Faculty Bibliography
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International journal of psychiatry in clinical practice. 2020:24(1):96-101.DOI: 10.1080/13651501.2019.1699118
Proton magnetic resonance spectroscopic analysis of changes in brain metabolites following electroconvulsive therapy in patients with major depressive disorder
PMID: 31825726
ISSN: 1471-1788
CID: 5913482
Neuropeptide Y in PTSD, MDD and Chronic Stress: A Systemic Review and Meta-Analysis [Meeting Abstract]
ISI:000535308200495
ISSN: 0006-3223
CID: 4560822
Plasma Neuronal and Glial Markers and Anterior Cingulate Metabolite Levels in Major Depressive Disorder: A Pilot Study
INTRODUCTION/BACKGROUND:Neuroglial functions may be deteriorated in major depressive disorder (MDD). OBJECTIVE:To evaluate the markers of glial and neuronal cell turnover and to explore their associations with brain metabolites. METHODS:In 10 participants with MDD and 10 healthy controls (HC) we investigated neuronal and glial plasma markers (the neuron-specific enolase, NSE; and S100beta, S100B) and brain metabolites (N-acetyl aspartate, NAA; total choline, Cho; and total creatine, Cr). Blood was collected for NSE and S100B. NAA, Cho, and Cr metabolite levels were measured in the anterior cingulate cortex (ACC) with proton magnetic resonance spectroscopy (1H-MRS) at 3T. RESULTS:NSE and S100B levels were significantly higher in MDD subjects than in HC. The Cr level was significantly higher in MDD subjects than in HC, but the NAA and Cho levels did not differ between groups. NAA/Cr and Cho/Cr ratios were significantly lower in patients with MDD versus HC. S100B was negatively correlated with the Cho levels. CONCLUSIONS:These results provide supporting evidence of neuronal and glial distress in MDD. Neuronal viability appears decreased, whereas glial regenerative activity and energy metabolism in the ACC increase in acute major depressive episode. Since low concentrations of S100B have neuroplastic effects, these changes may indicate a possible compensatory mechanism.
PMID: 32045918
ISSN: 1423-0224
CID: 4317502
Neuropeptide Y in PTSD, MDD, and chronic stress: A systematic review and meta-analysis
Previous studies have suggested that neuropeptide Y (NPY) levels may be altered in patients with major depressive disorder (MDD), post-traumatic stress disorder (PTSD) and chronic stress. We investigated, through systematic review and meta-analysis, whether the mean levels of NPY are significantly different in patients with MDD, PTSD or chronic stress, compared to controls. The main outcome was the pooled standardized mean difference (SMD) with 95% confidence intervals between cases and controls, using the random-effects model. Heterogeneity and publication bias were evaluated. Thirty-five studies met eligibility criteria. Meta-regression determined that medication and sex could explain 27% of the between-study variance. Females and participants currently prescribed psychotropic medications had significantly higher levels of NPY. NPY levels were significantly lower in plasma and cerebrospinal fluid (CSF) in PTSD patients versus controls. Patients with MDD had significantly lower levels of NPY in plasma compared to controls, but not in the CSF. The magnitudes of the decrease in plasma NPY levels were not significantly different between PTSD and MDD. However, chronic stress patients had significantly higher plasma NPY levels compared to controls, PTSD or MDD. Our findings may imply a shared role of NPY in trauma and depression: nevertheless, it is not clear that the association is specific to these disorders. Psychotropic medications may help restore NPY levels. Further controlled studies are needed to better delineate the contribution of confounding variables such as type of depression, body mass index, appetite or sleep architecture.
