Association of BDNF / TrkB and NGF / TrkA Levels in Postmortem Brain with Major Depression and Suicide.

BACKGROUND: Suicide Attempts are the main complications of Major Depressive Episodes and are difficult to predict. There is still a lack of knowledge about its neurochemical aspects. There is increasing evidence that Brain-derived neurotrophic factor (BDNF) and Nerve growth factor (NGF) play a role in the pathophysiology and treatment of depression by binding and activating cognate receptors Tyrosine Kinase B (TrkB) and Tyrosie Kinase A (TrkA), respectively. This study was conducted to examine whether BDNF and / or TrkB as well as NGF and / or TrkA expression profiles were changed in the hippocampus of postmortem brain of individuals with depression who committed suicide. SUBJECTS AND METHODS: This study was conducted with the brain tissue of 61 victims who died as a result of suicide due to depression and 25 people who died due to traffic accidents. The psychiatric history of the cases was determined by the psychological autopsy method. Samples were taken from the hippocampus region of the brain at the forensic medicine institution. After storage under appropriate conditions, protein and mRNA levels of BDNF, TrkB, NGF and TrkA were determined in the genetics laboratory. RESULTS: Average age of the suicide group was 30 and the average age of the control group was 24.5. The suicide group consisted of 70.5% male and 29.5% female cases. There was no significant difference between the groups in terms of age (p=0.062) and gender (p=0.718). BDNF, NGF, TrkA and TrkB values were found to be lower in the suicide group compared to the control group and there was a significant difference between the groups (p≤0.001; p=0.001; p=0.001; p=0.011). CONCLUSION: Given the importance of BDNF and NGF and their cognate receptors in mediating physiological functions, including cell survival and synaptic plasticity, our findings regarding decreased expression of BDNF, TrkB, NGF and TrkA in both protein and mRNA levels of postmortem brains of suicide victims suggests that it may play an important role in the pathophysiological aspects of its behavior. Further studies in this context may be useful both in understanding the molecular basis of suicide and in designing therapeutic models targeting these molecular pathways.

Anxiety, depression and post-traumatic stress disorder symptoms in adolescents during the COVID-19 outbreak and associated factors.

INTRODUCTION: Outbreaks of infectious diseases have negative effects on mental health. Currently, there is very little information about the psychological effects of the COVID-19 pandemic on adolescents and associated factors affecting their mental health. The aim of the present study is to determine the severity of anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in adolescents during the COVID-19 outbreak, and to investigate the associated factors with these symptoms. METHODS: The present study was conducted with a total of 447 adolescents. Psychiatric symptoms were evaluated by the use of DSM-5 Level 2 Anxiety Scale, DSM-5 Level 2 Depression Scale and National Stressful Events Survey PTSD Short Scale. The association between age, gender, residential area, presence of COVID-19 in the participant, presence of COVID-19 in the family or environment and psychiatric symptoms were evaluated with linear regression analysis. RESULTS: The mean age of participants was 15.06, and 38.3% of the participants were men and 61.7% were women. The rate of participants with moderate or high levels of anxiety, depression and PTSD symptoms was 28%, 37.6% and 28.5%, respectively. High age and living in an urban area were associated with increased anxiety, depression and PTSD symptoms. In addition, female gender was associated with increased depression symptoms, and the presence of COVID-19 in the family or environment was associated with increased anxiety symptoms. CONCLUSION: The present study shows that adolescents have serious levels of anxiety, depression and PTSD symptoms during the COVID-19 pandemic. These results emphasise the need for mental health interventions that are appropriate for the characteristics of this age group.

Evaluation of CSF flow dynamics in patients with schizophrenia using phase-contrast cine MRI.

Patients with schizophrenia show progressive clinical deterioration. Brain abnormalities have been suggested in these patients, including enlargement of the lateral ventricles, increased cerebrospinal fluid (CSF) volume and reductions in the frontal and temporal lobes. CSF flow pathology is a central factor in the development of many neurological disorders, but much less is known about the role of CSF flow dynamics in schizophrenia. In this study, parameters of CSF flow dynamics at the aqueduct level of 50 schizophrenic patients were compared to those of 50 controls using phase-contrast cine magnetic resonance imaging. Patients had lower peak velocity, lower net forward volume, and lower average flow over the range studied than controls. The average velocity was significantly lower in patients exhibiting violent behavior compared to non-violent patients. The aqueduct tendedto be larger in schizophrenic patients with earlier age of onset of the disorder. Furthermore, as the number of hospitalizations increased, the average velocity and flow over the range studied decreased commensurately. This study demonstrated that CSF flow dynamics are altered in patients with schizophrenia. The results indicated that additional studies of CSF flow dynamics in schizophrenia are needed, along with volumetric examinations of the brain, to elucidate the pathophysiology of the disease.

