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Major depression (MD) is one of the common mood disorders. MD prevalence is 8–16% among reproductive women in United States of America and studies show that the prevalence of MD in pregnant women i...

study question: We aimed to determine the impact of an oral contraceptive (OC) treatment on health-related quality of life (HRQOL), depressive and anxiety symptoms in polycystic ovary syndrome (PCOS). summary answer: OC therapy in PCOS improves hirsutism and menstrual disturbances, along with HRQOL. This improvement is not associated with any change in the prevalence of depressive and anxiety symptoms. what is known and what this article adds: Limited data are available regarding the effects of an OC on HRQOL, and depressive and anxiety symptoms in PCOS. This study reports the effects of the ethinyl estradiol/drospirenone (EE/DRSP) OC on an HRQOL questionnaire for women with PCOS (PCOSQ), depressive and anxiety symptoms after 6 months of treatment. design: Prospective observational study. All participants completed PCOSQ, Beck Depression Inventory, Hospital Anxiety and Depression Scale and General Health Questionnaire. Serum androgens, fasting insulin, fasting and postload glucose values during an oral glucose tolerance test were measured. Changes in these variables and the scores of questionnaires were evaluated after 6 months of treatment with EE/DRSP (3 mg/30 mg). participants and setting: Thirty-six patients with PCOS without a previous psychiatric diagnosis were included in the study. main results and the role of chance: The main complaints of the patients were hirsutism and irregular menses. Accordingly, menstrual and hirsutism problems were the most serious concerns followed by emotional problems on the PCOSQ. Eight patients (22.2%) had clinical depression scores. After treatment, regular menstrual cycles were attained and hirsutism was significantly improved in all patients. Hirsutism and emotion domains of the PCOSQ improved at 6 months (P , 0.05 for both). Depression was improved in five of eight depressive patients and four new patients showed increased depression scores. Overall, depression, anxiety mean scores and depression rates did not show a significant change. bias, confounding and other reasons for caution: The study is subject to the strengths and limitations of observational study design. A limitation of our study is the small sample size and lack of data related to possible confounding factors. generalizability to other populations: Generalizable to Caucasian PCOS.

The purpose of this study was to investigate the influence of clozapine on plasma serotonin, platelet serotonin and monoamine oxidase (MAO) levels in schizophrenic patients and to compare their results with those of unmedicated healthy controls. Groups of 20 outpatients with schizophrenia and 20 healthy controls matched for age, sex and smoking status were recruited for the study. Psychopathology, neurocognitive functioning, plasma serotonin, platelet serotonin and MAO levels were assessed after 1-week drug free interval, and 8 weeks after initiation of clozapine treatment in an open design. The mean clozapine dose at week 8 was 382.5+/-96.4 (range: 250-600) mg/day. In the patient group, at baseline, plasma serotonin and platelet MAO levels were significantly lower, and platelet serotonin levels were significantly higher than in controls. After 8 weeks of clozapine treatment, plasma serotonin and platelet MAO levels increased significantly, while a significant decrease in platelet serotonin levels was detected compared with baseline values. Baseline platelet MAO levels explained 22% of the variance in Clinical Global Impression - Improvement (CGI-I) and improvement in attention, while baseline platelet serotonin predicted 23% of the variance in the improvement in positive symptoms during clozapine treatment. Our data indicate that clozapine may be reversing or compensating for a pre-existing alteration in serotonergic neurotransmission in schizophrenic patients. The prediction of response to clozapine through peripheral biochemical markers may have important clinical implications if repeated in larger samples.

Purpose Atypical antipsychotics (AAPs) are used as adjunct therapy in the treatment of resistant obsessive-compulsive symptoms (OCSs). Paradoxically other reports suggest that AAPs, particularly clozapine, risperidone, and olanzapine can induce de novo emergence or exacerbation of OCSs in psychotic patients. The authors present here the first report suggesting an association between de novo appearance of OCSs and quetiapine treatment in a schizophrenic patient. Case The patient was a 33-year-old woman with the diagnosis of paranoid schizophrenia, who displayed OCSs for the first time during treatment with quetiapine. The symptoms reduced remarkably when fluoxetine was added to her treatment regimen while keeping the quetiapine dosage unchanged. Conclusion AAP-induced OCSs merit consideration and early identification, as these drugs are now widely in use in clinical practice. This rare but disabling side effect should also be monitored in quetiapine treated schizophrenic patients.

