Noropsikiyatri Arsivi-Archives of Neuropsychiatry最新文献

Introduction: Multiple sclerosis (MS), an autoimmune disease, attacks the central nervous system, causing inflammation and damage. Diagnosed in four forms, many clinically isolated syndrome (CIS) patients progress to relapsing-remitting MS (RRMS). C1QA, a molecule linked to MS, might be a treatment target due to its abnormal activity in the disease. This study investigated mir-335-5p and its targeting C1QA expression as potential biomarkers for disease progression. This relationship was also evaluated from an epigenetic perspective between CIS, RRMS and control groups.

Methods: Peripheral blood mononuclear cells (PBMCs) were isolated from 18 CIS, 32 RRMS, and 16 control blood samples. RNA isolation and Quantitative Real-Time PCR (qRT-PCR) were performed to detect the expression levels of C1QA and miR-335-5p, while C1QA protein levels were determined using ELISA.

Results: The data revealed significant increases in both C1QA gene expression (p=0.0291) and miR-335-5p expression (p=0.0196) in CIS patients compared to controls. Although increased expression levels were observed for both parameters in RRMS patients versus controls, they did not reach statistical significance. Patients with RRMS showed lower levels of C1QA and miR-335-5p compared to those with CIS. Notably, the decrease in miR-335-5p was statistically significant (p=0.0442). No significant difference in C1QA protein levels was observed among the groups (p >0.05).

Conclusion: miR-335-5p and C1QA emerge as potential biomarkers for MS progression, exhibiting significant upregulation in CIS compared to controls. miR-335-5p also shows significant downregulation in RRMS compared to CIS. These findings support the potential of miR-335-5p for distinguishing and understanding the progression of both CIS and RRMS.

Introduction: The increase in spatial learning and memory performance caused by music is called the 'Mozart effect'. Increased NMDA receptor (NMDAR) expression plays a role in this effect. Inhibition of NMDARs reduces Prepulse Inhibition (PPI) % values. The study aims to investigate the relationship between the Mozart effect and the NMDAR expression.

Methods: Rats were divided into 6 groups. Three groups listened to white noise (WN) while the other three groups listened to Mozart (M). After the rats were performed in the 8-arm radial maze test, one of the three groups in both sound environments was chosen as the control group and was injected with saline. For the remaining two groups, one was injected with ketamine and the other was injected with MK-801. Then all groups underwent the PPI protocol.

Results: It was found that Mozart groups had higher memory errors. The M+MK-801 group had lower PPI% values with 74 dB prepulse compared to the WN+Ketamine group.

Conclusions: While the Mozart effect was not observed, on the contrary, a decrease in memory performance was detected. The effect of music on NMDARs may be at levels that do not change PPI values. Considering that parameters like the duration and intensity of music may cause stress, repeating the experiment with different conditions may provide new clues.

Introduction: The aim of this study is to investigate the relationship of melatonin supplementation with serum element metabolism in pinealectomized rats.

Methods: The research was conducted on 32 adult male Spraque-Dawley rats. The study protocol was approved by the local animal ethics committee.Animals were divided into four equal groups. Control (Group 1), Melatonin (Group 2), Pinealectomy "Px" (Group 3), Pinealectomy+melatonin (Group 4). Animals in groups 2 and 4 were given intraperitoneal (ip) melatonin support (4 weeks/day; 3 mg/kg melatonin). Animals in groups 3 and 4 underwent pinealectomy under general anesthesia. At the end of the applications, serum element levels were determined by atomic emission (μg/dl) in the blood samples taken from the sacrificed animals.

Results: While pinealectomy increased chromium and manganese levels in Group 3 (p<0.001), it caused significant suppression of magnesium, calcium and zinc levels (p<0.001). Melatonin supplementation in pinealectomized animals (Group 4) treated the impairments in the mentioned parameters.

Conclusion: The results of the current study show that the melatonin hormone secreted from the pineal gland has a regulatory effect on serum element metabolism. This study is the first to examine the relationship between the pineal gland and element metabolism as a whole.

Introduction: Diagnosis and treatment of breast cancer is traumatic for both patients and their relatives. It is crucial to understand the factors that enhance the psychological resilience of breast cancer survivors. This study aims to investigate posttraumatic growth following breast cancer and its relationship with psychiatric disorders, social support, and stigma.

