Zeynep Kotan

Serum brain-derived neurotrophic factor, vascular endothelial growth factor and leptin levels in patients with a diagnosis of severe major depressive disorder with melancholic features

Objective: Brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF) and leptin have been hypothesized to be involved in the neurobiology of depression. The aim of this study was to investigate BDNF, VEGF and leptin levels in patients with severe melancholic depression. Methods: A total of 40 drug-free patients with major depressive disorder (MDD) with melancholic features and 40 healthy controls were included in the study. Demographic information, psychiatric evaluation and physical examination were documented for both groups. Serum BDNF, VEGF levels were determined by enzyme-linked immunosorbent assay and leptin with radioimmunoassay methods. The Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale were applied to the patients. Results: There were no significant differences in serum BDNF, VEGF and leptin levels between the patient and control groups. There was a negative correlation between BDNF levels and the number of depressive episodes. It was noted that VEGF levels decreased with increasing severity of depression. Conclusions: These findings suggest that BDNF levels might be associated with the recurrence of depression and VEGF levels might be a determinant of the severity of depression.

Hyperprolactinemia and possibly related development of prolactinoma during amisulpride treatment; three cases

Abstract Schizophrenia is a chronic and debilitating psychotic mental disorder that affects about 1% of the worlds population. Antipsychotic drugs are the mainstay of treatment in schizophrenia. Hyperprolactinemia, which is a common side effect of typical antipsychotics, is also associated with the use of some of the newer atypical agents. Antipsychotics may enhance prolactinoma growth as manifested by an increase in serum prolactin concentration. Prolactin-secreting pituitary adenomas possibly related with antipsychotics have been described in the literature. To our knowledge, this is the first series of cases showing a possible relation between pituitary adenomas and amisulpride treatment in patients with schizophrenia.

Metabolic, endocrinologic and cardiac effects of amisulpride: a 24-week follow-up study

Background: Amisulpride is a second-generation antipsychotic which has been proved to be effective in the control of both positive and negative symptoms of schizophrenia. In this study we aimed to determine metabolic, endocrinologic and cardiac effects of amisulpride commonly used in our clinical practice. Methods: A total of 18 patients (11 males, 7 females) diagnosed with schizophrenia received amisulpride at the dosage of 800 mg/day and were followed up for 24 weeks. Positive and negative psychotic symptoms, extrapyramidal and sexual side effects, metabolic, endocrinologic and cardiac parameters were evaluated at regular intervals. Results: Significant improvement in both positive and negative symptoms was observed in patients starting from the second week of treatment. Prolactin levels increased significantly both in men and women starting from the measurement on day 4. Prolactin elevation was significantly higher in women than in men. Increase in total cholesterol level became significant at week 24. No other significant difference was observed between weeks 1 and 24 regarding the other parameters. Conclusions: The clinical data from the present study supports the fact that amisulpride is an effective and safe antipsychotic drug, but elevates prolactin levels in both sexes.

Help Seeking Behavior and Related Factors in Schizophrenia Patients: A Comparative Study of Two Populations from Eastern and Western Turkey

Help seeking behavior and related factors in schizophrenia patients: a comparative study of two populations from eastern and western Turkey Objective: In this study, it is aimed to investigate and compare the properties of help-seeking behaviour of schizophrenia patients from two districts situated in eastern and western Turkey. Method: Thirty one schizophrenia patients admitted to Tatvan State Hospital in 2006 and 41 schizophrenia patients admitted to Menemen State Hospital in 2007 were recruited in the study. All the patients were in remission. A semi-structured, short questionnaire type interview was carried out with the patients inquiring about their socio-demographic properties and the ways they explain and seek help for their illness. Results: The populations from Tatvan and Menemen significantly differed in terms of educational and income levels. Mean education duration of patients was 4.3±4.2 years for Tatvan and 6.8±3.5 years for Menemen (p=0.008). Fourty five percent of patients from Tatvan were of low income level and 54% of patients from Menemen were of middle-income level (p=0.016). Seventy four percent of all patients seeked help from religious sources for their illness. The percentage of patients seeking for psychiatric help was 85 for Menemen and 32 for Tatvan (p<0.001). Patients with education level of secondary-school and higher seeked for psychiatric help more than the less educated patients (p=0.039). Seventy one percent of all patients were advised to consult a psychiatrist by their family members. Discussion: This study revealed that a substantial proportion of schizophrenia patients from the two different districts were in seek of help from religious sources. Seeking for psychiatric help increased with

Prevalence and Socio-Demographic Determinants of Tobacco, Alcohol, Substance Use and Drug Misuse in General Population in Turkey

INTRODUCTION The aim of the current study is to determine prevalence ratios of tobacco, alcohol, substance use and drug misuse in a large scale sample of general population and recognize related socio-demographic factors. METHODS The study was based on a cross-sectional survey conducted with a nationally representative sample of 8045 individuals with face-to-face, in-house interviews implemented by a trained team of interviewers. RESULTS Life-time prevalences of tobacco, alcohol, substance use and drug misuse are 51.8%, 28.3%, 2.8% and 10.5% respectively. Age, gender, education level and marital status are important socio-demographic determinants for tobacco, alcohol use and drug misuse. Income level is an important determinant for alcohol and substance use. CONCLUSION Tobacco, alcohol, substance use and drug misuse are significant health concerns in Turkey. Socio-demographic status is an important determinant of several aspects of tobacco, alcohol, substance use and drug misuse and should therefore be evaluated carefully to develop effective protective and preventive strategies.

