ObjectiveChronic inflammation is associated with cardiovascular (CV) risk factors and psychiatric disorders. The neutrophil to lymphocyte ratio (NLR) has been investigated as a new biomarker for systemic inflammatory response. The aim of the study is to investigate the relation of NLR with severity of depression and CV risk factors.MethodsThe study population consisted of 256 patients with depressive disorder. Patients were evaluated with the Hamilton Rating Scale for Depression (HAM-D). Patients were classified into four groups according to their HAM-D score such as mild, moderate, severe, and very severe depression. Patients were also evaluated in terms of CV risk factors.ResultsPatients with higher HAM-D score had significantly higher NLR levels compared to patients with lower HAM-D score. Correlation analysis revealed that severity of depression was associated with NLR in depressive patients (r=0.333, p<0.001). Patients with one or more CV risk factors have significantly higher NLR levels. Correlation analysis revealed that CV risk factors were associated with NLR in depressive patients (r=0.132, p=0.034). In logistic regression analyses, NLR levels were an independent predictor of severe or very severe depression (odds ratio: 3.02, 95% confidence interval: 1.867-4.884, p<0.001). A NLR of 1.57 or higher predicted severe or very severe depression with a sensitivity of 61.4% and specificity of 61.2%.ConclusionHigher HAM-D scores are associated with higher NLR levels in depressive patients. NLR more than 1.57 was an independent predictor of severe or very severe depression. A simple, cheap white blood cell count may give an idea about the severity of depression.
Koroner arter hastalığı olan hastalarda anksiyete ve depresyon Amaç: Önceki prospektif çalışmalarda depresyonun miyokardiyal enfarktüs ve kardiyovasküler mortalite için bağımsız bir risk faktörü olduğu bildirilmiştir. Anksiyete bozukluklarının da koroner arter hastalığı (KAH) ile ilişkili olduğu bilinmektedir. Psikolojik faktörler de sigara içme, azalmış fiziksel aktivite, kötü diyet ve tedaviye uyumun azalması gibi davranışsal mekanizmalar ile KAH seyrini etkileyebilmektedir. Bu çalışmanın amacı KAH şüphesiyle elektif olarak koroner anjiyografi yapılmak üzere kabul edilmiş hastalarda anksiyete ve depresyon düzeylerini araştırmak ve aterosklerotik risk faktörlerini saptamaktır. Yöntem: Çalışma örneklemi ardışık olarak elektif koroner anjiyografi yapılan 116 hastadan oluşmuştur. Bulgular iki majör grup olarak sınıflandırıldı: normal ve anormal koroner anjiyografi. Koroner arterlerinde aterosklerotik hastalık saptanan (%50 ya da daha fazla darlık) ve/veya koroner arterlerinde yavaş kan akımı olan hastaların anjiyografileri anormal olarak değerlendirilmiştir. Hastaların anksiyete ve depresyon düzeyleri özbildirime dayalı Beck Depresyon Envanteri, Beck Anksiyete Envanteri ve Spielberger'in Durumluluk-Süreklilik Anksiyete Envanteri kullanılarak ölçülmüştür. Bulgular: Altmışüç hastada (44 erkek, ortalama yaş: 52.2±11.1 yıl) anormal koroner anjiyografi bulgusu saptanmışken elli üç hastanın (40 erkek, ortalama yaş: 54.5±10.5 yıl) anjiyografisi normal olarak değerlendirilmiştir. Sosyodemografik özellikler ve aterosklerotik risk faktörleri her iki grupta benzerdi. Anormal koroner anjiyografi bulguları saptanan hastalar, normal bulgular saptanan hastalarla karşılaştırıldığında, anlamlı olarak daha yüksek depresyon ve anksiyete düzeylerine sahipti. Logistik regresyon analizinde sadece Beck Anksiyete Envanteri skorunun 15'den daha yüksek (odds ratio: 13.2, CI: 3.8-46.4) ve Durumluluk Anksiyete Envanteri skorunun 42'den yüksek olması (odds ratio: 4.9, CI: 1.7-14.2) koroner arter hastalığı için bağımsız belirleyicisidir. Sonuç: Her iki grup için kardiyovasküler risk faktörleri benzer iken koroner arter hastalığı ile depresyon ve anksiyete düzeyleri arasında anlamlı bir ilişkinin olabileceği gösterilmiştir.
Objective: Although it has been suggested that attention-deficit/hyperactivity disorder (ADHD) is common in children who were abused and that ADHD can be a risk factor for abuse itself, there are very few studies which investigated whether adult ADHD is associated with childhood abuse and neglect. The aim of this study was to fill this gap in the literature. Method: Seventy adults with DSM-IV ADHD diagnosis and 70 healthy control subjects were included in the study. We used Adult ADHD Self Rating Scale (ASRS) and Wender Utah Rating Scale (WURS) to support the diagnosis. All subjects were assessed using Childhood Trauma Questionnaire (CTQ), Adverse Childhood Experiences (ACE) Scale, Post-traumatic Stress Disorder Checklist (PCL), Dissociative Experiences Scale (DES), and Symptom Checklist-90-Revised. Results: ADHD subjects had higher ASRS inattentiveness, hyperactivity/impulsivity, WURS, and Symptoms Checklist-90 (SCL-90) General Symptom Index scores than controls. ADHD group also had higher PCL, DES and ACE scores. In CTQ, ADHD subjects had higher emotional abuse and neglect scores than control subjects. ASRS and WURS scores were correlated with PCL, ACE, CTQ Emotional Abuse, and DES scores; WURS score was also correlated with CTQ Physical Abuse and Neglect scores. Regression analysis indicated that general level of psychopathology was most significantly associated with DES and PCL scores. Conclusions: Results suggested that ADHD cases were more commonly exposed to emotional abuse and neglect. They had significantly more dissociative experiences and reported Posttraumatic Stress Disorder (PTSD) symptoms more frequently. The results pointed to the importance of childhood traumatic and adverse experiences in adults with ADHD. ARTICLE HISTORY
Objective. Noncardiac chest pain (NCCP) is seen more frequently in young population and in these patients loss of function is evolving in social and professional areas. The aim of the study is to evaluate the levels of anxiety and somatic perception in patients with chest pain presenting to cardiology clinic. Methods. Fifty-one patients with noncardiac chest pain and 51 healthy controls were included in the study. All participants performed self-report based health anxiety inventory (HAI), somatosensory amplification scale (SAS), and Toronto alexithymia scale (TAS). Results. The patient group had significantly higher scores on the SAS, HAI-1, and HAI-T scales compared to controls (P < 0.001, P = 0.006, and P = 0.038, resp.). SAS, HAI-1, and HAI-T scores were significantly higher in female patients than male (P = 0.002, 0.036, and 0.039, resp.). There were significant differences in all TAS subscale scores between two groups. Patients, who had total TAS score more than 50, also presented higher levels of health anxiety (P = 0.045). Conclusions. Anxiety, somatic symptoms, and the exaggerated sense of bodily sensations are common in patients with NCCP. These patients unnecessarily occupy the cardiology outpatient clinics. These negative results can be eliminated when consultation-liaison psychiatry evaluates these patients in collaboration with cardiology departments.
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