Archives of Clinical Psychiatry (São Paulo), Volume: 47, Issue: 6, Published: 2020
  • Comparison of OCT findings of schizophrenia patients using FGA, Clozapine, and SGA other than Clozapine Original Article

    Orum, Mehmet Hamdi; Bulut, Mahmut; Karadag, Ayse Sevgi; Dumlupinar, Ebru; Kalenderoglu, Aysun

    Abstract in English:

    ABSTRACT Objective: The effect of antipsychotic (AP) drugs on optical coherence tomography (OCT) findings in schizophrenia has not yet been fully elucidated. In this study, we aimed to investigate the effects of APs (the first generation antipsychotic group [FGAG], the second generation antipsychotic group [SGAG], the clozapine group [CG]) on OCT findings in schizophrenia. Methods: The thickness of the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and choroidal thickness were measured using a spectral OCT device. Results: No significant difference was found between FGAG, SGAG, CG (p > 0.05) while there was a significant difference between the control group and the patients group in terms of RNFL, GCL, and IPL (p < 0.05). A significant difference between SGAG and CG, FGAG (p < 0.05); between control group and FGAG (p < 0.05) were found in terms of choroidal thickness. Conclusion: These findings suggested the deterioration of the metabolic parameters due to the SGA use. Thinner choroidal layer thickness in the CG compared to the SGAG and control group was thought to be related to the patients using clozapine had a resistance to the treatment.
  • TNF-α-308 G/A variant may be associated with bipolar disorder in a Turkish population Original Article

    Nursal, Ayse Feyda; Aytac, Hasan Mervan; Ciftci, Hayriye Sentürk; Yazar, Menekse Sila; Oyaci, Yasemin; Pehlivan, Mustafa; Pehlivan, Sacide

    Abstract in English:

    ABSTRACT Background: Tumor necrosis factor alpha (TNF-α) is a proinflammatory multifunctional cytokine produced by macrophages. A dysregulation of the immune system contribute to the pathogenesis of bipolar disorder (BD). In this study, we aimed to investigate the relationship between the TNF-α gene -308G/A promoter variant and the risk of BD. Methods: A total of 104 BD patients and 94 healthy controls were enrolled in the study. Genomic DNA was isolated and TNF-α -308G/A variant was analyzed using PCR-RFLP method. Results: TNF-α -308G/A variant GG genotype and G allele were more prevalent in BD patients compared to the controls (p = 0.002 and p = 0.017, respectively). The patients carrying GG genotype had a 5.927-fold higher risk of developing BD. Then, we divided patients into two groups as smokers and non-smokers. TNF-α -308G/A variant GA genotype was higher in non-smoker BD patients than smoker patients (p = 0.027). We found that TNF-α -308G/A AA genotype and A allele increased in smoker patients compared to non-smoker patients (p = 0.008, p = 0.002, respectively). Discussion: Our results provided evidence that TNF-α -308G/A variant may contribute to development of BD in a Turkish cohort. In addition, this variant plays a relevant role in the smoker status of BD.
  • Early Maladaptive Schemas, Depression, Distress and Discomfort Tolerance in Migraine Headache Original Article

    Onen, Sinay; Günes, Aygül

    Abstract in English:

    ABSTRACT Background: Depression and maladaptive schemas were found to worsen the pain experience in individuals with chronic pain. Objectives: The aim of the present study was to evaluate the relationship between depressive symptoms, early maladaptive schemas, distress and discomfort tolerance in female patients with migraine. Methods: Seventy eight female migraine patients(37 depressed and 41 non-depressed subjects according to BDI scores) and 55 healthy controls were evaluated with Numeric Pain Rating Scale(NPRS),Beck Depression Inventory(BDI),Young Schema Questionnaire-Short Form-3(YSQ-SF-3),Discomfort Intolerance Scale(DIS) and Distress Tolerance Scale(DTS). Results: Distress and discomfort tolerance were lower in both migraine groups than control subjects. EMSs were higher in depressed migraine patients than in non-depressed migraine group and non-clinical controls. A positive correlation between BDI and YSQ-SF-3 scores(p<0.001), a negative correlation between BDI and DIS(p<0.01), and also a negative correlation between BDI and DTS(p<0.001) were found among migraine patients. Hierarchical regression analysis revealed that 20% of the depressive symptoms were explained with DIS scores, while explanatoriness raised up to 46% by addition of YSQ-SF-3 scores to the model. Discussion: Cognitive interventions for modifying EMSs and improving distress and discomfort tolerance might be added to the treatment strategies in female migraine patients.
  • Prefrontal gray matter volume in adults bipolar I outpatients is associated with history of suicide attempts? Original Article

