Effects of enuresis nocturna on parents of affected children: case-control study

BACKGROUND

Enuresis nocturna (EN) is a chronic medical disorder that may cause a parent to question their parenting ability and contribute to an inability to perform the parental role. The aim of the study was to investigate the effects of EN on the relationship between parents, and the effect of mood changes in the couples on the children.

METHODS

Forty children with EN (group 1) were enrolled in the study, and 44 consecutive healthy children (group 2) were randomly selected from the same school. The clinical diagnosis for the patient group was based on a careful history. Spielberg's State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and Dyadic Adjustment Scale (DAS) were applied to all parents, and the answers were recorded.

RESULTS

STAI scores differed between the mothers in the two groups in terms of trait anxiety, while significant differences between the fathers in terms of both state and trait anxiety were observed. The BDI scores were similar between the two groups. The scores of dyadic consensus were lower in the mothers, while the affectional expression scores were lower in the EN study group fathers compared with controls. The total DAS scores were significantly lower in the parents of the children with EN.

CONCLUSION

The parents of children with EN seem to experience increased levels of anxiety. Their desire to continue the marital relationship, the overall quality of their marital relationship and their comfort as a family may also be negatively affected by having a child with EN.

Latent class analysis of obsessive-compulsive symptoms in a clinical sample

OBJECTIVE

Obsessive-compulsive disorder (OCD) is probably a heterogeneous condition. To date, research investigating the symptom structure of OCD has generally focused on variable-classification approaches, primarily factor analysis. Our aim was to use the latent class analysis, an advanced individual-classification method, in order to define homogeneous sub-groups based on the Yale-Brown Obsessive-Compulsive Scale Check List (Y-BOCS CL) assessments within 193 outpatients with OCD.

METHOD

Latent class analysis of 13 obsessive-compulsive symptom-clusters measured by the Yale-Brown Obsessive-Compulsive Scale Check List was performed. Associations of demographic and clinical features with latent class membership were tested by using logistic regression models. Differences in severity of obsessive-compulsive symptoms, obsessive beliefs, and depressive symptomotology between latent classes were evaluated with the chi-square likelihood test.

RESULTS

Latent class analysis models of best fit yielded 3 latent classes: "autogenous obsessions", "reactive obsessive-compulsive", and "reactive obsessions". Outpatients in reactive obsessive-compulsive group reported significantly higher scores on the Y-BOCS global, obsessions, and compulsions scales than outpatients in other two sub-groups. Participants in reactive obsessive-compulsive group were predominantly female, single, and had a history of family psychopathology; whereas autogenous and reactive obsessions groups were predominantly male. There were no differences in severity of depression and obsessive belief domains.

CONCLUSIONS

The results provide support for the validity of autogenous/reactive distinction for OCD. These three classes may have important implications for research and clinical purposes.

Sleep quality in rheumatoid arthritis: relationship between the disease severity, depression, functional status and the quality of life

BACKGROUND

The aim of this study was to evaluate sleep quality and the related variables in patients with rheumatoid arthritis (RA).

METHODS

Ninety-four patients diagnosed with RA and fifty two healthy controls were enrolled in the study. Disease activity was assessed through the Disease Activity Score (DAS) 28 scale. All patients were assessed using the Rheumatoid Arthritis Quality of Life and Health Assessment Questionnaire scales, together with the Beck Depression Inventory. Radiological damage was calculated with the modified Larsen method. The Pittsburgh Sleep Quality Index (PSQI) was used for the evaluation of the sleep disturbance.

RESULTS

The patients with RA had significantly higher scores in the subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbance domains and the total PSQI score compared to the healthy control group. According to the results of Spearman's analysis, there was a significantly correlation between the age, disease activity, CRP, pain, fatigue, depression, functional disability, quality of life, radiological damage, menopause status, duration of morning stiffness, ESR levels and the sleep disturbance. The logistic regression analysis indicated that depression and DAS 28 scores were predictors for poor sleep quality.

CONCLUSION

The sleep quality is disturbed in patients with RA. The poor sleep quality is especially associated with the disease activity and depression.

Palmitate de palipéridone à doses flexibles – Réponse thérapeutique, tolérance et sécurité d’emploi: une étude prospective chez des patients en période d’exacerbation aiguë d’un trouble schizophrénique après échec d’un traitement par antipsychotiques oraux

Objectifs

Évaluer la tolérance, la sécurité d’emploi et l’efficacité de doses flexibles de PP chez des patients adultes en période d’exacerbation aiguë d’une schizophrénie, après échec d’un traitement par antipsychotiques oraux.

