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Hasan Kandemir,1 Mehmet Emin Erdal,2 Salih Selek,3 Özlem İzci Ay,2 İbrahim Fatih Karababa,4 Mustafa Ertan Ay,2 Sultan Basmaci Kandemir,5 Şenay Görücü Yılmaz,2 Suat Ekinci,6 Bahar Taşdelen,7 Hüseyin Bayazit41Department of Child and Adolescent Psychiatry, Faculty of Medicine, Harran University, Sanliurfa, Turkey; 2Department of Medical Biology and Genetics, Faculty of Medicine, Mersin University, Mersin, Turkey; 3Harris County Psychiatric Center, University of Texas Health Science Center at Houston, TX, USA; 4Department of Psychiatry, Faculty of Medicine, Harran University, Sanliurfa, Turkey; 5Department of Psychiatry, Balikligöl State Hospital, Sanliurfa, Turkey; 6Department of Psychiatry, Balikli Rum Hospital, Istanbul, Turkey; 7Department of Biostatistics, Faculty of Medicine, Mersin University, Mersin, TurkeyAim: Obsessive–compulsive disorder (OCD) is a disorder characterized by the presence of obsessions and/or compulsions. Although disorder etiology and pathogenesis remains unknown, several theories about OCD development have been proposed, and many researchers believe that it is caused by both genetic and environmental factors. In the current study, our aim was to investigate miRNA levels in OCD.Methods: In the current study, we evaluated miR18a-5p, miR22-3p, miR24-3p, miR106b-5p, miR107, miR125b-5p, and miR155a-5p levels in child and adolescent OCD patients. The research sample consisted of a group of 23 OCD patients and 40 healthy volunteer controls.Results: There was no significant difference in age and sex between the two groups (P>0.05).The levels of miR22-3p, miR24-3p, miR106b-5p, miR125b-5p, and miR155a-5p were significantly increased in the OCD subjects (P≤0.05). There were no statistically significant differences in miR18a-5p or miR107 levels between groups (P≥0.05).Conclusion: There could be a close relationship between levels of circulating miRNAs and OCD. If we could understand how the signaling pathways arranged by miRNAs impact on central nervous system development, function, and pathology, this understanding could improve our knowledge about OCD etiology and treatment.Keywords: OCD, micro RNA, miRNA, psychiatry, child psychiatry

Hasan Kandemir,1 Ömer Aydemir,2 Suat Ekinci,3 Salih Selek,4 Sultan B Kandemir,5 Hüseyin Bayazit61Department of Child and Adolescent Psychiatry, School of Medicine, Harran University, Sanliurfa, 2Department of Psychiatry, School of Medicine, Celal Bayar University, Manisa, 3Balikli Rum Hospital, Istanbul, 4Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, Texas, USA; 5Department of Psychiatry, Balikligol State Hospital, Sanliurfa, 6Department of Psychiatry, School of Medicine, Harran University, Sanliurfa, TurkeyAim: This study aimed to validate the CRAFFT diagnostic test, against the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition, Axis 1-based diagnostic inventory in a Turkish population of adolescents.Method: The 124 adolescents who were 15–18 years old were enrolled to this study. CRAFFT was self-administered. Interviews took approximately 30 minutes, including the DSM-IV diagnostic interview for alcohol/drug dependence.Results: The mean age of subjects was 16.653 years (minimum: 15 years, maximum: 18 years). A score of 2 or higher in part B was found to be optimal for detecting youths with substance dependence problems (sensitivity: 0.82; specificity: 0.88) and it was sufficiently discriminative.Conclusion: The CRAFFT is a valid and reliable instrument for identifying Turkish-speaking youths at risk for substance use disorders.Keywords: CRAFFT, substance abuse, validity, Turkish, adolescent

Background: This study investigates the association between Methamphetamine (MA) intoxication and suicidal ideation/behavior in patients presenting to emergency departments. Amidst rising MA use and co-use with opioids, this "twin epidemic" has manifested in increasing admissions for MA intoxication, often accompanied by psychiatric symptoms that can escalate to suicidal behaviors., Method: This retrospective study utilized patient records and analyzed data from 629 patients admitted to a Texas emergency department in 2020, with MA intoxication confirmed via urine tests and patient interviews. The suicidal tendencies were assessed using the Columbia-Suicide Severity Scale. The 629 patients were divided into three groups for analysis: Group I ( n  = 188), MA positive with suicidal ideation (SI) (MA + SI+); Group II ( n  = 202), MA-positive without SI (MA + SI-); and Group III ( n  = 239), MA-negative with SI (MA- SI+). Multiple regression analysis was used to elicit clinical features predicting patients presenting to the emergency department with acute MA intoxication., Results: Results reveal that approximately half of patients with acute MA intoxication reported suicidal thoughts, indicating a significant association between MA use and suicidal tendencies. Females exhibited higher rates of suicidal thoughts, behavior, and subsequent medical attention compared to males. Sociodemographic characteristics and clinical features differed among MA-positive patients with and without SI. Multivariable regression analysis identified factors influencing MA use, including cannabis use, male gender, agitation, and an inverse association with alcohol use. Notably, the severity and potential lethality of suicidal behavior in MA-intoxicated patients paralleled those observed in psychiatric patients without MA use., Conclusion: These results underscore the urgent need for targeted interventions to address the complex interplay between MA use and suicidal risks in the emergency department setting, as well as broader public health strategies to combat the increasing prevalence of MA use.

