Brain-Derived Neurotrophic Factor (BDNF) as an Indicator for Effects of Cognitive Behavioral Therapy (CBT): A Systematic Review.

Brain-derived neurotrophic factor (BDNF) is a protein affecting survival of existing neurons and neuronal maturation. Patients suffering from several mental disorders exhibit reduced BDNF levels comparing to healthy population. In this systematic review we aim to evaluate the effect of broadly defined cognitive behavioral therapy (CBT) on BDNF levels in psychiatric patients. A literature search was performed using PubMed and Google Scholar data bases. The resources were searched between 14 January and 3 February 2022. Following the inclusion criteria, a total of 10 randomized-controlled trials were included. The results of our research indicate that BDNF levels might be considered an indicator of a result achieved in psychotherapy of cognitive functions. However, no such correlation was observed for mindfulness-based practices intended to lower stress levels or improve the quality of life. It is important to notice that present research showed no consistent correlation between the increase in BDNF levels and the perceived effectiveness of the procedures. Thus, the exact role of BDNF remains unknown, and so far, it cannot be taken as an objective measure of the quality of the interventions.

Polish Psychiatric Association consensus statement on non-pharmacological methods in the treatment of negative symptoms of schizophrenia. / Stanowisko grupy roboczej PTP na temat stosowania metod niefarmakologicznych w leczeniu objawów negatywnych schizofrenii.

This consensus statement has been prepared by a group of experts consisting of professionals with long experience in the treatment of psychiatric disorders, who were appointed by the Management Board of the Polish Psychiatric Association. The evaluation involved the analysis of literature databases and information derived from meta-analyses of these data for years 2010-2020. The searched publications were in English, German and Polish language versions and involved interventions performed in groups of adult patients. The efficacy of nonpharmacological methods applied for treatment of negative symptoms of schizophrenia were compared with effects of adifferent treatment/combined treatment/a group with no intervention. When formulating the recommendations, the experts analysed the source data in terms of their application in the Polish conditions. The current recommendations of academic societies and literature on the treatment of schizophrenia with predominant negative symptoms were taken into account. The experts included items that involved a comparison of a study group in terms of non-pharmacological interventions, and pharmacologically treated cases were taken into account only when divisions were made into standard treatment and additional intervention. The results were divided into 7 sections: 1. Psychoeducation, 2. Psychotherapy (individual, group and family therapy), 3. Psychiatric rehabilitation, 4. Emotional intelligence, social skills and mindfulness training, 5. Cognitive remediation/rehabilitation, cognitive training, 6. Clinical efficacy of physical activity, behavioral activation and metacognitive training, 7. Other rehabilitation methods (including biological methods). The recommendations were debated by experts, approved by the Management Board of the Polish Psychiatric Association,and -upon consideration of the submitted comments - adopted as aconsensus statement of the Association with the recommendation of their application in the treatment of schizophrenic patients in Poland.

The reasons for use of cannabinoids and stimulants in patients with schizophrenia. / Przyczyny zazywania kannabinoidów i substancji psychostymulujacych u pacjentów ze schizofrenia.

OBJECTIVES: Both cannabinoids and psychoactive substances from the group of stimulants can have a significant effect on the induction, course and treatment of severe mental illness. They also can be treated as self-medication. Many patients feel subjective benefits of using psychoactive substances in the areas of social competence, to cope with side effects of neuroleptics, stress accompanying mental illness or to control its symptoms. Our research tries to explain the causes of taking psychoactive substances by patients with schizophrenia. METHODS: A total of 50 schizophrenia patients using cannabinoids, including 25 of them using also stimulants, took part in our research. They filled out questionnaires about the causes of drug use and subjectively perceived mental complaints. We analyzed medical documentation. RESULTS: It was found that subjects using both cannabinoids and stimulants pointed to spirituality as a cause significantly more often than subjects taking only cannabinoids. Marijuana and hashish were significantly more often taken to improve social relations. In both groups, the most common reasons were: curiosity, the need to relax, problem solving, improving relationships, and remedy for 'shyness'. In the group using only cannabinoids, it was observed that people who felt misunderstood often smoked marijuana to solve problems. Individuals using stimulants often complained of poor concentration. CONCLUSIONS: Ignorance of the consequences of using psychoactive substances in people at risk of schizophrenia or in those already ill is an additional risk factor. The results may indicate an increased demand for psychoeducation and social support regarding many areas of life of patients suffering from schizophrenia.

