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1.
PLoS One ; 19(3): e0288386, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38466678

RESUMO

Impaired executive functions (EF) have been found within various mental disorders (e.g., attention deficit hyperactivity disorder, autism spectrum disorder, schizophrenia spectrum disorders) as described in DSM-5. However, although impaired EF has been observed within several categories of mental disorders, empirical research on direct relations between EF and broader dimension of psychopathology is still scarce. Therefore, in the current investigation we examined relations between three EF performance tasks and self-reported dimensions of psychopathology (i.e., the internalizing, externalizing, and thought disorder spectra) in a combined dataset of patients with a broad range of mental disorders (N = 440). Despite previously reported results that indicate impaired EF in several categories of mental disorders, in this study no direct relations were found between EF performance tasks and self-reported broader dimensions of psychopathology. These results indicate that relations between EF and psychopathology could be more complex and non-linear in nature. We evaluate the need for integration of EF and dimensional models of psychopathology and reflect on EF as a possible transdiagnostic factor of psychopathology.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Esquizofrenia , Humanos , Função Executiva , Transtorno do Espectro Autista/diagnóstico , Psicopatologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Esquizofrenia/diagnóstico
2.
Clin Nutr ESPEN ; 60: 343-347, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38479933

RESUMO

OBJECTIVE: The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recently released the first international consensus on the diagnostic criteria for Sarcopenic obesity (SO). The present study aimed to explore the ability of SO to predict the risk of pneumonia in patients with stable schizophrenia. METHODS: This was a prospective study involving hospitalized patients with schizophrenia aged ≥50 years from two mental health centers in western China. Baseline patient data were collected from September 1 to September 30, 2020. Follow-up data on pneumonia were collected from October 2020 to October 2022. The diagnosis of SO was based on the ESPEN/EASO criteria. Patients were assessed for handgrip strength (HGS), skeletal muscle mass/weight (SMM/W), and fat mass percentage (FM%). Logistic regression analysis was used to explore the effect of SO on the risk of pneumonia in patients with stable schizophrenia. RESULTS: A total of 320 patients with stable schizophrenia were included. Of these, 74 (23.13%) were diagnosed with SO, while 117 (36.56%) developed pneumonia. Compared with patients in the non-low HGS, non-low HGS + non-low SMM/W (or non-low HGS + low SMM/W or low HGS + non-low SMM/W) and non-SO groups, the proportions of patients with pneumonia in the low HGS (42.3% vs. 25.9%, p = 0.004), low HGS + low SMM/W (45.3% vs. 33.3%, p = 0.048), and SO (47.3% vs. 33.3%, p = 0.029) groups, respectively, were higher. However, there was no difference in the proportion of patients with pneumonia in the low SMM/W group and the obese group compared with the non-low SMM/W and non-obese groups. Further logistic regression analysis after adjustment for potential influencing factors showed that compared with the non-low HGS group, patients in the low HGS group had a higher risk of pneumonia (OR = 1.892, 95%CI: 1.096-3.264). CONCLUSION: SO defined according to the ESPEN/EASO criteria was not found to be significantly associated with the development of pneumonia in patients with stable schizophrenia. Further verification of these results is needed with larger sample sizes and the establishment of a cutoff value for this population.


Assuntos
Pneumonia , Sarcopenia , Esquizofrenia , Humanos , Sarcopenia/complicações , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Estudos Prospectivos , Força da Mão/fisiologia , Esquizofrenia/complicações , Esquizofrenia/diagnóstico , Composição Corporal/fisiologia , Obesidade/complicações , Obesidade/epidemiologia , Pneumonia/complicações , Pneumonia/diagnóstico
5.
Int J Mol Sci ; 25(5)2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38474035

