Major depressive disorder is one of the most common mental illnesses that highly impairs quality of life. Pharmacological interventions are mainly focused on altered monoamine neurotransmission, ...which is considered the primary event underlying the disease's etiology. However, many other neuropathological mechanisms that contribute to the disease's progression and clinical symptoms have been identified. These include oxidative stress, neuroinflammation, hippocampal atrophy, reduced synaptic plasticity and neurogenesis, the depletion of neurotrophic factors, and the dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis. Current therapeutic options are often unsatisfactory and associated with adverse effects. This review highlights the most relevant findings concerning the role of flavonols, a ubiquitous class of flavonoids in the human diet, as potential antidepressant agents. In general, flavonols are considered to be both an effective and safe therapeutic option in the management of depression, which is largely based on their prominent antioxidative and anti-inflammatory effects. Moreover, preclinical studies have provided evidence that they are capable of restoring the neuroendocrine control of the HPA axis, promoting neurogenesis, and alleviating depressive-like behavior. Although these findings are promising, they are still far from being implemented in clinical practice. Hence, further studies are needed to more comprehensively evaluate the potential of flavonols with respect to the improvement of clinical signs of depression.
Although depressive symptoms seem to be frequent in schizophrenia they have received significantly less attention than other symptom domains. As impaired serotonergic and dopaminergic ...neurotransmission is implicated in the pathogenesis of depression and schizophrenia this study sought to investigate the putative association between several functional gene polymorphisms (SERT 5-HTTLPR, MAO-A VNTR, COMT Val158Met and DAT VNTR) and schizophrenia. Other objectives of this study were to closely examine schizophrenia symptom domains by performing factor analysis of the two most used instruments in this setting (Positive and negative syndrome scale - PANSS and Calgary depression rating scale - CDSS) and to examine the influence of investigated gene polymorphisms on the schizophrenia symptom domains, focusing on depressive scores. A total of 591 participants were included in the study (300 schizophrenic patients and 291 healthy volunteers). 192 (64%) of schizophrenic patients had significant depressive symptoms. Genotype distribution revealed no significant differences regarding all investigated polymorphisms except the separate gender analysis for MAO-A gene polymorphism which revealed significantly more allele 3 carriers in schizophrenic males. Factor analysis of the PANSS scale revealed the existence of five separate factors (symptom domains), while the CDSS scale revealed two distinct factors. Several investigated gene polymorphisms (mostly SERT and MAO-A, but also COMT) significantly influenced two factors from the PANSS (aggressive/impulsive and negative symptoms) and one from the CDSS scale (suicidality), respectively. Depressive symptoms in schizophrenic patients may be influenced by functional gene polymorphisms, especially those implicated in serotonergic neurotransmission.
•3 repeat allele of MAO-A gene polymorphism was significantly more prevalent in male schizophrenic patients.•Five separate PANSS and two CDSS symptom factors were identified.•Investigated SERT and MAO-A gene polymorphisms seem to influence several schizophrenia symptom domains.•Negative symptoms of schizophrenia seem to be influenced by the investigated COMT gene polymorphism.
Abstract The aim of the present study was to explore possible differences between serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and cortisol concentration ...in patients with major depressive disorder (MDD) with melancholic features, and MDD with atypical features. As secondary aim, we investigated possible associations with clinical features such as suicidal ideation, number of episodes, duration of depression and symptomatology severity. We included 55 MDD patients (32 with melancholic features and 23 with atypical features) and 18 healthy controls. When compared to healthy controls, MDD with melancholic or atypical features showed higher CRP and IL-6, but not TNF-α. Cortisol concentration was higher in MDD with melancholic type, in comparison to the atypical type of MDD or controls. A positive correlation was found between the severity of depressive symptoms, concentrations of IL-6 and cortisol in the MDD group with melancholic features, while a negative correlation was observed between IL-6 and CRP in the MDD group with atypical feature. Also, in the MDD group with atypical features, there was a correlation between the severity of anxiety symptoms based on the Hamilton Rating Scale for Anxiety (HARS), concentration of CRP, and the duration of symptoms. In conclusion, we observed several differences in serum CRP, IL-6, and cortisol concentrations in MDD patients considering clinical features as well.
