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Seeman MV. Women with Schizophrenia Have Difficulty Maintaining Healthy Diets for Themselves and Their Children: A Narrative Review. Behav Sci (Basel) 2023; 13:967. [PMID: 38131823 PMCID: PMC10740554 DOI: 10.3390/bs13120967] [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: 10/12/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
Severe psychiatric disorders such as schizophrenia are inevitably linked to unemployment, meagre per capita income, and residence in disadvantaged, poorly resourced neighbourhoods. This means difficult access to healthy food and is particularly problematic for pregnant women and mothers with children to feed. The necessity of taking antipsychotic drugs is an additional barrier to healthy eating because these drugs are associated with serious cognitive, psychological, behavioural, and metabolic sequelae. Being ill with psychosis makes it extremely difficult to maintain a healthy diet; nutritional deficiencies result, as do medical complications. The results of present literature review confirm the gravity of the problem and suggest a number of potentially useful clinical interventions.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 3G4, Canada
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2
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Maino Vieytes CA, Zhu R, Gany F, Burton-Obanla A, Arthur AE. Empirical Dietary Patterns Associated with Food Insecurity in U.S. Cancer Survivors: NHANES 1999-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14062. [PMID: 36360938 PMCID: PMC9656362 DOI: 10.3390/ijerph192114062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Food insecurity (FI) is a public health and sociodemographic phenomenon that besets many cancer survivors in the United States. FI in cancer survivors may arise as a consequence of financial toxicity stemming from treatment costs, physical impairment, labor force egress, or a combination of those factors. To our knowledge, an understanding of the dietary intake practices of this population has not been delineated but is imperative for addressing the needs of this vulnerable population; (2) Methods: Using data from NHANES, 1999-2018, we characterized major dietary patterns in the food insecure cancer survivor population using: i. penalized logistic regression (logit) and ii. principal components analysis (PCA). We validated these patterns by examining the association of those patterns with food insecurity in the cancer population; (3) Results: Four dietary patterns were extracted with penalized logit and two with PCA. In the pattern validation phase, we found several patterns exhibited strong associations with FI. The FI, SNAP, and Household Size patterns (all extracted with penalized logit) harbored the strongest associations and there was evidence of stronger associations in those moderately removed from a cancer diagnosis (≥2 and <6 years since diagnosis); (4) Conclusions: FI may play an influential role on the dietary intake patterns of cancer survivors in the U.S. The results highlight the relevance of FI screening and monitoring for cancer survivors.
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Affiliation(s)
| | - Ruoqing Zhu
- Department of Statistics, The University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Francesca Gany
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Amirah Burton-Obanla
- Division of Nutritional Sciences, The University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Anna E. Arthur
- Department of Dietetics and Nutrition, The University of Kansas Medical Center, Kansas City, KS 66160, USA
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Zurrón Madera P, Casaprima Suárez S, García Álvarez L, García-Portilla González MP, Junquera Fernández R, Lluch Canut MT. Eating and nutritional habits in patients with schizophrenia. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:54-60. [PMID: 35105526 DOI: 10.1016/j.rpsmen.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/21/2019] [Indexed: 06/14/2023]
Abstract
BACKGROUND There are few studies that relate eating and nutritional habits to the severity of the disease and demographic profile in patients with schizophrenia. OBJECTIVE To describe eating and nutritional habits and their relationship with the severity of the disease in patients with schizophrenia. METHOD Cross-sectional descriptive study. SAMPLE 31 patients with schizophrenia (ICD-10) under outpatient treatment. INCLUSION CRITERIA age 18-65 years, clinically stable and, written informed consent. ASSESSMENT Demographic, clinical characteristics (CGI-SCH, length of illness, BMI, abdominal perimeter), ad hoc questionnaire (eating, nutritional, and physical activity). RESULTS Mean age 43.13(SD = 7.85) years, males 61.3%. Mean severity of illness was 3.94(SD = 1.06), mean duration of the illness 18.42(SD = 8.27) years. 74.2% used to eatweekly fat meat and 64.5% less than 3-4 servings of fish, 77.4% less than 3 servings of fruit per day, and 51.6% drink less than 1 L of water. 83.9% used to drink coffee daily, 2.81(SD = 2.02) cups per day. Patients showed lower levels of Vitamin A, D, E, K1, C, folic acid, and magnesium. 93.5% did not fulfill the WHO recommendations on physical activity. Only retinol (r = -0.602, P = .039) and vitamin K1 (r = -0.693, P = .012) in women were related to the severity of illness. CONCLUSIONS Outpatients with schizophrenia do not follow WHO recommendations on healthy diets, neither physical activity. Both clinical severity of the illness and marital status and cohabitation were associated with poor eating habits and nutrients deficit. These data should be taken into account by the nursing staff when implementing specific care in routine clinical practice.
