Sex difference in alcohol withdrawal syndrome: a scoping review of clinical studies

BackgroundWe conducted a review of all studies comparing clinical aspects of alcohol withdrawal syndrome (AWS) between men and women.MethodsFive databases (PubMed, Cochrane, EMBASE, Scopus and Clinical Trials) were searched for clinical studies using the keywords “alcohol withdrawal syndrome” or “delirium tremens” limited to “sex” or “gender” or “sex difference” or “gender difference.” The search was conducted on May 19, 2023. Two reviewers selected studies including both male and female patients with AWS, and they compared males and females in type of AWS symptoms, clinical course, complications, and treatment outcome.ResultsThirty-five observational studies were included with a total of 318,730 participants of which 75,346 had AWS. In twenty of the studies, the number of patients presenting with or developing AWS was separated by sex, resulting in a total of 8,159 (12.5%) female patients and a total of 56,928 (87.5%) male patients. Despite inconsistent results, males were more likely than females to develop complicated AWS [delirium tremens (DT) and AW seizures, collective DT in Males vs. females: 1,792 (85.4%) vs. 307 (14.6%), and collective seizures in males vs. females: 294 (78%) vs. 82 (22%)]. The rates of ICU admissions and hospital length of stay did not show sex differences. Although variable across studies, compared to females, males received benzodiazepine treatment at higher frequency and dose. One study reported that the time from first hospitalization for AWS to death was approximately 1.5 years shorter for males and males had higher mortality rate [19.5% (197/1,016)] compared to females [16% (26/163)].ConclusionDespite the significant heterogeneity of the studies selected and the lack of a focus on investigating potential sex differences, this review of clinical studies on AWS suggests that men and women exhibit different AWS manifestations. Large-scale studies focusing specifically on investigating sex difference in AWS are needed

Investigation of gnal polymorphisms in children with attention deficit hyperactivity disorder

Dopaminerjik reseptörler DEHB etyopatogenezinde önemli bir rol oynarlar. D1 benzeri reseptör ailesinin striatumda cAMP artışı sağlaması için Golf proteini gereklidir. Bu çalışmada Golf 'ün kodlandığı gen olan GNAL'deki rs8095592 ve rs 3892113 polimorfizmlerinin DEHB tanısı alan çocuklarda incelenmesi amaçlanmıştır. Ayrıca bu polimorfizmlerin DEHB tipi, tanı alma yaşı ve aile öyküsü ile ilişkisinin araştırılması planlanmıştır. Çalışmaya Gazi Üniversitesi Çocuk-Ergen Ruh Sağlığı ve Hastalıkları Anabilim Dalı'na başvuran DSM IV'e göre DEHB tanısı konmuş 6-18 yaş arası 100 hasta ve 7-18 yaş arası 81 sağlıklı kontrol dahil edilmiştir. IQ değeri 70'in altında ve özgül öğrenme güçlüğü tanısı alan hastalar çalışma dışı bırakılmıştır. Hastalardan venöz kan örneği anlınmış, gen analizi yapılmış, GNAL'ye ait rs8095592 ve rs 3892113 polimorfizmleri incelenmiştir. rs8095592 ve rs3892113 polimorfizmleri açısından hasta ve kontrol grubunda herhangi bir istatistiksel anlamlı farklılık bulunmamıştır. Ancak hasta grubunda ailede DEHB öyküsü bulunanlarda rs8095592'de GG genotipinin istatiksel olarak anlamlı bir şekilde arttığı saptanmıştır. Ayrıca rs8095592'de GG genotipinin, rs3892113'de ise TG genotipinin dikkat eksikliği baskın tip DEHB tanısı alanlarda görece yüksek olduğu; rs 8095592'de GG genotipinin 8 yaş ve 67 öncesinde tanı alanlarda arttığı saptanmıştır. Ancak bu farklılıklar istatistiksel olarak anlamlı bulunmamıştır. Sonuç olarak; rs8095592 polimorfizminin DEHB genetiğinde önemli bir oynayabileceği, bu bölgede A alleline sahip olmanın ailede DEHB öyküsü olanlarda DEHB için bir koruyucu faktör olabileceği düşünülmüştür. Ancak bu bağlantıların kanıtlanması için yeni çalışmalara ihtiyaç duyulmaktadır.The dopaminerjik receptors play an important role in the etiopathogenesis of attention deficit hyperactivity disorder (ADHD). Golf is essential for the activation of adenylate cyclase by D1- like receptors in striatum. The aim of this study to investigate rs8095592 and rs3892113 polymorfisms in GNAL which codes Golf protein. The other objectives of the study is to investigate the relationships between GNAL and ADHD types, age of diagnosis and family history. The patient group consisted of the 100 children aged 6-18 with ADHD from the department of Child and Adolescent Psychiatry at Gazi University. The control group were also recruited from the same place aged 7-18 with no psychiatric disorder. Excluding criteria were having IQ score lower than 70 and learning disability. Genetic analysis were performed with the venous blood samples, rs8095592 and rs3892113 polymorfisms in GNAL had been investigated. Findings were as follows; There was no statistically significant difference between ADHD and control groups for rs8095592 and rs3892113 polymorfisms. Yet GG genotype in rs8095592 was significantly higher in ADHD group and the group with positive family history. GG genotype in rs8095592 and TG genotypes in rs3892113 were predominantly higher in inattentive type. GG genotype in rs8095592 was also higher in the patient group who diagnosed at the age of 8 and before. However these relations were not statistically significant. The results of this study showed that rs8095592 polymorfism in GNAL could play an important role in ADHD genetics. Having allel A in rs8095591 could be protective for the people who had a family history for ADHD. Further researches are needed to confirm this result

