Biomarkers of Depression among Adolescent Girls: BDNF and Epigenetics.

Alterations in brain-derived neurotrophic factor (BDNF) expression have been suggested to mediate the influence of environmental factors on the emergence of depression through epigenetic modifications. However, research on this subject in the developmental population is lacking and the pathophysiology of adolescent depression remains unclear. We aimed to investigate the alterations in BDNF expression and global DNA methylation in depression among adolescent girls. Thirty female inpatients with the initial diagnosis of depression were assessed before and after the period of antidepressant treatment and compared with thirty age-matched healthy controls. The assessment involved BDNF and proBDNF serum levels, the BDNF gene exon IV promoter methylation, and global DNA methylation. The methylation level in the BDNF gene exon IV promoter was significantly lower in the studied group compared with the control and correlated negatively with the severity of depression. The test distinguished the studied group from the controls with a sensitivity of 37% and specificity of 90%. The differences were no longer present after the period of antidepressant treatment. No differences in the global DNA methylation, BDNF, and proBDNF levels were found. We concluded that decreased methylation in the BDNF exon IV promoter could be considered as a biomarker of a depression state among adolescent girls.

FTO and MC4R polymorphisms, and selected pre-, peri- and postnatal factors as determinants of body mass index and fatness in children: a thorough analysis of the associations.

BACKGROUND: Overweight and obesity among children have become significant global health concerns. Previous studies have highlighted the potential role of genetic factors, particularly polymorphisms in the FTO and MC4R genes, as well as environmental factors in the development of childhood obesity. This study aimed to investigate the relationships between genetic, socioeconomic and perinatal factors, adverse childhood events (ACEs), and lifestyle, and their impact on overweight, obesity and body composition parameters in children. Additionally, we explored potential interactions between genetic factors and ACEs. METHODS: Four hundred fifty-six children aged 6-12 years participated in our study. Information on the socioeconomic status, perinatal factors, ACEs and lifestyle of the children was collected with a questionnaire completed by their parents/guardians. We examined the children's body weight and conducted an electrical bioimpedance analysis. Overweight and obesity were diagnosed based on the International Obesity Task Force and McCarthy criteria. We genotyped two selected polymorphisms in the FTO and MC4R genes using the TaqMan SNP allelic discrimination method. RESULTS: Higher BMI (Body Mass Index) z scores were related to higher paternal BMI and lower maternal age at the child's birth. Higher FMI (Fat Mass Index) z scores were associated with higher paternal BMI, increased gestational weight, lower maternal education and the presence of the FTO risk allele. Higher FatM (fat mass in kg) z scores were linked to lower maternal education, lower maternal age at the child's birth, higher maternal body weight gain, paternal BMI and the presence of the FTO risk allele. Moreover, interaction effects were observed on BMI z scores between ACE and FTO AA, and on FMI z scores and FatM z scored between ACE and MC4R CC. CONCLUSIONS: The contribution of environmental factors is more strongly related to changes in body composition than genetic ones. Additionally, the presence of the risk allele combined with unfavourable environmental factors like ACEs leads to visible interaction effects, resulting in increased BMI z scores and FMI z scores in children.

Mentalizing in Adolescents with Borderline Personality Disorder.

Mentalizing, recognized as the capacity to understand behaviors in the context of our own mental states and those of other people, is being researched more and more commonly in regard to various mental disorders. The research on mentalization focuses on, among other things, borderline personality disorder, which is at present perceived as an emerging problem in the population of adolescents. In order to summarize the currently accessible knowledge of mentalizing in adolescents with borderline personality disorder, we thoroughly analyzed relevant publications. Based on the available literature, it can be concluded that the mentalizing ability of adolescents with borderline personality disorder can be impaired. The evidence demonstrates that they are prone to hypermentalizing, defined as an overattribution of mental states to other people. However, this tendency has not been proven to be specific to teenagers with this disorder. Moreover, the existing data suggest that young people with borderline personality exhibit a reduced capacity to mentalize their own inner states.