Methods: The study included 100 female breast cancer patients and 100 relatives. Patients underwent a DSM-5-based structured psychiatric interview and were assessed with the Posttraumatic Growth Inventory (PTGI), the Hospital Anxiety-Depression Scale (HADS), the Cancer Patient Perceived Social Support Scale (CPPSSS), and Cancer-related Attitudes Measurement Questionnaire (CRAMQ)-patient version. The patient's relatives were administered the PTGI, HADS, and CRAMQ-community versions.

Results: Psychiatric disorders were diagnosed in 40% of individuals with breast cancer, most commonly major depressive disorder (22%). Posttraumatic growth demonstrated a negative correlation with age and a positive association with being employed. The presence of psychiatric disorders and elevated anxiety levels are associated with reduced personal growth. Perceived emotional/confidence social support were associated with increased growth. A subscale of stigma 'impossibility of recovery', led to a positive shift in life philosophy and interpersonal relationships. Additionally, both patients' age and the level of growth in their relatives were found to predict posttraumatic growth in the patients (B=-0.499, p=0.021; B=0.211, p=0.044, logistic regression).

Conclusion: Posttraumatic growth is negatively associated with age and the presence of a psychiatric disorder, and positively associated with employment and social support. Additionally, relatives' posttraumatic growth and patients' age predict posttraumatic growth in patients. Stigmatising the perception of "impossibility of recovery" is associated with positive psychological change, possibly reflecting a more traumatic perception of the cancer diagnosis, a reduction in denial, and increased acceptance of the illness. This acceptance of mortality may lead to deeper personal transformation for a more meaningful life and improved interpersonal relationships.

Introduction: Anxiety disorders (AD) constitute a significant part of mental health problems; however, their pathogenesis remains not fully elucidated. The balance between the oxidative and antioxidative systems are disrupted in children with AD. The total oxidant/antioxidant status (TOS/TAS) and thiol/disulphide homeostasis (TDH) show oxidative stress through different mechanisms. To date, research in this context has tended to focus on adults rather than children. Despite this, understanding oxidative stress in pediatric populations is increasingly emphasized. Therefore, this research aims to investigate TOS/TAS and TDH in children with AD.

Methods: The study included 40 treatment-naive children with AD and 40 healthy controls matched by age and sex. Sociodemographic data and The Screen for Child Anxiety-Related Emotional Disorders (SCARED) were used for assessment.

Results: The results showed that TOS and the Oxidative Stress Index (OSI) were elevated, and TAS was reduced in children with AD compared to controls. However, when evaluated in terms of TDH, there was no significant difference. Logistic regression analysis identified TOS as a significant predictor of AD (p=0.027; OR=5.49, 95% CI: 1.21-24.84). Although dynamic-disulphide level improved the model's predictive accuracy, they did not reach statistical significance (p=0.063).

Conclusion: These findings suggest a potential oxidative dysfunction in AD. The study highlights the potential utility of TOS as a robust biomarker for distinguishing pediatric AD from HC. Furthermore, the absence of significant changes in TDH suggests that oxidative stress in pediatric AD may primarily involve alternative pathways. This may involve a complex interplay of DNA damage, lipid peroxidation, and protein oxidation processes contributing to the oxidative stress observed in AD. To explore the potential for using oxidative stress markers as novel targets for treatment and diagnostic tools for AD, prospective, large-scale, randomized trials are required.

Delirium tremens represents the most severe condition of alcohol withdrawal, with the associated highest mortality rate. The primary treatment for cases of delirium tremens consists of benzodiazepines. Within the literature, prolonged cases of delirium tremens have been identified that do not respond to high-dose benzodiazepine treatments or respond late. Different treatment modalities, such as propofol, dexmedetomidine, and parenteral antipsychotic administrations, are being attempted in the management of these cases. In this case, a case of prolonged delirium tremens with insufficient response to benzodiazepine treatment will be presented.

Introduction: Despite these efforts, the pathogenesis of schizophrenia remains unclear. Recent studies suggest that excessive synaptic pruning during adolescence may contribute to schizophrenia, potentially linking it to uncontrolled apoptosis. Given its role in inflammation and apoptosis, amphiregulin may play a key role in this process. The objective of this study was to investigate the role of the Amphiregulin/Epidermal Growth Factor Receptor (EGFR) complex in the pathogenesis of schizophrenia.

Methods: Seventy-three drug-naive patients who were admitted to our outpatient clinic or hospitalized in our clinic and diagnosed for the first time with a psychotic disorder spectrum according to Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), along with 77 healthy controls matched for sociodemographic characteristics and who did not have a history of psychiatric or chronic diseases were recruited for the study. The patients' symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), administered by a skilled psychiatrist. Blood samples were collected from all participants to measure amphiregulin and EGFR levels.