Méthodes

Étude internationale, prospective, ouverte, de six mois.

Critères d’évaluation

Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S), événements indésirables (EI), changement de poids.

Résultats

Deux cent douze patients (population en intention de traiter) : âge moyen 36,4 ± 12,1 ans, 59,0 % d’hommes, 85,4 % souffrant de schizophrénie paranoïde ont été inclus. La principale raison de la substitution d’un antipsychotique oral par le PP était un manque d’efficacité (45,8 %). 70,3 % des patients ont terminé l’étude de six mois. Les raisons les plus fréquentes d’arrêt précoce ont été : le choix du patient (9,4 %), des EI (9,0 %), les perdus de vue (4,7 %), le manque d’efficacité (2,8 %). Le score total moyen à la PANSS initiale (98,5 ± 20,1) a diminué, et ce dès j8, pour atteindre 67,4 ± 24,0 à la fin de l’étude (diminution de −31,0 ± 29,0, p < 0,0001). 66,7 % des patients ont eu une amélioration de plus de 30 % du score PANSS total et le pourcentage de patients jugés manifestement malades ou pire (CGI-S) a diminué de 75,1 % à 20,5 %. Les EIs (≥ 5 % patients) : douleur au site d’injection (13,7 %), insomnie (10,8 %), trouble psychotique (10,4 %), céphalées (6,1 %) et anxiété (6,1 %). Le changement moyen de poids a été de 2,6 ± 5,6 kg (IC 95 % [1,8; 3,4]).

Conclusions

Ces résultats confirment que le PP à doses flexibles est bien toléré et permet une réponse clinique précoce et cliniquement significative chez des patients en période d’exacerbation aiguë de leur trouble schizophrénique, après échec d’un traitement par antipsychotiques oraux.

Predictive value of obsessive compulsive symptoms involving the skin on quality of life in patients with acne vulgaris

Acne is one of the most common dermatological diseases, and obsessive compulsive disorder is among the most frequent psychiatric conditions seen in dermatology clinics. Comorbidity of these conditions may therefore be expected. The aim of this study was to measure obsessive compulsive symptoms and quality of life in patients with acne vulgaris, compare them with those of healthy control subjects, and determine whether there is any predictive value of obsessive compulsive symptoms for quality of life in patients with acne. Obsessive compulsive symptoms and quality of life measurements of 146 patients with acne vulgaris and 94 healthy control subjects were made using the Maudsley Obsessive Compulsive Questionnaire and Short Form-36 in a cross-sectional design. Patients with acne vulgaris had lower scores for physical functioning, physical role dysfunction, general health perception, vitality, and emotional role dysfunction. They also had higher scores for checking, slowness, and rumination. The only predictor of physical functioning and vitality dimensions of health-related quality of life in these patients was rumination score. Obsessive compulsive symptoms in patients with acne vulgaris are higher than in controls, and this may correlate with both disease severity and quality of life for patients.

Vision-related quality of life in patients with chronic central serous chorioretinopathy

PURPOSE

To evaluate vision-related quality of life in patients with chronic central serous chorioretinopathy (CSCR).

DESIGN

Prospective, cross-sectional study.

METHODS

The interviewer-administered National Eye Institute visual function questionnaire (NEI-VFQ-25) was used in 30 adult consecutive patients with chronic CSCR patients. The controls were 30 gender- and age-matched people with normal visual function who came from the same socioeconomic and educational background as the participants.

RESULTS

Patients with CSCR had statistically significant lower scores than controls for all the subscales, except for general health. In the study group, all subscale scores of vision-related quality of life, except general health, showed statistically significant negative correlations with the visual acuity.

CONCLUSIONS

People with CSCR have worse vision-related quality of life than people without the condition.