Cool executive functions and their association with body mass & fatness and the FTO gene in school-aged children.

The FTO gene rs9936909 polymorphism is one of the well-documented single nucleotide polymorphisms in the context of increased risk of obesity, including in children. Few studies have tested the association of the FTO gene with cognitive functions. Deficits of "cool" executive functions (EFs) are considered a potential risk factor for excessive weight. The aims of our study were to investigate whether cool EFs are associated with the Body Mass Index, the Fat Mass Index and the risk of excess body mass and overfatness in neurotypically school-aged children, and whether the FTO gene polymorphism is involved in development of this possible association. The sample consisted of 553 children aged 6-12 years old. A body composition analysis, a neuropsychological assessment of EFs, and FTO polymorphism genotyping were performed in the children studied. The study found a significant association of an interference effect in theStroop Color-Word Interference Task and the risk of excessive body fatness, but not excessive body mass. There were no explicit associations between the FTO genotype and EFs deficits. Environmental factors, and particularly low maternal education, appeared to be the strongest contributors to the increased risk of obesity.

Biomarkers in Child and Adolescent Depression.

Despite the significant prevalence of Major Depressive Disorder in the pediatric population, the pathophysiology of this condition remains unclear, and the treatment outcomes poor. Investigating tools that might aid in diagnosing and treating early-onset depression seems essential in improving the prognosis of the future disease course. Recent studies have focused on searching for biomarkers that constitute biochemical indicators of MDD susceptibility, diagnosis, or treatment outcome. In comparison to increasing evidence of possible biomarkers in adult depression, the studies investigating this subject in the youth population are lacking. This narrative review aims to summarize research on molecular and biochemical biomarkers in child and adolescent depression in order to advocate future directions in the research on this subject. More studies on depression involving the youth population seem vital to comprehend the natural course of the disease and identify features that may underlie commonly observed differences in treatment outcomes between adults and children.

The place of selective serotonin reuptake inhibitors (SSRIs) in the treatment of depressive disorders in children and adolescents. Recommendations of the Main Board of the Polish Psychiatric Association. Part 1 - Clinical efficacy and areas of application. / Miejsce selektywnych inhibitorów zwrotnego wychwytu serotoniny (SSRI) w leczeniu zaburzen depresyjnych u dzieci i mlodziezy. Rekomendacje Zarzadu Glównego Polskiego Towarzystwa Psychiatrycznego. Cz. I ­ Skutecznosc kliniczna i obszary zastosowania.

In the adult population of patients with major depression, both psychotherapeutic and pharmacological interventions are effective, but antidepressants remain the mainstay of treatment. In the case of child and adolescent psychiatry, there is still controversy over whether to use pharmacological interventions and which drug to prefer. Although psychotherapeutic treatment is still considered a first-line treatment, antidepressants are widely used to treat depression in children and adolescents, and the number of medications prescribed for this indication has increased over time. In Poland, about 57,000 patients under 18 years of age currently use reimbursed antidepressants. Antidepressants are generally effective and well tolerated by children, but between 31% and 48% will not respond to them and up to 25% will experience side effects. The aim of the study was to present the effectiveness and tolerance of antidepressants used in depression in the pediatric population. Among all SSRIs, the largest amount of data from short-term RCTs and their meta-analyses indicate the effectiveness of fluoxetine in patients diagnosed with depression < 18 years of age. which still makes it the drug of first choice in this indication. However, the results of meta-analyses do not allow to draw clear conclusions as to the effectiveness of individual SSRIs in the treatment of depression in children and adolescents. Single placebo-controlled studies show the efficacy of sertraline, escitalopram and citalopram in the treatment of depression in patients <18 years of age, making them important treatment options worth considering. There is no reliable evidence on the effectiveness of fluvoxamine.

