Antidepressants and menstruation disorders in women: a cross-sectional study in three centers.

OBJECTIVE: The relationship between menstruation disorders and antidepressant drugs usage in women remains unclear. In this study, we aimed to investigate the incidence rate of antidepressant-related menstruation disorders and to examine whether or not antidepressant use is associated with menstrual disorders in women. METHODS: The study sample was gathered from three centers and four hospitals. A total of 1432 women who met the criteria of inclusion were included in the study. The sample was divided into two groups: the antidepressant group (n=793) and the control group (n=639). The menstruation disorders were established with reports from the study participants on the basis of related gynecological descriptions. RESULTS: The prevalence of menstrual disorders was significantly higher in the antidepressant group (24.6%) than the control group (12.2%). The incidence of antidepressant-induced menstruation disorder was 14.5%. The antidepressants most associated with menstrual disorders were paroxetine, venlafaxine, sertraline and their combination with mirtazapine. Overall, the incidence rate was similar in women receiving selective serotonin reuptake inhibitors and serotonin noradrenaline reuptake inhibitors. CONCLUSIONS: The results of the present study suggest that menstruation disorders are frequently observed in women taking antidepressants and that it appears to be associated with antidepressant use at least in some women.

[Therapeutic response to plasmapheresis in four cases with obsessive-compulsive disorder and tic disorder triggered by streptococcal infections]. / Streptokok enfeksiyonu ile iliskili OKB ve tik bozuklugu olan dört olguda plazmaferez tedavisine yanit.

The acronym PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) has been assigned to a subgroup of patients experiencing pediatric onset obsessive-compulsive symptoms and tics as a result of autoimmune response to group A beta-hemolytic streptococcal infection. It has been hypothesized that an immune process initiated by infection affects the basal ganglia and causes neuropsychiatric symptoms. In cases with severe neuropsychiatric symptoms, the use of treatment strategies that interrupt the autoimmune process responsible for the pathogenesis of PANDAS, such as therapeutic plasmapheresis or intravenous immunoglobulin, has been proposed. In this paper, we discuss the effect of plasmapheresis treatment in 4 adult cases of obsessive-compulsive disorder and tic disorder triggered by streptococcal infections.

Longitudinal assessment of symptom and subtype categories in obsessive-compulsive disorder.

Although it has been postulated that symptom subtypes are potential predictors of treatment response, few data exist on the longitudinal course of symptom and subtype categories in obsessive-compulsive disorder (OCD). Putative subtypes of OCD have gradually gained more recognition, but as yet there is no generally accepted subtype discrimination. Subtypes, it has been suggested, could perhaps be discriminated based on autogenous versus reactive obsessions stemming from different cognitive processes. In this study, our aim was to assess whether symptom and subtype categories change over time. Using the Yale-Brown Obsessive Compulsive Symptom Checklist (Y-BOCS-SC), we assessed 109 patients who met DSM-IV criteria for OCD to establish baseline values, then reassessed 91 (83%) of the initial group after 36+/-8.2 months. Upon reassessment, we found significant changes from baseline within aggressive, contamination, religious, symmetry and miscellaneous obsessions and within checking, washing, repeating, counting and ordering compulsion categories. Sexual, hoarding, and somatic obsessions, and hoarding and miscellaneous compulsions, did not change significantly. In accordance with the relevant literature, we also assigned patients to one of three subtypes--autogenous, reactive, or mixed groups. Though some changes in subtype categories were found, no subtype shifts (e.g., autogenous to reactive or reactive to autogenous) were observed during the course of the study. Significantly more patients in the autogenous group did not meet OCD criteria at follow-up than did patients in the other groups. Our results suggest that the discrimination between these two types of obsession might be highly valid, because autogenous and reactive obsessions are quite different, both in the development and maintenance of their cognitive mechanisms, and in their outcome.

A discrimination based on autogenous versus reactive obsessions in obsessive-compulsive disorder and related clinical manifestations.

INTRODUCTION: Although putative subtypes of obsessive-compulsive disorder (OCD) have been gradually more recognized, there is no generally accepted subtype discrimination. It has been suggested that autogenous and reactive obsessions stem from different cognitive process. This study aimed to assess existence of gender, age at onset of illness, and comorbidity differences in OCD patients suffering from autogenous and reactive obsessions. METHODS: The medical records of 177 OCD patients were evaluated retrospectively for gender, age at onset, comorbid diagnoses, and predisposing life events. Obsessions and compulsions were coded according to the Yale-Brown Obsessive-Compulsive Scale. All patients were grouped as the patients with autogenous (autogenous group [AG] n=32), reactive (reactive group [RG] n=77) and mixed obsessions (mixed group [MG] n=68). RESULTS: AG patients were significantly more likely to be male, compared with the RG and MG patients. They also had significantly later onset of illness. Dissociative disorders were less common among AG patients compared with the other groups. CONCLUSION: Results suggest that the discrimination between autogenous and reactive obsessions are not only based on their development and maintenance mechanism through different cognitive process but that there also clinical manifestations of this discrimination.