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Affiliation(s)
- Paula Zurrón Madera
- Servicio de Salud del Principado de Asturias, SESPA, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Área de Psiquiatría, Facultad de Medicina, Universidad de Oviedo, Spain.
| | | | - Leticia García Álvarez
- Fundación para la Investigación y la Innovación Biosanitaria del Principado de Asturias (FINBA); Instituto de Investigación Sanitaria del Principado de Asturias (ISPA); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Área de Psiquiatría, Facultad de Medicina, Universidad de Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain
| | - María Paz García-Portilla González
- Servicio de Salud del Principado de Asturias, SESPA, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Área de Psiquiatría, Facultad de Medicina, Universidad de Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain
| | | | - María Teresa Lluch Canut
- Escuela de Enfermería, Facultad de Medicina Ciencias de la Salud, Campus Bellvitge Universidad de Barcelona, Spain
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Lee YY, Lau JH, Seet V, Whitton C, Asharani PV, Siva Kumar FD, Wang P, Roystonn K, Cetty L, The WL, Verma S, Mok YM, Subramaniam M. Dietary intake of persons with depressive and psychotic disorders in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021; 50:379-389. [PMID: 34100515 DOI: 10.47102/annals-acadmedsg.2020585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Nutritional psychiatry is an emerging field of study that investigates the role of diet and nutrition in mental health. Studies conducted in the general population have linked depressive symptoms with poor dietary patterns. The aim of this study was to characterise the dietary intake and analyse the dietary pattern using the Dietary Approach to Stop Hypertension (DASH) in a sample of psychiatric patients in a multiethnic Asian nation. METHODS Participants were recruited from an outpatient clinic and an inpatient unit at the Institute of Mental Health in Singapore. Self-reported dietary habits of a sample of psychiatric patients (N=380) were analysed using DASH. To examine the variables associated with DASH scores, a linear regression was conducted with the full sample and sociodemographic variables. RESULTS Persons with depressive disorders had a mean DASH score of 21.3 (±4.2), while persons with psychotic disorders had a mean DASH score of 21.2 (±4.9). Respondents who were older (B=1.94, 95% confidence interval [CI] 0.91-2.96, P<0.001), female (B=1.09, 95% CI 0.07-2.11, P=0.04) and economically inactive (B=1.98, 95% CI 0.006-3.96, P=0.049) were more likely to report a higher diet quality compared with their respective counterparts, while smokers (B= -1.39, 95% CI -2.45 to -0.34, P=0.009) tended to report a lower diet quality compared with their non-smoking counterparts. CONCLUSION Dietary patterns of persons with mental disorders were characterised. A host of sociodemographic factors, and not diagnosis of mental disorders, influenced the dietary quality of people with depressive and psychotic disorders. Clinicians treating psychiatric patients need to be aware of the nuanced reasons behind poor dietary choices and provide targeted psychoeducation to specific subgroups within the patient population.
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Affiliation(s)
- Ying Ying Lee
- Research Division, Institute of Mental Health, Singapore
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Ghorbani M, Rajandas H, Parimannan S, Stephen Joseph GB, Tew MM, Ramly SS, Muhamad Rasat MA, Lee SY. Understanding the role of gut microbiota in the pathogenesis of schizophrenia. Psychiatr Genet 2021; 31:39-49. [PMID: 33252574 DOI: 10.1097/ypg.0000000000000270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Schizophrenia is a chronic mental disorder with marked symptoms of hallucination, delusion, and impaired cognitive behaviors. Although multidimensional factors have been associated with the development of schizophrenia, the principal cause of the disorder remains debatable. Microbiome involvement in the etiology of schizophrenia has been widely researched due to the advancement in sequencing technologies. This review describes the contribution of the gut microbiome in the development of schizophrenia that is facilitated by the gut-brain axis. The gut microbiota is connected to the gut-brain axis via several pathways and mechanisms, that are discussed in this review. The role of the oral microbiota, probiotics and prebiotics in shaping the gut microbiota are also highlighted. Lastly, future perspectives for microbiome research in schizophrenia are addressed.