The place of selective serotonin reuptake inhibitors (SSRIs) in the treatment of depressive disorders in children and adolescents. Recommendations of the Main Board of the Polish Psychiatric Association. Part 2 - pharmacological properties and safety of use. / Miejsce selektywnych inhibitorów zwrotnego wychwytu serotoniny (SSRI) w leczeniu zaburzen depresyjnych u dzieci i mlodziezy. Rekomendacje Zarzadu Glównego Polskiego towarzystwa Psychiatrycznego. Cz. II ­ wlasciwosci farmakologiczne i bezpieczenstwo stosowania.

The aim of the study was to review studies evaluating the pharmacodynamic properties of selective serotonin reuptake inhibitors (SSRIs) and their safety. SSRIs in patients <18 years of age sometimes have different pharmacokinetic parameters compared to adults, which has a significant impact on their effectiveness and tolerance. The concentration of fluoxetine, fluvoxamine or paroxetine is about 2 times higher in children compared to adolescents and adults, which should be taken into account at the stage of both drug introduction and setting target doses. In the event of significant problems with the selection of the drug and / or dose of the drug due to unsatisfactory efficacy and / or tolerance in a patient < 18 years of age, examination of the dominant polymorphism for the metabolism of a given isoenzyme may be very important. SSRIs are generally well tolerated in patients less than 18 years of age and the majority of adverse reactions (TEAEs) during treatment are mild or moderate. Most RCTs evaluating the efficacy of SSRIs in depression in patients <18 years of age rates of suicidal ideation or suicidal ideation during follow-up are comparable to placebo, suicide attempts are rare, and isolated cases occur in both the active treatment groups and the placebo arm. There was no statistically significant increased risk for antidepressants (including all SSRIs) or psychotherapy or combinations of antidepressants with psychotherapy (except venlafaxine). Only venlafaxine therapy was associated with an increased risk of suicidal behavior and/or ideation in short-term therapy compared to placebo.

Apelin-13 and Asprosin in Adolescents with Anorexia Nervosa and Their Association with Psychometric and Metabolic Variables.

Anorexia nervosa (AN) is a widespread, metabo-psychiatric disorder with high relapse rates, comorbidity, and mortality. Many regulatory proteins and neurohormones studied to date play essential roles in the etiopathogenesis of eating disorders and the maintenance of psychopathological symptoms. Nevertheless, the regulatory and pathophysiological mechanisms of AN are still poorly understood. In the presented study, the plasma levels of apelin-13 (APE-13) and asprosin (ASP), as well as carbohydrate metabolism parameters and psychometric parameters, were evaluated in low-weight adolescent female patients with AN (AN1), after partial weight normalization (AN2) and in an age-matched healthy control group (CG) were evaluated. APE-13 levels were higher in the AN1 group than in the post-realimentation and the CG group. APE-13 levels were independent of insulin and glucose levels. Plasma ASP levels increased with increasing body weight in patients with AN, correlating with the severity of eating disorder symptoms in emaciation. The presented data suggest that APE-13 and ASP may be AN's biomarkers-regulation of eating behavior by APE-13 and ASP, the close relationship between them and emotional behavior, and changes in neurohormone levels in patients with eating and affective disorders seem to support these hypotheses. Moreover, their plasma levels seem to be related to the severity of psychopathological symptoms of eating disorders.

Expression of salivary immunoglobulins and their association with analgesic neuropeptide opiorphin in anorexia nervosa during adolescence.

