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    2D:4D ratio, alexithymia, impulsivity, aggression, and ADHD in men with opioid and methamphetamine use disorders: A comparative analysis with healthy controls
    (Elsevier Ireland Ltd, 2024) Akkuş, Merve; Aydoğan Avşar, Pınar
    Substance use disorder is an important mental health problem with increasing frequency. This study aims to investigate the 2D:4D ratio, Dr-I values (right-left differences), alexithymia, aggression, impulsivity, and attention deficit hyperactivity disorder (ADHD) symptoms in male patients with methamphetamine use disorder (MUD), opioid use disorder (OUD), and healthy controls. The study included a total of 57 male patients diagnosed with OUD, 42 male patients diagnosed with MUD, and 72 healthy male controls. The study indicated that the OUD and MUD patients were significantly different from the healthy controls in terms of the 2D:4D ratio, alexithymia, impulsivity, aggression, and ADHD. Compared to healthy controls, 2D:4D ratios, and Dr-I values were lower in OUD and MUD patients. OUD and MUD patients had higher scores of alexithymia, impulsivity, aggression, and ADHD compared to healthy controls. There were statistically significant negative correlations between the right-hand 2D:4D ratios and the ADHD, impulsivity, alexithymia and aggression scores and a significant negative correlation between Dr-I scores and the impulsivity scores of MUD and OUD patients. These findings contribute to the existing literature examining the complex relationship between prenatal testosterone exposure, substance use disorders and related psychological traits. © 2024 Elsevier B.V.
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    Anksiyete Duyarlılığı ve Sosyal Anksiyete Semptomları Arasındaki Bağlantı: Aracı Faktör Olarak Bilişsel Esneklik
    (Alanya Alaaddin Keykubat University, 2025) Özdemir, Çağla; Akkuş, Merve
    Amaç: Bu çalışmanın amacı, sosyal anksiyete belirtileri ile anksiyete duyarlılığı arasındaki ilişkiyi ve bilişsel esnekliğin aracı rolünü araştırmaktır. Yöntem: Çalışmaya psikiyatrik takip ve tedavi öyküsü olmayan, 18-35 yaş aralığında toplam 552 kişi dahil edildi. Katılımcılara sosyodemografik veri formu, Liebowitz Sosyal Anksiyete Ölçeği, Anksiyete Duyarlılığı İndeksi-3 ve Bilişsel Esneklik Envanteri uygulandı. Bulgular: Kadın katılımcılarda sosyal anksiyete puanlarının (86.11 ± 23.50) erkeklere kıyasla (79.43 ± 26.10) anlamlı derecede yüksek olduğu belirlenmiştir (p < 0.001).Sosyal anksiyete belirtileri ile anksiyete duyarlılığı ve alt ölçekleri arasında pozitif (p < 0.001), bilişsel esneklik (p < 0.001) ile negatif ilişki bulunmuştur. Aracılık analizi sonuçlarına göre, bilişsel esneklik, anksiyete duyarlılığının sosyal anksiyete belirtileri üzerindeki toplam etkisinin %13’üne aracılık etmektedir. Sonuç: Çalışmanın bulguları, sosyal anksiyete belirtileri ile anksiyete duyarlılığı arasındaki güçlü ilişkiye dikkat çekmekte ve bilişsel esnekliğin bu süreçte önemli bir aracı mekanizma olabileceğini göstermektedir. Bu doğrultuda, sosyal anksiyete tedavisinde bilişsel esnekliği artırmaya yönelik müdahalelerin faydalı olabileceği düşünülmektedir.
