Psychometric properties of the Turkish version of the Anxiety and Preoccupation about Sleep Questionnaire in clinical and non-clinical samples.

Objectives: The aim of the study was to investigate the psychometric properties of the Turkish version of Anxiety and preoccupation about sleep questionnaire (APSQ) in clinical and non-clinical samples. Material and Methods: Two samples (141 university students and 42 patients with major depressive disorders) completed Turkish APSQ, the Pittsburgh sleep quality index (PSQI), the insomnia severity index (ISI) and the sociodemographic data form. Content validity analysis was performed with the Davis technique after the translation process of the original scale. Explanatory factor analysis and principal component analysis were performed to determine the scales construct validity, and internal consistency and temporal stability analyses were conducted to evaluate its reliability. The PSQI and the insomnia severity index (ISI) were used to assess criterion- related validity. In addition, we divided all the participants into two groups as good-sleepers and clinical insomnia according to ISI scores. Predictive validity analyses were also computed via comparing groups. Results: Confirmatory factor analysis showed that the scale model aligns well with the original scales 10 items and two-factor structure. The scales and subdimensions Cronbach's alpha coefficients were excellent (Factor 1; 0.935, factor 2; 0.906, total scale; 0.952). The test-retest correlations were 0.661 and 0.828 for depression group and university student group, respectively. Turkish APSQ scores were found to be significantly higher in both of the clinical groups (depression group vs. university student group, clinic insomnia group vs. good-sleepers group). Conclusion: The Turkish APSQ is adequate reliability and validity for assessing anxiety and preoccupation about sleep in Turkish clinical and non-clinical samples.

Diagnostic Performance of Increased Malondialdehyde Level and Oxidative Stress in Patients with Schizophrenia.

INTRODUCTION: Schizophrenia is typically diagnosed through interviews with patients and their relatives. Thus, molecular biomarkers for this mental illness have recently become a hot topic for research. Oxidative stress and antioxidant parameters, such as catalase (CAT), superoxide dismutase (SOD) and malondialdehyde (MDA), have been investigated in schizophrenia; however, no studies have been conducted on the diagnostic performance of oxidative parameters. The goal of the present study is to examine the serum levels of SOD, CAT and MDA and to test the diagnostic performance of MDA in patients with schizophrenia. METHODS: Thirty patients with schizophrenia and 30 healthy gender- and age-matched controls were included in our study. Symptom severity in the patient group was rated using the Positive and Negative Syndrome Scale (PANSS). RESULTS: The serum levels of MDA, SOD and CAT were found to be significantly increased in patients with schizophrenia compared to the control group. A receiver operating characteristic curve showed a cut-off point of 2.72 nmol/ml for the MDA diagnostic measure. No significant correlation was found (p>0.05) between MDA, SOD and CAT activity and PANSS scores or the chlorpromazine equivalent and clinical characteristics. CONCLUSION: In summary, we found higher serum levels of SOD, CAT and MDA in patients with schizophrenia compared to healthy controls. MDA is considered a very good diagnostic lipid peroxidation marker, and further studies should be done to test its validity in patients with schizophrenia.

The effects of Maras powder use on patients with migraine.

