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Ulaganathan V, Lye MS, Loh SP, Yap YY, Kandiah M, Augundhooa D, Bhattacharya T, Al-Olayan E, Wang C. Serum 25-Hydroxyvitamin D Is Inversely Associated with Nasopharyngeal Carcinoma: A Hospital-Based Matched Case-Control Study in Malaysia. Nutrients 2024; 16:397. [PMID: 38337681 PMCID: PMC10857213 DOI: 10.3390/nu16030397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Serum 25(OH)D deficiency consistently demonstrated molecular mechanisms through which chronic inflammation is associated with the risk of nasopharyngeal carcinoma (NPC). This study aimed to determine the association between serum 25(OH)D and NPC. A matched case-control study was conducted at two local hospitals. A total of 300 histologically confirmed NPC cases were matched with controls for age, gender, and ethnicity, and assessed for vitamin D status and other nutritional factors. Mean Vitamin D concentration was significantly lower among cases compared to controls (63.17 ± 19.15 nmol/L and 67.34 ± 23.06 nmol/L) (t = -2.41, p = 0.016). Multiple conditional logistic regression analysis indicated that higher levels of serum 25(OH)D were associated with reduced odds of NPC (AOR = 0.73, 95% CI = 0.57-0.94, p = 0.016) controlling for confounders including BMI, physical activity, smoking status, alcohol consumption, consumption of food high in vitamin D, salted fish consumption, and family history of NPC. There was a significant association between inadequate serum 25(OH)D status with accumulation of four risk factors and increased odds of getting NPC using polynomial regression analysis. Increased NPC odds ratios were observed after sequential accumulation of additional risk factors with the presence of inadequate serum 25(OH)D status (OR = 0.54, 95% CI = 0.27, 4.77, p = 0.322, OR = 1.04, 95% CI = 0.64, 1.72, p = 0.267, OR = 1.15, 95% CI = 0.73, 1.80, p = 0.067, OR = 1.93, 95% CI = 1.13, 3.31, p = 0.022, and OR = 5.55, 95% CI = 1.67, 10.3, p < 0.001 respectively). Future research in Malaysia should involve both prospective cohort studies and randomized controlled trials to confirm and further clarify the role of vitamin D in NPC outcomes.
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Affiliation(s)
- Vaidehi Ulaganathan
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, Kuala Lumpur 43000, Malaysia; (M.K.); (D.A.)
| | - Munn Sann Lye
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Su Peng Loh
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia;
| | - Yoke Yeow Yap
- Graduate School of Medicine, KPJ Healthcare University, Nilai 71800, Negeri Sembilan, Malaysia;
- Otorhinolaryngology, KPJ Johor Specialist Hospital, Johor Bharu 80100, Johor, Malaysia
| | - Mirnalini Kandiah
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, Kuala Lumpur 43000, Malaysia; (M.K.); (D.A.)
| | - Digsha Augundhooa
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, Kuala Lumpur 43000, Malaysia; (M.K.); (D.A.)
| | - Tanima Bhattacharya
- Faculty of Applied Science, Lincoln University College, Petaling Jaya 47301, Selangor, Malaysia;
| | - Ebtesam Al-Olayan
- Department of Zoology, College of Science, King Saud University, Riyadh 11495, Saudi Arabia;
| | - Chuanyi Wang
- School of Environment Science and Engineering, Shaanxi University of Science and Technology, Xi’an 710021, China;
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Lakshimi VI, Kavitha M. New Insights into Prospective Health Potential of ω-3 PUFAs. Curr Nutr Rep 2023; 12:813-829. [PMID: 37996669 DOI: 10.1007/s13668-023-00508-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE OF REVIEW Docosahexaenoic acid and eicosapentaenoic acid are the two essential long-chain ω-3 polyunsaturated fatty acids (ω-3 PUFAs) promoting human health which are obtained from diet or supplementation. The eicosanoids derived from ω-6 and ω-3 PUFAs have opposite characteristics of pro- and anti-inflammatory activities. The proinflammatory effects of ω-6 PUFAs are behind the pathology of the adverse health conditions of PUFA metabolism like cardiovascular diseases, neurological disorders, and inflammatory diseases. A balanced ω-6 to ω-3 ratio of 1-4:1 is critical to prevent the associated disorders. But due to modern agricultural practices, there is a disastrous shift in this ratio to 10-20:1. This review primarily aims to discuss the myriad health potentials of ω-3 PUFAs uncovered through recent research. It further manifests the importance of maintaining a balanced ω-6 to ω-3 PUFA ratio. RECENT FINDINGS ω-3 PUFAs exhibit protective effects against diabetes mellitus-associated complications including diabetic retinopathy, diabetic nephropathy, and proteinuria. COVID-19 is also not an exception to the health benefits of ω-3 PUFAs. Supplementation of ω-3 PUFAs improved the respiratory and clinical symptoms in COVID-19 patients. ω-3 PUFAs exhibit a variety of health benefits including anti-inflammatory property and antimicrobial property and are effective in protecting against various health conditions like atherosclerosis, cardiovascular diseases, diabetes mellitus, COVID-19, and neurological disorders. In the present review, various health potentials of ω-3 PUFAs are extensively reviewed and summarized. Further, the importance of a balanced ω-6 to ω-3 PUFA ratio has been emphasized besides stating the diverse sources of ω-3 PUFA.
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Affiliation(s)
- V Iswareya Lakshimi
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, 632014, Tamil Nadu, India
| | - M Kavitha
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, 632014, Tamil Nadu, India.
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Jiang M, Yan W, Li X, Zhao L, Lu T, Zhang D, Li J, Wang L. Calcium Homeostasis and Psychiatric Disorders: A Mendelian Randomization Study. Nutrients 2023; 15:4051. [PMID: 37764834 PMCID: PMC10535008 DOI: 10.3390/nu15184051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Observational studies have investigated the impact of calcium homeostasis on psychiatric disorders; however, the causality of associations is yet to be established. Bidirectional Mendelian randomization (MR) analysis of calcium homeostasis hormones was conducted on nine psychiatric disorders. Calcium, serum 25-hydroxyvitamin D levels (25OHD), parathyroid hormone, and fibroblast growth factor 23 are the major calcium homeostasis hormones. The causality was evaluated by the inverse variance weighted method (IVW) and the MR Steiger test, while Cochran's Q test, the MR-Egger intercept test, funnel plot, and the leave-one-out method were used for sensitivity analyses. Bonferroni correction was used to determine the causative association features (p < 6.94 × 10-4). Schizophrenia (SCZ) was significantly associated with decreased 25OHD concentrations with an estimated effect of -0.0164 (Prandom-effect IVW = 2.39 × 10-7). In the Multivariable MR (MVMR) analysis adjusting for potentially confounding traits including body mass index, obesity, mineral supplements (calcium, fish oil, and vitamin D) and outdoor time (winter and summer), the relationship between SCZ and 25OHD remained. The genetically predicted autism spectrum disorder and bipolar disorder were also nominally associated with decreased 25OHD. This study provided evidence for a causal effect of psychiatric disorders on calcium homeostasis. The clinical monitoring of 25OHD levels in patients with psychiatric disorders is beneficial.
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Affiliation(s)
- Miaomiao Jiang
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health, Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing 100191, China
| | - Weiheng Yan
- Children's Hospital Capital Institute of Pediatrics, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, China
| | - Xianjing Li
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health, Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing 100191, China
| | - Liyang Zhao
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health, Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing 100191, China
| | - Tianlan Lu
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health, Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing 100191, China
| | - Dai Zhang
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health, Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing 100191, China
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Institute for Brain Research and Rehabilitation (IBRR), South China Normal University, Guangzhou 510631, China
| | - Jun Li
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health, Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing 100191, China
| | - Lifang Wang
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health, Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing 100191, China
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von Gerichten J, West AL, Irvine NA, Miles EA, Calder PC, Lillycrop KA, Burdge GC, Fielding BA. Oxylipin secretion by human CD3 + T lymphocytes in vitro is modified by the exogenous essential fatty acid ratio and life stage. Front Immunol 2023; 14:1206733. [PMID: 37388745 PMCID: PMC10300345 DOI: 10.3389/fimmu.2023.1206733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 05/30/2023] [Indexed: 07/01/2023] Open
Abstract
Immune function changes across the life stages; for example, senior adults exhibit a tendency towards a weaker cell-mediated immune response and a stronger inflammatory response than younger adults. This might be partly mediated by changes in oxylipin synthesis across the life course. Oxylipins are oxidation products of polyunsaturated fatty acids (PUFAs) that modulate immune function and inflammation. A number of PUFAs are precursors to oxylipins, including the essential fatty acids (EFAs) linoleic acid (LA) and α-linolenic acid (ALA). LA and ALA are also substrates for synthesis of longer chain PUFAs. Studies with stable isotopes have shown that the relative amounts of LA and ALA can influence their partitioning by T lymphocytes between conversion to longer chain PUFAs and to oxylipins. It is not known whether the relative availability of EFA substrates influences the overall pattern of oxylipin secretion by human T cells or if this changes across the life stages. To address this, the oxylipin profile was determined in supernatants from resting and mitogen activated human CD3+ T cell cultures incubated in medium containing an EFA ratio of either 5:1 or 8:1 (LA : ALA). Furthermore, oxylipin profiles in supernatants of T cells from three life stages, namely fetal (derived from umbilical cord blood), adults and seniors, treated with the 5:1 EFA ratio were determined. The extracellular oxylipin profiles were affected more by the EFA ratio than mitogen stimulation such that n-3 PUFA-derived oxylipin concentrations were higher with the 5:1 EFA ratio than the 8:1 ratio, possibly due to PUFA precursor competition for lipoxygenases. 47 oxylipin species were measured in all cell culture supernatants. Extracellular oxylipin concentrations were generally higher for fetal T cells than for T cells from adult and senior donors, although the composition of oxylipins was similar across the life stages. The contribution of oxylipins towards an immunological phenotype might be due to the capacity of T cells to synthesize oxylipins rather than the nature of the oxylipins produced.
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Affiliation(s)
- Johanna von Gerichten
- School of Chemistry and Chemical Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Annette L. West
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, Hampshire, United Kingdom
| | - Nicola A. Irvine
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, Hampshire, United Kingdom
| | - Elizabeth A. Miles
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, Hampshire, United Kingdom
| | - Philip C. Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, Hampshire, United Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, Hampshire, United Kingdom
| | - Karen A. Lillycrop
- Centre for Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
| | - Graham C. Burdge
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, Hampshire, United Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, Hampshire, United Kingdom
| | - Barbara A. Fielding
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
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Vallés AS, Barrantes FJ. The synaptic lipidome in health and disease. BIOCHIMICA ET BIOPHYSICA ACTA. BIOMEMBRANES 2022; 1864:184033. [PMID: 35964712 DOI: 10.1016/j.bbamem.2022.184033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Adequate homeostasis of lipid, protein and carbohydrate metabolism is essential for cells to perform highly specific tasks in our organism, and the brain, with its uniquely high energetic requirements, posesses singular characteristics. Some of these are related to its extraordinary dotation of synapses, the specialized subcelluar structures where signal transmission between neurons occurs in the central nervous system. The post-synaptic compartment of excitatory synapses, the dendritic spine, harbors key molecules involved in neurotransmission tightly packed within a minute volume of a few femtoliters. The spine is further compartmentalized into nanodomains that facilitate the execution of temporo-spatially separate functions in the synapse. Lipids play important roles in this structural and functional compartmentalization and in mechanisms that impact on synaptic transmission. This review analyzes the structural and dynamic processes involving lipids at the synapse, highlighting the importance of their homeostatic balance for the physiology of this complex and highly specialized structure, and underscoring the pathologies associated with disbalances of lipid metabolism, particularly in the perinatal and late adulthood periods of life. Although small variations of the lipid profile in the brain take place throughout the adult lifespan, the pathophysiological consequences are clinically manifested mostly during late adulthood. Disturbances in lipid homeostasis in the perinatal period leads to alterations during nervous system development, while in late adulthood they favor the occurrence of neurodegenerative diseases.
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Affiliation(s)
- Ana Sofia Vallés
- Instituto de Investigaciones Bioquímicas de Bahía Blanca (UNS-CONICET), 8000 Bahía Blanca, Argentina.
| | - Francisco J Barrantes
- Laboratory of Molecular Neurobiology, Institute of Biomedical Research (BIOMED), UCA-CONICET, Av. Alicia Moreau de Justo 1600, Buenos Aires C1107AAZ, Argentina.
