1
|
Rami FZ, Li L, Le TH, Kang C, Han MA, Chung YC. Risk and protective factors for severe mental disorders in Asia. Neurosci Biobehav Rev 2024; 161:105652. [PMID: 38608827 DOI: 10.1016/j.neubiorev.2024.105652] [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: 09/06/2023] [Revised: 03/22/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
Among 369 diseases and injuries, the years lived with disability (YLDs) and disability-adjusted life-years (DALYs) rates for severe mental illnesses (SMIs) are within the top 20 %. Research on risk and protective factors for SMIs is critically important, as acting on modifiable factors may reduce their incidence or postpone their onset, while early detection of new cases enables prompt treatment and improves prognosis. However, as most of the studies on these factors are from Western countries, the findings are not generalizable across ethnic groups. This led us to conduct a systematic review of the risk and protective factors for SMIs identified in Asian studies. There were common factors in Asian and Western studies and unique factors in Asian studies. In-depth knowledge of these factors could help reduce disability, and the economic and emotional burden of SMIs. We hope that this review will inform future research and policy-making on mental health in Asian countries.
Collapse
Affiliation(s)
- Fatima Zahra Rami
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Ling Li
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Thi Hung Le
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Chaeyeong Kang
- Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Republic of Korea
| | - Young-Chul Chung
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea; Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.
| |
Collapse
|
2
|
Liu F, Wu Y, Chen J, Zou T, Qin Y, Teng Z, Su Y, Wu R, Huang J. Risk factors for osteoporosis in chronic schizophrenia on long-term treatment with antipsychotics: a cross-sectional study. BMC Psychiatry 2023; 23:454. [PMID: 37344770 DOI: 10.1186/s12888-023-04951-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/11/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Little is known about the laboratory variable risks with bone mineral density (BMD) in patients with schizophrenia. This study was designed to fully investigate the related risk factors for decreased BMD in schizophrenia, as well as evaluate the gender difference of BMD. METHOD The BMD of the forearm of 211 patients (males/females = 140/71) who met the diagnostic criteria for DSM-5 schizophrenia was measured by dual-energy X-ray absorptiometry. Basic demographic information, clinical assessments, and laboratory variables (regarding nutrition, hormones, metabolism, and inflammatory markers) were comprehensively collected. RESULTS Among 211 subjects, seventy-four (35%) patients had low BMD. Males had a significantly lower BMD T-score than females (P = 0.002). Multiple regression analyses showed that the independent risks with low BMD were lower folate, glycosylated hemoglobin levels, higher age, serum ferritin, and follicle-stimulating hormone (FSH) levels. In female patients, the BMD was mainly associated with age and serum hormones (FSH and testosterone), while the BMD of male patients was primarily related to age, microelements (serum ferritin and 25-OH-VD), and parathyroid hormone. CONCLUSION Our study found several meaningful correlations between osteoporosis and schizophrenia, especially regarding laboratory measures, which may provide new clues to identifying or preventing osteoporosis in clinical patients.
Collapse
Affiliation(s)
- Furu Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central, South University, 410011, Changsha, Hunan, China
| | - Ying Wu
- Department of Intensive Care Unit, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China
| | - Jindong Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central, South University, 410011, Changsha, Hunan, China
| | - Tianxiang Zou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central, South University, 410011, Changsha, Hunan, China
| | - Yue Qin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central, South University, 410011, Changsha, Hunan, China
| | - Ziwei Teng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central, South University, 410011, Changsha, Hunan, China
| | - Yuhan Su
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central, South University, 410011, Changsha, Hunan, China
| | - Renrong Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central, South University, 410011, Changsha, Hunan, China
| | - Jing Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central, South University, 410011, Changsha, Hunan, China.
