased with age, female sex, smoking and chronic medical illness. A total of 75.9% of participants who reported insomnia symptoms did not seek medical help for their complaint. According to the ISI, among the subjects with insomnia symptoms, 79 (32.2%) had subthreshold insomnia, 43 (17.6%) had clinical insomnia, 12 (4.9%) had severe clinical insomnia, while 88 (35.9%) did not score in the range indicating insomnia. The findings are discussed in the light of previous research and in relation to sociocultural factors emphasizing the need for public education on sleep disorders as medical conditions.

Psychiatric symptoms and diagnoses in thyroid disorders: a cross-sectional study

Objective Endocrine dysfunction may produce symptoms that are difficult to distinguish from the clinical manifestations of psychiatric disorders. In particular, the function of the hypothalamic–pituitary–thyroidal axis is known to be associated with a number of psychiatric abnormalities, such as depression and anxiety. In this study, we tested the hypothesis that depression is more commonly encountered in hypothyroidism, while anxiety is more prevalent in hyperthyroidism. Additionally, we aimed to evaluate the correlations of the intensity of the psychiatric symptomatology in these patients with the specific parameters of thyroid function, such as levels of TSH, T3 and T4. Method Patients newly diagnosed as having thyroid disorders were included in the study. They were classified into five study groups (according to the results of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4) and autoantibody (anti-thyroglobulin antibodies and anti-microsomal antibodies) measurements): hypothyroid, hyperthyroid, subclinical hypothyroid, subclinical hyperthyroid, and euthyroid Hashimotos thyroiditis. Psychopathological symptoms were evaluated on the 17-item Hamilton Rating Scale for Depression (HDRS), Brief Symptom Inventory (BSI), BSI Sub-scales and Hospital Anxiety and Depression Scale (HAD). Psychiatric diagnoses were performed using DSM-IV-SCID (Structured Clinical Interview for DSM). The relationship between the results of the psychiatric evaluation and thyroid function tests was assessed statistically by ANOVA and Pearson correlation tests. Results Eighty patients (68 female and 12 male), with a mean age of 42.5±13.4 years, were evaluated. A positive correlation between the total BSI scores and TSH levels (r = 0.65, P = 0.01) was noted in the hypothyroid (n=25) group. Hyperthyroid patients (n=22) showed a positive correlation between HDRS scores and fT4 levels (r = 0.62, P = 0.01). The BSI scores in hypo- and hyperthyroidism were significantly higher than normal (P<0.05). In the subclinical hypothyroid (n=7), subclinical hyperthyroid (n=11), and euthyroid Hashimotos thyroiditis (n=15) groups no correlation was found between thyroid function tests and HDRS, BSI, and HAD scores. Conclusion The results indicate that patients with thyroid disorders have high levels of anxiety and depressive symptoms. Thirty-five patients (43%) out of 80 had an axis I psychiatric disorder. However, our findings did not support an association between high levels of depression and hypothyroidism or between high levels of anxiety and hyperthyroidism. Moreover, this study did not reveal any specific psychiatric manifestation of hypothyroidism or hyperthyroidism.

Comparison of DRD2 rs1800497 (TaqIA) polymorphism between schizophrenic patients and healthy controls: Lack of association in a Turkish sample

Abstract Objective. The association of DRD2 rs1800497 (TaqIA) polymorphisms and schizophrenia has been studied in a number of populations, but the results are contradictory. We aimed to define Taq IA allelic differences between schizophrenic and healthy subjects. Methods. The schizophrenic group consisted of 99 schizophrenic inpatients, diagnosed and treated at Gazi University Hospital Psychiatry Service, the healthy group was composed of 109 subjects who did not suffer from any psychiatric or organic diseases. High molecular weight genomic DNAs were prepared from peripheral venous blood cells by using proteinase K digestion followed by salt extraction method. Target DNA amplification of DRD2 gene (Taq1A, 310-bp region) was performed by polymerase chain reaction (PCR) with the primers 5014 and 971. Results. Of the 208 subjects involved in the study, 98.6% had A1 allele (hetero- or homo-zygote) and 1.4% had A2 allele (homozygote). While all schizophrenia patients had A1 allele, 97.2%, of the healthy subjects (n=106) had A1 allele and there was no significant difference between the groups. Conclusion. This study was the first study related to DRD2 polymorphism conducted in a Turkish schizophrenic patient sample. A great percentage of our sample has A1 allele. Our study could not find a significant association between schizophrenia and DRD2 rs1800497 polymorphism.

