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Introduction: Schizophrenia is a chronic illness that negatively affects the quality of life and psychosocial functions. Defined criteria to assess remission in schizophrenia are considered to be useful in the long-term follow-up of patients and in discriminating diagnostic factors. This study investigated the quality of life and functionality in schizophrenia patients in symptomatic remission (R-Sch) and not in remission (Non-R-Sch)., Methods: Sociodemographic data were collected for 40 R-Sch and 40 Non-R-Sch patients, and the following scales were administered: the Clinical Global Impression-Severity (CGI-S) Scale; Positive and Negative Syndrome Scale (PANSS), World Health Organization Quality of Life Questionnaire-Short Form, Turkish Version (WHOQOL-BREF-TR), Quality of Life Scale for Schizophrenia Patients (QLS), and Global Assessment of Functioning Scale (GAF)., Results: The total and all subscale scores of PANSS and the CGI-S score were significantly lower in the R-Sch group than in the Non-R-Sch group, whereas the GAF scores and all subscales of QLS and WHOQOL-BREF-TR were significantly higher., Conclusion: This study demonstrates that improvement in symptoms in schizophrenia patients improves quality and functionality in all areas of life, suggesting that an improvement in symptoms is the most important determinant of functional recovery in the treatment of schizophrenia., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

BACKGROUND Although genetic factors are risk factors for schizophrenia, some environmental factors are thought to be required for the manifestation of disease. Epigenetic mechanisms regulate gene functions without causing a change in the nucleotide sequence of DNA. Brain-derived neurotrophic factor (BDNF) is a neurotrophin that regulates synaptic transmission and plasticity. It has been suggested that BDNF may play a role in the pathophysiology of schizophrenia. It is established that methylation status of the BDNF gene is associated with fear learning, memory, and stressful social interactions. In this study, we aimed to investigate the DNA methylation status of BDNF gene in patients with schizophrenia. MATERIAL AND METHODS The study included 49 patients (33 male and 16 female) with schizophrenia and 65 unrelated healthy controls (46 male and 19 female). Determination of methylation pattern of CpG islands was based on the principle that bisulfite treatment of DNA results in conversion of unmethylated cytosine residues into uracil, whereas methylated cytosine residues remain unmodified. Methylation-specific PCR was performed with primers specific for either methylated or unmethylated DNA. RESULTS There was no significant difference in methylated or un-methylated status for BDNF promoters between schizophrenia patients and controls. The mean duration of illness was significantly lower in the hemi-methylated group compared to the non-methylated group for BDNF gene CpG island-1 in schizophrenia patients. CONCLUSIONS Although there were no differences in BDNF gene methylation status between schizophrenia patients and healthy controls, there was an association between duration of illness and DNA methylation.

The coping of patients with prodromal syndromes prevents relapses, and the differences in coping strategies affect the results of bipolar disorder. The various functionality levels of bipolar disorder patients such as work, marital relations, parental abilities and social presentation are significantly related with how well they cope. The objective of this study was to determine the family functionality and coping attitudes of bipolar disorder patients. The study planned as a descriptive one was carried with 81 bipolar disorder patients. Personal description form, family assessment device and Coping Attitudes Scale were used as data acquisition tools. It was determined that the adaptive coping attitudes used most frequently by the patients were religious coping, positive reinterpretation, active coping, problem-focused coping and emotional focused coping, beneficial social support use, emotional social support use, planning, suppression of competing activities and restraint coping; maladaptive coping attitudes used most frequently by the patients were "focusing on the problem and venting of emotions and mental disengagement." It was determined that family functions affected the coping attitudes of patients and that the patients who evaluated family functions in a healthy manner made use of adaptive coping strategies more at a statistically significant level.

