Sema Baykara

Pituitary gland volumes in patients with obsessive-compulsive disorder before and after cognitive-behavioral therapy

Objective: The beneficial effects of psychopharmacological and cognitive behavioral therapy (CBT) on the brain are not well understood. In a previous study, we found smaller pituitary volumes in patients with obsessive-compulsive disorder (OCD). The purpose of this study was to examine the effect of CBT on pituitary gland volume. Methods: A total of 81 patients with various anxiety disorders and the same number of healthy controls underwent magnetic resonance imaging, and their pituitary gland volumes were compared at baseline. Pituitary gland volumes were also measured before and after CBT in the patient group. Results: OCD patients had smaller pituitary gland volumes at baseline than healthy controls (0.54±0.29 cm3 for OCD patients vs. 0.82±0.30 cm3 for healthy controls; p < 0.001). We found no significant changes in OCD patient pituitary gland volume after the 16-week treatment period, with mean pre- and post-treatment values of 0.54±0.29 cm3 and 0.56±0.32 cm3, respectively (p > 0.05). Conclusion: Our results indicate an absence of post-CBT volumetric changes in the pituitary gland of OCD patients.

Effect of exercise on therapeutic response in depression treatment

ABSTRACT OBJECTIVES: The aim of this study is to investigate the effect of exercise on therapeutic response in depression treatment. METHODS: Thirty-three patients admitted to the Psychiatry Department of Firat University Hospital and diagnosed with major depressive disorder according to DSM-IV criteria and met the study criteria were included in the study. The patients in Group 1 were treated with antidepressant medication and were asked for brisk walking for at least 30 minutes a day, at least 4 days a week, for 12 weeks. Only antidepressant medication was given to the patients in Group 2. The Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, and the Clinical Global Impression Scale were applied to both groups at baseline and at the end of 6 weeks and 12 weeks. RESULTS: Anxiety and depression levels decreased in both groups. The decrease in anxiety and depression scores with antidepressant use is an expected outcome. However, there was a statistically more decrease in the average-scaled scores in the Group treated with antidepressant and exercise than the Group treated with only antidepressant. CONCLUSIONS: Exercise had a positive effect on the therapeutic response in depression treatment. However, long-term studies in larger sample groups are needed.

QT dispersion and P wave dispersion in schizophrenia

ABSTRACT BACKGROUND: The difference between maximum QT (QTmax) and minimum (QTmin) on electrocardiography (ECG) is known as QT dispersion (QTd). An increase in QTd carries the risk of ventricular arrhythmia and subsequent death. P wave dispersion (Pd) shows the difference between maximum P (Pmax) and minimum P (Pmin). Prolonged P wave duration and an increase in Pd are a risk for irregular electrical transmission and atrial fibrillation. OBJECTIVES: The aim of this study was to examine QTd and Pd values which indicate atrial fibrillation and ventricular arrhythmia in schizophrenia patients with whom cardiovascular diseases (CVD) are seen at a higher rate than the general population. METHOD: The patient group consisted of 30 male patients diagnosed with schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and receiving treatment either as inpatients or outpatients in the Mental Health and Diseases Hospital. The patient group had no other psychiatric, neurological or physical disease. The control group comprised 30 age-matched healthy males with no history of neurological, psychiatric, or physical disease. RESULTS: The cases in both groups were all males and there was no difference between the groups in respect of age. Corrected QTd was determined as 25.55 ± 13.18 (ms) in the control group and 54.26 ± 8.46 (ms) in the patient group (p < .001). Pd was determined as 36.22 ± 10.08 (ms) in the control group and 46.32 ± 5.87 (ms) in the patient group (p < .001). The differences in the values between the groups were statistically significant. DISCUSSIONS: The QTd and Pd values which show increased CVD risk were found to be significantly greater in schizophrenia patients than in the healthy control group. However, there is a need for further studies to determine whether this is a result of the nature of schizophrenia or the effect of the treatment drugs used. Thus, future studies could be planned to compare the QTd and Pd values of treated and untreated schizophrenia patients.

Should patients be informed about the side effects of psychotropic drugs? According to us: Yes

BACKGROUND In our daily clinical practice, we observe that patients who were informed about the probable side effects of any medication experience less side effects. For this reason, we decided to examine this in a systematic investigation. METHODS We divided patients into two groups, the informed and uninformed one about side effects of the drugs. During the control examination, tolerability of the drugs given was questioned in detail. RESULTS At the end of one month, the mean total UKU score was statistically significantly lower in patients from the informed group compared to that of the uninformed one (p < 0.05). The proportion of patients who discontinued the drug during the one month-period was statistically significantly higher in the uninformed group compared to informed group 9% in the informed group vs. 25% in the uninformed group) (p < 0.05). CONCLUSIONS Finally, we found that giving information about the side effects of a psychopharmacological agent seems to be useful and to provide beneficial effects on the tolerability of the drug, independent of the kind of psychotropic agent.

Oromandibular dystonia with sertraline treatment: a case report

Selective serotonin reuptake inhibitors are generally first choice drugs in the treatment of depression, anxiety disorder, eating disorder and various psychiatric disturbances, such as impulse control disorder. Sertraline is a selective serotonin reuptake inhibitor. It also makes dopamine reuptake inhibition. It may show somnolence, nervousness, sweating, drowsiness, insomnia, dizziness, nausea, chilling, skin rash, dyspepsia, loss of appetite, headache, diarrhea, ejaculation disorder, dry mouth, and weight loss as side effects. It has been reported that akathisia, dystonia, tardive dyskinesia and Parkinsonism may be seen as the extrapyramidal system findings during use of sertraline. Acute dystonia is a psychiatric emergency. It develops not only due to use of antipsychotics but, it has also been reported to occur due to use of antiemetics and antidepressants as well. In this report, we present a case with oromandibular dystonia, which developed during 50 mg sertraline treatment on the patient with adjustment disorder. Clinicians should always keep in their mind that there may be extrapyramidal side effects during use of selective serotonin reuptake inhibitors.

Hippocampus and amygdala volumes in patients with vaginismus

AIM To compare hippocampus and amygdala volumes of patients with vaginismus with those of healthy control subjects. METHODS Magnetic resonance imaging was performed on ten patients with vaginismus and ten control subjects matched for age and gender. Volumes of the hippocampus and amygdala were blindly measured. RESULTS We found that the mean right amygdala volume of patients with vaginismus were smaller than that of the healthy controls. With regard to hippocampus volumes, the mean left and right hippocampus volumes were smaller than those of the healthy controls. CONCLUSION Our present findings suggest that there have been hippocampus and amygdala structural abnormalities in patients with vaginismus. These changes provide the notion that vaginismus may be a fear-related condition.

Development of facial, hand, and feet edema due to aripiprazole use with sertraline -

Aripiprazole, a novel antipsychotic agent, is considered to be a dopamine-serotonin system stabilizer. It is from the dihydroquinolone group. It has been widely used in the treatment of schizophrenia, bipolar disorder, major depressive disorder, and anxiety disorders. Typical and atypical antipsychotics are known to cause cardiovascular side effects, but there is limited data on aripiprazole. During the treatment of an inpatient diagnosed with obsessive-compulsive disorder, edema occurred on the face, hands, and feet when the treatment was augmented with aripipirazole.