RESUMO

MicroRNAs (miRNAs) play a crucial role in the regulation of gene expression levels and have been implicated in the pathogenesis of autism spectrum disorder (ASD) and schizophrenia (SCZ). In this study, we examined the adult expression profiles of specific miRNAs in the prefrontal cortex (PFC) of a neurodevelopmental mouse model for ASD and SCZ that mimics perinatal pathology, such as NMDA receptor hypofunction, and exhibits behavioral and neurophysiological phenotypes related to these disorders during adulthood. To model the early neuropathogenesis of the disorders, mouse pups were administered subcutaneously with ketamine (30 mg/Kg) at postnatal days 7, 9, and 11. We focused on a set of miRNAs most frequently altered in ASD (miR-451a and miR-486-3p) and in SCZ (miR-132-3p and miR-137-3p) according to human studies. Additionally, we explored miRNAs whose alterations have been identified in both disorders (miR-21-5p, miR-92a-2-5p, miR-144-3p, and miR-146a-5p). We placed particular emphasis on studying the sexual dimorphism in the dynamics of these miRNAs. Our findings revealed significant alterations in the PFC of this ASD- and SCZ-like mouse model. Specifically, we observed upregulated miR-451a and downregulated miR-137-3p. Furthermore, we identified sexual dimorphism in the expression of miR-132-3p, miR-137-3p, and miR-92a-2-5p. From a translational perspective, our results emphasize the potential involvement of miR-92a-2-5p, miR-132-3p, miR-137-3p, and miR-451a in the pathophysiology of ASD and SCZ and strengthen their potential as biomarkers and therapeutic targets of such disorders.


Assuntos
Transtorno do Espectro Autista , Ketamina , MicroRNAs , Esquizofrenia , Adulto , Humanos , Animais , Camundongos , Transtorno do Espectro Autista/genética , MicroRNAs/genética , Biomarcadores
6.
BMC Psychiatry ; 24(1): 173, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429778

RESUMO

BACKGROUND: Inflammation has an important role in the pathogenesis of schizophrenia. The aim of this study was to investigate the levels of tumor necrosis factor (TNF) and matrix metalloproteinase-2 (MMP-2) in male patients with treatment-resistant schizophrenia (TRS) and chronic medicated schizophrenia (CMS), and the relationship with psychopathology. METHODS: The study enrolled 31 TRS and 49 cm male patients, and 53 healthy controls. Serum MMP-2 and TNF-α levels were measured by the Luminex liquid suspension chip detection method. Positive and Negative Syndrome Scale (PANSS) scores were used to evaluate symptom severity and Repeatable Battery for the Assessment of Neuropsychological Status was used to assess cognitive function. RESULTS: Serum TNF-α and MMP-2 levels differed significantly between TRS, CMS and healthy control patients (F = 4.289, P = 0.016; F = 4.682, P = 0.011, respectively). Bonferroni correction demonstrated that serum TNF-α levels were significantly elevated in CMS patients (P = 0.022) and MMP-2 levels were significantly higher in TRS patients (P = 0.014) compared to healthy controls. In TRS patients, TNF-α was negatively correlated with age (r=-0.435, P = 0.015) and age of onset (r=-0.409, P = 0.022). In CMS patients, MMP-2 and TNF-α were negatively correlated with PANSS negative and total scores, and TNF-α was negatively correlated with PANSS general psychopathology scores (all P < 0.05). MMP-2 levels were positively correlated with TNF-α levels (P < 0.05), but not with cognitive function (P > 0.05). CONCLUSION: The results indicate the involvement of inflammation in the etiology of TRS and CMS. Further studies are warranted.


Assuntos
Esquizofrenia , Humanos , Masculino , Cognição , Inflamação , Metaloproteinase 2 da Matriz/sangue , Metaloproteinase 2 da Matriz/química , Esquizofrenia/diagnóstico , Esquizofrenia/tratamento farmacológico , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/química
7.
Psychol Med ; 54(6): 1074-1083, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38433596

