The Role of Microbiota in the Etiology of Schizophrenia

In recent years, the role of microbiota in the etiology of schizophrenia has been a focus of investigation. It is now increasingly recognized that bidirectional communication exists between brain and gut microbiota. Evidence that indicate possible microbiota alteration in schizophrenia includes structural damage to the gastrointestinal tract, a heightened immune response to infectious pathogens and food antigens. It is proposed that an altered microbiome may contribute to abnormalities in metabolic function in schizophrenia. The aim of this article is to review recent literature on connection of the microbiota and schizophrenia

The Role of Catechol-O-Methyltransferase (COMT) Gene in the Etiopathogenesis of Schizophrenia

Genetic factors in the risk of developing schizophrenia is of great importance. With the help of the advances in the field of genetics in recent years by using linkage analysis several genes have been identified that may be a risk factor in schizophrenia. Several association studies have been performed in many different populations on the candidate susceptibility genes that were defined in previous studies. However, these studies give controversial results in different countries with different populations, and there are problems in obtaining replicable results. In this review we aimed to focus on the genetic basis of schizophrenia and the relationship between schizophrenia and catechol-O-methyltransferase (COMT) gene. COMT encodes an enzyme molecule which has an important function in dopamine pathways. It has great importance in catecholamine metabolism and pharmacology and genetic mechanism of catechol metabolism variations and their clinical consequences. COMT transfers the methyl group from S-adenosyl-methionine to the hydroxyl group of catechol nucleus (such as dopamine, norepinephrine or catechol estrogen). Genetic variations found in COMT gene are associated with a broad spectrum of clinical phenotype including psychiatric disorders or estrogen related cancers. Several groups have performed studies on the relationship between schizophrenia and COMT. The most commonly studied polymorphism in COMT gene is rs4680 and it causes a valine methionine conversion at codon 158. The association studies on this polymorphism in different populations gave both positive and negative results. Schizoprenia is a complex disease caused by the interaction of environmental and genetic factors, while interpreting the genetic data, this fact and the possibility of the presence of different gene products should be taken into account. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(3.000): 217-226

Testosterone and 17-OH progesteron levels in women with depression and the effects of antidepressant treatment

Objective: Women suffer from depression more often than males, indicating that sex hormones might be involved in the etiology of this disease. The aim of this study was to investigate whether testosterone and 17-OH progesterone are related to the pathophysiology of depression in depressed women. We also investigated if any alteration takes place in these hormonal variables with antidepressant treatment. Methods: Forty female inpatients suffering from a depressive episode and 20 healthy female controls were recruited in the study. In the patient and control groups, serum total testosterone, 17-OH progesterone and SHBG levels were assayed. Pharmacotherapy was given to the patient group for 6-10 weeks (venlafaxine n=19, fluoxetine n=12, imipramine n=9). Hormonal measurements were repeated after the treatment in the patient group who responded to antidepressant treatment. Results: Serum testosterone levels were higher in the depressive women than in the healthy women. The testosterone levels were normalized by antidepressant treatment. 17-OH progesterone and SHBG levels did not differ between patients and controls. Conclusions: The result of normalized testosterone levels with pharmacotherapy suggests that testosterone may have a relationship with depression. Elevated levels of testosterone in depressed women might be a result of over activation of the adrenal glands, which are the main source of this hormone in women. (Anatolian Journal of Psychiatry 2010; 11:285-292

Effects of antidepressant treatment on thyrotropin-releasing hormone stimulation, growth hormone response to L-DOPA, and dexamethasone suppression tests in major depressive patients

