Browsing by Author "Esen-Danaci A."
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Item Mirtazapine-induced arthralgia and coagulopathy: A case report [6](2005) Demet M.M.; Mizrak S.; Esen-Danaci A.[No abstract available]Item Venlafaxine in the treatment of depression in schizophrenia; [Şizofrenide depresyonun venlafaksinle saǧaltimi](2006) Esen-Danaci A.; Aydemir Ö.Objective: Depression in schizophrenia is associated with a poor outcome, an increased risk of relapse and a high rate of suicide therefore it must be treated carefully. Venlafaxine is a dual-action serotonin and noradrenergic reuptake inhibitor and is effective in treating depressive patients. Method: In this study the efficacy and tolerability of venlafaxine is evaluated in 8 schizophrenic patients with depression who used venlafaxine adjunctive to atypical antipsychotics. Results: The patients were assessed with Calgary Depression Scale for Schizophrenia (CDSS), Scale for the Assessment of Positive and Negative Symptoms (SAPS and SANS) at the beginning, 4th week and 8th week. At the end of 8th week of treatment, 2 patients were fully remitted, the other 4 patients showed 80-90% improvement. Total SAPS scores dropped 2 points whereas SANS scores were dropped by 25%. No patients had an adverse event leading to an intervention. Conclusion: Venlafaxine may be an effective and safe alternative in the treatment of depression in schizophrenia.Item Serum brain-derived neurotrophic factor level in dysthymia: A comparative study with major depressive disorder(Elsevier Inc., 2007) Aydemir Ö.; Deveci A.; Taskin O.E.; Taneli F.; Esen-Danaci A.In this present work, it is aimed to demonstrate BDNF serum concentrations in patients with dysthymia and to compare them with BDNF serum concentrations in patients with major depressive disorder and healthy subjects. The study was carried out in Celal Bayar University Hospital, Manisa, Turkey. Seventeen patients with dysthymia, 24 patients with major depressive disorder and 26 subjects without any psychiatric diagnosis and any psychiatric treatment were included in the study. The severity of depression was assessed with 17-item HAM-D. All subjects were asked to give their written consent. Blood samples were collected at baseline. Serum BDNF was kept at - 70 °C before testing, and assayed with an ELISA Kit (Promega; Madison, WI, USA), after dilution with the Block and Sample solution provided with the kit. The data were subjected to the analysis of variance. The BDNF serum concentrations of the dysthymia group (mean = 28.9 ± 9.2 ng/ml) were significantly higher than that of the major depressive disorder group (21.2 ± 11.3 ng/ml) (p = 0.002), and it was not different from the level of the control group (31.4 ± 8.8 ng/ml). BDNF serum concentrations and HAM-D score did not have any significant correlation in the dysthymia and major depression groups (r = - 0.276, p = 0.086). The low level of BDNF in patients with dysthymic disorder seems to point out that BDNF changes in mood disorders are state-dependent and vary according to the severity of depressive episodes. © 2007 Elsevier Inc. All rights reserved.Item Serum brain-derived neurotrophic factor levels in conversion disorder: Comparative study with depression(2007) Deveci A.; Aydemir O.; Taskin O.; Taneli F.; Esen-Danaci A.The aim of the present study was to compare serum brain-derived neurotrophic factor (BDNF) levels of patients with major depressive disorder (MDD) and conversion disorder (CD). Serum BDNF levels were measured in the following three groups: 15 CD patients without any comorbid diagnosis of psychiatric disorder, 24 patients with MDD, and 26 healthy subjects without any psychiatric diagnosis or psychiatric treatment. The serum BDNF level of the healthy control group (31.4 ± 8.8 ng/mL) was statistically higher than the level of the MDD group (21.2 ± 11.3 ng/mL) and the CD group (24.3 ± 9.0 ng/mL; P = 0.008). This suggests that BDNF level may play a similar role in the pathophysiology of MDD and CD. © 2007 The Authors.Item The effect of the family history of diabetes on glucose metabolism of the patients recieving atypical antipsychotics; [Atipik antipsikotik kullanan hastalarda ailede diyabet öykü sü olmasinin glukoz metabolizmasi üzerine olan etkisi](2007) Yurtsever F.; Esen-Danaci A.; Taneli F.; Günay Ö.; Veznedaroǧlu B.Objective: Diabetes is observed 2-3 times more frequently in schizophrenic patients with comparison to the general population. Recently, many publications have reported diabetes related to atypical antipsychotics. Risk factors such as age, ethnicity, overweight, duration of obesity, physical activity, and family history of diabetes seem to help development of diabetes. This study aims to investigate how the glucose metabolism is affected from familial history of diabetes which is a risk factor for the disease. Method: Seventy patients who have a diagnosis of schizophrenia or other psychotic disorders and are treated with atypical antipsychotics for at least one year were recruited for the study. The patients were divided into two groups defined as those with or without a family