The high comorbidity of depression in patients with diabetes mellitus type 2 has been established.

The association between Obsessive Compulsive Disorder (OCD) and diabetes mellitus type 2 is poorly understood.

The aim of the present study was to assess the degree in which diabetes mellitus type 2 is accompanied by OCD.

131 diabetic patients, 55 female and 76 male were randomly enrolled and during the first assessment was administered in all participants the Zung Self Rating Scale (ZUNG) and the Maudsley O-C Inventory Questionnaire (MOCI). After one year, while an intensive effort to improve the patients’ metabolic profile was performed, the diabetic patients that were initially uncontrolled (n = 31) were re-evaluated by the same psychometric tools. From those 31 patients 10 had managed to control their metabolic profile.

MOCI and the sub-scale of slowness are statistically related with the diabetic profile (controlled-uncontrolled), with uncontrolled patients scoring significantly higher on the overall MOCI score and the factor of slowness of MOCI scale (p = 0.028). Regarding the association between the values of Glycosylated Haemoglobin (HbA1c) and the scores of MOCI it was found that they were significantly positively correlated in overall scores (p = 0,028) and in the subscale of slowness (p = 0,028). The analysis revealed a positive association between depression (p = 0.004) and obsessive compulsive disorder symptomatology (p < 0.001) and thepatient’s metabolic profile.

Diabetes mellitus type 2 is associated with obsessive compulsive disorder symptomatology and depression. Improvements in glycaemic control were found to decrease the severity of the symptoms.

Cysts are common findings at magnetic resonance (MR) and computed tomographic(CT) brain imaging. Their histopathologic spectrum is broad, and differentiation of these cysts on the basis of imaging findings alone can be problematic

This is a case of a 32 year old man reported depressive syptomatology and after brain MRI examination a epidermoid cyst was found.

The relation between brain epidermoid cyst and depressive symptomatology

The patient had suddenly symptoms of severe headache accompanied, fatigue, depressed mood most of the day, marked diminished interest or pleasure in all, or almost all activites, insomnia and diminished ability to think or concentrate. there was no organic problem in his medical history and there were any difficulties in his professional or his personal life. there was no family history for neurological diseases but his brother is suffering from Gille de la tourette. the symptoms progressively increased and patient visited a psychiatrist who recommended an MRI examination and the result was the following:

Brain MRI Examination revealed a cystic lesion in the posterior part of the 3rd ventricle, with a maximum diameter of 2.8 cm approximatelly and obstucts the Sylvious aqueduct which causes more centrally dilatation of the 3rd ventricle and the lateral ventricles too. the images after the intravenous contrast administration show no abnormal enhancement. Pituitary gland and paranasal sinuses appeared normal.

Orbital structures appeared normal.

After a surgical intervention depressive symptomatology was remised.

Epidermoid cysts can be masked from depressive syptomatology.

Chronic poor metabolic control of type 2 diabetes is characterized by elevation of plasma homocysteine and there is a evidence of both hypothalamic-pituitary-adrenocortical(HPA) axis and cognitive dysfunction in type 2 diabetes.

Recent research indicates an association between cortizol and homocysteine and psychological factors in diabetes type 2 however the nature of this relationship remains unclear.

The aim of this study was to investigate the association of cortizol and homocysteine with trait and state psychological factors in diabetic patients.

In this study cortizol and homosysteine and psychological data were analyzed from 86 controlled diabetic patients (Glycosylated Haemoglobin HbA1c < 7) and from 45 uncontrolled diabetic patients (HbA1c ≥ 7). Trait psychological characteristics were assessed with the Eysenck Personality Questionnaire (EPQ)and Hostility and Direction of Hostiity Questionnaire(HDHQ) while state psychological characteristics were measured with the Symptom Checklist 90-R (SCL 90-R). Blood samples were taken for measuring cortizol and homocysteine of both subgroups, during the initial phase of the study (T0).

One year later (T1), the uncontrolled diabetic patients were re-evaluated with the use of the same psychometric instruments and with an identical blood analysis.

Uncontrolled diabetic patients type 2 with high levels of cortizol score lower in the extraversion subscale of EPQ. in the controlled diabetic patiens high levels of homocysteine are correlated with high scores in the psychotism subscale of EPQ.

These findings give credence to the idea that cortizol and homocysteine in association with personality traits may be implicated in diabetes type 2.