Dexamethasone suppression (DST), thyroid-stimulating hormone (TSH) and prolactin (PRL) responses to thyrotropin-releasing hormone (TRH) and growth hormone (GH) response to L-DOPA tests were evaluated in 19 depressed inpatients before the commencement of the antidepressant treatment and after the clinical response to examine: (i) the functional relationships among the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-thyroid (HPT) axis and dopaminergic system in depression, (ii) any alterations in these hormonal functions with the antidepressant treatment. TSH responses to TRH showed a tendency to increase from pre- to posttreatment period, while TRH-induced PRL and L-DOPA-induced GH responses did not change with treatment in depressed patients who responded to the treatment. Females showed significantly higher TSH and PRL responses to TRH compared to males. No interconnections were found among the responses in DST, TRH stimulation test and L-DOPA-induced GH test in the patients. The results do not support the interrelations between the abnormalities in the HPT and HPA axes and central dopaminergic activity in depression. (C) 2003 Elsevier Inc. All rights reserved

Neurosteroids and cognitive functions in depressed women

Objective: Dehydroepiandrosterone (DHEA) and its sulfate ester dehydroepiandrosterone sulfate (DHEAS) are known to be neuroactive steroids and are proposed to have GABA antagonistic properties. The aim of this study was to investigate whether DHEAS is related to the pathophysiology of depression by examining alterations in serum DHEAS levels and its regulatory factors by the dexamethasone suppression test (DST), and whether there is any relationship between these alterations and cognitive functions in depression. We also investigated if any alteration takes place in these hormonal variables with antidepressant treatment

Avaliação da comunicação de psiquiatras com pacientes psicóticos

Evaluation of the physician-patient relationship is very important in determining priorities in medical practice and medicine. For this purpose, in this study the psychiatrist’s communication with psychotic patients as a sensitive group was evaluated. A questionnaire was administered to 210 patients in a psychiatric clinic of Inonu University Hospital in Turkey to determine how the examination is performed in the facility for outpatients in the psychosis unit. According to the study conducted, it was observed that the evaluation score of the psychiatrist's communication with psychotic patients increased positively with increasing consultation duration. Our work is particularly noteworthy because it deals with a sensitive area, such as a group of psychiatric patients. The scores were obtained based on data from the evaluation of the questionnaires, which showed that the communication between the psychiatrist and the psychotic patient was conducted in a sensitive and careful manner, and without ethical problems.La evaluación de la relación médico-paciente es muy importante para determinar las prioridades en la práctica médica y la medicina. Para este propósito, en este estudio se evaluó la comunicación del médico psiquiatra con los pacientes psicóticos como grupo sensible. Se administró un cuestionario a 210 pacientes de una clínica psiquiátrica del Hospital de la Universidad de Inonu en Turquía, para determinar cómo se realiza el examen en el establecimiento para los pacientes externos de la unidad de psicosis. De acuerdo con el estudio realizado, se observó que el puntaje de evaluación de la comunicación del psiquiatra con los pacientes psicóticos se incrementó positivamente al aumentar la duración de la consulta. Nuestro trabajo se destaca particularmente por tratarse de un área sensible, como es un grupo de pacientes psiquiátricos. Los puntajes se obtuvieron basándose en datos de la evaluación de los cuestionarios, que mostraron que la comunicación entre el psiquiatra y el paciente psicótico se realizó de una forma sensible y cuidadosa, y sin problemas éticos.A avaliação da relação médico-paciente é muito importante para determinar as prioridades na prática médica e na medicina. Para este fim, neste estudo foi avaliada a comunicação do psiquiatra com pacientes psicóticos como um grupo sensível. Um questionário foi aplicado a 210 pacientes em uma clínica psiquiátrica do Hospital Universitário Inonu na Turquia para determinar como o exame é conduzido nas instalações para pacientes ambulatoriais da unidade de psicose. De acordo com o estudo realizado, observou-se que a pontuação da avaliação da comunicação do psiquiatra com pacientes psicóticos aumentou positivamente à medida que a duração da consulta aumentava. Nosso trabalho é particularmente notável porque trata de uma área sensível, tal como um grupo de pacientes psiquiátricos. Os resultados foram obtidos com base nos dados da avaliação dos questionários, que mostraram que a comunicação entre psiquiatra e paciente psicótico foi realizada de forma sensível e cuidadosa, e sem problemas éticos