history of diabetes. In order to evaluate the glucose metabolism fasting blood glucose, oral glucose tolerance, blood insuline, c-peptide, hemoglobine A1c, leptin and ghrelin levels were measured. Results: The results of the comparison of fasting blood glucose, oral glucose tolerance, blood insuline, c-peptide, hemoglobine A1c, leptin and ghrelin levels between two patient groups with and without family history of diabetesonly ghrelin levels were found to be statistically higher in the group of patients with a history of diabetes in their family; no other parameters have statistically significant differencesbetween two groups. Conclusion: Having a family history of diabetes may increase the probabality of disturbance in glucose metabolism of the patients receiving atypical antipsychotics. It would be reasonable to evaluate the risk factors prior to the treatment and routinely review the parameters required to evaluate the metabolic side effects in clinical follow-ups.Item Mechanism of diabetes related to atypical antipsychotics; [Atipik antipsikotiklere baǧli geliflen diyabetin mekanizmasi](2007) Yurtsever F.; Esen-Danaci A.; Deveci A.New researches and case reports have revealed that diabetes incidence is higher in patients treated with new generation antipsychotics. The incidence of diabetes is 2-3 fold in schizophrenic patients compared to normal population. It is confuses that the use of new generation antipsychotics increases the risk of diabetes and cardiovascular diseases related to it. With the use of new generation antipsycotics onset age of diabetes went under 40 years in patients with schizophrenia. Even though the mechanism of diabetes caused by new generation antipsychotics is unclear some hypotheses include mechanisms related with dopamine receptor antagonism, increase in body weight, histamine 1 and 5-HT2A or 5-HT2C receptor antagonism, increase in serum leptin, insulin resistance and direct effects on pancreas. We reviewed the evidence regarding the diabetogenic effects of new generation antipsychotics and possible underlying mechanisms of this effect.Item Homocystinuria and early onset schizophrenia: A case report; [Homosistinüri ve erken başlangiçli şizofreni: Olgu sunumu](2008) Taş C.; Esen-Danaci A.Although schizophrenia is known as a late adolescence or early adulthood disorder psychotic symptoms can be seen in children. Schizophrenia which begins before 17-18 years of age is named as "early onset schizophrenia" and before age of 13 is named as "very early onset schizophrenia". Studies on organic etiology of schizophrenia were increased after the description of early onset schizophrenia. It was determined that cerebral trauma, infections, demyelinization diseases, endocrinopathies, systemic diseases, vitamin deficiencies, drugs, epilepsy, sex chromosome abnormalities, and diseases with Mendelian inheritance can cause clinical symptoms like schizophrenia. In this article a homocystinuria case which was diagnosed as early onset schizophrenia according to its onset is presented.Item Effects of second generation antipsychotics on leptin and ghrelin(2008) Esen-Danaci A.; Sarandöl A.; Taneli F.; Yurtsever F.; Özlen N.Background: Weight gain is a major side effect of antipsychotic treatment. Some atypical antipsychotic agents have profound effects on weight. Body weight is regulated by a complex system, including both peripheral and central factors. Two of the hormones that seem to play an important role in the regulation of food intake, energy metabolism, and body weight are leptin and ghrelin. Leptin is a mediator of long-term regulation of energy balance, suppressing food intake and thereby inducing weight loss. Ghrelin on the other hand is a fast-acting hormone, seemingly playing a role in meal initiation. In this present study it is aimed to compare the effects of five different atypical antipsychotic medications on leptin and ghrelin. Method: 112 patients who were treated either with clozapine (n = 20), olanzapine (n = 28), risperidone (n = 22), quetiapine (n = 20) or amisulpride (n = 22) as monotherapy for at least one year and age, gender, and body mass index (BMI) matched control group (n = 23) were assessed cross-sectionally. Ghrelin and leptin levels were measured with enzyme-immunoassay. Results: When fasting serum leptin levels were compared between groups, control group had the highest mean value (9.2 ± 6.7) and amisulpride group had the lowest mean value (3.7 ± 2.1) but still there was no statistically significant difference between six groups (F = 1993, p = 0.084). In the comparison of the mean values of fasting serum ghrelin levels there was a statistically significant difference between groups (F = 11,473, p = 0.00). In post-hoc analysis it was seen that the control group had the lowest ghrelin level (194.5 ± 86.8). Quetiapine treated group (378.1 ± 260.4) had similar fasting serum ghrelin levels to control group. All the other antipsychotic treatment groups had significantly higher levels of fasting serum ghrelin compared to control group, highest in amisulpride treated group (597.0 ± 150.0). Conclusion: The weight-gain