Noropsikiyatri Arsivi-Archives of Neuropsychiatry最新文献

Introduction: In this cross-sectional study, whether there is a difference in the prevalence of developmental/behavioral problems in children of those who received mono/polytherapy during pregnancy; How Valproic Acid (VPA) exposure affects developmental/behavioral characteristics compared to other antiseizure medications (ASM) was also investigated.

Method: 64 children of 46 women with epilepsy (WWE) with children aged 0-18 years were included. Ankara Development and Screening Inventory (ADSI) for their children up to the age of six and The Child Behavior Checklist for Ages 4-18-CBCL/4-18 scale was applied for the ages of 6-18. Children exposed to prenatal ASM were divided into two groups as polytherapy and monotherapy. Children exposed to monotherapy were investigated by drug exposure, as well as exposure to VPA and other ASMs. Chi-square test was used to compare qualitative variables.

Results: When monotherapy and polytherapy groups were compared, a significant difference was found in the language cognitive development area of the ADSI (p=0.015) and in terms of the sports activity variable in CBCL/4-18 (p=0.039). When the VPA monotherapy and other ASM monotherapy groups were compared, a significant difference was found in terms of sports activity in CBCL-4-18 (p=0.013).

Conclusion: It was found that language and cognitive development can be delayed, the level of engagement in sports activities can be reduced in children exposed to polytherapy. The rate of doing sports activities in valproic acid monotherapy exposure may decrease.

Introduction: Among the executive functions affected in attention deficit hyperactivity disorder (ADHD), inhibitory control is one of the primary areas of impairment, characterized by components that include response inhibition and interference control. Determining the impaired inhibitory control components will be useful in the differential diagnosis and treatment of ADHD. The present study aimed to investigate response inhibition and interference control abilities of adults with ADHD.

Methods: The study included 42 adults diagnosed with ADHD and 43 healthy controls. The stop-signal task (SST) and Stroop test were used for assessing the response inhibition and interference control, respectively. Multivariate analysis of covariance was used for comparing the ADHD and healthy control groups in terms of their SST and Stroop test scores, wherein the age and education level of the participants were taken as covariables. The relationship between SST and Stroop Test and Barratt Impulsiveness Scale-11 (BIS-11) was tested by Pearson correlation analysis. Mann-Whitney U test was used for comparing the test scores between those who were administered with psychostimulants among the adults with ADHD and those who were not.

Results: Response inhibition was observed to be impaired in adults with ADHD compared with the healthy controls, whereas no difference regarding interference control was observed. As per the Barratt Impulsiveness Scale-11 (BIS-11), a weak and moderately negative relationship was found between the stop signal delay and the attentional, motor, non-planning scores, and total scores and a weak positive relationship was found between the stop-signal reaction time and the attentional, motor, non-planning scores, and total scores. A significant improvement was observed in the response inhibition skills of the adults with ADHD who had received methylphenidate treatment compared to those who had not, and the former also showed lower impulsivity levels as measured by the BIS-11.

Conclusions: It should be noted that response inhibition and interference control, which are considered under the umbrella of inhibitory control, may exhibit different characteristics in adult individuals diagnosed with ADHD and this is important for differential diagnosis. An improvement was observed in the response inhibition of adults with ADHD caused by psychostimulant treatment, which was associated with positive outcomes that were also noticeable by the patients. Understanding the underlying neurophysiological mechanisms of the condition would further facilitate the development of appropriate treatments.

Introduction: Coronavirus disease 2019 (COVID-19) is the biggest health challenge of recent times. Studies so far reveal that vaccination is the only way to prevent this pandemic. There may be factors that decrease or increase vaccine effectiveness. In multiple sclerosis (MS), some of these factors may cause changes in the effectiveness of the vaccine, depending on the nature of the disease and disease-modifying treatments (DMT). In this study, we aimed to investigate the relationship between antibody titer and smoking in non-treated and DMT-treated MS patients who received inactivated vaccine (Sinovac) and messenger RNA BNT162b2 (BioNTech) mRNA vaccines.