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6
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Montazer M, Ebrahimpour-Koujan S, Surkan PJ, Azadbakht L. Effects of Fish-Oil Consumption on Psychological Function Outcomes in Psychosis: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2022; 13:2149-2164. [PMID: 36166847 PMCID: PMC9879727 DOI: 10.1093/advances/nmac083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/22/2022] [Accepted: 07/25/2022] [Indexed: 02/02/2023] Open
Abstract
Research on the effects of fish oil on clinical symptoms and psychosocial functioning in people with psychosis has been inconsistent. We conducted this systematic review and meta-analysis to summarize the available data on the effects of oral intake of fish oil on psychological functioning in patients with psychosis. Three online databases including PubMed, Scopus, and Web of Science were searched to identify relevant studies published by April 2021. The exposure was oral fish-oil supplementation. The Positive and Negative Syndrome Scale (PANSS), the Brief Psychiatric Rating Scale (BPRS), and the Global Assessment of Functioning (GAF) were our outcome measures. Seventeen randomized clinical trials involving 1390 patients were included. No change in PANSS was observed following oral fish-oil intake [weighted mean difference (WMD): -0.87; 95% CI: -16.99, 15.26; P = 0.92]. In a nonlinear dose-response analysis, a significant inverse association was observed between <10 wk of fish-oil supplementation and PANSS (WMD: -10; P-nonlinearity = 0.02). Although analysis of 4 studies showed a nonsignificant reduction in BPRS after fish-oil intake (WMD: -2.990; 95% CI: -6.42, 0.44; P = 0.08), a nonlinear dose-response analysis revealed significant inverse associations between dose (>2200 mg/d) and duration of fish-oil supplementation (<15 wk) with BPRS score (WMD: -8; P-nonlinearity = 0.04). Combined effect sizes from 6 randomized clinical trials showed significant increases in GAF after oral administration of fish oil (WMD: 6.66; 95% CI: 3.39, 9.93; P < 0.001). In conclusion, we did not find any significant changes in PANSS and BPRS scores following fish-oil supplementation. Nevertheless, oral fish-oil intake significantly contributed to improvement in GAF scores. This is the first meta-analysis to examine the effects of fish oil on the psychological functioning scores of PANSS, BPRS, and GAF simultaneously.
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Affiliation(s)
- Mohsen Montazer
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Soraiya Ebrahimpour-Koujan
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran,Autoimmune Bullous Disease Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Xu X, Shao G, Zhang X, Hu Y, Huang J, Su Y, Zhang M, Cai Y, Zhou H. The efficacy of nutritional supplements for the adjunctive treatment of schizophrenia in adults: A systematic review and network meta-analysis. Psychiatry Res 2022; 311:114500. [PMID: 35287043 DOI: 10.1016/j.psychres.2022.114500] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 12/19/2022]
Abstract
Nutritional supplementations have been widely used as adjunctive treatments for schizophrenia. However, among these supplementations, of which the most beneficial is currently unknown. This study aimed to compare and rank the effectiveness of nutritional supplementations in the adjunctive treatments of schizophrenia. The four nutritional supplementations evaluated were: 1) folate acid or vitamin B12; 2) vitamin D; 3) N-acetyl cysteine (NAC); 4) Omega-3 polyunsaturated fatty acid, including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). 17 eligible RCTs with 1165 participants were included in this network meta-analysis based on study criteria. NAC supplementation was significantly more efficacious than folic acid or vitamin B12 [MD (95% CI): -6.6 (-10.8, -2.4)] and omega-3 polyunsaturated fatty acid [MD (95% CI): -5.1(-9.9, -0.8)] supplementation in the term of PANSS score changes. There were no significant differences in the PANSS score changes between NAC and vitamin D [MD (95% CI): -5.2 (-10.9, 0.5)] supplementations. The estimated ranking probabilities of treatments showed that NAC might be the most effective adjunctive intervention over all nutritional supplementations. These results indicate that NAC could improve PANSS score and it may be among the most effective nutritional supplementations in schizophrenia patients.
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Affiliation(s)
- Xianrong Xu
- Departmemnt of Nutrition and toxicology, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, PR China
| | - Ge Shao
- Departmemnt of Nutrition and toxicology, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, PR China; School of Public Health, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Xu Zhang
- Departmemnt of Nutrition and toxicology, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, PR China
| | - Yan Hu
- Departmemnt of Nutrition and toxicology, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, PR China
| | - Jia Huang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, PR China
| | - Yousong Su
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, PR China
| | - Min Zhang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, PR China
| | - Yiyun Cai
- Department of Psychiatry, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, PR China.
| | - Huiping Zhou
- Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University , Hangzhou, 310021, PR China.
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Bahrami A, Rezaeitalab F, Farahmand SK, Mazloum Khorasani Z, Arabi SM, Bahrami-Taghanaki H, Ferns GA, Ghayour-Mobarhan M. High-dose Vitamin D Supplementation and Improvement in Cognitive Abilities, Insomnia, and Daytime Sleepiness in Adolescent Girls. Basic Clin Neurosci 2021; 12:339-348. [PMID: 34917293 PMCID: PMC8666927 DOI: 10.32598/bcn.2021.1910.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/10/2019] [Accepted: 09/02/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction: Vitamin D may affect the modulation of signaling pathways in the central nervous system. We aimed to evaluate the effect of high-dose vitamin D supplementation on neuropsychological functions in female adolescents. Methods: We studied the effects of 9 weeks of vitamin D supplementation (50000 IU vitamin D3 [cholecalciferol]/week) on cognitive abilities and sleep disorders in 940 adolescent girls. Results: Oral vitamin D supplementation improved cognitive abilities, including memory, inhibitory control, selective attention, decision making, planning, sustained attention, and cognitive flexibility in healthy adolescent girls (P<0.001). The prevalence of subjects with insomnia after intervention fell from 15.0% to 11.3%. Similar results were also found for the prevalence of sleepiness (15.6% reduced to 14.7%), or cases with both insomnia and sleepiness (8.0% reduced to 6.1%; P<0.05). Conclusion: High dose of vitamin D can improve cognitive abilities and alleviate insomnia and daytime sleepiness in adolescent girls. Further investigations are required on different population groups (age and gender) to determine the sustainability of these effects. The value of vitamin D therapy in other neurological disorders would also be of research interest.
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Affiliation(s)
- Afsane Bahrami
- Cellular and Molecular Research Center, School of Medicine, Birjand University of Medical Sciences, Bijand, Iran
| | - Fariborz Rezaeitalab
- Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Kazem Farahmand
- Department of Traditional Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Mazloum Khorasani
- Endocrine Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mostafa Arabi
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Bahrami-Taghanaki
- Chinese and Complementary Medicine Research Center, School of Traditional and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, School of Brighton & Sussex Medical, University of Brighton and the University of Sussex, Falmer, Brighton, Sussex, UK
| | - Majid Ghayour-Mobarhan
- Metabolic Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Alvarez-Mon MA, Guillen-Aguinaga S, Pereira-Sanchez V, Onambele L, Al-Rahamneh MJ, Brugos-Larumbe A, Guillen-Grima F, Ortuño F. Being Born in Winter-Spring and at Around the Time of an Influenza Pandemic Are Risk Factors for the Development of Schizophrenia: The Apna Study in Navarre, Spain. J Clin Med 2021; 10:jcm10132859. [PMID: 34203208 PMCID: PMC8267856 DOI: 10.3390/jcm10132859] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 12/19/2022] Open
Abstract
Background: We analyzed the relationship between the prevalence of schizophrenia and the season of birth and gestation during a period of an influenza pandemic. Methods: Cross-sectional analysis of a prospective population-based cohort of 470,942 adults. We fitted multivariant logistic regression models to determine whether the season of birth and birth in an influenza-pandemic year (1957, 1968, 1977) was associated with schizophrenia. Results: 2077 subjects had been diagnosed with schizophrenia. Logistic regression identified a significantly greater prevalence of schizophrenia in men than in women (OR = 1.516, CI 95% = 1.388–1.665); in those born in the winter or spring than in those born in the summer or autumn (OR = 1.112, CI 95% = 1.020–1.212); and in those born in a period of an influenza pandemic (OR = 1.335, CI 95% = 1.199–1.486). The increase in risk was also significant when each influenza pandemic year was analyzed separately. However, neither month of birth nor season of birth, when each of the four were studied individually, were associated with a statistically significant increase in that risk. Conclusions: The winter–spring period and the influenza pandemics are independent risk factors for developing schizophrenia. This study contradicts many previous studies and thus revitalizes a locked debate in understanding the neurodevelopmental hypothesis of this disorder.
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Affiliation(s)
- Miguel A. Alvarez-Mon
- Department of Psychiatry and Medical Psychology, University of Navarra Clinic, 31008 Pamplona, Spain; (V.P.-S.); (F.O.)
- Department of Medicine and Medical Specialities, University of Alcala, 28805 Alcala de Henares, Spain
- Correspondence: ; Tel.: +34-948255400
| | - Sara Guillen-Aguinaga
- Primary Health Care, Navarra Health Service, 31008 Pamplona, Spain; (S.G.-A.); (A.B.-L.)
- Department of Health Sciences, Public University of Navarra (UPNA), 31008 Pamplona, Spain;
| | - Victor Pereira-Sanchez
- Department of Psychiatry and Medical Psychology, University of Navarra Clinic, 31008 Pamplona, Spain; (V.P.-S.); (F.O.)
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Luc Onambele
- École des Sciences de la Santé, Université Catholique d’Afrique Centrale, Yaoundé, Cameroon;
| | - Moad J. Al-Rahamneh
- The Eastern Mediterranean Public Health Network (EMPHNET), Global Health Development (GHD), Amman 11195, Jordan;
| | - Antonio Brugos-Larumbe
- Primary Health Care, Navarra Health Service, 31008 Pamplona, Spain; (S.G.-A.); (A.B.-L.)
- Department of Health Sciences, Public University of Navarra (UPNA), 31008 Pamplona, Spain;
| | - Francisco Guillen-Grima
- Department of Health Sciences, Public University of Navarra (UPNA), 31008 Pamplona, Spain;
- Department of Preventive Medicine, University of Navarra Clinic, 31008 Pamplona, Spain
- Healthcare Research Institute of Navarre (IdiSNA), 31008 Pamplona, Spain
| | - Felipe Ortuño
- Department of Psychiatry and Medical Psychology, University of Navarra Clinic, 31008 Pamplona, Spain; (V.P.-S.); (F.O.)
- Healthcare Research Institute of Navarre (IdiSNA), 31008 Pamplona, Spain
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10
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Mongan D, Healy C, Jones HJ, Zammit S, Cannon M, Cotter DR. Plasma polyunsaturated fatty acids and mental disorders in adolescence and early adulthood: cross-sectional and longitudinal associations in a general population cohort. Transl Psychiatry 2021; 11:321. [PMID: 34059620 PMCID: PMC8167090 DOI: 10.1038/s41398-021-01425-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/23/2021] [Accepted: 04/08/2021] [Indexed: 02/07/2023] Open
Abstract
Polyunsaturated fatty acids (PUFAs) may be pertinent to the development of mental disorders, for example via modulation of inflammation and synaptogenesis. We wished to examine cross-sectional and longitudinal associations between PUFAs and mental disorders in a large cohort of young people. Participants in the Avon Longitudinal Study of Parents and Children were interviewed and provided blood samples at two sampling periods when approximately 17 and 24 years old. Plasma PUFA measures (total omega-6 [n-6], total omega-3 [n-3], n-6:n-3 ratio and docosahexaenoic acid [DHA] percentage of total fatty acids) were assessed using nuclear magnetic resonance spectroscopy. Cross-sectional and longitudinal associations between standardised PUFA measures and three mental disorders (psychotic disorder, moderate/severe depressive disorder and generalised anxiety disorder [GAD]) were measured by logistic regression, adjusting for age, sex, body mass index and cigarette smoking. There was little evidence of cross-sectional associations between PUFA measures and mental disorders at age 17. At age 24, the n-6:n-3 ratio was positively associated with psychotic disorder, depressive disorder and GAD, while DHA was inversely associated with psychotic disorder. In longitudinal analyses, there was evidence of an inverse association between DHA at age 17 and incident psychotic disorder at age 24 (adjusted odds ratio 0.44, 95% confidence interval 0.22-0.87) with little such evidence for depressive disorder or GAD. There was little evidence for associations between change in PUFA measures from 17 to 24 years and incident mental disorders at 24 years. These findings provide support for associations between PUFAs and mental disorders in early adulthood, and in particular, for DHA in adolescence in relation to prevention of psychosis.