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Affiliation(s)
- Mahin Ghorbani
- Centre of Excellence for Omics-Driven Computational Biodiscovery (COMBio), Faculty of Applied Sciences, AIMST University
| | - Heera Rajandas
- Centre of Excellence for Omics-Driven Computational Biodiscovery (COMBio), Faculty of Applied Sciences, AIMST University
| | - Sivachandran Parimannan
- Centre of Excellence for Omics-Driven Computational Biodiscovery (COMBio), Faculty of Applied Sciences, AIMST University
| | - Gerard Benedict Stephen Joseph
- Centre of Excellence for Omics-Driven Computational Biodiscovery (COMBio), Faculty of Applied Sciences, AIMST University
| | - Mei Mei Tew
- Clinical Research Centre (CRC), Hospital Sultanah Bahiyah, Alor Setar
| | - Siti Salwa Ramly
- Psychiatry and Mental Health Department, Hospital Sultan Abdul Halim, Sungai Petani
| | | | - Su Yin Lee
- Centre of Excellence for Omics-Driven Computational Biodiscovery (COMBio), Faculty of Applied Sciences, AIMST University
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Behavioural effects of high fat diet in adult Nrg1 type III transgenic mice. Behav Brain Res 2020; 377:112217. [DOI: 10.1016/j.bbr.2019.112217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/22/2019] [Accepted: 09/05/2019] [Indexed: 12/20/2022]
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Zurrón Madera P, Casaprima Suárez S, García Álvarez L, García-Portilla González MP, Junquera Fernández R, Canut MTL. Eating and nutritional habits in patients with schizophrenia. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2019; 15:S1888-9891(19)30098-9. [PMID: 31864966 DOI: 10.1016/j.rpsm.2019.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 10/03/2019] [Accepted: 10/21/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND There are few studies that relate eating and nutritional habits to the severity of the disease and demographic profile in patients with schizophrenia. OBJECTIVE To describe eating and nutritional habits and their relationship with the severity of the disease in patients with schizophrenia. METHOD Cross-sectional descriptive study. SAMPLE 31 patients with schizophrenia (ICD-10) under outpatient treatment. INCLUSION CRITERIA age 18-65 years, clinically stable and, written informed consent. ASSESSMENT Demographic, clinical characteristics (CGI-SCH, length of illness, BMI, abdominal perimeter), ad hoc questionnaire (eating, nutritional, and physical activity). RESULTS Mean age 43.13(SD=7.85) years, males 61.3%. Mean severity of illness was 3.94(SD=1.06), mean duration of the illness 18.42(SD=8.27) years. 74.2% used to eat weekly fat meat and 64.5% less than 3-4 servings of fish, 77.4% less than 3 servings of fruit per day, and 51.6% drink less than 1l of water. 83.9% used to drink coffee daily, 2.81(SD=2.02) cups per day. Patients showed lower levels of Vitamin A, D, E, K1, C, folic acid, and magnesium. 93.5% did not fulfill the WHO recommendations on physical activity. Only retinol (r=-0.602, p=0.039) and vitamin K1 (r=-0.693, p=0.012) in women were related to the severity of illness. CONCLUSIONS Outpatients with schizophrenia do not follow WHO recommendations on healthy diets, neither physical activity. Both clinical severity of the illness and marital status and cohabitation were associated with poor eating habits and nutrients deficit. These data should be taken into account by the nursing staff when implementing specific care in routine clinical practice.
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Affiliation(s)
- Paula Zurrón Madera
- Servicio de Salud del Principado de Asturias, SESPA, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Área de Psiquiatría, Facultad de Medicina, Universidad de Oviedo, España.
