The frequency of metabolic syndrome in psychiatric patients using antidepressant medications

Amaç: Antidepresan kullanan hastalarda metabolik sendrom (MS) varlığını araştıran çalışma sayısı kısıtlıdır. Bu çalışma ile polikliniğe başvuran ve çeşitli antidepresan kullanan psikiyatrik hastalarda MS ve ilişkili faktörlerin oranlarını araştırmak ve karşılaştırmak amaçlanmıştır. Yöntem: Çalışma fluoksetin, paroksetin, sertralin, citalopram, essitalopram, klomipramin, venlafaksin kullanan 18-60 yaş arası depresif ve anksiyete bozukluğuna sahip 70 hastadan oluşmuştur. Çalışma ölçütlerine uyan hastaların açlık kan şekerleri, kan trigliserit ve kolesterol düzeyleri, ortalama kan basıncı, vücut kitle indeksi, bel çevresi ve Ulusal Kolesterol Eğitim Programı - Erişkin Tedavi Paneli III'e göre (NCEP-III) MS oranları tespit edildi. Sonuç: NCEP-III'e göre tüm hastalardaki MS sıklığı %32,8 idi. En yüksek metabolik sendrom oranları klomipramin, paroksetin ve venlafaksin gruplarında saptandı. Fluoksetin grubu metabolik sendrom açısından en güvenli ilaç olarak saptandı. Tartışma: Klasik antidepresanlar metabolik senrom oranlarını artırmaktadır ve bu da psikiyatrik hastaların mortalite, morbidite ve yaşam kalitesini etkilemesi açısından oldukça önemlidir.Objective: There are limited studies investigating the metabolic syndrome (MS) in patients using antidepressants. This study examines and compares the prevalence of MS and related factors in psychiatric patients taking various antidepressants at an outpatient clinic. Methods: The study comprised a total of 70 patients using fluoxetine, paroxetine, sertralin, citalopram, essitalopram, clomipramine and venlafaxine aged 18- 60 years with depressive and anxiety disorder. MS rates of patients (according to National Cholesterol Education Program-Adult Treatment Panel III-(NCEP III)) who met the study criteria were obtained. Results: In our study metabolic syndrome frequency was 32.8% in total patient groups according to NCEP-III criteria. The higher metabolic syndrome frequency was found in drug groups such as clomipramine, paroxetine and venlafaxine groups. The safest drug for metabolic syndrome was fluoxetine as seen in its relevant group. Conclusion: Conventional antidepressants may cause metabolic syndrome which is important for mortality, morbidity and quality of life of psychiatric patients

Psychiatric Symptoms and Psychosocial Problems in Patients with Breast Cancer

Cancer is a physical disease and also one of the leading clinical manifestations where psychosocial problems are prevalent. Psychosocial problems that these patients may have in the long run include anxiety, uneasiness, mourning, helplessness, fatigue, impairment of concentration, sleep disorders, mental and cognitive reservation, sexual dysfunction, infertility, psychological distress, and psychiatric disorders. Psychosocial problems have a nature of underpinning the emergence of psychological troubles. The prevalence of psychological disorders in patients with cancer range from 29% to 47%. Psychiatric disorders that are likely to be seen are severe stress disorder, adjustment disorder, depressive disorder, and other neurotic disorders. It is considered by the present author that in the event of breast cancer, potential psychiatric disorders may affect prognosis of the disease, adherance to and success of therapy, social and societal functioning, and survival rate. This paper aims to review the psychiatric symptoms and diseases that may develop in patients with breast cancer, which is one of the most frequent types of a globally common disease; i.e., cancer, as well as the impact of psychiatric symptoms on the treatment of disease

Evaluation of estrogen and G protein-coupled estrogen receptor 1 (GPER) levels in drug-naïve patients with attention deficit hyperactivity disorder (ADHD)

Estrogen has a crucial role in the regulation of reproductive and neuroendocrine function and exerts its effects through two classes of receptors, nuclear and membrane estrogen receptors (mERs). G protein-coupled estrogen receptor 1 (GPER) is a member of mERs, and despite limited research on the levels of GPER in patients with psychiatric diseases, a role of GPER in such conditions has been suggested. Here we evaluated serum estrogen and GPER levels in children with attention deficit hyperactivity disorder (ADHD) in relation to their age- and gender-matched healthy controls. A total of 82 children were included in the study, 47 drug- naïve patients with ADHD (age: 6–12 years; male/female: 34/13) and 35 healthy controls (age: 6–12 years; male/female: 19/16). The subgroups according to ADHD types were inattentive, hyperactive/impulsive, and combined. Serum estrogen was measured using an immunoassay system, while serum GPER was determined using a commercial sandwich enzyme-linked immunosorbent assay kit. Estrogen levels in children with ADHD were similar as in control group, while GPER levels were significantly lower in ADHD group compared to controls (p 0.05). No significant differences were found in GPER and estrogen levels between ADHD subgroups (p > 0.05). To the best of our knowledge, this study is the first to investigate estrogen and GPER levels in ADHD. Our preliminary findings suggest a relationship between serum GPER levels and ADHD, and this should be further investigated