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Affiliation(s)
- David Mongan
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Hannah J Jones
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Stan Zammit
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David R Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
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11
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Goh KK, Chen CYA, Chen CH, Lu ML. Effects of omega-3 polyunsaturated fatty acids supplements on psychopathology and metabolic parameters in schizophrenia: A meta-analysis of randomized controlled trials. J Psychopharmacol 2021; 35:221-235. [PMID: 33586517 DOI: 10.1177/0269881120981392] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Several monotherapy and augmentation strategies have been introduced to improve the treatment of schizophrenia. The benefits of omega-3 polyunsaturated fatty acids in patients with mental disorders is becoming increasingly acknowledged. However, its role in the treatment of schizophrenia raises complex considerations about which there has been little consensus. The aim of this study was to synthesize the findings of randomized controlled trials that were conducted to determine the efficacy and safety of omega-3 polyunsaturated fatty acids in patients with schizophrenia. METHODS The MEDLINE, Embase, Cochrane, Scopus, and Web of Science databases were searched for relevant literature. The primary outcome was changes in psychopathology and the secondary outcomes were changes in metabolic parameters and safety profiles. RESULTS Twenty double-blind randomized controlled trials in 1494 patients were included. Omega-3 polyunsaturated fatty acids augmentation was associated with significantly improved psychopathology in patients with schizophrenia, particularly general psychopathology and positive symptoms but not negative symptoms. Patients who were severely ill and received omega-3 polyunsaturated fatty acids containing eicosapentaenoic acid >1 g/d showed significant improvement. A favorable effect of omega-3 polyunsaturated fatty acids supplements on serum triglycerides was also demonstrated. Omega-3 polyunsaturated fatty acids are well-tolerated and safe in patients with schizophrenia. CONCLUSIONS These findings tentatively support the use of omega-3 polyunsaturated fatty acids as a potential augmentation strategy in schizophrenia. Further research in larger samples is warranted to clarify the optimal dosage and the correct proportions of omega-3 polyunsaturated fatty acids to administer, together with elucidation of the underlying mechanisms.
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Affiliation(s)
- Kah K Goh
- Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cynthia Yi-An Chen
- Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chun-Hsin Chen
- Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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12
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Lisi G, Ribolsi M, Siracusano A, Niolu C. Maternal Vitamin D and its Role in Determining Fetal Origins of Mental Health. Curr Pharm Des 2020; 26:2497-2509. [PMID: 32370709 DOI: 10.2174/1381612826666200506093858] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/26/2020] [Indexed: 12/21/2022]
Abstract
There is evidence that mental health disorders may have roots in fetal life and are associated with deficiencies in various micronutrients, including vitamin D. During pregnancy, vitamin D balance is influenced by an increase in maternal calcitriol and a substantial increase in maternal Vitamin D Binding Protein concentrations. In the early stages of life, vitamin D is necessary to mediate numerous brain processes such as proliferation, apoptosis, and neurotransmission. Furthermore, Vitamin D has a recognized anti-inflammatory activity that normally suppresses inflammation. Increased activation of hypothalamo-pituitary-adrenal axis (HPA) and inflammation during gestation may influence maternal health and fetal neurodevelopment during and beyond pregnancy. A deficit of Vitamin D and maternal stressful events during gestation, such as perinatal depression, could influence the efficacy of the immune system altering its activity. Vitamin D deficiency during gestation associated with a reduction in fetal brain development has been widely described and correlated with alteration in the production of the brain-derived neurotrophic factor. To this regard, many studies highlights that low maternal vitamin D dosage during gestation has been related to a significantly greater risk to develop schizophrenia and other severe mental illnesses in later life. The objective of this paper is a comprehensive overview of maternal vitamin D balance in determining the fetal origins of mental health with some references to the link between vitamin D levels, inflammatory responses to stress and mental disorders in adult life.
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Affiliation(s)
- Giulia Lisi
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Mental Health, ASL ROMA 1, Rome, Italy
| | - Michele Ribolsi
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Policlinico Tor Vergata Foundation, Rome, Italy
| | - Alberto Siracusano
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Policlinico Tor Vergata Foundation, Rome, Italy
| | - Cinzia Niolu
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Policlinico Tor Vergata Foundation, Rome, Italy
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13
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Aucoin M, LaChance L, Cooley K, Kidd S. Diet and Psychosis: A Scoping Review. Neuropsychobiology 2020; 79:20-42. [PMID: 30359969 DOI: 10.1159/000493399] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/29/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Schizophrenia spectrum disorders (SSD) represent a cluster of severe mental illnesses. Diet has been identified as a modifiable risk factor and opportunity for intervention in many physical illnesses and more recently in mental illnesses such as unipolar depression; however, no dietary guidelines exist for patients with SSD. OBJECTIVE This review sought to systematically scope the existing literature in order to identify nutritional interventions for the prevention or treatment of mental health symptoms in SSD as well as gaps and opportunities for further research. METHODS This review followed established methodological approaches for scoping reviews including an extensive a priori search strategy and duplicate screening. Because of the large volume of results, an online program (Abstrackr) was used for screening and tagging. Data were extracted based on the dietary constituents and analyzed. RESULTS Of 55,330 results identified by the search, 822 studies met the criteria for inclusion. Observational evidence shows a connection between the presence of psychotic disorders and poorer quality dietary patterns, higher intake of refined carbohydrates and total fat, and lower intake or levels of fibre, ω-3 and ω-6 fatty acids, vegetables, fruit, and certain vitamins and minerals (vitamin B12 and B6, folate, vitamin C, zinc, and selenium). Evidence illustrates a role of food allergy and sensitivity as well as microbiome composition and specific phytonutrients (such as L-theanine, sulforaphane, and resveratrol). Experimental studies have demonstrated benefit using healthy diet patterns and specific vitamins and minerals (vitamin B12 and B6, folate, and zinc) and amino acids (serine, lysine, glycine, and tryptophan). DISCUSSION Overall, these findings were consistent with many other bodies of knowledge about healthy dietary patterns. Many limitations exist related to the design of the individual studies and the ability to extrapolate the results of studies using dietary supplements to dietary interventions (food). Dietary recommendations are presented as well as recommendations for further research including more prospective observational studies and intervention studies that modify diet constituents or entire dietary patterns with statistical power to detect mental health outcomes.
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Affiliation(s)
- Monique Aucoin
- Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada,
| | - Laura LaChance
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Kieran Cooley
- Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada.,Australian Research Centre in Complementary and Integrative Medicine, University of Technology, Sydney, New South Wales, Australia
| | - Sean Kidd
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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14
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Lozano-Muñoz I, Muñoz S, Díaz NF, Medina A, Bazaes J, Riquelme C. Nutritional Enhancement of Farmed Salmon Meat via Non-GMO Nannochloropsis Gaditana: Eicosapentaenoic Acid (EPA, 20:5 n-3), Docosapentaenoic Acid (DPA, 22:5 n-3) and Vitamin D3 for Human Health. Molecules 2020; 25:E4615. [PMID: 33050537 PMCID: PMC7587176 DOI: 10.3390/molecules25204615] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 02/07/2023] Open
Abstract
Omega-3 long-chain polyunsaturated fatty acids (n-3 LC PUFAs) and vitamin D3 are essential components of human nutrition. A regular human diet is highly deficient in n-3 LC PUFAs. Fish like salmon are highly recommended in the human diet as they are a major source of high-value n-3 LC PUFAs and vitamin D3. The levels of these nutrients have been decreasing over the last few years in farmed salmon, whose production urgently needs sustainable sources of these nutrients. The microalga Nannochloropsis gaditana (NG) is known for its naturally high potential for the production of eicosapentaenoic (EPA, 20:5 n-3) fatty acid. A commercial diet for Atlantic salmon was supplemented with 1% and 10% of spray-dried NG grown under controlled conditions for a high EPA content. Salmon were harvested on day 49, following which, boneless and skinless salmon meat was recovered from fish and analyzed for the fatty acid profile, total fat, and vitamin D3. Vitamin D3, EPA, and docosapentaenoic fatty acid (DPA, 22:5 n-3) levels were significantly increased (p < 0.05) by supplementing the basal diet with 10% NG, thus, NG represents a novel, functional, natural ingredient and a sustainable source of n-3 LC-PUFAs that can raise the levels of healthy fats and vitamin D3 in farmed salmon meat.
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Affiliation(s)
- Ivonne Lozano-Muñoz
- Departamento de Producción Animal, Facultad de Ciencias Agronómicas, Universidad de Chile, Santiago 8820000, Chile; (S.M.); (N.F.D.)
| | - Susana Muñoz
- Departamento de Producción Animal, Facultad de Ciencias Agronómicas, Universidad de Chile, Santiago 8820000, Chile; (S.M.); (N.F.D.)
| | - Nelson F. Díaz
- Departamento de Producción Animal, Facultad de Ciencias Agronómicas, Universidad de Chile, Santiago 8820000, Chile; (S.M.); (N.F.D.)
| | - Alberto Medina
- Departamento de Acuicultura y Recursos Agroalimentarios, Universidad de Los Lagos, Osorno 5290000, Chile;
| | - Jazmín Bazaes
- Centro de Bioinnovación, Facultad de Ciencias del Mar y Recursos Biológicos, Universidad de Antofagasta, Antofagasta 1240000, Chile; (J.B.); (C.R.)
| | - Carlos Riquelme
- Centro de Bioinnovación, Facultad de Ciencias del Mar y Recursos Biológicos, Universidad de Antofagasta, Antofagasta 1240000, Chile; (J.B.); (C.R.)
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15
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Thompson AD, Jones HJ, Heron J, Hibbeln J, Sullivan S, Zammit S. Omega-3 and Omega-6 fatty acids and risk of psychotic outcomes in the ALSPAC birth cohort. Schizophr Res 2020; 224:108-115. [PMID: 33067055 PMCID: PMC7738752 DOI: 10.1016/j.schres.2020.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 06/12/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Long chain polyunsaturated fatty acid (PUFA) levels have been implicated in the pathology of psychotic disorders. We investigated the relationship between childhood PUFA levels and later psychotic experiences (PE's) in a large birth cohort. METHODS Plasma levels of Ω-3 and Ω-6 fatty acids (FA's) were assayed at ages 7 and 16 years. PE's were assessed at ages 12 and 18 years using a semi-structured interview. Primary outcome was any PE's at 18 years; sensitivity analyses examined incident PE's between ages 12 and 18 years, persistent PE's (at 12 and 18) and psychotic disorder at 18 years. Genetic instruments for Ω-3 and Ω-6 were derived and used in a multivariable Mendelian Randomization analysis. RESULTS Higher levels of Ω-6 FA's AA, OA and AdA at age 7 years were weakly associated with a reduced risk for PE's at 18 years, however, effect sizes were small and attenuated after adjusting for confounders (strongest evidence for OA; adjusted OR, 0.842; 95% CI, 0.711, 0.998; p, 0.048). Total Ω-6 levels at age 16 years were associated with an increased odds of psychotic disorder at age 18 years. However, there was no association between Ω-6/Ω-3 ratio and psychosis outcomes, nor with genetic instruments of total Ω-3 or Ω-6 levels. CONCLUSIONS There is no strong evidence that total plasma Ω-3 FA levels or Ω-6/Ω-3 ratios in childhood and mid-adolescence are associated with increased risk for PE's or psychotic disorder, but very marginal evidence that alterations in the Ω-6 pathway at developmental time points might influence risk2.
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Affiliation(s)
- A D Thompson
- Division of Mental Health and Wellbeing, University of Warwick, UK; Orygen, the Centre of Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC 3250, Australia.
| | - H J Jones
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust, University of Bristol, UK
| | - J Heron
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - J Hibbeln
- Laboratory of Membrane Biochemistry and Biophysics, Section of Nutritional Neuroscience, National Institute for Health, Bethesda, USA
| | - S Sullivan
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK; NIHR CLAHRC West, Whitefriars, Lewins Mead, Bristol, UK
| | - S Zammit
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust, University of Bristol, UK; MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
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16
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Okasha TA, Sabry WM, Hashim MA, Abdeen MS, Abdelhamid AM. Vitamin D serum level in major depressive disorder and schizophrenia. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00043-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Vitamin D is involved in many brain processes including neurological immune process, regulation of neurological factors, and neuroplasticity. Some studies have linked low serum vitamin D to major depressive disorder (MDD) and schizophrenia, while others have not shown any relationship. The study aimed to assess vitamin D level in patients with depression and those with schizophrenia. Sixty participants were recruited from outpatient clinics of the Institute of Psychiatry, Ain Shams University, Cairo, Egypt. The sample was divided into three groups: group A, 20 patients with MDD; group B, 20 patients with schizophrenia, and group C, 20 healthy control subjects. Ain Shams Psychiatry Clinical Interview was used to gather demographic data, and Structured Clinical interview (SCID-I) and laboratory vitamin D serum levels (ELISA) were applied to subjects.
Results
Eighty-five percent of patients with MDD and 80% of patients with schizophrenia had below normal vitamin D serum level. Compared to controls, vitamin D serum concentration in patients with MDD was statistically significantly lower than controls, while schizophrenia had vitamin D level lower than did control group but higher level than patients with MDD. However, vitamin D level failed to differentiate between patients diagnosed with schizophrenia and those with MDD.
Conclusions
Patients with MDD and those with schizophrenia demonstrated lower vitamin D level compared with health controls. There was no statistically significant difference in vitamin D level between patients with MDD and those with schizophrenia.