    Rocha, Marlos Vasconcelos; Nery-Fernandes, Fabiana; Baldaçara, Leonardo; Jackowski, Andrea Parolin; Quarantini, Lucas de Castro; Ladeia-Rocha, Giovanna; Araujo Neto, César de; Oliveira, Irismar Reis de; Caribé, André; Miranda-Scippa, Ângela

    Abstract in English:

    ABSTRACT Background: Patients with Bipolar Disorder (BD) have the highest lifetime risk for suicidal behavior (SB) compared to other psychiatric disorders. Neuroimaging research provides evidence of some structural and functional abnormalities in the brain of BD suicide attempters (SA), but interpretation of these findings may represent a number of features. Objective: The purpose of this study was to evaluate the volume of the prefrontal cortex in euthymic BD type I outpatients, with and without history of SA. Methods: 36 euthymic BD I outpatients (18 with and 18 without suicide attempt history) were underwent structural MRI and total and regional gray matter volumes were assessed and compared with 22 healthy controls (HC). Results: We did not found any differences in all areas between suicidal and non-suicidal BD I patients and BD patients as a group compared to HC as well. Discussion: our findings suggest that can be a different subgroups of patients in relation to prefrontal cortex volumes according to some clinical and socio-demographic caractheristics, such as number of previous episodes and continuous use of medical psychotropic drugs that may induce neuroplasticity phenomena, which restore cerebral volume and possibly can lead to long-term euthymia state.
  • The effects of parental depression and anxiety on child behavior from 6 to 12 years old: a review Review Article

    Gabriel, Rose Skripka do Nascimento; Antonietto, Eloisa Aparecida Barroso; Serafim, Antonio de Pádua; Gomes, Miria Benincasa

    Abstract in English:

    ABSTRACT Background: Parental depression and anxiety are relevant factors that may influence child externalizing and internalizing behavior; also influenced by stigmatized knowledge about such mental illnesses. Objectives: To identify which instruments were used in studies on the effects of parental depression and anxiety on child behavior from 6 to 12 years old; to analyze the main results in offspring's behaviors on articles published between 2011 to 2019. Methods: we did a literature review searching PubMed, BVS, ISI, and Scopus databases; keywords: “Maternal Depression”, “Maternal Anxiety”, “Paternal Depression”, “Paternal Anxiety”, “Mother's (also Mothers') Depression”, “Mother's (also Mothers') Anxiety”, “Father's (also Fathers') Depression”, “Father's (also Fathers') Anxiety”, “Parental Depression”, “Parental Anxiety” AND “Child Behavior”, in Portuguese and English. Results: We found 1,500 articles, after applying the inclusion criteria, n = 23 were selected and analyzed. 78.3% of studies were performed with mothers, 17.4% with both parents, and 0% with fathers alone. Different instruments were used to assess depression or anxiety in parents, and child behavior. Discussion: studies that included both parents and parental anxiety assessments were scarce; no study in this review evaluated only fathers. Social abilities, personality traits, self-conceptions, and knowledge about anxiety and depression could enhance the quality of studies' results.
  • Anxiety and depression of general population in the early phase of COVID-19 pandemic: A systematic review of cross-sectional studies Review Article

    Lin, Chung-Yi; Lin, Ying-Li

    Abstract in English:

    ABSTRACT Background: The rapid outbreak of COVID-19 pandemic promptly changed people's daily lives, influenced human interactions and economic activities and induced mental reactions. Objective: This review synthesized the evidence of correlation between demographic factors, social media exposure, stressors and anxiety and depression status in the early phase of COVID-19. Method: A systematically search included observational studies published before May15, 2020. We selected studies designed with valid measuring instruments of anxiety and depression. Result: 20 articles were included (19 cross-sectional) for review. People who were divorced/widowed, with poor self-rated health status, chronic illness and previous psychiatric illness had higher anxiety and depression prevalence. Higher COVID-19 awareness (including COVID-19 knowledge and precautionary measure) decreased anxiety and depression. The protective measures to reduce anxiety and depression levels included avoiding sharing meals, frequently washing hands and wearing mask. Economic loss, academic delay, influence of daily life, worrying and symptoms related to infection were stressors of anxiety and depression. There were lots of inconsistent results due to convenience sampling and diverse measuring instrument. Conclusion: Our review suggested that reliable information from health authorities, enhancing health literacies and prevention measures of general population can reduce anxiety and depression levels.
  • Pragmatic Language and Schizophrenia: Interpretation of Metaphors Brief Report

    Daud, Pamella Furquim; Setti, Viviane; Khafif, Tatiana Cohab; Rocca, Cristiana Castanho; Serafim, Antonio de Pádua