| | | | - Leticia García Álvarez
- Fundación para la Investigación y la Innovación Biosanitaria del Principado de Asturias (FINBA); Instituto de Investigación Sanitaria del Principado de Asturias (ISPA); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Área de Psiquiatría, Facultad de Medicina, Universidad de Oviedo, España; Instituto de Neurociencias del Principado de Asturias (INEUROPA), España
| | - María Paz García-Portilla González
- Servicio de Salud del Principado de Asturias, SESPA, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Área de Psiquiatría, Facultad de Medicina, Universidad de Oviedo, España; Instituto de Neurociencias del Principado de Asturias (INEUROPA), España
| | | | - María Teresa Lluch Canut
- Escuela de Enfermería, Facultad de Medicina Ciencias de la Salud, Campus Bellvitge Universidad de Barcelona, España
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Zieba J, Morris MJ, Karl T. Behavioural effects of high fat diet exposure starting in late adolescence in neuregulin 1 transmembrane domain mutant mice. Behav Brain Res 2019; 373:112074. [DOI: 10.1016/j.bbr.2019.112074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 12/17/2022]
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Teasdale SB, Ward PB, Samaras K, Firth J, Stubbs B, Tripodi E, Burrows TL. Dietary intake of people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry 2019; 214:251-259. [PMID: 30784395 DOI: 10.1192/bjp.2019.20] [Citation(s) in RCA: 157] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Severe mental illness (SMI) is thought to be associated with lower diet quality and adverse eating behaviours contributing towards physical health disparities. A rigorous review of the studies looking at dietary intake in psychotic disorders and bipolar disorder is lacking.AimsTo conduct a systematic, comprehensive evaluation of the published research on dietary intake in psychotic disorders and bipolar disorder. METHOD Six electronic databases were searched for studies reporting on dietary intakes in psychotic disorders and bipolar disorder. Dietary-assessment methods, and dietary intakes, were systematically reviewed. Where possible, data was pooled for meta-analysis and compared with healthy controls. RESULTS In total, 58 eligible studies were identified. People with SMI were found to have significantly higher dietary energy (mean difference 1332 kJ, 95% CI 487-2178 kJ/day, P = 0.002, g = 0.463) and sodium (mean difference 322 mg, 95% CI 174-490 mg, P < 0.001, g = 0.414) intake compared with controls. Qualitative synthesis suggested that higher energy and sodium intakes were associated with poorer diet quality and eating patterns. CONCLUSIONS These dietary components should be key targets for preventative interventions to improve weight and other physical health outcomes in people with SMI.Declaration of interestS.B.T. and E.T. have clinical dietitian appointments within the South Eastern Sydney Local Health District and do not receive any further funding.
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Affiliation(s)
- Scott B Teasdale
- Senior Mental Health Dietitian,Keeping the Body in Mind Program,South Eastern Sydney Local Health District; andSchool of Psychiatry,University of New South Wales,Australia
| | - Philip B Ward
- Professor of Psychiatry,School of Psychiatry,University of New South Wales;Schizophrenia Research Unit,South Western Sydney Local Health District; and Ingham Institute for Applied Medical Research,Australia
| | - Katherine Samaras
- Senior Staff Specialist (Endocrinology),Department of Endocrinology,St Vincent's Hospital; Diabetes and Metabolism Division,Garvan Institute of Medical Research; andSt Vincent's Clinical School,University of New South Wales,Australia
| | - Joseph Firth
- Senior Research Fellow, NICM Health Research Institute, Western Sydney University, Australia; andDivision of Psychology and Mental Health, Faculty of Biology, Medicine and Health,University of Manchester,UK
| | - Brendon Stubbs
- Head of Physiotherapy,Physiotherapy Department,South London and Maudsley NHS Foundation Trust; andHealth Service and Population Research Department and Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience,King's College London,UK
| | - Elise Tripodi
- Mental Health Dietitian,Keeping the Body in Mind Program,South Eastern Sydney Local Health District,Australia
| | - Tracy L Burrows
- Associate Professor in Nutrition and Dietetics,School of Health Sciences and Priority Research Centre for Physical Activity and Nutrition,University of Newcastle,Australia
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Sugawara N, Sagae T, Yasui-Furukori N, Yamazaki M, Shimoda K, Mori T, Sugai T, Matsuda H, Suzuki Y, Ozeki Y, Okamoto K, Someya T. Effects of nutritional education on weight change and metabolic abnormalities among patients with schizophrenia in Japan: A randomized controlled trial. J Psychiatr Res 2018; 97:77-83. [PMID: 29220825 DOI: 10.1016/j.jpsychires.2017.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/24/2017] [Accepted: 12/01/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Patients with schizophrenia have a higher prevalence of metabolic syndrome (MetS) than the general population. Minimizing weight gain and metabolic abnormalities in a population with an already high prevalence of obesity is of clinical and social importance. This randomized controlled trial investigated the effect of monthly nutritional education on weight change and metabolic abnormalities among patients with schizophrenia in Japan. METHODS From July 2014 to December 2014, we recruited 265 obese patients who had a DSM-IV diagnosis of schizophrenia or schizoaffective disorder. Participants were randomly assigned to a standard care (A), doctor's weight loss advice (B), or an individual nutritional education group (C) for 12 months. The prevalence of MetS and body weight were measured at baseline and 12 months. RESULTS After the 12-month treatment, 189 patients were evaluated, and the prevalence of MetS based on the ATP III-A definition in groups A, B, and C was 68.9%, 67.2%, and 47.5%, respectively. Group C showed increased weight loss (3.2 ± 4.5 kg) over the 12-month study period, and the change in weight differed significantly from that of group A; additionally, 26.2% of the participants in group C lost 7% or more of their initial weight, compared with 8.2% of those in group A. CONCLUSION Individual nutrition education provided by a dietitian was highly successful in reducing obesity in patients with schizophrenia and could be the first choice to address both weight gain and metabolic abnormalities induced by antipsychotic medications.