Many factors can affect the pressure pain threshold in the elderly population, especially those with cognitive impairment. The purpose of this study was to assess the pressure pain threshold (PPT) and its correlation with depression and anxiety status in geriatric nursing home residents with cognitive impairments. This study included 20 elderly subjects with cognitive impairment and 13 with normal cognitive functions. Cognitive function was assessed by Mini-Mental State Examination test. PPT of masseter and biceps brachii muscles were measured. Also, Geriatric Depression Scale (GDS) and Hamilton Anxiety Rating Scale (HAM-A) were used for screening depression and anxiety, respectively. PPT values did not differ significantly between the two groups. In the group with cognitive impairment, PPT and, depression and anxiety were not correlated. In subjects with normal cognitive function, PPT was positively correlated with depression and negatively with anxiety (p < 0.05). Subjects with cognitive impairm...

Twenty female patients with lumbar disc herniation were assessed in order to evaluate their depression, psychosocial status, and stress symptoms and to analyze the relation with activities of daily living, stair activity and walking speed, agility, disability, and occupational handicap. In addition, depression and stress symptoms were also assessed in 20 healthy female subjects. Statistically positive correlations were obtained. Depression was correlated positively with disability, functional limitation, stair activity and walking speed, social isolation, and stress symptoms; psychosocial status was correlated with disability, functional limitation, and pain.

Polymorphisms in the genes encoding alcohol metabolizing enzymes are associated with alcohol dependence.To evaluate the association between the alcohol dehydrogenase 1C (ADH1C) Ile350Val and aldehyde dehydrogenase 2 (ALDH2) Glu504Lys polymorphisms and alcohol dependence in a Turkish sample.235 individuals (115 alcohol-dependent patients and 120 controls) were genotyped for ADH1C and ALDH2 with PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism). Association between the polymorphisms and family history, daily and maximum amount of alcohol consumed was investigated. The associations between alcohol dependence, severity of consumption and family history and the polymorphisms were analyzed by chi-square or Fisher's exact test where necessary. Relationship between genotypes and dependence related features was evaluated using analysis of variance (ANOVA).The -350Val allele for ADH1C (ADH1C*2) was increased in alcohol-dependent patients (P = 0.05). In individuals with a positive family history, the genotype distribution differed significantly (P = 0.031) and more patients carried the Val allele compared with controls (P = 0.025). Genotyping of 162 participants did not reveal the -504Lys allele in ALDH2.These findings suggest that ADH1C*2 is associated with alcohol dependence in the Turkish population displaying a dominant inheritance model. ADH1C*2 allele may contribute to the variance in heritability of alcohol dependence. The ALDH2 -504Lys/Lys or Glu/Lys genotypes were not present in alcohol-dependent patients, similar to that seen in European populations and in contrast to the findings in the Asian populations.

PubMed ID: 23303416, Objective: Electroconvulsive therapy (ECT) is safe and effective for the treatment of various psychiatric disorders. Despite being a well-known treatment method among health care professionals, lay people generally have a negative opinion of ECT. The present study aimed to examine knowledge of and attitudes toward ECT among medical students, psychology students, and the general public. Psychology students were included because they are among the important groups in mental health care in Turkey. MATERIALS AND Methods: A Likert-type questionnaire was administered to fifth-year medical students (n = 28), master of science and doctor of philosophy clinical psychology students (n = 35), and a sample of the general public (n = 26). The questionnaire included questions about the general principles of and indications for ECT, and sources of knowledge of and attitudes toward ECT. Results: The medical students were the most knowledgeable about ECT, as expected. The medical students also had a more positive attitude toward ECT than the other 2 groups. More psychology students had negative attitudes on some aspects than general public sample, despite being more knowledgeable. Conclusions: Medical school theoretical and practical training in ECT played an important role in increasing the level of knowledge of and decreasing the prevalence of negative attitudes toward ECT among the medical students; similar training for psychology students is required to achieve similar results. © 2012 Lippincott Williams & Wilkins.

