The Endogenous Opioid System in Schizophrenia and Treatment Resistant Schizophrenia: Increased Plasma Endomorphin 2, and κ and µ Opioid Receptors Are Associated with Interleukin-6.

BACKGROUND: activation of the immune-inflammatory response system (IRS) and the compensatory immune-regulatory system (CIRS) plays a key role in schizophrenia (SCZ) and treatment resistant SCZ. There are only a few data on immune and endogenous opioid system (EOS) interactions in SCZ and treatment resistant SCZ. METHODS: we examined serum ß-endorphin, endomorphin-2 (EM2), mu-opioid (MOR) and kappa-opioid (KOR) receptors, and interleukin (IL)-6 and IL-10 in 60 non responders to treatment (NRTT), 55 partial RTT (PRTT) and 43 normal controls. RESULTS: serum EM2, KOR, MOR, IL-6 and IL-10 were significantly increased in SCZ as compared with controls. ß-endorphin, EM2, MOR and IL-6 were significantly higher in NRTT than in PRTT. There were significant correlations between IL-6, on the one hand, and ß-endorphin, EM2, KOR, and MOR, on the other, while IL-10 was significantly correlated with MOR only. A large part of the variance in negative symptoms, psychosis, hostility, excitation, mannerism, psychomotor retardation and formal thought disorders was explained by the combined effects of EM2 and MOR with or without IL-6 while increased KOR was significantly associated with all symptom dimensions. Increased MOR, KOR, EM2 and IL-6 were also associated with neurocognitive impairments including in episodic, semantic and working memory and executive functions. CONCLUSION: the EOS contributes to SCZ symptomatology, neurocognitive impairments and a non-response to treatment. In SCZ, EOS peptides/receptors may exert CIRS functions, whereas increased KOR levels may contribute to the pathophysiology of SCZ and EM2 and KOR to a non-response to treatment.

Study of the relationship between aggression and chronic diseases (diabetes and hypertension).

INTRODUCTION: This study focused on the widely examined psychosomatic diseases - diabetes mellitus and arterial hypertension as chronic conditions. The Buss-Perry validated questionnaire was used in it to measure aggression in Bulgarian conditions. AIM: To study aggression as a predictor and a connection of the chronic diseases diabetes and hypertension. MATERIAL AND METHODS: The number of the studied people was 142: 54 (38%) men and 88 (62%) women. Thirty-six of them had musculoskeletal disorders (77.8% women and 22.2% men), 54 had diabetes mellitus (29% women and 25% men) and 52 had hypertension (31% women and 21% men). RESULTS: During the statistical analysis of the data, the results from the Buss-Perry questionnaire were compared in the group of patients with hypertension and diabetes mellitus with chronic diseases, related to musculoskeletal disorders. CONCLUSION: The study revealed that there was a statistically significant difference in 95% of the cases between anger, hostility in patients with diabetes, hypertension and musculoskeletal disorders. The highest levels of physical aggression were observed in patients with arterial hypertension, M = 17.32 ± 0.86. The highest average levels of verbal aggression were observed in patients with diabetes, M = 15.24 ± 0.64. The highest levels of anger were observed with patients with hypertension, M = 17.96 ± 0.90, and hostility - in patients with hypertension, M = 19.15 ± 0.86. The comparison between the four Aggression Questionnaire scales showed statistically significant differences between the patients with musculoskeletal disorders and the ones with hypertension and diabetes.