Suleyman Akarsu | Gulhane Military Medical Academy (original) (raw)

Papers by Suleyman Akarsu

Research paper thumbnail of The investigation of leptin and hypothalamic neuropeptides role in first attack psychotic male patients: Olanzapine monotherapy

Psychoneuroendocrinology, 2013

The mechanism underlying the weight gain due to treatment with olanzapine and other second genera... more The mechanism underlying the weight gain due to treatment with olanzapine and other second generation antipsychotics has not been fully understood. To examine olanzapine's weight gain effects, we accepted first attack psychotic patients with no medication (pre-treatment) (n = 22) and the healthy control group (n = 26) in this study. After patientś diagnosis, they were hospitalized and then treated for four weeks with olanzapine (post-treatment). We used case-control association design to test body mass index (BMI) and biochemical changes in each group. We also investigated peripheral leptin and neuropeptides/hormones namely, pro-opiomelanocortin (POMC), cocaine and amphetaime regulated transcript (CART), and neuropeptide Y (NPY) levels. These neuropeptides which are synthesized/secreted from arcuate nucleus of hypothalamus affect food intake and therefore, body weight. After 4 weeks of olanzapine treatment; BMI (body mass index), waist circumference, blood triglyceride, total cholesterol, and very low density lipoprotein (VLDL) levels were increased significantly in patients compared to their pre-treatment baseline. In pre-treatment, patients' NPY levels were significantly lower while a-MSH, the anorexigenic product of POMC levels were significantly higher vs. control. Both leptin and NPY levels were significantly increased in patients after the treatment but the NPY levels were also significantly lower in post-treatment vs. the control group. The CART levels did not change after the treatment. We may presume that the antagonist effect of olanzapine on the serotonin (5HT2CR and 5HT1BR) receptors of the arcuate hypothalamic neurons may be a basis for a deregulation of the neurohormones secretion. #

Research paper thumbnail of Schizophrenia and Mitochondrial Dysfunction

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 2014

Etyolojisi net olarak bilinmeyen şizofreninin oluşumunda genetik faktörler önemli rol oynamaktadı... more Etyolojisi net olarak bilinmeyen şizofreninin oluşumunda genetik faktörler önemli rol oynamaktadır. Ancak, bu bozukluğun spesifik kalıtımsal mekanizması henüz açıklanamamıştır. Şizofreni kalıtımının poligenik veya multifaktöryel olabileceği düşünülmektedir. Son dönemde yapılan çalışmalarda, şizofreni olgularında mitokondrial fonksiyon ve serebral enerji metabolizmasında anormallikler tespit edilmiştir. Mitokondri fonksiyonlarındaki bozulma ile nöronal plastisite ve beyin devreleri etkilenerek, şizofreninin klinik tablosunda da belirgin olarak rastlanabilen davranış anormallikleri ve bilişsel defisitler gelişebilir. Şizofreni olgularının hem beyin hem de periferal dokularının incelendiği araştırmalarda, şizofreni olgularında sağlıklı olgulara göre bazı değişiklikler saptanmıştır. Ayrıca şizofreni tedavisinde kullanılan antipsikotiklerin solunum zinciri inhibisyonu yaparak mitokondrinin oksidatif fosforilasyon kapasitesinde progresif olarak azalmaya neden olabileceği görülmüştür. Bu çalışmalarda, özellikle periferal dokulardan elde edilen bulguların, şizofreni tanısında biyolojik bir belirteç olarak kullanılabileceği önerilmiştir. Plateletlerin kendi DNA'sı olmadığı için, platelet mitokondrisinde gerçekleşen değişiklikler nöronlar için periferal bir model olarak kabul edilmektedir. Bu değişiklikler çeşitli nöropsikiyatrik rahatsızlıklarda beyindeki bulguları yansıtmaktadır. Günümüzde şizofreni tanısının klinik ölçütlere dayalı olması, şizofreni için periferal biyolojik bir belirteç gerekliliğini ortaya koymaktadır. Bu nedenle mitokondrial elektron transport zincirindeki değişikliklerin şizofreni ile ilişkisini araştıran daha sistematik çalışmaların yapılması gereklidir.

Research paper thumbnail of The investigation of leptin and hypothalamic neuropeptides role in first attack psychotic male patients: Olanzapine monotherapy

Psychoneuroendocrinology, 2013

The mechanism underlying the weight gain due to treatment with olanzapine and other second genera... more The mechanism underlying the weight gain due to treatment with olanzapine and other second generation antipsychotics has not been fully understood. To examine olanzapine's weight gain effects, we accepted first attack psychotic patients with no medication (pre-treatment) (n = 22) and the healthy control group (n = 26) in this study. After patientś diagnosis, they were hospitalized and then treated for four weeks with olanzapine (post-treatment). We used case-control association design to test body mass index (BMI) and biochemical changes in each group. We also investigated peripheral leptin and neuropeptides/hormones namely, pro-opiomelanocortin (POMC), cocaine and amphetaime regulated transcript (CART), and neuropeptide Y (NPY) levels. These neuropeptides which are synthesized/secreted from arcuate nucleus of hypothalamus affect food intake and therefore, body weight. After 4 weeks of olanzapine treatment; BMI (body mass index), waist circumference, blood triglyceride, total cholesterol, and very low density lipoprotein (VLDL) levels were increased significantly in patients compared to their pre-treatment baseline. In pre-treatment, patients' NPY levels were significantly lower while a-MSH, the anorexigenic product of POMC levels were significantly higher vs. control. Both leptin and NPY levels were significantly increased in patients after the treatment but the NPY levels were also significantly lower in post-treatment vs. the control group. The CART levels did not change after the treatment. We may presume that the antagonist effect of olanzapine on the serotonin (5HT2CR and 5HT1BR) receptors of the arcuate hypothalamic neurons may be a basis for a deregulation of the neurohormones secretion. #

