European Archives of Psychiatry and Clinical Neuroscience最新文献

Schizophrenia has been linked to an elevated cardiovascular risk profile and premature onset of cardiovascular disease. Quantifying epicardial adipose tissue (EAT) volume provides insight into its correlation with coronary artery disease (CAD) severity and associated risk factors. Previous research indicates higher pericardial adipose tissue in individuals with schizophrenia compared to non-schizophrenic counterparts. RBP4, FABP3, and FABP4 have been implicated in CAD pathogenesis. In this study, we examined the potential increase in EAT volume in individuals with chronic schizophrenia and aimed to elucidate the relationship between circulating levels of RBP4, FABP3, and FABP4 with EAT volume and coronary artery calcium score within this cohort. We recruited 186 consecutive patients with chronic schizophrenia and utilized enzyme-linked immunosorbent assay to assess plasma concentrations of RBP4, FABP3, and FABP4. Cardiac multislice computed tomography measured EAT volume and coronary artery calcium scores. Significantly higher EAT volume in patients with chronic schizophrenia compared to controls. RBP4 associated positively with metabolic factors and EAT volumes, while FABP3 associated positively with creatinine and coronary atherosclerosis markers. FABP4 showed positive associations with metabolic factors, hypertension, and EAT volumes, but negative associations with HDL-C and eGFR. Logistic regression identified RBP4 and FABP4 as independent factors associated with increased EAT volumes, even after adjusting for known biomarkers. Both RBP4 and FABP4 were significantly associated with metabolic syndrome components and EAT volume. This study elucidates the association between chronic schizophrenia and augmented EAT volume, suggesting plausible correlations with CAD-related health complications through RBP4 and FABP4 pathways.

Adverse alcohol consumption is a major public health concern, which might have been further increased by the COVID-19 pandemic. In this study we investigated the impact of a lockdown stage on the association between alcohol consumption, loneliness, and COVID-19-related worries. We used smartphone-based Ecological Momentary Assessment (EMA) conducted during the COVID-19 pandemic in Germany. We recruited 280 participants from the general population, who experienced at least mild loneliness and distress due to the COVID-19 pandemic. We assessed daily alcohol intake, loneliness, and COVID-19-related worries every evening for 7 consecutive days across a no-lockdown [8th August 2020-1st November 2020] and lockdown stage [2nd November 2020-11th March 2021]. We did not find that a lockdown stage, compared to a no-lockdown stage, is associated with increased alcohol consumption. We found that loneliness, previous day drinking, and COVID-19-related worries were not associated with increased, but with decreased alcohol consumption. Moreover, COVID-19-related worries were more negatively associated with alcohol consumption during a no-lockdown stage compared to a lockdown stage. We found that the effect of COVID-19 related worries on alcohol consumption is mediated by loneliness. Our study suggests that heightened levels of worry can decrease alcohol intake. This association can be explained by loneliness: individuals who worry more are lonelier and thus less likely to engage in social drinking. However, during a lockdown stage, the negative association between worrying and drinking diminishes.

Alcohol consumption (AC) is a leading risk factor for death, morbidity, and disability worldwide. Gender-specific differences in AC and its moderators, which may serve as markers for preventing severe alcohol use disorders (AUD), showed inconsistent results. Additionally, the impact of COVID-19-related lockdowns on these differences remains unclear. We examined gender-specific differences in short- and long-term factors affecting AC in individuals at risk for alcohol dependence, focusing on mood, stress, and the influence of restriction-dependent lockdown phases. 358 subjects with AUD aged 16 to 65 were studied over one year. Daily electronic diaries and monthly questionnaires were conducted from 10/01/2020 to 09/30/2021, assessing real-world trajectories of AC, mood (MDMQ), and stress (PSS-10) during Germany's second COVID-19 wave. Multi-level models were used to assess associations between these measures and with several within- and between-subject variables. During lockdown, women experienced lower and even decreasing mood (valence: β = - 0.2, p < .039; calmness: β = - 0.3, p < .010), while men's mood increased from the most restrictive lockdown phase (valence: β = 0.2, p < .001; calmness: β = 0.3, p < .001) to post-lockdown (valence: β = 0.5, p < .001; calmness: β = 0.6, p < .001). Stress increased earlier (β = 0.8, p < .001) and more prolonged (β = 0.4, p = .021) in women than in men. For both genders, daily mood was positively associated with daily AC (valence: β = 0.6, p = .004; calmness: β = 0.4, p = .013), leading to stronger drinking on days with elevated mood. Conversely, average mood was negatively associated with average AC (valence: β = - 1.6, p = .011; calmness: β = - 1.2, p = .041), indicating higher overall consumption with worse overall mood. Our findings highlight the need for interventions targeting mental distress in women with AUD during pandemics, as this group faces increased mental burden during social isolation and increased risk of alcohol dependence during persistent distress.