side effect of atypical antipsychotics can be related with the orexigenic effect of elevated serum ghrelin rather than leptin deficit. Among the five widely used atypical antipsychotics quetiapine is the only one which does not elevate the ghrelin level. © 2008 Elsevier Inc. All rights reserved.Item Serum BDNF levels in suicide attempters related to psychosocial stressors: A comparative study with depression(2008) Deveci A.; Aydemir O.; Taskin O.; Taneli F.; Esen-Danaci A.Although many studies have examined the neurobiological aspects of suicide, the molecular mechanisms and pathophysiologic mechanisms associated with suicide remain unclear. In this study, it is aimed to investigate whether there is a difference in serum brain-derived neurotrophic factor (BDNF) levels among suicide attempters without a major psychiatric disorder, compared to major depressive disorder patients and healthy subjects. It was undertaken with the hypothesis that suicide per se lowers serum BDNF levels, since it is a source of stress. The study was carried out in Celal Bayar University Hospital, Manisa, Turkey. Ten suicide attempters, 24 patients with major depressive disorder and 26 subjects without any psychiatric diagnosis and any psychiatric treatment were included in the study. All subjects were asked to give their written consent. Blood samples were collected at the baseline. Serum BDNF was kept at -70°C before testing, and assayed with an ELISA kit (Promega; Madison, Wisc., USA) after dilution with the block and sample solution provided with the kit. The data were subjected to the Kruskal-Wallis test for nonparametric analysis of variance. Mean serum BDNF levels were significantly lower in the suicide group (21.2 ± 12.4 ng/ml) and the major depressive disorder group (21.2 ± 11.3 ng/ml) than the control group (31.4 ± 8.8 ng/ml; p = 0.004). These results suggest that BDNF may play an important role in the neurobiology of suicidal behavior. BDNF levels may be a biological marker for suicidal behavior. To investigate the role of BDNF in suicide, further studies with a wider sample size and a variety of psychiatric diagnoses accompanying suicide attempt are needed. Copyright © 2007 S. Karger AG.Item The validation of Turkish version of personal and social performance scale (PSP); [Bireysel ve sosyal performans ölçeǧi'nin Türkçe sürümünün geçerlilik ve güvenilirlik çalişmasi](2009) Aydemir Ö.; Üçok A.; Esen-Danaci A.; Canpolat T.; Karadayi G.; Emiroǧlu B.; Sariöz F.Objective: Functioning in severe mental disorders is very important and brief functioning rating instruments are needed. Even though patients with severe psychiatric disorders achieve symptomatic recovery, most of them cannot return to their initial level of social functioning. Personal and Social Performance Scale (PSP) is one of the instruments which can be used in severe mental disorders such as schizophrenia and takes a short time to complete. Methods: The study was performed in departments of psychiatry of two university hospitals. In- or out-patients diagnosed with schizophrenia or bipolar disorders were included in the study. The exclusion criteria were comorbidity of other psychiatric disorders including substance use disorders or of physical diseases. For concurrent validity, beside PSP, Clinical Global Impression (CGI), Global Assessment of Functioning (GAF) of DSM-IV, Quality of Life and Satisfaction Questionnaire (QLS-Q), and Positive and Negative Syndrome Scale (PANSS) were used. For discriminant validity, the mean scores of PSP in patients with and without symptomatic remission were compared. Results: The study was carried out with a total of 135 patients, 105 (77.8%) patients diagnosed with schizophrenia and 30 (22.2%) patients diagnosed with bipolar disorder. The mean age of the patients was 34.1±10.7 and 75 (55.6%) of them were male. The duration of illness was 10.4±7.5 years. The mean score of PSP was found to be 60.0±17.1. In the reliability analysis, the Cronbach alpha coefficient was calculated to be 0.8327, and item-total score correlations were found to be between 0.4920-0.7462. Intraclass correlation coefficient was calculated to be 0.8324. The inter-rater reliability of PSP performed on 30 schizophrenic patients was found to be 0.973 (p<0.0001). In the validity analyses, the total score of PSP was significantly correlated with the total score of Clinical Global Impression (CGI) (r=-0.854, p<0.0001), Global Assessment of Functioning (GAF) (r=0.748, p<0.0001), Quality of Life and Satisfaction Questionnaire (QLS-Q) (r=0.734, p<0.0001), and Positive and Negative Syndrome Scale (PANSS) (r=-0.664, p<0.0001). There was a significant difference between the patients with and without symptomatic remission (54.8±14.8 vs. 72.6±9.8, t=7.434, p<0.0001). Conclusion: The Turkish version of PSP was found to be reliable and valid in severe mental disorders and was sensitive to change. It can be used both in clinical trials and routine clinical practice.Item Serum brain-derived neurotrophic factor (BDNF) levels in schizophrenic patients with depressive sypmptoms: A preliminary study(2009) Esen-Danaci A.; Aydemir