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17
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van der Leeuw C, de Witte LD, Stellinga A, van der Ley C, Bruggeman R, Kahn RS, van Os J, Marcelis M. Vitamin D concentration and psychotic disorder: associations with disease status, clinical variables and urbanicity. Psychol Med 2020; 50:1680-1686. [PMID: 31327333 DOI: 10.1017/s0033291719001739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The association between schizophrenia and decreased vitamin D levels is well documented. Low maternal and postnatal vitamin D levels suggest a possible etiological mechanism. Alternatively, vitamin D deficiency in patients with schizophrenia is presumably (also) the result of disease-related factors or demographic risk factors such as urbanicity. METHODS In a study population of 347 patients with psychotic disorder and 282 controls, group differences in vitamin D concentration were examined. Within the patient group, associations between vitamin D, symptom levels and clinical variables were analyzed. Group × urbanicity interactions in the model of vitamin D concentration were examined. Both current urbanicity and urbanicity at birth were assessed. RESULTS Vitamin D concentrations were significantly lower in patients (B = -8.05; 95% confidence interval (CI) -13.68 to -2.42; p = 0.005). In patients, higher vitamin D concentration was associated with lower positive (B = -0.02; 95% CI -0.04 to 0.00; p = 0.049) and negative symptom levels (B = -0.03; 95% CI -0.05 to -0.01; p = 0.008). Group differences were moderated by urbanicity at birth (χ2 = 6.76 and p = 0.001), but not by current urbanicity (χ2 = 1.50 and p = 0.224). Urbanicity at birth was negatively associated with vitamin D concentration in patients (B = -5.11; 95% CI -9.41 to -0.81; p = 0.020), but not in controls (B = 0.72; 95% CI -4.02 to 5.46; p = 0.765). CONCLUSIONS Lower vitamin D levels in patients with psychotic disorder may in part reflect the effect of psychosis risk mediated by early environmental adversity. The data also suggest that lower vitamin D and psychopathology may be related through direct or indirect mechanisms.
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Affiliation(s)
- C van der Leeuw
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Mondriaan, Maastricht, the Netherlands
| | - L D de Witte
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - A Stellinga
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- University Center for Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - C van der Ley
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - R Bruggeman
- University Center for Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - R S Kahn
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - J van Os
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - M Marcelis
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands
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18
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Liu C, Jiang W, Deng M, Wang F, Wang Y. Lower vitamin D levels in panic attacks in Shanghai: A case-control study. Asian J Psychiatr 2020; 51:101948. [PMID: 32109855 DOI: 10.1016/j.ajp.2020.101948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/08/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Chen Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Weiqing Jiang
- Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Mingzhu Deng
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Fei Wang
- Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Yonggang Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China; Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China.
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19
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Song L, Luo X, Jiang Q, Chen Z, Zhou L, Wang D, Chen A. Vitamin D Supplementation is Beneficial for Children with Autism Spectrum Disorder: A Meta-analysis. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2020; 18:203-213. [PMID: 32329301 PMCID: PMC7242097 DOI: 10.9758/cpn.2020.18.2.203] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/03/2019] [Accepted: 12/02/2019] [Indexed: 01/03/2023]
Abstract
Objective We conducted a meta-analysis of randomized controlled trials to explore whether vitamin D supplementation is beneficial for symptom improvement in children with autism spectrum disorder. Methods We systematically searched the PubMed database, EMBASE, Cochrane Library, Web of Science, Sino-Med, Wanfang Data, and China National Knowledge Infrastructure mainly up to September 2019. Using a fixed effects model, we calculated the standard mean difference with 95% confidence interval. Furthermore, we analyzed baseline serum 25-hydroxyvitamin D levels and outcome scores including the Social Responsiveness Scale and Child Autism Rating Scale scores after vitamin D supplementation. Results There was no significant difference in baseline serum 25-hydroxyvitamin D levels among 203 children included from three studies in the meta-analysis. After vitamin D supplementation, the outcome scores in the experimental group were dramatically elevated compared with those in the control group (p = 0.03). Conclusion Vitamin D supplementation improves the typical symptoms of autism spectrum disorder, as indicated by reduced Social Responsiveness Scale and Child Autism Rating Scale scores; thus, it is beneficial for children with autism spectrum disorder.
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Affiliation(s)
- Liyao Song
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiaomei Luo
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qing Jiang
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhi Chen
- Nursing Department, The Affiliated Hospital of Southwest Medical University, Luzhou
| | - Lifang Zhou
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Dan Wang
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Ai Chen
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Department of Pediatric, Sichuan Provincial Hospital for Women and Children, Chengdu, Sichuan Province, China
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20
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Seiler N, Nguyen T, Yung A, O'Donoghue B. Terminology and assessment tools of psychosis: A systematic narrative review. Psychiatry Clin Neurosci 2020; 74:226-246. [PMID: 31846133 DOI: 10.1111/pcn.12966] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 12/05/2019] [Indexed: 12/20/2022]
Abstract
AIM Phenomena within the psychosis continuum that varies in frequency/duration/intensity have been increasingly identified. Different terms describe these phenomena, however there is no standardization within the terminology. This review evaluated the definitions and assessment tools of seven terms - (i) 'psychotic experiences'; (ii) 'psychotic-like experiences'; (iii) 'psychotic-like symptoms'; (iv) 'attenuated psychotic symptoms'; (v) 'prodromal psychotic symptoms'; (vi) 'psychotic symptomatology'; and (vii) 'psychotic symptoms'. METHODS EMBASE, MEDLINE, and CINAHL were searched during February-March 2019. Inclusion criteria included 1989-2019, full text, human, and English. Papers with no explicit definition or assessment tool, duplicates, conference abstracts, systematic reviews, meta-analyses, or no access were excluded. RESULTS A total of 2238 papers were identified and of these, 627 were included. Definitions and assessment tools varied, but some trends were found. Psychotic experiences and psychotic-like experiences were transient and mild, found in the general population and those at-risk. Psychotic-like symptoms were subthreshold and among at-risk populations and non-psychotic mental disorders. Attenuated psychotic symptoms were subthreshold but associated with distress, risk, and help-seeking. Prodromal psychotic symptoms referred to the prodrome of psychotic disorders. Psychotic symptomatology included delusions and hallucinations within psychotic disorders. Psychotic symptoms was the broadest term, encompassing a range of populations but most commonly involving hallucinations, delusions, thought disorder, and disorganization. DISCUSSION A model for conceptualizing the required terms is proposed and future directions needed to advance this field of research are discussed.
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Affiliation(s)
- Natalie Seiler
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,The University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Tony Nguyen
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,The University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Alison Yung
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Brian O'Donoghue
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
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21
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Gaughran F, Stringer D, Berk M, Smith S, Taylor D, Whiskey E, Landau S, Murray R, McGuire P, Gardner-Sood P, Wojewodka G, Ciufolini S, Jordan H, Clarke J, Allen L, Krivoy A, Stubbs B, Lowe P, Arbuthnott M, Rathod S, Boardman A, Firdosi M, McGrath JJ. Vitamin D supplementation compared to placebo in people with First Episode psychosis - Neuroprotection Design (DFEND): a protocol for a randomised, double-blind, placebo-controlled, parallel-group trial. Trials 2020; 21:14. [PMID: 31907006 PMCID: PMC6945550 DOI: 10.1186/s13063-019-3758-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 09/26/2019] [Indexed: 12/12/2022] Open
Abstract
Background People experiencing their first episode of psychosis are often deficient in vitamin D. Observational studies have reported an association between low vitamin D concentrations and poorer subsequent health outcomes in psychosis. A vitamin D deficiency in neonates and children has been linked to a later increased risk of schizophrenia and psychotic-like experiences. This trial aims to examine the effect of high-dose vitamin D supplementation on outcomes in early psychosis. We hypothesise that vitamin D supplementation will be associated with better mental health outcomes. Methods/design The DFEND study is a multicentre double-blind placebo-controlled parallel-group trial of vitamin D supplementation in people with early psychosis. Patients with an ICD-10 diagnosis of functional psychosis will be randomised in a 1:1 ratio to receive either 120,000 IU/month of vitamin D (cholecalciferol) or a matched placebo for 6 months. The primary outcome is the total Positive and Negative Syndrome Scale (PANSS) score at the 6-month follow-up for all patients. Secondary outcomes include assessment of mood (Calgary Depression Scale), general function (Global Assessment of Functioning), cardiovascular risk (body mass index, waist circumference, C-reactive protein, cholesterol and HbA1c) and vitamin D levels at the 6-month follow-up. Additionally, 3- and 6-month total PANSS scores will be analysed for those with inadequate vitamin D levels at the baseline. Discussion The DFEND study is the first trial to examine whether vitamin D supplementation in early psychosis is associated with better mental health outcomes. The findings of this study may help to resolve the clinical equipoise regarding the benefits and cost-effectiveness of routine vitamin D supplementation in people with psychosis. Trial registration ISRCTN, ISRCTN12424842. Registered on 25 February 2015.
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Affiliation(s)
- Fiona Gaughran
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK. .,South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK.
| | - Dominic Stringer
- Department of Biostatistics and Health Informatics, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Michael Berk
- Deakin University and Barwon Health, Ryrie Street, Geelong, Victoria, 3220, Australia
| | - Shubulade Smith
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - David Taylor
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Eromona Whiskey
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Sabine Landau
- Department of Biostatistics and Health Informatics, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Robin Murray
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Philip McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Poonam Gardner-Sood
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Gabriella Wojewodka
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Simone Ciufolini
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Harriet Jordan
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Jessie Clarke
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Lauren Allen
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Amir Krivoy
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Brendon Stubbs
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Philippa Lowe
- Carer Expert and Chair of Trustees, Rethink Mental Illness, 89 Albert Embankment, London, SE1 7TP, UK
| | | | - Shanaya Rathod
- Clinical Trials Facility, Research Department, Tom Rudd Unit, Moorgreen Hospital, Southampton, SO3 03J, UK
| | - Andrew Boardman
- Cheshire & Wirral Partnership NHS Trust, Churton House, Countess of Chester Health Park, Chester, CH2 1BQ, UK
| | - Mudasir Firdosi
- South West London and St George's Mental Health NHS Trust, Queen Mary's Hospital, Roehampton Lane, London, SW15 5PN, UK
| | - John J McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia.,Queensland Brain Institute, University of Queensland, Brisbane, QLD, 4072, Australia.,National Centre for Register-Based Research, Aarhus University, 8000, Aarhus C, Denmark
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22
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Hashemi S, Amani R, Cheraghian B, Neamatpour S. Stress and Anxiety Levels Are Associated with Erythrocyte Fatty Acids Content in Young Women. IRANIAN JOURNAL OF PSYCHIATRY 2020; 15:47-54. [PMID: 32377214 PMCID: PMC7193237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective: Recent studies have revealed that fatty acid profile can be associated with psychological disorders. However, evidence on stress and anxiety is scarce. The aim of this study was to investigate the relationship between stress and anxiety, defined as mood states, and erythrocyte fatty acid (FA) profile. Method : This case-control study was conducted on 45 female students with degrees of stress and anxiety without depression disorder and 45 matched controls with no depression, stress, or anxiety. Self-administered questionnaires included a 28-item Food Frequency questionnaire and Depression Anxiety Stress Scales (DASS-21), which were used to measure dietary patterns and psychological disorders, respectively. Erythrocyte membrane fatty acids were analyzed using gas-liquid chromatography. Results: Docosahexaenoic acid (DHA) was significantly lower in the case group (p = 0.008). Hydrogenated fats were associated with degrees of stress and anxiety (OR = 1.53, p = 0.019), while linoleate and DHA were inversely associated with stress and anxiety scores (OR = 0.37, p = 0.05; OR = 0.31, p = 0.014, respectively). Monounsaturated FAs (MUFAs) and total RBC trans FA were associated with increased risk of stress and anxiety (OR = 1.81, p < 0.001; OR = 3.38, p = 0.003, respectively). Conclusion: Trans-fatty acids may be related to stress and anxiety scales but linoleate and DHA could decrease the risk. The effect of MUFAs may be regarded as a result of compensatory biological mechanisms.