BACKGROUND: It is accepted that smoking often triggers migraine. However, studies evaluating the relationship between the use of smokeless tobacco and migraine are limited, and there is no clear consensus on the subject. In this study, it was aimed to evaluate the relationship between migraine and Maras powder, which is the most common smokeless tobacco in Turkey. SUBJECTS AND METHODS: The study included a total of 600 subjects, consisting of 300 patients (aged >18 years) diagnosed with a migraine according to the International Headache Society (IHS-ICHD-3 Beta) criteria after presenting at Sütçü Imam University Medical Faculty Neurology Policlinic with the complaint of headache between July 2016 and December 2016 and a control group of 300 individuals with similar features of age, gender, and educational level. A questionnaire was administered to each patient to record the status of smoking or using Maras powder. RESULTS: In the migraine patient group, 16.4% smoked and 9.7% used Maras powder. In the control group, the rate of smoking was 8.5% and the rate of Maras powder use was 11.86%. In males diagnosed with a migraine, the use of Maras powder was found to be at a higher rate than smoking (p<0.001). The Visual Pain Score and the headache frequency values were higher in those who smoked or used Maras powder than in non-users (p<0.001). The Fagerström Test for Nicotine Dependence Smokeless Tobacco results of the patients diagnosed with migraine and who used Maras powder were found to be higher than of those who smoked (Fagerström Test for Nicotine Dependence; p<0.001). When patients were evaluated according to the Migraine Disability Assessment Scale, the majority of migraine patients were seen to be at stages 1 and 2, and one in every three patients who used Maras powder cigarette and one in every two patients who smoked had headaches of a severity which affected their daily activities (p<0.001). CONCLUSION: Smoking or the use of Maras powder increases the frequency and severity of migraines in a similar way. Therefore, Maras powder must be included in the scope of the fight against tobacco and people should be warned about this issue.

Serum levels of GPER-1 in euthymic bipolar patients.

INTRODUCTION: Estrogen and its receptors have been suggested as playing a role in the pathogenesis of bipolar disorder (BD). Estrogen functions through the estrogen receptors alpha and beta and the recently discovered G-protein-coupled estrogen receptor-1 (GPER-1). The aim of this study was to evaluate serum GPER-1 levels in euthymic BD patients. PATIENTS AND METHODS: The study population consisted of 38 euthymic outpatients meeting the criteria for BD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and 35 age- and gender-matched healthy controls. Medical histories were obtained and physical examinations and laboratory tests conducted. RESULTS: Serum GPER-1 levels were measured in both patients and controls and found to be significantly higher in the BD patients than in controls. These results were not influenced by the medications in use. CONCLUSION: The results of this study demonstrated that GPER-1 may play a role in BD pathophysiology.

Temperament and character profiles of male COPD patients.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a respiratory disorder, and is characterized by persistent airflow obstruction. These patients are exposed to severe physical limitations and substantial psychosocial trouble. The aims of this study were to determine the temperament and character profiles of personality in patients with COPD and to compare the results with those of healthy controls. METHODS: Thirty-nine male COPD patients and 67 age- and gender-matched healthy controls completed the self-administered 240-item temperament and character inventory (TCI) and 14-item hospital anxiety and depression scale. The relationships between temperament and character personality profiles and clinical factors such as severity of COPD, anxiety, and depression were evaluated. RESULTS: COPD patients had significantly higher mean scores of Harm avoidance and lower mean score of Self-directedness than those of healthy controls. In the COPD patients, the anxiety score was significantly higher (P=0.03) and the depression score was found to be insignificantly higher than that of control group. The TCI profiles were not correlated with the severity of COPD. In COPD patients, Self-directedness and Cooperativeness traits of TCI character negatively correlated with anxiety, but any of traits did not correlate with depression. CONCLUSIONS: The present study defined the Harm avoidance score was higher and Self-directedness was lower in COPD patients and the COPD severity did not correlate with any of the personality trait. We suggest that during evaluation of COPD patients for treatment, personality trait should also be considered in clinical practice.

Sociodemographic variables and depression in Turkish women from polygamous versus monogamous families.

In this study, we aimed to determine the different sociodemographic variables of polygamous and monogamous wives, and the relationship between depression and polygamous marriage. Seventy-nine polygamous wives and 73 monogamous wives from Kahramanmaras, located in southern Turkey, were interviewed. After reviewing the data, we suggest that there is a statistically significant difference between polygamous wives and monogamous wives in terms of Beck Depression Inventory (BDI) scores. The results highlighted many implications for clinical practice and for future research. Additional research needs to be conducted in order to investigate the effects of polygamy on women's mental health.