Choline Compounds of the Frontal Lobe and Temporal Glutamatergic System in Bipolar and Schizophrenia Proton Magnetic Resonance Spectroscopy Study.

PURPOSE: Modern neuroimaging techniques allow investigating brain structures and substances involved in the pathophysiology of mental disorders, trying to find new markers of these disorders. To better understanding of the pathophysiology and differential diagnosis of schizophrenia and bipolar disorder, this study was conducted to assess the neurochemical alterations in the frontal and temporal lobes in hospitalized patients with schizophrenia and bipolar disorder. METHODS: Twenty-one subjects with schizophrenia (paranoid and differentiated types), 16 subjects with bipolar I disorder (manic, depressive, and mixed episode), and 20 healthy subjects were studied. Magnetic resonance (MR) imaging and proton resonance magnetic spectroscopy (1H MRS) were performed on a 1.5 T scanner. Voxels of 8 cm3 were positioned in the left frontal and left temporal lobes. RESULTS: Glx/H2O (GABA, glutamine, and glutamate/nonsuppressed water signal) ratios were significantly increased in the left temporal lobe in schizophrenia, but not in bipolar disorder, compared with controls. Cho/H2O (choline/nonsuppressed water signal) ratios in the left frontal lobe had a tendency to increase in bipolar disorder and schizophrenia, relative to controls. A lower temporal lobe NAA/H2O ratio in mixed than in manic and depressive episode of bipolar patients was also found. No other significant differences were found among three studied groups as regards NAA, Cr, and mI ratios. CONCLUSIONS: Our results partially confirm the role of a glutamatergic system in schizophrenia, however, only in a temporal lobe. We also point to the importance of the choline-containing compounds (marker of cellular density) in the frontal lobe of patients suffering from bipolar disorder and schizophrenia. We also found the deleterious effect of mixed bipolar episode on the integrity and functioning of the temporal lobe. Glutamatergic left temporal spectroscopic changes may potentially help in differential diagnosis of schizophrenia from bipolar disorder.

Neurochemical alterations in anterior cingulate cortex in bipolar disorder: a proton magnetic resonance spectroscopy study (1H-MRS). / Zmiany neurochemiczne w przednim zakrecie obreczy w zaburzeniu afektywnym dwubiegunowym: spektroskopia protonowa rezonansu magnetycznego (1H-MRS).

OBJECTIVES: The aim of this study was to determine neurochemical alterations in bipolar disorder using proton magnetic resonance spectroscopy (1H-MRS). METHODS: We investigated a group of 27 patients diagnosed with bipolar disorder (with manic and mixed episodes, depression and after remission of symptoms) and 10 healthy subjects. MR imaging and 1H-MRS were performed on a 1.5 T scanner. Voxels of 8 cm3 were positioned in the anterior cingulate, left frontal lobe and left temporal lobe. Spectral peaks of NAA (N-acetylaspartate), Glx (glutamate/glutamine/GABA complex), Cho (choline), Cr (creatine/phosphocreatine) and mI (myo-inositol) were analyzed and the ratios of these metabolites to creatine (Cr) and non-suppressed water signal were determined. RESULTS: In the anterior cingulate cortex of patients with bipolar disorder a significantly higher Cho/H2O ratio (p = 0.029) and a trend toward higher Cho/Cr ratio values (p = 0.096) were observed as compared to healthy controls. CONCLUSIONS: The findings of our study prove that neurochemical changes occurring in the anterior cingulate cortex of bipolar patients are related to altered choline levels.

[Does the usual dietary intake of patients with depression require vitamin-mineral supplementation?]. / Czy zwyczajowy sposób zywienia pacjentów z depresja wymaga suplementacji witaminami i skladnikami mineralnymi?