Research paper thumbnail of Post-traumatic stress disorder and comorbid psychotic disorder: electroconvulsive therapy response in two patients

Bulletin of Clinical Psychopharmacology, Feb 16, 2013

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Research paper thumbnail of İki Uçlu Bozukluk ve Oksidatif Stres. (Turkish)

Research paper thumbnail of Cortical Excitability and Post-Traumatic Stress Disorder

Noro Psikiyatri Arsivi, 2016

Research paper thumbnail of Practice of electroconvulsive therapy between the years of 2006-2011 at a university hospital in Turkey

Anatolian Journal of Psychiatry, 2013

ABSTRACT Objective: The frequency of electroconvulsive therapy (ECT) application rates have been ... more ABSTRACT Objective: The frequency of electroconvulsive therapy (ECT) application rates have been reported between 9% and 16.4% in Turkey. These results are higher than in the United States, European countries and some Asia-Pacific countries. These rates do not reflect the actual prevalence of ECT in the general psychiatric population due to nonexitence of a nationwide registry. In this study, we aimed to evaluate inpatients that underwent ECT at the clinic of a university hospital comprehensively. Methods: The patients who were hospitalized and treated with ECT in the Department of Psychiatry of Gulhane Military Medical Academy between 2006 and 2011 were included in this study. The medical files of patients who were hospitalized and treated with ECT within this period were evaluated retrospectively. Results: Of the 176 patients treated with ECT, the most common diagnosis for the application was psychotic disorder and the second was unipolar depression. Average duration of seizures was 27.6±9.7 sec, the average number of ECT was 9.1±4.2 and these have not shown difference according to the diseases. Complication rates were between 3% and 11% and were found to be the highest at the depression group. Balıkcı ve ark. 341 _____________________________________________________________________________________________________ ECT has provided significant improvements in both clinical as well as psychometric measurements at 90.9% of the patients' and in all diagnostic groups. Discussion: The rate of ECT was found to be 2.2% in a 5-year period. The results show that ECT is a safe and effective treatment. Prospective and similar studies in different populations should be useful.

Research paper thumbnail of Is there a role of gender in electroconvulsive therapy response?

Bulletin of Clinical Psychopharmacology, 2015

Research paper thumbnail of Bipolar Hastalarda Depresif Dönem Öyküsü Varliğina Göre Klinik Ve Sosyodemografik Özelliklerin Karşilaştirilmasi

Anatolian Journal of Clinical Investigation

Bu çalışmanın amacı bipolar bozukluk tip I tanısı konmuş hastalarda, depresif dönem öyküsü olan v... more Bu çalışmanın amacı bipolar bozukluk tip I tanısı konmuş hastalarda, depresif dönem öyküsü olan ve olmayan hastaların klinik ve sosyodemografik özelliklerini incelemektir. Araştırmada bir üniversite hastanesi psikiyatri kliniği'ne 2007-2009 yıllarında manik dönem nedeniyle yatmış 108 bipolar bozukluk tip I hastanın dosyaları retrospektif olarak incelenerek veriler elde edilmiştir. Bu verilere göre bipolar bozukluk tip I tanısı konmuş 108 hastanın 16 sının (% 14.8) yaşamları boyunca en az 4 manik dönem geçirdiği, hastalıkları en az 4 yıldır devam ettiği halde hiç depresif dönem öyküsü olmadığı tespit edilmiştir. Depresif dönem öyküsü bulunan ve bulunmayan bipolar tip I hastalar arasında sosyodemografik ve klinik özellikler açısından farklılık tespit edilmemiş, depresif dönem öyküsü bulunmayanların yaşamları boyunca hastaneye yatış sayısının daha fazla olduğu saptanmıştır. Şu anki bilgiler unipolar maniyi ayrı bir nosolojik sınıf olarak tanımlamak için yeterli görülmemektedir. Bu konuda geniş ölçekli, prospektif desenli, patofizyoloji ve etyolojiyi aydınlatabilecek çalışmaların yapılması gerekmektedir. (Anatol J Clin Investig 2012;6(2):104-108) Anahtar kelimeler: Unipolar mani, depresif dönem, sosyodemografik özellikler

Research paper thumbnail of Is transcranial magnetic stimulation effective in treatment-resistant combat related posttraumatic stress disorder?

Neurosciences

To examine the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in patients w... more To examine the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in patients with treatment-resistant posttraumatic stress disorder (PTSD) with co-occurring major depression. We examined data on 20 male combat related PTSD patients admitted to the Post Traumatic Stress Disorder Clinic of Gulhane Military Medical Academy, Ankara, Turkey between January 2011 and December 2012 that received rTMS in addition to medical therapy. We obtained the data by examining the case files and hospital computer records. Decreases in the Impact of Event Scale (IES) hyperarousal scores were statistically significant. However, there were no statistically significant differences between the total IES scores, IES intrusion scores, IES avoidance scores, Beck Depression Inventory, and Beck Anxiety Inventory scores before and after rTMS treatment. The efficacy of rTMS on the hyperarousal symptoms indicated that rTMS could be used in the treatment of patients with treatment-resistant PTSD. ...