Assessment of temperament and character profile with anxiety and depression in patients with acne.

BACKGROUND: Acne is the most common skin disease, affecting nearly 85% of the population as well as their lives. Acne can severely affect social and psychological functioning. Patients with acne may have anxiety, depression, decreased self-esteem, interpersonal difficulties, unemployment, social withdrawal, and even suicidal intent. AIMS: The aim of this study was to evaluate the temperament and character inventory (TCI) of patients with acne and to compare the results with those of healthy controls. STUDY DESIGN: Case-control study. METHODS: The study population consisted of 47 patients with acne, and 40 healthy control subjects. All participants were instructed to complete a self-administered 240-item TCI and the Hospital Anxiety and Depression Scale. RESULTS: In this study, the scores for the temperament properties Worry and pessimism (HA1) and Dependence (RD4) and the character properties Social acceptance (C1) and Integrated conscience (C5) were found to be higher in acne patients than in healthy controls (p<0.05). Compared to the controls, depression and anxiety scores were found to be markedly higher in the patients with acne. Acne type correlated positively with the Disorderliness (NS4) subscale of Novelty seeking (NS) and anxiety. Additionally, acne type correlated negatively with the Attachment (RD3) subscale of Reward Dependence (RD), with the Transpersonal identification (ST2) and Spiritual acceptance (ST3) subscales of Self-Trancendence (ST), and with the Compassion (C4) sub-scale of Cooperativeness (C). CONCLUSION: Studies in this area may lead to the development of specific and focused interventions for TCI in patients with acne vulgaris. We suggest that the evaluation and treatment of acne should also include psychosomatic approaches in clinical practice.

Evaluation of Anxiety and Levels of Serum B12, Folate, TSH, Ferritin, and Zinc in Telogen Alopecia Patients with Trichodynia.

BACKGROUND: Trichodynia refers to pain, discomfort, and/or paresthesia of the scalp. Trichodynia may be associated with anxiety. AIM: To assess serum vitamin B12, folate, thyroid stimulating hormone (TSH), ferritin, and zinc levels, and to investigate anxiety in telogen alopecia patients with trichodynia. MATERIALS AND METHODS: The study included 31 telogen alopecia patients who complained of trichodynia and 30 telogen alopecia patients without trichodynia. Their serum vitamin B12, folate, TSH, ferritin, and zinc levels were assessed and their anxiety levels were scored using the Beck Anxiety Inventory (BAI) and the State-Trait Anxiety Inventory (STAI). RESULTS: No significant difference was found in the serum levels of vitamin B12, folate, TSH, ferritin, and zinc in the patient and control groups. The anxiety scores in both groups were similar. CONCLUSION: Our data provide no evidence for the association of serum vitamin B12, folate, TSH, ferritin, and zinc levels or anxiety scores with trichodynia.

Relationship between sleep quality and depression among elderly nursing home residents in Turkey.

OBJECTIVES: Epidemiological studies indicate that more than half of the elderly population suffers from chronic sleep disturbances. Therefore, this descriptive study was conducted to examine sleep quality, excessive daytime sleepiness, daytime napping, and depression among a population of nursing home residents. METHODS: The study's sample included 73 elderly people living in a nursing home in Turkey. Geriatric Depression Scale, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and a sleep diary were used. RESULTS: The participants' mean age was 74.0 years (standard deviation (SD) = 6.7). Forty-four of the individuals had a poor sleep quality prevalence of 60.3%; and the mean global PSQI score was 6.6 (SD = 3.6). Their mean ESS score was 5.9 (SD = 4.6) and 14 participants (19.2%) had daytime sleepiness. The mean daytime napping duration was 1.0 h (SD = 1.3) according to the participants' sleep diaries. The study found that 60.3% of the participants were depressed, furthermore the mean depression score was 15.9 (SD = 7.0). There was a significant correlation between the PSQI subscores; subjective sleep quality, the sleep latency, and sleep disturbances scores and depression scores. Also, daytime napping frequency and daytime napping duration, according to the sleep diary, were correlated positively with depression scores. CONCLUSIONS: The current study's results confirm the previously reported high prevalence of poor sleep quality and depression in this nursing home population. Clinicians need to assess patients appropriately to identify high prevalence of sleep problems and depression in nursing home patients and initiate appropriate referrals and interventions.