RESUMO

Decision-making capacity (DMC) among psychiatric inpatients is a pivotal clinical concern. A review by Okai et al. (2007) suggested that most psychiatric inpatients have DMC for treatment, and its assessment is reliable. Nevertheless, the high heterogeneity and mixed results from other studies mean there is considerable uncertainty around this topic. This study aimed to update Okai's research by conducting a systematic review with meta-analysis to address heterogeneity. We performed a systematic search across four databases, yielding 5351 results. We extracted data from 20 eligible studies on adult psychiatric inpatients, covering DMC assessments from 2006 to May 2022. A meta-analysis was conducted on 11 papers, and a quality assessment was performed. The study protocol was registered on PROSPERO (ID: CRD42022330074). The proportion of patients with DMC for treatment varied widely based on treatment setting, the specific decision and assessment methods. Reliable capacity assessment was feasible. The Mini-Mental State Examination (MMSE), Global Assessment of Function (GAF), and Brief Psychiatric Rating Scale (BPRS) predicted clinical judgments of capacity. Schizophrenia and bipolar mania were linked to the highest incapacity rates, while depression and anxiety symptoms were associated with better capacity and insight. Unemployment was the only sociodemographic factor correlated with incapacity. Assessing mental capacity is replicable, with most psychiatric inpatients able to make treatment decisions. However, this capacity varies with admission stage, formal status (involuntary or voluntary), and information provided. The severity of psychopathology is linked to mental capacity, though detailed psychopathological data are limited.


Assuntos
Competência Mental , Esquizofrenia , Adulto , Humanos , Competência Mental/psicologia , Pacientes Internados/psicologia , Tomada de Decisões , Incerteza
8.
Artigo em Russo | MEDLINE | ID: mdl-38465820

RESUMO

OBJECTIVE: To establish the relationships of functional changes of the brain of patients with schizophrenia with clinical manifestations of the disease and their constitutional and morphological features. MATERIAL AND METHODS: One hundred and eighteen patients with schizophrenia (64 men and 54 women), aged 33 [29; 40], years were examined. The following clinical and dynamic parameters were used: age of manifestation of the disease, duration of the disease, severity of clinical and psychopathological symptoms according to the PANSS. The anthropometric examination of patients was carried out according to V.V. Bunak's method in V.P. Chitetsov's modification for adult samples with calculation of Rees-Eysenk and Tanner indices. The EEG was recorded and analyzed in a state of calm, relaxed wakefulness with closed eyes with the calculation of the absolute spectral power for theta (4-7 Hz), alpha (8-13 Hz) and beta (14-30 Hz) rhythms. RESULTS: Significant (p<0.05) direct correlations between the age of the disease manifestation and the spectral power of the beta rhythm in the frontal leads (Fp1, Fp2, F3 and F4) were revealed. Inverse correlations (p<0.05) were found between the duration of the disease in patients with schizophrenia and the spectral power of the alpha rhythm in the left temporal (T3) and right central leads (C4), the spectral power of the beta rhythm in the parietal-occipital (P3, P4, O1,O2) and temporal leads (T3, T4, T5), the spectral power of the theta rhythm in the left occipital (O1) and posterior temporal leads (T5). Significant inverse correlations were also found between the Tanner index and the spectral power of the alpha rhythm in the frontal and temporal leads, between the Rees-Eysenk index and the spectral power of the theta rhythm in the frontal leads. CONCLUSION: The results indicate the presence of the conjugation of functional changes in the brain of patients with schizophrenia with clinical manifestations of the disease and their constitutional and morphological features. Thus, the assessment of the functional state of the central nervous system in patients with schizophrenia is an important component of the diagnostic search.


Assuntos
Eletroencefalografia , Esquizofrenia , Adulto , Masculino , Humanos , Feminino , Eletroencefalografia/métodos , Esquizofrenia/diagnóstico , Encéfalo/diagnóstico por imagem , Ritmo Teta , Ritmo alfa
9.
CNS Neurosci Ther ; 30(3): e14645, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38432851

RESUMO

BACKGROUND: Noninvasive brain stimulation (NIBS) techniques are a promising tool for treating the negative symptoms of schizophrenia. Growing evidence suggests that different dimensions of negative symptoms have partly distinct underlying pathophysiological mechanisms. Previous randomized controlled trials (RCTs) have shown inconsistent impacts of NIBS across dimensions. OBJECTIVE: This systematic review and meta-analysis evaluated the effects of NIBS on general negative symptoms, and on specific domains, including blunted affect, alogia, asociality, anhedonia, and avolition. DATA SOURCES: PubMed, Web of Science, Embase, Cochrane CENTRAL, PsycINFO, OpenGrey, and Clinicaltrials.gov from the first date available to October, 2023. RESULTS: Among 1049 studies, we identified eight high-quality RCTs. NIBS significantly affects general negative symptoms (SMD = -0.54, 95% CI [-0.88, -0.21]) and all five domains (SMD = -0.32 to -0.63). Among dimensions, better effects have been shown for improvement of avolition (SMD = -0.47, 95% CI [-0.81, -0.13]) and anhedonia (SMD = -0.63, 95% CI [-0.98, -0.28]). Subgroup analyses of studies that applied once daily stimulation or >10 sessions showed significantly reduced negative symptom severity. CONCLUSION: NIBS exerts distinct effects across multiple dimensions of negative symptom, with treatment effects related to stimulation frequency and total sessions. These results need to be confirmed in dedicated studies.