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Affiliation(s)
- Norio Sugawara
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira City, Tokyo, 187-8551, Japan; Department of Neuropsychiatry, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki City, Aomori, 036-8562, Japan; Japanese Society of Clinical Neuropsychopharmacology, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan.
| | - Toyoaki Sagae
- Department of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, 6-15-1 Torimachi, Yonezawa City, Yamagata, 992-0025, Japan; Japan Psychiatric Dietetic Association, 4-11-11 Komone, Itabashi-ku, Tokyo, 173-0037, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki City, Aomori, 036-8562, Japan; Japanese Society of Clinical Neuropsychopharmacology, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
| | - Manabu Yamazaki
- Japan Psychiatric Hospital Association, 3-15-14 Shibaura, Minato-ku, Tokyo, 108-8554, Japan
| | - Kazutaka Shimoda
- Japanese Society of Clinical Neuropsychopharmacology, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan; Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Takao Mori
- Japan Psychiatric Hospital Association, 3-15-14 Shibaura, Minato-ku, Tokyo, 108-8554, Japan
| | - Takuro Sugai
- Japanese Society of Clinical Neuropsychopharmacology, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan; Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Hiroshi Matsuda
- Japan Psychiatric Hospital Association, 3-15-14 Shibaura, Minato-ku, Tokyo, 108-8554, Japan
| | - Yutaro Suzuki
- Japanese Society of Clinical Neuropsychopharmacology, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan; Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Yuji Ozeki
- Japanese Society of Clinical Neuropsychopharmacology, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan; Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Kurefu Okamoto
- Japan Psychiatric Hospital Association, 3-15-14 Shibaura, Minato-ku, Tokyo, 108-8554, Japan
| | - Toshiyuki Someya
- Japanese Society of Clinical Neuropsychopharmacology, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan; Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
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The Gut-Brain Axis, BDNF, NMDA and CNS Disorders. Neurochem Res 2016; 41:2819-2835. [PMID: 27553784 DOI: 10.1007/s11064-016-2039-1] [Citation(s) in RCA: 137] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/09/2016] [Accepted: 08/17/2016] [Indexed: 02/08/2023]
Abstract
Gastro-intestinal (GI) microbiota and the 'gut-brain axis' are proving to be increasingly relevant to early brain development and the emergence of psychiatric disorders. This review focuses on the influence of the GI tract on Brain-Derived Neurotrophic Factor (BDNF) and its relationship with receptors for N-methyl-D-aspartate (NMDAR), as these are believed to be involved in synaptic plasticity and cognitive function. NMDAR may be associated with the development of schizophrenia and a range of other psychopathologies including neurodegenerative disorders, depression and dementias. An analysis of the routes and mechanisms by which the GI microbiota contribute to the pathophysiology of BDNF-induced NMDAR dysfunction could yield new insights relevant to developing novel therapeutics for schizophrenia and related disorders. In the absence of GI microbes, central BDNF levels are reduced and this inhibits the maintenance of NMDAR production. A reduction of NMDAR input onto GABA inhibitory interneurons causes disinhibition of glutamatergic output which disrupts the central signal-to-noise ratio and leads to aberrant synaptic behaviour and cognitive deficits. Gut microbiota can modulate BDNF function in the CNS, via changes in neurotransmitter function by affecting modulatory mechanisms such as the kynurenine pathway, or by changes in the availability and actions of short chain fatty acids (SCFAs) in the brain. Interrupting these cycles by inducing changes in the gut microbiota using probiotics, prebiotics or antimicrobial drugs has been found promising as a preventative or therapeutic measure to counteract behavioural deficits and these may be useful to supplement the actions of drugs in the treatment of CNS disorders.
