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Falkai P, Koutsouleris N. Why is it so difficult to implement precision psychiatry into clinical care? THE LANCET REGIONAL HEALTH. EUROPE 2024; 43:100952. [PMID: 38883308 PMCID: PMC11169462 DOI: 10.1016/j.lanepe.2024.100952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 06/18/2024]
Affiliation(s)
- Peter Falkai
- Department of Psychiatry, Munich University Hospital, Munich, Germany
- Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry, Munich University Hospital, Munich, Germany
- Max-Planck-Institute of Psychiatry, Munich, Germany
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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2
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Blasbalg U, Toren P. The association between multiple sclerosis and early psychiatric background. Mult Scler Relat Disord 2024; 88:105720. [PMID: 38909524 DOI: 10.1016/j.msard.2024.105720] [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] [Received: 03/24/2024] [Revised: 05/27/2024] [Accepted: 06/09/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND The exact cause of Multiple Sclerosis (MS) is unclear. Since its definition in the late 19th century, researchers have repeatedly suggested a connection between the disease and mental state. Studies have shown that mental symptoms tend to precede the initiation of the disease by up to ten years. However, the hypothesis that psychiatric issues might precede MS onset by longer periods has not been empirically established. This study seeks to fill this research gap. The current matched cohort study investigated the possibility that psychiatric conditions may precede the initiation of multiple sclerosis by 15 years or more METHODS: A retrospective analysis utilizing the electronic database of Clalit Health Services (CHS), Israel's largest HMO, compared a group of 9,533 MS-diagnosed female and male individuals with 28,599 non-MS matched controls RESULTS: Logistic regression analysis revealed a significant association (p < 0.001) between MS diagnosis and prior psychiatric conditions, indicating a 93% increased likelihood of psychiatric history among those later diagnosed with MS compared with those who were not CONCLUSIONS: The heightened probability of mental health issues preceding the onset of MS by extended durations suggests a potential etiological role in the development of MS, rather than solely representing a component of the prodromal stage of the disease. Limitations include the retrospective design and the need for prospective studies to validate these associations.
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Affiliation(s)
- Uri Blasbalg
- Ramat-Chen Brull Mental Health Center, Tel-Aviv, Clalit Health Services Community Division, Tel-Aviv District, Israel.
| | - Paz Toren
- Ramat-Chen Brull Mental Health Center, Tel-Aviv, Clalit Health Services Community Division, Tel-Aviv District, Israel; Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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Falkai P, Frodl T, Grabe HJ, Rupprecht R, Philipsen A. [Assessment of university psychiatry and psychotherapy in Germany: Responsibilities and challenges : Position paper of the Lehrstuhlinhaber für Psychiatrie und Psychotherapie e. V. (LIPPs) in Germany]. DER NERVENARZT 2024:10.1007/s00115-024-01688-4. [PMID: 38904789 DOI: 10.1007/s00115-024-01688-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/22/2024]
Affiliation(s)
- P Falkai
- Klinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München, Nußbaumstraße 7, 80366, München, Deutschland.
| | - T Frodl
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - H J Grabe
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Greifswald, Ellernholzstraße 1-2, 17489, Greifswald, Deutschland
| | - R Rupprecht
- Klinik für Psychiatrie und Psychotherapie, Universität Regensburg, Universitätsstraße 84, 93053, Regensburg, Deutschland
| | - A Philipsen
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
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Rivera AD, Normanton JR, Butt AM, Azim K. The Genomic Intersection of Oligodendrocyte Dynamics in Schizophrenia and Aging Unravels Novel Pathological Mechanisms and Therapeutic Potentials. Int J Mol Sci 2024; 25:4452. [PMID: 38674040 PMCID: PMC11050044 DOI: 10.3390/ijms25084452] [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: 02/01/2024] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/28/2024] Open
Abstract
Schizophrenia is a significant worldwide health concern, affecting over 20 million individuals and contributing to a potential reduction in life expectancy by up to 14.5 years. Despite its profound impact, the precise pathological mechanisms underlying schizophrenia continue to remain enigmatic, with previous research yielding diverse and occasionally conflicting findings. Nonetheless, one consistently observed phenomenon in brain imaging studies of schizophrenia patients is the disruption of white matter, the bundles of myelinated axons that provide connectivity and rapid signalling between brain regions. Myelin is produced by specialised glial cells known as oligodendrocytes, which have been shown to be disrupted in post-mortem analyses of schizophrenia patients. Oligodendrocytes are generated throughout life by a major population of oligodendrocyte progenitor cells (OPC), which are essential for white matter health and plasticity. Notably, a decline in a specific subpopulation of OPC has been identified as a principal factor in oligodendrocyte disruption and white matter loss in the aging brain, suggesting this may also be a factor in schizophrenia. In this review, we analysed genomic databases to pinpoint intersections between aging and schizophrenia and identify shared mechanisms of white matter disruption and cognitive dysfunction.
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Affiliation(s)
- Andrea D. Rivera
- Department of Neuroscience, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127 Padua, Italy;
| | - John R. Normanton
- GliaGenesis Limited, Orchard Lea, Horns Lane, Oxfordshire, Witney OX29 8NH, UK; (J.R.N.); (K.A.)
| | - Arthur M. Butt
- GliaGenesis Limited, Orchard Lea, Horns Lane, Oxfordshire, Witney OX29 8NH, UK; (J.R.N.); (K.A.)
