The complementary role of different neurophysiological methods to demonstrate organicity in male with premature ejaculation and erectile dysfunction

Erectile dysfunction and premature ejaculation are the most common male sexual disorders. Generally, it is considered that erectile dysfunction is related to organic factors whilst premature ejaculation is related to psychological factors. A detailed history along with physical examination such as using penile doppler, penile tumesans and ultrasonography are insufficient for differential diagnosis in 15-20% of cases. Therefore the role of neurophysiological techniques are important. In this study urological and biochemical investigations were used in conjunction with other neurophysiological methods. According to our results, using a neurophysiological test study on its own was ineffective. As a conclusion our study has shown that neurophysiological methods are important differential diagnosis of revealing suspicious organicity - generally believed to be due to psychological factors- in male sexual disorders

Psychodrama in patients with psoriasis: Stress and coping

Objective: The aim of the present study is to investigate the effect of a psychodramatic group work on psychological symptoms and coping styles with stressful life event in a group of psoriasis patients. Ten patients (a male and nine females), who have been followed by Dermatology out patient services of Medical Faculty, Pamukkale University, participated our group work. Seven patients completed eighteen psychodrama orientated group work sessions. Each session lasted three hours and took place only once a week. Methods: Before and immediately after the group work, the participants completed the Beck Depression Inventory and the State- Trait Anxiety Inventory and the Ways of Coping Questionnaire. Psoriasis severity was assessed by using PASI (Psoriasis Area Severity Index). Results: Before group work, the patients had suffered from significant depressive symptoms and the coping strategies most frequently used by patients were religious, emotion focused coping and planning. Three patients have reported that an overt stressful life event caused their psoriasis; the remaining had believed their disease as a result of the emotional aggregation of their life-time stressful experiences. The reported psychosocial stressors by the patients were mostly emotional problems with family member or close relationships. Compared to baseline, at the end of group, while there was a significant reduction of religious coping style and there was an increase of positive re-interpretation (p.05). The severity of psoriasis did not significantly change after group work although it was observed partial improvements in some patients. Discussion: Our results suggest that psychodrama orientated group work may effect positively on coping styles with stress in psoriasis patients

Effects of catechol-O-methyltransferase enzyme Val158Met polymorphism on cognitive functions in schizophrenic patients

Objective: Catechol-O-Methyltransferase (COMT) enzyme plays an important role in dopamine metabolism. Three different genotypes have been defined, one resulting from a valine (val)→methionine (met) amino acid change due to a guanine→adenine nucleotide change at codon 108/158 of the COMT gene, while the other two genotypes are formed by alleles containing val (heat-resistant, high activity) and met (heat-sensitive, low activity). This functional polymorphism in the COMT gene causes an alteration in the enzyme activity, where the enzyme activity is reduced 4 times in genotypes related to low enzyme activity. In schizophrenic patients, alterations in the amounts and efficiency of dopamine are known to be related to the clinical symptoms and cognitive functions. This study aimed to investigate the effects of COMT Val158Met functional polymorphisms on clinical symptoms, executive functions related to prefrontal functions, and attention and verbal memory in schizophrenic patients. Method: Schizophrenic patients in remission, who were followed up at the Psychosis Clinics of Pamukkale University Faculty of Medicine, Department of Psychiatry between the years of 2007- 2009, were included in the study. The Brief Psychiatric Rating Scale (BPRS), the Scale for Assessment of Positive Symptoms (SAPS), and theScale for Assessment of Negative Symptoms (SANS), were used to evaluate the patients. Neuropsychological evaluation included the Wisconsin Card Sorting Test (WCST) for executive functions, the Verbal Memory Processes Test (VMPT) for verbal memory and the Stroop Test (ST) for attention tasks. COMT enzyme Val158Met polymorphisms were defined from the isolated DNA of the patients by Polymerase Chain Reaction (PCR) and Restriction Fragment Length Polymorphism (RFLP) analysis, as defined in literature. Results: A total of 42 patients (16 female, 26 male) were included in the study. The patients were grouped into high-level enzyme activity (Val/Val) and low-level enzyme activity (Val/Met and Met/Met) groups, according to their COMT Val158Met functional polymorphisms, and statistical analysis was carried out accordingly. Patients with Val/Val polymorphism had lower SANS scores, while the number of conceptual level responses, the percentage of conceptual level responses, and the failure to maintenance set scores at WCST were lower compared to those with the met allele. No difference was determined between the two groups in the scores on the SAPS and BPRS, and on the performance of the Stroop Test and the VPMT. Conclusion: We measured lower levels of negative symptoms in patients with high enzyme activity compared to those with low enzyme activity. There was no difference in executive functions assessed with the WCST in scores related to perseveration, while the patients with high enzyme activity presented a better performance in the fields related to working memory. Although the small subject number of the study represents a serious limitation, these results suggest that COMT Val158Met polymorphism has a limited effect on clinical symptoms and executive functions, but no effect on attention level and memory in schizophrenia