Evaluation of arterial stiffness in patients with schizophrenia

Multilevel hybrid handcrafted feature extraction based depression recognition method using speech

BACKGROUND AND PURPOSE

Diagnosis of depression is based on tests performed by psychiatrists and information provided by patients or their relatives. In the field of machine learning (ML), numerous models have been devised to detect depression automatically through the analysis of speech audio signals. While deep learning approaches often achieve superior classification accuracy, they are notably resource-intensive. This research introduces an innovative, multilevel hybrid feature extraction-based classification model, specifically designed for depression detection, which exhibits reduced time complexity.

MATERIALS AND METHODS

MODMA dataset consisting of 29 healthy and 23 Major depressive disorder audio signals was used. The constructed model architecture integrates multilevel hybrid feature extraction, iterative feature selection, and classification processes. During the Hybrid Handcrafted Feature (HHF) generation stage, a combination of textural and statistical methods was employed to extract low-level features from speech audio signals. To enhance this process for high-level feature creation, a Multilevel Discrete Wavelet Transform (MDWT) was applied. This technique produced wavelet subbands, which were then input into the hybrid feature extractor, enabling the extraction of both high and low-level features. For the selection of the most pertinent features from these extracted vectors, Iterative Neighborhood Component Analysis (INCA) was utilized. Finally, in the classification phase, a one-dimensional nearest neighbor classifier, augmented with ten-fold cross-validation, was implemented to achieve detailed, results.

RESULTS

The HHF-based speech audio signal classification model attained excellent performance, with the 94.63 % classification accuracy.

CONCLUSIONS

The findings validate the remarkable proficiency of the introduced HHF-based model in depression classification, underscoring its computational efficiency.

Polygenic risk for schizophrenia and bipolar disorder in relation to cardiovascular biomarkers

Individuals with schizophrenia and bipolar disorder are at an increased risk of cardiovascular disease (CVD), and a range of biomarkers related to CVD risk have been found to be abnormal in these patients. Common genetic factors are a putative underlying mechanism, alongside lifestyle factors and antipsychotic medication. However, the extent to which the altered CVD biomarkers are related to genetic factors involved in schizophrenia and bipolar disorder is unknown. In a sample including 699 patients with schizophrenia, 391 with bipolar disorder, and 822 healthy controls, we evaluated 8 CVD risk biomarkers, including BMI, and fasting plasma levels of CVD biomarkers from a subsample. Polygenic risk scores (PGRS) were obtained from genome-wide associations studies (GWAS) of schizophrenia and bipolar disorder from the Psychiatric Genomics Consortium. The CVD biomarkers were used as outcome variables in linear regression models including schizophrenia and bipolar disorder PGRS as predictors, age, sex, diagnostic category, batch and 10 principal components as covariates, controlling for multiple testing by Bonferroni correction for the number of independent tests. Bipolar disorder PGRS was significantly (p = 0.03) negatively associated with BMI after multiple testing correction, and schizophrenia PGRS was nominally negatively associated with BMI. There were no other significant associations between bipolar or schizophrenia PGRS, and other investigated CVD biomarkers. Despite a range of abnormal CVD risk biomarkers in psychotic disorders, we only found a significant negative association between bipolar disorder PGRS and BMI. This has previously been shown for schizophrenia PGRS and BMI, and warrants further exploration.

Multimorbidity in Severe Mental Illness as Part of the Neurodevelopmental Continuum: Physical Health-Related Endophenotypes of Schizophrenia-A Narrative Review

BACKGROUND

The majority of deaths in patients with schizophrenia and other severe mental illnesses (SMIs) are caused by natural causes, such as cardiovascular diseases (CVDs). The increased risk of CVD and other somatic diseases in SMIs cannot be fully explained by the contribution of traditional risk factors, behavioral risk factors, patients' lifestyle peculiarities, and the influence of antipsychotics. The present review has the following main objectives: (1) to aggregate evidence that neurodevelopmental disorders are the basis of SMIs; (2) to provide a review of studies that have addressed the shared genetic architecture of SMI and cardiovascular disease; and (3) to propose and substantiate the consideration of somatic diseases as independent endophenotypes of SMIs, which will make it possible to place the research of somatic diseases in SMIs within the framework of the concepts of the "neurodevelopmental continuum and gradient" and "endophenotype".

