The deficit subtype of schizophrenia is associated with a pro-inflammatory phenotype but not with altered levels of zonulin: Findings from a case-control study.

There is evidence that subclinical inflammation and increased gut permeability might be involved in the pathophysiology of schizophrenia. Less is known about these phenomena in patients with the deficit subtype of schizophrenia (D-SCZ) characterized by primary and enduring negative symptoms. Therefore, in the present study we aimed to compare the levels of zonulin (the marker of gut permeability) and immune-inflammatory markers in patients with D-SCZ, those with non-deficit schizophrenia (ND-SCZ) and healthy controls (HCs). A total of 119 outpatients with schizophrenia and 120 HCs were enrolled. The levels of 26 immune-inflammatory markers and zonulin were determined in serum samples. The following between-group differences were significant after adjustment for multiple testing and the effects of potential confounding factors: 1) higher levels of interleukin(IL)- 1ß and C-reactive protein (CRP) in patients with D-SCZ compared to those with ND-SCZ and HCs; 2) higher levels of tumor necrosis factor-α and RANTES in both groups of patients with schizophrenia compared to HCs and 3) higher levels of IL-17 in patients with D-SCZ compared to HCs. No significant between-group differences in zonulin levels were found. Higher levels of IL-1ß and CRP were associated with worse performance of attention after adjustment for age, education and chlorpromazine equivalents. Also, higher levels of IL-1ß were correlated with greater severity of negative symptoms after adjustment for potential confounding factors. In conclusion, individuals with D-SCZ are more likely to show subclinical inflammation. However, findings from the present study do not support the hypothesis that this phenomenon is secondary to increased gut permeability.

Gut microbiota alterations in stable outpatients with schizophrenia: findings from a case-control study.

OBJECTIVE: The pathogenesis of schizophrenia is multidimensional and intensively studied. The gut-brain axis disturbances might play a significant role in the development of schizophrenia. METHODS: We compared the gut microbiota of 53 individuals with schizophrenia and 58 healthy controls, using the 16S rRNA sequencing method. Individuals with schizophrenia were assessed using the following scales: the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, the Social and Occupational Functioning Assessment Scale and the Repeatable Battery for the Assessment of Neuropsychological Status. RESULTS: No significant between-group differences in α-diversity measures were observed. Increased abundance of Lactobacillales (order level), Bacilli (class level) and Actinobacteriota (phylum level) were found in individuals with schizophrenia regardless of potential confounding factors, and using two independent analytical approaches (the distance-based redundancy analysis and the generalised linear model analysis). Additionally, significant correlations between various bacterial taxa (the Bacteroidia class, the Actinobacteriota phylum, the Bacteroidota phylum, the Coriobacteriales order and the Coriobacteria class) and clinical manifestation (the severity of negative symptoms, performance of language abilities, social and occupational functioning) were observed. CONCLUSIONS: The present study indicates that gut microbiota alterations are present in European patients with schizophrenia. The abundance of certain bacterial taxa might be associated with the severity of negative symptoms, cognitive performance and general functioning. Nonetheless, additional studies are needed before the translation of our results into clinical practice.

Risk factors of deficit and non-deficit schizophrenia: Results from a cross-sectional study.

AIM: It has been observed that deficit and non-deficit schizophrenia (SCZ-D and SCZ-ND) might be characterized by different risk factors. Therefore, the present study aimed to assess as to whether previously reported risk factors of schizophrenia are specifically associated with SCZ-D and SCZ-ND. METHOD: This study was based on a cohort of 118 stable outpatients with schizophrenia. A diagnosis of SCZ-D was established using the Schedule for the Deficit Syndrome (SDS). Risk factors were recorded using structured interview, the Operational Criteria for Psychotic Illness (OPCRIT) checklist and the Traumatic Experience Checklist (TEC). The following risk factors were explored: male sex, a history of schizophrenia in first-degree relatives, seasonality of birth, birth weight <3000g, delivery by cesarean section, a history of childhood trauma (emotional abuse, emotional neglect, physical abuse and sexual abuse) as well as substance abuse (other than nicotine) and cigarette smoking at psychosis onset. RESULTS: Individuals with SCZ-D were more likely to be males as well as reported higher rates of birth weight <3000g and any categories of childhood trauma. In turn, substance abuse (other than nicotine) at psychosis onset was significantly more frequent in patients with SCZ-ND. Binary logistic regression, controlling for multiple comparisons, revealed similar findings, except for the association with any categories of childhood trauma that appeared to be not significant. CONCLUSION: Our findings partially replicate differential patterns of risk factors for SCZ-D (male sex and birth weight <3000g) and SCZ-ND (substance abuse at psychosis onset), likely attributable to the effects of timing of exposure.