    Abstract in English:

    ABSTRACT Background: Schizophrenia is a severe and chronic psychiatric disorder with significant cognitive deficits, which are considered structural markers for the disease. Language disturbances have an important role in patients' social functioning and interpersonal relationships. Objectives: Evaluate the capacity to understand pragmatic language in schizophrenic patients, through the comprehension of non-literal meaning in metaphors and the ability to use contextual clues to better understand their meanings. Methods: Thirty patients were evaluated using Abbreviated Intelligence Scale (WASI), Interpretation of Metaphors subtest of the Montreal Communication Evaluation Battery (MAC). Results: The linear regression model showed that schizophrenic patients presented below average performance in the interpretation of metaphors task, with tendency to concrete interpretations. Variables such as IQ, WASI Vocabulary subtest and years since onset influenced the patients' pragmatic language skills. This relation was not found for family history. Existence of the metaphor in native colloquial language (Portuguese) and being given alternatives to choose from, enhanced patients' performance. Discussion: Results corroborate findings regarding this population's difficulties in the language cognitive domain. Development of interventions aiming comprehension of pragmatic language could help ease patients' social difficulties, especially if started early at onset. Also, better understanding of this deficit can help create rehabilitation strategies.
  • Manic states related to antidepressant withdrawal – a case report and literature review Brief Report

    Barranha, Rui; Teixeira, Tânia; Felgueiras, João; Doellinger, Orlando von

    Abstract in English:

    ABSTRACT Background: A manic state induced by antidepressant withdrawal is a rare clinical occurrence that has been increasingly reported in the last decades and currently represents a nosological entity with specified criteria. Objectives: This paper aims to report a case of mania induced by escitalopram withdrawal in a patient with unipolar depression. Furtherly, we intend to review the published case reports of manic states induced by antidepressant withdrawal, analysing its epidemiology and discussing the current theories concerning its pathophysiology. Methods: We conducted a search in PubMed database in July 2019, without restriction by year of publication, and selected case reports and literature reviews in English, which were fully read. Results: Only 29 reported cases fulfil the most accepted diagnostic criteria. This phenomenon is more frequent in patients with unipolar depression, may occur with any major class of antidepressant and it is still unclear whether it indicates a latent bipolar disorder. Our case report is the third case associated with the use of escitalopram published in the literature. Conclusion: Although a rare phenomenon, mania induced by antidepressant withdrawal poses relevant clinical challenges and its possible pathophysiological processes may shed some light on the mechanisms underlying affective disorders.
  • Psychological impacts on patients with COVID-19 in a Thai field hospital Brief Report

    Lerthattasilp, Tiraya; Kosulwit, Lampu; Phanasathit, Muthita; Nuallaong, Winitra; Tapanadechopone, Pairath; Thanetnit, Chommakorn; Charernboon, Thammanard

    Abstract in English:

    ABSTRACT Objective: This study investigates the psychological impacts and their associated factors on patients with COVID-19 at a Thai field hospital. Methods: All eligible patients confirmed to have COVID-19 at Thammasat University field hospital completed an online self-reported mental health screening questionnaire which collected sociodemographic data, their clinical characteristics, and used the depression, anxiety, and stress scale (DASS-21). Results: A total of 40 patients participated in the study. The depression rate was found to be 22.5%, while the anxiety rate was 30%, and the stress rate was 20%. Having a history of psychiatric disorder alone was significantly associated with a higher DASS-21 score (p = 0.001). Meanwhile, gender, age, level of education, occupation, living status, severity of COVID-19, and the number of days admitted to hospital prior to the field hospital were not found to be associated with the DASS-21 scores (P > 0.05). Conclusion: The depression, anxiety, and stress symptoms in patients with COVID-19 at the field hospital were common. Patients with a history of psychiatric disorder should undergo specific evaluation during the isolation phase.
  • Depressive disorder following withdrawal pregabalin: A case report Letter to the Editor

    Gündoğmuş, İbrahim; Par, Asuhan; Bolu, Abdullah; Öznur, Taner; Çeliİk, Cemİl; Özmenler, Kamiİl Nahiİt
  • Neurosyphilis in a middle-aged woman with rapid cognitive decline and psychosis: A case report Letter to the Editor

    Huang, Yen-Chen; Wang, Ying-Chieh; Wu, Chia-Liang
  • Claustrophobia in an oncologic patient: a life-saving treatment Letter to the Editor

    Leite, Ana Rita Cabral Almeida; Roque, Carolina Maria De Oliveira; Fernandes, Emília Conceição Albuquerque
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