Manic symptoms probably associated with short-term low-dose quetiapine use

WOS: 000255873200008PubMed: 18224291Nowadays, there is a widespread use of atypical (second-generation) antipsychotics as an adjunct pharmacotherapy in psychiatry clinics, especially at lower doses in several diagnoses. Here, 2 cases are reported where patients with diagnosed schizophrenia displayed manic symptoms on quetiapine 100 mg/d. The cases presented here had no history of mood disorders. It is discussed that the mania/hypomania may be associated with quetiapine treatment and defined as an adverse effect. Manic symptoms may be a 'probable adverse effect' according to the Naranjo adverse drug reactions probability scale, with a score of 6 points in both our cases. Several studies have suggested that quetiapine-induced mania/hypomania may be associated with frontal dopamine release via serotonin 5HT2A receptor blockade. Hence, clinicians should monitor the mood alterations of patients carefully during the atypical antipsychotic treatment. This is also the conclusion of our study as the patients may be slow metabolisers of CYP450-3A4, as suggested by their previous side effects on different antipsychotics

Children with fractures show higher levels of impulsive-hyperactive behavior

WOS: 000248076800030PubMed: 17353797Children with fractures have been reported to have impulsive-hyperactive behavior problems although whether they exhibited such behavior more often than children with other orthopaedic conditions is unknown. We investigated whether impulsivity-hyperactivity was more prominent in children with extremity fractures than in children with orthopaedic conditions not involving a fracture. From outpatient clinical intakes, we recruited 39 consecutive children with extremity fractures and 33 children with orthopaedic conditions not involving a fracture. We used the Conners' Parent Rating Scale to detect behavioral symptoms in children with and without extremity fractures. Children who were treated for extremity fractures had higher mean scores for impulsivity-hyperactivity than those treated for nontrauma-related reasons. Additionally, more children in the fracture group reached impulsive-hyperactive behavior scores high enough to warrant additional psychiatric evaluation. In terms of injury prevention, the orthopaedic surgeon should be familiar with problem behaviors of children, particularly impulsivity and hyperactivity, to be able to make appropriate referrals for psychiatric evaluation and treatment

Executive dysfunctions and depression in Behcet's disease without explicit neurological involvement

WOS: 000239010500012PubMed: 16884449This study aims to assess the executive functions and depression status in patients with Behcet's disease without explicit neurological involvement and to evaluate cognitive functions in this group of patients independent of accompanying depression. In the present study, 30 patients with Behcet's disease in the non-active phase of their illness and 30 healthy volunteers were included. In the evaluation of depression levels, Beck Depression Inventory was employed. The executive functions of the patients were evaluated by Wisconsin Card Sorting Test (WCST) and Stroop Test (ST). Beck Depression Inventory scores measured in the Behcet's disease group, in which no clinically serious depression was observed, were higher than the control group. Then, it was observed that the scores of neuropsychological tests of the Behcet's disease group were found to be significantly lower, especially in WCST, while significant relations were revealed between Beck Depression Inventory scores and WCST, ST scores. The authors' findings suggest that there may be factors other than depression causing executive impairment in patients with Behcet's disease without explicit neurological symptoms. Executive dysfunctions may occur in association with mild depressive states due to chronic disease stress or silent and/or future neurological involvement of Behcet's disease, especially in the frontal lobes

Pseudocyesis in a patient with anorexia nervosa: etiologic factors and treatment approach

Objective: Pseudocyesis is a rare condition in which a non-pregnant woman has all signs and symptoms of pregnancy, such as abdominal and breast enlargement, cessation of menses and sensation of foetal movement. We hereby present a case of a young woman who presented with pseudocyesis while experiencing anorexia nervosa. Methods: After psychiatric examination, psychopharmacotherapy including cognitive behavioural therapy (CBT) techniques and medication for ongoing depression and eating disorder was provided. Results: After six months of psychopharmacotherapy, depressive mood and belief of being pregnant were diminished; but after two years, she presented to psychiatry for depression and pseudocyesis symptoms again. Conclusions: Etiologic risk factors and treatment approaches including psychotherapy and psychopharmacology are addressed in this case report

Differences Between Childhood Traumatic Experiences and Coping Styles for Male and Female Patients with Major Depression

