Practice of Acute and Maintenance Electroconvulsive Therapy in the Psychiatric Clinic of a University Hospital from Turkey: Between 2007 and 2013

Objective: Electroconvulsive therapy (ECT) can be given as the form of acute, continuation or maintenance ECT according to the process of administration. We report our 7 years' observation with acute and maintenance ECT in a university hospital in Turkey. Methods: The medical records of the hospitalized patients treated with acute or maintenance ECT between the years 2007 and 2013 was retrospectively analyzed. The sociodemographic characteristics, diagnosis, data of ECT and the co-administered psychotropic drugs were recorded. The frequency of ECT was calculated by identifying the total number of the hospitalized patients during the study period from the hospital records. Results: A total number of 1,432 female and 1,141 male patients hospitalized in a period of 7 years, with a total number of 111 patients treated with ECT. The ratio of ECT was 4%, maintenance/acute ECT 11%. For acute ECT, affective disorders (65.3%) and psychotic disorders (21.6%) were among the leading diagnoses. Maintenance ECT, the diagnosis was; 6 affective disorders, 4 psychotic disorders and 1 obsessive compulsive disorder. There was a significant difference between the patients receiving acute and maintenance ECT in terms of age, duration of illness, and number of previous hospitalizations and ECTs. Conclusion: The percentage of patients treated with acute ECT is lower in our institution than that in many other institutions from our country. Acute and maintenance ECT should be considered as an important treatment option particularly for patients with long disease duration, a high number of hospitalizations and a history of benefiting from previous ECTs. Copyright © 2016, Korean College of Neuropsychopharmacology

The impact of synapsin III gene on the neurometabolite level alterations after single-dose methylphenidate in attention-deficit hyperactivity disorder patients

Objective: To investigate the neurometabolite level changes according to synapsin III gene rs133945G.A and rs133946C.G polymorphisms by using magnetic resonance spectroscopy (MRS) in patients with attention-deficit hyperactivity disorder (ADHD). Methods: Fifty-seven adults diagnosed with ADHD were recruited for the study. The participants were examined by single-voxel1H MRS when medication naïve and 30 minutes after oral administration of 10 mg methylphenidate (Mph). Those who had been on a stimulant discontinued the medication 48 hours before MRS imaging. Spectra were taken from the anterior cingulate cortex, dorsolateral prefrontal cortex, striatum, and cerebellum, and N-acetylaspartate (NAA), choline, and creatine levels were examined. For genotyping of the synapsin III gene polymorphisms, DNA was isolated from peripheral blood leukocytes. The effects of age, sex, and ADHD subtypes were controlled in the analyses. Results: After a single dose of Mph, choline levels increased significantly in the striatum of rs133945G.A polymorphism-GG genotypes (P=0.020) and NAA levels rose in the anterior cingulate cortex of rs133946C.G polymorphism-CG genotypes (P=0.014). Both rs133945G.A and rs133946C.G polymorphisms were found to statistically significantly affect the alteration of NAA levels in response to Mph in dorsolateral prefrontal cortex with two-way repeated measure of analysis of variance. Post hoc comparisons revealed a significant difference between CG and GG genotypes of rs133946C.G polymorphisms after Bonferroni adjustment (P=0.016). Conclusion: Synapsin III gene polymorphisms may be affecting the changes in neurometabolite levels in response to Mph in adult ADHD patients. Future studies are needed to confirm our findings. © 2016 Başay et al

Association among SNAP-25 gene DdeI and MnlI polymorphisms and hemodynamic changes during methylphenidate use: A functional near-infrared spectroscopy study

Objective: To investigate the interaction of treatment-related hemodynamic changes with genotype status for Synaptosomal associated protein 25 (SNAP-25) gene in participants with attention deficit hyperactivity disorder (ADHD) on and off single dose short-acting methylphenidate treatment with functional near-infrared spectroscopy (fNIRS). Method: A total of 15 right-handed adults and 16 right-handed children with DSM-IV diagnosis of ADHD were evaluated. Ten milligrams of short-acting methylphenidate was administered in a crossover design. Results: Participants with SNAP-25 DdeI T/T genotype had decreased right deoxyhemoglobin ([HHb]) with treatment. SNAP-25 MnlI genotype was also associated with right deoxyhemoglobin ([HbO2]) and [HHb] changes as well as left [HHb] change. When the combinations of these genotypes were taken into account, the participants with [DdeI C/C or T/C and MnlI G/G or T/G] genotype had increased right [HHb] with MPH use whereas the participants with [DdeI T/T and MnlI T/T] or [DdeI T/T and MnlI G/G or T/G] genotypes had decreased right prefrontal [HHb]. Conclusions: These results suggested that SNAP-25 polymorphism might be associated with methylphenidate induced brain hemodynamic changes in ADHD participants. © 2011 SAGE Publications