Research paper thumbnail of Mitochondrial complex I and III mRNA levels in bipolar disorder

Journal of Affective Disorders, 2015

Studies that have focused on the mitochondrial electron transport chain indicate that bipolar dis... more Studies that have focused on the mitochondrial electron transport chain indicate that bipolar disorder (BD) is associated with pathology in mitochondrial function. These pathological processes occur in the brain circuits that regulate affective functions, emotions, and motor behaviors. The present study aimed to determine the relationship between mitochondrial complex dysfunction and BD. The BD group included 32 male patients diagnosed with first-episode manic BD. The control group included 35 sociodemographically matched healthy males. Messenger ribonucleic acid (mRNA) was isolated from peripheral blood samples obtained from the patients and control group, and the mRNA levels of the NDUFV1, NDUFV2, and NDUFS1 genes of mitochondrial complex I and the UQCR10 gene of mitochondrial complex III were investigated. Significant differences were identified in complex I gene mRNA levels between the BD group (n=32) and the control group (n=35) for the following genes: NDUFV1 (P=0.01), NDUFV2 (P<0.01), and NDUFS1 (P=0.02). The UQCR10 gene (complex III) mRNA level did not differ between the groups (P=0.1). The mRNA levels of the four genes studied were lower at the 3-month follow-up; however, these differences were not significant (P>0.05). All of the BD patients were in manic episodes; thus, we were unable to separately compare these levels with those during depressive and euthymic episodes. The mRNA levels of all of the genes representing the subunits of mitochondrial complex I (NDUFV1, NDUFV2, and NDUFS1) were significantly higher in the present study's BD patients during manic episodes than in the controls. With the data obtained from further research, biomarkers that could be used for the diagnosis and follow-up of neuropsychiatric disorders may be discovered.

Research paper thumbnail of The Relationship Between Brain Regions and Neuropsychological Deficits In Obsessive-Compulsive Disorder

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 2013

Research paper thumbnail of Türk Psikiyatri Topluluğunun Uluslararası Literatüre Katkısının Pubmed Veritabanının Beş Yılı Dikkate Alınarak Değerlendirilmesi / Contribution of Turkish Psychiatric Society to The International Literature: Five Year Evaluation Of Database Pubmed

Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2011

Giriş: Bir bilim dalının bilimsel düzeyini değerlendirmek için, ne kadar yayın yapıldığı, bu yayı... more Giriş: Bir bilim dalının bilimsel düzeyini değerlendirmek için, ne kadar yayın yapıldığı, bu yayınlara yapılan atıfların sayısı ve yayınların dünya sıralamasındaki yeri önemli bir veridir. Bu çalışmada, son beş yıl içinde Türkiye'den yayınlanan psikiyatri ile ilgili bilimsel çalışmaların genel karakteristik özelliklerini ortaya koymak ve yapılacak araştırmalara yol göstermek amaçlanmıştır. Yöntem: PubMed veritabanındaki arama limitleri, 01 Ocak 2005 -31 Aralık 2010 tarihleri arasındaki 5 yıllık süreyi kapsayacak şekilde ayarlanmış, yazarın kurum ve adres bilgilerini içeren 'affiliation' kısmında, Turkey (Türkiye) ve Psychiatry (Psikiyatri) bulunan makaleler değerlendirmeye alınmıştır. Makalelerin yıllara göre dağılımı, konu başlıkları, türü, yazarların kurumu ve sayısı, etki değeri gibi özellikleri incelenmiştir. Bulgular: En sık rastlanan konu başlığı, psikofarmakoloji olmuştur. Araştırma tipine bakıldığında, makalelerin %84.7'sinin (n=476) orijinal araştırma makalesi, %13'ünün (n=73) olgu sunumu, %1.4'ünün (n=8) derleme, %0.7'sinin (n=4) meta-analiz olduğu saptanmıştır. Çalışmaların %0.7'sinin (n=4) hayvanlar üzerinde yapıldığı tespit edilmiştir. Çalışmaların %3.9'unun (n=22) randomize kontrollü, %2.3'ünün (n=13) ise retrospektif olduğu belirlenmiştir. Yalnızca bir çalışmanın çok merkezli olduğu görülmüştür. Sonuç: Türk tıbbındaki gelişmelere paralel olarak, uluslararası bilimsel yayın üretimindeki artış psikiyatri alanında da görülmektedir. Randomize kontrollü klinik çalışmaların, meta-analizlerin ve etki faktörü yüksek dergilerde yayınlanan çalışmaların azlığı, yayın sayısı kadar yayın kalitesi konusuna da önem verilmesi gerektiğini düşündürmektedir. Anahtar kelimeler: Türkiye, psikiyatri, bilim, yayınlar ABSTRACT Contribution of the Turkish psychiatric society to the international literature: a five year evaluation of PubMed database Objective: To assess the scientific level of a scientific discipline, the number of publications, the number of citations these publications received and their rank in the world order are important data. In this study, we aimed to show general characteristics of the scientific studies in the psychiatry field published during the last five years in Turkey and to lead the way for the future studies. Method: PubMed database search was limited for the five-year period between January 1, 2005 and December 31, 2010, and covered the articles containing 'Turkey' and 'Psychiatry' words in the fields of authors' institution and affiliation. The annual distribution of the articles, subject headings, type, author's institutions and its number, its impact value were examined. Results: The most common titles were the ones about psychopharmacology. According to the type of the research, it was determined that 84.7% (n=476) of the articles were original researches; 13.0% (n=73) were case reports and the remaining consisted of 8 reviews (1.4%) and 4 meta-analysis (0.7%). 0.7% (n=4) of the studies were performed on animal models. 3.9% (n=22) of the articles were designed as randomized controlled and 2.3% (n=13) were retrospective. Only one study was determined as multicentre. Conclusion: In line with developments in medicine, a significant increase in the production of scientific publications in psychiatry field has been observed in Turkey. The scarcity of randomized controlled clinical trials, meta-analysis and studies published in high impact factor journals suggest the need for emphasis on the quality of the publications as much as on their quantity.