The modulation of gut microbiota through probiotics holds promise as a novel avenue for schizophrenia treatment. This study aims to analyze probiotic complementary therapy on individuals with schizophrenia systematically, to investigate probiotic efficacy, potential mechanisms, and implications for clinical practice. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched in Medline, Web of Science, Embase, ClinicalTrials.gov, CNKI, VIP, and WanFang databases using keywords ("probiotics" OR "prebiotics" OR "synbiotics" OR "Lactobacillus" OR "Bifidobacterium") AND ("schizophrenia"), focused on randomized controlled trials published before July 1, 2023. Among the identified studies, 8 randomized controlled trials met the inclusion criteria, encompassing a total of 342 participants in the intervention group and 306 participants in the control group. Our analysis revealed a statistically significant reduction (p = 0.03) in the total Positive and Negative Syndrome Scale (PANSS) scores following probiotic treatment in individuals with schizophrenia. While no statistical significance was observed in individual subscales (P > 0.05), significant improvements were noted in insulin levels, Insulin Resistance Index (IRI), and glucose levels. Additionally, the Quantitative Insulin Sensitivity Check Index (QUICKI) demonstrated a significant increase (all P < 0.05). The probiotic intervention significantly reduced gastrointestinal discomfort among schizophrenia patients (P = 0.003). This study suggests that probiotics could hold therapeutic potential for addressing clinical symptoms, abnormal glucose metabolism, and gastrointestinal discomfort in individuals with schizophrenia. Future research should encompass comparative trials employing robust experimental designs to explore the differential effects of various probiotic strains on schizophrenia treatment to provide evidence-based therapeutic approaches. TRIAL REGISTRATION: This review protocol was pre-registered on PROSPERO (No. CRD42023455273).

In this article we aimed synthesize all available evidence regarding the effects of non-invasive brain stimulation (NIBS) techniques combined with mindfulness-based interventions (MBIs) on mental health indicators. We performed a systematic review of randomized controlled trials evaluating NIBS/MBIs combinations in clinical populations and a random effects pairwise meta-analysis of studies evaluating anxiety and depression symptoms. After independent trial selection by two authors based on titles/abstracts, and then on full texts, twelve trials were retrieved. There was a large effect size favoring the NIBS/MBIs over the control intervention for anxiety symptoms (Cohen's d = - 0.82 (- 1.35, - 0.30), I² = 55%, moderate certainty of evidence). As for depression symptoms, there was a small-to-medium effect size that did not reach statistical significance (Cohen's d = - 0.24 (- 0.61, 0.13), I² = 30%, low certainty of evidence). MBIs/NIBS combination is feasible and well tolerated. There is preliminary evidence for its therapeutic promise. Future studies should inform combination choices by neural correlates of respective interventions and offer patients mindfulness familiarization before implementation of the NIBS/MBIs treatment.Trial registration CRD42022353971.