Background: Nesfatin-1 (NF-1) is a parameter that has been shown to have an important potential in the modulation of the emotional state such as depression. The study focused to investigate the relationship between the plasma NF-1 level and depression., Subjects and Methods: Seventy-three patients who have a major depressive disorder (MDD) and 71 healthy individuals participated in the study. Plasma NF-1 was analyzed by Enzyme Linked Immunosorbent Assay (ELISA) and compared according to the groups., Results: The mean NF-1 was lower in the patients with MDD than being in the healthy (p:0.019). Plasma NF-1 level was statistically significantly lower in the overweight MDD than in the non-overweight MDD (p:0.024). We observed a negative correlation between plasma NF-1 level and age (r:-0.178, p:0.033), BMI (r:-0.212, p:0.011), HAM-D scores (r:-0.185, p:0.026). However, there was no correlation for smoking status in both groups (r:0.095, p:0.259)., Conclusion: This study demonstrated the relationship between plasma NF-1 level and MDD as well as overweight. Therefore, NF-1 might be related to certain nervous system pathologies as well as adipose tissue in the body.

Background: Coronavirus disease 2019 (COVID-19) has taken a significant toll on people worldwide, and in particular, on the health care workers (HCWs) who have worked on the frontlines in the fight against the pandemic. The goal of this study was to investigate the prevalence of posttraumatic stress disorder (PTSD) and related factors in HCWs in the era of COVID-19., Methods: This cross-sectional survey study was conducted between September 15, and October 15, 2020, among HCWs in Turkey. The survey consisted of self-administered questionnaires, which included questions about sociodemographic variables, experiences caring for patients with COVID-19, and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), a trauma screening tool. The online survey was completed by 1833 HCWs. Univariate and multivariate logistic regression analyses were used to identify independent predictors of PTSD., Results: The mean age of the participants was 32.7±7.0 years; 81.9% were physicians, and 56.5% were female. The rates of COVID-19 history in the respondents, a family member, or a coworker were 13.6%, 32.3%, and 12.6%, respectively. Among the HCWs who participated, 39.9% met the criteria for PTSD. Compared with the physicians, the nonphysician HCWs had a higher rate of PTSD (49.5% vs. 36%) (P<0.001) and higher PCL-5 scores (53.31±19.6 vs. 42.5±20.3) (P<0.001). In addition, 9.7% of the surveyed HCWs reported having suicidal ideation during the COVID-19 pandemic. Independent predictors of PTSD in HCWs were working on a COVID-19 unit, feeling isolated, suicidal ideation, being a nonphysician HCW, fear of spreading coronavirus to family, female sex, and a history of having COVID-19., Conclusions: HCWs were at risk for impairment in mental well-being in the era of COVID-19, with a significant number experiencing PTSD as well as suicidal ideation. Therefore, HCWs, especially those who are working on a COVID-19 unit and are female, should be monitored regularly for PTSD., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Neurotrophin levels and oxidative stress markers such as ceruloplasmin and free thiols have been shown to contribute to pathophysiology in several psychiatric disorders., Objective: Our aim is to evaluate whether those markers are altered in cannabis dependence., Methods: Forty-five cannabis-dependent patients diagnosed according to the DSM-IV criteria and 45 healthy controls matched according to sex, age, BMI, and smoking status were enrolled. Brain-derived neurotrophic factor (BDNF), ceruloplasmin, lipid hydroperoxide, and total free thiols were measured in both groups. Those who had psychiatric comorbidities were excluded before sampling., Results: We found significantly increased BDNF, ceruloplasmin, and lipid hydroperoxide, and decreased free thiol levels in patients with cannabis dependence. There is also a positive correlation between BDNF and lipid hydroperoxide (n = r = 0.472, p < 0.001) and a negative correlation between BDNF and total thiols (n = r = -0.412, p = 0.001)., Conclusions: Increased BDNF might be a sign of impaired neuronal plasticity that is crucial for memory formation and adaptive response to drug addiction. Neuronal plasticity in the ventral tegmental area dopaminergic neurons was implied to play a role in substance addiction disorders, and these adaptations can be secondary to oxidative stress. Our findings, including increased lipid hydroperoxide, ceruloplasmin, and decreased free thiols, might support this hypothesis. In conclusion, cannabis dependency alters BDNF levels and increases oxidative stress., (© 2019 S. Karger AG, Basel.)