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Affiliation(s)
- Samira Hashemi
- Health Research Institute, Diabetes Research Centre, Department of Nutrition, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Amani
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. ,Corresponding Author: Address: Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Postal Code: 81746-73461. Tel: +98 9163139856, Fax: +98 313668 1378,
| | - Bahman Cheraghian
- Department of Biostatistics and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sorour Neamatpour
- Department of Psychiatry, Golestan Medical Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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23
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Nasir M, Bloch MH. Trim the fat: the role of omega-3 fatty acids in psychopharmacology. Ther Adv Psychopharmacol 2019; 9:2045125319869791. [PMID: 31489174 PMCID: PMC6713969 DOI: 10.1177/2045125319869791] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/22/2019] [Indexed: 12/21/2022] Open
Abstract
The American Psychiatric Association (APA) currently recommends the use of omega-3 fatty acid supplementation for depressive disorders, impulse-control disorders, and psychotic disorders in treatment guidelines. This review examines the evidence for efficacy of omega-3 fatty acids in depressive disorders, bipolar disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and psychosis. Meta-analysis of randomized-controlled trials of omega-3 fatty acids for depression are inconclusive, with strong evidence of publication bias, sizable heterogeneity between included studies, and substantial methodological shortcomings in included trials. The large amount of heterogeneity in findings of RCTs of omega-3 fatty acids for unipolar depression is likely attributable to highly heterogeneous sample populations that are given different omega-3 supplements [which differ widely in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) content, ratio, and dosage] as either adjunctive or monotherapy of other existing treatments, and then measure several different outcomes of depression symptomatology with likely incomplete blinding. Evidence of efficacy of omega-3 supplementation in treating psychosis, PTSD, anxiety, and bipolar mania is minimal. The current guidelines recommending the use of omega-3 fatty acids in adulthood psychiatric conditions should be revisited, especially given several recent negative studies examining the effects of omega-3 fatty acids for cardiovascular disease. Recommending likely ineffective treatment to patients, no matter how benign the side-effect profile, has opportunity cost (e.g. other more effective medications or therapies not being utilized) and likely affects patient compliance with other evidence-based treatments.
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Affiliation(s)
- Madeeha Nasir
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Michael H. Bloch
- Child Study Center, Yale University School of Medicine, 230 S. Frontage Road, New Haven, CT, 06520, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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24
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Petimar J, O'Reilly É, Adami HO, van den Brandt PA, Buring J, English DR, Freedman DM, Giles GG, Håkansson N, Kurth T, Larsson SC, Robien K, Schouten LJ, Weiderpass E, Wolk A, Smith-Warner SA. Coffee, tea, and caffeine intake and amyotrophic lateral sclerosis mortality in a pooled analysis of eight prospective cohort studies. Eur J Neurol 2018; 26:468-475. [PMID: 30326172 DOI: 10.1111/ene.13840] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/10/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Caffeine is associated with a lower risk of some neurological diseases, but few prospective studies have investigated caffeine intake and risk of amyotrophic lateral sclerosis (ALS) mortality. We therefore determined associations between coffee, tea and caffeine intake, and risk of ALS mortality. METHODS We conducted pooled analyses of eight international, prospective cohort studies, including 351 565 individuals (120 688 men and 230 877 women). We assessed coffee, tea and caffeine intake using validated food-frequency questionnaires administered at baseline. We used Cox regression to estimate study- and sex-specific risk ratios and 95% confidence intervals (CI) for ALS mortality, which were then pooled using a random-effects model. We conducted analyses using cohort-specific tertiles, absolute common cut-points and continuous measures of all exposures. RESULTS During follow-up, 545 ALS deaths were documented. We did not observe statistically significant associations between coffee, tea or caffeine intake and risk of ALS mortality. The pooled multivariable risk ratio (MVRR) for ≥3 cups per day vs. >0 to <1 cup per day was 1.04 (95% CI, 0.74-1.47) for coffee and 1.17 (95% CI, 0.77-1.79) for tea. The pooled MVRR comparing the highest with the lowest tertile of caffeine intake (mg/day) was 0.99 (95% CI, 0.80-1.23). No statistically significant results were observed when exposures were modeled as tertiles or continuously. CONCLUSIONS Our results do not support associations between coffee, tea or total caffeine intake and risk of ALS mortality.
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Affiliation(s)
- J Petimar
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - É O'Reilly
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,School of Public Health, College of Medicine, University College Cork, Cork, Ireland
| | - H-O Adami
- Karolinska Institutet, Stockholm, Sweden
| | | | - J Buring
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - D R English
- Cancer Council Victoria, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - D M Freedman
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - G G Giles
- Cancer Council Victoria, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - T Kurth
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - K Robien
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - L J Schouten
- Caphri School, Maastricht University, Maastricht, The Netherlands
| | - E Weiderpass
- Karolinska Institutet, Stockholm, Sweden.,Institute of Population-Based Cancer Research, Oslo, Norway
| | - A Wolk
- Karolinska Institutet, Stockholm, Sweden
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25
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Roswall N, Sandin S, Adami HO, Weiderpass E. Cohort Profile: The Swedish Women's Lifestyle and Health cohort. Int J Epidemiol 2018; 46:e8. [PMID: 26066328 DOI: 10.1093/ije/dyv089] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nina Roswall
- Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Research, Cancer Registry of Norway, Oslo, Norway.,Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway and.,Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
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26
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Sun GY, Simonyi A, Fritsche KL, Chuang DY, Hannink M, Gu Z, Greenlief CM, Yao JK, Lee JC, Beversdorf DQ. Docosahexaenoic acid (DHA): An essential nutrient and a nutraceutical for brain health and diseases. Prostaglandins Leukot Essent Fatty Acids 2018; 136:3-13. [PMID: 28314621 PMCID: PMC9087135 DOI: 10.1016/j.plefa.2017.03.006] [Citation(s) in RCA: 143] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 03/06/2017] [Accepted: 03/09/2017] [Indexed: 01/01/2023]
Abstract
Docosahexaenoic acid (DHA), a polyunsaturated fatty acid (PUFA) enriched in phospholipids in the brain and retina, is known to play multi-functional roles in brain health and diseases. While arachidonic acid (AA) is released from membrane phospholipids by cytosolic phospholipase A2 (cPLA2), DHA is linked to action of the Ca2+-independent iPLA2. DHA undergoes enzymatic conversion by 15-lipoxygenase (Alox 15) to form oxylipins including resolvins and neuroprotectins, which are powerful lipid mediators. DHA can also undergo non-enzymatic conversion by reacting with oxygen free radicals (ROS), which cause the production of 4-hydoxyhexenal (4-HHE), an aldehyde derivative which can form adducts with DNA, proteins and lipids. In studies with both animal models and humans, there is evidence that inadequate intake of maternal n-3 PUFA may lead to aberrant development and function of the central nervous system (CNS). What is less certain is whether consumption of n-3 PUFA is important in maintaining brain health throughout one's life span. Evidence mostly from non-human studies suggests that DHA intake above normal nutritional requirements might modify the risk/course of a number of diseases of the brain. This concept has fueled much of the present interest in DHA research, in particular, in attempts to delineate mechanisms whereby DHA may serve as a nutraceutical and confer neuroprotective effects. Current studies have revealed ability for the oxylipins to regulation of cell redox homeostasis through the Nuclear factor (erythroid-derived 2)-like 2/Antioxidant response element (Nrf2/ARE) anti-oxidant pathway, and impact signaling pathways associated with neurotransmitters, and modulation of neuronal functions involving brain-derived neurotropic factor (BDNF). This review is aimed at describing recent studies elaborating these mechanisms with special regard to aging and Alzheimer's disease, autism spectrum disorder, schizophrenia, traumatic brain injury, and stroke.
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Affiliation(s)
- Grace Y Sun
- Biochemistry Department, University of Missouri, Columbia, MO, United States
| | - Agnes Simonyi
- Biochemistry Department, University of Missouri, Columbia, MO, United States
| | - Kevin L Fritsche
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Dennis Y Chuang
- Department of Neurology, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH, United States
| | - Mark Hannink
- Biochemistry Department, University of Missouri, Columbia, MO, United States
| | - Zezong Gu
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, MO, United States
| | | | - Jeffrey K Yao
- Medical Research Service, VA Pittsburgh Healthcare System, and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - James C Lee
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, United States
| | - David Q Beversdorf
- Department of Radiology, Neurology, and Psychological Sciences, and the Thompson Center, William and Nancy Thompson Endowed Chair in Radiology, University of Missouri School of Medicine, Columbia, MO, United States
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27
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Altunsoy N, Yüksel RN, Cingi Yirun M, Kılıçarslan A, Aydemir Ç. Exploring the relationship between vitamin D and mania: correlations between serum vitamin D levels and disease activity. Nord J Psychiatry 2018; 72:221-225. [PMID: 29308715 DOI: 10.1080/08039488.2018.1424238] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Several studies suggest an association between hypovitaminosis D and mood disorders including major depressive disorder, seasonal affective disorder and premenstrual dysphoric disorder. On the other hand, there is not enough study about acute manic episode and hypovitaminosis D. This data insufficient zone led us to study on whether vitamin D deficiency is associated with acute manic episode and has an impact on disease activity Methods: Thirty-one patients with bipolar disorder in remission, 26 patients with acute manic episode and 40 healthy controls with no major psychopathology were recruited in this study. Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS) and the Clinical Global Impression - Severety scale (CGI-S) were used to evaluate disease activity. Total vitamin D (D2 + D3) values were measured. RESULTS Patients in acute manic episode had significantly lower (p = .002) vitamin D serum concentrations than healthy controls (respectively 15.16 ± 7.48 and 22.31 ± 8.8) but remission group's serum concentrations (18.40 ± 7.30) did not differ significantly from healthy controls or acute manic episode patients (p > .05). We observed negative and moderate correlations between vitamin D levels and YMRS scores (r: -0.641, p < .001), vitamin D levels and CGI scores (r: -0.559, p= .003). CONCLUSIONS Our results contribute to the idea that vitamin D deficiency and acute manic episode may have interactions with many pathways. Future trials may investigate this association with longer follow up. We recommend that serum vitamin D levels should be measured in patients with bipolar disorder especially in long term care.
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Affiliation(s)
- Neslihan Altunsoy
- a Department of Psychiatry , Ankara Numune Training and Research Hospital , Ankara , Turkey
| | - Rabia Nazik Yüksel
- a Department of Psychiatry , Ankara Numune Training and Research Hospital , Ankara , Turkey
| | - Merve Cingi Yirun
- a Department of Psychiatry , Ankara Numune Training and Research Hospital , Ankara , Turkey
| | - Ayşegül Kılıçarslan
- b Ankara Physical Medicine and Rehabilitation Training and Research Hospital , Ankara , Turkey
| | - Çiğdem Aydemir
- a Department of Psychiatry , Ankara Numune Training and Research Hospital , Ankara , Turkey
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28
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Lerner PP, Sharony L, Miodownik C. Association between mental disorders, cognitive disturbances and vitamin D serum level: Current state. Clin Nutr ESPEN 2018; 23:89-102. [DOI: 10.1016/j.clnesp.2017.11.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 07/31/2017] [Accepted: 11/29/2017] [Indexed: 01/02/2023]
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29
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Lipid profile disturbances in antipsychotic-naive patients with first-episode non-affective psychosis: A systematic review and meta-analysis. Schizophr Res 2017; 190:18-27. [PMID: 28325572 DOI: 10.1016/j.schres.2017.03.031] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/10/2017] [Accepted: 03/11/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Dyslipidaemia is one of the most prevalent metabolic disturbances observed in schizophrenia patients and has been largely attributed to the effects of poor lifestyle habits and adverse effects of antipsychotic treatment. However, less is known whether patients with first-episode non-affective psychosis (FENP) present subthreshold indices of dyslipidaemia. Therefore, we tested the hypothesis whether subclinical lipid profile alterations occur already in antipsychotic-naïve FENP patients. METHODS In this systematic review and meta-analysis we adhered to the PRISMA guidelines and searched PubMed, CINAHL Complete, Academic Search Complete, ERIC and Health Source: Nursing/Academic Edition from database inception to Dec 12, 2016, for case-control studies measuring the levels of total cholesterol, low- and high-density lipoproteins (LDL and HDL) and triglycerides in patients with FENP and controls. W calculated effect size (ES) estimates as Hedges' g and pooled data using random- or fixed-effects models depending on heterogeneity. Our study was registered in the PROSPERO database (CRD42016051732). RESULTS Out of 2466 records identified, 19 studies representing 1803 participants were finally included in our systematic review and meta-analysis. Pooled analysis revealed that FENP patients had significantly lower levels of total cholesterol [ES=-0.16 (95% CI: -0.27, -0.06), p=0.003], LDL [ES=-0.13 (95% CI: -0.24, -0.01), p=0.034] and HDL [ES=-0.27 (95% CI: -0.49, -0.05), p=0.018] as well as significantly higher levels of triglycerides [ES=0.22 (95% CI: 0.11, 0.32), p<0.001] compared to controls. After removing single studies in sensitivity analysis, ES estimate for LDL levels was insignificant. CONCLUSIONS Antipsychotic-naïve patients with FENP present subclinical dyslipidaemia. Future studies should disentangle whether our findings reflect disease-specific mechanisms.