Circulating insulin and leptin in women with and without premenstrual disphoric disorder in the menstrual cycle

Abstract Premenstrual dysphoric disorder (PMDD) is a syndrome related with mood and appetite changes during the late luteal phase. Leptin and insulin are the hormones related to appetite, and leptin may have a role in reproductive functions and mood. Our aim was to determine whether there are differences in serum leptin and insulin levels between women with and without PMDD during the follicular and luteal phases. In this study, 20 women with PMDD and 18 women without PMDD were included. Fasting blood glucose, insulin, leptin, progesterone levels and HOMA-IR were measured in the follicular and luteal phases separately. Repeated-measures analysis of variance revealed significant interactions for serum leptin, insulin and HOMA-IR levels between the diagnosis of PMDD and menstrual phases (F = 5.4, p = 0.025; F = 5.4, p = 0.026; and F = 4.7, p = 0.036, respectively). A significant correlation was found between progesterone and insulin levels in subjects without PMDD in the luteal phase (r = 0.58, p = 0.01). Whether the alterations in serum leptin and insulin are related with the changes of appetite and mood in PMDD or secondary to other factors should be clarified.

Measuring the beliefs on alcohol craving by using craving beliefs questionnaire: preliminary results of its psychometric properties in a Turkish sample

Abstract Introduction: Therapist can assess patients’ maladaptive beliefs about drug via Craving Beliefs Questionnaire (CBQ), which was originally developed by Wright to measure beliefs about the craving phenomenon. The aim of the study is to assess the psychometric properties of CBQ and its usefulness in the patients with alcohol dependency. Method: The study population was consisted of 70 alcohol addict male patients. Beliefs about substance use questionnaire (BSU), craving beliefs questionnaire (CBQ), Beck anxiety inventory (BAI), clinical institute withdrawal assessment (CIWA), automatic thoughts questionnaire (ATQ) and dysfunctional attitudes scale (DAS) were used as the assessment tools. Results: The internal consistency of the CBQ for the alcohol dependent was adequate (Cronbach’s alpha 0.94). Item-total score correlations were between 0.50 and 0.84 for alcohol-dependent patients. The principal component analysis revealed one main factor. Positive correlations found between CBQ, and BSU, BAI and ATQ. In discriminant validity analysis, mean CBQ scores were found significantly higher than occasional drinkers and none-alcohol drinkers. Conclusion: Our results supported that the Turkish version of the CBQ has an adequate instrument for evaluating alcohol-related craving beliefs in alcoholic patients. However, further studies should be performed for assessing its validity in large number of social drinkers and alcohol-dependent patient.

A combined VBM and DTI study of schizophrenia: bilateral decreased insula volume and cerebral white matter disintegrity corresponding to subinsular white matter projections unlinked to clinical symptomatology