Assuntos
Anedonia , Terapia por Estimulação Elétrica , Esquizofrenia , Humanos , Encéfalo , PubMed , Esquizofrenia/terapia
10.
BMC Psychiatry ; 24(1): 179, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38439012

RESUMO

BACKGROUND: People with schizophrenia often face challenges such as lower psychological resilience, reduced self-worth, and increased social stigma, hindering their recovery. Mindfulness-Based Cognitive Therapy (MBCT) has shown promise in boosting psychological resilience and self-esteem while diminishing stigma. However, MBCT demands professional involvement and substantial expenses, adding to the workload of professionals and the financial strain on patients. Mixed-mode Mindfulness-Based Cognitive Therapy (M-MBCT) integrates both "face-to-face" and "self-help" approaches to minimize staff effort and costs. This study aims to assess the impact of M-MBCT on the psychological resilience, self-esteem, and stigma in schizophrenia patients. METHODS: This randomized, controlled, parallel-group, assessor-blinded clinical trial enrolled 174 inpatients with schizophrenia. Participants were randomly assigned to either the experimental or control group. The experimental group underwent an 8-week M-MBCT intervention, while the control group received standard treatment. Data collection employed the Connor-Davidson Resilience Scale (CD-RISC), Internalized Stigma of Mental Illness Scale (ISMI), and Rosenberg Self-Esteem Scale (RSES) before and after the intervention. Post-intervention, significant differences in ISMI, CD-RISC, and RSES scores were observed between the experimental and control groups. RESULTS: In the experimental group, ISMI scores notably decreased, while CD-RISC and RSES scores significantly increased (P < 0.05). Multiple linear regression analysis identified age, education, and family history of mental illness as significant factors related to stigma (P < 0.05). Additionally, correlation analysis indicated a significant negative relationship between the reduction in CD-RISC scores and the reduction in ISMI scores (P < 0.05). CONCLUSION: M-MBCT effectively enhanced psychological resilience and self-esteem while diminishing stigma in individuals with schizophrenia. M-MBCT emerges as a promising treatment option for schizophrenia sufferers. TRIAL REGISTRATION: The trial was registered at the Chinese Clinical Trial Registry on 03/06/2023 ( www.chictr.org.cn ; ChiCTR ID: ChiCTR2300069071).


Assuntos
Terapia Cognitivo-Comportamental , Atenção Plena , Testes Psicológicos , Resiliência Psicológica , Esquizofrenia , Humanos , Esquizofrenia/terapia , Estigma Social , Pacientes Internados , Autoimagem
11.
BMC Psychiatry ; 24(1): 177, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38439019

RESUMO

BACKGROUND: Healthy lifestyle is an important protective factor of developing cardiovascular disease in people with schizophrenia. However, little is known about the determinants of lifestyle and its contribution to metabolic syndrome. This study aimed to explore the influencing factors of health-promoting lifestyle (HPL) and its association with metabolic syndrome among people with schizophrenia. METHODS: A cross-sectional study was conducted in twenty-two primary health centers of Guangzhou, China between December 2022 and April 2023. A total of 538 patients with schizophrenia were recruited through convenience sampling. Self-administered scales, questionnaires, and clinical data were collected. Scales and questionnaires included social-demographic information, Health-Promoting Lifestyles Profile (HPLP-C), UCLA Loneliness Scale (ULS), and International Physical Activity Questionnaire-Short Form (IPAQ-SF). Cluster analyses were used to divide participants into two groups based on the distribution characteristics of HPLP-C scores. Logistic regression models were used to identify factors associated with HPL and the association between HPL and metabolic syndrome. RESULTS: There were 271 participants in the high HPL group and 267 participants in the low HPL group. Logistic regression analysis revealed that loneliness posed a risk factor for high HPL, while high education and moderate-vigorous physical activity served as protective factors for high HPL. Low HPL was a risk factor for the prevalence of metabolic syndrome. CONCLUSIONS: Promotion of high education literacy and a physically active lifestyle should be priority targets in the health management of schizophrenia. Primary healthcare providers can play a pivotal role in assisting patients to mitigate metabolic syndrome by reinforcing healthy lifestyle strategies.