Objective: The aim of this study was to evaluate the impact of childhood traumas, determine their effects on coping skills, and assess gender specific differences in patients with major depression. Method: Fifty female and fifty male patients with unipolar depression were enrolled. All patients were administered sociodemographic a data form, the Beck Depression Inventory, and subjected to a COPE Scale. Experiences of childhood abuse and neglect were assessed by the Childhood Trauma Questionnaire (CTQ-28). Results: First, female patients with childhood traumas were found to use emotion focused coping styles whereas, male patients used problem focused and less useful coping styles more frequently. Second, there were positive relationships between childhood trauma scores and depression severity, childhood sexual abuse, and emotion focused coping styles in both male and female groups according to correlation analyses. In addition, childhood traumas led to further modifications on coping styles in the male group. Finally, a multiple linear regression model was used to identify independent predictors of coping styles. For both men and women, it was shown that childhood sexual abuse was significantly and positively related to emotion focused coping styles. Depression severity was the other predictor for emotion focused coping styles and was less useful in only the male group. Conclusion: Increased information on childhood trauma history and gender specific coping strategies could help to identify individual's at risk for depression and/or predict response to treatment. Future studies should focus on the prospective investigation of potential predictors and mediators in this area

The effect of the angiotensin-converting enzyme gene polymorphism on the depression and anxiety levels

WOS: 000270343400004Objective: We aimed to investigate the relationship between the angiotensin-converting enzyme (ACE) gene insertion (I) and deletion (D) polymorphism and the levels of anxiety and depression. Methods: This is a cross-sectional study, which included the cases who admitted a university hospital cardiology department with the complaint of chest pain without cardiac etiology. It is well known that there is a strong connection between the ACE and hypertension (HT) and coronary arterial diseases (CAH) among peripheral mechanisms. Hence, the subjects included the study were preferred that have no cardiovascular diseases at that time. In this way, it was aimed to conclude that ACE might have an effect on the levels of the anxiety and depression via possible central mechanisms. The study group, which was total 39 patients, was constituted that 26 female with the mean age 51.92 +/- 9.78 and 13 male with the mean age 49.77 +/- 10.01. Their first examination was carried out in cardiology department and performed the necessary techniques. Then the subjects were given the Beck Depression Inventory and Beck Anxiety Inventory in psychiatry department. Serum samples of the group were transferred to genetic laboratory. The statistical analyses were performed by SPSS 15.0 for Windows. MANOVA, Post Hoc Bonferroni Test, Kruskal Wallis Test and Fischer's Exact Test were used with a related manner. Results: It was found that DID polymorphism that is related with the high ACE activity has a significant association between I/I polymorphism that is related with the low ACE activity and D/I polymorphism that is related with the moderate ACE activity in terms of BDI scores (p=0.010 and p=0.030, respectively). On the other hand, in the BAI scores, DID polymorphism was seen to be a significant association only with I/I polymorphism (p=0.002). Conclusion: It is well established that the ACE gene D polymorphism could be associated with the essential hypertension in the human. In our study, significant relation with the D genotyping and the levels of depression and anxiety were observed in a group, which have no cardiovascular problem detected. It could be suggested that the effect of the ACE system on the arterial pressure may have a role in a different manner from the central mechanisms which may be related the anxiety and depression etiology. (Anatolian Journal of Psychiatry 2009; 10:181-186

State and Trait Anxiety Levels of Adolescents in a Changing Society, Kirikkale City, Turkey

WOS: 000303866900010PubMed: 22383015Adolescents face rapidly changing challenges. Psychosocial health problems during adolescence are relatively common in all cultures. This study was designed to evaluate the state and trait anxiety status and influencing sociodemographic and other factors, thought to pertain to youth, on anxiety among school children in Kirikkale. It was carried out at three public primary and two high schools representative of two different socioeconomic statuses. 430 Turkish school children (246 girls, 184 boys) were asked voluntarily to answer a set of questionnaires in their classrooms at the beginning of a training programme. Then the State and Trait Anxiety Inventory for Children was administered. Mean age of the students was 14.16 +/- A 1.87 years. The mean total STAI-CS and STAI-CT scores were 40.24 +/- A 11.64, and 44.71 +/- A 9.64, respectively. There were no differences in STAI-CS and STAI-CT scores between boys and girls in both schools and in all age groups. Among girls, a positive body image had a significant effect on state anxiety scores. There was a positive correlation between age and anxiety scores (r = .17, F:12.176, p < .001). Students identifying their families SES as bad and/or moderate scored significantly higher in comparison to the other groups (p < .05). STAI-CS scores were higher for lower educational grade, higher body weight and sleep problems. In Kirikkale, a city faced with substantial changes in cultural and traditional norms, adolescents could be expected to be under stress and appear to be responding to stress with anxiety