Research paper thumbnail of Bipolar Disorder and Oxidative Stress

Journal of Mood Disorders, 2013

Research paper thumbnail of Depression, Anxiety, and Anger in Patients with Polycystic Ovary Syndrome

Noro Psikiyatri Arsivi, 2014

Introduction: Polycystic Ovary Syndrome (PCOS) is a syndrome of heterogeneous nature, affecting m... more Introduction: Polycystic Ovary Syndrome (PCOS) is a syndrome of heterogeneous nature, affecting multiple systems, particularly the endocrine system. We propose to investigate the possible relationships among hormonal changes, levels of anxiety, depression, and anger in patients with PCOS.

Research paper thumbnail of Neuroradiological Imaging Studies in Bipolar Disorder

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 2012

ÖZET Bipolar bozukluk tekrarlayan ataklarla seyreden, işlevselliği belirgin olarak bozan kronik b... more ÖZET Bipolar bozukluk tekrarlayan ataklarla seyreden, işlevselliği belirgin olarak bozan kronik bir ruhsal bozukluktur. Nörobiyolojik temelleri olan hastalıkla ilgili birçok çalışma yapılmasına rağmen patofizyolojisi tam olarak bilinmemektedir. Yapısal ve işlevsel görüntüleme tekniklerinin, bipolar bozukluğun etyolojisinin daha iyi anlaşılmasına ve tanısal yaklaşımının gelişmesine belirgin katkısı olmuştur. Beyin görüntüleme modalitelerindeki güncel gelişmeler sayesinde hastalığın altında yatan nöral sistemlerdeki anormallikler hakkında bilinenler artmaktadır. Nörobilişsel ve duygusal alanlarda belirgin bozulma olan bu hastalıkta, nesnel biyobelirteçlerin tanımlanması bozukluğun patofizyolojisini aydınlatmakta fayda sağlayacaktır. Anahtar Sözcükler: Bipolar bozukluk, nörogörüntüleme, nörobiyoloji ABSTRACT Bipolar disorder is characterized by recurrent attacks, significantly disrupts the functionality of a chronic mental disorder. Although there is growing number of studies on the neurobiological basis of the disorder, the pathophysiology has not yet been clearly understood. Structural and functional imaging techniques present a better understanding of the etiology of bipolar disorder and has contributed significantly to the development of the diagnostic approach. Recent developments in brain imaging modalities have let us learn more about the underlying abnormalities in neural systems of bipolar patients. Identification of objective biomarkers would help to determine the pathophysiology of bipolar disorder, a disorder which causes significant deterioration in neurocognitive and emotional areas.

Research paper thumbnail of A rare symptom in posttraumatic stress disorder: Spontaneous ejaculation

American Journal of Case Reports, 2014

Unusual clinical course Background:

Research paper thumbnail of Neurobiology of Placebo Effect

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 2013

Research paper thumbnail of Mitochondrial complex I and III gene mRNA levels in schizophrenia, and their relationship with clinical features

Journal of Molecular Psychiatry, 2014

Background: The etiology of schizophrenia is not precisely known; however, mitochondrial function... more Background: The etiology of schizophrenia is not precisely known; however, mitochondrial function and cerebral energy metabolism abnormalities were determined to be possible factors associated with the etiology of schizophrenia. Impaired mitochondrial function negatively affects neuronal plasticity, and can cause cognitive deficits and behavioral abnormalities observed during the clinical course of schizophrenia. The present study aimed to investigate the relationship between the clinical features of schizophrenia, and mitochondrial complex activation, based on measurement of mRNA levels in the NDUFV1, NDUFV2, NDUFS1, and UQCR10 genes involved in the peripheral mitochondrial complex.

Research paper thumbnail of The evaluation of primary idiopathic focal hyperhidrosis patients in terms of alexithymia

Journal of Health Psychology, 2013

The aim of this study was to evaluate the primary focal hyperhidrosis patients in terms of alexit... more The aim of this study was to evaluate the primary focal hyperhidrosis patients in terms of alexithymia. Participants (n = 50) diagnosed with primary focal hyperhidrosis by a dermatologist were referred to a psychiatrist and evaluated via Structured Clinical Interview for DSM-IV Axis I Disorders and Toronto Alexithymia Scale-20. The rate of alexithymia was 45.6 percent and 18.2 percent, respectively, for primary focal hyperhidrosis and control participants (n = 44). Multivariate analysis of variance results showed that the primary focal hyperhidrosis group scored significantly higher than the control group in Difficulty Identifying Feelings and Difficulty Describing Feelings subscales, and total score. Psychotherapeutic interventions can increase the chances of dermatological treatment success and can have a positive impact on the quality of life in chronic cases.