- School of Pharmacy and Biomedical Science, University of Portsmouth, Hampshire PO1 2UP, UK
| | - Kasum Azim
- GliaGenesis Limited, Orchard Lea, Horns Lane, Oxfordshire, Witney OX29 8NH, UK; (J.R.N.); (K.A.)
- Independent Data Lab UG, Frauenmantelanger 31, 80937 Munich, Germany
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Misiak B, Pawlak E, Rembacz K, Kotas M, Żebrowska-Różańska P, Kujawa D, Łaczmański Ł, Piotrowski P, Bielawski T, Samochowiec J, Samochowiec A, Karpiński P. Associations of gut microbiota alterations with clinical, metabolic, and immune-inflammatory characteristics of chronic schizophrenia. J Psychiatr Res 2024; 171:152-160. [PMID: 38281465 DOI: 10.1016/j.jpsychires.2024.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/31/2023] [Accepted: 01/22/2024] [Indexed: 01/30/2024]
Abstract
The present study had the following aims: 1) to compare gut microbiota composition in patients with schizophrenia and controls and 2) to investigate the association of differentially abundant bacterial taxa with markers of inflammation, intestinal permeability, lipid metabolism, and glucose homeostasis as well as clinical manifestation. A total of 115 patients with schizophrenia during remission of positive and disorganization symptoms, and 119 controls were enrolled. Altogether, 32 peripheral blood markers were assessed. A higher abundance of Eisenbergiella, Family XIII AD3011 group, Eggerthella, Hungatella, Lactobacillus, Olsenella, Coprobacillus, Methanobrevibacter, Ligilactobacillus, Eubacterium fissicatena group, and Clostridium innocuum group in patients with schizophrenia was found. The abundance of Paraprevotella and Bacteroides was decreased in patients with schizophrenia. Differentially abundant genera were associated with altered levels of immune-inflammatory markers, zonulin, lipid profile components, and insulin resistance. Moreover, several correlations of differentially abundant genera with cognitive impairment, higher severity of negative symptoms, and worse social functioning were observed. The association of Methanobrevibacter abundance with the level of negative symptoms, cognition, and social functioning appeared to be mediated by the levels of interleukin-6 and RANTES. In turn, the association of Hungatella with the performance of attention was mediated by the levels of zonulin. The findings indicate that compositional alterations of gut microbiota observed in patients with schizophrenia correspond with clinical manifestation, intestinal permeability, subclinical inflammation, lipid profile alterations, and impaired glucose homeostasis. Subclinical inflammation and impaired gut permeability might mediate the association of gut microbiota alterations with psychopathological symptoms and cognitive impairment.
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Affiliation(s)
- Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
| | - Edyta Pawlak
- Laboratory of Immunopathology, Department of Experimental Therapy, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Krzysztof Rembacz
- Laboratory of Immunopathology, Department of Experimental Therapy, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Marek Kotas
- Laboratory of Immunopathology, Department of Experimental Therapy, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Paulina Żebrowska-Różańska
- Laboratory of Genomics & Bioinformatics, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Dorota Kujawa
- Laboratory of Genomics & Bioinformatics, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Łukasz Łaczmański
- Laboratory of Genomics & Bioinformatics, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Patryk Piotrowski
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Bielawski
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Agnieszka Samochowiec
- Department of Clinical Psychology, Institute of Psychology, University of Szczecin, Poland
| | - Paweł Karpiński
- Laboratory of Genomics & Bioinformatics, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland; Department of Genetics, Wroclaw Medical University, Wroclaw, Poland
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Rejek M, Misiak B. Modelling the effects of the exposome score within the extended psychosis phenotype. J Psychiatr Res 2024; 169:22-30. [PMID: 37995498 DOI: 10.1016/j.jpsychires.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/26/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023]
Abstract
It has been reported that cumulative measures of risk factors for psychosis might help to predict its development. However, it remains unknown as to whether these measures are also associated with the extended psychosis phenotype that refers to a continuum of features bridging subclinical symptoms with clinically relevant outcomes. In this study, we aimed to investigate the association of the exposome score (ES) with psychosis risk in a non-clinical population. A total of 1100 non-clinical adults (aged 18-35 years, 51.4% females) with a negative history of psychiatric treatment were recruited. The Prodromal Questionnaire-16 (PQ-16) was used to screen for psychosis risk. Self-reports were used to record environmental exposures. The ES was significantly higher in participants with the positive PQ-16 screening. Specifically, the prevalence of obstetric complications, non-right handedness, all categories of childhood trauma, and problematic cannabis use was significantly higher in this group of participants. A network analysis demonstrated that the ES was directly connected not only to items representing psychotic experiences ("paranoid thoughts", "a lack of control over own ideas or thoughts", "thought echo", and "being distracted by distant sounds") but also those covering depressive or anxiety symptoms ("uninterested in things used to enjoy" and "feeling anxious when meeting people for the first time"). In conclusion, the ES is associated with the extended psychosis phenotype, suggesting its potential to identify individuals who may benefit from further psychosis risk assessment. The ES appears to contribute to non-specific psychopathology, which may, in some cases, progress to psychosis.
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Affiliation(s)
- Maksymilian Rejek
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
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