Evaluation of Transcranial Magnetic Stimulation Efficiency in Major Depressive Disorder Patients: A Magnetic Resonance Spectroscopy Study.

OBJECTIVE: Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD). This study evaluated the antidepressant effect of rTMS and examined how it affected N-asetyl aspartate (NAA), choline (Cho), creatine (Cr), lactate (Lac), myoinositol (mIns), glutamate (Glu), glutathione (GSH), and glutamine (Gln) metabolite levels in the left dorsolateral prefrontal cortex (DLPFC) of MDD patients who were not receiving antidepressant medication. METHODS: In total, 18 patients (10 female, 8 male) were evaluated. Each patient underwent H magnetic resonance spectroscopy (H-MRS) before and within 3 days of completion of TMS therapy. All patients completed 20 sessions of rTMS directed at the left DLPFC over a 2-week period. The Hamilton Depression Scale (HAMD) scores of patients were calculated, and their responses to treatment were assessed within 1-3 days of completion of TMS. RESULTS: We found statistically significant differences in HAMD scores before and after rTMS. Moreover, the peak metabolite ratios of NAA/Cr, GSH/Cr, and Gln/Cr were significantly higher after rTMS compared to those before rTMS. CONCLUSION: Increased understanding of the mechanism of action of TMS will improve its application and may stimulate development of new-generation therapeutic agents.

Does Psychodrama Affect Perceived Stress, Anxiety-Depression Scores and Saliva Cortisol in Patients with Depression?

OBJECTIVE: Little is known about the effects of psychodrama group therapy on the level of stress, anxiety and depression of the group members, and the biological markers of stress. The aim of this study test cortisol level as a biological reflection of some mental characteristics gained by the psychodrama method in coping with stress. METHODS: Depressive patients aged between 18 and 65 years, who diagnosed with depression according to DSM-5, without psychiatric comorbidity, who do not use drugs and were available for psychodrama were enrolled into the study. These patients were evaluated using the Perceived Stress Scale, State-Trait Anxiety Inventory and Beck Depression Inventory. In order to observe the circadian rhythm of cortisol, samples were collected from the participants before lunch, before dinner and before going to sleep on the day before psychodrama and on the 0, 15th, and 30th minutes after awakening in the morning of the psychodrama day; as well as just before and after the psychodrama session. Saliva cortisol level just before the initial session of psychodrama group therapy was compared with the saliva cortisol level just after the last psychodrama session at the end of 16 weeks. RESULTS: Statistically significant difference was determined between the scores of perceived stress scale, STAI-1, STAI-2, beck depression inventory and salivary cortisol level before and after psychodrama session. There was significant decrease in both the scale scores and salivary cortisol after vs. before psychodrama. CONCLUSION: This results is important as it shows the biological aspect of clinical improvement. Further studies would provide us with better understanding of the effects of psychodrama group psychotherapy on depressive mood and biological projections by means of short-term and long-term follow-up studies.

Relationship between childhood trauma and suicide probability in obsessive-compulsive disorder.

The aim of this study is to assess the relationship between childhood trauma with the probability of suicide in obsessive compulsive disorders. Sixty-seven patients who were diagnosed with OCD were included in the study out of the patients who were admitted to Malatya Training and Research Hospital psychiatry outpatient clinic. The research data were collected using Yale Brawn Obsessive Compulsive Scale (YBOCS), Beck Depression (BDS) and Beck Anxiety Scales (BAS), Childhood Trauma Questionnaire-28 (CTQ-28), and Suicide Probability Scale (SPS). CTQ was detected as ≥ 35 in 36 of 67 patients who were included in the study. Aggression (p = 0.003), sexual (p = 0.007) and religious (p = 0.023) obsessions and rituelistic (p = 0.000) compulsions were significantly higher in the group with CTQ ≥ 35. Mild correlation was detected between the SPS score and the scores of CTQ. Correlation remained even when the effect of BAS and BDS scores were excluded. At the end of our study, childhood traumas were found to be associated with obsessive symptoms. In the group with childhood trauma, increased suicide probability was detected independently from depression and anxiety.

Effects of Electroconvulsive Therapy on Some Inflammatory Factors in Patients With Treatment-Resistant Schizophrenia.

