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Biomedical subjects

Kemal Yazici

Publications and source records attributed to Kemal Yazici.

10 recordsLinked to original sources

Bone mineral density in premenopausal women with major depression.

AIM: To investigate the relationship between the major depression and bone mineral density (BMD) in premenopausal women. MATERIAL AND METHODS: We compared BMD, plasma cortisol level, osteocalcin and C-telopeptide levels of 35 premenopausal women with major depression with those of 30 healthy women who were matched for age and body mass index. Major depression was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (fourth edition) criteria. Nineteen patients had mild and 16 patients had moderate severity of major depression as measured by Hamilton rating scale for depression. RESULTS: Women with any risk factor for osteoporosis were excluded from the study. All women underwent BMD measurement by DEXA at lumbar (L2-4) and femoral neck region. After an overnight fasting, plasma cortisol levels were measured at 08:00 h by using competitive immunoassay method. Osteocalcin and C-telopeptide were used for the evaluation of bone turnover. There were no significant differences in BMD, plasma cortisol level, osteocalcin and C-telopeptide levels between the patients and the control groups. There was also no correlation between the plasma cortisol level, the duration and the severity of disease, antidepressant drug use and BMD. CONCLUSION: Major depression had no significant effect on BMD and bone turnover markers in our patient group of mild to moderate severity of the disorder.

Adult↗

IL-6 levels decrease with SSRI treatment in patients with major depression.

OBJECTIVE: Some evidence indicates that an immune response with an increased production of proinflammatory cytokines often accompanies major depression. The objective of this study was to examine the serum levels of IL-6 in patients with major depression and the changes occurring in IL-6 levels during treatment with selective serotonin reuptake inhibitors (SSRI). METHOD: Twenty-three patients with a DSM-IV diagnosis of major depressive disorder and 23 healthy matched controls were included in the study. The severity of depression was measured with the Hamilton rating scale for depression. Blood samples for IL-6 levels were obtained at baseline and at week 6 of treatment and IL-6 concentrations were evaluated using a solid phase sandwich enzyme immunoassay. All patients were treated with an SSRI. RESULTS: The IL-6 levels showed no statistically significant difference between the patients and the controls at baseline. However, IL-6 levels after treatment with SSRIs were significantly lower compared with the baseline IL-6 levels of both the patients and the controls. CONCLUSION: The results of this study suggest that proinflammatory cytokines show some changes during the course of treatment of major depression. These findings might also be considered as supporting the hypothesis of a modulatory role of antidepressants on the immune system.

Adult↗

Psychosocial correlates of substance use among adolescents in Mersin, Turkey.

The objective of this study was to determine the effects of psychosocial factors such as peer group, family and academic self-perception on smoking, alcohol and substance use by adolescents living in Mersin, Turkey. The study included a total of 3282 students from the sixth and tenth grades and college. The number of participating students required from each school was obtained through stratification, and by weighing the enrolled student population in each subgroup. The final sample was derived using a simple random sampling technique. A 45-item self-administered questionnaire was used. The questionnaire included questions about socio-demographic characteristics and lifetime and current (i.e. within the past month) use of cigarettes, alcohol, cannabis, inhalants and other illicit drugs (heroin, cocaine, sedative-hypnotic drugs, etc.). This study found that: (1) higher socio-economic status of the family increased the likelihood of smoking and alcohol use in adolescents; (2) the prevalence of alcohol use was higher in adolescents whose mothers had a higher educational level and whose mothers and fathers drank alcohol; (3) there was a significant association between substance use and having a peer who used a substance; and (4) the prevalence of smoking was significantly higher in students who perceived their academic performance to be poor. Understanding the role and importance of psychosocial factors associated with smoking, alcohol and substance use will be crucial to develop preventive measures for adolescents.

Adolescent↗

Lack of association of catechol-O-methyltransferase gene polymorphism in obsessive-compulsive disorder.

The COMT gene has been implicated to be involved in the pathogenesis of obsessive-compulsive disorder (OCD) and various other psychiatric disorders. COMT enzyme activity is governed by a common genetic polymorphism at codon 158 that results in substantial 3- to 4-fold variation in enzymatic activity [a high-activity COMT variant (H) and a low activity variant (L)]. This study evaluates the association between OCD and the COMT gene polymorphism. Fifty-nine OCD patients that were diagnosed according to DSM-IV criteria and 114 healthy control subjects were included in the study. PCR technique was used for molecular analysis. The genotypic pattern of distribution of the COMT gene (H/H, H/L, and L/L genotypes) was not different between the OCD patients and controls. There were no significant differences among the patients with positive family history for OCD, those with negative family history for OCD, and the controls with respect to allele frequencies of the COMT gene polymorphisms. Patients that were homozygous or heterozygous for the L allele had significantly higher insight scores (i.e., poorer insight) on Y-BOCS compared to those homozygous for the H allele. We did not find an association between OCD, family history for OCD, and the COMT gene polymorphism. This study suggests that the COMT gene polymorphism is not directly associated with OCD in our patient group.