| |
Collapse
|
3
|
Yang X, Yang H, Li N, Li C, Liang W, Zhang X. Increased serum homocysteine in first episode and drug-naïve individuals with schizophrenia: sex differences and correlations with clinical symptoms. BMC Psychiatry 2022; 22:759. [PMID: 36463129 PMCID: PMC9719155 DOI: 10.1186/s12888-022-04416-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Accumulating evidence shows that homocysteine (Hcy) is implicated in the pathophysiology of schizophrenia, and plays an important role in clinical characteristics. This study evaluated the relationships between Hcy levels and clinical features in first-episode, Chinese Han, drug-naïve (FEDN) patients with schizophrenia. METHODS FEDN individuals (119 with schizophrenia and 81 healthy controls matched for age, sex, education, and body mass index (BMI)) were enrolled. The serum Hcy levels were determined by enzyme cycle assay experiments. Severities of clinical symptoms were rated on the Positive and Negative Syndrome Scale (PANSS). RESULTS FEDN individuals with schizophrenia had higher Hcy levels compared with healthy controls (F = 46.865, P < 0.001). Correlation analysis and multiple stepwise regression analyses showed that serum Hcy levels in FEDN schizophrenia individuals were positively correlated with PANSS general psychopathology subscale (r = 0.294, P = 0.001) and PANSS total score (r = 0.273, P = 0.003). No significant association was found between Hcy and age, BMI, PANSS positive subscale, and the PANSS negative subscale (all, P > 0.05). Male individuals had significantly higher serum Hcy levels than female individuals (F = 7.717, P = 0.006) after controlling for confounding factors (F = 0.759, P = 0.011). CONCLUSIONS Serum Hcy levels were increased in FEDN individuals with schizophrenia, and Hcy levels may be involved in pathophysiological mechanisms. Sex differences in Hcy levels were observed, with higher levels in male FEDN individuals compared to females.
Collapse
Affiliation(s)
- Xu Yang
- Department of Psychiatry, Beijing Hui Long Guan Hospital, Peking University Hui Long Guan Clinical Medical School, Beijing, 100096, People's Republic of China
| | - Haidong Yang
- Department of Psychiatry, The Fourth People's Hospital of Lianyungang, The Affiliated KangDa College of Nanjing Medical University, Lianyungang, 222003, People's Republic of China
| | - Na Li
- Department of Pathology, Beijing Kingmed Clinical Laboratory, Affiliated Peking University, Beijing, 100015, People's Republic of China
| | - Chunyu Li
- Clinical Laboratory, Beijing Hui Long Guan Hospital, Peking University Hui Long Guan Clinical Medical School, Beijing, 100096, People's Republic of China
| | - Weiye Liang
- Department of Psychiatry, Beijing Hui Long Guan Hospital, Peking University Hui Long Guan Clinical Medical School, Beijing, 100096, People's Republic of China.
| | - Xiaobin Zhang
- Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, People's Republic of China.
| |
Collapse
|
4
|
Shahini N, Jazayeri SMMZ, Jahanshahi R, Charkazi A. Relationship of serum homocysteine and vitamin D with positive, negative, and extrapyramidal symptoms in schizophrenia: a case-control study in Iran. BMC Psychiatry 2022; 22:681. [PMID: 36333678 PMCID: PMC9635078 DOI: 10.1186/s12888-022-04246-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 09/07/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Schizophrenia is a devastating condition characterized by frequent recurrences, cognitive decline, and emotional and functional disabilities. This condition includes positive and negative symptoms and cognitive impairments resistant to drug treatment. According to studies, many biomarkers can affect this disorder. However, there is little information about vitamin D and homocysteine levels in patients with disease complications. We aimed to investigate this relationship in schizophrenia. METHOD In this case-control study, 33 patients with schizophrenia and 33 healthy individuals were enrolled from Golestan, the north of Iran, in 2021. Blood samples were taken from all participants to assess vitamin D and homocysteine serum levels. In addition, schizophrenic patients completed the Positive And Negative Syndrome Scale (PANSS) and Simpson-Angus Extrapyramidal Side Effects Scale (SAS). Data analysis was performed at a significance level of 0.05 using SPSS 16 software. RESULTS Of the 66 participants, 66.7% had vitamin D deficiency, and 71.2% had normal homocysteine levels. However, the serum level of vitamin D was lower in schizophrenic patients than in controls (p = 0.035), and serum homocysteine levels were higher in the schizophrenic group than in controls (p < 0.001). Vitamin D levels in patients with schizophrenia were significantly correlated with the overall assessment of extrapyramidal symptoms (r = 0.35, p = 0.04). However, no significant relationship existed between vitamin D and homocysteine levels and PANSS results (p > 0.05). CONCLUSION Serum levels of vitamin D and homocysteine were significantly lower and higher in schizophrenic patients than in the control group. Improvement of extrapyramidal symptoms in schizophrenic patients had a direct and significant relationship with serum vitamin D.