Ö.; Deveci A.; Taneli F.; Taşkin O.Objectives: Evidence from clinical, pharmacological and animal studies, have led to neurodevelopment, neurodegeneration, and dopamine hypotheses, and to the investigation of BDNF as a potential candidate molecule in the pathophysiology of schizophrenia. The aim of this study is to investigate the BNDF levels of schizophrenic patients with depression and compare them with major depression patients and controls in order to understand the nature of depressive symptoms seen in schizophrenia. Methods: The BDNF levels of eight schizophrenic patients with depressive symptomatology (SD) were compared with two control groups. The first group consisted of major depressed patients (MDD) (n=24) and the second was the healthy control group (n=26). Results: SD group had BDNF levels similar to control group and MDD group had significantly lower levels than the other two groups. Conclusion: This difference of BDNF levels between schizophrenia with depression group and major depression group supports the hypothesis of distinct etiologies.Item Intrinsic motivation and metacognition as predictors of learning potential in patients with remitted schizophrenia(Elsevier Ltd, 2012) Tas C.; Brown E.C.; Esen-Danaci A.; Lysaker P.H.; Brüne M.Background: Previous research has suggested that neurocognitive functioning predicts best the potential of patients with schizophrenia to acquire newly learned material, which, in turn may impact patients' social functioning. Recent studies have also shown that intrinsic motivation and metacognitive abilities play a decisive role in social functioning in schizophrenia. Accordingly, the present study sought to examine the relationship between intelligence, motivation, metacognition, and learning during a cognitive remediation experimental training. We hypothesized that metacognition and intrinsic motivation would have a strong relationship and independently predict learning potential. Method: Thirty-two patients with schizophrenia who fulfilled the criteria of functional remission were recruited. In a pre-training-post experimental design, patients' learning potential was assessed using previously defined cognitive remediation training for WCST. Intrinsic motivation was examined using Intrinsic Motivation Inventory for schizophrenia; mastery, a domain of metacognition, was measured using the Metacognitive Assessment Scale. Results: Metacognition significantly correlated with subdomains of intrinsic motivation. Patients with higher intrinsic motivation and preserved metacognition improved more in the learning paradigm compared to poorly motivated patients and patients with reduced metacognitive abilities. In particular, " mastery" was determined as an independent predictor of learning potential. Conclusions: Motivation and metacognition are important predictors of learning in schizophrenia. Psychological interventions in schizophrenia may therefore consider incorporating techniques to stimulate metacognitive and motivational abilities as well as developing individualized training programs. © 2012 Elsevier Ltd.Item Oxidative stress in schizophrenia: A case-control study on the effects on social cognition and neurocognition(BioMed Central Ltd., 2014) Gonzalez-Liencres C.; Tas C.; Brown E.C.; Erdin S.; Onur E.; Cubukcoglu Z.; Aydemir O.; Esen-Danaci A.; Brüne M.Background: Schizophrenia is a debilitating mental disorder that presents impairments in neurocognition and social cognition. Several studies have suggested that the etiology of schizophrenia can be partly explained by oxidative stress. However, our knowledge about the implications of oxidative stress on illness-related cognitive deficits is still far from being clear. The aim of this work was to study the role of oxidative stress molecules on social cognition and neurocognition in patients with schizophrenia.Methods: We assessed the peripheral levels of several molecules associated with oxidative stress, namely nitric oxide (NO), malondialdehyde (MDA), glutathione (GSH), homocysteine, superoxide dismutase (SOD) and neurotrophin 4/5 (NT4/5), in forty-one patients with schizophrenia and forty-three healthy participants. A battery of tests to measure neurocognition and social cognition was also administered to the schizophrenia group.Results: We found that the schizophrenia group presented substantially higher levels of oxidative stress than the control group, as revealed by elevated quantities of the pro-oxidants NO and MDA, and decreased levels of the antioxidants GSH, SOD and NT4/5. Interestingly, the levels of NT4/5, which have been shown to have antioxidant effects, correlated with executive functioning, as measured by two distinct tests (WCST and TMT). However, social cognition and symptom severity were not found to be associated with oxidative stress.Conclusions: We propose a protective role of NT4/5 against oxidative stress, which appears to have a potentially beneficial impact on neurocognition in schizophrenia. © 2014 Gonzalez-Liencres et al.; licensee BioMed Central Ltd.Item Social approach and avoidance behaviour for negative emotions is modulated