Hyperandrogenism-related metabolic changes in drug-naïve transmen compared to cisgender women: a case-controlled study

Introduction: The aetiology of gender dysphoria is still unclear. Although prior studies have shown that trans men have higher androgen levels than cisgender women, they all concluded unselected populations. Our reason for performing this study is to evaluate trans men’s hormone profile and metabolic status to compare with cisgender women in a more selected population. This is the first case-controlled study to compare anthropometric, metabolic, and endocrinological parameters of drug-naïve trans men with those of cisgender women. Material and methods: We designed this study as a single-centre observational cohort study. We included 70 drug naïve trans men, and the control group comprised 34 healthy cisgender women. We measured and compared hormone profiles and metabolic parameters in the 2 groups. Results: Of the 70 trans men individuals, 16 (22.85%) met the Rotterdam criteria and were diagnosed with polycystic ovary syndrome (PCOS); 4 individuals in the control group met the criteria (11.7%). Although we matched body mass index in the groups, total testosterone, free androgen index, androstenedione, 17 hydroxyprogesterone, muscle strength, triglyceride, and homeostatic model assessment of insulin resistance levels were significantly higher in the trans men than in the cisgender women (p < 0.05). Even after were excluded PCOS patients, hyperandrogenaemia was apparent in the trans men. Conclusion: Our study showed that trans men have clearly higher androgen levels, which may have been the reason for metabolic changes compared to cisgender women. However, the main reason for hyperandrogenism in drug-naïve trans men is still not known, and more comprehensive studies are needed

Optical Coherence Tomography Findings in Cannabis Users

Objective: In this study, we aimed to evaluate the effects of cannabis use on the retinal nerve fiber layer (RNFL) and the macular ganglion cell - inner plexiform layer GCL-IPL using optical coherence tomography (OCT). Method: This prospective, comparative study included 26 cannabis users who were evaluated at the Psychiatry Outpatient Unit of Mus State Hospital and 27 age and gender matched healthy controls. OCT was performed on both groups. The RNFL and GCL - IPL thicknesses, measured automatically by OCT, were recorded and compared between the groups. Results: The sociodemographic parameters of the two groups did not differ. The mean retinal nerve fiber thickness and thickness at the superior, nasal, inferior quadrants were not significantly different; but there was a significant difference at the temporal quadrant (p=0,022). In the analysis of macular ganglion cell - inner plexiform layer, the mean values as well as the infetotemporal, inferior, inferonasal and superonasal quadrants did not show significant differences. But there was a statistically significant decrease in the superior and superotemporal quadrants (p=0,006, p=0,027). Conclusion: These findings suggest that cannabis use leads to the thinning on retinal layers. As it is an easily observable part of the brain, evaluating retinal nerve fiber and ganglion cell layer with OCT may be important for monitoring toxic and degenerative effects in cannabis users

Efficacy of bright light therapy in bipolar depression

For 30 years, bright light therapy (BLT) has been considered as an effective, well-tolerated treatment for seasonal affective disorder (SAD). Because of low response rates, new treatment strategies are needed for bipolar depression (BD), which resembles SAD in certain respects. Few placebo-controlled studies of BLT efficacy have been carried out for BD. Accordingly, this study evaluates the efficacy and safety of BLT as an add-on treatment for BD. Thirty-two BD outpatients were randomly assigned to BLT (10000 lx) or dim light (DL, < 500 lx). During a two-week period, light was administered each morning for 30 min. The Hamilton Rating Scale for Depression and the Montgomery-Asberg Depression Rating Scale assessed clinical outcome, and the UKU Side Effects Rating Scale evaluated side effects. No significant difference was observed in baseline depression scores in the two groups. Response rates for BLT and DL were 81% and 19%, and remission rates were 44% and 12.5%, respectively. Analyses showed statistically significant reductions in depression scores for the BLT group compared with the DL group on all scales. Side effects were similar in both groups, with headache as the most common side effect. The results suggest that BLT is an effective and safe add-on treatment for BD

Validity and reliability of the Turkish version of the adult ADHD Self-Report Screening Scale for DSM-5