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30
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Mitra S, Natarajan R, Ziedonis D, Fan X. Antioxidant and anti-inflammatory nutrient status, supplementation, and mechanisms in patients with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2017; 78:1-11. [PMID: 28499901 DOI: 10.1016/j.pnpbp.2017.05.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/06/2017] [Accepted: 05/08/2017] [Indexed: 10/19/2022]
Abstract
Over 50 million people around the world suffer from schizophrenia, a severe mental illness characterized by misinterpretation of reality. Although the exact causes of schizophrenia are still unknown, studies have indicated that inflammation and oxidative stress may play an important role in the etiology of the disease. Pro-inflammatory cytokines are crucial for normal central nervous development and proper functioning of neural networks and neurotransmitters. Patients with schizophrenia tend to have abnormal immune activation resulting in elevated pro-inflammatory cytokine levels, ultimately leading to functional brain impairments. Patients with schizophrenia have also been found to suffer from oxidative stress, a result of an imbalance between the production of free radicals and the ability to detoxify their harmful effects. Furthermore, inflammation and oxidative stress are implicated to be related to the severity of psychotic symptoms. Several nutrients are known to have anti-inflammatory and antioxidant functions through various mechanisms in our body. The present review evaluates studies and literature that address the status and supplementation of omega-3 polyunsaturated fatty acids, vitamin D, B vitamins (B6, folate, B12), vitamin E, and carotenoids in different stages of schizophrenia. The possible anti-inflammatory and antioxidant mechanisms of action of each nutrient are discussed.
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Affiliation(s)
- Sumedha Mitra
- Department of Psychiatry, UMass Memorial Medical Center/University of Massachusetts Medical School, One Biotech, 365 Plantation Street, Worcester, MA 01605, USA
| | - Radhika Natarajan
- Department of Psychiatry, UMass Memorial Medical Center/University of Massachusetts Medical School, One Biotech, 365 Plantation Street, Worcester, MA 01605, USA
| | - Douglas Ziedonis
- Department of Psychiatry, UMass Memorial Medical Center/University of Massachusetts Medical School, One Biotech, 365 Plantation Street, Worcester, MA 01605, USA
| | - Xiaoduo Fan
- Department of Psychiatry, UMass Memorial Medical Center/University of Massachusetts Medical School, One Biotech, 365 Plantation Street, Worcester, MA 01605, USA.
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Tardelli VS, Lago MPPD, Silveira DXD, Fidalgo TM. Vitamin D and alcohol: A review of the current literature. Psychiatry Res 2017; 248:83-86. [PMID: 28033511 DOI: 10.1016/j.psychres.2016.10.051] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 08/28/2016] [Accepted: 10/23/2016] [Indexed: 01/09/2023]
Abstract
Vitamin D is associated with bone mineral density, and its deficiency is a global health problem. In psychiatry, low vitamin D levels have been associated with schizophrenia, depression, psychotic symptoms, and, more recently, alcohol use disorders. Alcohol use disorders are among the most prevalent mental disorders worldwide. Therefore, our aim was to evaluate the association between alcohol use and vitamin D serum levels. The PubMed, SCIELO, and Lilacs databases were searched for this systematic review. We assessed all articles published from 1976 to December 2015, and we examined the associated reference lists to retrieve articles that appeared to fulfill our criteria. Of 932 articles, 49 met our inclusion criteria. The majority of the papers (71.4%) were cross-sectional studies. Alcohol intake was found to be positively associated with vitamin D status in 15 articles and negatively associated with vitamin D in 18 articles; no association was found in 16 articles. Heterogeneous results were found in our review, with a similar number of papers indicating a positive association, a negative association or the absence of any association between alcohol use and vitamin D levels. Nevertheless, it is important to note that the studies in which a positive association was found were more recent papers that involved considerably larger sample sizes than those in other studies. The older studies compared vitamin D levels in alcoholic and non-alcoholic patients, in contrast to more recent studies, which focused on more specific populations. In addition, most of the selected papers were from high latitude countries, where exposure to sunlight tends to be lower than in tropical countries. The data concerning vitamin D levels in patients with alcohol use disorders remain controversial. Additional research using a standardized methodology is necessary to demonstrate the real impact of alcohol consumption on vitamin D serum levels as well as on the health status of alcohol users.
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El Sayed El Taweel M, El Shafei T. Relationship between vitamin D status and psychopathology in patients with first-episode schizophrenia. MIDDLE EAST CURRENT PSYCHIATRY 2017. [DOI: 10.1097/01.xme.0000508433.27202.4e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Pilecka I, Sandin S, Reichenberg A, Scragg RKR, David A, Weiderpass E. Sun Exposure and Psychotic Experiences. Front Psychiatry 2017; 8:107. [PMID: 28674506 PMCID: PMC5474873 DOI: 10.3389/fpsyt.2017.00107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 06/01/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Sun exposure is considered the single most important source of vitamin D. Vitamin D deficiency has been suggested to play a role in the etiology of psychotic disorders. The aim of the present study was to evaluate the association between sun exposure and psychotic experiences (PEs) in a general population sample of Swedish women. METHODS The study population included participants from The Swedish Women's Lifestyle and Health cohort study. The 20-item community assessment of psychic experiences (CAPEs) was administered between ages 30 and 50 to establish PEs. Sun exposure as measured by (1) sunbathing holidays and (2) history of sunburn was measured between ages 10 and 39. The association between sun exposure and PEs was evaluated by quantile regression models. RESULTS 34,297 women were included in the analysis. Women who reported no sunbathing holidays and 2 or more weeks of sunbathing holidays scored higher on the CAPE scale than women exposed to 1 week of sunbathing holidays across the entire distribution, when adjusting for age and education. Similarly, compared with women who reported a history of one sunburn, the women with none or two or more sunburns showed higher scores on the CAPE scale. CONCLUSION The results of the present study suggest that, in a population-based cohort of middle aged women, both low and high sun exposure is associated with increased level of positive PEs.
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Affiliation(s)
- Izabela Pilecka
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Friedman Brain Institute, New York, NY, United States.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mindich Institute of Child Development, New York, NY, United States.,Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, Friedman Brain Institute, New York, NY, United States.,Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, Mindich Institute of Child Development, New York, NY, United States.,The Seaver Autism Center for Research and Treatment at Mount Sinai, New York, NY, United States
| | - Abraham Reichenberg
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Friedman Brain Institute, New York, NY, United States.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mindich Institute of Child Development, New York, NY, United States.,Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, Friedman Brain Institute, New York, NY, United States.,Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, Mindich Institute of Child Development, New York, NY, United States
| | - Robert K R Scragg
- Section of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Anthony David
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Faculty of Health Sciences, Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.,Department of Research, Cancer Registry of Norway, Oslo, Norway.,Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
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Kočovská E, Gaughran F, Krivoy A, Meier UC. Vitamin-D Deficiency As a Potential Environmental Risk Factor in Multiple Sclerosis, Schizophrenia, and Autism. Front Psychiatry 2017; 8:47. [PMID: 28396640 PMCID: PMC5366333 DOI: 10.3389/fpsyt.2017.00047] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/08/2017] [Indexed: 12/18/2022] Open
Abstract
In this short review, we want to summarize the current findings on the role of vitamin-D in multiple sclerosis (MS), schizophrenia, and autism. Many studies have highlighted hypovitaminosis-D as a potential environmental risk factor for a variety of conditions such as MS, asthma, cardiovascular disease, and, more recently, psychiatric diseases. However, whether hypovitaminosis-D is a potential causative factor for the development or activity in these conditions or whether hypovitaminosis-D may be due to increased vitamin-D consumption by an activated immune system (reverse causation) is the focus of intense research. Here, we will discuss current evidence exploring the role of vitamin-D in MS, schizophrenia, and autism and its impact on adaptive and innate immunity, antimicrobial defense, the microbiome, neuroinflammation, behavior, and neurogenesis. More work is needed to gain insight into its role in the underlying pathophysiology of these conditions as it may offer attractive means of intervention and prevention.
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Affiliation(s)
- Eva Kočovská
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Blizard Institute, Queen Mary University of London , London , UK
| | - Fiona Gaughran
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, National Psychosis Service, South London and Maudlsey NHS Foundation Trust , London , UK
| | - Amir Krivoy
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, National Psychosis Service, South London and Maudlsey NHS Foundation Trust , London , UK
| | - Ute-Christiane Meier
- Neuroinflammation and Psychoimmunology Group, Department of Neuroscience and Trauma, Barts and The London School of Medicine and Dentistry, Blizard Institute, Queen Mary University of London , London , UK
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Róg J, Karakuła-Juchnowicz H. Omega – 3 fatty acids in schizophrenia – part I: importance in the pathophysiology of schizophrenia. CURRENT PROBLEMS OF PSYCHIATRY 2016. [DOI: 10.1515/cpp-2016-0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Abstract
Despite the increasing offer of antipsychotic drugs, the effectiveness of pharmacotherapy in schizophrenia is still unsatisfactory. Drug resistance, lack of complete remission and the increasing risk of metabolic complications are the reasons why the new forms of therapy in schizophrenia among which unsaturated essential fatty acids omega 3 (EFAs ω-3) affecting the proper functioning of nervous system, are mentioned, are being looked for.
Fatty acids represent 50-60% of the dry weight of the brain and diet is one of the factors that influence the value of each of the fat fractions in the neuron membranes. Patients with schizophrenia tend to have irregular nutritional status concerning essential fatty acids ω-3, which might result from metabolic disorders or irregular consumption of fatty acids.
Apart from being a review of the literature on this subject, this very paper characterizes essential fatty acids ω-3, their metabolism, the most important sources in the diet and the opinions of experts in the field about the recommended intake. It pays attention to the role of essential fatty acids in both the structure and functioning of the central nervous system is, as well as their role in the pathophysiology of schizophrenia, with particular emphasis on the membrane concept by David Horrobin. The assessment of the errors in consumption and metabolism of essential fatty acids are described as well.
The evidence was found both in epidemiological and modeling studies. It supports the participation of EFAs in etiopathogenesis and pathophysiology of schizophrenia. Further research is needed, both observational and interventional, as to the role of essential fatty acids ω-3 in the functioning of the CNS as well as the development and course of schizophrenia.
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Affiliation(s)
- Joanna Róg
- Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences
| | - Hanna Karakuła-Juchnowicz
- I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin
- Department of Clinical Neuropsychiatry, Medical University in Lublin
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Association between serum levels of bioavailable vitamin D and negative symptoms in first-episode psychosis. Psychiatry Res 2016; 243:390-4. [PMID: 27449008 DOI: 10.1016/j.psychres.2016.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 06/20/2016] [Accepted: 07/03/2016] [Indexed: 01/01/2023]
Abstract
Total vitamin D levels had been commonly reported to be lowered in patients with chronic psychotic illnesses in countries from the higher latitudes. However, studies on patients with first episode psychosis (FEP) are limited. In this study we investigated serum concentrations of total and bioavailable vitamin D levels in FEP patients compared to healthy controls and the association between symptom severity and vitamin D components. A total of 31 FEP patients and 31 healthy controls were recruited from Institute of Mental Health, Singapore. FEP patients were identified using Structured Clinical Interview for DSM-IV Axis I disorders (SCID-1) and severity symptoms were assessed using the positive and negative syndrome scale (PANSS). Sera from participants were analyzed for total vitamin D, vitamin D-binding protein (DBP) and bioavailable vitamin D. Linear regressions were performed to examine the associations between serum total and bioavailable vitamin D and the PANSS subscales. Current study noted a significantly lower bioavailable vitamin D was in the FEP group and an association between bioavailable vitamin D and negative symptoms in FEP patients in a population with a consistent supply of sun exposure throughout the year.
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37
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Montejo ÁL, Arango C, Bernardo M, Carrasco JL, Crespo-Facorro B, Cruz JJ, del Pino J, García Escudero MA, García Rizo C, González-Pinto A, Hernández AI, Martín Carrasco M, Mayoral Cleries F, Mayoral van Son J, Mories MT, Pachiarotti I, Ros S, Vieta E. Spanish consensus on the risks and detection of antipsychotic drug-related hyperprolactinaemia. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.rpsmen.2016.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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38
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Investigating causality in the association between 25(OH)D and schizophrenia. Sci Rep 2016; 6:26496. [PMID: 27215954 PMCID: PMC4877705 DOI: 10.1038/srep26496] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 05/03/2016] [Indexed: 01/08/2023] Open
Abstract
Vitamin D deficiency is associated with increased risk of schizophrenia. However, it is not known whether this association is causal or what the direction of causality is. We performed two sample bidirectional Mendelian randomization analysis using single nucleotide polymorphisms (SNPs) robustly associated with serum 25(OH)D to investigate the causal effect of 25(OH)D on risk of schizophrenia, and SNPs robustly associated with schizophrenia to investigate the causal effect of schizophrenia on 25(OH)D. We used summary data from genome-wide association studies and meta-analyses of schizophrenia and 25(OH)D to obtain betas and standard errors for the SNP-exposure and SNP-outcome associations. These were combined using inverse variance weighted fixed effects meta-analyses. In 34,241 schizophrenia cases and 45,604 controls, there was no clear evidence for a causal effect of 25(OH)D on schizophrenia risk. The odds ratio for schizophrenia per 10% increase in 25(OH)D conferred by the four 25(OH)D increasing SNPs was 0.992 (95% CI: 0.969 to 1.015). In up to 16,125 individuals with measured serum 25(OH)D, there was no clear evidence that genetic risk for schizophrenia causally lowers serum 25(OH)D. These findings suggest that associations between schizophrenia and serum 25(OH)D may not be causal. Therefore, vitamin D supplementation may not prevent schizophrenia.