Method: Vaccine antibody responses were measured between 4-12 weeks after two doses of inactivated vaccine and mRNA vaccines. Patients were separated into 6 groups as: patients with MS without treatment PwMS w/o T, ocrelizumab, fingolimod, interferons (interferon beta-1a and interferon beta-1b), dimethyl fumarate, and teriflunomide. Antibody titers of smokers and non-smokers were compared for both vaccines and for each group.

Results: The study included 798 patients. In the mRNA vaccine group, smokers (n=148; 2982±326 AU/mL) had lower antibody titers compared to the non-smokers (n=244; 5903±545 AU/mL) in total (p=0.020). In the inactivated vaccine group, no significant difference was detected between smokers (n=136; 383±51 AU/mL) and non-smokers (n=270; 388±49 AU/mL) in total (p=0.149). In both vaccine groups, patients receiving ocrelizumab and fingolimod had lower antibody titers than those receiving other DMTs or PwMS w/o T. In untreated MS patients, antibody levels in smokers were lower than in non-smokers in the mRNA vaccine group. No difference was found between antibody levels of smokers and non-smokers in any of the inactivated vaccine groups.

Conclusion: Ocrelizumab and fingolimod have lower antibody levels than PwMS w/o T or other DMTs in both mRNA and inactivated vaccine groups. Smoking decreases antibody levels in the mRNA vaccine group, while it has no effect in the inactivated vaccine group.

Introduction: Low self-esteem is a known risk factor for mental illnesses. Neuroimaging studies have identified evidence for a functional association between default mode network (DMN) and self-esteem levels. However, it is not clear whether there is a similar association between trait self-esteem and the structures composing DMN. This study aimed to investigate the relationship between the DMN associated brain structures and trait self-esteem.

Methods: We obtained 3T structural magnetic resonance imaging (MRI) data of 75 healthy subjects and detected anatomical regions correlated with their Rosenberg Self-Esteem scores via voxel-based morphometry (VBM).

Results: We found positive associations between self-esteem and regional grey matter volumes in the right temporoparietal junction/inferior parietal lobule (BA 39), cortical midline regions at precuneus/dorsal cingulate cortex (BA 31), rostral and dorsal anterior cingulate cortices (BA 32).

Conclusion: The results of the current study support the fMRI studies suggesting self-esteem levels associated with DMN. Further neuroimaging studies should consider the functional and structural coupling of the default mode network during the execution of the functions related to self-esteem.

Introduction: Cardiovascular diseases (CVD) are the one of the most important causes of mortality in patients with schizophrenia. This study aimed to investigate ten-year CVD risk and its relationship with clinical features in patients with schizophrenia.

Methods: The sample of the study consisted of 208 patients with a diagnosis of schizophrenia. The Positive and Negative Syndrome Scale (PANSS) was administered to each patient to assess symptom severity of schizophrenia. The 10-year CVD risk of the participants was calculated with the QRISK*3 model.

Results: 10-year CVD risk of the patients was found to be 7.4%. The mean healthy heart age (QAGE) of the patients was 53.1. Duration of disease, body mass index (BMI), and negative symptoms severity was positively correlated with 10-year CVD risk in patients with schizophrenia (r=0.57, r=0.37, and r=0.49, respectively). Duration of disease, BMI, and severity of negative symptoms predicted a 10-year CVD risk in patients with schizophrenia (t=4.349 and p<0.001; t=2.108 and p=0.037; t=2.836 and p=0.006 respectively).

Conclusion: The findings of this study have shown that duration of disease, negative symptoms, and BMI may be important risk factors for increased CVD risk in patients with schizophrenia.