Risk factors of deficit and non-deficit schizophrenia: Results from a cross-sectional study / Factores de riesgo para la esquizofrenia deficitaria y no deficitaria: resultados de un estudio transversal

Aim: It has been observed that deficit and non-deficit schizophrenia (SCZ-D and SCZ-ND) might be characterized by different risk factors. Therefore, the present study aimed to assess as to whether previously reported risk factors of schizophrenia are specifically associated with SCZ-D and SCZ-ND. Method: This study was based on a cohort of 118 stable outpatients with schizophrenia. A diagnosis of SCZ-D was established using the Schedule for the Deficit Syndrome (SDS). Risk factors were recorded using structured interview, the Operational Criteria for Psychotic Illness (OPCRIT) checklist and the Traumatic Experience Checklist (TEC). The following risk factors were explored: male sex, a history of schizophrenia in first-degree relatives, seasonality of birth, birth weight <3000g, delivery by cesarean section, a history of childhood trauma (emotional abuse, emotional neglect, physical abuse and sexual abuse) as well as substance abuse (other than nicotine) and cigarette smoking at psychosis onset. Results: Individuals with SCZ-D were more likely to be males as well as reported higher rates of birth weight <3000g and any categories of childhood trauma. In turn, substance abuse (other than nicotine) at psychosis onset was significantly more frequent in patients with SCZ-ND. Binary logistic regression, controlling for multiple comparisons, revealed similar findings, except for the association with any categories of childhood trauma that appeared to be not significant. Conclusion: Our findings partially replicate differential patterns of risk factors for SCZ-D (male sex and birth weight <3000g) and SCZ-ND (substance abuse at psychosis onset), likely attributable to the effects of timing of exposure. (AU)

Objetivo: Se ha observado que la esquizofrenia deficitaria y no deficitaria (ES-D y ES-ND) pueden caracterizarse por diferentes factores de riesgo. El presente estudio tuvo como objetivo evaluar si los factores de riesgo de esquizofrenia previamente informados están específicamente asociados con ES-D y ES-ND. Método: Este estudio se basó en una cohorte de 118 pacientes ambulatorios. Se estableció el diagnóstico de ES-D mediante el Inventario para la Esquizofrenia Deficitaria. Los factores de riesgo se registraron mediante entrevista estructurada, la lista de verificación de Criterios Operativos para Enfermedades Psicóticas y la Lista de Verificación de Experiencia Traumática. Se exploraron los siguientes factores de riesgo: sexo masculino, antecedentes de esquizofrenia en familiares de primer grado, estacionalidad del nacimiento, peso al nacer <3.000g, parto por cesárea, antecedentes de trauma infantil, así como el abuso de sustancias (aparte de la nicotina) y el tabaquismo al inicio de la psicosis. Resultados: Las personas con ES-D tenían más probabilidades de ser varones y también informaron de tasas más altas de peso al nacer <3.000g y cualquier categoría de trauma infantil. A su vez, el abuso de sustancias (diferentes a la nicotina) al inicio de la psicosis fue significativamente más frecuente en pacientes con ES-ND. La regresión logística binaria, controlando comparaciones múltiples, reveló hallazgos similares, excepto por la asociación con cualquier categoría de trauma infantil que pareció no ser significativa. Conclusión: Nuestros resultados replican parcialmente los patrones diferenciales de los factores de riesgo para ES-D (sexo masculino y peso al nacer <3.000g) y ES-ND (abuso de sustancias al inicio de la psicosis), probablemente atribuibles a los efectos del momento de la exposición. (AU)

Novel psychopathological picture during the COVID-19 pandemic based on a first episode of psychotic depression. / Nowy obraz objawów psychopatologicznych w dobie pandemii COVID-19 na podstawie pierwszego epizodu depresji psychotycznej.

The emerging SARS-CoV-2 pandemic is known to take a toll on both physical and mental health. We present a case of a patient with a first episode of severe depression with COVID-19-related psychotic features. A patient with no history of mental disorders was admitted to the Psychiatric Unit due to the symptoms of severe depressive episode with psychotic features. Progressive deterioration of his mental health, behavior and activity was observed in March of 2020. He was not infected nor exposed to infectious agents but presented delusions about being infected with SARS-CoV-2 and being a source of transmission to other people. He suffered from Hashimoto disease and recently diagnosed lymphoma which further diagnosis was postponed. He was administrated venlafaxine 150 mg and mirtazapine 45 mg with addition of olanzapine up to 20 mg and risperidone up to 6 mg per day. No side effects were reported. The patient reached a full recovery with the exception of slightly blunted ability to feel pleasure, minor problems with concentration and occasional pessimistic thoughts. Discussion: The social distancing recommendations put a psychological strain related to alienation and negative emotions which can favor development of depressive symptoms. Analysis of psychological mechanisms related to the pandemic and restrictions is significant for limiting negative influence of global crisis on individual mental well-being. Conclusions: In this case the impact of global anxiety and its integration into the developing psychopathological symptoms is especially significant. The circumstances surrounding an episode of affective disorder may shape its course and thought content.

The Impact of Adverse Childhood Experiences on Coping Strategies in Schizophrenia Spectrum Disorders: A Case-Control Study.