Collapse
Affiliation(s)
- Najmeh Shahini
- grid.411747.00000 0004 0418 0096Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Reza Jahanshahi
- grid.411747.00000 0004 0418 0096BSN, Student research committee, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdurrahman Charkazi
- grid.411747.00000 0004 0418 0096Health Education and Promotion, Faculty of Health, Environmental Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| |
Collapse
|
5
|
When should a psychiatrist remember to test homocysteine levels? - a literature review. CURRENT PROBLEMS OF PSYCHIATRY 2021. [DOI: 10.2478/cpp-2021-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Introduction: Homocysteine is an endogenous sulfur amino acid, formed as a result of biochemical changes in methionine. The normal concentration of homocysteine in healthy people is within the range of 5 - 15 µmol / l, and values above 15 µmol / l are referred to as hyperhomocysteinemia. Moreover, it has been shown that the level of homocysteine may be associated with the occurrence of mental disorders. The aim of this article was to search for a relationship between the level of this amino acid and the incidence and prognosis of bipolar disorder, depression, anxiety disorders, schizophrenia or Alzheimer’s disease.
Material and method: For the review of the literature, available articles from the PubMed database and Google Scholar were used under the following keywords: homocysteine, depression, bipolar disorder, schizophrenia, Alzheimer’s disease in the period from 1992 to 2021.
Results: The research conducted so far shows that there is a significant correlation between elevated levels of homocysteine and the above-mentioned mental disorders.
Conclusion: In order to prevent the consequences of the increased level of homocysteine, its concentration in blood serum should be monitored periodically and appropriate treatment should be implemented in case of abnormal results. It is important to educate patients about the consequences of hyperhomocysteinemia i.a. atherosclerosis, stroke, ischemic heart disease, osteoporosis, neural tube defects, mental disorders and neurodegenerative diseases. It should be also established a strategy to lower the level of this amino acid through lifestyle changes, as well as the supply of folic acid, vitamins B12, B6, B2, N-acetylcysteine and betaine.
Collapse
|
6
|
Involvements of Hyperhomocysteinemia in Neurological Disorders. Metabolites 2021; 11:metabo11010037. [PMID: 33419180 PMCID: PMC7825518 DOI: 10.3390/metabo11010037] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/27/2020] [Accepted: 01/01/2021] [Indexed: 12/14/2022] Open
Abstract
Homocysteine (HCY), a physiological amino acid formed when proteins break down, leads to a pathological condition called hyperhomocysteinemia (HHCY), when it is over a definite limit. It is well known that an increase in HCY levels in blood, can contribute to arterial damage and several cardiovascular disease, but the knowledge about the relationship between HCY and brain disorders is very poor. Recent studies demonstrated that an alteration in HCY metabolism or a deficiency in folate or vitamin B12 can cause altered methylation and/or redox potentials, that leads to a modification on calcium influx in cells, or into an accumulation in amyloid and/or tau protein involving a cascade of events that culminate in apoptosis, and, in the worst conditions, neuronal death. The present review will thus summarize how much is known about the possible role of HHCY in neurodegenerative disease.
