Evaluation of socio-demographic factors and attempted suicides in the elderly

Introduction: The aim of this study is to reveal the socio-demographic and certain clinical characteristics of elderly patients admitted to the emergency department after a suicide attempt.Methods: This is a cross-sectional study. The universe of the study consisted of 96 patients aged 60 and over who were admitted to emergency department of Izmir Dokuz Eylul University Hospital between 2015-2019 due to a suicide attempt. Information for the study was obtained by retrospectively scanning the files of the patients.Results: Mean age of the 96 patients included in the study was 68.22 ± 9.45 years. The most common suicide method among the patients was drug overdose (n: 59, 61.45%). It was found that 45.05% of the patients who attempted suicide had a known psychiatric diagnosis (n:41). The suicide rate of women (n:42, 43.75%) who were primary school graduates (p=0.026), had a known psychiatric illness (p=0.001), continuously used drugs (p=0.002) and used antidepressants (p lt;0.001) was significantly higher compared to men (n:54, 56.25%).Conclusion: Being a primary school graduate, having a psychiatric illness, and using antidepressants increase suicide rates in women. It was suggested that this group of patients with suicidal tendencies should be treated with more care in emergency department

Biological Determinants of Depression: An epidemiological approach

Understanding the biology behind depression has a long history in research. To date, no unique marker or specific etiological factor was detected. However, we know more about the possible mechanisms that predispose depression or affect clinical presentation and prognosis of depression. In this thesis, we studied various hypotheses to extend our knowledge about biological determinants of depression using an epidemiological approach.The main aims of this thesis were1) to scrutinize the determinants and the genetic control of different functions of the HPA axis, a well-known neurohormonal correlate of depression,2) to revisit the vascular depression hypothesis and explored the associations of non-clinical cerebrovascular alterations with depression, and3) to explore genetic etiology of depression using the genome-wide association approach

Clinical, genetic, and epigenetic markers associated with lithium response in bipolar disorder

Bipolar bozukluk yaşam kalitesinde azalma ve işlevsellik kaybına neden olan, kronik seyirli ve yaygın bir psikiyatrik hastalıktır. Lityum, bipolar bozukluğun akut mani ve sürdürüm tedavisinde ilk sıradaki yerini korumaklabirlikte lityumun etki mekanizmaları günümüzde hala net olarak bilinmemektedir. Ayrıca lityum yanıtı hastalararasında yüksek oranda değişkenlik göstermektedir. Bipolar bozuklukta %30-55 kadar hasta lityum tedavisindenfayda görmemekte veya tedaviyi bırakmasına neden olan yan etkiler yaşamaktadır. Bugüne kadar yapılanaraştırmalar sonucunda kişiler arasında lityum yanıt farklılığını yordayan bazı klinik değişkenler saptanmış ancaktutarlı sonuçlar elde edilememiştir. Klinik değişkenler üzerinden lityum yanıtını saptamada yaşanan güçlükler,tutarlı periferik ve nörogörüntüleme belirteçlerinin bulunmayışı, hastalığın ve tedavi yanıtının ailesel kümelenmeler göstermesi araştırmacıları genetik araştırmalar yapmaya yönlendirmiştir. Araştırmacılar öncelikle aday gençalışmalarına odaklanmıştır. Ancak polijenik olduğu düşünülen lityum yanıtını saptamada aday gençalışmalarının yetersiz kalması nedeni ile tüm genom ilişki çalışmaları yapılmaya başlanmıştır. Bu çalışmalardanlityum yanıtı ile bazı tek nükleotid polimorfizmleri, kodlama yapmayan RNA’lar ve polijenik risk skoru ilişkilerinedair veriler elde edilmiştir. Son dönemde araştırmacılar gen-çevre etkileşiminde rol alan epigenetikmekanizmaların aydınlatılması için çalışmaktadır. Bu makalede lityum yanıtı ile ilişkili gerek klinik özelliklergerekse öne çıkan genetik ve epigenetik belirteçler gözden geçirilmiş ve gelecek araştırmalarda dikkat edilmesigereken kritik noktalar vurgulanmıştır.Bipolar disorder is a chronic and common psychiatric disease that causes poor quality of life and loss of functionality. Although lithium remains in the first place in the acute mania and maintenance treatment of bipolardisorder, its mechanism of action is still unclear. In addition, the response to lithium varies widely amongpatients. Up to 30-55% of patients with bipolar disorder do not benefit from lithium treatment or experienceside effects that cause them to discontinue the treatment. As a result of the studies carried out to date, someclinical variables that predict the difference in lithium response among individuals have been identified, butconsistent results have not been obtained. Difficulties in detecting lithium response over clinical variables, lackof consistent peripheral and neuroimaging markers, and familial clustering of the disease and treatmentresponse led researchers to conduct genetic studies. Researchers have primarily focused on candidate genestudies. However, whole genome association studies have begun to be performed due to the inadequacy ofcandidate gene studies in detecting the lithium response, which is estimated to be polygenic. Data on lithiumresponse and some single nucleotide polymorphisms, noncoding RNAs, and polygenic risk score associationswere acquired from these studies. Recently, researchers have been working to elucidate the epigenetic mechanisms involved in gene-environment interaction. In this article, both clinical features and both prominentgenetic and epigenetic markers associated with lithium response are reviewed and critical points that shouldbe considered in future research are emphasized.&nbsp;</p