Gut Microbiome Composition and Its Association with Sleep in Major Psychiatric Disorders.

INTRODUCTION: Sleep disturbances are highly prevalent across most major psychiatric disorders. Alterations in the hypothalamic-pituitary-adrenal axis, neuroimmune mechanisms, and circadian rhythm disturbances partially explain this connection. The gut microbiome is also suspected to play a role in sleep regulation, and recent studies suggest that certain probiotics, prebiotics, synbiotics, and fecal microbiome transplantation can improve sleep quality. METHODS: We aimed to assess the relationship between gut-microbiota composition, psychiatric disorders, and sleep quality in this cross-sectional, cross-disorder study. We recruited 103 participants, 63 patients with psychiatric disorders (major depressive disorder [n = 31], bipolar disorder [n = 13], psychotic disorder [n = 19]) along with 40 healthy controls. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). The fecal microbiome was analyzed using 16S rRNA sequencing, and groups were compared based on alpha and beta diversity metrics, as well as differentially abundant species and genera. RESULTS: A transdiagnostic decrease in alpha diversity and differences in beta diversity indices were observed in psychiatric patients, compared to controls. Correlation analysis of diversity metrics and PSQI score showed no significance in the patient and control groups. However, three species, Ellagibacter isourolithinifaciens, Senegalimassilia faecalis, and uncultured Blautia sp., and two genera, Senegalimassilia and uncultured Muribaculaceae genus, were differentially abundant in psychiatric patients with good sleep quality (PSQI >8), compared to poor-sleep quality patients (PSQI ≤8). CONCLUSION: In conclusion, this study raises important questions about the interconnection of the gut microbiome and sleep disturbances.

Altered state and trait disgust in borderline personality disorder.

Clinical experience suggests that the emotion disgust plays an important role in borderline personality disorder (BPD). We investigated 30 female patients with BPD and 30 healthy women who answered different measures of trait disgust, specifically disgust proneness, disgust sensitivity, and self-disgust. Moreover, all participants rated affective facial expressions as well as affective scenes according to perceived or elicited basic emotions. The patients with BPD reported elevated trait disgust, especially for the area of self-disgust. They also rated facial expressions of disgust as more intense than did the healthy women but only when the person who displayed this emotion was male. This sex-specific disgust bias was independent of depression and experienced sexual/physical abuse in the clinical group. Altogether, the patients with BPD showed a broad spectrum of altered disgust processes, which was positively correlated with disorder severity. Consequently, the assessment of disgust reactivity should be introduced as a diagnostic tool for this disorder.

Sinusoidal smooth pursuit eye tracking at different stimulus frequencies: position error and velocity error before catch-up saccades in schizophrenia and in major depressive disorder.

OBJECTIVE: The aim of the present study was to ascertain the extent of impairment of position error and velocity error processing in eye tracking dysfunction in schizophrenic and depressive patients. METHOD: A total of 21 schizophrenic and 19 unipolar depressive patients and 21 healthy controls were subjected to an eye tracking test with electro-oculography using horizontal sinusoidal stimuli with frequencies of 0.2-0.7 Hz. Position error and velocity error were measured over a saccade-free range of 200 ms before catch-up saccades at 50 ms intervals. RESULTS: For position error, the schizophrenia patients displayed increased values particularly compared to controls, more rarely compared to depressive patients, depending on the stimulus frequency used. The increase in stimulus frequency did not lead to an increase in position error in any group of subjects over a prolonged period. For velocity error, in contrast, the study groups differed only in a few, isolated pre-saccadic intervals. The increase in stimulus frequency, however, led to an increase in velocity error in the schizophrenia patients over the entire 200 ms interval. The depressive patients did not differ notably from the controls, neither in terms of position error nor velocity error. CONCLUSIONS: Eye tracking dysfunction in schizophrenia can be described as follows with regard to position error and velocity error: On the one hand, there is an increased position error tolerance largely independent of stimulus frequency, possibly due to an impairment of processing localization information. On the other hand, velocity processing is more severely impaired by an increase in stimulus frequency.

[Atypical antipsychotics and metabolic syndrome]. / Atypische Neuroleptika und metabolisches Syndrom.

The introduction of atypical antipsychotics in psychopharmacology represented a major advance in the treatment of psychotic disorders. However, there have been numerous studies that certain atypical antipsychotics may be associated with a greater risk of metabolic abnormalities than others, including weight gain, hyperlipidemia and new-onset typ 2 diabetes mellitus. A G-Protein beta3 subunit Gen (C825T) polymorphism, an increased carbohydrate metabolism and dyshormonism are discussed as pathogenetic mechanisms. High risk patients (adiposity, hyperlipidaemia, hyperglycaemia, preexisting diabetes) should maintain an antipsychotic agent with a favourable side effect profile. In these cases a periodical diabetes screening and blood lipid controls are required. Clinicans must balance the significant benefits of atypical antipsychotics against the risk of metabolic disturbances. In this article recent findings are reviewed.