Collapse
|
7
|
Semennov IV, Pyatoikina AS, Zagryazhskaya YS, Rukavishnikov GV, Kas’yanov ED, Zhilyaeva TV, Blagonravova AS, Mazo GE. Biochemical Markers of Folate Metabolism Disorders in Schizophrenia in the Russian Population. NEUROCHEM J+ 2021. [DOI: 10.1134/s1819712421010116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
8
|
Fe'li SN, Yassini Ardekani SM, Dehghani A. Relationship between Serum Homocysteine and Metabolic Syndrome among Patients with Schizophrenia and Bipolar Disorder: A Cross Sectional Study. IRANIAN JOURNAL OF PSYCHIATRY 2020; 15:266-273. [PMID: 33240376 PMCID: PMC7610070 DOI: 10.18502/ijps.v15i4.4292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: This study aimed to compare the prevalence of metabolic syndrome and hyperhomocysteinemia and to specify predictors of the metabolic syndrome among patients with schizophrenia and bipolar disorder. Method: This cross sectional study was conducted on 100 patients with schizophrenia and 100 patients with bipolar disorder. The participants' metabolic syndrome was determined according to the criteria set by Third Report of the National Cholesterol Education Program–Adult Treatment Panel III. Hyperhomocysteinemia was considered as homocysteine levels higher than 15 µmol/L. Chi-square test, Fisher's exact test, student t test, Mann-Whitney test, and logistic regression were used for data analysis. Results: The prevalence of metabolic syndrome was not significantly different (P = 0.07) between patients with schizophrenia (27%) and bipolar disorder (39%). No statistically significant difference (P = 0.17) was observed between patients with schizophrenia (82%) and bipolar disorder (74%) in the prevalence of hyperhomocysteinemia. The results of multivariable logistic regression model showed a significant association of smoking and BMI with metabolic syndrome in patients with schizophrenia (OR = 3.69, 95% CI: 1.13-12.05, and OR = 1.38, 95% CI: 1.20-1.60, respectively). In patients with bipolar disorder, BMI was a significant predictor of developing metabolic syndrome (OR = 1.29, 95% CI: 1.14-1.47). Metabolic syndrome was more prevalent in women than in men in both diagnostic groups (P < 0.05). No significant difference was observed in hyperhomocysteinemia prevalence between male and female patients with schizophrenia (P = 1.00). However, hyperhomocysteinemia was more prevalent in males than in females among patients with bipolar disorder (P = 0.001). Conclusion: Findings showed a high prevalence of metabolic syndrome and hyperhomocysteinemia among patients with schizophrenia and bipolar disorder. To deal with this problem, regular monitoring and conducting early interventions are recommended to determine the metabolic risk profile and to prevent the cardiovascular diseases.
Collapse
Affiliation(s)
- Shadi Naderyan Fe'li
- Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Dehghani
- Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
9
|
Tomioka Y, Kinoshita M, Umehara H, Nakayama T, Watanabe SY, Nakataki M, Numata S, Ohmori T. Association between serum folate levels and schizophrenia based on sex. Psychiatry Clin Neurosci 2020; 74:466-471. [PMID: 32445495 DOI: 10.1111/pcn.13074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/17/2020] [Accepted: 05/10/2020] [Indexed: 02/06/2023]
Abstract
AIM Sex differences in serum folate concentrations are well known, but no studies have investigated the association between serum folate levels and schizophrenia based on sex. With this study in a Japanese population, we examined the difference in serum folate levels between patients with schizophrenia and non-psychiatric controls stratified by sex. The relations among serum folate levels, plasma total homocysteine (tHcy), and serum vitamin B6 (pyridoxal) levels were also examined using data from our previous studies. METHODS The serum folate concentrations of 482 patients diagnosed with schizophrenia and 1350 non-psychiatric control subjects were measured. We conducted an analysis of covariance to examine the differences in serum folate levels between the two groups based on sex. Spearman's rank correlation was used to evaluate the relations among folate, tHcy, and vitamin B6 levels. RESULTS In the control group, serum folate concentrations were higher in women than in men. Lower levels of serum folate were observed in both male and female patients with schizophrenia. An inverse correlation between serum folate and plasma tHcy and a weak positive correlation between serum folate and vitamin B6 were observed in the combined cohort. CONCLUSION Our findings suggest that: (i) a low serum folate level may be associated with schizophrenia regardless of sex; and (ii) folate administration may be beneficial for the treatment of schizophrenia. In schizophrenic patients with low serum folate levels, folate administration might result in improvements in high tHcy and an increase in low vitamin B6 levels.
