Bipolar Bozuklukta Çalışma Statüsü ve İlaç Uyumu: Kuram Temelli Bir Değerlendirme

The aim of this study is to examine how medication adherence differs in patients diagnosed with bipolar disorder who have different employment status and also to examine the relationship of employment status with disorder severity and sociodemographic variables from the perspective of Integrated Behavioural Model (IBM), one of the health behaviour models. To that end, 167 patients diagnosed with bipolar disorder were reached. IBM Bipolar Disorder Medication Adherence Inventory, Medication Adherence Scale, and medication adherence in terms of measured medication level in blood were used. At the end of the analyses conducted, it was found that both the severity of disorder and the medication nonadherence of civil servants were higher than other groups with different employment status. It is concluded that there is a need for intervention programs for medication adherence, especially for civil servant groups with bipolar disorder.Bu çalışmanın amacı ilaç uyumunun farklı çalışma statüsüne sahip bipolar bozukluk tanılı hastalarda nasıl farklılaştığını sağlık davranış modellerinden biri olan Bütünleşik Davranış Modeli (BDM) perspektifinden incelemek ve çalışma statüsünün hastalık şiddeti ve sosyodemografik değişkenlerle olan ilişkisini değerlendirmektir. Bu amaç doğrultusunda 167 bipolar bozukluk tanılı hastaya ulaşılmıştır. Veri toplama araçları olarak BDM Bipolar Bozukluk İlaç Uyumu Bataryası, Tıbbi Tedaviye Uyum Oranı Ölçeği ve İlaç Uyumunu Bildirim Ölçeği, kanda ölçülen ilaç düzeyi açısından ilaç uyumu kullanılmıştır. Yapılan analizler sonucunda memurların diğer çalışma statüsüne sahip gruplara göre hem hastalık şiddetinin hem de ilaç uyumsuzluğunun daha yüksek olduğu saptanmıştır. Özellikle bipolar bozukluk tanılı memur gruplarında ilaç uyumuna yönelik müdahale programlarına ihtiyaç duyulduğu düşünülmektedir

Investigating the effects of glucose and lipid metabolism on neuronal structure using optical coherence tomography in treatment-resistant schizophrenia

Objective:The effects of metabolic changes on neural structures in the later stages of schizophrenia remain unknown. Alterations in glucose and lipid metabolism could impact disease progression. This study aims to investigate the effects of glucose and lipid metabolism on neuronal structures in treatment-resistant schizophrenia using optical coherence tomography (OCT), glycogenic proteins, and cholesterol values.Method:The study included 39 schizophrenia patients with remission, 43 treatment-resistant schizophrenia (TRS) patients, and 40 healthy controls (HC). Optical coherence tomography (OCT) was performed on all participants. Serum samples were collected to determine fasting glucose, Low-Density Lipoprotein (LDL), High-Density Lipoprotein (HDL), triglycerides, total cholesterol, fasting insulin, and Insulin-like Growth Factor 1 (IGF-1) levels. Results: IGF-1 levels in TRS patients were higher than those in the remission group. Additionally, the thickness of the inferior retinal nerve fiber layer (RNFL), superior RNFL, and global RNFL regions was significantly lower in the TRS group than in the HC group.Conclusion: While OCT measurements and elevated IGF-1 levels indicate neural thinning in treatment-resistant schizophrenia, there was no observed effect from lipid and glucose metabolism on this phenomenon

Can the imbalance between neurotrophic and apoptotic proteins be the "beware the ides of march" for unaffected relatives of schizophrenia patients?

Schizophrenia (SZ) is a mental disorder with a strong genetic basis as well as epigenetic aspects. Siblings of patients with SZ can share certain endophenotypes with the patients, suggesting that siblings may be important for distinguishing between trait and state markers. In the current study, we aimed to characterize the balance between pro-BDNF/mature BDNF and its receptors p75NTR/TrkB, which are tPA-BDNF pathways proteins and are thought to play a role in synaptic pruning, as a possible endophenotype of schizophrenia. Forty drug-naive patients with first-episode psychosis (FEP) matched for age, gender, and level of education, 40 unaffected siblings (UAS) of patients with FEP, and 67 healthy controls (HC) were included in the study. Blood samples were collected from all participants to determine BDNF, pro-BDNF, TrkB and p75NTR, PAI1, tPA, ACTH, and cortisol levels. We showed that levels of proteins of the tPA-BDNF pathway as well as the pro-BDNF/m-BDNF and p75NTR/TrkB ratios could successfully differentiate FEP and their siblings from the HCs by using ROC analysis. Plasma levels of m-BDNF were found to be the lowest in the healthy siblings and highest in the HCs with statistically significant differences between all 3 groups. The plasma level of pro-BDNF in the HC group was similar to the FEP patients, the same in the healthy siblings of the FEP patients. Our data support the hypothesis that imbalance between neurotrophic and apoptotic proteins might occur in SZ and this imbalance could be an endophenotype of the disease.University of (University of Health Sciences Turkey) Research Projects Uni

Extended-release trazodone in the treatment of major depressive disorder

Majör depresif bozukluk (MDB) sık görülen bir psikiyatrik bozukluktur. Tedavinin amacı belirtilerde remisyon ile günlük işlevlerin düzelmesidir ve antidepresanlar, majör depresif bir nöbetin (orta-şiddetli depresif nöbet) ilk sırada gelen tedavileridir. Bu makale uzatılmış salımlı trazodonun (TzCOAD) farmakolojik özelliklerini, MDB’deki klinik etkinliği ve güvenliğini incelemektedir. Uzman görüşü: Günde tek doz TzCOAD, hızlı salımlı trazodon (TzIR) ve diğer antidepresanlara benzer bir etkinlik ve artmış tolerabilite sağlayabilir. (Anadolu Psikiyatri Derg 2019; 20(5):453-459)Major depressive disorder is a common psychiatric disorder. the aim of the treatment is to improve daily functions with remissions in symptoms, and antidepressants are the first-line treatments for a major depressive episode (moderate-severe depressive episode). in this paper, the pharmacological properties, clinical efficacy and safety of extended-release trazodone (TzCOAD) are studied. Expert opinion: A single daily dose of TzCOAD may provide similar efficacy and increased tolerability to immediate-release trazodone (TzIR) and other antidepressants. (Anatolian Journal of Psychiatry 2019; 20(5):453-459