INTRODUCTION: Research on diet and nutrition of patients with depression show that their eating habits are frequently irrational and result in the inconsistent supply of nutrients, especially vitamins and minerals, the deficiency of which leads to nervous system dysfunction. AIM: The aim of the study was to evaluate the content of selected vitamins and minerals in daily food rations of patients suffering from recurrent depressive disorders. METHODS: The study involved a group of 69 people (54 women and 15 men, aged 18-65 years, mean age of women 45.7 +/- 12.2 years, men 46.0 +/- 12.2 years), treated for recurrent depressive disorders. A questionnaire designed in the Department of Dietetics and Clinical Nutrition, Medical University of Bialystok was used to collect dietary data. The quantitative assessment of eating habits used a 24-hour diet recall including 3 weekdays and 1 weekend day. RESULTS: The study showed that the supply of most nutrients assessed was inconsistent with recommendations. CONCLUSIONS: The results indicate that the need for vitamin-mineral supplementation should be considered individually. Nutritional education related to the proper choice of groups of food products is indicated at the time of clinical improvement to ensure the optimum supply of vitamins and minerals.

[Psychoactive plant species--actual list of plants prohibited in Poland]. / Roslinne srodki odurzajace--aktualnie obowiazujaca lista w Polsce.

According to the Act on Counteracting Drug Addiction (20-th of March, 2009, Dz. U. Nr 63 poz. 520.) the list of federally prohibited plants in Poland was expanded to include 16 new species. Until that time the only illegal plant materials were cannabis, papaver, coca and most of their products. The actual list of herbal narcotics includes species which significantly influence on the central nervous system work but which are rarely described in the national literature. The plants usually come from distant places, where--among primeval cultures--are used for ritual purposes. In our civilization the plants are usually used experimentally, recreationally or to gain particular narcotic effects. The results of the consumption vary: they can be specific or less typical, imitate other substances intake, mental disorders or different pathological states. The plant active substances can interact with other medicaments, be toxic to internal organs, cause serious threat to health or even death. This article describes the sixteen plant species, which are now prohibited in Poland, their biochemical ingredients and their influence on the human organism.

Plasma carnitine concentrations after chronic alcohol intoxication.

BACKGROUND: Carnitine transports fatty acids from the cytoplasm to the mitochondrial matrix, where the fatty acids are oxidized. Chronic alcohol consumption reduces the concentration of carnitine and interferes with oxidative processes occurring in the cell. AIM: The assessment of carnitine concentrations in plasma of chronically intoxicated alcohol dependent persons in a 49-day abstinence period. MATERIAL/METHODS: The study included 31 patients (5 women and 27 men) aged from 26 to 60 years (44.6 ± 8.9) and 32 healthy subjects (15 women and 17 men) aged 22-60 years (39.8 ± 9.4). The patients' alcohol dependence ranged from 2 to 30 years (13.6 ± 7.5). Examined subjects consumed 75-700 g of ethanol/day (226.9 ± 151.5). Plasma concentrations of free and total carnitine were measured three times: at the first (T0), 30th (T30) and 49th (T49) day of hospital detoxification. Free (FC) and total (TC) carnitine were determined by the spectrophotometric method. Plasma acylcarnitine (AC) concentration was calculated from the difference between TC and FC; then the AC/FC ratio was calculated. To determine statistically significant differences for related variables, Student's t-test was used. RESULTS: At T0, alcoholics had significantly lower concentration of FC and TC (p < 0.05) in plasma, as compared to the control group. In comparison to controls, at T30, plasma TC and FC (p < 0.01) as well as AC (p < 0.001) were reduced. The lowest concentration of TC, FC and AC (p < 0.001)was found at T49. The ratio of AC/FC at T0 had a tendency to be higher in alcoholics than in the control group (p = 0.05), whereas at T49 it was significantly lower in alcoholics as compared to the control subjects (p < 0.05). CONCLUSIONS: Chronic alcohol intoxication causes a plasma deficiency of carnitine. Forty-nine days of abstinence showed a significant decrease in the concentration of TC, FC and AC. Further research is necessary to clarify whether a low level of plasma carnitine after chronic alcohol intoxication is caused by the uptake of blood carnitine by tissues such as liver or muscles. In alcoholics the supplementation of carnitine is recommended in the case of a low level of plasma carnitine.