Pharmacological Treatment of Tourette Disorder

Tourette disorder is a chronic neuropsychiatric disorder characterized by vocal and motor tics. The course of the disorder shows waxing and vaning pattern and symptoms adversely affect patients’ quality of life. Patients use psychopharmacologic agents for long periods to control their symptoms during which they also struggle with drug related side effects. Clinicians face serious difficulties in controlling symptoms with psychopharmacological agents. Primarily alpha 2 receptor agonists and antipsychotic drugs have been used in the treatment of Tourette disorder. Risperidone and aripiprazole are the most commonly used new generation antipsychotics in the treatment. In addition there are contradictory findings regarding the use of dopamine agonists, tetrabenazine, topiramate, levatirasetame, and delta-9-tetrahydrocannabinol in these patient

A Comparison of Obsessive Compulsive Disorder, Pervasive Developmental Disorder, and Control Groups in Terms of 2D:4D Ratio and Finger Lengths

Objective: Obsessive compulsive disorder (OCD) and autism share some common features, such as repetitive behaviors. Second finger to fourth finger ratio (2d: 4d) is thought to be associated with prenatal androgen exposure and differs between the sexes and 2d:4d ratio is reported to be more "masculine like features" in autism. The aim of this study is to compare OCD and autism that display common features in terms of 2d: 4d ratio and finger lengths. Methods: This study included 15 boys diagnosed with OCD, 12 boys diagnosed with Pervasive Developmental Disorder (PDD), and 54 healthy boys with no psychiatric disorders between the ages of 6 and 18 years. The diagnoses of OCD and PDD were reached after detailed clinical evaluations according to DSM IV-TR criteria. After the evaluation, the children's and adolescents' hand length, hand width, and finger lengths were measured with a digital compass. Results: In this study, we found no statistically significant difference between the control, OCD, and PDD groups regarding the right and left 2d: 4d ratio. Whereas in the PDD group, we found that the right hand second and third fingers and the left hand second, third, and fourth fingers were shorter than the fingers of those in the control group. We also found that left hand length was shorter in the PDD group than in the OCD group and the second finger of the right hand and third finger of left hand was shorter in the PDD group than in the OCD and control groups. Conclusion: In this study, we did not observe any differences between the OCD, PDD, and control groups in terms of 2d: 4d ratio; however, we found that that some finger lengths were shorter in the PDD group than in the control group. This result may be a dysmorphological sign that could be screened in the PDD group, but we need further research with larger sample sizes to confirm its significance

functional outcome in late adolescence/early adulthood of patients with autism spectrum disorder and its relationships with parental burnout and depression: A preliminary multi-center, cross-sectional study.

The aim of this study is to determine the functioning of adults with autism spectrum disorders (ASDs) diagnosed in childhood and depression and burnout levels among their parents. A total of 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported “good” or “very good” outcomes. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD. Modifications for those with ASD may have to be made for support in workplaces, achieving driving licenses, using public transportation and attendance at tertiary education