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Metabolic dysregulation in first-episode schizophrenia patients with respect to genetic variation in one-carbon metabolism. Psychiatry Res 2016; 238:60-67. [PMID: 27086212 DOI: 10.1016/j.psychres.2016.01.077] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 12/20/2015] [Accepted: 01/31/2016] [Indexed: 11/22/2022]
Abstract
The aim of this study was to investigate the prevalence of metabolic disturbances in patients with first-episode schizophrenia (FES) and test the hypothesis that genetic variation in one-carbon metabolism may account for metabolic dysregulation in early psychosis. We measured fasting glucose, lipid profile parameters, homocysteine, folate and vitamin B12 in 135 patients with FES and 146 healthy controls (HCs). Polymorphisms in the following genes were determined: MTHFR (C677T and A1298C), MTHFD1 (G1958A), MTRR (A66G) and BHMT (G742A). Serum levels of folate and high-density lipoproteins (HDL) were significantly lower in patients with FES compared to HCs. In turn, serum levels of homocysteine and triglycerides were significantly higher in patients with FES than in HCs. Prevalence of hyperhomocysteinemia, low folate and HDL levels together with dyslipidemia was significantly higher in patients with FES compared to HCs. Higher homocysteine levels, lower vitamin B12 levels and the presence of metabolic syndrome were associated with higher severity of negative symptoms. None of studied polymorphisms was associated with schizophrenia risk. Several associations between studied polymorphisms and cardio-metabolic parameters were found. None of them remained significant after Bonferroni correction. Our results indicate that metabolic dysregulation in patients with FES is not associated with genetic variation in one-carbon metabolism.
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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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Sugawara N, Yasui-Furukori N, Yamazaki M, Shimoda K, Mori T, Sugai T, Matsuda H, Suzuki Y, Minami Y, Ozeki Y, Okamoto K, Sagae T, Someya T. Attitudes toward metabolic adverse events among patients with schizophrenia in Japan. Neuropsychiatr Dis Treat 2016; 12:427-36. [PMID: 26966364 PMCID: PMC4771408 DOI: 10.2147/ndt.s98711] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Metabolic syndrome is a growing concern among patients with schizophrenia because metabolic abnormalities are widely regarded as a major risk factor for cardiovascular disease and premature death. The current study assessed attitudes toward metabolic adverse events among patients with schizophrenia. METHODS A brief questionnaire was constructed to investigate patient recognition of the following broad areas: dietary habits, lifestyle, self-monitoring, knowledge, and medical practice. Between January 2012 and June 2013, questionnaires were sent to patients associated with 520 outpatient facilities and 247 inpatient facilities belonging to the Japan Psychiatric Hospital Association. All of the participants (n=22,072; inpatients =15,170, outpatients =6,902) were diagnosed with schizophrenia based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, or the International Classification of Diseases, tenth revision. RESULTS Approximately 55.0% (8,069/14,669) of inpatients and 44.8% of outpatients (2,978/6,649) reported that they did not exercise at all. Although 60.9% (4,116/6,760) of outpatients reported that they felt obese, only 35.6% (5,261/14,794) of inpatients felt obese. More than half of the inpatients (51.2%; 7,514/14,690) and outpatients (60.8%; 4,086/6,721) hoped to receive regular blood tests to prevent weight gain and diseases such as diabetes. CONCLUSION Although more than half of patients hoped to prevent weight gain and diabetes, only a minority of patients were mindful of eating balanced meals and having physical exercise. Educational efforts and the promotion of the best pharmacotherapy and monitoring practices are needed for patients with schizophrenia.
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Affiliation(s)
- Norio Sugawara
- Aomori Prefectural Center for Mental Health and Welfare, Aomori, Japan; Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan; Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan; Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
| | | | - Kazutaka Shimoda
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Takao Mori
- Japan Psychiatric Hospital Association, Tokyo, Japan
| | - Takuro Sugai
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Yutaro Suzuki
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Yuji Ozeki
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
| | | | - Toyoaki Sagae
- Department of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, Yonezawa, Japan
| | - Toshiyuki Someya
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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