Research paper thumbnail of The investigation of leptin and hypothalamic neuropeptides role in first attack psychotic male patients: Olanzapine monotherapy

Psychoneuroendocrinology, 2013

The mechanism underlying the weight gain due to treatment with olanzapine and other second genera... more The mechanism underlying the weight gain due to treatment with olanzapine and other second generation antipsychotics has not been fully understood. To examine olanzapine's weight gain effects, we accepted first attack psychotic patients with no medication (pre-treatment) (n = 22) and the healthy control group (n = 26) in this study. After patientś diagnosis, they were hospitalized and then treated for four weeks with olanzapine (post-treatment). We used case-control association design to test body mass index (BMI) and biochemical changes in each group. We also investigated peripheral leptin and neuropeptides/hormones namely, pro-opiomelanocortin (POMC), cocaine and amphetaime regulated transcript (CART), and neuropeptide Y (NPY) levels. These neuropeptides which are synthesized/secreted from arcuate nucleus of hypothalamus affect food intake and therefore, body weight. After 4 weeks of olanzapine treatment; BMI (body mass index), waist circumference, blood triglyceride, total cholesterol, and very low density lipoprotein (VLDL) levels were increased significantly in patients compared to their pre-treatment baseline. In pre-treatment, patients' NPY levels were significantly lower while a-MSH, the anorexigenic product of POMC levels were significantly higher vs. control. Both leptin and NPY levels were significantly increased in patients after the treatment but the NPY levels were also significantly lower in post-treatment vs. the control group. The CART levels did not change after the treatment. We may presume that the antagonist effect of olanzapine on the serotonin (5HT2CR and 5HT1BR) receptors of the arcuate hypothalamic neurons may be a basis for a deregulation of the neurohormones secretion. #

Research paper thumbnail of Schizophrenia and Mitochondrial Dysfunction

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 2014

Etyolojisi net olarak bilinmeyen şizofreninin oluşumunda genetik faktörler önemli rol oynamaktadı... more Etyolojisi net olarak bilinmeyen şizofreninin oluşumunda genetik faktörler önemli rol oynamaktadır. Ancak, bu bozukluğun spesifik kalıtımsal mekanizması henüz açıklanamamıştır. Şizofreni kalıtımının poligenik veya multifaktöryel olabileceği düşünülmektedir. Son dönemde yapılan çalışmalarda, şizofreni olgularında mitokondrial fonksiyon ve serebral enerji metabolizmasında anormallikler tespit edilmiştir. Mitokondri fonksiyonlarındaki bozulma ile nöronal plastisite ve beyin devreleri etkilenerek, şizofreninin klinik tablosunda da belirgin olarak rastlanabilen davranış anormallikleri ve bilişsel defisitler gelişebilir. Şizofreni olgularının hem beyin hem de periferal dokularının incelendiği araştırmalarda, şizofreni olgularında sağlıklı olgulara göre bazı değişiklikler saptanmıştır. Ayrıca şizofreni tedavisinde kullanılan antipsikotiklerin solunum zinciri inhibisyonu yaparak mitokondrinin oksidatif fosforilasyon kapasitesinde progresif olarak azalmaya neden olabileceği görülmüştür. Bu çalışmalarda, özellikle periferal dokulardan elde edilen bulguların, şizofreni tanısında biyolojik bir belirteç olarak kullanılabileceği önerilmiştir. Plateletlerin kendi DNA'sı olmadığı için, platelet mitokondrisinde gerçekleşen değişiklikler nöronlar için periferal bir model olarak kabul edilmektedir. Bu değişiklikler çeşitli nöropsikiyatrik rahatsızlıklarda beyindeki bulguları yansıtmaktadır. Günümüzde şizofreni tanısının klinik ölçütlere dayalı olması, şizofreni için periferal biyolojik bir belirteç gerekliliğini ortaya koymaktadır. Bu nedenle mitokondrial elektron transport zincirindeki değişikliklerin şizofreni ile ilişkisini araştıran daha sistematik çalışmaların yapılması gereklidir.

Research paper thumbnail of The investigation of leptin and hypothalamic neuropeptides role in first attack psychotic male patients: Olanzapine monotherapy

Psychoneuroendocrinology, 2013

The mechanism underlying the weight gain due to treatment with olanzapine and other second genera... more The mechanism underlying the weight gain due to treatment with olanzapine and other second generation antipsychotics has not been fully understood. To examine olanzapine's weight gain effects, we accepted first attack psychotic patients with no medication (pre-treatment) (n = 22) and the healthy control group (n = 26) in this study. After patientś diagnosis, they were hospitalized and then treated for four weeks with olanzapine (post-treatment). We used case-control association design to test body mass index (BMI) and biochemical changes in each group. We also investigated peripheral leptin and neuropeptides/hormones namely, pro-opiomelanocortin (POMC), cocaine and amphetaime regulated transcript (CART), and neuropeptide Y (NPY) levels. These neuropeptides which are synthesized/secreted from arcuate nucleus of hypothalamus affect food intake and therefore, body weight. After 4 weeks of olanzapine treatment; BMI (body mass index), waist circumference, blood triglyceride, total cholesterol, and very low density lipoprotein (VLDL) levels were increased significantly in patients compared to their pre-treatment baseline. In pre-treatment, patients' NPY levels were significantly lower while a-MSH, the anorexigenic product of POMC levels were significantly higher vs. control. Both leptin and NPY levels were significantly increased in patients after the treatment but the NPY levels were also significantly lower in post-treatment vs. the control group. The CART levels did not change after the treatment. We may presume that the antagonist effect of olanzapine on the serotonin (5HT2CR and 5HT1BR) receptors of the arcuate hypothalamic neurons may be a basis for a deregulation of the neurohormones secretion. #