background: Polycystic ovary syndrome (PCOS) is associated with psychological and metabolic disturbances. The aim of this study was to determine whether depression, anxiety and reduced health-related quality of life (HRQOL) are more common in women with PCOS and associated with metabolic risk. methods: The study included 226 PCOS patients and 85 BMI-matched healthy control women. All participants completed standardized questionnaires assessing depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory) and both depression and anxiety (Hospital Anxiety and Depression Scale and General Health Questionnaire). Patients also completed a PCOS HRQOL questionnaire. Hirsutism scores, serum androgens and lipids were obtained. All subjects underwent a standard oral glucose tolerance test. results: 28.6% of PCOS women versus 4.7% of control women had clinical depression scores indicating an 8.1-fold increased risk of depression in PCOS (P , 0.001). Depression and anxiety scores were higher in PCOS women than controls (P , 0.01 for all subscales). Obese PCOS subjects had higher depression scores and rates than non-obese PCOS women (P , 0.05). Depression scores were significantly correlated with insulin resistance and lipid parameters and with the number of components comprising the metabolic syndrome. Menstrual and hirsutism problems were the most serious concerns followed by emotional problems on the HRQOL. conclusions: Depression and anxiety are more common in patients with PCOS compared with healthy women. Depression in PCOS might be associated with obesity and metabolic abnormalities including insulin resistance and dyslipidemia.

Background: Few studies have looked at healthcare professionals' knowledge of and attitudes to later life sexuality in both Western and Eastern cultures. Here we examine the attitudes and knowledge of Turkish medical doctors toward sexuality in older people. Method: Eighty-seven doctors, from various specialties, who were directly involved in the care of older people, were contacted by post and asked to complete the Turkish version of the Aging Sexual Knowledge and Attitudes Scale (ASKAS). Results: A majority of physicians indicated that they had limited information and knowledge regarding sexual health issues in older people (69%). Although a small percentage (14.5%) reported that they "always" discuss sexuality and sexual problems with older patients, the majority (69%) indicated that they "sometimes" raise questions about sexuality with these patients. A high percentage (81%) stated that they would be helpful and receptive should an elderly patient initiate a discussion about sexual issues. Most participants (77%) thought that the patient's gender was of no importance when taking a sexual history. Overall, the responses to ASKAS showed that physicians had limited knowledge but their attitude was positive toward sexuality in the elderly. Female physicians had less knowledge than males and had more negative attitudes toward sexuality in this age group. Total and knowledge subscale scores of ASKAS showed that older physicians had more knowledge than younger physicians but similar attitudes. A comparison of the knowledge and attitude scores of psychiatrists, surgeons and non-surgeons showed no significant difference among the three groups. Conclusion: This study identified a low level of awareness of later life sexuality among Turkish medical doctors. These findings identify a need to improve the education and training of doctors at both undergraduate and postgraduate levels to enable them to provide better sexual health care to older people.

Purpose Clozapine is indicated in the treatment of patients with tardive dyskinesia. However, there have been some reports of movement disorders associated with clozapine treatment in the literature. The authors report a patient who developed tardive dyskinesia 1 year after initiation of clozapine treatment. Case The patient was a 65-year-old male with diagnosis of schizophrenia who had used multiple typical and atypical antipsychotics for 30 years. Clozapine treatment was initiated for his resistant symptoms. He developed buccolingual dyskinesia of moderate severity, which started 1 year after the initiation of clozapine treatment and did not ameliorate during follow-up. Conclusion This case may contribute to existing knowledge by raising the possibility that clozapine can induce dyskinesia.