Background: Approximately half of the children with attention-deficit hyperactivity disorder continue to meet diagnostic criteria in adulthood. The prevalence of adult attention-deficit hyperactivity disorder is reported between 2.5% and 4.4% and is associated with significant impairment in quality of life and increased psychiatric comorbidity. Attention-deficit hyperactivity disorder in adults remains mostly undiagnosed and/or untreated despite the availability of effective treatments. The majority of people who do not receive necessary treatment are in the nonclinical or nonpsychiatric clinical population. Screening is an important step for diagnosing adults with attention-deficit hyperactivity disorder. Yet, there are no valid and reliable screening questionnaires calibrated for the Diagnostic and Statistical Manual for Mental Disorders-5 in Turkish. Aims: We aimed to test the reliability and the validity of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 screening questionnaire designed according to DSM-5 in the Turkish population. Study Design: Methodological and cross-sectional study. Methods: The translation was carried out according to the World Health Organization Composite International Diagnostic Interview translation guide using a linguistic adaptation approach. We used a convenience sampling method to recruit an individual with adult attention-deficit hyperactivity disorder (n = 68) and a control group (n = 68). The participants completed a sociodemographic form, 6-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, and the previous version 18-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 for the concurrent validity analysis. For the diagnostic validity, clinical diagnosis made by psychiatrists according to the Diagnostic and Statistical Manual for Mental Disorders-5 criteria was used. Internal consistency and item-total correlation coefficients, exploratory factor analyses, correlation with Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1, and receiver operating characteristic curve analysis were conducted. Results: The internal consistency measured by Cronbach alpha was 0.869. Item-total correlation coefficients were calculated to be between 0.602 and 0.717, and the correlations were statistically significant (P < 0.0001). The Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 showed to have a unidimensional factor structure explaining 60.54% of the variance. The correlation between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 total score was calculated as 0.992 (P < 0.0001), and that between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 attention-deficit subdimension was 0.868 (P < 0.0001). In the receiver operating characteristic analysis of Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, the area under the curve was found to be 0.916. The cut-off score was calculated as 9 of 10 with a sensitivity of 85.2% and specificity of 89.7%. Conclusion: Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 is a valid and reliable self-report measure to assess and screen attention-deficit hyperactivity disorder in the Turkish population. It may be useful for both clinical and population studies

Heart rate variability response to affective pictures processed in and outside of conscious awareness: Three consecutive studies on emotional regulation

Previous research has increased understanding of the neurobiological basis of emotional regulation. However, less is known concerning the unconscious processing of affective information. Three experiments were performed to investigate the extent to which complex affective stimuli can be processed outside of consciousness and demonstrate possible mechanisms for regulation of resulting emotional responses. In Experiment 1, participants were either instructed to passively observe blocked-picture cues (neutral and negative) or to down regulate their emotions by distancing. Resulting emotional regulation activity was assessed with 0.1-Hz heart rate variability (HRV) indices. In Experiment 2, participants were presented with affective pictures that were rendered consciously invisible by means of continuous flash suppression (CFS). In Experiment 3, two equivalent sets of negative affective pictures were covertly presented and the effect of a cognitive task on emotional regulation was evaluated. Our findings revealed that 0.1-Hz HRV indices exhibited greater change over baseline in response to negative compared to neutral stimuli for both presentation conditions (consciously perceived or not). The implementation of distancing and the cognitive task were both associated with higher 0.1-Hz HRV change scores. These results indicate that even complex affective stimuli can be processed without awareness, resulting in a congruent emotional response that is physiologically detectable. Cognitive strategies can help more effectively regulate this response, implying that conscious perception of a triggering stimulus may not be essential for cognitive regulation

Auxiliary differential diagnosis of schizophrenia and phases of bipolar disorder based on the blood serum Raman spectra

Schizophrenia (SZ) and bipolar disorder (BP) are severe psychiatric disorders that are characterized by an extensive spectrum of symptoms and affect approximately 2% of the world population. BP exhibits three well-distinct phases, which are classified as manic and depressive episodes and euthymic phase. These disorders are of difficult differential clinical diagnosis due to the similarity of their symptoms. Diagnostic approaches for SZ and BP are based on constructed patient interviews and subjective evaluations of clinical symptoms, and there are still no molecular-based auxiliary diagnostic tools to support the clinical diagnosis. In this study, an analytical model for auxiliary differential diagnosis of SZ and BP, based on the analysis of patients' blood serum Raman spectra, is developed, which is able to account for the different BP phases and can also differentiate SZ and BP patients from healthy individuals. The model is based on a hierarchical sequence of four two-class PLS-DA steps where the Raman spectra are theX-predictor variables. It is concluded that the full 400-3,100 cm(-1)Raman spectroscopic range is a sensitive probe for the disorders, thus working as a general spectroscopic biomarker for the illnesses. The proposed methodology is reliable, fast, cheap, essentially minimal-invasive, and might be implemented easily in the clinical environment