The association between chronotype and sleep quality, and cardiometabolic markers in patients with schizophrenia.

Current data on chronotype and sleep quality and their relationship with clinical characteristics of schizophrenia are insufficient to evaluate whether these variables are associated with cardiometabolic risk. We aimed to identify the interplay between chronotype, sleep quality and metabolic indices that can potentially predict negative cardiometabolic outcomes in schizophrenia patients. One-hundred schizophrenia patients who were under a stable antipsychotic regime were enrolled in the study. Clinical information, anthropometric measurements, as well as recent metabolic parameters including serum lipids, atherogenic, and metabolic indices suggestive of cardiometabolic risk were recorded. High and low sleep quality groups (HSQ and LSQ) were determined via the Pittsburgh Sleep Quality Index and chronotypes were evaluated with the Morningness-Eveningness Questionaire. Patients with eveningness chronotype had poorer sleep quality compared to intermediate or morningness (p = .017) patients. The LSQ group had higher total cholesterol (p = .004) and low-density lipoprotein (LDL) (p = .041) compared to the HSQ group. Mean blood pressure was higher in the eveningness chronotype patients compared to intermediate or morningness patients (p = .015). According to a logistic regression model, total cholesterol, disposition index, and having an eveningness chronotype significantly predicted LSQ in schizophrenia. Eveningness chronotype may lead to impaired cardiometabolic regulation with the mediation of poor sleep quality in schizophrenia patients. Cardiovascular diseases, sleep quality, and sleep patterns can influence each other; thus, this complex relationship in schizophrenia should be considered while configuring both pharmacological and behavioral interventions.

Depression and cognitive distortions in hemodialysis patients with end stage renal disease: A case-control study

Background and objectives: Identifying cognitive distortions is essential for Cognitive Behavioral Therapy (CBT) that plays a key role in the treatment of depression. Depression seen in patients with End-Stage Renal Disease (ESRD) has not been sufficiently diagnosed and treated. This study aimed to examine the cognitive distortions and schemas of patients diagnosed with ESRD.MethodsFifty-six patients undergoing hemodialysis and forty-seven controls were enrolled in the study. A sociodemographic and clinic data form, Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Hospital Anxiety and Depression Scale (HADS), Dysfunctional Attitudes Scale (DAS), Automatic Thoughts Questionnaire (ATQ) were applied to all participants.ResultsThe prevalence of the psychiatric disorder in the case group was significantly higher than the prevalence of the psychiatric disorder in the control group. Compared with the control group, the HADS depression subscale was significantly high in the patient group. There was a positive correlation between the duration of hemodialysis and total scores of DAS as well as the “dependency attitudes” factor among the case group. The “helplessness” subscale scores of the ATQ were significantly higher in the case group compared to the control group.ConclusionsThe duration of hemodialysis was related to dependency attitudes of cognitive distortions among patients with ESRD. Studies investigating cognitive modalities are needed to treat depression more successfully in this population. It will contribute to the Cognitive Behaviour Therapy of ESRD patients when these factors are taken into consideration. (AU)

Relationship between impulsivity, comorbid anxiety and neurocognitive functions in bipolar disorder.

OBJECTIVE: The aim of the study is to examine the relationship between anxiety and impulsivity and to reveal the correlation of these variables with clinical and sociodemographic features. It is also aimed to investigate the relationship between impulsivity and anxiety with neurocognitive functions in bipolar disorder. METHODS: The sample of the study comprises of 71 patients with bipolar disorder type I without any comorbidity (BD), 37 patients with anxiety disorder comorbidity with bipolar disorder type I (BDAD), 52 patients with anxiety disorder (AD) and 50 healthy controls (HC). Participants completed Barratt Impulsivity Scale-11, State-Trait Anxiety Inventory 1-2, Panic Disorder Severity Scale (PDSS), brief version of Fear of Negative Evaluation Scale (FNES), Anxiety Sensitivity Index-3 (ASI-3), Trail-Making Test A-B, Digit Span Test, Stroop Test. RESULTS: PDSS scores, trait anxiety level, hypomanic and mixed episode numbers explain 26% of attention impulsivity. Gender and ASI-3 social dimensions explain 16% of motor impulsivity. Trait anxiety explains non-planning and total impulsivity at 26 and 24%, respectively. When neurocognitive impairment's effect was controlled, it was found AD and BDAD groups had higher impulsivity levels than the BD and HC groups. CONCLUSION: Anxiety disorder comorbidity increases impulsivity in bipolar disorder.KEYPOINTSIn the presence of anxiety disorder spectrum comorbidity, bipolar disorder patients will have increased impulsivity and the clinical course may be more severe.Trait anxiety levels and anxiety sensitivity may be predictive factors for impulsivity.In the presence of anxiety disorder spectrum comorbidity, it should be taken into consideration that these patients may be more impulsive and should be treated with more care in terms of evaluation of the disorder.

Electroconvulsive Therapy and Extracellular Matrix Glycoproteins in Patients with Depressive Episodes.

Background: The brain extracellular matrix (ECM) is composed of glycoproteins deriving from the cell membrane and joining into nets called perineuronal nets (PNNs). The ECM glycoproteins limit neuroplasticity, cell proliferation, and differentiation. Electroconvulsive therapy (ECT) is provided by electrical currents that may alter several cascades and biophysical effects. ECM conformation might be influenced by the effects of ECT. Methods: Patients with depressive disorders (n = 23) and healthy control subjects (n = 21) were enrolled. Serum levels of the ECM glycoproteins versican, brevican, neurocan, phosphocan and tenascin C were measured with enzyme-linked immunosorbent assay. Serum samples were collected from the patients in the patient group at 3 time points: before ECT, 30 min after the first session, and 30 min after the seventh session. Results: There was a significant difference in tenascin C levels (P = .001) between the groups. No other significant difference was observed. Serum levels of the measured ECM glycoproteins and prolidase activity did not differ in the depression group after the administration of ECT. Conclusions: Our results did not support the claim suggesting a possible mechanism for modulation of ECM glycoproteins by ECT. Serum levels may not necessarily reflect conformational changes in the ECM. Further studies are needed to investigate the effects of ECT on ECM glycoproteins. Modulation of the ECM may provide a new window suggesting improvement in treatments.

Executive function and genetic loading in nonpsychotic relatives of schizophrenia patients.

Executive functions meet the "endophenotype candidate" criteria in neuropsychological measures for schizophrenic patients. To determine which area of executive functioning has the greatest value in differentiating the so called "candidate endophenotype" of schizophrenia through comparing the effect sizes of four commonly used executive function tests. A Wisconsin Card Sorting Test, a Stroop Test, a Trail Making Test and a Verbal Fluency Test were used to evaluate executive function in two study groups: healthy relatives of schizophrenia patients from simplex and multiplex families and a healthy control group. In all four tests, study groups performed poorly in contrast to the control group. In the B time, A error and B error results of the Trail Making Test, the multiplex group performed poorly compared to the simplex group; control group did better than both study groups. Our findings support that the presence of a schizophrenia patient in a family predicts worse performance on executive function tests in a group of healthy relatives of that individual. The results of our study suggest that the Trail Making Test in particular may signify a stronger endophenotypic trait.