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Yıl:2020; Cilt: 21; Sayı: 4>> Özet
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Anadolu Psikiyatri Dergisi; 2020;21(4):341-348
Karma belirtili olan ve olmayan unipolar depresyon hastalarında oksidatif stresin tiyol disülfit dengesi parametreleri ile değerlendirilmesi
ÇA Yıldızoğlu, Hİ Taş
Muş Devlet Hastanesi, Muş
Amaç: Unipolar depresyonda oksidatif stresi değerlendiren çalışmalar giderek artmaktadır. Bu çalışmada unipolar depresyonda ve unipolar depresyonun alt türü olan karma belirtili unipolar depresyonda oksidatif stres düzeylerinin dinamik tiyol/disülfit dengesi parametreleri ile değerlendirilmesi amaçlanmıştır. Yöntem: Çanakkale Onsekiz Mart Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı Psikiyatri Polikliniği’ne Nisan 2018-Eylül 2018 tarihleri arasında ardışık başvuran, DSM-5 tanı ölçütlerine göre unipolar depresif bozukluk tanısı konan, 18-65 yaşları arasında, çalışmaya katılmaya gönüllü 97 hasta ve yaş ve cinsiyet bakımından eşleştirilmişÌ§ 97 sağlıklı birey araştırmaya alınmıştır. Hastaların depresif ve hipomanik belirtilerini saptamak amacıyla Hamilton Depresyon Ölçeği (HDÖ) ve Değiştirilmiş Hipomani Kontrol Listesi (DHKL) uygulandı. Dinamik tiyol/disülfit dengesi parametreleri tüm katılımcı-lardan alınmış açlık kan örnekleri değerlendirilerek ölçüldü. Bulgular: Unipolar depresyon grubunda oksidasyon lehine disülfit düzeyi, total tiyol, oksidasyon redüksiyon oranı ve okside tiyol düzeyi istatistiksel olarak anlamlı düzey-de yüksek saptanmıştır (p<0.05). Antioksidan sistem lehine bulgu olan redükte tiyol düzeyi kontrol grubuna göre istatistiksel olarak anlamlı düzeyde düşük saptanmıştır (p<0.05). DSM-5 ve DHKL’ye göre unipolar depresyonun gidiş belirleyicilerinden olan karma belirtili depresyon ile karma belirtili olmayan unipolar depresyon arasında tiyol disülfit dengesi parametreleri arasında istatistiksel olarak anlamlı farklılık saptanmamıştır. Sonuç: Çalışmamızda artmış oksidasyon lehine olan dinamik tiyol/disülfit dengesi parametrelerinin tüm depresyon grubunda, kontrol grubuna göre anlamlı olarak yüksek olduğu bir kez daha gösterilmiştir. Karma belirtili depresyon grubu ile karma belirtili olmayan depresyon grubu arasındaki dinamik tiyol/disülfit dengesi parametreleri açısından anlamlı fark saptanmadı. Bu bulgu depresyonda oksidasyon lehine bozulan dengenin karma belirtili depresyonda depresyon gidiş belirleyicileri açısından anlamlı fark oluşturmayabileceğini göstermiştir. Oksidasyon dengesi açısından tüm depresyon gidiş belirleyicilerinin değerlendirildiği uzunlamasına yapılacak çalışmalar bu konuya ışık tutacaktır.
Evaluation of oxidative stress with thiol disulfide balance parameters in unipolar depression patients with and without mixed symptoms
Objective: Number of studies evaluating oxidative stress in unipolar depression are increasing. The aim of this study was to evaluate the scores of oxidative stress in unipolar depression patients and in mixed type of unipolar depression and to compare these scores with healthy subjects in terms of dynamic thiol/disulfide balance para-meters. Methods: Ninety-eight patients aged between 18 and 65 years with the diagnosis of unipolar depressive disorder diagnosed according to DSM-5 criteria and 97 age- and sex-matched 97 healthy individuals who applied to the Psychiatry Outpatient Clinic of Çanakkale Onsekiz Mart University Faculty of Medicine Psychiatry Department between April 2018 and September 2018 were included in the study. Hamilton Depression Rating Scale (HAM-Dand Modified Hypomania Checklist (M-HCL) were used respectively to determine depressive symptoms, manic symptoms and the severity of the disease. Oxidative stress parameters were measured by evaluating fasting blood samples taken from all participants. Results: In the unipolar depression group, the levels of disulfide, total thiol, oxidation-reduction and oxidized thiol levels were found to be statistically significant in favor of oxidation (p<0.05). Reduced thiol levels, which are favorable for the antioxidant system, were statistically lower than the control group (p<0.05). There was no statistically significant difference between the mixed featured depression as a specifier for unipolar depression and non-mixed featured unipolar depression in thiol-disulfide balance. Discussion: The studies to be carried out longitudinally in terms of the oxidation balance, in which all depression specifiers are evaluated, will shed more light on this subject. In our study, dynamic thiol/disulfide balance parameters in favor of increased oxidation were shown to be significantly higher in the depression group than the control group. There was no signi-ficant difference between the dynamic thiol/disulfide balance parameters between the mixed depression group and the non-mixed depression group. This finding showed that the balance deteriorated in favor of oxidation in depres-sion may not make a significant difference in terms of depression prognosis in mixed symptom depression. Long-term studies that assess all depression predictors in terms of oxidation balance will shed more light on this issue.

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