Introduction: Obesity is more common among patients with bipolar disorder as compared to normal population. There are studies showing increased leptin levels in obese patients. The aim of the present study was to investigate the alterations in leptin levels, body mass index (BMI), and lipid-lipoprotein levels during manic period, as well as during euthymic period, after one month in patients with bipolar disorder., Methods: Thirty-one adult patients, who had been hospitalized in the psychiatry clinic because of manic period of bipolar disorder, were included in the present study. Serum leptin and lipid-lipoprotein levels and BMI of the patients were analyzed both on the first day and 30th day of hospitalization after they became euthymic., Results: Total cholesterol and triglyceride levels significantly increased in male patients (p<.05). The increase in total cholesterol and LDL-C levels was not significant in female patients (p=.066 and p=.056, respectively). BMI was significantly, but slightly increased in both genders (.56±.14 kg/m 2 ), however, such a change was not observed in serum leptin levels., Conclusion: Results of the present study demonstrated that clinical improvement in bipolar patients showed different association in each gender with the alterations in BMI and serum lipid and/or lipoprotein levels. Such an alteration might have resulted from direct or indirect effect of drugs, as well as from lifestyle changes., Competing Interests: Conflict of interest: The authors reported no conflict of interest related to this article.. Çıkar Çatışması: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemişlerdir.

Despite having been previously associated with schizophrenia, catatonia is more often associated with mood disorders and factors related to general medical conditions. Benzodiazepines are recommended as the first option in treatment of catatonia. For patients who do not sufficiently respond to benzodiazepines and for patients that need a fast response, electroconvulsive therapy is then recommended. In this case, we present a case that developed catatonia after myocardial infarction and remained catatonic for 1.5 years until he was treated with electroconvulsive therapy.

Background and Aims: Ceruloplasmin, an acute phase reactant with antioxidant capacity, has been found to be increased in some psychiatric disorders like schizophrenia and obsessive compulsive disorder. However, studies in depression are very scarce. We undertook this study determine the serum ceruloplasmin levels of depressive patients before and after treatment, to compare them with those of healthy control subjects, and to assess any possible association of ceruloplasmin and treatment response., Methods: Nineteen (8 male, 11 female) patients with major depressive disorder and 40 (17 male, 23 female) healthy control subjects were included in the study. The patients received naturalistic antidepressant treatment for 8 weeks after diagnosis. Serum ceruloplasmin levels and Hamilton Depression Rating Scale (HAM-D) scores of the patients were measured before and after their antidepressant treatment. Blood collection for ceruloplasmin measurement was done only once for healthy control subjects., Results: Patients' ceruloplasmin levels before and after antidepressant treatment were significantly higher than control subjects (t = 7.569, p <0.001 and t = 6.764, p <0.001, respectively). Despite clinical improvement, ceruloplasmin did not show any significant change after treatment in patients with depression (t = -1.163, p = 0.260) and remained higher than levels of control subjects. No correlation was found between HAM-D score, presence of response, and ceruloplasmin levels., Conclusions: Compared to healthy control subjects, ceruloplasmin level seemed to be higher in patients with depression and remained high, despite acute antidepressant treatment. Improvement in clinical measurements of depression after antidepressant treatment was not reflected as significant alterations in serum ceruloplasmin levels., (Copyright © 2012. Published by Elsevier Inc.)