Collapse
Affiliation(s)
- Yukiko Tomioka
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Makoto Kinoshita
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Hidehiro Umehara
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Tomohiko Nakayama
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Shin-Ya Watanabe
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Masahito Nakataki
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Shusuke Numata
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Tetsuro Ohmori
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| |
Collapse
|
10
|
Simamora RH, Loebis B, Husada MS, Effendy E. Folic Acid and Vitamin B12 Supplementation on Male Patients with Schizophrenia Predominant Negative Symptoms. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401314666180620142607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Schizophrenia is a chronic mental disorder that affects approximately 1% of
the world’s population. Particularly, negative symptoms are frequently resistant and are the main contributors
to the disability on schizophrenia patients. Folic acid and vitamin B12 supplementation is the
safe and affordable approach, which can significantly improve the outcome on the patients with residual
symptoms.
Objectives:
We aimed to understand the difference of negative subscale of Positive and Negative Syndrome
Scale (PANSS) Score on patients with schizophrenia who receive risperidone with the addition
folic acid and Vitamin B12 and patients who receive only risperidone after 6 weeks.
Methods:
This study is a quasi experimental pre-test and post-test designs that are divided into two
groups, they are group receiving risperidone with the addition of folic acid and vitamin B12 and the
group receiving only risperidone. Diagnosis of schizophrenia according to the International Classification
of Diseases (ICD-10) criteria and negative symptoms assessed by using negative subscale of
PANSS Scores are observed. Statistical analysis is conducted using Statistical Package for the Social
Sciences (SPSS) software.
Results:
There was a significant difference in the mean score of negative-scale PANSS scores at the
end of week 6 between the group receiving folic acid and vitamin B12 supplementation and the group
receiving only risperidone with p = 0.002; p <0.05.
Conclusion:
Folic acid and vitamin B12 Supplementation provide benefits to patients schizophrenia.
Collapse
Affiliation(s)
- Rona Hanani Simamora
- Department of Psychiatry, Faculty of Medicine, University of Sumatera Utara, Medan, Indonesia
| | - Bahagia Loebis
- Department of Psychiatry, Faculty of Medicine, University of Sumatera Utara, Medan, Indonesia
| | - Muhammad Surya Husada
- Department of Psychiatry, Faculty of Medicine, University of Sumatera Utara, Medan, Indonesia
| | - Elmeida Effendy
- Department of Psychiatry, Faculty of Medicine, University of Sumatera Utara, Medan, Indonesia
| |
Collapse
|
11
|
Caliskan M, Orenay-Boyacioglu S, Dondu A. Roles of 5,10-methylenetetrahydrofolate reductase C677T and A1298C polymorphisms in early- and late-onset obsessive-compulsive disorder. Indian J Psychiatry 2019; 61:161-166. [PMID: 30992611 PMCID: PMC6425796 DOI: 10.4103/psychiatry.indianjpsychiatry_370_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The C677T and A1298C mutations of 5,10-methylenetetrahydrofolate reductase (MTHFR) have been linked with conditions such as depression, bipolar disorder, and schizophrenia, but there are not clear the relationship between MTHFR polymorphisms and obsessive-compulsive disorder (OCD). AIM The current study was planned to investigate the link between the MTHFR polymorphisms and OCD in patients to reveal any potential correlations that may be used as a novel marker in diagnosis of people who are in high-risk group of developing OCD. MATERIALS AND METHODS Blood samples from 64 highly characterized symptomatic cases and 64 gender- and age-matched control participants were analyzed for MTHFR C677T and A1298C gene variants. The MTHFR gene polymorphisms were detected through real-time polymerase chain reaction, followed by melting curve analysis. The results were tested with analysis of variance test and the differences with P < 0.05 were reported as statistically significant. RESULTS A statistically significant difference in age, education level, and marital status was found in the comparison of all groups in sociodemographic findings (P = 0.004, P = 0.001, and P = 0.001, respectively). A statistically significant difference was found in the comparison of the tic story of early- and late-onset OCD patients (P = 0.002). There was no significant difference in the genotype frequencies and allele distributions of MTHFR polymorphisms between the patients and controls (P > 0.05). CONCLUSION The results suggest that MTHFR polymorphisms are unlikely to play a major role in the pathogenesis of OCD. Further studies are needed in biochemical data on folate metabolism to clarify the effect of the MTHFR polymorphisms in OCD pathophysiology.