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    Relationship between serum oxidative stress and blood brain barrier parameters in patients with major depression
    (Elsevier Ltd, 2025) Solak, Hatice; Akkuş, Merve; Aydoğan Avşar, Pınar
    Objective: Research emphasises the critical role of blood-brain barrier (BBB) integrity in psychiatric disorders. This study aimed to investigate the relationship between serum Zonula occludens protein - 1 (ZO-1) and serum occludin levels, which are blood brain barrier markers, and serum oxLDL levels, which are known to be associated with oxidative stress and inflammation, in patients with major depression. Methods: The study included 44 drug-naïve patients diagnosed with Major Depressive Disorder (MDD) and 48 healthy controls matched for Body Mass Index (BMI), gender, age. Laboratory data, together with concentrations of Ox-LDL, Occludin, ZO-1, were evaluated. The Hamilton Depression Rating Scale (HADRS) was employed to evaluate the severity of depression in the major depression cohort. Result: Compared to healthy controls, patients with major depression exhibited significantly lower serum levels of ZO-1 (p = 0.001) and occludin (p = 0.001), while oxLDL levels were significantly higher (p = 0.001). The differences maintained as significant after corrections for age, sex, smoking, and BMI via ANCOVA (all p = 0.001). A positive correlation was identified between ZO-1 and occludin levels (r = .400, p = 0.001), whereas a negative correlation was found between ZO-1 and oxLDL levels (r = ?.369, p = 0.001). Conclusion: This study's findings indicate that serum oxLDL levels, related with oxidative stress and inflammation in the pathogenesis of MDD, may influence the alteration of serum ZO-1 and occludin levels, recognised as indicators of the BBB. © 2025 Elsevier Ltd
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    Serum ZO-1 and occludin levels in bipolar disorder patients
    (Springer Science and Business Media Deutschland GmbH, 2025) Aydoğan Avşar, Pınar; Akkuş, Merve
    Bipolar disorder is a mental illness with a complex and multidimensional etiology. The blood-brain barrier (BBB) is a semi-permeable barrier between the central nervous system (CNS) and peripheral circulation that protects the CNS from external threats. The healthy functioning of the BBB is ensured by tight junctions (TJs) between cells. This research aims to investigate the serum levels of TJ proteins occludin and zonula occludens-1 protein (ZO-1) in bipolar disorder to elucidate etiopathogenesis. This study included 40 BD patients (20 manic episodes, 20 euthymic episodes) and 40 healthy controls. Serum occludin and ZO-1 values were obtained and compared between the two groups. The serum occludin and ZO-1 levels were significantly higher in the bipolar disorder patients. The analysis of covariance (ANCOVA) revealed a significant main effect of groups in the serum occludin and ZO-1 levels and an effect that was independent of age, gender, BMI, and smoking.BBB disruption and neuroinflammation may play a role in bipolar disorder etiopathogenesis. Occludin and ZO-1 may serve as potential biomarkers for BBB leakage in bipolar disorder. Further research may lead to additional pharmacological therapies targeting BBB for drug-resistant bipolar disorder patients. © Springer-Verlag GmbH Germany, part of Springer Nature 2025.
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    The Relationship of Serum Uric Acid, Serum Uric Acid Creatinine Ratios With Disease Severity and Metabolic Syndrome in Schizophrenia Patients
    (Alanya Alaaddin Keykubat Üniversitesi, 2024) Akkuş, Merve; Karataş, Kader Semra; Gökçen, Onur; Dönmez, Feyza; Özdemir, Çağla
    Aim: The objective of this research was to examine the association between serum uric acid (SUA) and serum uric acid/creatinine ratio (SUA/Cre), disease severity and metabolic syndrome in schizophrenia with a multifaceted etiopathogenesis. Methods: The study comprised 240 participants in total, 120 of whom were healthy controls and 120 of whom were schizophrenia patients. Sociodemographic, clinical and laboratory data was collected and metabolic syndrome was assessed according to the established criteria. SUA and creatinine levels were measured and the SUA/Cre ratio was calculated. The severity of the disease was evaluated utilizing the Positive and Negative Syndrome Scale (PANSS). Statistical analyses were conducted to ascertain correlations and associations. Results: SUA levels and SUA/Cre ratio higher in schizophrenia patients than controls (p=0.14, p=0.010, respectively). SUA/Cre ratio was positively correlated with PANSS negative score (r=0.266, p=0.03). SUA levels were elevated in individuals diagnosed with schizophrenia who also had metabolic syndrome, in comparison to those who did not have metabolic syndrome (p=0.009). Linear regression analyses showed that the association between SUA levels and SUA/Cre ratio and schizophrenia persisted when the effects of gender, age, metabolic syndrome, BMI and smoking were fixed. Conclusions: This study highlights the association of SUA and SUA/Cre ratio with disease severity and metabolic syndrome among individuals diagnosed with schizophrenia.
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    ZO-1 Serum Levels as a Potential Biomarker for Psychotic Disorder
    (Lippincott Williams and Wilkins, 2024) Aydoğan Avşar, Pınar; Akkuş, Merve
    Objective There are limited studies in the literature on the relationship between intestinal and blood-brain barrier permeability and the etiology of schizophrenia. We hypothesized that the difference in serum ZO-1 levels in patients with schizophrenia may affect the severity of the disease. The aim of this study was to investigate the role of changes in serum ZO-1 concentrations in the etiopathogenesis of patients with schizophrenia. Methods A total of 46 patients, 34 with schizophrenia, 12 with a first psychotic attack, and 37 healthy controls, were included in the study. Symptom severity was determined by applying the Positive and Negative Syndrome Scale and the Clinical Global Impression-Severity Scale. Serum ZO-1 levels were measured from venous blood samples. Results Serum ZO-1 levels were higher in patients with psychotic disorder compared to healthy controls. There was no statistically significant difference between the groups in the first psychotic attack group and the schizophrenia patients. There was a statistically significant positive correlation between serum ZO-1 levels and Positive and Negative Syndrome Scale positive symptom score. Conclusions These findings regarding ZO-1 levels suggest that dysregulation of the blood-brain barrier in psychotic disorder may play a role in the etiology of the disorder. © Wolters Kluwer Health, Inc. All rights reserved.