Adult Attention Deficit Hyperactivity Disorder (A-ADHD) is one of the psychiatric disorders which awareness is growing. The exact causes of A-ADHD are still unknown. In addition to neurochemical and neuroanatomic disorders, genetic and environmental factors are discussed in its etiology. In our study, we aimed to evaluate the oxidative status of A-ADHD patients and investigate whether oxidative metabolites can be used as diagnostic tools or not in A-ADHD. Blood samples were taken from enrolled 50 A-ADHD patients and 31 controls in appropriate way and Total Antioxidative Status (TAS), Total Oxidative Status (TOS), and Oxidative Stress Index (OSI) were studied in Harran University Biochemistry Labs. Results were compared between groups and ROC curve was drawn in order to evaluate diagnostic performances. Patients' TAS, TOS and OSI were significantly higher than controls. There was not a significant difference between comorbid cases and only A-ADHD patients in terms of measured values. A-ADHD can be predicted for TOS over 9.8575 μmol H(2)O(2) Eqv./L level with 86% positive predictive value and %100 negative predictive value. In A-ADHD, oxidative balance is impaired. High antioxidant levels may be compensatory against the oxidant increase. Oxidative parameters may be used in A-ADHD diagnosis., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Objectives: Psychiatric disorders are common in obstructive sleep apnea syndrome (OSAS); however, interrelating factors influencing psychiatric comorbidity (PC) in OSAS are unclear. The aim of this study is to investigate gender related differences with PC in OSAS., Methods: Data of patients diagnosed as OSAS in University of Gaziantep from January 2006 to January 2010 were retrospectively evaluated. Polysomnographic data were recorded with Viasys Sleep Screen (Viasys Healthcare, Germany). Patients younger than 18 years old were excluded., Results: PC was present in 53.1% of OSAS patients. The rate of male subjects with PC was 42.6%; however, 76.26% of females had PC (P = 0.00). Age (P = 0.00) and body mass index (BMI) (P = 0.00) were higher in patients with PC. Ferritin levels were lower in patients with PC (P = 0.00). Male subjects with PC were older and had lower sleep efficiency and longer rapid eye movement latency than males without PC. BMI was the only contributory factor to PC in female subjects., Conclusion: PC in OSAS is common, especially in females. Apnea hypopnea index does not seem to influence probability of PC.

Objective: Even though quality of life and functioning are topics that are point of interest, they are not assessed adequately in mood disorders. In this study, it is aimed to develop a functioning assessment scale in bipolar disorder., Method: Bipolar Disorder Functioning Questionnaire (BDFQ) is developed by the Scientific Section for Mood Disorders of the Psychiatric Association of Turkey. The questionnaire contains 58 items, and consists of eleven subscales: emotional functioning, intellectual functioning, sexual functioning, feelings of stigmatization, social withdrawal, household relations, relations with friends, participation to social activities, daily activities and hobbies, taking initiative and self sufficiency, and occupation., Results: In this study, 252 remitted bipolar patients from 15 centers were included. In addition, thirty subjects without any lifetime psychiatric, neurological or physical disease were recruited. The mean age of the patients was 38.6+/-12.1 and 56% (n=141) were female. The mean duration of the bipolar disorder was 11.9+/-9.2 years, and 91.3% of the patients were diagnosed to have bipolar I disorder. In the reliability analyses, after the exclusion of six items with low reliability coefficients, The Cronbach alpha coefficient was calculated to be 0.91. The item-total scale correlations were between 0.22-0.86. In test-retest reliability, the correlation between the two ratings was high (r=0.82, p<0.0001). In validity analyses, 13 factors were obtained representing 65.1% of the total variance in exploratory factor analysis. In confirmatory factor analysis, 11 domains fit the model with a RMSEA of 0.061. BDFQ significantly correlated with GAF (r=0.428, p<.0001). BDFQ also showed significantly negative correlation with HAM-D (r=-0.541, p<0.0001) and YMRS (r=-0.365, p<0.0001). It discriminated the patients (mean score=111.8+/-15.2) from the healthy subjects (mean score=121.4+/-10.4) well (t=-2.300, p=0.038)., Conclusion: With the six items excluded, it is suggested that the 52-item BDFQ is a reliable and valid instrument in the assessment of functioning in bipolar disorder.