Assuntos
Síndrome Metabólica , Esquizofrenia , Humanos , Esquizofrenia/complicações , Estudos Transversais , Estilo de Vida Saudável , Estilo de Vida
12.
Medicine (Baltimore) ; 103(10): e37226, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38457544

RESUMO

BACKGROUND: The efficacy and safety of Xiaoyao Pill combined with Western medicine in the treatment of schizophrenia are still inconclusive. This meta-analysis summarized relevant studies to compare the efficacy and safety of Xiaoyao Pill combined with Western medicine and Western medicine alone in the treatment of schizophrenia, aiming to provide guidance for clinical treatment. METHODS: In this meta-analysis, we searched PubMed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP, and CBM databases from the establishment of the databases to August 2023. The study proposed to include studies that reported combination of Xiaoyao Pill with Western medicine and Western medicine alone in the treatment of schizophrenia, excluding published literature, unpublished literature, literature with incomplete or inadequate information, animal experiments, literature reviews and systematic studies. Data were analyzed using Review manager 5.3. RESULTS: About 9 studies (6 RCTs and 3 case-control studies) were included in this meta-analysis. The sample size ranged from 60 to 128, with a total of 779 patients, including 395 in the combined treatment group and 384 in the control group. Pooled results showed that the total effective rate of combined treatment group was significantly higher than that of Western medicine alone (OR = 4.21, 95% CI: 1.50-11.83, P = .006). Positive and Negative Syndrome Scale (PANSS) (-) (MD = -2.30, 95% CI: -3.72 ~ -0.89, P = .001) and PANSS (+) (MD = -2.60, 95% CI: -3.34 ~ -1.86, P < .00001) of combined treatment group were all significantly lower than that of Western medicine alone. Additionally, PRL levels of combined treatment group was significantly lower than that of Western medicine alone (MD = -28.78, 95% CI: -42.20 ~ -15.35, P < .0001). However, there was no significant difference in BPRS and total PANSS between combined treatment group and Western medicine alone group. Notably, pooled results showed that there was no significant difference in incidence of adverse events between combined treatment group and Western medicine alone group. CONCLUSION: The effective rate of Xiaoyao Pill combined with Western medicine in the treatment of schizophrenia is higher than that of Western medicine alone, which can effectively relieve the positive and negative symptoms of schizophrenia, and can significantly reduce the level of PRL. In the treatment of schizophrenia, clinicians can give priority to Xiaoyao Pill combined with Western medicine therapy.


Assuntos
Medicamentos de Ervas Chinesas , Esquizofrenia , Humanos , Esquizofrenia/tratamento farmacológico , Medicamentos de Ervas Chinesas/efeitos adversos , Estudos de Casos e Controles
13.
Arch Psychiatr Nurs ; 48: 13-19, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38453277