Collapse
Affiliation(s)
- Metin Caliskan
- Department of Medical Biology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Seda Orenay-Boyacioglu
- Department of Medical Genetics, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - Ayse Dondu
- Department of Psychiatry, Aydın Government Hospital, Aydin, Turkey
| |
Collapse
|
12
|
Arranz B, Sanchez-Autet M, San L, Safont G, Fuente-Tomás LDL, Hernandez C, Bogas JL, García-Portilla MP. Are plasma 25-hydroxyvitamin D and retinol levels and one-carbon metabolism related to metabolic syndrome in patients with a severe mental disorder? Psychiatry Res 2019; 273:22-29. [PMID: 30639560 DOI: 10.1016/j.psychres.2019.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/15/2018] [Accepted: 01/01/2019] [Indexed: 11/27/2022]
Abstract
There is a scarcity of studies assessing the influence of biomarkers in metabolic syndrome in psychiatric patients. Our aim was to correlate serum or plasma levels of 25-hydroxyvitamin D (25-OH-VD), retinol, vitamin B12 (VB12), folate and homocysteine (Hcy), with the metabolic status, in a sample of 289 outpatients with Schizophrenia or Bipolar Disorder. Logistic regression and multiple linear regressions were performed to assess the ability of biomarkers to predict the presence of MetS, the number of risk factors for MetS, and insulin resistance indexes (HOMA and QUICKI). Regarding the association between biomarkers and the QUICKI index, the model explained 6.8% of the variance, with folate and 25-OH-VD levels contributing significantly to the model. The model predicting the number of MetS risk factors was significant and explained 21.7% of the variance, being 25-OH-VD and retinol the statistically significant factors. As for the impact of biomarkers on MetS, the model was statistically significant, being 25-OH-VD and retinol levels the significant factors. We report for the first time an association between MetS and both low 25-OH-VD and high retinol concentrations. Inflammation-related biomarkers may help identify patients with a high risk of MetS who might benefit from healthy lifestyle counselling and early intervention.
Collapse
Affiliation(s)
- Belén Arranz
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Mónica Sanchez-Autet
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; University of Barcelona, Barcelona, Spain.
| | - Luis San
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; University of Barcelona, Barcelona, Spain
| | - Gemma Safont
- Hospital Universitari Mutua Terrassa, Terrassa, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; University of Barcelona, Barcelona, Spain
| | - Lorena De La Fuente-Tomás
- Department of Psychiatry, University of Oviedo, Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | | | | | - María Paz García-Portilla
- Department of Psychiatry, University of Oviedo, Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| |
Collapse
|
13
|
Analysis of gut microbiota diversity and auxiliary diagnosis as a biomarker in patients with schizophrenia: A cross-sectional study. Schizophr Res 2018; 197:470-477. [PMID: 29352709 DOI: 10.1016/j.schres.2018.01.002] [Citation(s) in RCA: 194] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 12/26/2017] [Accepted: 01/01/2018] [Indexed: 12/20/2022]
Abstract
With the advent of sequencing technology, characterization of schizophrenia with underlying probing of gut microbiome can provide abundant clues for diagnosis and prognosis of schizophrenia. In this study, we first compared the difference of gut microbiota between schizophrenia patients and healthy controls by 16S rRNA sequencing. We further explored whether gut microbiota can be used as a biomarker to assist in the diagnosis of schizophrenia. We restricted inclusion criteria strictly to control confounding bias. Finally, we investigated differences in fecal microbiota between 64 schizophrenia patients and 53 healthy controls. At the phylum level, we found that the abundance of Proteobacteria in the schizophrenia patients was significantly increased. At the genus level, the relative abundance of Succinivibrio, Megasphaera, Collinsella, Clostridium, Klebsiella and Methanobrevibacter was significantly higher whereas the abundance of Blautia, Coprococcus, Roseburia was decreased compared to health controls. The receiver operating characteristic curve analysis demonstrated that 12 significant microbiota biomarkers were capable of being used as diagnostic factors for distinguishing the schizophrenia cohort from those in the control cohort (AUC = 0.837). We performed PICRUSt analysis and found that several metabolic pathways differed significantly between healthy controls and schizophrenia patients, including vitamin B6 and fatty acid. In conclusion, there are some difference of gut microbiota between schizophrenia patients and healthy controls and the insights from this study could be used to develop microbiota-based diagnosis for schizophrenia.
