Serum Ghrelin and Leptin Levels in Patients with Depression and the Effects of Treatment

OBJECTIVE: Ghrelin and leptin, appetite-regulating hormones, play a role in mood regulation. Current data about the relation between leptin/ghrelin and depression are still controversial. This study aimed to investigate serum leptin and ghrelin levels in patients with depression and the effects of treatment on these levels. METHODS: Serum ghrelin and leptin levels were measured before and after treatment with antidepressant drugs and/or electroconvulsive therapy in 28 patients with depression and once in 21 healthy controls. RESULTS: Serum ghrelin levels of the patients were high in the pre-treatment. After the treatment, ghrelin levels were not different from those of the controls. We found no difference in serum levels of leptin between the patients and controls and no change with treatment. body mass index of the patients increased after the treatment especially in the drug-treated group. CONCLUSION: The present study found increased serum ghrelin levels in depressive patients and normalization with improving of depression but no alteration in leptin levels.

Effect of psychoeducation and telepsychiatric follow up given to the caregiver of the schizophrenic patient on family burden, depression and expression of emotion

Objective: This randomized-controlled experimental study was conducted to determine the effects of psychoeducation in the inpatient clinic and regular telepsychiatric follow-up [via telephone] after discharge on emotional expression, depression and family burden of primary caregivers of the schizophrenic patients

Methods: This study was performed on 62 caregivers of the schizophrenic patients, assigned to experiment [n=32] and control [n=30] groups, from 1[st] July 2010 to 31[st] May 2011. The Scales for Expressed Emotion, the Beck Depression and the Zarit Family Burden were applied for the caregivers in experiment and control groups before education, after education and after 6-months telephone follow-up

Results: The mean scores of the caregivers in experiment group on family burden, emotional expression and depression were decreased after education and after telephone follow-up and difference was significant [p < 0.001]

Conclusions: Psychoeducation and telepsychiatric follow-up via telephone induced decrease in family burden, emotional expression and depressive symptoms for their caregivers and was a support for the family in the patient care

Manic Episode Associated with Mega Cisterna Magna

Mega cisterna magna is a part of "Dandy-Walker Complex" and it is characterized by the enlargement of the cisterna magna, morphologically intact vermis and cerebellar hemispheres. We report a case of manic attack in a 23-year-old man with mega cisterna magna. The patient was treated with quetiapine 1,000 mg/day and sodium valproate 1,500 mg/day and the symptoms were ameliorated within 2.5 months. In this case, mega cisterna magna and manic symptoms may be found together coincidentally or any cerebellar dysfunction due to mega cisterna magna may cause or contribute to the appearance of affective symptoms. To our knowledge, this is the first case reporting manic attack with psychotic symptoms associated with mega cisterna magna. This report suggests that any lesion in the cerebellum might contribute to the occurrences of some affective and psychotic symptoms seen in bipolar disorder.

The Effects of Galantamine Hydrobromide Treatment on Dehydroepiandrosterone Sulfate and Cortisol Levels in Patients with Chronic Fatigue Syndrome

OBJECTIVE: Mental fatigue, cognitive disorders, and sleep disturbances seen in chronic fatigue syndrome (CFS) may be attributed to cholinergic deficit. A functional deficiency of cholinergic neurotransmission may cause the hypothalamic-pituitary-adrenal axis hypoactivity seen in CFS. Therefore, we investigated the alterations in stress hormones such as cortisol and dehydroepiandrosterone sulfate (DHEAS) in CFS patients before and after 4-week administration of galantamine hydrobromide, a selective acetylcholinesterase inhibitor, and aimed to investigate whether there are any relationships between the probable hormonal changes and cholinergic treatment. METHODS: Basal levels of cortisol and DHEAS were measured in 29 untreated CFS patients who were diagnosed according to Centers for Disease Control (CDC) criteria and in 20 healthy controls. In the patient group, four weeks after 8 mg/d galantamine hydrobromide treatment, cortisol and DHEAS levels were measured again. After the treatment 22 patients who stayed in study were divided into two subgroups as responders and nonresponders according to the reduction in their Newcastle Research Group ME/CFS Score Card (NRG) scores. RESULTS: Important findings of this study are lower pre-and post-treatment cortisol levels and in all CFS patients compared to controls (F=4.129, p=0.049; F=4.803, p=0.035, respectively); higher basal DHEAS values and higher DHEAS/cortisol molar ratios which were normalized following four weeks' treatment with 8 mg/d galantamine hydrobromide in the treatment-respondent group (F=5.382, p=0.029; F=5.722, p=0.025, respectively). CONCLUSION: The findings of the decrease in basal DHEAS levels and DHEAS/cortisol molar ratios normalizing with galantamine treatment may give some support to the cholinergic deficit hypothesis in CFS.

Poststroke depressive symptoms and their relationship with quality of life, functional status, and severity of stroke

The present study aimed to investigate the relationship between depressive symptoms in 6 months after stroke and the quality of life [QOL], clinical and socio-demographical characteristics, functional status, and severity of stroke. Ninety consecutive stroke patients who attended the neurology outpatient clinic at Erciyes University, Kayseri, Turkey from March 2004 to March 2005 were evaluated for the study. Seventy outpatients who had a stroke 6 months previously were included in the study. As a data-collecting device, Short Form 36, Functional Independence Measure [FIM], Canadian Neurological Scale, and Beck Depression Inventory [BDI] were used. In addition, a questionnaire was administered to obtain clinical and socio-demographic data. Seventy patients were included in the study. Depression measured using BDI was identified in 47.1% of the patients. Total FIM scores, especially motor subscale scores, were decreased in the depressive patients. No difference was found in the stroke severity scores of the depressed and non-depressed patients. The QOL subscale scores, such as physical functioning, bodily pain, general health perception, vitality, social functioning, and mental health, were lower in the patient group with high BDI scores. There was a positive correlation between age and BDI scores of the patients. Negative correlations were found between the scores of QOL and FIM in both total and motor subscale scores. Poststroke depression seems to be associated with age, education level, QOL, and functional status