OBJECTIVES: Electroconvulsive therapy (ECT) is the most effective option for several psychiatric conditions, including treatment-resistant schizophrenia. However, little is known about the molecular mechanism of action of ECT. The link between inflammatory system and schizophrenia is the focus of recent studies. However, the impact of ECT on inflammatory functioning in this disorder remains elusive. Whether ECT could modulate inflammatory factors in patients with schizophrenia was examined. METHODS: Plasma levels of interleukin-4 (IL-4), transforming growth factor-ß (TGF-ß), myeloperoxidase (MPO), and nuclear factor-κB (NF-κB) activation were analyzed in 20 schizophrenic patients, mainly with resistant to antipsychotic medication disorders, and in 20 sex- and age-matched healthy controls. Disease severity was evaluated using the Brief Psychiatric Rating Scale. All patients were followed with measurement of the inflammatory factors before and after ECT treatment and compared with the controls. RESULTS: Patients with schizophrenia had markedly raised NF-κB and but decreased TGF-ß levels compared with healthy controls. On the other hand, no significant differences were found for the levels of IL-4 and MPO levels. The clinical improvement during repeated ECT was accompanied by a gradual and significant increase in IL-4 and TGF-ß level, but MPO and NF-κB activation were left unaffected. Increases in TGF-ß were negatively correlated with the change in Brief Psychiatric Rating Scale scores after ECT. CONCLUSIONS: It is shown that ECT, while increasing the anti-inflammatory response such as the levels of IL-4 and TGF-ß, it did not affect the levels of MPO and NF-κB activation in this study.

Neurosteroid Levels in Patients with Obsessive-Compulsive Disorder.

OBJECTIVE: Changes in serum neurosteroid levels have been reported in stress-related disorders such as anxiety and depression, but not in patients with obsessive-compulsive disorder (OCD). We thus investigated such changes in patients with OCD. METHODS: We compared the serum levels of progesterone, pregnanolone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEA-S), cortisol and testosterone in 30 patients with OCD and 30 healthy controls. RESULTS: When male and female patients were evaluated together, DHEA and cortisol levels were significantly higher in patients with OCD than the control group. When the genders were evaluated separately, DHEA and cortisol levels were higher in female patients than the female controls. The increase in DHEA levels in female patients is likely an effect of the hypothalamic-pituitary-adrenal (HPA) axis. In contrast, cortisol levels in male patients were higher than the control group, while testosterone levels were lower. The increased cortisol and decreased testosterone levels in male patients likely involves the hypothalamic-pituitary-gonadal (HPG) axis. CONCLUSION: These findings suggest that neurosteroid levels in patients with OCD should be investigated together with the HPA and HPG axes in future studies.

Testosterone levels of children with a diagnosis of developmental stuttering.

BACKGROUND: Stuttering is defined as a disruption in the rhythm of speech and language articulation, where the subject knows what he/she wants to say, but is unable to utter the intended word or phrase fluently. The effect of sex on development and chronicity of stuttering is well known; it is more common and chronic in males. We aimed to investigate the relationship between developmental stuttering and serum testosterone levels in this study. MATERIALS AND METHODS: In this study, we evaluated a total of 50 children (7-12 years of age); eight (16%) were female and 42 (84%) were male. Twenty-five children who stutter and 25 typically fluent peers with the same demographic properties (ages between 7 years and 12 years) were included in this study. The testosterone levels of the two groups were determined in terms of nanogram per milliliter (ng/mL) by enzyme-linked immunosorbent assay. The difference between the means of the two groups was analyzed. RESULTS: The medians of the testosterone levels of the stutterer and control groups were determined as 20 ng/mL (range =12-184 ng/mL) and 5 ng/mL (range =2-30 ng/mL), respectively. Testosterone levels of the stutterer group were significantly higher than in the control group (P=0.001). Besides, there was a significant correlation between the severity of the stuttering and testosterone levels in the stutterer group (P=0.0001). CONCLUSION: The findings of this study show that testosterone may have an effect on the severity of developmental stuttering and on the clinical differences between sexes. However, further investigations are needed to show that testosterone may play a role in the etiology of developmental stuttering.

Is there any relation between pseudoexfoliation syndrome and Alzheimer's type dementia?

PURPOSE: To investigate the frequency of Alzheimer-related dementia in patients with pseudoexfoliation syndrome (PEX). METHODS: Sixty-seven patients with PEX and 67 age-, gender-, and educational-background-matched control subjects were compared for the presence of Alzheimer-related dementia according to DSM- IV-TR. The effects of cataract, glaucoma, additional ocular and systemic disease on the dementia incidence were also evaluated in patients with PEX and the control group. RESULTS: The frequency of Alzheimer-related dementia was higher in patients with PEX (p = 0.0001). The frequency of dementia in patients who had cataract was higher than in patients without cataract (p = 0.003). There was also an association between additional ocular disease and dementia (p < 0.05). However, there was no association between systemic disease and dementia (p > 0.05). Furthermore, there was no difference for the frequency of dementia between patients who had glaucoma or not among patients with PEX (p = 0.953). CONCLUSION: The increased frequency of Alzheimer-related dementia in patients with PEX is important and a possible association between PEX and Alzheimer's disease could be present.