Night eating syndrome among patients with depression.

OBJECTIVE: The purpose of this study was to identify the rate of night eating syndrome (NES) in a depressed population. METHOD: The study sample was composed of 162 depressed patients and 172 healthy control participants. RESULTS: The rates of night eating in our sample with depression (35.2%) was higher as compared with healthy control participants (19.2%) (p less than 0.05). In addition, in the depression group, the rate of NES-positive patients did not differ in accordance with body mass index (BMI) classification (p more than 0.05). However, in the control group, the rate of NES-positive patients was significantly different with regard to BMI classification, and NES diagnosis was highest in the obese members of the control group (p less than 0.05). Multiple logistic regression analysis was then used to evaluate the relationships of four variables: depression, gender, education status and BMI with the diagnosis of NES. Results showed that significant independent predictors of NES were depression, gender, and a BMI of 25 or greater. DISCUSSION: This is the first study to find that depressed patients are at a significantly greater risk for NES. Depression, male gender and BMI may account for the high rate of NES found in this population.

Effects of enflurane and propofol on seizure duration and recovery profiles in electroconvulsive therapy.

UNLABELLED: The aim of this study is to investigate effect of enflurane that is a pro-convulsive anesthetic agent and propofol on seizure durations and recovery times during electroconvulsive therapy. METHODS: The subjects were divided into two groups according to the induction anesthetics. Anesthesia was induced with enflurane 5% in group E or propofol 1.2 mg x kg(-1) in group P. After the loss of consciousness, 0.5 mg x kg(-1) of succinylcholine was given. The patients maintained normocapnia. RESULTS: There were no significant differences between groups regarding seizure times. Recovery times were shorter in group E, but postictal agitation was significantly lower in propofol group. DISCUSSION: High incidence of spike activity on EEG and grand mal seizure patterns could be induced by enflurane. But motor and EEG seizure times were not prolonged by enflurane in the presence normocapnia. In conclusion, propofol is more suitable anesthetic agent for ECT, but enflurane might be preferred in patients because of rapid recovery.

Restless legs syndrome in hemodialysis patients: association with depression and quality of life.

PURPOSE: The prevalence of restless legs syndrome (RLS) ranging from 6.6% to 83% has been reported in different case series. The pathophysiology of RLS in uremia is still unclear. The aim of this study was to assess the frequency of RLS in the hemodialysis patients and to explore depression and associated detrimental impact on quality of life. METHODS: The diagnosis of RLS was made using the criteria of the International Restless Legs Study Group. The polyneuropathy was diagnosed according to clinical signs and symptoms. Each subject completed three questionnaires: Beck Depression Inventory, Short Form-36 Quality of Life Scale, and the Epworth Sleepiness Scale (ESS). Biochemical parameters including hemoglobin, serum ferritin, and Kt/V index were collected. The data of the patients with and without RLS or clinical polyneuropathy (PNP) were compared. RESULTS: There were 41 male and 40 female patients. RLS, PNP, and high ESS scores were seen in 12%, 47%, and 7% of hemodialysis patients, respectively. Beck depression inventory scores were high in patients with RLS when compared to those without (28.9 ± 9, p = 0.007). General health score in the RLS patients, physical functioning score in the PNP patients were significantly lower (GH, 20.7; p = 0.036; PF, 10.5; p < 0.005). We did not observe any association between hemoglobin, ferritin levels, and Kt/V index in the RLS patients. However, Kt/V index in the PNP patients were low. CONCLUSIONS: The frequency of RLS in hemodialysis patients was lower than that reported from similar studies in other countries. The presence of RLS and PNP in hemodialyzed patients negatively affects quality of life, and RLS contributes to occurrence of depression.