PURPOSE Grey matter and white matter changes within the brain are well defined in schizophrenia. However, most studies focused on either grey matter changes or white matter integrity separately; only in limited number of studies these changes were interpreted in the same frame. In addition, the relationship of these findings with clinical variables is not clearly established. Here, we aimed to investigate the grey matter and white matter changes in schizophrenia patients and exhibit the relation of these imaging findings with clinical variables. METHODS A total of 20 schizophrenia patients and 16 matched healthy controls underwent magnetic resonance imaging to investigate the grey matter and white matter alterations that occur in schizophrenia patients using voxel-based morphometry (VBM) and whole brain voxel-wise analysis of diffusion tensor imaging (DTI) parameters with SPM8, respectively. While the preprocessing steps of VBM were performed with the default parameters of VBM8 toolbox, the preprocessing steps of DTI were carried out using FSL. Additionally, VBM results were correlated with clinical variables. RESULTS Bilateral insula showed decreased grey matter volume in schizophrenia patients compared with healthy controls (P < 0.01). The opposite contrast did not show a significant difference. Psychiatric scores, duration of illness, and age were not correlated with the decreased grey matter volume of insula in schizophrenia patients. DTI analysis revealed a significant increase in mean, radial, and axial diffusivity, mainly of the fibers of bilateral anterior thalamic radiation and superior longitudinal fasciculus with left predominance, which intersected with bilateral subinsular white matter (P < 0.05). CONCLUSION Our findings suggest that insula may be the main affected brain region in schizophrenia, which is also well supported by the literature. Our results were independent of disease duration and schizophrenia symptoms. White matter alterations were observed within bilateral anterior thalamic radiation and superior longitudinal fasciculus that intersects with subinsular white matter. Studies with larger sample sizes and more detailed clinical assessments are required to understand the function of insula in the neurobiology of schizophrenia.

Cognitive behvioral psychotherapy of a severe anorexia nervosa case

Anorexia Nervosa is a chronic, severe psychiatric illness characterized with life threatening weight loss. Patients with eating disorder almost devote their lives to lose weight. In the course of disorder, patients hold irrational fears of becoming overweight and are committed to lose weight with/without engaging bulimic behaviors. The effectiveness of drug treatment and psychotherapy is scant. Therefore, in this paper, treatment process of a 28 y.o patient with anorexia nervosa whom hospitalized to inpatient unit with 33kg is presented to discuss the effectiveness CBT treatment. After two weeks of intense psychiatric care, 10 sessions of CBT is delivered in inpatient unit resulting with significant improvements in her weight control behavior. She completed 6-week inpatient treatment and followed by this, she completed her treatment process as an outpatient client. By the end of treatment, she reached 50kg and sustained her weight afterwards. The records revealed that she manages to cope with her fears of gaining weights and stopped using safety behaviors. Moreover, it is reported that her maintaining behaviors like excessive exercising habits, purging and restrictive dieting abated. Exposure intervention is combined with CBT treatment introduced to help her to first accommodate an imaginary acceptance to idea of gaining weight and tolerating to reach her healthy targeted weight. This followed by using exposure interventions as a preventative instrument to help her overcome her fears of gaining weights, during the 6 months followup she maintained the healthy weight.

Evaluation of Insomnia Frequency, Beliefs and Attitudes Related Insomina in Primary Care -

OBJECTIVE: Sleep disorders; are a health problem affecting the quality of life of individuals in society. We aimed to determine the prevalence of insomnia disorders, understand cognitive aprasials of pateints about their insomnia symptoms, and perpeutuating factors and coping mechanism to cope with insomnia problems. METHOD: In this study; patients with sleep problems were examined in a outpatient family medicine clinic in Ankara between 2009 and 2012. Insomnia Severity Index (ISI), and dysfunctional beliefs and attitudes about sleep (DBAS) ; were performed in patients with sleep disorder. Sleep problems history (difficulty falling asleep, excessive sleep, etc.), demographic information, additional chronic diseases, smoking, tea and coffee consumption and sleep habits were analyzed. RESULTS: 230 patients were enrolled to the study. Of those 180 (78.4%) were female and 50 (21.6%) male patients. 92 female patients (40.1%) stated that they were menopausal period. 137 patients (%60) had comorbid chronic disease, and 93 patients (%40) had no chronic diseases. DBAS score was significantly higher in female patients (p