RESUMO

OBJECTIVES: The goal of this quality improvement project (QIP) was to increase awareness of the serious medical consequences of clozapine-associated constipation to front line nursing staff and patients with schizophrenia. METHODS: The QIP was developed iteratively by psychiatric nurses, psychiatrists and pharmacists with input from patients. The processes involved a literature review, development of educational materials for staff and patients, and the creation of a daily bowel movements log (BML). Implementation involved review of the BML at treatment team meetings, and deployment of pharmacological and non-pharmacological interventions to resolve constipation and increase awareness and knowledge of this clinical concern. OUTCOMES: The initial pilot screened for symptoms of constipation in patients receiving clozapine and non-clozapine antipsychotic agents and intervening as necessary during multidisciplinary team meetings. Patients benefited from relief of constipation and improved bowel habits. Staff benefited from improved knowledge and making requisite changes in workflow and practice. Feedback allowed refinements to be made to the educational materials for patients and staff. Since full implementation, bowel habits are routinely monitored, and interventions are reviewed for effectiveness. Staff satisfaction with this QIP is reflected in answers to a structured questionnaire and in patient reports (n = 50). CONCLUSIONS: Clozapine, the only approved and efficacious medication for treatment-resistant schizophrenia is significantly underutilized. Medically consequential constipation can be a serious barrier to retention of patients benefiting from clozapine. Increased awareness and use of educational materials for patients and staff, routine monitoring of bowel habits combined with pharmacological and non-pharmacological interventions can successfully address this clinical problem.


Assuntos
Antipsicóticos , Clozapina , Esquizofrenia , Humanos , Clozapina/efeitos adversos , Melhoria de Qualidade , Constipação Intestinal/induzido quimicamente , Constipação Intestinal/tratamento farmacológico , Antipsicóticos/efeitos adversos , Esquizofrenia/tratamento farmacológico , Esquizofrenia/diagnóstico
14.
Psychiatr Genet ; 34(2): 61-67, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38441082

RESUMO

OBJECTIVES: Schizophrenia is a chronic brain disorder and needs objective diagnostic biomarkers. MicroRNAs are highly expressed in the nervous system. The study investigated the expression and clinical values of serum miR-320d in schizophrenia patients. In addition, the underlying mechanism was preliminarily examined via bioinformatic analysis. MATERIALS AND METHODS: Serum samples were collected from 57 patients with first-episode schizophrenia and 62 healthy controls. The cognitive function of patients was assessed via Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) consisting of seven domains. Serum miR-320d levels were tested via qRT-PCR. The miRNA target predictions were obtained from Target Scan, and annotated through Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. RESULTS: Based on the GSE167630 dataset, downregulated serum miR-320d in schizophrenia was identified, which was determined in the serum of schizophrenia patients. Serum miR-320d presented a conspicuous relationship with MCCB score in both the control group and the schizophrenia group. After adjusting for age, sex, BMI, and education, serum miR-320d was still independently related to the occurrence of schizophrenia. It can identify schizophrenia cases from healthy ones with an AUC of 0.931. The Go enrichment analysis indicated that the target genes were mainly enriched in homophilic cell adhesion and cell-cell adhesion via plasma-membrane adhesion molecules, and GTPase activity and guanosine diphosphate (GDP) binding. Rap1 signaling pathway was enriched via KEGG analysis. CONCLUSION: Serum miR-320d can be taken as a candidate marker for the diagnosis of schizophrenia. Its regulatory role in neuronal cell adhesion and Rap1 signaling pathway might be the potential underlying mechanism of miR-320d in schizophrenia.


Assuntos
MicroRNAs , Esquizofrenia , Humanos , Esquizofrenia/genética
15.
Psychiatr Genet ; 34(2): 43-53, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38441075

RESUMO

OBJECTIVE: Some observational studies have shown that gut microbiome is significantly changed in patients with schizophrenia. We aim to identify the genetic causal link between gut microbiome and schizophrenia. METHODS: A two-sample Mendelian randomization (MR) study was used to evaluate the causal link between gut microbiome and schizophrenia with 28 gut microbiome-associated genetic instrumental variants chosen from recent MR reports and the largest schizophrenia genome-wide association studies (8-Apr-22 release). RESULTS: Inverse variance weighted method showed that genetically increased Bacteroidales_S24-7 (per SD) resulted in increased risk of schizophrenia (OR = 1.110, 95% CI: [1.012-1.217], P  = 0.027). Similarly, genetically increased Prevotellaceae promoted schizophrenia risk (OR = 1.124, 95% CI: [1.030-1.228], P  = 0.009). However, genetically increased Lachnospiraceae reduced schizophrenia risk (OR = 0.878, 95% CI: [0.785-0.983], P  = 0.023). In addition, schizophrenia risk was also suppressed by genetically increased Lactobacillaceae (OR = 0.878, 95% CI: [0.776-0.994], P  = 0.040) and Verrucomicrobiaceae (OR = 0.860, 95% CI: [0.749-0.987], P  = 0.032). Finally, we did not find any significant results in the causal association of other 23 gut microbiome with schizophrenia. CONCLUSION: Our analysis suggests that genetically increased Bacteroidales_S24-7 and Prevotellaceae promotes schizophrenia risk, whereas genetically increased Lachnospiraceae, Lactobacillaceae, and Verrucomicrobiaceae reduces schizophrenia risk. Thus, regulation of the disturbed intestinal microbiota may represent a new therapeutic strategy for patients with schizophrenia.