The effects of electroconvulsive therapy (ECT), which is a widely used treatment for psychiatric disorders, have not yet been established. Therefore, we aimed to explore whether the patients' serum ghrelin and leptin levels are associated with the action of ECT treatment. In the case of the mood disorders, which occurred in 16 patients with major depressive episode (MDE) and 12 patients with bipolar disorder-manic episode (BD-me) and 25 healthy controls, we have determined the serum levels of ghrelin, leptin and cholesterol before ECT and 2 days after ECT. The BMI was also calculated in all subjects. Although ECT treatment did not change mean the BMI and serum leptin level, the mean serum ghrelin level decreased and the total cholesterol level increased after ECT compared with before ECT. While the leptin levels in the patient group were significantly lower than the controls before and after ECT, the mean serum ghrelin and total cholesterol levels differed statistically only before ECT, but not after ECT than those in controls. The ghrelin levels have decreased significantly after ECT in both sub-groups MDE and BB-me. However, the mean serum total cholesterol level increased statistically after ECT only in the MDE sub-group, and the leptin levels did not differ in both sub-groups after ECT compared with before ECT. In conclusion, ECT treatment seems to be associated with decreased ghrelin levels and increased cholesterol levels but not leptin levels. However, more comprehensive and detailed studies are needed to decipher the exact role of ECT on ghrelin, leptin and total cholesterol in mood disorders.

There is a reciprocal regulation of arginase and nitric oxide synthase (NOS) in L-arginine-metabolizing pathways. Nitric oxide (NO) may be involved in some psychiatric disorders like schizophrenia, depression and bipolar affective disorder (BPAD). To our knowledge, there is no study in the literature in which the role of arginase, an important part of the arginine regulatory system affecting NOS activity, was investigated in BPAD. This study aims to investigate arginase, manganese (Mn) and total nitrite levels (a metabolite of NO) and their relationship to the arginine-NO pathway in patients with BPAD. Arginase activities, Mn and total nitrite levels were measured in plasma from forty-three patients with BPAD (Type one) and thirty-one healthy control subjects. Plasma arginase activities and Mn were found to be significantly lower and total nitrite level higher in patients with BPAD compared with controls. Our results suggest that the arginine-NO pathway is involved in the pathogenesis of BPAD.

Background: There is evidence that oxygen free radicals play an important role in the pathophysiology of many neuropsychiatric disorders. Although it has not been investigated yet, several recent studies proposed that nitric oxide (NO) and other parameters related to oxidative stress may have a pathophysiological role in autism., Methods: We assessed the changes in superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activities and thiobarbituric acid-reactive substances (TBARS) levels in plasma as well as NO levels in red blood cells (RBC) in patients with autism (n=27) compared to age- and sex-matched normal controls (n=30)., Results: In the autistic group, increased RBC NO levels (p<0.0001) and plasma GSH-Px activity (p<0.0001) and unchanged plasma TBARS levels and SOD activity were detected., Conclusions: These findings indicate a possible role of increased oxidative stress and altered enzymatic antioxidants, both of which may be relevant to the pathophysiology of autism.

Several studies indicate that nitric oxide (NO) is involved in the aetiopathogenesis of many neuropsychiatric disorders such as schizophrenia, bipolar disorder, depression, Alzheimer's disease, Hungtington disease and stroke. Although it has not been investigated yet, several recent studies proposed that NO may have a pathophysiological role in autism. Adrenomedullin (AM), a recently discovered 52-amino acid peptide hormone, induces vasorelaxation by activating adenylate cyclase and also by stimulating NO release. AM immune reactivity is present in the brain consistent with a role as a neurotransmitter. It has been stated that NO and AM do function in the regulation of many neurodevelopmental processes. We hypothesized that NO and AM activities have been affected in autistic patients and aimed to examine these molecules. Twenty-six autistic patients and 22 healthy control subjects were included in this study. AM and total nitrite (a metabolite of NO) levels have been measured in plasma. The mean values of plasma total nitrite and AM levels in the autistic group were significantly higher than control values, respectively (p < 0.001, p = 0.028). There is no correlation between total nitrite and AM levels (r = 0.11, p = 0.31). Certainly, this subject needs much further research investigating autistic patients in earlier periods of life and with subtypes of the disorder., (Copyright 2002 John Wiley & Sons, Ltd.)