Adolescent↗

Amisulpiride augmentation in treatment resistant obsessive-compulsive disorder: an open trial.

Despite the effectiveness of clomipramine and selective serotonin reuptake inhibitors (SSRIs) in the treatment of obsessive-compulsive disorder (OCD), 40% to 60% of patients who receive an adequate treatment with these agents have significant persisting symptoms. Newer atypical antipsychotic drugs showed efficacy as augmenting agents in patients with OCD resistant to serotonin reuptake inhibitors (SRIs). The objective of this study was to evaluate the efficacy and safety of amisulpiride augmentation in treatment resistant OCD. A total of 20 patients diagnosed with OCD according to DSM-IV criteria and having a history of resistance to treatment with SRIs were included in the study. Amisulpiride 200 mg/day was added to ongoing SRI treatment and titrated up to 600 mg/day in flexible doses. The mean amisulpiride dose was 325 +/- 106 mg/day. The patients were assessed with the Yale-Brown obsessive-compulsive scale (Y-BOCS) at baseline and at week 12 of amisulpiride treatment. Side effects were monitored by the UKU side effect rating scale. The reduction in Y-BOCS scores between the baseline (26.7 +/- 6.3) and the end of the treatment (12.5 +/- 2.8) was statistically significant (p=0.0001). The most commonly observed side effects included weight gain (14 patients, 70%), mild sedation (13 patients, 65%) and asthenia (7 patients, 35%). This study has several limitations and, hence, the results are preliminary and require confirmation in a randomized controlled trial. In conclusion, this study suggests that amisulpiride may be a promising option as an augmentation strategy in treatment resistant OCD.

Adult↗

T102C and -1438 G/A polymorphisms of the 5-HT2A receptor gene in Turkish patients with obsessive-compulsive disorder.

OBJECTIVE: This study aimed to investigate the possible association between T102C and -1438 G/A polymorphism in the 5-HT2A receptor gene and susceptibility to and clinical features of obsessive-compulsive disorder (OCD). METHOD: Fifty-eight patients with OCD and 83 healthy controls were included in the study. All patients were interviewed and rated by Yale-Brown Obsessive-Compulsive Scale. T102C and -1438 G/A polymorphisms of 5-HT2A receptor gene were determined by PCR technique in DNAs of peripheral leucocytes. RESULTS: OCD patients and healthy controls did not show significant differences in genotype distribution for both polymorphisms investigated. We found that frequencies of the TT genotype for T102C polymorphism and the AA genotype for -1438 G/A polymorphism were significantly higher in patients with severe OCD compared to those with moderate or moderate-severe OCD. CONCLUSION: The -1438 G/A and T102C polymorphisms of the 5-HT2A receptor gene are not associated with an increased risk of OCD. Our data suggest that the TT genotype of T102C and the AA genotype of -1438 G/A polymorphism might be a factor in clinical severity of OCD.

Adolescent↗

[The effects of hormone replacement therapy in menopause on symptoms of anxiety and depression].

OBJECTIVE: Replacement of deficient hormones (hormone replacement therapy, HRT) is the main treatment modality in menopause. There is no concensus among researchers as to how HRT influences psychiatric symptoms that might develop during menopausal period. In this study we aimed to explore the effects of HRT on symptoms of anxiety and depression comparatively by using either estrogen or tibolone. METHOD: Women with natural menopause who applied to the outpatient Clinic of Obstetrics and Gynecology Department were included in the study. Subjects (n=70) were randomized into two groups with one group to receive 17beta-estradiol and other group tibolon. All subjects were evaluated at baseline and after 3-months of HRT with Hamilton Anxiety Rating Scale (HARS) and Hamilton Depression Rating Scale (HDRS). RESULTS: Forty six of 70 patients completed the study. The 17beta-estradiol (n=23) and the tibolone (n=23) groups were similar with respect to age, education and occupational status. The time from onset of menopause was longer in the tibolon group. HARS and HDRS scores were significantly decreased after 3 months of HRT in both the 17beta-estradiol and the tibolone groups. The two drug regimens were not significantly different in this respect. CONCLUSION: HRT with 17beta-estradiol and tibolone improves symptoms of anxiety and depression in menopausal women.