Results: A statistically significant positive correlation was found between amphiregulin and EGFR levels in the patient group. However, there was no significant difference in serum amphiregulin and EGFR levels between the first-episode psychosis group and the healthy control group. Additionally, a positive correlation was observed between both age and age of onset of the disease and serum EGFR levels in the patient group, a correlation that was not present in the healthy control group.

Conclusion: The similar correlation between amphiregulin and its receptor in the central nervous system suggests that amphiregulin levels may play a stable role in the disease process rather than being a primary driver of disease development. It remains unclear whether plasma neurotrophins accurately reflect central neurotrophic activity. The presence of amphiregulin in serum, which is thought to be secreted by regulatory T cells (Tregs) in the central nervous system, may be low. Further studies using cerebrospinal fluid and brain tissue samples are particularly needed in schizophrenia research.

Introduction: Non-adherence to antipsychotics, which plays a critical role in the treatment of individuals with severe mental disorders, is the most significant predictor of relapse. The effectiveness of long-acting injectable antipsychotics (LAIs) in ensuring treatment adherence and preventing relapse is well established. However, studies examining the factors influencing the clinical choice between first-generation and second-generation LAIs and the adherence differences between them are limited. This study aimed to compare patients with schizophrenia and bipolar disorder, who were hospitalized and discharged on either a first- or second-generation LAI, in terms of LAI choice, factors influencing adherence to LAIs, and adherence differences between the two groups of LAIs.

Methods: Our study is a naturalistic, follow-up study. The sample consists of 187 patients (99 females, 88 males) who were hospitalized, initiated on LAI treatment, and discharged. Sociodemographic and clinical information was obtained from patient records. Patients and/or their relatives were contacted by phone at 3, 6, and 12 months after discharge to assess treatment continuation, and this information was verified through health system records.

Results: First-generation LAIs were more frequently chosen for patients who were unemployed, diagnosed with schizophrenia, had a longer illness duration, had a higher number of prior hospitalizations, exhibited homicidal behavior, or had a history of electroconvulsive therapy (p<0.05). Patients with alcohol or substance-use developed non-adherence to treatment earlier (p<0.05). Treatment adherence was higher in patients with bipolar disorder (p=0.025). Adherence to second-generation LAIs at 12 months was higher compared to first-generation LAIs. Adherence was particularly higher with long-acting (LA) aripiprazole and LA paliperidone compared to the other three LAIs (haloperidol, risperidone, and zuclopenthixol) (p<0.05). Adherence to treatment prior to hospitalization significantly predicted LAI adherence at 12 months (p<0.001). Adherence to LAIs administered every four weeks was higher than those administered every two weeks (p=0.014).

Conclusion: For patients expected to face challenges with adherence to LAIs, second-generation agents with longer administration intervals may be preferred.

Introduction: Childhood trauma (CT), low psychologic resilience (PR) and emotion regulation difficulties (DER) have been associated with suicidal behavior (SB); however limited research has explored this association in patients diagnosed with bipolar disorder type 1 (BPDI). This study aimed to investigate the differences in terms of CT, PR, DER among euthymic BPDI patients with and without suicide attempts and healthy individuals and the relationship of SB with these factors.

Methods: Seventy euthymic BPDI patients with suicide attempt [(BPDI (+)] and 81 euthymic BPD1 patients without suicide attempt [BPDI (-)] and 90 healthy controls were included. The SCID-5, Beck Depression Inventory, Young Mania Rating Scale (YMRS), Sociodemographic form, Columbia-Suicide Severity Ranking Scale, and Childhood Trauma Questionnaire (CTQ), Resilience Scale for Adults (RSA) and Difficulties in Emotion Regulation Scale (DERS) were administered to participants.

Results: BPDI (+) group had significantly higher CTQ scores than both BPD1(-) and control groups. The BPDI (+) group had significantly higher DERS clarity, non-acceptance, strategies, impulsivity, goals and total scores than both the BPDI (-) and control groups. Both patient groups had significantly lower RSA perceptions of self, planned future, social resources and total scores than the control group. Emotional abuse scores of CTQ and strategies scores of DERS had a significant and independent effect in distinguishing the BPDI (+) patients from the BPDI (-).

Conclusions: Our findings indicate that BPDI patients with a history of CT and DER are at a higher risk for SB. In light of these results, it is concluded that suicide risk assessments in clinical practice should include CT history and emotion regulation skills, that interventions aimed at enhancing PR should be developed, and that further prospective studies are needed to investigate the effects of these factors on the clinical course of BPDI.