BACKGROUND: Patients who suffer from anorexia nervosa (AN) are characterized by exceedingly lower body weight, micro- and macro-nutrient deficiencies, and hyposalivation as compared to healthy subjects. In addition, AN may predispose to difficulties in oral health maintenance. However, little is known about the relationship between stress-dependent salivary neuro/immunopeptidergic biomarkers such as opiorphin and immunoglobulins (Ig) and AN.The aim of this case-control study was to evaluate salivary opiorphin and immunoglobulins in female children and adolescents diagnosed with AN compared to healthy controls. METHODS: Adolescent patients with clinically-confirmed severe restrictive subtype AN (Body Mass Index BMI < 15 kg/m2, mean age 15.0 ± 1.8, n = 83) were examined in the first week of hospital admission and compared to healthy matched controls (n = 79). Measurements of salivary opiorphin, IgA, IgG, IgM (ELISA technique), and oral hygiene levels (Plaque Control Record index-PCR) were performed. RESULTS: In the AN group, a significantly higher concentration of opiorphin was evidenced (3.1 ± 4.1 ng/ml) compared to the control group (1.1 ± 1.2 ng/ml), (p < 0.001), contrary to IgM, which was significantly lower (311.0 ± 185.3 ng/ml) than in the control group (421.2 ± 168.1 ng/ml), (p < 0.001). There were no significant differences in the levels of IgA and IgG, despite a higher concentration of IgA in the AN group vs. controls (p = 0.14). Spearman analysis revealed a correlation between opiorphin and age (p < 0.05), but also with all immunoglobulins IgA, IgG, IgM (p = 0.006, p < 0.001, p < 0.001). Similarly a correlation was found between PCR index and immunoglobulins IgG, IgM (respectively p = 0.028, p < 0.001), and between body mass, BMI, IBW% and IgA, IgM (all p < 0.05). CONCLUSIONS: In the acute phase of AN, salivary changes in opiorphin and immunoglobulins related to dental plaque suggest an essential role in oral health balance. Changes related to AN may affect the anti-inflammatory and analgesic components of saliva and suggest their use as neurobiological markers in severe malnutrition.

The orofacial region is affected by various inflammatory and autoimmune conditions, which might translate into general and regional changes. Saliva is one of the biological fluids where biomarkers of the aforementioned conditions, including sensitivity to pain, could be detected. It is also noteworthy that anorexia nervosa (AN) and malnutrition may change the saliva's analgesic or immune content, but this scientific area is still not satisfactorily explored. The present work related to analgesic (opiorphin peptide) and anti-infectious agents (immunoglobulins Ig A, IgG, IgM) in said body fluid among 83 adolescent patients with severe AN compared to 79 healthy controls. In addition, oral hygiene levels were assessed in the oral cavity via the Plaque Control Record index (PCR). In the AN group, the concentration of opiorphin was significantly higher as compared to the control group, in contrast to IgM, which was significantly lower than in the control group. There were no notable differences in the levels of IgA and IgG between groups, despite a slightly higher concentrations of IgA in the AN group. A correlation was found between opiorphin and all immunoglobulins. A similar correlation was found between PCR index and all immunoglobulins.The present work shows how analgesic opiorphin depends on the oral inflammatory status. This might be a direction for further investigating the immune alterations in patients with AN-related malnutrition. Inclusion of AN patients in intensive oral hygiene care may also be considered.

Corrigendum: Risk of Dental Caries and Erosive Tooth Wear in 117 Children and Adolescents' Anorexia Nervosa Population-A Case-Control Study.

[This corrects the article DOI: 10.3389/fpsyt.2022.874263.].

Management for Caries Prevention in ADHD Children.

Emotional Dysregulations (ED) represent a major health risk present in about 5% of children and are associated with diverse forms of childhood psychiatric disorders and symptoms such as Attention-Deficit/Hyperactivity Disorder (ADHD) [...].

The relation between prenatal stress, overweight and obesity in children diagnosed according to BMI and percentage fat tissue.

BACKGROUND: One of the environmental factors contributing to abnormal weight changes in children may be maternal exposure to adverse environmental factors during pregnancy, which in previous studies led to inconclusive results showing both overweight or obesity and underweight in children. The aim of the study was to assess the influence of prenatal stress on the BMI status and cut-off points for the percentage of fat content. METHODS: The cohort study included 254 girls and 276 boys. Information on prenatal stress was collected retrospectively with a questionnaire on objective adverse events completed by a parent/guardian of a 6-12-year-old child. We examined the body weight of children and performed an electrical bioimpedance analysis of their body composition. We assessed the BMI status according to the International Obesity Task Force (IOTF) criterion and on the basis of body fat according to McCarthy criterion. RESULTS: The results of our study show that the prenatal stress was related to increased risk of overweight (OR 2.14, 95% CI: 1.25-3.65) diagnosed on the basis of body fat cut-off points, but not when the BMI was a diagnostic criterion (OR 1.03, 95% CI: 0.58-1.83). CONCLUSION: The method of diagnosis based on the fat content appears to be an indicator of the occurrence of abnormalities in body composition due to prenatal stress more sensitive than that based on the BMI. LEVEL OF EVIDENCE: Level III evidence obtained from well-designed cohort or case-control analytic studies.