Could psychiatric assessment before hematopoietic stem cell transplantation predict the need for psychiatric consultation during transplantation period

Psychiatric morbidity seems to be a significant concern associated with all stages of hematopoietic stem cell transplantation (HSCT). We aimed to understand whether psychiatric consultation before HSCT procedure could predict the need for psychiatric support during isolation period. Seventy-eight patients undergoing HSCT were included in the study. Patients were diagnosed according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Standard anxiety and depression scores were performed. Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and State and Trait Anxiety Inventory (STAI) were performed. Psychiatric consultation was required for 45 (58%) patients during hospitalization. Only pre-HSCT STAI trait scores were higher in patients who were found to have psychopathology at consultation during hospitalization compared to patients without established psychopathology. Sixteen (76%) and 29 (51%) patients needed consultation with and without pre-HSCT psychopathology, respectively. Our study showed that the psychiatric consultation request rate during the transplantation process was higher for cases previously diagnosed with psychopathology and who had high trait anxiety scale scores before HSCT.

Serum glial cell line-derived neurotrophic factor levels and impulsivity in heroin addiction: a cross-sectional, case-control study of 129 heroin addicts

ABSTRACT OBJECTIVE Glial cell line-derived neurotrophic factor (GDNF), being a protective of dopaminergic neurons, is reported to modulate addictive behaviours and have a role as a negative regulator for biochemical and behavioural adaptations to drug abuse. We aimed to reveal impulsivity and serum GDNF levels in patients with heroin addiction and investigate their relationships in order to contribute to the understanding of behavioural aspects and biological mechanisms in heroin addiction via this study. METHODS This study was performed at the Department of Psychiatry of Ankara Numune Training and Research Hospital, Turkey. We recruited 129 heroin-dependent patients and 90 age, sex, and smoking-matched healthy controls with no major psychopathology. Barratt Impulsivity Scale-11, Hospital Anxiety and Depression Scale (HADS) and sociodemographic data form were applied to all participants. Laboratory analysis for serum GDNF levels was performed for each participant’s blood sample. RESULTS Total impulsivity scores and scores of Attentional Impulsivity, Motor Impulsivity, and Unplanned Impulsivity subscales were all higher in heroin addicts compared to the controls. Heroin addicts had also lower serum GDNF levels and lower GDNF levels were associated with high impulsivity and high HADS scores in heroin addicts. CONCLUSION Decrement in GDNF levels in heroin addiction seems as to be an important data which could be associated with impulsivity, anxiety, and depressive symptoms. GDNF could find a prominent place among the target molecules in the treatment of heroin addiction.

Fundamental Characteristics, Attitudes and Behaviors Regarding Substance Use Focusing on Cannabis: Findings from the General Population Survey in Turkey, 2011

Cannabis is the most prevalent illicit drug used in the world. We aimed to determine prevalence and some characteristics of cannabis use in Turkey. The study was based on a cross-sectional survey conducted with a nationally representative sample of 8045 individuals with in-house interviews. The life-time prevalence of substance use was found as 2.8%. Cannabis with 0.7% life-time prevalence, was the most commonly used substance. Cannabis users were concerned about some adverse outcomes such as anxiety with withdrawal (14%), losing control about using the drug (14%), daily performance problems (10.9%) and problems about interpersonal violence (6.9%). 35.1% of them wanted to quit and 18% regretted using cannabis. Prevalence of cannabis use is lower in Turkey compared with most of the other countries in the world. Nevertheless, it is a significant health concern. Identifying characteristics and attitudes related with cannabis use may help to improve policies about protective measures.

Association of Domestic Violence Against Women With Sociodemographic Factors, Clinical Features, and Dissociative Symptoms in Patients Who Receive Services From Psychiatric Outpatient Units in Turkey:

Domestic violence (DV) against women is a serious problem with its negative effects on all family members and the society. Women exposed to DV not only have physical but also psychological damage. This study investigates prevalence of DV and its relations with some descriptive and clinical features in a psychiatric outpatient population in Turkey. A total of 277 female outpatients were included in the study. After a semistructured clinical interview, they were assessed by sociodemographic data form, DV questionnaire, Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Dissociative Experiences Scale (DES), and Somatoform Dissociation Questionnaire (SDQ). Prevalence of exposure to DV by intimate partner is found to be 58.8% (n = 163). The current study provided strong evidence that occupation status of the woman, education level of the partner, and family type are predictors of DV. Another predictor of DV exists where the child is battered by either parent. Prevalence of depression, conversion disorder, and other somatoform disorders are higher in women exposed to DV. These women also have higher scores from HDRS, HARS, DES, and SDQ compared with female patients who have not experienced DV (p < .001). Number of women scoring above cutoff levels for DES and SDQ were significantly higher in women exposed to DV (p < .001).

A case of delusional parasitosis dealt within the scope of consultation liaison psychiatry

A case of delusional parasitosis dealt within the scope of consultation liaison psychiatry Delusional parasitosis is a rare disorder characterized by delayed admission to psychiatry clinic. This leads to time lags in diagnosis and treatment. Here we describe a woman diagnosed as organic delusional parasitosis secondary to her comorbid diabetes mellitus, hypertension and hypothyroidism. Treatment with low dose risperidone was found to be effective in a short span of time. This case is noteworthy as it emphasizes the importance of consultation-liaison psychiatry in the management of delusional parasitosis.