Objective
Recent‐onset schizophrenia (ROS) represents a critical period that can greatly influence the clinical course of schizophrenia. The use of long‐acting injectable antipsychotics (LAIs) in ...this period is increasingly being considered as a first‐line treatment option. Aripiprazole LAI (ALAI) is the newest of all LAI's available on the market, with limited data on its effects on hospitalization rates after first episode of schizophrenia. It was our goal to evaluate whether ALAI has an effect on hospitalization rates, number of bed days and clinical improvement in patients with ROS.
Methods
This mirror‐image study included 138 inpatients suffering from schizophrenia. We collected sociodemographic data on all individuals, number of hospitalization days, hospitalization rates as well as Clinical Global Impression Scale—severity of illness (CGI‐S) and Clinician‐Rated Dimensions of Psychosis Symptom Severity (CRDPSS) scores at the initiation of ALAI and at the end of a 1 year follow up.
Results
Mean number of hospitalizations and hospitalization days in the year after starting ALAI significantly decreased compared to the year before (p = 0.005 and p < 0.001). Mean scores on both CGI and CRDPSS also significantly decreased after initiating ALAI (p < 0.001).
Conclusion
Results suggest that ALAI is an important therapeutic option in patients with ROS. It leads to reduced usage of hospital services, potentially reducing the socio‐economic healthcare burden.
Abstract Depressive symptoms seem to be frequent in schizophrenia, but so far they have received less attention than other symptom domains. Impaired serotonergic neurotransmission has been implicated ...in the pathogenesis of depression and schizophrenia. The objectives of this study were to investigate platelet serotonin concentrations in schizophrenic patients with and without depressive symptoms, and to investigate the association between platelet serotonin concentrations and symptoms of schizophrenia, mostly depressive symptoms. A total of 364 patients were included in the study, 237 of which had significant depressive symptoms. Significant depressive symptoms were defined by the cut-off score of 7 or more on Calgary Depression Rating Scale (CDSS). Platelet serotonin concentrations were assessed by the enzyme-linked immunosorbent assay (ELISA). Prevalence of depression in patients with schizophrenia was 65.1%. Schizophrenic patients with depressive symptoms showed lower platelet serotonin concentrations (mean±SD; 490.6±401.2) compared to schizophrenic patients without depressive symptoms (mean±SD; 660.9±471.5). An inverse correlation was established between platelet serotonin concentration and depressive symptoms, with more severe symptoms being associated with lower platelet serotonin concentrations. Depressive symptoms in schizophrenic patients may be associated with reduced concentrations of platelet serotonin.
Objective Impaired serotonergic neurotransmission has been implicated in the pathogenesis of depression and schizophrenia. Blood platelets have been used for years as a peripheral model of neuronal ...serotonin dynamics. The objective was to investigate platelet count and serotonin concentration in patients with depression and schizophrenia, in an attempt to ascertain their clinical usefulness.Methods 953 participants were included in the study, 329 patients with depression, 339 patients with schizophrenia and 285 healthy controls. ELISA was used to assess platelet serotonin concentrations.Results There were no statistically significant differences among groups regarding age, total platelet count and serotonin concentration. Linear regression analyses revealed inverse correlations between platelet serotonin concentration and age of patients with depression and healthy individuals, as well as between platelet serotonin concentration and illness duration in patients with schizophrenia. In other words, longer illness duration in patients with schizophrenia, and higher age in patients with depression and healthy individuals was associated with lower platelet serotonin concentrations.Conclusion Platelet count and serotonin concentration did not prove to be of diagnostic value in differentiating patients and healthy individuals. However, illness duration in patients with schizophrenia may be associated with reduced concentrations of platelet serotonin.