Duration of untreated psychosis and proton magnetic resonance spectroscopy (1H-MRS) findings in first-episode schizophrenia.

BACKGROUND: The duration of untreated psychosis (DUP) is a factor associated with the natural course of schizophrenia and an independent predictor of treatment outcome. Recent studies focus on the effects of DUP on the functioning of the nervous system, but the findings are inconsistent. As proton magnetic resonance spectroscopy (1H-MRS) enables the assessment of signals from chemical compounds in vivo, it seems a useful tool to explore this problem. MATERIAL/METHODS: In this study the relationships between DUP and 1H-MRS measurements were investigated. Thirty patients with first-episode schizophrenia and 19 controls were examined. Median DUP was 10 weeks. Voxels were positioned in the following regions of interest: the left frontal lobe, left temporal lobe, and left thalamus. The ratios of N-acetylaspartate (NAA), choline-containing compounds (Cho), myoinositol (mI), and glutamate/glutamine/GABA complex (Glx) to creatine (Cr) and the non-suppressed water signal were determined. RESULTS: There were no significant differences between the whole group of patients and healthy subjects for the analyzed metabolite ratios in any region of interest. No differences were found between the groups of patients with short and long DUP and controls. No significant correlation was observed between DUP and metabolite ratios. CONCLUSIONS: The results of the study may suggest that the relatively short DUP does not influence brain metabolism in first-episode schizophrenia.

Relationship between frontal N-acetylaspartate and cognitive deficits in first-episode schizophrenia.

BACKGROUND: The aim of this study was to evaluate the relationship between N-acetylaspartate (NAA) levels in selected brain regions and cognitive performance in patients with first-episode schizophrenia. MATERIAL/METHODS: Thirty patients (20 male, 10 female; mean age: 22.5 years) with the diagnosis of first-episode schizophrenia and 19 comparable healthy controls were studied. The Wisconsin Card Sorting Test (WCST) was used to assess cognitive functions. MR imaging and MR spectroscopy examinations were performed on a 1.5 T scanner. Voxels of 8 cm3 were positioned in the left frontal lobe, left temporal lobe, and left thalamus. The ratio of NAA to creatine and the ratio of NAA to unsuppressed water signal were analyzed. RESULTS: Patients performed significantly worse than controls on measures of the WCST. In the patient group, NAA levels in the frontal lobe were significantly related to poorer WCST performance. CONCLUSIONS: Cognitive impairment related to dysfunction of the prefrontal cortex in first-episode schizophrenia is associated with NAA level in the frontal lobe.

[Clinical and neuropsychological correlates of proton magnetic resonance spectroscopy detected metabolites in brains of first-episode and schizophrenic patients]. / Badania wybranych obszarów mózgu metoda spektroskopii protonowej rezonansu magnetycznego (1H MRS) w aspekcie dysfunkcji poznawczych i obrazu klinicznego u osób ze schizofrenia wczesna i przewlekla--doniesienie wstepne.

OBJECTIVE: This study examined 1H MRS detected metabolite levels (in left frontal, temporal lobes and thalamus) and clinical and cognitive features of patients with first-episode and chronic schizophrenia. METHOD: We studied 31 first-episode patients (group 1) and 17 chronic patients (group 2) with ICD-10 diagnosis of schizophrenia (and 13 healthy subjects). Patients were also assessed by the means of PANSS, CGI, Calgary scales and WCST, TMT, Stroop tests. RESULTS: We did not observe statistically significant differences in metabolite levels between group 1 and 2. We observed only a trend toward higher Cho level in temporal lobe in group 2 and lower NAA level in group 1. When comparing with the control group we observed a significantly higher Cho level in the frontal lobe (group 1,2) (p < 0.05). We observed a trend toward lower NAA levels in the frontal lobe (group 1,2), and lower NAA level in the temporal lobe (group 1). Patients with chronic schizophrenia performed significantly worse in WCST, TMT and Stroop tests (p < 0.05). CONCLUSION: These results suggest, that abnormalities in metabolite levels in frontal and temporal lobes are present at the onset of disease and don't progress over time. The cognitive dysfunction is more prominent in chronic patients.