PMID: 32048334
ISSN: 1097-4547
CID: 4304402
Analysis of 24-Hour Heart Rate Variability among Panic Disorder Patients without Previous Drug Treatment and Comorbid Disorders
OBJECTIVE:One of the METHODS used to assess autonomic nervous system dysfunction in the etiology of panic disorder (PD) is heart rate variability (HRV). HRV is controlled by the sympathetic and parasympathetic (vagal) branches of the autonomic nervous system and reflects the capacity of autonomic stimulation by the parasympathetic system. The aim of this study was to evaluate heart rate variability (HRV) time domain parameters based on twenty four hour holter ECG analysis among drug-naive patients with panic disorder (PD) without any other medical and psychiatric comorbidity. METHOD/METHODS:The study group consisted of 41 patients with PD and 46 healthy controls. Participants were evaluated with SCID-1 for psychiatric diagnoses. Then Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Panic Disorder Severity Scale (PDSS) and Clinical Global Impression Scale (CGI-S) were applied to participants. Twenty four hour Holter ECG outcomes were analyzed on a computer program and time domain parameters were evaluated. RESULTS:Among the parameters analyzed from HRV, SDANN was significantly higher (p <0.001); duration of RMSSD, NN50 and pNN50 were lower in PD group than the control group (p = 0.003, p = 0.005, p = 0.047, respectively). In the correlation analysis, there was a moderate negative correlation between CGI-S and NN50 and pNN50. In logistic regression analysis, the increase in SDNN was found to increase the probability of PD by 1.11 (95% CI, 1.010-1.209); the increase in SDANN was found to decrease the probability of PD by 0.892 (95% CI, 0.818-0.973), and the increase in pNN50 was found to decrease the probability of PD by 0.523 (95% CI, 0.342-0.801). CONCLUSION/CONCLUSIONS:The data obtained in our study confirm that there is a decrease in some HRV parameters like RMSSD, NN50 and pNN50 reflecting parasympathetic activity among patients with PD.
PMID: 32594484
ISSN: 2651-3463
CID: 5913492
The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T)
AIM/OBJECTIVE:The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. METHOD/METHODS:A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. RESULTS:Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. CONCLUSION/CONCLUSIONS:This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.
PMID: 30964388
ISSN: 1502-4725
CID: 5913452
Double Blind Controlled Study of Adding Folic Acid to Fluoxetine in the Treatment of OCD
BACKGROUND:Folate is important for the synthesis of serotonin the neurotransmitter which plays a main role in OCD. We, therefore, explored the efficacy of folic acid as add on treatment to fluoxetine in a double blind study among patients with OCD. SUBJECTS AND METHODS/METHODS:levels were measured both baseline and the end of study. RESULTS:level between the treatment groups at the baseline. Consecutively scores collected over six measurements on YBOCS, HAM-D, HAM-A and CGI showed non-significant differences between folic acid and placebo groups. CONCLUSION/CONCLUSIONS:None of the biological markers of one carbon metabolism were associated with the change in YBOCS scores. It may be assumed that there is no beneficial effect of folic acid addition to fluoxetine in the treatment of OCD.
PMID: 30948692
ISSN: 0353-5053
CID: 5913442
The Prevalence of Internet Addiction in Turkish Adolescents with Psychiatric Disorders
INTRODUCTION/BACKGROUND:The aim of this study is to determine the prevalence of Internet addiction (IA) in adolescents with psychiatric disorders. METHODS:A total of 310 adolescents, aged from 12 to 18, participated in the study. The psychiatric sample group included 162 participants who had applied to the child psychiatry outpatients service. The psychiatric disorders among those in this group were assessed through clinical interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR). The control group was chosen from adolescents of families who had never sought psychiatric help. The demographics of the participants and the features of their Internet usage habits were gathered through a questionnaire prepared by researchers. Young's Internet Addiction Test was used to assess internet addiction. RESULTS:The frequency of IA was found to be significantly higher in the psychiatric sample group than in the control group (24.1% vs. 8.8%, respectively). A total of 23.9% of the subjects had one, and 12.6% had two or more co-morbid psychiatric diagnoses. The frequencies of the diagnostic groups were as follows: attention deficit hyperactivity disorder 55.6%, anxiety disorder 29.0%, mood disorder 21.0%. CONCLUSION/CONCLUSIONS:IA was found to be significantly more common among adolescents in the child psychiatry outpatient department than among the adolescents who had no psychiatric history, even after confounding variables had been controlled. Further studies are needed to define IA more precisely and to improve prevention approaches.