Risk of Dental Caries and Erosive Tooth Wear in 117 Children and Adolescents' Anorexia Nervosa Population-A Case-Control Study.

Introduction: Restrictive type of anorexia nervosa (AN) is still one of the most severe eating disorders worldwide with an uncertain prognosis. Patients affected by AN should be encouraged to undertake psychiatric care and psychotherapy, but whether they should necessarily be included in careful dental care or not may still be questionable. Even though there is a constantly increasing number of AN studies, there are just a few data about the youngest group of AN children and adolescents aged < 18. Methodology: This case-control study aimed to compare the dental health and gingival inflammation level in female adolescent inpatients affected by severe AN restrictive subtype vs. controls. Based on clinically confirmed 117 AN cases (hospitalized in years 2016-2020 in public Psychiatric Unit, BMI < 15 kg/m2, mean age 14.9 ± 1.8), the dental status has been examined regarding the occurrence of caries lesions using Decay Missing Filling Teeth (DMFT), erosive wear as Basic Erosive Wear Examination (BEWE), gingival condition as Bleeding on Probing (BOP) and plaque deposition as Plaque Control Record (PCR). The results were compared with age-matched 103 female dental patients (BMI 19.8 ± 2.3 kg/m2, age 15.0 ± 1.8, p = 0.746) treated in a public University dental clinic. Results: AN patients were found to present a higher incidence of oral-related complications according to dental status (DMFT 3.8 ± 4.5 vs. 1.9 ± 2.1, p = 0.005), erosive tooth wear (BEWE 18.9 vs. 2.9%, p < 0.001), less efficient in controlling plaque (PCR 43.8 vs. 13.7%, p < 0.001) and gingival inflammation (BOP 20.0 vs. 3.9%, p < 0.001) compared with female adolescents. In the AN group, a significant correlation between BOP, BEWE, and duration of AN disease (p < 0.05), similarly to the number of decayed teeth D, filled teeth F and PCR were detected (p < 0.05). Conclusions: Although the obtained results did not reveal any severe oral status, our findings indicated impaired dental and gingival conditions in young anorexics. Considering AN's potential role in oral health, it is essential to monitor dental treatment needs and oral hygiene levels in their present status to prevent forward complications in the future.

ProBDNF as an Indicator of Improvement among Women with Depressive Episodes.

Depression is a chronic psychiatric disorder with a heavy socioeconomic burden. Studies on biomarkers are needed to comprehend the pathophysiology of depression and to improve treatment outcomes. Research points to the importance of imbalance between mature brain-derived neurotrophic factor (BDNF) and its precursor, pro-brain-derived neurotrophic factor (proBDNF), in the pathophysiology of mood disorders and the potential neurodegenerative role of calcium-binding protein B (S100B). Our objective was to compare BDNF, proBDNF, and S100B serum levels before and after the treatment of acute depressive episodes and to assess their correlation with the severity of symptoms and history of stress. We also aimed to investigate the differences in BDNF, proBDNF, and S100B levels between depression in the course of bipolar disorder (BD) and major depressive disorder (MDD). We recruited 31 female patients diagnosed with BD or MDD who were hospitalized due to current depressive episodes. The patients had their serum BDNF, proBDNF, and S100B levels evaluated using the ELISA method upon admission and after the symptoms improved, at discharge. We found that proBDNF levels decreased significantly with the treatment (p = 0.0478), while BDNF and S100B levels were not altered significantly. No differences in biochemical parameters between MDD and BD subjects were observed. Consequently, we concluded that a decrease in serum proBDNF levels could be considered a biomarker of recovery from depressive episodes.