Objective: Cannabis is the most commonly used illegal drug in the world and it has several adverse effects such as anxiety, panic reactions and psychotic symptoms. In this study, we aimed to evaluate oxidant, anti-oxidant status and cytokine levels in individuals with cannabis use disorder., Methods: Thirty-four patients with cannabis use disorder and 34 healthy controls were enrolled to the study. Serum total antioxidant status, total oxidant status and cytokine levels were investigated in patients with cannabis use disorder and healthy controls., Results: We found increased levels of total oxidant status, oxidative stress index and interleukin (IL) 1β, IL-6, IL-8, and tumor necrosis factor (TNF) α in individuals with cannabis dependency compared to healthy people. When we compared total antioxidant status, IL-12, and interferon (IFN) γ levels, there were no differences in both groups. There was positive correlation between IL-6 and total oxidant status, oxidative stress index levels., Conclusion: The oxidative balance of individuals with cannabis use disorder was impaired and they had higher levels of IL-1β, IL-6, IL-8, and TNF-α, which is a pro-inflammatory cytokine and indicates increased inflammation compared to healthy controls. Thus, these findings suggest that cannabis increased inflammation and impaired the oxidative balance.

Objective: In our study, we aimed to evaluate the plasma homocysteine levels and oxidative stress parameters in patients with adult ADHD (A-ADHD)., Method: Blood samples were taken from 32 A-ADHD patients and 32 controls enrolled in the study and plasma homocysteine, serum folate, vitamin B12, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were determined. Results were compared between the groups., Results: Patients' plasma homocysteine level was significantly lower and serum folate level was significantly higher than the controls. The means of plasma homocysteine and folate levels were statistically significantly different between the groups ( p < .05). However, a statistically significant difference was not detected between groups for mean serum vitamin B12, TAS, TOS, and OSI levels ( p > .05)., Conclusion: Our study suggests that oxidative balance is not impaired in A-ADHD, and contrary to other psychiatric disorders, homocysteine levels were found to be lower.

Background: It has been determined that cannabis has adverse effects on brain tissue, and that increased S100 calcium binding protein B (S100B) blood levels are markers of neuronal damage. Therefore, the aim of this study was to evaluate the S100B levels in cannabis use disorder., Method: Thirty-two patients with cannabis use disorder and 31 matched healthy controls were enrolled in this study. Appropriate blood samples were taken from the enrolled subjects, and the serum S100B protein levels were measured with an electrochemiluminescence immunoassay for the quantification of the protein., Findings: We found significantly increased S100B protein levels in patients with cannabis use disorder. The mean serum concentration of S100B was 0.081 ± 0.018 μg/l in patients with cannabis use disorder, and 0.069 ± 0.018 μg/l in the control group (p = 0.008)., Interpretation: Our data suggest that elevated S100B protein levels might indicate neuronal damage in the brains of people with cannabis use disorder., (© 2015 S. Karger AG, Basel.)

Fixed drug eruption (FDE) represents a frequent type of drug eruption in Turkey. The aim of this open study is to analyze the clinical features with special emphasize on drug related pattern in our case series. Sixty-four cases with established FDE by oral provocation were clinically evaluated. Cotrimoxazole, a combination of sulfamethoxazole and trimethoprim, was the most common offender for FDE (75%), followed by naproxen sodium (12.5%), dipyrone (9.5%), dimenhydrinate (1.5%) and paracetamol (1.5%). Sensitivity to more than one drug was not observed. Cotrimoxazole-induced FDE was mainly located on male genitalia. Naproxen predominantly affected lips and face whereas dipyrone mainly caused FDE on trunk and extremities. Statistical analysis revealed a significant difference only for dipyrone versus cotrimoxazole over trunk and extremities (p = 0.03). Familial occurrence, symmetrical and asymmetrical nonpigmenting FDE, linear FDE, solitary plaque on the cheek, and "wandering" FDE were unusual findings of cotrimoxazole-induced FDE. Cotrimoxazole was the leading etiological agent in our series. Cotrimoxazole-induced FDE had some rarely or previously unreported features, but a significant relation between drugs and involved areas or clinical pattern could not be established.

The purpose of this study was to investigate the usefulness of topical provocation in the diagnosis of cotrimoxazole-induced fixed-drug eruption (FDE). 27 patients with established cotrimoxazole-induced FDE by oral provocation and 20 healthy controls were tested with drugs at increasing concentrations in white petrolatum and dimethyl sulfoxide (DMSO) both on previously involved and uninvolved skin sites. Tape-stripping occlusive patch testing in petrolatum remained negative in 19 tested patients. Open testing with drug preparations in DMSO revealed positive results in 25 of 27 tested patients. 1 patient showed an additional positive reaction on previously uninvolved skin. Lesions on male genitalia and on face reacted to testing once with 10% or 20% of the suspected drug, whereas repeated testing with concentrations up to 50% was necessary in lesions on trunk & extremities. Open testing with drug preparations in DMSO at concentrations of 10%, 20% and 50% and pure DMSO remained negative in 20 healthy controls. The present study shows that repeated open testing with graded concentrations of the drugs up to 50% in DMSO is a reliable test method in sulfamethoxazole/trimethoprim-induced FDE. Patients and physicians should be aware of the transient irritant reaction to DMSO that is not infrequent, so as to avoid false-positive interpretations.