Anxiety↗

Different neuroendocrine profiles of remitted and nonremitted schizophrenic patients.

BACKGROUND: Thyrotropin-releasing hormone (TRH) test and Dexamethasone Suppression Test (DST) are two neuroendocrine tests that have been extensively used in an attempt to predict treatment response and outcome in schizophrenia. The objectives of this study were to investigate (1) the relationship between TRH test and DST and various psychiatric symptoms and (2) the potential value of these tests in prediction of short-term outcome in schizophrenic patients. METHODS: TRH test and DST were administered to 58 patients with schizophrenia. All patients were evaluated with a battery of rating scales before neuroendocrine test procedures and at regular intervals for 1 year. Patients were divided into two groups as remitted (RP; n = 30) and nonremitted patients (NRP; n = 28). Baseline results of these two groups were compared with each other and 30 healthy controls. RESULTS: Basal levels of total T3 (T3T) and free T3 (T3F) were higher in RP group than controls. Basal prolactin (PRL) level was higher in RP group, but not in NRP, compared to controls. Basal growth hormone (GH) and thyroid-stimulating hormone (TSH) levels of NRP were significantly higher than those of RP. DST nonsuppression was observed at a significantly higher rate in RP than NRP and control group. Blunted TSH response rate in RP group was higher significantly compared to other two groups. CONCLUSIONS: The data implicate that higher basal TSH and GH levels may be associated with a poorer treatment response, whereas higher total and free T3 levels, a blunted TSH response to TRH and nonsuppression on the DST may indicate a better response in schizophrenics.

Adult↗

Association of QEEG findings with clinical characteristics of OCD: evidence of left frontotemporal dysfunction.

OBJECTIVE: Our objectives were 1) to determine hemispheric asymmetry and regional differences on the EEGs of patients with obsessive-compulsive disorder (OCD); and 2) to investigate the effects of sex, treatment response, illness duration, and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores on quantitative electroencephalographic (QEEG) measurements. METHOD: We recorded EEGs (12-channel) from 22 unmedicated patients with OCD but no depression and from 20 age- and sex-matched control subjects. All patients and control subjects underwent detailed neurological and psychiatric evaluations including the Hamilton Depression Rating Scale (HDRS) and Y-BOCS. RESULTS: QEEG revealed higher frequencies of slow-wave bands and lower frequencies of alpha activity at predominantly left frontotemporal localization in patients with OCD, compared with control subjects. Analysis of variance of QEEG parameters and clinical characteristics showed that sex had a significant effect on delta and alpha frequencies of frontotemporal areas during hyperventilation (HV). Increasing total Y-BOCS score correlated positively with increased frequencies of right parietal delta activity and decreased frequencies of right frontotemporal alpha activity during HV. A significantly increased left frontal slow-wave activity and decreased beta activity during HV in treatment responders led us to consider that frontal lobe functions were better in this group of patients. Illness duration had no important effect on QEEG. CONCLUSION: Patients with OCD showed important frontotemporal dysfunction, predominantly in the left hemisphere. This was particularly evident in female subjects and in treatment responders. QEEG may be beneficial in understanding the neurobiological basis of OCD.

Adolescent↗

Pulmonary muscle strength, pulmonary function tests, and dyspnea in women with major depression.

OBJECTIVE: To evaluate the subjective sensation of dyspnea compared with pulmonary function tests, pulmonary muscle strength, and chest expansion in depressed women and control subjects free of cardiorespiratory disease. METHODS: Thirty female patients with major depression (MD) and 30 age-matched female control subjects were included in the study. All subjects were assessed by pulmonary function tests (spirometry) and pulmonary muscle strength measurement (maximum inspiratory and expiratory pressures [MIP and MEP]) by mouth pressure meter (MPM). Chest expansion was measured, and body mass index (kg/m(2)) (BMI) was calculated. The Health Assessment Questionnaire (HAQ) was used to evaluate the activities of daily living, and a dyspnea score was used to determine dyspnea severity. RESULTS: There were no significant differences between groups regarding pulmonary function tests, pulmonary muscle strength, and chest expansion. HAQ scores were significantly lower in women, and dyspnea was higher with MD compared with controls (p < 0.05). BMI was also lower in depressed patients (p < 0.05). CONCLUSIONS: The subjective sensation of dyspnea is increased in women with MD in the presence of normal lung function and is associated with the level of anxiety rather than that of depression.

Adult↗