Research paper thumbnail of Post-traumatic stress disorder and comorbid psychotic disorder: electroconvulsive therapy response in two patients

Bulletin of Clinical Psychopharmacology, Feb 16, 2013

Add ress rep rint re qu ests to:

Research paper thumbnail of İki Uçlu Bozukluk ve Oksidatif Stres. (Turkish)

Research paper thumbnail of Cortical Excitability and Post-Traumatic Stress Disorder

Noro Psikiyatri Arsivi, 2016

Research paper thumbnail of Practice of electroconvulsive therapy between the years of 2006-2011 at a university hospital in Turkey

Anatolian Journal of Psychiatry, 2013

ABSTRACT Objective: The frequency of electroconvulsive therapy (ECT) application rates have been ... more ABSTRACT Objective: The frequency of electroconvulsive therapy (ECT) application rates have been reported between 9% and 16.4% in Turkey. These results are higher than in the United States, European countries and some Asia-Pacific countries. These rates do not reflect the actual prevalence of ECT in the general psychiatric population due to nonexitence of a nationwide registry. In this study, we aimed to evaluate inpatients that underwent ECT at the clinic of a university hospital comprehensively. Methods: The patients who were hospitalized and treated with ECT in the Department of Psychiatry of Gulhane Military Medical Academy between 2006 and 2011 were included in this study. The medical files of patients who were hospitalized and treated with ECT within this period were evaluated retrospectively. Results: Of the 176 patients treated with ECT, the most common diagnosis for the application was psychotic disorder and the second was unipolar depression. Average duration of seizures was 27.6±9.7 sec, the average number of ECT was 9.1±4.2 and these have not shown difference according to the diseases. Complication rates were between 3% and 11% and were found to be the highest at the depression group. Balıkcı ve ark. 341 _____________________________________________________________________________________________________ ECT has provided significant improvements in both clinical as well as psychometric measurements at 90.9% of the patients' and in all diagnostic groups. Discussion: The rate of ECT was found to be 2.2% in a 5-year period. The results show that ECT is a safe and effective treatment. Prospective and similar studies in different populations should be useful.

Research paper thumbnail of Is there a role of gender in electroconvulsive therapy response?

Bulletin of Clinical Psychopharmacology, 2015

Research paper thumbnail of Bipolar Hastalarda Depresif Dönem Öyküsü Varliğina Göre Klinik Ve Sosyodemografik Özelliklerin Karşilaştirilmasi

Anatolian Journal of Clinical Investigation

Bu çalışmanın amacı bipolar bozukluk tip I tanısı konmuş hastalarda, depresif dönem öyküsü olan v... more Bu çalışmanın amacı bipolar bozukluk tip I tanısı konmuş hastalarda, depresif dönem öyküsü olan ve olmayan hastaların klinik ve sosyodemografik özelliklerini incelemektir. Araştırmada bir üniversite hastanesi psikiyatri kliniği'ne 2007-2009 yıllarında manik dönem nedeniyle yatmış 108 bipolar bozukluk tip I hastanın dosyaları retrospektif olarak incelenerek veriler elde edilmiştir. Bu verilere göre bipolar bozukluk tip I tanısı konmuş 108 hastanın 16 sının (% 14.8) yaşamları boyunca en az 4 manik dönem geçirdiği, hastalıkları en az 4 yıldır devam ettiği halde hiç depresif dönem öyküsü olmadığı tespit edilmiştir. Depresif dönem öyküsü bulunan ve bulunmayan bipolar tip I hastalar arasında sosyodemografik ve klinik özellikler açısından farklılık tespit edilmemiş, depresif dönem öyküsü bulunmayanların yaşamları boyunca hastaneye yatış sayısının daha fazla olduğu saptanmıştır. Şu anki bilgiler unipolar maniyi ayrı bir nosolojik sınıf olarak tanımlamak için yeterli görülmemektedir. Bu konuda geniş ölçekli, prospektif desenli, patofizyoloji ve etyolojiyi aydınlatabilecek çalışmaların yapılması gerekmektedir. (Anatol J Clin Investig 2012;6(2):104-108) Anahtar kelimeler: Unipolar mani, depresif dönem, sosyodemografik özellikler

Research paper thumbnail of Is transcranial magnetic stimulation effective in treatment-resistant combat related posttraumatic stress disorder?

Neurosciences

To examine the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in patients w... more To examine the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in patients with treatment-resistant posttraumatic stress disorder (PTSD) with co-occurring major depression. We examined data on 20 male combat related PTSD patients admitted to the Post Traumatic Stress Disorder Clinic of Gulhane Military Medical Academy, Ankara, Turkey between January 2011 and December 2012 that received rTMS in addition to medical therapy. We obtained the data by examining the case files and hospital computer records. Decreases in the Impact of Event Scale (IES) hyperarousal scores were statistically significant. However, there were no statistically significant differences between the total IES scores, IES intrusion scores, IES avoidance scores, Beck Depression Inventory, and Beck Anxiety Inventory scores before and after rTMS treatment. The efficacy of rTMS on the hyperarousal symptoms indicated that rTMS could be used in the treatment of patients with treatment-resistant PTSD. ...