Maras powder usage among Turkish psychiatric outpatients.

A kind of smokeless tobacco known as Maras powder, which is used in the southeastern region of Turkey, causes nicotine dependence. The aim of this study was to determine the usage of Maras powder among psychiatric outpatients and nonpsychiatric controls. The study group consisted of 276 psychiatric patients and 283 nonpsychiatric patients from psychiatry and family medicine outpatient clinics. A socio-demographic form, the Fagerström Test for Nicotine Dependence, and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders?4th Edition were given to the participants. The rates of Maras powder usage in the patient group (10.1%) were significantly higher than those in the control group (5.6%). Men were found to use Maras powder at a higher rate in both groups. The rates of Maras powder usage according to the psychiatric diagnosis were evaluated. This is the first study estimating Maras powder usage rates among psychiatric patients in Turkey. The study's limitations are noted.

Combination therapy of imipramine and melatonin: additive antidepressant effect in mouse forced swimming test.

Although there are tools to treat depressive patients, a considerable amount of the cases remains to be untreated. These drug-resistant patients need new drugs or drug combinations to overcome this problem. Thus, the potential synergistic effect of melatonin on a classical drug, imipramine was evaluated in the present study. To test this hypothesis, porsolt swim test, a test predictive of antidepressant-like action, was conducted in mice. Imipramine at doses of 20 and 40 mg/kg caused no alteration and statistically significant reduction in the duration of immobility in forced swim test, respectively. While 5 mg/kg melatonin had no effect, 10 mg/kg melatonin slightly reduced the duration of immobility. When sub-effective doses of imipramine and melatonin (20 and 5 mg/kg, respectively) were co-administered, there was no alteration in responses compared with those of each drug alone. Likewise, the effective dose of melatonin (10 mg/kg) did not cause any increase in responses to 20 mg/kg imipramine. Although combination of imipramine (40 mg/kg) and melatonin (5 mg/kg) did not exert an antidepressant effect above that of imipramine alone, co-administration of the effective doses (10 and 40 mg/kg for melatonin and imipramine, respectively) displayed an additive effect. There were no significant differences between groups in relation with locomotor activity test. The results show that co-administration of imipramine and melatonin exhibits an additive effect and that there seems to be no interaction between the drugs.

Co-administration of a nitric oxide synthase inhibitor and melatonin exerts an additive antidepressant-like effect in the mouse forced swim test.

BACKGROUND: The aim was to assess the combination therapy of nitric oxide synthase inhibitors and melatonin, since they had been separately shown to be as efficacious as conventional antidepressant drugs in pre-clinical antidepressant screening procedures. MATERIAL/METHODS: The Porsolt swim test was conducted to resemble the symptornatolog of major depressive disorder and an open-filed locomotor activity was also used. RESULTS: N(G)-nitro-L-arginine (L-NNA) at 3 mg/kg slightly, but not significantly, reduced the duration of immobility, and increasing the dose to 10 mg/kg was sufficient to attain a significant reduction. On the other hand, the maximal dose of L-NNA (30 mg/kg) was without effect, although a non-significant small increase was observed. The results obtained with L-NNA were in accorldance with a U-shape effect. While 3 mg/kg melatonin was ineffective, a statistically significant decrease in the duration of immobility was determined at the dose of 10 mg/kg. While the combination of ineffective doses (3 mg/kg, each) of L-NNA and melatonin revealed no further inhibition in the duration of immobility, the most effective doses (10 mg/kg, each) caused a more pronounced reduction when compared with those of each drug alone. None of the drugs used in the present study had any effects on locomotor activity over the dose range applied. CONCLUSIONS: The combination therapy with L-NNA and melatonin seems to have an additive effect and may be considered as a feasible candidate in attenuating the symptoms of major depressive disorder.