Schizophrenia is a debilitating disease that disrupts the lives of many affected individuals and exerts a toll on the health system. Only few studies assessed once-monthly injectable formulation of ...paliperidone palmitate (PP-1M) and other long-acting antipsychotics in recent onset schizophrenia (ROS). To evaluate whether PP-1M is efficacious in reducing frequency and length of hospitalizations and psychosis symptom severity in patients with ROS.
This mirror-image study included 112 patients, suffering from ROS admitted in a psychiatric ward and successively treated with PP-1M for 1-year. Other psychotic disorders were excluded. We collected socio-demographic data of all subjects included, number and days of hospitalization, as well as Clinical Global Impression-Severity scale (CGI-S) and Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS) scores at the initiation and after 1-year of PP treatment.
After 1-year PP-1M treatment, mean scores of both CGI and CRDPSS significantly decreased (
< 0.001), as well as the mean number of hospitalizations (
= 0.002) and total hospitalization days (
< 0.001) in comparison with those of the previous year.
Our results suggest that PP-1M can be considered as an important therapeutic option in patients with ROS. Its use led to a meaningful reduction in the patient's use of hospital services, as well as a significant clinical improvement of psychotic symptoms in our sample.
Vitamin D is involved in brain development and functioning, as well as in regulation of neurotrophic factors. Changes in the expression of those factors are possibly responsible for morphologic ...abnormalities and symptoms in patients suffering from schizophrenia.
The main goal of this research was to investigate the interrelationship between vitamin D, nerve growth factors (NGF, brain-derived neurotrophic factor BDNF, and neuregulin-1 NRG1), and schizophrenia symptom domains.
This research included 97 inpatients diagnosed with schizophrenia. Schizophrenia symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Blood samples were taken in order to analyze concentrations of vitamin D, BDNF, NRG1, and NGF growth factors. The obtained results were used in a multiple regression analysis.
The vitamin D concentration positively affected the concentration of NRG1 (F = 8.583, p = 0.005) but not the concentration of other investigated growth factors (BDNF and NGF). The clinical characteristics and symptom domains of schizophrenia seemed to be unaffected by the concentrations of vitamin D, BDNF, and NGF, while the NRG1 concentration significantly affected positive symptom domains of schizophrenia (F = 4.927, p = 0.030).
The vitamin D concentration positively affected NRG1 levels but not schizophrenia symptomatology as measured by PANSS. The as-sociation between the two could be intermediated via NRG1.
Abstract Background Recent studies suggest comorbidity between major depressive disorder (MDD) and metabolic syndrome. For both disorders, impaired serotoninergic neurotransmission and inflammatory ...factors have been suggested. The objective of this study was to investigate the concentration of platelet serotonin, interleukin-6 (IL-6) and C-reactive protein (CRP) in MDD patients with and without metabolic syndrome. The second goal was to investigate the association of the concentrations of platelet serotonin, IL-6 and CRP with individual components of metabolic syndrome in MDD patients. Methods A total of 145 MDD patients were included in the study (diagnosed according DSM IV TR criteria). The metabolic syndrome was defined according to the criteria of the American National Cholesterol Education Program-Treatment Panel III (ATP III). Inflammation factors (IL-6 and CRP) and platelet serotonin concentration were assessed by the enzyme-linked immunosorbent assay (ELISA). Results MDD patients with metabolic syndrome showed lower platelet serotonin and higher IL-6 and CRP concentrations when compared to MDD patients without metabolic syndrome. An inverse correlation was found between platelet serotonin and waist circumference and serum glucose levels. A positive correlation was found between IL-6 and glucose or triglyceride concentrations, while the correlation with HDL cholesterol was negative. Limitations Data on dietary habits or physical activity prior to hospitalisation were not collected. Also, the study was a cross-sectional without a prospective design. Conclusion Metabolic syndrome in patients with MDD may be associated with reduced concentrations of platelet serotonin and increased concentrations of IL-6 and CRP.
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