Research paper thumbnail of Mitochondrial complex I and III mRNA levels in bipolar disorder

Journal of Affective Disorders, 2015

Studies that have focused on the mitochondrial electron transport chain indicate that bipolar dis... more Studies that have focused on the mitochondrial electron transport chain indicate that bipolar disorder (BD) is associated with pathology in mitochondrial function. These pathological processes occur in the brain circuits that regulate affective functions, emotions, and motor behaviors. The present study aimed to determine the relationship between mitochondrial complex dysfunction and BD. The BD group included 32 male patients diagnosed with first-episode manic BD. The control group included 35 sociodemographically matched healthy males. Messenger ribonucleic acid (mRNA) was isolated from peripheral blood samples obtained from the patients and control group, and the mRNA levels of the NDUFV1, NDUFV2, and NDUFS1 genes of mitochondrial complex I and the UQCR10 gene of mitochondrial complex III were investigated. Significant differences were identified in complex I gene mRNA levels between the BD group (n=32) and the control group (n=35) for the following genes: NDUFV1 (P=0.01), NDUFV2 (P<0.01), and NDUFS1 (P=0.02). The UQCR10 gene (complex III) mRNA level did not differ between the groups (P=0.1). The mRNA levels of the four genes studied were lower at the 3-month follow-up; however, these differences were not significant (P>0.05). All of the BD patients were in manic episodes; thus, we were unable to separately compare these levels with those during depressive and euthymic episodes. The mRNA levels of all of the genes representing the subunits of mitochondrial complex I (NDUFV1, NDUFV2, and NDUFS1) were significantly higher in the present study's BD patients during manic episodes than in the controls. With the data obtained from further research, biomarkers that could be used for the diagnosis and follow-up of neuropsychiatric disorders may be discovered.

Research paper thumbnail of The Relationship Between Brain Regions and Neuropsychological Deficits In Obsessive-Compulsive Disorder

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 2013

Research paper thumbnail of Türk Psikiyatri Topluluğunun Uluslararası Literatüre Katkısının Pubmed Veritabanının Beş Yılı Dikkate Alınarak Değerlendirilmesi / Contribution of Turkish Psychiatric Society to The International Literature: Five Year Evaluation Of Database Pubmed

Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2011

Giriş: Bir bilim dalının bilimsel düzeyini değerlendirmek için, ne kadar yayın yapıldığı, bu yayı... more Giriş: Bir bilim dalının bilimsel düzeyini değerlendirmek için, ne kadar yayın yapıldığı, bu yayınlara yapılan atıfların sayısı ve yayınların dünya sıralamasındaki yeri önemli bir veridir. Bu çalışmada, son beş yıl içinde Türkiye'den yayınlanan psikiyatri ile ilgili bilimsel çalışmaların genel karakteristik özelliklerini ortaya koymak ve yapılacak araştırmalara yol göstermek amaçlanmıştır. Yöntem: PubMed veritabanındaki arama limitleri, 01 Ocak 2005 -31 Aralık 2010 tarihleri arasındaki 5 yıllık süreyi kapsayacak şekilde ayarlanmış, yazarın kurum ve adres bilgilerini içeren 'affiliation' kısmında, Turkey (Türkiye) ve Psychiatry (Psikiyatri) bulunan makaleler değerlendirmeye alınmıştır. Makalelerin yıllara göre dağılımı, konu başlıkları, türü, yazarların kurumu ve sayısı, etki değeri gibi özellikleri incelenmiştir. Bulgular: En sık rastlanan konu başlığı, psikofarmakoloji olmuştur. Araştırma tipine bakıldığında, makalelerin %84.7'sinin (n=476) orijinal araştırma makalesi, %13'ünün (n=73) olgu sunumu, %1.4'ünün (n=8) derleme, %0.7'sinin (n=4) meta-analiz olduğu saptanmıştır. Çalışmaların %0.7'sinin (n=4) hayvanlar üzerinde yapıldığı tespit edilmiştir. Çalışmaların %3.9'unun (n=22) randomize kontrollü, %2.3'ünün (n=13) ise retrospektif olduğu belirlenmiştir. Yalnızca bir çalışmanın çok merkezli olduğu görülmüştür. Sonuç: Türk tıbbındaki gelişmelere paralel olarak, uluslararası bilimsel yayın üretimindeki artış psikiyatri alanında da görülmektedir. Randomize kontrollü klinik çalışmaların, meta-analizlerin ve etki faktörü yüksek dergilerde yayınlanan çalışmaların azlığı, yayın sayısı kadar yayın kalitesi konusuna da önem verilmesi gerektiğini düşündürmektedir. Anahtar kelimeler: Türkiye, psikiyatri, bilim, yayınlar ABSTRACT Contribution of the Turkish psychiatric society to the international literature: a five year evaluation of PubMed database Objective: To assess the scientific level of a scientific discipline, the number of publications, the number of citations these publications received and their rank in the world order are important data. In this study, we aimed to show general characteristics of the scientific studies in the psychiatry field published during the last five years in Turkey and to lead the way for the future studies. Method: PubMed database search was limited for the five-year period between January 1, 2005 and December 31, 2010, and covered the articles containing 'Turkey' and 'Psychiatry' words in the fields of authors' institution and affiliation. The annual distribution of the articles, subject headings, type, author's institutions and its number, its impact value were examined. Results: The most common titles were the ones about psychopharmacology. According to the type of the research, it was determined that 84.7% (n=476) of the articles were original researches; 13.0% (n=73) were case reports and the remaining consisted of 8 reviews (1.4%) and 4 meta-analysis (0.7%). 0.7% (n=4) of the studies were performed on animal models. 3.9% (n=22) of the articles were designed as randomized controlled and 2.3% (n=13) were retrospective. Only one study was determined as multicentre. Conclusion: In line with developments in medicine, a significant increase in the production of scientific publications in psychiatry field has been observed in Turkey. The scarcity of randomized controlled clinical trials, meta-analysis and studies published in high impact factor journals suggest the need for emphasis on the quality of the publications as much as on their quantity.

