Involuntary social cue integration in patients with obsessive compulsive disorder

Objective Patients with obsessive compulsive disorder (OCD) have inferior social functioning compared to healthy controls, but the exact nature of these social deficits, and the underpinning mechanisms, are unknown. We sought to investigate social functioning in patients with OCD by measuring their involuntary/spontaneous processing of social cues using a specifically designed test, which might reveal deficits in these patients that explicit voluntary tasks do not detect. Methods The sample of the study consisted of an OCD group (n = 25) and a control group (n = 26). Both groups performed an adaptation of the Social Distance Judgment Task (SDJT; Jellema et al., 2009), in which participants have to judge the geometrical distance between two human cartoon figures presented on a computer screen. Head/gaze direction and body direction were manipulated to be either compatible, i.e. both directed to the left or to the right (Compatible condition) or incompatible, i.e. body directed toward the observer (frontal view) and head/gaze directed to the left or right (Incompatible condition). Results In the Compatible condition, controls nor OCD patients were influenced by the social cues in their judgments of the geometrical distances. However, in the Incompatible condition, where the attentional cue was more conspicuous, both groups were influenced by the cues, but the controls to a significantly larger extent than the OCD patients. Conclusions This study showed that patients with OCD are less likely, compared to controls, to automatically/spontaneously integrate the other’s direction of attention into their visual percept. This may have resulted in their judgments of the geometrical distances between the agents to be more accurate than those of controls. The suggested impairment in automatically integrating social cues may have important repercussions for the social functioning of OCD patients

Depressive symptomatology among university students in Denizli, Turkey: Prevalence and sociodemographic correlates

Aim: To determine overall and subgroup prevalence of depressive symptomatology among university students in Denizli, Turkey during the 1999-2000 academic year, and to investigate whether sociodemographic factors were associated with depressive symptoms in university students. Methods: A stratified probability sample of 504 Turkish university students (296 male, 208 female) was used in a cross-sectional study. Data were obtained by self-administered questionnaire, including questions on sociodemographic characteristics and problem areas. The revised Beck Depression Inventory (BDI) was used to determine depressive symptoms of the participants. BDI scores 17 or higher were categorized as depressive for logistic regression analysis. Student t-test and linear regression were used for continuous data analysis. Results: Out of all participants, 26.2% had a BDI score 17 or higher. The prevalence of depressive symptoms increased to 32.1% among older students, 34.7% among students with low socioeconomic status, 31.2% among seniors, and 62.9% among students with poor school performance. The odds ratio of depressive symptoms was 1.84 (95% confidence interval [CI], 1.03-3.28) in students with low socioeconomic status and 7.34 (95% CI, 3.36-16.1) in students with poor school performance in the multivariate logistic model. The participants identified several problem areas: lack of social activities and shortage of facilities on the campus (69.0%), poor quality of the educational system (54.8%), economic problems (49.3%), disappointment with the university (43.2%), and friendship problems (25.9%). Conclusions: Considering the high frequency of depressive symptoms among Turkish university students, a student counseling service offering mental health assistance is necessary. This service should especially find the way to reach out to poor students and students with poor school performance

Efficacy of transcranial magnetic stimulation in treatment-resistant depression

Background/aim: The use of Transcranial Magnetic Stimulation (TMS) in the add-on treatment of patients with treatment-resistant depression (TRD) is becoming more common. This study aims to investigate the efficacy of TMS on depression and accompanying anxiety symptoms among patients with TRD. Materials and methods: The current study was conducted with 38 patients diagnosed with TRD. The patients were randomly divided into two groups and received 20 sessions of high-frequency (10Hz) TMS and 20 sessions of sham TMS to the left dorsolateral prefrontal cortex in a double-blind and cross-over fashion without a change in their pharmacotherapy. In the clinical evaluation, Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A) were carried out three times in total: before, crossover phase, and at the end of the treatment. Results: A statistically significant decrease was found in the HAM-D and HAM-A in the group who were actively stimulated in the cross-over phase of the study. While there was a significant decrease in the HAM-A in the group who received sham stimulation, the decrease in the HAM-D was not statistically significant. Group comparisons revealed a statistically significant decrease in HAM-D in the group who were actively stimulated compared to the group receiving sham stimulation. At the end of the study, 63% of 38 patients responded to treatment, 15% partially responded, and 42% reached remission. Conclusion: This randomized, double-blind, sham-controlled, cross-over study revealed that TMS is superior to sham-TMS, provides clinically significant improvement when implemented besides pharmacotherapy among patients with treatment-resistant depression, and is beneficial for accompanying anxiety symptoms

Prevalence of dementia, related risk factors and psychiatric comorbidity in nursing home residents