Reduced PON1 enzymatic activity and increased lipid hydroperoxide levels that point out oxidative stress in generalized anxiety disorder

In recent years, there has been an increasing focus on generalized anxiety disorder (GAD) which is one of the most prevalent mental disorders in general population. Psychological, genetic, neurobiological, and neurochemical factors are believed to play role in the etiopathogenesis of GAD. The role of oxidative stress, as a neurochemical cause, in various anxiety disorders has been studied in recent years; however, it has not been thoroughly studied in GAD, yet. In this paper, we aimed to evaluate the serum levels of lipid hydroperoxide (LOOH), paraoxonase, and arylesterase in GAD patients without any co-morbid psychiatric disorders and investigate their diagnostic performance. Blood samples were collected from 40 GAD patients and 40 healthy control subjects to measure their serum LOOH levels, arylesterase and paraoxonase activities. Obtained results have been compared between groups and receiver operating characteristic (ROC) curve has been drawn for diagnostic performance of measured biochemical markers. Positive and negative predictive values have been estimated where appropriate. Mean LOOH level of the GAD patients was significantly higher than that of control subjects (t=-5.49, p<0.001), whereas, mean paraoxonase activity was lower in these patients (t=3.056, p=0.03). GAD could be predicted for LOOH level over 7.740 μmol/l with 92.5% positive predictive value and 92% negative predictive value. Increased LOOH level and decreased paraoxonase activity of GAD patients may suggest increased lipid peroxidation and oxidative stress in these patients. LOOH levels may be a state marker for diagnosing GAD.

Decreased serum sulphydryl levels as a sign of increased oxidative stress in generalized anxiety disorder

OBJECTIVE

In recent years, many published studies have focused on the relationship between oxidative stress and psychiatric disorders. However, studies in generalized anxiety disorder (GAD) are few despite relatively high prevalence rates. In an attempt to fill this gap in the literature we aimed to measure serum levels of free sulphydryl, an important member of antioxidant defense mechanisms, of the patients with GAD.

METHODS

A total of 35 (23 female, 12 male) GAD patients without any other co-morbid medical or psychiatric disorder and 35 (23 female, 12 male) healthy controls have been included in the study. Disease severity of the patients were quantified by using the Hamilton Anxiety Rating Scale (HAM-A). Serum free sulphydryl group levels of patients and healthy controls were measured in an appropriate way.

RESULTS

Mean level of serum sulphydryl groups was significantly lower in the patient group. There was a negative correlation between their level and the disease duration. However, they did not show any significant correlation with the disease severity.

CONCLUSION

Decreased serum sulphydryl level observed in pure GAD patients suggests an increased oxidative stress in these patients. Well designed future researches are needed to replicate our findings and to test the implications of the present study.

Increased psychological trauma and decreased desire to have children after a complicated pregnancy

OBJECTIVE

Information about fertility desire and psychological sequelae after high-risk pregnancies are scarce in the literature. The aim of the present study is to investigate the psychological effects of high-risk pregnancies.

MATERIAL AND METHODS

The patients who had a history of severe preeclampsia, eclampsia or major hemorrhage during the peripartum period were enrolled as the study group and compared with the control subjects with respect to fear about new pregnancy, anxiety/ depression and post-traumatic stress disorder (PTSD) scores. The study was carried out by submitting a questionnaire form to the participants. Numbers of planned children before and after the last delivery were evaluated in both groups.

RESULTS

Fear about a new pregnancy was found to be significantly higher in the study group compared with the controls. There were no statistically significant difference between the two groups in terms of anxiety and depression. In terms of re-experience and avoidance in PTSD was significantly higher in the study group, however no significant difference was found for hyper-arousal.

CONCLUSION

Fear regarding new pregnancy is high and planning more children is decreased after high-risk pregnancies and PTSD symptom scores were higher after high-risk pregnancies.

Sleep quality and associated factors in ankylosing spondylitis: relationship with disease parameters, psychological status and quality of life

The aim of this study is to investigate sleep quality in patients with ankylosing spondylitis (AS) and to evaluate the relationship of the disease parameters with sleep disturbance. Eighty AS patients (60 males and 20 females) fulfilling the modified New York criteria, and 52 age- and gender-matched controls (33 males and 19 females) were enrolled in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Pain was measured by visual analogue scale. The disease activity and functional status were assessed by the Bath AS disease Activity Index and the Bath AS Functional Index. The Bath AS Metrology Index was used to evaluate mobility restrictions, and the Bath AS Radiology Index was employed to evaluate the radiological damage. The psychological status and quality of life were assessed with the hospital anxiety-depression scale and AS quality of life scale. The patients with AS had significantly more unfavourable scores in the subjective sleep quality, habitual sleep efficiency domains (p < 0.001) and the total PSQI score (p < 0.05). Poor sleep quality (total PSQI score) was positively correlated with increased pain, poor quality of life, higher depressed mood, higher disease activity and mobility restrictions. Pain was also an independent contributor to poorer sleep quality (p = 0.002). The sleep quality is disturbed in patients with AS. The lower quality of sleep is greatly associated with the pain, disease activity, depression, quality of life and increased limitation of mobility.