Association of SNAP-25 gene Ddel and Mnll Polymorphisms with adult attention deficit hyperactivity disorder

Objective The synaptosomal-associated protein of 25 kDa (SNAP-25) gene is a presynaptic plasma membrane protein and an integral component of the vesicle docking and fusion machinery mediating secretion of neurotransmitters. Previously, several studies reported association between SNAP-25 and attention deficit hyperactivity disorder (ADHD). We investigated whether these SNAP-25 polymorphisms (MnlI T/G and DdelI T/C) were also associated with ADHD in the Turkish population. Methods: Our study comprised unrelated 139 subjects who met DSM-IV criteria for ADHD and 73 controls and all were of Turkish origin. Genetic analyses were performed and patients were evaluated with Wender-Utah Rating Scale and Adult ADD/ADHD DSM IV-Based Diagnostic Screening and Rating Scale. Results: SNAP-25 DdelI polymorphism was not associated with ADHD but there was a statistically significant difference between ADHD patients and controls for SNAP-25 MnlI polymorphism. For SNAP-25 MnlI polymorphism patients with G/G genotype of the SNAP-25 gene MnlI polymorphism had higher Wender-Utah scores and higher scores in the 1st and 3rd parts of adult ADD/ADHD Scale. Conclusion: We detected a significant association of the MnlI polymorphism in our ADHD sample which was similar to previous findings. Our study also revealed that SNAP-25 MnlI polymorphism was also associated with symptom severity of ADHD. This study is also, the first report on the association of SNAP-25 with ADHD in the Turkish population. © 2014 Korean Neuropsychiatric Association

Gençlerin sigara kullanma davranışına anne-baba tutumunun, sosyokültürel değişkenlerin ve sosyal öğrenmenin etkileri

Çalışma, Selçuk Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalınca 1997 yılında yapıldı. Gençlerin sigara kullanma davranışında anne baba tutumunun, sosyo kültürel değişkenlerin ve sosyal öğrenmenin etkisini belirlemek amaçlandı. Veriler 1996-1997 Öğretim döneminde Konya merkezinde bulunan Ortaokul, Lise, Yüksekokul ve Çıraklık Eğitim merkezlerinde eğitim gören 12-21 yaş arasında bütün sosyal katmanları kapsayacak şekilde seçilen 1559 olgu üzerinde yapıldı. Sonuçlar ki-kare, t- testi ve tek yönlü varyans analizi ile SPSS 5.0 programında değerlendirildi. Çalışmada erkekler kızlara göre (p0.05). Annenin birden fazla evlilik yapmasının kızların sigara kullanımını artırdığı bulundu (p0.05). The important variable increasing girl cigarette using is found as mother's marriage more than once (p<0.01)

From genetics to epigenetics: Alcohol addiction

Alcohol addiction is a chronic, relapsing disorder with a huge societal impact. Understanding the genetic basis of alcohol addiction is crucial to characterize individuals' risk and to develop efficacious prevention and treatment strategies. Recent studies have also begun to focus on the molecular mechanisms and epigenetics of alcohol addiction. Changes in gene expression in brain reward regions are thought to contribute to the pathogenesis and persistence of drug addiction. Data from classical genetic studies to new epigenetic studies could show us new dimensions of alcohol addiction. Data from genetic studies also guide pharmacotherapeutic agent choice for optimum treatment of alcohol addiction. In this review, we examined the Pubmed database, using alcoholism, genetics, epigenetics and polymorphism key words and than discussed results of studies

Pharmacogenetics of antipsychotic-induced weight gain

Antipsychotic-induced noticeable weight gain and metabolic syndrome cause serious health problems in psychiatric patients with the foremost of diabetes. The nature of medication-induced weight gain is not the same for everyone; besides varying with the medication and person, most frequently it is observed in people using atypical antipsychotics. Mostly Foremost genetic, but also other studies researching to predict what rate of weight gain in which patients have been going on. With the aim of guiding future genetic studies exploring the genetics of weight gain the previous studies conducted on this topic were reviewed in this study

Aripiprazole In Delusional Disorder

Though it has been known for a long time, due to the fact that the controlled studies are limited and the disorder is uncommon, case reports have been important supporting the data of the treatments. In general, depending on whether the patient used drug before and considering the effects and side effects of the drugs the first choice in the treatment is antipsychotic drugs. New atypical antipsychotic agents are preferred for their relatively less side effects and higher drug adaptation. We aimed to report a case of delusional disorder (jealous type) which did not respond to different atypical antipsychotic agents previously but shows a prognostic improvement by aripiprazole of 30mg/day. Aripiprazole may be an effective option for the treatment of delusional disorder, with few side effects, high drug compliance and efficacy