PMCID:6732812
PMID: 31523147
ISSN: 1300-0667
CID: 5913472
[A Meta-Analysis of Efficacy of Carbon Dioxide Inhalation as a Challenge Test in Panic Disorder]
OBJECTIVE:The objective of this study is to perform a systematic review and meta-analysis on whether patients with panic disorder (PD) and their healthy first-degree relatives have an increased sensitivity to carbon dioxide inhalation test compared to healthy controls (HC) or patients with psychiatric disorders other than panic disorder. METHOD:The databases of PubMed, EMBASE and PsycNET were searched using Boolean operators "panic AND carbon dioxide" and "panic AND CO2". Selected research articles were classified according to the carbon dioxide concentrations used in testing and the clinical characteristics of the samples. The assumption of heterogeneity across the studies was assessed by chi square based Q and I2 statistics. Publication biases were explored by Begg-Mazumdar's and Egger's tests in addition to funnel graphics. Odds ratios representing effect size of the carbon dioxide inhalation procedure were calculated according to fixed effect and random effect models after obtaining percent weight effects of each study. RESULTS:Meta-Analysis was conducted on 33 research studies that include 2114 participants totally. Participants with PD experienced significantly more frequent panic attacks (PA) compared to HC following in both 5% (OR=14.713, 95% CI 7.532 - 28.739) and 35% carbon dioxide inhalation (OR=11.507, 95% CI 7.775 - 17.031). HC who have a first-degree relative with PD experienced PA approximately 3 times more than HC who have not a first-degree relative with PD (OR=2.658, 95% CI 1.678 - 4.212) following carbon dioxide inhalation test. Participants with PD experienced significantly more frequent PA than the patients with other psychiatric disorders following the carbon dioxide inhalation test (OR = 3.524, 95% CI 1.945 - 6.384). CONCLUSION:There is an increased sensitivity of carbon dioxide inhalation in patients with PD and their healthy first-degree relatives. The role and possible mechanisms of carbon dioxide in etiology and physiopathology of PD should be studied extensively.
PMID: 31487375
ISSN: 2651-3463
CID: 5913462
The role of facial fear recognition and trait aggressiveness in determining violent behavior in schizophrenia and in the general population [Meeting Abstract]
Background and aims.- Facial fear recognition impairment (FRI) and trait predisposition to physical aggressiveness (PTA) have been associated with greater violence in violent subjects. We investigated the role these factors play in violent patients with schizophrenia (VS) and contrasted this to their roles in non-psychotic violent subjects (NPV), non-violent schizophrenic patients (NV) and healthy controls (HC). Methods.- 144 subjects were included: 40 VS's, 35 NPV's, 35 HC's, 34 NV's. FRI was measured with the Penn Emotion Recognition Task; Physical Aggressiveness with the Buss Perry Aggression Questionnaire; aggression with Life History of Aggression (LHA) Questionnaire. General linear models were used with relevant covariates. Results.- FRI and PTA played an important role in determining violence in the violent but not in the non-violent group. In NPV's, there were strong main effects for FRI (F = 17.1, p < .001) and PTA (F = 32.6, p < .001) but no interaction effect in determining LHA score. In the VS (N = 40) there was a main effect for FRI (F = 10.1, p = .004), and for PTA (F = 5.3, p = .03). There was also a significant interaction effect between the two (F = 9.1, p = .005): with more severe impairment in fear recognition, patients were more violent regardless of their PTA score. If, however, FRI was low, subjects with more severe PTA were much more aggressive than those with low PTA. Conclusions.- FRI and PTA are important factors influencing violence. In the violent non-psychotic group both contributed strongly in an additive fashion to violence. In the schizophrenic patients, impairment in fear recognition played a more important role than physical aggressiveness and interacted with it
EMBASE:639494038
ISSN: 1778-3585
CID: 5366522