PINEAL GLAND VOLUME IN SCHIZOPHRENIA AND MOOD DISORDERS

Background: The majority of patients with schizophrenia and mood disorders have disruptions in sleep and circadian rhythm. Melatonin, which is secreted by the human pineal gland, plays an important role in sleep and circadian rhythm. The aim of the present study was to evaluate and compare pineal gland volumes in patients with schizophrenia and mood disorders. Subjects and methods: We retrospectively evaluated the pineal gland volumes of 80 cases, including 16 cases of unipolar depression, 17 cases of bipolar disorder, 17 cases of schizophrenia, and 30 controls. The total pineal gland volume of all cases was measured via magnetic resonance images, and the total mean pineal volume of each group was compared. Results: The mean pineal volumes of patients with schizophrenia, bipolar disorder, unipolar depression, and the controls were 83.55±10.11 mm³, 93.62±11.00 mm³, 95.19±11.61 mm³ and 99.73±12.03 mm³, respectively. The mean pineal gland volume of the patients with schizophrenia was significantly smaller than those of the other groups. Conclusions: Our data show that patients with schizophrenia have smaller pineal gland volumes, and this deviation in pineal gland morphology is not seen in those with mood disorders. We hypothesize that volumetric changes in the pineal gland of patients with schizophrenia may be involved in the pathophysiology of this illness

The differences in temperament-character traits, suicide attempts, impulsivity, and functionality levels of patients with bipolar disorder I and II.

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Background: The primary aim of this study was to compare the differences in temperament-character traits, suicide attempts, impulsivity, and functionality levels of patients with bipolar disorder I (BD-I) and bipolar disorder II (BD-II). Methods: Fifty-two BD-I patients and 49 BD-II patients admitted to Erenköy Mental and Neurological Disease Training and Research Hospital psychiatry clinic and fifty age- and sex-matched healthy control subjects were enrolled in this study. A structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I Disorders, Temperament and Character Inventory, Barrett Impulsiveness Scale-11 (BIS-11), Hamilton Depression Inventory Scale, Young Mania Rating Scale, and Bipolar Disorder Functioning Questionnaire (BDFQ) were administered to patients and to control group

Association between sociodemographic characteristics and anxiety levels of violence-exposed patients admitted to emergency clinic.

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Background: Here we aimed to investigate sociodemographic characteristics, psychiatric history, and association between sociodemographic characteristics and anxiety levels of violence-exposed patients admitted to emergency clinic. Methods: This study consists of 73 violence-exposed patients admitted to emergency clinic who were literate and agreed to participate in the study. A sociodemographic data form created by us to investigate alcohol-substance abuse, suicide attempt, previous history of trauma, self and family history of psychiatric disorders and Beck Anxiety Inventory was given to the patients

Assessment of malondialdehyde levels, superoxide dismutase, and catalase activity in children with autism spectrum disorders

OBJECTIVE: Blood biomarkers for diseases have recently become a topic of great interest. Many studies of Autism Spectrum Disorder (ASD) have been made to date looking for biomarkers in peripheral tissues, but no specific biomarker has yet been found. The aim of this study was to examine oxidative stress parameters including malondialdehyde (MDA) levels, superoxide dismutase (SOD), and catalase (CAT) activity and to determine both their sensitivity and specificity as biomarkers associated with oxidative stress in ASD. METHODS: This study measured the plasma MDA levels, SOD, and CAT activities in erythrocyte in 52 patients with ASD (aged 3–6 years) and in 48 age- and gender-matched healthy controls. ASD severity was rated using the Childhood Autism Rating Scale (CARS). RESULTS: MDA levels, SOD, and CAT activity were significantly higher in patients with ASD in comparison to the controls (p < .001). The receiver operator characteristic curve analysis showed a high diagnostic value for MDA, SOD, and CAT. Their areas under curve (AUC) were 0.937, 1.0, and 1.0, respectively (p < .001). A positive statistically significant correlation was determined between the total CARS score and MDA levels in ASD patients (r = 0.368, p = 0.007). CONCLUSION: This study shows that oxidative stress is higher in children with ASD. Increased vulnerability to oxidative stress may contribute to the development of ASD. Given the high sensitivity and specificity results, it is thought that these selected oxidative stress parameters could be important as biomarkers for ASD. Future studies should focus on the sensitivity and specificity of oxidative stress biomarkers in larger ASD populations