Assuntos
Microbioma Gastrointestinal , Esquizofrenia , Humanos , Microbioma Gastrointestinal/genética , Estudo de Associação Genômica Ampla , Análise da Randomização Mendeliana , Esquizofrenia/genética
16.
Psychiatr Genet ; 34(2): 54-60, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38441120

RESUMO

OBJECTIVE: The molecular mechanism of electroconvulsive therapy (ECT) for schizophrenia remains unclear. The aim of this study was to uncover the underlying biological mechanisms of ECT in the treatment of schizophrenia using a transcriptional dataset. METHODS: The peripheral blood mRNA sequencing data of eight patients (before and after ECT) and eight healthy controls were analyzed by integrated co-expression network analysis and the differentially expressed genes were analyzed by cluster analysis. Gene set overlap analysis was performed using the hypergeometric distribution of phypfunction in R. Associations of these gene sets with psychiatric disorders were explored. Tissue-specific enrichment analysis, gene ontology enrichment analysis, and protein-protein interaction enrichment analysis were used for gene set organization localization and pathway analysis. RESULTS: We found the genes of the green-yellow module were significantly associated with the effect of ECT treatment and the common gene variants of schizophrenia ( P  = 0.0061; family-wise error correction). The genes of the green-yellow module are mainly enriched in brain tissue and mainly involved in the pathways of neurotrophin, mitogen-activated protein kinase and long-term potentiation. CONCLUSION: Genes associated with the efficacy of ECT were predominantly enriched in neurotrophin, mitogen-activated protein kinase and long-term potentiation signaling pathways.


Assuntos
Eletroconvulsoterapia , Esquizofrenia , Humanos , Esquizofrenia/genética , Esquizofrenia/terapia , RNA-Seq , Fatores de Crescimento Neural , Biologia Computacional , Proteínas Quinases Ativadas por Mitógeno
17.
Expert Rev Neurother ; 24(4): 325-332, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38445396

RESUMO

INTRODUCTION: Paliperidone Palmitate is the only antipsychotic that has been developed in three different intramuscular long-acting injectable (LAI) dosing regimen: monthly (PP1M), quarterly (PP3M), and from 2020 also twice-yearly (PP6M). The latter was approved for the maintenance treatment of adults with schizophrenia and clinically stabilized with PP1M or PP3M. AREAS COVERED: Data from studies evaluating efficacy in the maintenance treatment of schizophrenia with PP6M are reviewed. Since no post-marketing safety studies are currently available, data from spontaneous reporting system databases, FAERS and Eudravigilance, are analyzed and the reported treatment-emergent adverse events of PP6M are discussed. EXPERT OPINION: The efficacy of PP6M is comparable to that of PP3M in terms of relapses prevention in patients with schizophrenia previously stabilized on PP3M or PP1M. Also, the maintenance of clinical efficacy in the long term has been demonstrated. Data from pharmacovigilance analyses, as well as from phase 3 studies, show that PP6M is generally well tolerated, consistently with PP3M safety data. PP6M allows a longer dosing interval than any other LAI antipsychotics, potentially reducing nonadherence and disease relapses. In future, an increase in the prescription rates of PP6M is expected and real-world efficacy and tolerability studies will be conducted.


