This study aims to assess the executive functions and depression status in patients with Behçet's disease without explicit neurological involvement and to evaluate cognitive functions in this group of patients independent of accompanying depression. In the present study, 30 patients with Behçet's disease in the non-active phase of their illness and 30 healthy volunteers were included. In the evaluation of depression levels, Beck Depression Inventory was employed. The executive functions of the patients were evaluated by Wisconsin Card Sorting Test (WCST) and Stroop Test (ST). Beck Depression Inventory scores measured in the Behçet's disease group, in which no clinically serious depression was observed, were higher than the control group. Then, it was observed that the scores of neuropsychological tests of the Behçet's disease group were found to be significantly lower, especially in WCST, while significant relations were revealed between Beck Depression Inventory scores and WCST, ST scores. The authors' findings suggest that there may be factors other than depression causing executive impairment in patients with Behçet's disease without explicit neurological symptoms. Executive dysfunctions may occur in association with mild depressive states due to chronic disease stress or silent and/or future neurological involvement of Behçet's disease, especially in the frontal lobes.
Nowadays, there is a widespread use of atypical (second-generation) antipsychotics as an adjunct pharmacotherapy in psychiatry clinics, especially at lower doses in several diagnoses. Here, 2 cases are reported where patients with diagnosed schizophrenia displayed manic symptoms on quetiapine 100 mg/d. The cases presented here had no history of mood disorders. It is discussed that the mania/hypomania may be associated with quetiapine treatment and defined as an adverse effect. Manic symptoms may be a 'probable adverse effect' according to the Naranjo adverse drug reactions probability scale, with a score of 6 points in both our cases. Several studies have suggested that quetiapine-induced mania/hypomania may be associated with frontal dopamine release via serotonin 5HT2A receptor blockade. Hence, clinicians should monitor the mood alterations of patients carefully during the atypical antipsychotic treatment. This is also the conclusion of our study as the patients may be slow metabolisers of CYP450-3A4, as suggested by their previous side effects on different antipsychotics.
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