ISSN 1302-6631
 

Original Research (Original Article) 


Plasma allopregnanolone levels in drug-free, comorbidity-free obsessive-compulsive disorder

Lara Utku İnce, Lale Gönenir Erbay.

Abstract
Objective: Although there are studies in the literature focusing on the relationship between neurosteroids and psychiatric disorders, the studies on patients with obsessive-compulsive disorder (OCD) are limited in number. Nevertheless, allopregnanolone, a neurosteroid, in OCD patients has not been investigated in this limited number of studies. Allopregnanolone is considered to have a role in the pathogenesis of many psychiatric disorders. Accordingly, the present study aimed to investigate the relationship between the neurosteroid allopregnanolone and OCD. Methods: The study included 40 OCD patients diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria and 40 healthy control subjects. The study participants completed the Yale-Brown Obsessive Compulsive Scale. Taking the diurnal rhythm of neurosteroids into consideration, blood samples for determination of plasma allopregnanolone levels were obtained from all patients and controls between 09:00 and 10:00 in the morning after 12 hours of fasting, tobacco abstinence, and 30 minutes of resting period. Plasma allopregnanolone level was analyzed using the enzyme-linked immunosorbent assay (ELISA). Results: No significant difference was determined between the patient and control groups regarding serum allopregnanolone levels. Evaluation of the allopregnanolone levels of the patients for each obsession type according to its presence and absence revealed no significant difference in any of them. Evaluation of the allopregnanolone levels of the patients for each compulsion type according to its presence and absence revealed that the allopregnanolone level of the patients with counting-organizing compulsive behavior was lower than that of those without. Discussion: Although there was no difference between OCD patients and controls regarding plasma allopregnanolone level, it is difficult to make a conclusion that allopregnanolone level does not play a role in the etiopathogenesis of disease. Conducting further studies, which would analyze allopregnanolone level in materials other than plasma such as cerebrospinal fluid using multiple analyses and separately evaluates females and males with higher number of patients, is of importance to enlighten at least some aspects of allopregnanolone-OCD relationship. Moreover, significantly lower plasma allopregnanolone level particularly in a single type of compulsion brings in mind again the suggestion that different etiopathogenesis might have a role in the symptom subtypes of OCD, which has begun to be discussed in the recent years.

Key words: Obsessive-compulsive disorder, allopregnanolone, neurosteroids



İlaç kullanmayan ve eş tanısı olmayan obsesif kompulsif bozukluk hastalarında plasma allopregnanolon düzeyleri

Ozet
Amaç: Literatürde nörosteroid ve psikiyatrik bozuklukların ilişkisine yönelik çalışmalar olsa da, obsesif kompulsif bozukluk (OKB) hastalarında yapılmış az sayıda çalışma vardır. Çalışmalar incelendiğinde OKB hastalarında bir nörosteroid olan allopregnanolon düzeylerinin araştırılmadığı görülmektedir. Allopregnanolonun birçok psikiyatrik bozukluğun patogenezinde etkisinin olduğu düşünülmektedir. Biz de çalışmamızda bir nörosteroid olan allopregna-nolon ve OKB arasındaki ilişkiyi incelemeyi amaçladık. Çalışmamızın bulgularının bozukluğun etiyopatogenezinin aydınlatılmasına ışık tutacağını ve belki de bu konunun aydınlatılmasına katkıda bulunacak yeni çalışmalarla bera-ber potansiyel yeni tedavi hedefleri belirlenmesine katkı sağlayacağını düşünmekteyiz. Yöntem: Çalışmaya DSM-5 tanı ölçütlerine göre 40 OKB hastası ve 40 sağlıklı gönüllü alındı. Katılımcılara Beck Depresyon Ölçeği, Beck Anksiyete Değerlendirme Ölçeği ve Yale-Brown Obsesyon Kompulsiyon Değerlendirme Ölçeği uygulandı. Allopreg-nanolon için kan örnekleri hasta ve kontrol gruplarından nörosteroidlerin diurnal ritmi olduğu düşünülerek sabah 09:00-10:00 arasında, 12 saatlik açlık, tütün perhizi ve 30 dakikalık dinlenme sonrası alındı. Plasma allopregnano-lon düzeyi ELISA yöntemiyle analiz edildi. Bulgular: Allopregnanolon düzeyleri açısından gruplar arasında istatis-tiksel olarak anlamlı bir fark saptanmadı. OKB belirti alt tipleri kendi içinde incelendiğinde obsesyon türleri arasında allopregnanolon düzeyleri açısından anlamlı fark saptanmazken, kompulsiyon türlerinden sayma ve düzen kompul-siyonları olanlarda olmayanlara göre allopregnanolon düzeylerinin istatistiksel olarak anlamlı derecede düşük oldu-ğu görüldü. Tartışma: Çalışmamızda OKB hastaları ve kontrol grubu arasında allopregnanolon düzeyleri açısından fark gözlenmemiş olsa da, tam olarak bozukluğun etiyopatogenezine katılmadığını söylemek zordur. Erkek ve kadınların ayrı değerlendirildiği, daha fazla hasta ile, plazma dışında BOS gibi farklı materyallerden çoklu analizlerle yapılacak çalışmalar, allopregnanolon-OKB ilişkisinin bazı yönlerinin aydınlatılması açısından önemli görünmekte-dir. Ayrıca sayma-düzen kompulsiyonu olanlarda olmayanlara göre allopregnanolon düzeylerinin anlamlı derecede düşük olması bu konuda daha önce yapılan hayvan çalışmasını desteklemektedir. Ayrıca kompulsif belirtilerden sadece bir kompulsiyon tipinde anlamlı düşüklük gözlenmesi özellikle son yıllarda tartışılmaya başlanan OKB’nin belirti alt tiplerinde farklı etiyopatogenezlerin rolü olabileceği düşüncesini desteklemektedir.