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Leibrock CB, Voelkl J, Kuro-O M, Lang F, Lang UE. 1,25(OH)2D3 dependent overt hyperactivity phenotype in klotho-hypomorphic mice. Sci Rep 2016; 6:24879. [PMID: 27109615 PMCID: PMC4843009 DOI: 10.1038/srep24879] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/05/2016] [Indexed: 02/06/2023] Open
Abstract
Klotho, a protein mainly expressed in kidney and cerebral choroid plexus, is a powerful regulator of 1,25(OH)2D3 formation. Klotho-deficient mice (kl/kl) suffer from excessive plasma 1,25(OH)2D3-, Ca2+- and phosphate-concentrations, leading to severe soft tissue calcification and accelerated aging. NH4Cl treatment prevents tissue calcification and premature ageing without affecting 1,25(OH)2D3-formation. The present study explored the impact of excessive 1,25(OH)2D3 formation in NH4Cl-treated kl/kl-mice on behavior. To this end kl/kl-mice and wild-type mice were treated with NH4Cl and either control diet or vitamin D deficient diet (LVD). As a result, plasma 1,25(OH)2D3-, Ca2+- and phosphate-concentrations were significantly higher in untreated and in NH4Cl-treated kl/kl-mice than in wild-type mice, a difference abrogated by LVD. In each, open field, dark-light box, and O-maze NH4Cl-treated kl/kl-mice showed significantly higher exploratory behavior than untreated wild-type mice, a difference abrogated by LVD. The time of floating in the forced swimming test was significantly shorter in NH4Cl treated kl/kl-mice compared to untreated wild-type mice and to kl/kl-mice on LVD. In wild-type animals, NH4Cl treatment did not significantly alter 1,25(OH)2D3, calcium and phosphate concentrations or exploratory behavior. In conclusion, the excessive 1,25(OH)2D3 formation in klotho-hypomorphic mice has a profound effect on murine behavior.
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Affiliation(s)
- Christina B Leibrock
- Department of Physiology, Cardiology &Vascular Medicine, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany
| | - Jakob Voelkl
- Department of Physiology, Cardiology &Vascular Medicine, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany
| | - Makoto Kuro-O
- Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Florian Lang
- Department of Physiology, Cardiology &Vascular Medicine, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany
| | - Undine E Lang
- Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse 27, CH-4012 Basel, Switzerland
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40
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Montejo ÁL, Arango C, Bernardo M, Carrasco JL, Crespo-Facorro B, Cruz JJ, Del Pino J, García Escudero MA, García Rizo C, González-Pinto A, Hernández AI, Martín Carrasco M, Mayoral Cleries F, Mayoral van Son J, Mories MT, Pachiarotti I, Ros S, Vieta E. Spanish consensus on the risks and detection of antipsychotic drug-related hyperprolactinaemia. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2016; 9:158-73. [PMID: 26927534 DOI: 10.1016/j.rpsm.2015.11.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 09/28/2015] [Accepted: 11/16/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Iatrogenic hyperprolactinaemia (IHPRL) has been more frequently related to some antipsychotic drugs that provoke an intense blockade of dopamine D2 receptors. There is a wide variation in clinical practice, and perhaps some more awareness between clinicians is needed. Due to the high frequency of chronic treatment in severe mental patients, careful attention is recommended on the physical risk. IHPRL symptoms could be underestimated without routine examination. METHODOLOGY An intense scientific literature search was performed in order to draw up a multidisciplinary consensus, including different specialists of psychiatry, endocrinology, oncology and internal medicine, and looking for a consensus about clinical risk and detection of IHPRL following evidence-based medicine criteria levels (EBM I- IV). RESULTS Short-term symptoms include amenorrhea, galactorrhoea, and sexual dysfunction with decrease of libido and erectile difficulties related to hypogonadism. Medium and long-term symptoms related to oestrogens are observed, including a decrease bone mass density, hypogonadism, early menopause, some types of cancer risk increase (breast and endometrial), cardiovascular risk increase, immune system disorders, lipids, and cognitive dysfunction. Prolactin level, gonadal hormones and vitamin D should be checked in all patients receiving antipsychotics at baseline although early symptoms (amenorrhea-galactorrhoea) may not be observed due to the risk of underestimating other delayed symptoms that may appear in the medium term. Routine examination of sexual dysfunction is recommended due to possible poor patient tolerance and low compliance. Special care is required in children and adolescents, as well as patients with PRL levels >50ng/ml (moderate hyperprolactinaemia). A possible prolactinoma should be investigated in patients with PRL levels >150ng/ml, with special attention to patients with breast/endometrial cancer history. Densitometry should be prescribed for males >50 years old, amenorrhea>6 months, or early menopause to avoid fracture risk.
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Affiliation(s)
- Ángel L Montejo
- Área de Neurociencias, Instituto de Biomedicina de Salamanca (IBSAL), Universidad de Salamanca, Servicio de Psiquiatría, Hospital Universitario de Salamanca, España.
| | - Celso Arango
- Departamento de Psiquiatría Infanto-Juvenil, Hospital General Universitario Gregorio Marañón (IiSGM). Facultad de Medicina, Universidad Complutense, CIBERSAM, Madrid, España
| | - Miguel Bernardo
- Unidad Esquizofrenia Clínic, Instituto Clínic de Neurociencias, Hospital Clínic. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
| | - José L Carrasco
- Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, CIBERSAM, Madrid, España
| | - Benedicto Crespo-Facorro
- Departamento de Medicina y Psiquiatría, Universidad de Cantabria. Hospital Universitario Marqués de Valdecilla, IDIVAL, CIBERSAM, Santander, España
| | - Juan J Cruz
- Servicio de Oncología Médica, Hospital Universitario de Salamanca, Universidad de Salamanca (IBSAL), España
| | - Javier Del Pino
- Servicio Medicina Interna, Hospital Clínico Universitario, Universidad de Salamanca, España
| | | | - Clemente García Rizo
- Unidad Esquizofrenia Clínic, Instituto Clínic de Neurociencias, Hospital Clínic. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
| | - Ana González-Pinto
- International Mood Disorders Research Centre, CIBERSAM, Hospital Santiago Apóstol, Universidad del País Vasco, Vitoria, España
| | - Ana I Hernández
- FEA Psiquiatría, Red de Salud Mental de Guipúzcoa, San Sebastián, España
| | - Manuel Martín Carrasco
- Instituto de Investigaciones Psiquiátricas, Fundación María Josefa Recio, Bilbao, España; Clínica Psiquiátrica Padre Menni, CIBERSAM, Pamplona, España
| | - Fermin Mayoral Cleries
- UGC Salud Mental, Hospital Regional Universitario, Instituto de Biomedicina de Málaga, Málaga, España
| | | | - M Teresa Mories
- Servicio de Endocrinología y Nutrición, Hospital Universitario de Salamanca, España
| | - Isabella Pachiarotti
- Programa de Trastornos Bipolares, Departamento de Psiquiatría, Hospital Clínic, Universidad de Barcelona, IDIBAPS, CIBERSAM, Barcelona, España
| | - Salvador Ros
- Instituto Internacional de Neurociencias Aplicadas, Barcelona, España
| | - Eduard Vieta
- Programa de Trastornos Bipolares, Departamento de Psiquiatría, Hospital Clínic, Universidad de Barcelona, IDIBAPS, CIBERSAM, Barcelona, España
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Holm-Hansen S, Low JK, Zieba J, Gjedde A, Bergersen LH, Karl T. Behavioural effects of high fat diet in a mutant mouse model for the schizophrenia risk gene neuregulin 1. GENES BRAIN AND BEHAVIOR 2016; 15:295-304. [PMID: 26707035 DOI: 10.1111/gbb.12267] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 07/29/2015] [Accepted: 07/29/2015] [Indexed: 11/29/2022]
Abstract
Schizophrenia patients are often obese or overweight and poor dietary choices appear to be a factor in this phenomenon. Poor diet has been found to have complex consequences for the mental state of patients. Thus, this study investigated whether an unhealthy diet [i.e. high fat diet (HFD)] impacts on the behaviour of a genetic mouse model for the schizophrenia risk gene neuregulin 1 (i.e. transmembrane domain Nrg1 mutant mice: Nrg1 HET). Female Nrg1 HET and wild-type-like littermates (WT) were fed with either HFD or a control chow diet. The mice were tested for baseline (e.g. anxiety) and schizophrenia-relevant behaviours after 7 weeks of diet exposure. HFD increased body weight and impaired glucose tolerance in all mice. Only Nrg1 females on HFD displayed a hyper-locomotive phenotype as locomotion-suppressive effects of HFD were only evident in WT mice. HFD also induced an anxiety-like response and increased freezing in the context and the cued version of the fear conditioning task. Importantly, CHOW-fed Nrg1 females displayed impaired social recognition memory, which was absent in HFD-fed mutants. Sensorimotor gating deficits of Nrg1 females were not affected by diet. In summary, HFD had complex effects on the behavioural phenotype of test mice and attenuated particular cognitive deficits of Nrg1 mutant females. This topic requires further investigations thereby also considering other dietary factors of relevance for schizophrenia as well as interactive effects of diet with medication and sex.
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Affiliation(s)
- S Holm-Hansen
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark.,Brain and Muscle Energy Group, Electron Microscopy Laboratory, Institute of Oral Biology, University of Oslo, Oslo, Norway
| | - J K Low
- Neuroscience Research Australia, Sydney, Australia.,Schizophrenia Research Institute, Randwick, Australia
| | - J Zieba
- Neuroscience Research Australia, Sydney, Australia.,Schizophrenia Research Institute, Randwick, Australia
| | - A Gjedde
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L H Bergersen
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark.,Brain and Muscle Energy Group, Electron Microscopy Laboratory, Institute of Oral Biology, University of Oslo, Oslo, Norway.,Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Karl
- Neuroscience Research Australia, Sydney, Australia.,Schizophrenia Research Institute, Randwick, Australia.,School of Medical Sciences, University of New South Wales, Sydney, Australia
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42
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Chiang M, Natarajan R, Fan X. Vitamin D in schizophrenia: a clinical review. EVIDENCE-BASED MENTAL HEALTH 2016; 19:6-9. [PMID: 26767392 PMCID: PMC10699337 DOI: 10.1136/eb-2015-102117] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 12/17/2015] [Accepted: 12/22/2015] [Indexed: 01/08/2023]
Abstract
Vitamin D (vitD) is known for its essential role in calcium homeostasis and bone health. VitD is made endogenously in the skin from UVB radiation from sunlight. VitD is now considered as a potent neurosteroid hormone, critical to brain development and normal brain function, and is known for its anti-inflammatory property affecting various aspects of human health. VitD ligand-receptor, a receptor that mediates much of vitD's biological actions, has been found throughout the body including the central nervous system. VitD deficiency is common in patients with severe mental illness such as schizophrenia. Schizophrenia is a debilitating chronic mental illness characterised by positive symptoms, such as hallucinations and delusions, and negative symptoms including flat affect and lack of motivation. Several environmental risk factors for schizophrenia, such as season of birth, latitude and migration, have been linked to vitD deficiency. Recent studies have suggested a potential role of vitD in the development of schizophrenia. For example, neonatal vitD status is associated with the risk of developing schizophrenia in later life obesity, insulin resistance, diabetes, hyperlipidaemia and cardiovascular disease, which are commonly seen in patients with schizophrenia. It has been well established that vitD deficiency is related to these metabolic problems. The biological mechanism is most likely related to vitD's action on the regulation of inflammatory and immunological processes, consequently affecting the manifestation of clinical symptoms and treatment response of schizophrenia. Potential benefits of vitD supplementation to improve schizophrenia symptoms as well as physical health in patients with schizophrenia should be further explored in future studies.