Project Extension for Community Health Outcomes (ECHO) Autism: A Successful Model to Increase Capacity in Community-Based Care.

Individuals with autism spectrum disorder (ASD) struggle to access high-quality health care due to the shortage of trained providers. ECHO (Extension for Community Healthcare Outcomes) Autism is a unique educational program that allows ASD experts to provide knowledge and skills to professionals in local communities to deliver evidence-based care to children with ASD and their families. The model teaches clinicians how to screen and diagnose ASD, as well as manage common co-occurring medical and mental health issues. ECHO Autism is particularly useful for addressing the complex needs of children with ASD and reducing disparities often present in rural and underserved communities. The model can be disseminated globally due to its flexibility in accommodating local and regional differences in social norms and constructs. This article provides an overview of the format of the ECHO Autism model, data supporting the model's efficacy, and discusses future research directions.

Association of adverse childhood experiences (ACEs) with obesity and underweight in children.

PURPOSE: The aim of the study was to test the hypothesis that adverse childhood experiences (ACEs) are related to both obesity and underweight from childhood, and that the association of ACEs with weight abnormalities is modulated by type of ACEs, sex and socioeconomic status (SES) indices. METHODS: The relations between ACEs (0 vs ≥ 1), ACE accumulation and ACE type with weight status and z scores BMI were assessed in 503 children aged 6-12 years from Poznan, Poland. The effects of interaction of ACEs with sex and SES on z scores BMI were included in the analyses. RESULTS: ACEs were significantly related to both obesity and underweight, in unadjusted analysis, and when sex and SES indices, such as size of place of residence, people per room in household, and parental education were controlled. The relation of ACEs with z scores BMI was modulated by ACE type, parental subjective assessment of economic situation of a family and parental education. ACE accumulation was not related to an increase of obesity or underweight rate, or z scores BMI. CONCLUSION: The study implicates the need for both obesity and underweight prevention in individuals with adverse experiences as early as in childhood. LEVEL OF EVIDENCE: III: evidence obtained from well-designed cohort study.

Expression of immune-related proteins and their association with neuropeptides in adolescent patients with anorexia nervosa.

Anorexia nervosa (AN) is a metabo-psychiatric disorder where alterations of cytokines, neuropeptides, neurotransmitters, and the interactions between these factors can play an important role. Thus, the primary goal of the presented study was a cross-sectional analysis of immune-related proteins in patients with AN. Moreover, the correlations between these molecules and selected neuropeptides were studied. Twenty-five adolescent inpatients girls in the acute stage of a restrictive type of AN were enrolled in the study within the first year of the disease. Additionally, thirty similar in age and height controls (CG) were also assessed. The levels of 24 immune-related proteins, including cytokines, chemokines, and proteases, were measured. Moreover, selected adipocytokines, gastrointestinal hormones, and centrally produced neuropeptides levels were determined. Finally, the correlations between these molecules were analyzed. The fasting levels of CXCL1, CXCL9, FGF2, GrB, IL1, IL6, IL8, MMP8, MMP9, CTSS were statistically lower in AN than in the CG. The concentrations of many immune-related proteins remain unchanged despite their metabolic and mental condition. Moreover, significant correlations were found between leptin and CXCL1, CXCL9, GrB, IL1, IL6, and MMP8. Leptin receptors were correlated with GrB, while resistin was associated with MMP9. Our findings suggest that the initial stage of restrictive AN among adolescents within the first year of the disease is not connected with a pro-inflammatory state. Some immune-related protein changes may be associated with altered neuropeptides, primarily leptin, its receptors, and resistin. Future research should clarify which changes are primary and secondary to weight loss and whether these changes normalize with increasing weight. This would aid in understanding the complex etiopathogenesis of AN and in the search for new methods of treatment.