Background: The pathophysiology of tardive dyskinesia (TD) is not completely understood.Aim. - To assess the relationship of TD with 5-HT2A receptor gene, serotonin transporter gene (5 HTT), and catechol-o-methyltransferase (COMT) gene polymorphisms., Method: Our study comprised 111 unrelated subjects who strictly met DSM-IV criteria for schizophrenia and 32 TD, and 79 healthy unrelated controls; all the subjects were of Turkish origin. The analyses of 5-HT2A receptor gene, 5 HTT gene, and COMT gene polymorphisms were performed using polymerase chain reaction (PCR) technique., Results: The polymorphisms of these genes were not significantly different between the schizophrenic patients, TD and control subjects., Conclusion: Our findings indicated that 5-HT2A receptor gene, 5 HTT gene, and COMT gene polymorphisms were similar in schizophrenia with non-TD, schizophrenia with TD, and healthy controls. These polymorphisms, though, do not help to evaluate the susceptibility to TD.

The reciprocal regulation of arginase and nitric oxide synthase (NOS) in L-arginine-metabolizing pathways has been demonstrated. There are various evidences of the role of the nitric oxide (NO) in several neuropsychiatric disorders including schizophrenia. However, there is no study which has investigated the role of arginase as an important part of the arginine regulatory system affecting NOS activity in schizophrenia. This study aims to investigate arginase, manganese (Mn) and total nitrite levels (a metabolite of NO) and their relationship to the arginine-NO pathway in patients with schizophrenia. Arginase activities, Mn and total nitrite levels were measured in plasma from 46 patients with schizophrenia and 32 healthy control subjects. Plasma arginase activities and Mn were found to be significantly lower and total nitrite level higher in patients with schizophrenia compared with controls. Our results suggest that the arginine-NO pathway is involved in the pathogenesis of schizophrenia., (Copyright 2003 S. Karger AG, Basel)

Evidence is accumulating for a possible role of nitric oxide (NO) in schizophrenia. Adrenomedullin (AM) induces vasorelaxation by activating adenylate cyclase and also by stimulating the release of NO. AM immune reactivity is present in the brain consistent with a role as neurotransmitter. We aimed to examine plasma levels of nitrite (a metabolite of NO) and AM in schizophrenic patients. Eighty-two patients with schizophrenia and 21 healthy control subjects were included in this study. DSM-IV diagnosis of chronic schizophrenia was established on the basis of independent structured clinical interviews and review of records by two qualified psychiatrists which included the Brief Psychiatric Rating Scale (BPRS), The Scale for the Assessment of Negative Symptoms (SANS) and The Scale for the Assessment of Positive Symptoms (SAPS). Total nitrite and AM have been studied in plasma. The mean values of plasma nitrite and AM levels in schizophrenic group were significantly higher than control values, respectively (P=0.03, P<0.0001). AM levels of schizophrenic patients were three fold higher than controls. In correlation analyses, there were statistically significant positive correlations between AM level and SAPS-delusion subscale (r=0.27, P=0.04); SAPS-bizarre behavior subscale (r=0.28, P=0.03) and SAPS-total (r=0.36, P=0.005). There is no correlation between total nitrite and AM levels (r=0.11, P=0.31). Both NO and AM may have a pathophysiological role in schizophrenia, and clinically symptomatology and prognosis of schizophrenia. This subject needs further study including treatment response and subtypes of schizophrenia.