Mental health and quality of life in patients with chronic otitis media

The present study focused on the comparison of mental health and quality of life (QoL) between chronic otitis media (COM) patients and the hearing population. The patients with chronic otitis media and healthy control group were enrolled in the study. The duration and severity of the auditory impairment were recorded. In addition to hearing loss (HL), the findings of each patient's other ear disorders (ear discharge and tinnitus) were also recorded. In both the groups, psychological symptom profile and health-related QoL were evaluated and compared using a sociodemographic questionnaire, the Symptom Check List 90-Revised Form (SCL-90-R), and the Short Form-36 (SF-36). According to SCL-90-R, somatization (p < 0.001), interpersonal sensitivity (p < 0.001), depression (p < 0.001), phobic anxiety (p < 0.001), and other subscores, and also global severity index score (p < 0.001) were significantly high in patient group when compared to the control group. The patients with COM reported significantly lower levels of QoL in terms of physical role difficulty (p < 0.001), general health perception (p < 0.004), social functioning (p < 0.001), and mental health (p < 0.017) than those of control subjects. Our results indicated that COM patients with mild or moderate HL have poorer life quality and higher psychological problems. Psychological well being should be also considered in assessment of COM patients in addition to the clinical evaluation and audiological tests.

Relationship of the sexual functions with the clinical parameters, radiological scores and the quality of life in male patients with ankylosing spondylitis

The aim of this study was to explore the impact of ankylosing spondylitis (AS) and the disease-related variables on the patients' sexual function according to the International Index of Erectile Function (IIEF) scoring system. A total of 70 sexually active male AS patients and 60 healthy controls were enrolled in this study. Their demographic data were evaluated, and the pain was assessed according to the visual analogue scale (VAS). Laboratory tests were conducted in order to measure the C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) of the patients. The disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional statement was evaluated with the help of the Bath Ankylosing Spondylitis Functional Index (BASFI) and with the scores obtained from the spinal measurements with the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Bath Ankylosing Spondylitis Radiology Index (BASRI) was used to evaluate the radiological damage. The disease-related quality of life was measured with the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL). The anxiety and depression level of the patients was revealed through the Hospital Anxiety and Depression Scale (HADS). In comparison with the healthy control group, patients with AS had significantly lower scores in each of the 5 domains of the IIEF (p < 0.0001). The BASDAI, BASFI, BASMI, BASRI, ASQoL, HADS scores and CRP levels were negatively correlated with IIEF (p < 0.05). Orgasmic function and sexual desire scores were significantly lower in patients with peripheral arthritis (p < 0.05). No significant correlation was observed with the disease duration, smoking status, pain (VAS), and ESR levels when the total scores and the scores from the domains of IIEF were compared. The multivariate regression analyses indicated that BASFI and BASMI were independently associated with the sexual function. The sexual function is impaired in male patients with AS. This impairment in the sexual function is especially correlated with the BASFI and BASMI among the clinical and laboratory parameters.

Varenicline-induced psychotic depressive episode in a patient with bipolar disorder

Varenicline is a relatively novel medication for smoking cessation. Increased neuropsychiatric symptoms have been reported with its use and it is listed among drugs with a black box warning. History of a psychiatric diagnosis is suggested to be a vulnerability factor for the development of some psychiatric side effects with its use. However, empirical evidence to support this point is very limited. Here, we report the case of a bipolar patient who developed a depressive episode with psychotic features immediately after varenicline use. Clinicians should be careful about the varenicline-induced neuropsychiatric effects. Healthcare professionals can provide an important role in helping to prevent and manage worsening psychiatric symptoms.

Serum adiponectin and resistin levels in patients with obsessive compulsive disorder

We aimed to investigate the changes in serum adiponectin and resistin levels in patients with obsessive compulsive disorder and control groups. The serum adiponectin and resistin levels of 29 patients (16 females, 13 males) with obsessive compulsive disorder and weight, age and sex-matched 31 healthy controls (17 females, 14 males) were determined. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was applied to all groups. ELISA method was used to measure adiponectin and resistin levels. The mean adiponectin level was 11.92±2.04 ng/ml and resistin level was 13.23±2.78 ng/ml in obsessive compulsive disorder group, while it was 18.81±5.24 ng/ml and 8.17±2.53 ng/ml in control group. Changes in plasma adiponectin and resistin levels in obsessive compulsive disorder may have implications about possible cardiovascular and metabolic abnormalities seen in obsessive compulsive patients.