Since December 2020, a significantly higher number of people worldwide have been vaccinated for coronavirus disease 2019 (COVID-19). Neurological complications have been reported after these vaccines, although a definitive causal relationship has not been proven in the available literature. We describe a 51-year-old man presenting with anti-glutamic acid decarboxylase (anti-GAD) antibody positive autoimmune encephalitis with progressive cognitive impairment and behavioral abnormalities, presenting shortly after the second dose of mRNA COVID-19 vaccine, possibly representing a serious vaccine-related adverse event. Response to high-dose steroid and intravenous immunoglobulin treatment was positive. As many people around the world have been vaccinated against COVID-19, this case shows that autoimmune encephalitis and even anti-GAD antibody positive autoimmune encephalitis can develop as a side effect after this new vaccine, but with early diagnosis and appropriate treatment, the clinic can have a good prognosis. Observational studies with large numbers of patients are needed to explain causality.

Introduction: The 12-item Utah Photophobia Symptom Impact Scale (UPSIS-12) is a questionnaire to assess the impact of photophobia on daily living during and outside migraine episodes. We aimed to translate UPSIS-12 and assess its usability in the Turkish cohort by analyzing internal consistency, reliability, and reproducibility.

Methods: In this multicenter prospective, descriptive study, 120 patients with migraine were recruited. The patients received the diagnosis of migraine without aura (MwoA) and migraine with aura (MwA) according to the International Classification of Headache Disorders 3rd edition. The scale was translated into Turkish, and the patients were evaluated by headache experts in two visits four weeks apart from each other.

Results: The questionnaire showed highly correlated test-retest reliability (r=0.828). Cronbach alpha values of internal consistency revealed good to excellent results ranging from 0.78-0.82. There was a strong and positive correlation between self and physician-administered scales at both visits (r=0.964 and 0.985, respectively). The questionnaire was considered "well understood" by 95.6% of the patients. The average UPSIS-12 score of each visit was 25.8 and 26.9 (average standard deviation of 10.4). Subjects with MwoA (25.5±10.4) had remarkably lower mean scores compared to MwoA plus MwA (29.2±8.9) and MwA (32.9±9.4) (p=0.0167). Patients with high frequency migraine presented with a higher mean UPSIS-12 score than those with low frequency (31.3±9.5 and 24.7±9.8, respectively). It was noted that the mean UPSIS-12 scores of those with severe (29.4±9.4) and moderate ictal cutaneous allodynia (CA) (28.4±10.6) were higher than those without CA (22.0±9.3)(p=0.020).

Conclusion: The Turkish version of the UPSIS-12 questionnaire is a reliable tool and well-understood by the Turkish population. Patients with MwA, frequent migraine headache days and moderate to severe CA presented with higher scores. Given the independent burden of photophobia in migraineurs, the use of UPSIS-12 scale should be encouraged in Turkish population.

Introduction: This study examines the association between perceived stress, death anxiety, psychological resilience and the sociodemographic and clinical features of patients with Coronavirus Disease 2019 (COVID-19).

Methods: 304 patients with COVID-19 diagnosis, who were admitted to İstanbul University İstanbul Faculty of Medicine Hospital "COVID-19 Patients Monitoring Center" were recruited. No sample selection was made, all the patients who were followed up and treated in the center were included. Data was collected by the researchers through face-to-face interviews using the Sociodemographic Information and Disease Progression Form, Psychological Hardiness Scale (PHS), Perceived Stress Scale (PSS), and Templer Death Anxiety Scale (TDAS).

Results: Women scored higher in PSS and TDAS. Participants with chronic diseases reported higher death anxiety whereas perceived stress was higher in individuals with psychiatric disorders and ones without a history of intensive care unit stay. Participants without psychiatric disorders, who had longer hospitalization and who fully recovered scored higher in PHS-Control. Patients' report of negative attitudes from their relatives/friends was associated with lower scores in PHS. Perceived stress was correlated with death anxiety and psychological resilience.

Conclusion: Being female, comorbid physical and mental illnesses, continuation of disease symptoms and low psychological resilience were found to be risk factors in terms of stress and death anxiety in COVID-19 patients. These vulnerable groups need to be closely evaluated with a bio-psychosocial approach and provided psychological support during the course of the disease. Health institutions are recommended to conduct medical treatment in cooperation with psychological care.