There is great evidence in recent years that oxygen free radicals play an important role in the pathophysiology of schizophrenia. The present study was performed to assess the changes in plasma nitric oxide (NO) and thiobarbituric acid-reactive substances (TBARS) levels, and superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and xanthine oxidase (XO) activities in schizophrenic patients compared to age- and sex-matched normal controls. A hundred patients with schizophrenia and 51 healthy volunteers were included in the study. XO, SOD, and GSH-Px activities as well as NO and TBARS levels were estimated by standard biochemical techniques in the plasma of normal healthy controls and schizophrenia patients. In schizophrenia, increased plasma XO activity (P < .0001) and NO levels (P < .0001), decreased SOD activity (P < .0001), and unchanged GSH-Px activity were detected compared to control group. Plasma TBARS levels were increased in schizophrenic patients (P < .01), especially in the residual subtype. TBARS levels in nonsmoker schizophrenic patients were found to be higher than nonsmoker controls. Although TBARS levels in both patients and controls were found to be higher in smokers as compared to nonsmokers, it was not statistically significant. No effects of duration of the illness, gender, and low and high dose of daily neuroleptic treatment equivalent to chlorpromazine on oxidant and antioxidant parameters were observed. Because the dose and the duration of treatment with drugs have no influence on the results, it can be interpreted that the findings are more likely to be related mainly to the underlying disease. These findings indicated a possible role of increased oxidative stress and diminished enzymatic antioxidants, both of which may be relevant to the pathophysiology of schizophrenia. On the other hand, increased NO production by nitric oxide synthetases (NOSs) suggests a possible role of NO in the pathophysiological process of schizophrenia. These findings may also suggest some clues for the new treatment strategies with antioxidants and NO synthase (NOS) inhibitors in schizophrenia.

The purpose of this study was to evaluate the relationship between attention deficit hyperactivity disorder (ADHD) and polymorphism of the two regions of the 5-HTT gene [variable number of tandem repeats (VNTR) and 5-HTTLRR] in a sample of Turkish children. Using the PCR technique, these polymorphisms were assessed in 71 patients with ADHD and 128 healthy controls. The 5-HTTLPR S/S genotype was significantly lower in the patients than in the controls (p = 0.018). Homozygous and heterozygous L variant predominated in the ADHD group. But the VNTR STin2.12/12 genotype was significantly less found in the patients than in the controls (p = 0.001). There was no significant difference between the frequency of the short (S), long, 10, and 12 alleles of both groups. The lack of an S/S variant of 5-HTTLPR polymorphism of the STin2.12/12 variant of VNTR polymorphism appears to be associated with an increased risk of ADHD., (Copyright 2002 S. Karger AG, Basel)

Nitric oxide (NO) has been implicated to play a role in the pathogenesis of depressive disorders. Adrenomedullin (AM) induces vasorelaxation by activating adenylate cyclase and also by stimulating the release of NO. AM immune reactivity is present in the brain, consistent with a role as neurotransmitter. Therefore, it is suggested that these two molecules may play a role together in the brain. We aimed to examine AM and NO in bipolar affective disorder (BPAD). Forty-four patients with BPAD and 21 healthy control subjects were included in this study. DSM-IV diagnosis of bipolar affective disorder (type I, manic episodes) was independently established by two psychiatrists and the Turkish version of the Bech-Rafaelson Mania Scale was administered. Also, a semistructured form was used to ascertain several sociodemographic and clinical variables of the patients. AM and NO were studied in plasma. The mean value of plasma NO levels in the BPAD group of 46.58 +/- 13.97 micromol/l was significantly higher than that of controls (31.81 +/- 8.14 micromol/l) (z = -4.15, p = 0.000). Mean plasma AM levels were found to be increased in patients with BPAD (35.13 +/- 5.26 pmol/l) compared to controls (16.22 +/- 3.02 pmol/l) (z = -6.16, p = 0.000). AM levels of BPAD patients were approximately 2-fold higher than controls. AM levels were positively correlated with the duration of hospitalization for the current episode and negatively correlated with the total duration of illness. Both NO and AM may have a pathophysiological role in BPAD (type I, manic episodes) and the clinical symptomatology and prognosis of BPAD., (Copyright 2002 S. Karger AG, Basel)