by endogenous oxytocin and paranoia in schizophrenia(Elsevier Ireland Ltd, 2014) Brown E.C.; Tas C.; Kuzu D.; Esen-Danaci A.; Roelofs K.; Brüne M.Patients with schizophrenia suffer from dysfunctional social behaviour. Social approach and avoidance (AA) has been associated with motor responses, as the affective valence and gaze direction of facial stimuli can bias push and pull motor tendencies. The aim of this study was to investigate the role of endogenous oxytocin in social AA behaviour in schizophrenia. Basal plasma oxytocin levels were collected from 28 patients who were then given a joystick-based Approach-Avoidance Task (AAT). Reaction times were recorded and AAT effect scores calculated for responses to happy and angry faces, which either had direct or averted gaze. Individual differences in basal oxytocin had a significant relationship with AAT responses, and patients with higher levels of oxytocin tended to avoid angry faces more. Furthermore, greater avoidance of angry faces was correlated with more severe psychotic (positive and general) symptoms and greater paranoia. This suggests that the endogenous effects of oxytocin may be specific to the interpretation of negative threatening emotions in schizophrenia patients, and also provides evidence that psychotic symptoms and paranoia can impact on social AA behaviour by heightening threat avoidance. © 2014 Elsevier Ireland Ltd.Item A closer look at the relationship between the subdomains of social functioning, social cognition and symptomatology in clinically stable patients with schizophrenia(2014) Brown E.C.; Tas C.; Can H.; Esen-Danaci A.; Brüne M.Impairments in social functioning commonly seen in schizophrenia are thought to be mediated by deficits in the domains of social cognition. Some previous research has explored how social cognitive skills and psychotic symptoms are associated with social functioning, however these associations are still under debate. The main aim of this study was to investigate the relationship between different domains of social cognition and psychotic symptomatology, and also to look at the relationships with individual subdomains of social functioning within a clinically stable schizophrenia population. 45 outpatients were recruited and symptoms were assessed with the PANSS, and measures of emotion processing, affective and cognitive theory of mind (ToM), mental state reasoning attributional biases, and social functioning were taken. A correlational analysis was performed with the data. Following this, a regression analysis was used to reveal which domains of social cognition best predicted psychotic symptoms. In this stable group of patients, our results support the suggestion of a likely distinction between affective and cognitive components of ToM. The study also demonstrated that ToM and mental state reasoning were the best predictors of psychotic symptoms. Here we reveal that cognitive ToM had the most widespread relationship with social functioning, across multiple subdomains, while only some specific subdomains of social functioning correlated with other domains of social cognition and symptomatology. Further to this, positive symptoms were associated with much fewer subdomains of social functioning than negative and general symptoms. These findings imply that different aspects of social functioning may be served by different domains of social cognition and symptomatology. © 2014 Elsevier Inc.Item Cortisol response to stress in schizophrenia: Associations with oxytocin, social support and social functioning(Elsevier Ireland Ltd, 2018) Tas C.; Brown E.C.; Eskikurt G.; Irmak S.; Aydın O.; Esen-Danaci A.; Brüne M.Previous studies reported attenuated cortisol reactivity as one explanation for poor social functioning in schizophrenia. Recent research has demonstrated that both glucocorticoid and oxytocin systems are central to stress regulation. Here, we studied the associations between basal oxytocin, stress-induced cortisol levels, and social functioning and social support in schizophrenia. A mock job interview was used as an ecologically-valid social stressor in 32 schizophrenia patients. Blood samples were taken before and after stress induction to assess basal oxytocin and cortisol levels. In addition social functioning and social support scales were collected. Patients were divided into cortisol responders and non-responders according to percentage change following stress induction. Our findings revealed a possible subgroup of patients who did not exhibit attenuated cortisol responses. Importantly, cortisol responders had generally better social functioning, but perceived social support was not different between groups. There was also no evidence of a relationship between cortisol and oxytocin. This study highlights the heterogeneity of cortisol responses to stress in a schizophrenia population, and the importance of the relationship between social functioning and cortisol reactivity. These findings could be relevant when considering therapeutic interventions that manipulate endocrinology in order to improve real-world functioning. © 2018 Elsevier B.V.