PURPOSE: Several studies have shown that individuals with schizophrenia-spectrum disorders (SSD) employ ineffective coping styles. However, it remains unknown whether a history of adverse childhood experiences (AC Es), associated with a risk of SSD, contributes to these observations. Therefore, in this study, we aimed to investigate whether exposure to ACEs is associated with coping styles in subjects with SSD. PATIENTS AND METHODS: We recruited 127 inpatients with SSD and 56 healthy controls. Coping styles and ACEs were recorded using self-reports. RESULTS: Individuals with SSD had significantly higher use of using avoidance coping. A history of parental antipathy, physical and sexual abuse was significantly more frequent in subjects with SSD compared to controls. Subjects with SSD had significantly higher multiplicity and severity of ACEs. Individuals with SSD and a history of parental loss had significantly higher use of avoidance coping compared to controls with and without a history of parental loss. Other characteristics of ACEs (age at first exposure, severity and multiplicity) were not associated with using specific coping strategies. CONCLUSION: These findings imply that higher use of using avoidance coping by individuals with SSD might be related to a history of parental loss.

Personality Factors Crucial in Internalized Stigma Understanding in Psychiatry.

Objective: The main purpose of this research was to establish the relationship between personality traits and internalized stigma in individuals living with severe mental illness. Additionally, the study aimed to identify individual differences that could be used to develop the theoretical socio-cognitive-behavioral equation model of internalized stigma. Methods: A total of 114 patients with diagnosis of nonorganic psychotic disorder or uni- or bipolar affective disorder took part in this study. The Internalized Stigma of Mental Illness (ISMI) scale, Eysenck Personality Questionnaire Revised (EPQ-R) and NEO Five-Factor Inventory (NEO-FFI) were administrated among all participants. Results: Patients presenting higher levels of neuroticism scored higher on the ISMI scale. Otherwise, those with higher levels of extraversion, openness to experience and conscientiousness had lower ISMI scores. With the use of multivariate linear regression, neuroticism, openness to experience and conscientiousness showed the strongest associations with internalized stigma. Conclusions: Intrapersonal factors such as personality traits might explain individual differences in responses to the stigmatization process. Moreover, sociodemographic conditions such as the place of residence and level of education can play a mediating role in reducing the level of internalized stigma. Adequate psychosocial interventions should consider demographics and personality traits when engaging patients with mental illnesses in activities aimed at understanding and accepting the disorders.

The Association between Lifestyle Choices and Schizophrenia Symptoms.

Due to poor eating habits, insufficient physical activity, and nicotine use, schizophrenia patients are at increased risk of lifestyle diseases. Factors contributing to unhealthy behaviors include lower socioeconomic status and level of education as well as social isolation. Schizophrenia manifestations such as amotivation, apathy, and cognitive deficits can further hinder development of proper health habits. The aim of this study was to assess the possible association between lifestyle-related choices and schizophrenia symptoms severity. This observational study enrolled 106 patients with schizophrenia (42 Males/64 Females), 18-69 years (mean: 41.89 ± 9.7 years). Mean duration of schizophrenia was 14.61 ± 9.7 years. Multiple significant correlations were found between patients' lifestyle and their biochemical laboratory parameters (lipid profile and fasting glucose). Most importantly, a significant link emerged between presented habits and schizophrenia symptom severity. There were also significant gender differences in the intake of sweets and sweet beverages. Quite unexpectedly, a behavioral shift towards more healthy lifestyle choices was observed after completion of questionnaires on lifestyle and health habits. There are clear benefits to systematic provision of educational interventions concerning physical activity and proper eating habits to schizophrenia patients. These simple preventive measures could significantly improve both mental and physical health outcomes in schizophrenia patient populations.

The SARS-CoV-2 and mental health: From biological mechanisms to social consequences.

In December 2019, the first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) infection was reported. In only few weeks it has caused a global pandemic, with mortality reaching 3.4%, mostly due to a severe pneumonia. However, the impact of SARS-CoV-2 virus on the central nervous system (CNS) and mental health outcomes remains unclear. Previous studies have demonstrated the presence of other types of coronaviruses in the brain, especially in the brainstem. There is evidence that the novel coronavirus can penetrate CNS through the olfactory or circulatory route as well as it can have an indirect impact on the brain by causing cytokine storm. There are also first reports of neurological signs in patients infected by the SARS-Cov-2. They show that COVID-19 patients have neurologic manifestations like acute cerebrovascular disease, conscious disturbance, taste and olfactory disturbances. In addition, there are studies showing that certain psychopathological symptoms might appear in infected patients, including those related to mood and psychotic disorders as well as post-traumatic stress disorder. Accumulating evidence also indicates that the pandemic might have a great impact on mental health from the global perspective, with medical workers being particularly vulnerable. In this article, we provide a review of studies investigating the impact of the SARS-CoV-2 on the CNS and mental health outcomes. We describe neurobiology of the virus, highlighting the relevance to mental disorders. Furthermore, this article summarizes the impact of the SARS-CoV-2 from the public health perspective. Finally, we present a critical appraisal of evidence and indicate future directions for studies in this field.