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.
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.
Peroxisome proliferator-activated receptor alpha (PPARα) and antipsychotic medications both influence polyunsaturated fatty acids (PUFA) homeostasis, and thus PPARα polymorphism may be linked to ...antipsychotic treatment response. Here we investigated whether the functional leucine 162 valine (L162V) polymorphism in PPARα influenced antipsychotic treatment in a group of psychosis patients (N = 186), as well as in a patient subgroup with risperidone, paliperidone, or combination treatment (N = 65). Antipsychotic-naïve first-episode patients and nonadherent chronic individuals were genotyped by polymerase chain reaction analysis. At baseline, and after 8 weeks of treatment with various antipsychotic medications, we assessed the patients' Positive and Negative Syndrome Scale (PANSS) scores; PANSS factors; and metabolic syndrome-related parameters, including fasting plasma lipid and glucose levels, and body mass index. In the total patient group, PPARα polymorphism did not affect PANSS psychopathology or metabolic parameters. However, in the subgroup of patients with risperidone, paliperidone, or combination treatment, PPARα polymorphism influenced changes in plasma LDL cholesterol. Specifically, compared to PPARα-L162L homozygous patients, PPARα-L162V heterozygous individuals exhibited significantly higher increases of LDL cholesterol levels after antipsychotic treatment. The PPARα polymorphism had a strong effect size, but a relatively weak contribution to LDL cholesterol level variations (∼12.8 %).
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.
Hikikomori silent epidemic: a case study Silić, Ante; Vukojević, Jakša; Čulo, Ilaria ...
Research in psychotherapy (Milano).,
07/2019, Letnik:
22, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Psychiatry, as we know it, is at a crucial point because it needs to adapt to the modern time and still maintain the integrity and ethic aspects of the therapeutic alliance. Bearing in mind the ...rising prevalence of new addictions like Internet and online gaming addictions, one can see that, however, disputed, there is a whole new category of psychiatric illnesses on the rise. An example of these kinds of illnesses is Hikikomori. Hikikomori, or severe social withdrawal, pertains to patients who have stopped participating in everyday routine and would spend the majority of time confined in their room for the period of 6 months or more, with no evident psychosis. Although this syndrome was originally described in Japan, over the course of last few years it has been documented in several parts of the world, spreading like a silent epidemic. Our case study, being the first documented case in Southeast Europe, according to our experience and literature search, is a vivid example of this syndrome. In this report we discuss differential diagnosis, show what kind of therapy was efficient in the successful treatment of this syndrome and how it can be prevented in the future
Major depressive disorder (MDD) is closely related to obesity, inflammation, and insulin resistance, all together being etiologically linked to metabolic syndrome (MetS) development. The depressive ...disorder has a neuroendocrinological component, co-influencing the MetS, while MetS is characterised by increased cytokine levels, which are known to cause a depressed mood. This study aimed to establish biological subtypes of the depressive disorder based on researched clinical, laboratory, and anthropometric variables.
We performed a cross-sectional study on a sample of 293 subjects (145 suffering from a depressive disorder and 148 healthy controls). Results were analysed with multivariate statistical methods as well as with cluster and discriminant analysis. In order to classify depressive disorder on the grounds of laboratory, anthropometric, and clinical parameters, we performed cluster analysis, which resulted in three clusters.
The first cluster is characterised by low platelet serotonin, high cortisol levels, high blood glucose levels, high triglycerides levels, high Hamilton Depression Rating Scale score, high waist circumference, high C-Reactive Protein values, and a high number of previous depressive episodes, was named Combined (Metabolic) depression. The inflammatory depression cluster is defined with average platelet serotonin values, normal cortisol, and all other parameter levels, except for increased IL-6 levels. The serotoninergic depression cluster is characterised by markedly low platelet serotonin, and all other parameters are within the normal range.
From a biological point of view, depressive disorder is not uniform, and as such, these findings suggest potential clinically useful and generalisable biological subtypes of depressive disorder.
The use of electroretinography (ERG) and optical coherence tomography (OCT) has currently expanded beyond ophthalmology alone. The aim of this review is to present the results and knowledge acquired ...by these two methods in patients suffering from schizophrenia. Reviewing the studies applying ERG and OCT methods in the field of psychiatry, one can conclude that results of the research imply morphological and functional changes of retina in patients with schizophrenia that are not consistent. However, in most studies there was reduction of the amplitude and changes in the implicit time related parameters on ERG and thinning of the retinal nerve fiber layer on OCT. Neurons in the eye use the same neurotransmitters as neurons in the basal brain structures that are most affected in schizophrenia, according to the dopamine hypothesis of schizophrenia. Unlike neurons in the basal brain structures, the neurons in the eye are
in vivo
available to ERG. Using the aforementioned tests together with clinical diagnostic criteria of schizophrenia, the subgroups with different prognostic and therapeutic specificities within schizophrenia as a group of diseases might be identified more precisely.
In 1937, Ugo Cerletti and Lucio Bini performed electroconvulsive treatment (ECT) in Rome for the first time. That was the time when different types of 'shock therapy' were performed; beside ECT, ...insulin therapies, cardiazol shock therapy, etc. were also performed. In 1938, Cerletti and Bini reported the results of ECT. Since then, this method has spread rapidly to a large number of countries. As early as 1940, just two years after the results of the ECT had been published, it was also introduced in Croatia, at Sestre milosrdnice Hospital, for the first time in our hospital and in the then state of Yugoslavia. Since 1960, again the first in Croatia and the state, we performed ECT in general anesthesia and continued it down to the present, with a single time brake.
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