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Affiliation(s)
- Mathew Chiang
- Psychotic Disorders Program, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Radhika Natarajan
- Psychotic Disorders Program, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Xiaoduo Fan
- Psychotic Disorders Program, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Henan Province Mental Hospital, The Second Affiliated Hospital/Xinxiang Medical University, Xinxiang, China
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43
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Antioxidant Interventions in Neuropsychiatric Disorders. OXIDATIVE STRESS IN APPLIED BASIC RESEARCH AND CLINICAL PRACTICE 2015. [DOI: 10.1007/978-1-4939-0440-2_25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Predictors of treatment response in young people at ultra-high risk for psychosis who received long-chain omega-3 fatty acids. Transl Psychiatry 2015; 5:e495. [PMID: 25585167 PMCID: PMC4312828 DOI: 10.1038/tp.2014.134] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 10/19/2014] [Accepted: 10/26/2014] [Indexed: 12/18/2022] Open
Abstract
Previous efforts in the prospective evaluation of individuals who experience attenuated psychotic symptoms have attempted to isolate mechanisms underlying the onset of full-threshold psychotic illness. In contrast, there has been little research investigating specific predictors of positive outcomes. In this study, we sought to determine biological and clinical factors associated with treatment response, here indexed by functional improvement in a pre-post examination of a 12-week randomized controlled intervention in individuals at ultra-high risk (UHR) for psychosis. Participants received either long-chain omega-3 (ω-3) polyunsaturated fatty acids (PUFAs) or placebo. To allow the determination of factors specifically relevant to each intervention, and to be able to contrast them, both treatment groups were investigated in parallel. Univariate linear regression analysis indicated that higher levels of erythrocyte membrane α-linolenic acid (ALA; the parent fatty acid of the ω-3 family) and more severe negative symptoms at baseline predicted subsequent functional improvement in the treatment group, whereas less severe positive symptoms and lower functioning at baseline were predictive in the placebo group. A multivariate machine learning analysis, known as Gaussian Process Classification (GPC), confirmed that baseline fatty acids predicted response to treatment in the ω-3 PUFA group with high levels of sensitivity, specificity and accuracy. In addition, GPC revealed that baseline fatty acids were predictive in the placebo group. In conclusion, our investigation indicates that UHR patients with higher levels of ALA may specifically benefit from ω-3 PUFA supplementation. In addition, multivariate machine learning analysis suggests that fatty acids could potentially be used to inform prognostic evaluations and treatment decisions at the level of the individual. Notably, multiple statistical analyses were conducted in a relatively small sample, limiting the conclusions that can be drawn from what we believe to be a first-of-its-kind study. Additional studies with larger samples are therefore needed to evaluate the generalizability of these findings.
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Ayehu M, Shibre T, Milkias B, Fekadu A. Movement disorders in neuroleptic-naïve patients with schizophrenia spectrum disorders. BMC Psychiatry 2014; 14:280. [PMID: 25298069 PMCID: PMC4195874 DOI: 10.1186/s12888-014-0280-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Accepted: 09/27/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Spontaneous Movements Disorders (SMDs) or dyskinetic movements are often seen in patients with schizophrenia and other psychotic disorders, and are widely considered to be adverse consequences of the use of antipsychotic medications. Nevertheless, SMDs are also observed in the pre-neuroleptic ear and among patients who were never exposed to antipsychotic medications. The aim of this study was to determine the extent of SMDs among antipsychotic-naïve patients in a low income setting, and to evaluate contextually relevant risk factors. METHODS The study was a cross-sectional facility-based survey conducted at a specialist psychiatric hospital in Addis Ababa, Ethiopia. Consecutive consenting treatment-naïve patients with a diagnosis of schizophrenia, schizoaffective disorder and schizophreniform disorder contacting services for the first time were assessed using the Simpson-Angus Rating Scale (SAS) and the Abnormal Involuntary Movement Scale (AIMS) to evaluate the presence of SMDS. Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS) were administered to evaluate negative and positive symptom profiles respectively. Body mass index (BMI) was used as a proxy measure for nutritional status. RESULT Sixty-four patients, 67.2% male (n = 43), with first contact psychosis who met the DSM-IV-TR criteria for schizophrenia (n = 47), schizophreniform disorder (n= 5), and schizoaffective disorder (n = 12) were assessed over a two month study period. Seven patients (10.9%) had SMDs. BMI (OR = 0.6, 95% CI = 0.40, 0.89; p = 0.011) and increasing age (OR = 1.10; 95% CI = 1.02, 1.20; p = 0.017) were associated with SMD. CONCLUSIONS This finding supports previous suggestions that abnormal involuntary movements in schizophrenia and other psychotic disorders may be related to the pathophysiology of psychotic disorders and therefore cannot be attributed entirely to the adverse effects of neuroleptic medication.
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Affiliation(s)
- Moges Ayehu
- Department of Psychiatry, Hawassa University, College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Teshome Shibre
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia ,University of Toronto, Ontario Shores Center for Mental Health Sciences, Toronto, Canada
| | - Barkot Milkias
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia.
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Dean OM, Turner A, Malhi GS, Ng C, Cotton SM, Dodd S, Sarris J, Samuni Y, Tanious M, Dowling N, Waterdrinker A, Smith D, Berk M. Design and rationale of a 16-week adjunctive randomized placebo-controlled trial of mitochondrial agents for the treatment of bipolar depression. ACTA ACUST UNITED AC 2014; 37:3-12. [PMID: 25295681 DOI: 10.1590/1516-4446-2013-1341] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 05/05/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Bipolar disorder places a significant burden on individuals, caregivers and family, and the broader community. Current treatments are believed to be more effective against manic symptoms, leaving a shortfall in recovery during the depressive phase of the illness. The current study draws on recent evidence suggesting that, in addition to increased oxidative load, alterations in mitochondrial function occur in bipolar disorder. METHODS This 16-week study aims to explore the potential benefits of N-acetylcysteine (NAC) alone or in combination (CT) with selected nutraceuticals believed to enhance mitochondrial function. The study includes adults diagnosed with bipolar disorder currently experiencing an episode of depression. Participants are asked to take NAC, CT, or placebo in addition to any usual treatments. A post-discontinuation visit is conducted 4 weeks following the treatment phase. RESULTS The primary outcome of the study will be mean change on the Montgomery-Asberg Depression Rating Scale. Secondary outcomes include functioning, substance use, mania ratings, and quality of life. Blood samples will be collected at baseline and week 16 to explore biochemical alterations following treatment. CONCLUSION This study may provide a novel adjunctive treatment for bipolar depression. Analysis of biological samples may assist in understanding the therapeutic benefits and the underlying etiology of bipolar depression. TRIAL REGISTRATION Australian and New Zealand Clinical Trial Registry ACTRN12612000830897.
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Affiliation(s)
- Olivia M Dean
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia
| | - Alyna Turner
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia
| | - Gin S Malhi
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Chee Ng
- Department of Psychiatry University of Melbourne, Melbourne, Australia
| | - Sue M Cotton
- Orygen Youth Health Research Centre, Melbourne, Australia
| | - Seetal Dodd
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia
| | | | - Yuval Samuni
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia
| | - Michelle Tanious
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Nathan Dowling
- Department of Psychiatry University of Melbourne, Melbourne, Australia
| | - Astrid Waterdrinker
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia
| | - Deidre Smith
- Department of Psychiatry University of Melbourne, Melbourne, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia
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McGorry P, Keshavan M, Goldstone S, Amminger P, Allott K, Berk M, Lavoie S, Pantelis C, Yung A, Wood S, Hickie I. Biomarkers and clinical staging in psychiatry. World Psychiatry 2014; 13:211-23. [PMID: 25273285 PMCID: PMC4219053 DOI: 10.1002/wps.20144] [Citation(s) in RCA: 198] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Personalized medicine is rapidly becoming a reality in today's physical medicine. However, as yet this is largely an aspirational goal in psychiatry, despite significant advances in our understanding of the biochemical, genetic and neurobiological processes underlying major mental disorders. Preventive medicine relies on the availability of predictive tools; in psychiatry we still largely lack these. Furthermore, our current diagnostic systems, with their focus on well-established, largely chronic illness, do not support a pre-emptive, let alone a preventive, approach, since it is during the early stages of a disorder that interventions have the potential to offer the greatest benefit. Here, we present a clinical staging model for severe mental disorders and discuss examples of biological markers that have already undergone some systematic evaluation and that could be integrated into such a framework. The advantage of this model is that it explicitly considers the evolution of psychopathology during the development of a mental illness and emphasizes that progression of illness is by no means inevitable, but can be altered by providing appropriate interventions that target individual modifiable risk and protective factors. The specific goals of therapeutic intervention are therefore broadened to include the prevention of illness onset or progression, and to minimize the risk of harm associated with more complex treatment regimens. The staging model also facilitates the integration of new data on the biological, social and environmental factors that influence mental illness into our clinical and diagnostic infrastructure, which will provide a major step forward in the development of a truly pre-emptive psychiatry.
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Affiliation(s)
- Patrick McGorry
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Matcheri Keshavan
- Beth Israel Deaconess Medical Centre, Harvard Medical SchoolBoston, MA, USA
| | - Sherilyn Goldstone
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Paul Amminger
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Kelly Allott
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Michael Berk
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia,School of Medicine, Deakin UniversityGeelong, Australia
| | - Suzie Lavoie
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Alison Yung
- Institute of Brain, Behaviour and Mental Health, University of Manchester, ManchesterUK
| | - Stephen Wood
- School of Psychology, University of Birmingham, BirminghamUK
| | - Ian Hickie
- Brain and Mind Research Institute, University of Sydney, SydneyAustralia
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Cunningham C, Peters K. Aetiology of schizophrenia and implications for nursing practice: a literature review. Issues Ment Health Nurs 2014; 35:732-8. [PMID: 25259635 DOI: 10.3109/01612840.2014.908441] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Schizophrenia is recognised as a major mental illness and is prevalent in approximately 1% of the global population. This paper reviewed literature published between 2001 and 2013 to explore the aetiology of schizophrenia and discuss implications for mental health nursing practice. Although the causes of schizophrenia are largely unknown, there is a strong correlation between identified physiological and environmental markers and the development of the disease. With this knowledge, mental health nurses can potentially contribute to the development of strategies and approaches to complement current treatments, and therefore ensure improved outcomes for mental health clients.
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Arroll MA, Wilder L, Neil J. Nutritional interventions for the adjunctive treatment of schizophrenia: a brief review. Nutr J 2014; 13:91. [PMID: 25228271 PMCID: PMC4171568 DOI: 10.1186/1475-2891-13-91] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 08/28/2014] [Indexed: 12/20/2022] Open
Abstract
Schizophrenia is a chronic condition that impacts significantly not only on the individual and family, but the disorder also has wider consequences for society in terms of significant costs to the economy. This highly prevalent condition affects approximately 1% of the worldwide population, yet there are few therapeutic options. The predominant treatment strategy for schizophrenia is anti-psychotic medication (with or without additional talking therapy) even though this approach lacks efficacy in managing the negative symptoms of the condition, is not effective in one-third of the patient group and the side effects of the medication can be severe and debilitating. In recent years, a number of pathophysiological processes have been identified in groups of people with schizophrenia including oxidative stress, one-carbon metabolism and immune-mediated responses. A number of studies have shown that these altered physiological mechanisms can be ameliorated by nutritional interventions in some individuals with schizophrenia. This review briefly describes the aforementioned processes and outlines research that has investigated the utility of nutritional approaches as an adjunct to anti-psychotic medication including antioxidant and vitamin B supplementation, neuroprotective and anti-inflammatory nutrients and exclusion diets. Whilst none of these interventions provides a ‘one-size-fits-all’ therapeutic solution, we suggest that a personalised approach warrants research attention as there is growing agreement that schizophrenia is a spectrum disorder that develops from the interplay between environmental and genetic factors.
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Schlögelhofer M, Amminger GP, Schaefer MR, Fusar-Poli P, Smesny S, McGorry P, Berger G, Mossaheb N. Polyunsaturated fatty acids in emerging psychosis: a safer alternative? Early Interv Psychiatry 2014; 8:199-208. [PMID: 24861004 DOI: 10.1111/eip.12151] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 03/25/2014] [Indexed: 01/16/2023]
Abstract
AIM A promising approach of indicated prevention in individuals at increased risk of psychosis was based on the finding of potential neuroprotective properties of omega-3 polyunsaturated fatty acids (PUFAs). Considering the rising interest in omega-3 PUFA supplementation as preventive treatment strategy in young people at risk of psychosis, the question of safety issues must be addressed. METHODS For this systematic review, a literature search for studies on omega-3 PUFAs for emerging psychosis with a focus on the safety profile was undertaken. Because limited data are available, information regarding potential side effects of omega-3 PUFAs was additionally derived from currently available data in psychotic disorders at different stages of the illness. Furthermore, helpful evidence from somatic disorders and healthy controls was used. RESULTS In terms of safety issues, evidence from the randomized controlled trial in ultra-high-risk individuals and a variety of studies in schizophrenia patients strongly suggests that omega-3 PUFAs are safe and well tolerated even when used in relatively high doses. Most commonly occurring but clinically rarely significant are mild gastrointestinal symptoms; similarly, the slight risk of prolonged bleeding time has not been shown to be clinically relevant. Differential effects on metabolic parameters, most of which appear beneficial, have been reported. CONCLUSIONS Taken together, one promising aspect of omega-3 PUFAs is that there seem to be no reports of relevant deleterious side effects in humans, even at high doses. The differential effects on lipid parameters and bleeding time are noteworthy and need further clarification.
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Affiliation(s)
- Monika Schlögelhofer
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria; Division of Biological Psychiatry, Medical University Vienna, Vienna, Austria
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