Research paper thumbnail of Bipolar Disorder and Oxidative Stress

Journal of Mood Disorders, 2013

Research paper thumbnail of Depression, Anxiety, and Anger in Patients with Polycystic Ovary Syndrome

Noro Psikiyatri Arsivi, 2014

Introduction: Polycystic Ovary Syndrome (PCOS) is a syndrome of heterogeneous nature, affecting m... more Introduction: Polycystic Ovary Syndrome (PCOS) is a syndrome of heterogeneous nature, affecting multiple systems, particularly the endocrine system. We propose to investigate the possible relationships among hormonal changes, levels of anxiety, depression, and anger in patients with PCOS.

Research paper thumbnail of Neuroradiological Imaging Studies in Bipolar Disorder

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 2012

ÖZET Bipolar bozukluk tekrarlayan ataklarla seyreden, işlevselliği belirgin olarak bozan kronik b... more ÖZET Bipolar bozukluk tekrarlayan ataklarla seyreden, işlevselliği belirgin olarak bozan kronik bir ruhsal bozukluktur. Nörobiyolojik temelleri olan hastalıkla ilgili birçok çalışma yapılmasına rağmen patofizyolojisi tam olarak bilinmemektedir. Yapısal ve işlevsel görüntüleme tekniklerinin, bipolar bozukluğun etyolojisinin daha iyi anlaşılmasına ve tanısal yaklaşımının gelişmesine belirgin katkısı olmuştur. Beyin görüntüleme modalitelerindeki güncel gelişmeler sayesinde hastalığın altında yatan nöral sistemlerdeki anormallikler hakkında bilinenler artmaktadır. Nörobilişsel ve duygusal alanlarda belirgin bozulma olan bu hastalıkta, nesnel biyobelirteçlerin tanımlanması bozukluğun patofizyolojisini aydınlatmakta fayda sağlayacaktır. Anahtar Sözcükler: Bipolar bozukluk, nörogörüntüleme, nörobiyoloji ABSTRACT Bipolar disorder is characterized by recurrent attacks, significantly disrupts the functionality of a chronic mental disorder. Although there is growing number of studies on the neurobiological basis of the disorder, the pathophysiology has not yet been clearly understood. Structural and functional imaging techniques present a better understanding of the etiology of bipolar disorder and has contributed significantly to the development of the diagnostic approach. Recent developments in brain imaging modalities have let us learn more about the underlying abnormalities in neural systems of bipolar patients. Identification of objective biomarkers would help to determine the pathophysiology of bipolar disorder, a disorder which causes significant deterioration in neurocognitive and emotional areas.

Research paper thumbnail of A rare symptom in posttraumatic stress disorder: Spontaneous ejaculation

American Journal of Case Reports, 2014

Unusual clinical course Background:

Research paper thumbnail of Neurobiology of Placebo Effect

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 2013

Research paper thumbnail of Mitochondrial complex I and III gene mRNA levels in schizophrenia, and their relationship with clinical features

Journal of Molecular Psychiatry, 2014

Background: The etiology of schizophrenia is not precisely known; however, mitochondrial function... more Background: The etiology of schizophrenia is not precisely known; however, mitochondrial function and cerebral energy metabolism abnormalities were determined to be possible factors associated with the etiology of schizophrenia. Impaired mitochondrial function negatively affects neuronal plasticity, and can cause cognitive deficits and behavioral abnormalities observed during the clinical course of schizophrenia. The present study aimed to investigate the relationship between the clinical features of schizophrenia, and mitochondrial complex activation, based on measurement of mRNA levels in the NDUFV1, NDUFV2, NDUFS1, and UQCR10 genes involved in the peripheral mitochondrial complex.

Research paper thumbnail of The evaluation of primary idiopathic focal hyperhidrosis patients in terms of alexithymia

Journal of Health Psychology, 2013

The aim of this study was to evaluate the primary focal hyperhidrosis patients in terms of alexit... more The aim of this study was to evaluate the primary focal hyperhidrosis patients in terms of alexithymia. Participants (n = 50) diagnosed with primary focal hyperhidrosis by a dermatologist were referred to a psychiatrist and evaluated via Structured Clinical Interview for DSM-IV Axis I Disorders and Toronto Alexithymia Scale-20. The rate of alexithymia was 45.6 percent and 18.2 percent, respectively, for primary focal hyperhidrosis and control participants (n = 44). Multivariate analysis of variance results showed that the primary focal hyperhidrosis group scored significantly higher than the control group in Difficulty Identifying Feelings and Difficulty Describing Feelings subscales, and total score. Psychotherapeutic interventions can increase the chances of dermatological treatment success and can have a positive impact on the quality of life in chronic cases.