Polish Psychiatric Association diagnostic and therapeutic management guidelines for patients with early-onset schizophrenia. / Rekomendacje Polskiego Towarzystwa Psychiatrycznego w zakresie postepowania diagnostycznego i terapeutycznego u chorych ze schizofrenia o wczesnym poczatku.

Early onset of schizophrenia (before the age of 18 years) is associated with a higher risk of delayed or missed diagnosis, more severe course of the disease, and an increased susceptibility to adverse reactions to antipsychotic drugs. The objective of this paper is to present the recommendations for the diagnostic and therapeutic management of patients with early-onset schizophrenia, developed on the basis of a literature review and a consensus of a group of experts working with schizophrenia therapy. The formal criteria that must be met to diagnose schizophrenia are the same for children and adults. Early-onset schizophrenia must be thoroughly differentiated from uni - or bipolar affective disorder, autism-spectrum disorders (ASDs) and anxiety disorder. Diagnostic assessment for psychotic disorders is also necessary in the case of abnormal, destructive or aggressive behaviour, or self-harm. The mainstay of schizophrenia treatment is pharmacological therapy, which is used in the treatment of acute episodes and in maintenance treatment - prevention of relapses. However, the use of pharmacological interventions in children and adolescents only to reduce the risk of psychosis development is not justified. Antipsychotic agents significantly differ by their tolerance profile and clinical efficacy. Second-generation antipsychotic agents approved for the treatment of early-onset schizophrenia - aripiprazole, lurasidone and paliperidone - enable its effective and safe treatment. The necessary complement to pharmacological therapy is non-pharmacological interventions that should be adapted to the patient's age, cognitive abilities, disease stage and the needs of the whole family.

Anorexia Nervosa-What Has Changed in the State of Knowledge about Nutritional Rehabilitation for Patients over the Past 10 Years? A Review of Literature.

Anorexia nervosa (AN) is a psycho-metabolic disorder with a high risk of somatic complications such as refeeding syndrome (RFS) and carries the highest mortality rate of all psychiatric illnesses. To date, the consensus on the care for patients with AN has been based on recommendations for a combination of alimentation and psychotherapy. It is important to establish an initial caloric intake that will provide weight gain and minimize the risk of complications in the treatment of undernourished patients. Research over the past few years suggests that current treatment recommendations may be too stringent and should be updated. The aim of this paper is to systematize the current reports on nutritional rehabilitation in AN, to present the results of studies on the safe supplementation of patients and its potential impact on improving prognosis and the healing process. This review of literature, from 2011-2021, describes the changing trend in the nutritional protocols used and the research on their efficacy, safety, and long-term effects. In addition, it presents previous reports on the potential benefits of introducing vitamin, pro-and prebiotic and fatty acid supplementation.

Common and Unique Genetic Background between Attention-Deficit/Hyperactivity Disorder and Excessive Body Weight.

Comorbidity studies show that children with ADHD have a higher risk of being overweight and obese than healthy children. This study aimed to assess the genetic alternations that differ between and are shared by ADHD and excessive body weight (EBW). The sample consisted of 743 Polish children aged between 6 and 17 years. We analyzed a unique set of genes and polymorphisms selected for ADHD and/or obesity based on gene prioritization tools. Polymorphisms in the KCNIP1, SLC1A3, MTHFR, ADRA2A, and SLC6A2 genes proved to be associated with the risk of ADHD in the studied population. The COMT gene polymorphism was one that specifically increased the risk of EBW in the ADHD group. Using the whole-exome sequencing technique, we have shown that the ADHD group contains rare and protein-truncating variants in the FBXL17, DBH, MTHFR, PCDH7, RSPH3, SPTBN1, and TNRC6C genes. In turn, variants in the ADRA2A, DYNC1H1, MAP1A, SEMA6D, and ZNF536 genes were specific for ADHD with EBW. In this way, we confirmed, at the molecular level, the existence of genes specifically predisposing to EBW in ADHD patients, which are associated with the biological pathways involved in the regulation of the reward system, intestinal microbiome, and muscle metabolism.