Intermittent theta burst stimulation (iTBS) has demonstrated potential in reducing suicidal ideation (SI) in patients with depression, however, stimulation protocols vary greatly across studies. For this secondary analysis, data from a three-site double-blind, randomized and sham-controlled clinical trial was analyzed to investigate the efficacy of a once-daily versus twice-daily iTBS protocol in the treatment of SI in patients with treatment resistant depression. Secondarily we aimed to explore the associations among SI, anhedonia and quality of life (QOL) measures. The primary outcome for this analysis was SI, which was assessed by computing an average score from four suicidality items on separate depression scales. 158 participants who experienced some degree of SI at baseline were included in the analysis. After 10 days of treatment, 15 (18.3%) participants from the once-daily group and 19 (25%) from the twice-daily group achieved remission from SI which was defined as a SI score of 0. After 30 days of treatment the remission rates were 27 (32.9%) and 30 (39.5%), respectively. There were no significant differences in remission rates between the groups. Moderate correlations between change in SI and change in depressive symptoms were observed. In addition, correlations between change in SI, anhedonia and QOL were observed that remained significant after controlling for change in depressive symptoms. Achieving remission from SI appears to be at least partially correlated to the anti-depressant effect of iTBS. Further studies investigating optimal treatment protocols for the treatment of suicidality with different iTBS schedules are urgently needed. Trial registration Clinicaltrials.gov ID: NCT02729792 ( https://clinicaltrials.gov/ct2/show/NCT02729792 ).

Sleep Disturbances (SD) have been linked to children and adolescents with ADHD, impacting its progression and outcomes. Methylphenidate (MPH), a commonly used stimulant medication for ADHD treatment, has been observed to potentially influence SD as a side effect, while SD can in turn potentially affect the response to MPH. This study aimed to explore the potential role of SD on MPH response in children and adolescents with ADHD. At this aim, 43 children and adolescents with ADHD received a single dose of MPH and were assessed for attention before and after medication administration. As expected, the administration of MPH resulted in improved attention levels. Our data indicate that patients with higher SD experienced greater benefits from the medication, stabilizing Reaction Times Variability (VRTs). This suggests that SD might influence the response to MPH, with individuals exhibiting higher SD deriving more advantages from the treatment. In addition, we found that other factors, such as externalizing problems and IQ, interact with each other and with SD, influencing the response to stimulant medication. Early detection of SD, along with the study of cognitive and emotional-behavioral characteristics, could assist clinicians in predicting the effectiveness of MPH therapy in children and adolescents with ADHD. However, further research is necessary to gain a deeper understanding of the role of SD and other factors in the long-term effects of MPH.

Childhood maltreatment may be linked to epigenetics and brain-derived neurotrophic factor (BDNF) changes, which are mechanisms altered in several psychiatric conditions, including bipolar disorder (BD). However, the specific mechanisms connecting childhood maltreatment to the pathophysiology of BD remain unclear. The present study aims to examine the effects of childhood maltreatment on epigenetic and neurotrophic outcomes in BD patients and health controls. History of childhood maltreatment was obtained using the Childhood Trauma Questionnaire (CTQ) from 36 BD outpatients and 46 healthy subjects. DNA methyltransferase (DNMT) activity, HMTH3K9 activity, histone 3 lysine 9 tri-methylation (H3K9me3) levels, histone deacetylase (HDAC)1 levels, HDAC2 levels, histone 3 lysine 14 acetylation (H3K14ac) levels, and mRNA of BDNF were evaluated in peripheral blood mononuclear cells. Plasma BDNF levels were also measured. Total scores of CTQ, as well as the subscale scores of emotional abuse, sexual abuse, and emotional neglect, were predictive of changes in DNMT and HMTh3k9 activity, H3K9m3 levels, BDNF mRNA expression, and BDNF levels. These findings were observed in all our samples and, in some cases, among BD patients. Emotional abuse was the main childhood maltreatment subtype associated with epigenetic alterations in BD. Our results elucidate some mechanisms by which childhood maltreatment can alter epigenetic and neurotrophic markers. Especially in BD subjects, our results suggest childhood maltreatment per se is not a direct cause for epigenetic alterations. In another way, we suppose that the effect of childhood maltreatment could be cumulative and interact with other factors associated with the pathophysiology of BD.

The quantity and quality of real-world data and real-world evidence in schizophrenia research are at a high level. However, these results are not included in the grading systems used to develop treatment guidelines for schizophrenia. A meta-analysis and a network meta-analysis have independently provided evidence that the results of randomized clinical trials in schizophrenia adequately translate to real-world settings. The authors propose the incorporation of a synthesis of evidence derived from analyses of randomized controlled trials and real-world data as a novel and highest level of evidence in grading instruments used to develop treatment guidelines for schizophrenia.