METHODS

A comprehensive literature search was performed on 1 July 2024. The search was performed using PubMed and Google Scholar databases up to June 2024.

RESULTS

The current literature reveals considerable overlap between the genetic susceptibility loci for SMIs and CVDs. We propose that somatic diseases observed in SMIs that have a shared genetic architecture with SMIs can be considered distinct physical health-related endophenotypes.

CONCLUSIONS

In this narrative review, the results of recent studies of CVDs in SMIs are summarized. Reframing schizophrenia as a multisystem disease should contribute to the activation of new research on somatic diseases in SMIs.

Arterial Stiffness in Patients with Bipolar Disorder

Objective

Bipolar disorder (BD) is an inflammatory and metabolic disease. The disease and the drugs used to treat it may affect cardiovascular disease (CVD) risk. The aim of this study is to investigate arterial stiffness in patients with BD and compare them with healthy controls.

Methods

Thirty-nine patients with BD type I in remission and 39 healthy control subjects were included in the study. Carotid and femoral artery intima-media thickness (IMT) and arterial thickness parameters were measured by Doppler ultrasonography.

Results

The elastic modulus value of the carotid artery was significantly higher in the patients than in the control group (p = 0.015). Although the IMT of both carotid and femoral artery was thicker in patients than in healthy control subjects, this difference was not statistically significant (p = 0.105; p = 0.391). There was a significant positive correlation between chlorpromazine equivalent dose and femoral elastic modulus value (p = 0.021, r = 0.539). There was a positive correlation between lithium equivalent dose and carotid compliance; a significant negative correlation between lithium equivalent dose and carotid elastic modulus was also determined (both p = 0.007, r = 0.466; p = 0.027, r = -0.391, respectively). No predictor was observed between drug dose and arterial stiffness parameters.

Conclusion

Arterial stiffness might be investigated for its potential to reduce CVD risk in patients with BD. Given the established CVD complications in this patient population, further studies are needed to determine whether the results are specific to antipsychotic treatment or BD and to clarify the potential arterial protective effects of mood stabilizers.

The Relationship of Cognitive Dysfunction with Inflammatory Markers and Carotid Intima Media Thickness in Schizophrenia

OBJECTIVES

Schizophrenia is a devastating and chronic mental disorder that affects 1% of the population worldwide. It is also associated with cognitive dysfunction and cardiovascular risk factors. The aim of this study is to investigate the relationship between cognitive impairment and some inflammatory markers and carotid intima-media thickness (CIMT) in schizophrenia.

METHODS

The participants of this study were 51 schizophrenia and 57 healthy controls (HC). The Positive and Negative Syndrome Scale (PANSS) was used for severity of illness, and the Montreal Cognitive Assessment Scale (MoCA) was used for cognitive functioning. The MoCA scores, some biochemical and inflammatory markers, and CIMT were compared between schizophrenia and HC groups.

RESULTS

Of the patients with schizophrenia, 11 were women (21.6%), and 40 were men (78.4%). MoCA scores were lower, and levels of NLR, MLR, PLR, SII, CRP, ESR, and CIMT were higher in schizophrenia compared to the HC group (respectively; p < 0.001, p < 0.001, p = 0.035, p = 0.008, p = 0.002, p < 0.001, p < 0.001, p < 0.001). In the schizophrenia group, there was no correlation between MoCA and inflammatory markers. MoCA and CIMT had a significant negative and moderate correlation (p < 0.001).

CONCLUSIONS

This is the first study to show the relationship between cognitive impairment and CIMT in schizophrenia. In this study, NLR, MLR, PLR, SII, CRP, and ESR markers were higher in schizophrenia compared to HC, indicating inflammation. Our finding of elevated CIMT in schizophrenia suggests that there may be an atherosclerotic process along with the inflammatory process. The finding of a positive correlation between cognitive impairment and CIMT may be promising for new therapies targeting the atherosclerotic process in the treatment of cognitive impairment.