Objective: The aim of this study is to determine the prevalence of dementia and related factors and comorbid psychiatric disorder among elderly in nursing home. Methods: This study was done in 141 elderly people who live in Denizli nursing home. Dementia and psychiatric disorder were diagnosed according to DSM-IV diagnostic criteria. Mini Mental State Examination, Hamilton Anxiety Rating Scale, Cornell Scale for Depression in Dementia, Global Deterioration Scale, Multidimensional observation scale for elderly subjects were used for elderly in this study. Results: Our study includes elderly people who are men (66%) and women, the mean age of group was 74.99±9.81 years, the mean education years was 1.79±3.03 years, mean duration in nursing home was 42.68 months. Prevalence of DSM-IV dementia was 62.4% (n=88). Out of patients with dementia 59 (67%) were Alzheimer Disorder, 22 (25%) were vascular dementia and 7 (%8) were the other type of dementia. Age, number of chronic physical disorder and the number of the drugs used were higher in dementia group than in non-dementia group. Level of education was lower in elderly with dementia than elderly without dementia. Older age than 76 years, residing in rural areas, low education level, having to Diabetes Mellitus are determined to be the risk factors for depressive disorders according to logistic regression analysis. At least one psychiatric disorder was associated with 45.6% of dementia patients and depressive disorder was found to be the most diagnosed entity. Conclusion: The prevalence of dementia and comorbid depression is common among elderly people in nursing homes

Quantitative EEG analysis in obsessive compulsive disorder

Quantitative analysis of the EEG (q-EEG) in patients with obsessive compulsive disorder (OCD) showed a decreased beta and an increased theta power at frontotemporal regions. The patients who had higher scores in doubting test (Maudsley Obsessive Compulsive Questionnaire) and more severely ill patients shared similar q-EEG features. The relative theta powers were significantly increased and alpha powers were significantly decreased in these patients, particularly in the frontotemporal region. It was suggested that the q-EEG may be useful in investigating the OCD patients with heterogeneous characteristics

A follow-up study of male sexual disorders: The neurophysiological assessments, anxiety-depression levels, and response to fluoxetine treatment [10]

Abstract Not Availabl

OCD symptoms in a sample of Turkish patients: A phenomenological picture

This study aimed to investigate the clinical features of obsessive-compulsive disorder (OCD) and the possible association between obsessive-compulsive symptoms and culture-related characteristics in a sample of Turkish patients with OCD. We studied 141 patients with OCD (according to DSM-IV criteria) consecutively admitted to our outpatient clinic during the period from February 1998 to December 2003. We used the Turkish version of the Structured Clinical Interview for DSM-IV (SCID) to interview all patients, and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to assess obsessive-compulsive symptoms and severity. The onset of OCD symptoms was earlier in males. Major depression was the most common comorbid disorder (30.5%). The most commonly occurring obsessions were contamination (56.1%), aggression (48.9%), and somatic (24.1%), followed by religious (19.9%), symmetry (18.4%), and sexual imagery (15.6%). Symmetry and sexual obsessions, and checking compulsions and rituals, tended to be more common in male patients. Dirt and contamination obsessions and washing compulsions were slightly more common in females. The vast majority of patients with religious obsessions (83%) and half of the patients with sexual obsessions had compulsions that included religious practices. Also, patients with sexual and religious obsessions had delayed seeking professional help. © 2006 Wiley-Liss, Inc

Prefrontal cortex neurochemical metabolite levels in major depression and the effects of treatment: An 1HMRS study

Objective: Neuronal degeneration in the prefrontal cortex during depression results in altered production of neurochemical metabolites. The aim of the present study is to examine changes in neurochemical metabolites in the prefrontal cortex and evaluate the effects of psychodrama group therapy and pharmacotherapy on neurochemical metabolism in the first episode depression using 1HMRS methodology. Method: Eighteen drug-free female patients with diagnosed first-episode major depression according to DSM-IV criteria and 10 healthy female subjects were enrolled in the study. The Hamilton Rating of Depression Scale (HAM-D) was used to asses the severity of depression in each of the study participants. Proton magnetic resonance spectroscopy (1HMRS) was applied to the right prefrontal cortex both before and after treatment and the concentration of N-Asetil Aspartate (NAA), choline (Cho), and creatine (Cr) were measured. All patients were prescribed ant-depressant medication at the time of the evaluation (essitalopram 10-20 mg/g). In addition, a psychodrama group therapy session was conducted in which 10 patients participated in one 3-hour session each week. HAM-D and 1HMRS were repeated after 16 weeks. Result: Prior to treatment, the HAM-D score in the patient group was 14.55±4.55 while the HAM-D score was 3.88±2.47 after 16 weeks of treatment. The severity of symptoms among the patient group was determined to be mild/moderate. No neurochemical abnormalities were identified in the right prefrontal cortex of depressed patients compared to the healthy subjects in the baseline measurements and no significant change was observed in neurochemical metabolites following treatment with pharmacotherapy or pharmacotherapy with group psychotherapy. Conclusion: Our results identified no neurodegeneration, cell membrane dysfunction, alterations in energy metabolism, or altered neurochemical metabolite levels in patients undergoing a first episode of mild/moderate depression. Further studies will be needed to evaluate the effects of alternate treatments and the presence or absence of neuronal damage during follow-up of patients with depression