Anahtar Kelimeler: Obsesif-kompulsif bozukluk, allopregnanolon, nörosteroid


 
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Pubmed Style

Lara Utku Ince, Lale Gonenir Erbay. Plasma allopregnanolone levels in drug-free, comorbidity-free obsessive-compulsive disorder. Anadolu Psikiyatri Derg. 2018; 19(5): 435-442. doi:10.5455/apd.283095


Web Style

Lara Utku Ince, Lale Gonenir Erbay. Plasma allopregnanolone levels in drug-free, comorbidity-free obsessive-compulsive disorder. http://www.anadolupsikiyatri.net/?mno=283095 [Access: December 11, 2018]. doi:10.5455/apd.283095


AMA (American Medical Association) Style

Lara Utku Ince, Lale Gonenir Erbay. Plasma allopregnanolone levels in drug-free, comorbidity-free obsessive-compulsive disorder. Anadolu Psikiyatri Derg. 2018; 19(5): 435-442. doi:10.5455/apd.283095



Vancouver/ICMJE Style

Lara Utku Ince, Lale Gonenir Erbay. Plasma allopregnanolone levels in drug-free, comorbidity-free obsessive-compulsive disorder. Anadolu Psikiyatri Derg. (2018), [cited December 11, 2018]; 19(5): 435-442. doi:10.5455/apd.283095



Harvard Style

Lara Utku Ince, Lale Gonenir Erbay (2018) Plasma allopregnanolone levels in drug-free, comorbidity-free obsessive-compulsive disorder. Anadolu Psikiyatri Derg, 19 (5), 435-442. doi:10.5455/apd.283095



Turabian Style

Lara Utku Ince, Lale Gonenir Erbay. 2018. Plasma allopregnanolone levels in drug-free, comorbidity-free obsessive-compulsive disorder. Anatolian Journal of Psychiatry, 19 (5), 435-442. doi:10.5455/apd.283095



Chicago Style

Lara Utku Ince, Lale Gonenir Erbay. "Plasma allopregnanolone levels in drug-free, comorbidity-free obsessive-compulsive disorder." Anatolian Journal of Psychiatry 19 (2018), 435-442. doi:10.5455/apd.283095



MLA (The Modern Language Association) Style

Lara Utku Ince, Lale Gonenir Erbay. "Plasma allopregnanolone levels in drug-free, comorbidity-free obsessive-compulsive disorder." Anatolian Journal of Psychiatry 19.5 (2018), 435-442. Print. doi:10.5455/apd.283095



APA (American Psychological Association) Style

Lara Utku Ince, Lale Gonenir Erbay (2018) Plasma allopregnanolone levels in drug-free, comorbidity-free obsessive-compulsive disorder. Anatolian Journal of Psychiatry, 19 (5), 435-442. doi:10.5455/apd.283095





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