A comparative study of the effects of chronic kidney disease on sonographic arterial stiffness parameters in geriatric and normal population

Aim: Due to its growing incidence rate worldwide, chronic kidney disease is a crucial public health problem which is strongly associated with cardiovascular disease. Cardiovascular disease in chronic kidney disease patients is characterized by arteriosclerosis and increased arterial stiffness, and is the leading cause of morbidity and mortality. A correlation was reported between an increased arterial stiffness and cardiovascular disease in high risk groups such as chronic kidney disease or hypertension as well as general undiagnosed population. Our aim was to show the changes in arterial stiffness parameters in patients with chronic kidney disease in the geriatric population. Material and Method: 44 chronic kidney disease patients and 44 control group cases of the same age were included in the study. There were 20 female and 24 male cases in each group. Systolic and diastolic diameter were measured for all cases. Intima-media thickness was measured in carotid and femoral arteries. Arterial stiffness parameters were calculated using formulas. Systolic and diastolic arterial blood pressure and body mass index were measured. Their urea and creatinine values were recorded. Results: There were no differences between two groups in terms of age and sex (p=0.069). Body mass index in the patient group was significantly lower compared to the control group (p=0.025). Systolic arterial blood pressure was higher in the patient group (p

Monocyte/HDL Cholesterol Ratios as a New Inflammatory Marker in Patients with Schizophrenia

PURPOSE

Monocyte/HDL cholesterol ratio (MHR) is a novel inflammatory marker that is used as a prognostic factor for cardiovascular diseases and has been studied in many diseases. The aim of this study was to investigate the role of inflammatory factors in schizophrenia patients by examining MHR levels and to compare schizophrenia patients and healthy controls in terms of cardiovascular disease risk.

METHOD

A total of 135 participants between the ages of 18-65, 85 diagnosed with schizophrenia, and 50 healthy individuals in the control group were included in this cross-sectional study. Venous blood samples were taken from the participants and CBC parameters and lipid profiles were analyzed. The sociodemographic and clinical data form and positive and negative symptoms scale (PANSS) were administered to all participants.

RESULTS

Although monocyte levels were significantly higher in the patient group, HDL-C levels were lower at significant levels. MHR was found to be higher in the patient group compared to the control group at significant levels. When compared to the control group, total cholesterol, triglyceride, WBC, neutrophil, basophil, and platelet levels were higher in the patient group at significant levels, and RBC, hemoglobin, and hematocrit levels were significantly lower.

CONCLUSION

The elevated MHR in patients with schizophrenia may contribute to our understanding that inflammation plays important roles in the pathophysiology of schizophrenia. Additionally, knowing the levels of MHR and considering the recommendations, such as diet and exercise, in the treatment approaches made us think that it might be beneficial in protecting schizophrenia patients against cardiovascular diseases and early death.

Lithium exposure and chronic inflammation with activated macrophages and monocytes associated with atherosclerosis in bipolar disorder

BACKGROUND

Atherosclerosis accounts for cardiovascular diseases (CVDs). This study aimed to explore the association between carotid intima-media thickness (CIMT), psycho-pharmacotherapy, and inflammatory markers along with other molecules related to atherosclerosis in bipolar disorder (BD).

METHODS

The euthymic patients with bipolar I disorder (BD-I) aged over 20 years were recruited to measure CIMT through ultrasound and the blood levels of lipid profiles, soluble tumor necrosis factor receptor-1 (sTNF-R1), soluble interleukin-6 receptor (sIL-6R), monocyte chemoattractant protein-1, chitinase 3-like 1, endothelial adhesive proteins, and thrombin-antithrombin complex.

RESULTS

Participants were 103 BD-I patients with mean 44.3 years old. The ratio of lithium exposure in relation to illness chronicity and the current daily dosage of lithium therapy exhibited an inverse relationship with CIMT in the entire sample. After controlling for age and BMI, multivariate regression indicated that a higher lithium level was significantly associated with decreased CIMT in the entire sample, high-risk (those with CVDs or endocrine diseases, N = 48), middle-risk (those without CVDs and endocrine diseases, N = 55), and low-risk (those aged <45 years in the middle-risk subgroup, N = 43) subgroups. Furthermore, higher levels of sTNF-R1 in the entire sample and high-risk subgroup and sIL-6R in the middle- and low-risk subgroups were statistically associated with greater CIMT.

LIMITATION

The age range was too wide to control for the effect of age on CIMT and medication.

CONCLUSIONS

Lithium exposure may be a protective factor for atherosclerosis progression in BD-I. The chronic inflammation in BD-I with activated macrophages and monocytes may link with the atherosclerosis development over time.