Assuntos
Antipsicóticos , Esquizofrenia , Adulto , Humanos , Palmitato de Paliperidona/uso terapêutico , Palmitato de Paliperidona/efeitos adversos , Esquizofrenia/tratamento farmacológico , Resultado do Tratamento , Recidiva
18.
Sci Rep ; 14(1): 5755, 2024 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-38459093

RESUMO

Identifying disease predictors through advanced statistical models enables the discovery of treatment targets for schizophrenia. In this study, a multifaceted clinical and laboratory analysis was conducted, incorporating magnetic resonance spectroscopy with immunology markers, psychiatric scores, and biochemical data, on a cohort of 45 patients diagnosed with schizophrenia and 51 healthy controls. The aim was to delineate predictive markers for diagnosing schizophrenia. A logistic regression model was used, as utilized to analyze the impact of multivariate variables on the prevalence of schizophrenia. Utilization of a stepwise algorithm yielded a final model, optimized using Akaike's information criterion and a logit link function, which incorporated eight predictors (White Blood Cells, Reactive Lymphocytes, Red Blood Cells, Glucose, Insulin, Beck Depression score, Brain Taurine, Creatine and Phosphocreatine concentration). No single factor can reliably differentiate between healthy patients and those with schizophrenia. Therefore, it is valuable to simultaneously consider the values of multiple factors and classify patients using a multivariate model.


Assuntos
Esquizofrenia , Humanos , Esquizofrenia/diagnóstico , Creatina , Fosfocreatina , Espectroscopia de Ressonância Magnética , Encéfalo
19.
Schizophr Res ; 266: 205-215, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38428118

RESUMO

Preventing relapse in schizophrenia improves long-term health outcomes. Repeated episodes of psychotic symptoms shape the trajectory of this illness and can be a detriment to functional recovery. Despite early intervention programs, high relapse rates persist, calling for alternative approaches in relapse prevention. Predicting imminent relapse at an individual level is critical for effective intervention. While clinical profiles are often used to foresee relapse, they lack the specificity and sensitivity needed for timely prediction. Here, we review the use of speech through Natural Language Processing (NLP) to predict a recurrent psychotic episode. Recent advancements in NLP of speech have shown the ability to detect linguistic markers related to thought disorder and other language disruptions within 2-4 weeks preceding a relapse. This approach has shown to be able to capture individual speech patterns, showing promise in its use as a prediction tool. We outline current developments in remote monitoring for psychotic relapses, discuss the challenges and limitations and present the speech-NLP based approach as an alternative to detect relapses with sufficient accuracy, construct validity and lead time to generate clinical actions towards prevention.


Assuntos
Transtornos Psicóticos , Esquizofrenia , Humanos , Fala , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/prevenção & controle , Esquizofrenia/diagnóstico , Prevenção Secundária , Recidiva , Doença Crônica
20.
Schizophr Res ; 266: 216-226, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38428119

RESUMO

BACKGROUND: Patients with schizophrenia exhibit a reduced life expectancy mainly due to medical-related pathologies which might have been initiated due to stressful events during fetal development. Indeed, intra-uterus growth patterns predict anthropometric measures in adulthood, describing risk factors for schizophrenia and metabolic disorders. We aim to evaluate anthropometric values in two cohorts of antipsychotic-naïve first-episode episode psychosis (FEP) and correlated them with surrogate markers of the fetal environment such as birth weight (BW) and season of birth. METHODS: BW, season of birth, and anthropometric values from 2 cohorts of FEP patients (Barcelona and Santander) were evaluated. In cohort B, 91 patients, and 110 controls while in cohort S, 644 and 235 were included respectively. RESULTS: Patients were shorter, slimmer, and with lower BMI compared with controls. In both cohorts, patients, and female patients born in winter displayed the shortest height. Regarding BW, height was significantly associated with the interaction of diagnosis and BW in the whole sample and the male subsample. CONCLUSIONS: Our results confirm reduced anthropometric features in FEP at onset while suggesting the influence of winter birth and BW, highlighting the role of early life events in the later outcome of FEP with sex differences.


Assuntos
Antipsicóticos , Transtornos Psicóticos , Esquizofrenia , Humanos , Feminino , Masculino , Antipsicóticos/uso terapêutico , Transtornos Psicóticos/complicações , Esquizofrenia/tratamento farmacológico , Fatores de Risco , Antropometria , Peso ao Nascer
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