Collapse
|
14
|
Association study of methylenetetrahydrofolate reductase genetic polymorphism 677C>T with schizophrenia in hospitalized patients in population of European Russia. Asian J Psychiatr 2018; 32:29-33. [PMID: 29202425 DOI: 10.1016/j.ajp.2017.11.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/26/2017] [Accepted: 11/27/2017] [Indexed: 12/23/2022]
Abstract
The purpose of the research was to investigate the association of methylenetetrahydrofolate reductase (hereinafter MTHFR) genetic polymorphism 677C>T with schizophrenia in the Russian population in comparison with the control group of healthy blood donors. Also some characteristics of schizophrenia were examined in patients with/without defective T-allele of MTHFR677C>T polymorphism. 500 patients with schizophrenia and 499 blood donors were examined for T-allele carriage of polymorphism MTHFR677C>T by PCR method. 150 archival medical records were studied (in the first patients included in the study). The carriage of T-allele of genetic polymorphism MTHFR677C>T was significantly more common in patients than in healthy donors: 255/500 versus 219/499 (p=0,0287, χ2=4,79; OR=1,33, 95%CI [1037; 1707]). The number of patients with chronic type of schizophrenia onset was significantly more among T-allele carriers (n=77) than among normal CC-genotype carriers (n=73): р=0.038. The number of "incapacitated" persons in the group of patients with defective T-allele (n=77) was significantly higher than in patients with normal genotype (n=73, p=0.0439; OR=2.878, 95%CI=1.111-7.456). The results suggest that T-allele of genetic polymorphism MTHFR677C>T in the population of European Russia may increase the risk of developing schizophrenia and its unfavorable prognosis, which requires further investigation.
Collapse
|
15
|
Esnafoğlu E, Yaman E. Vitamin B12, folic acid, homocysteine and vitamin D levels in children and adolescents with obsessive compulsive disorder. Psychiatry Res 2017; 254:232-237. [PMID: 28477545 DOI: 10.1016/j.psychres.2017.04.032] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 04/14/2017] [Accepted: 04/20/2017] [Indexed: 12/17/2022]
Abstract
Obsessive compulsive disorder (OCD) is a complex disorder with a poorly understood aetiopathogenesis. One carbon metabolism that includes vitamin B12, folic acid and homocysteine has been investigated in many psychiatric disorders like OCD. In recent years, vitamin D has also been considered to contribute to many of these psychiatric disorders. In this study we investigated whether vitamin B12, homocysteine and vitamin D play a role in the aetiology of paediatric OCD. With this aim we compared 52 children and adolescent OCD patients with 30 healthy controls. The participants were tested for vitamin B12, folic acid, homocysteine and vitamin D levels and were evaluated with a sociodemographic form, state-trait anxiety inventory 1 and 2, Kovacs Depression Inventory and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). As a result we found significantly lower levels of vitamin B12 and vitamin D and higher levels of homocysteine in the patient group compared to control group (p values for all three scores were <0.001), whereas there was no significant difference between groups in terms of folate levels (p=0.083). This demonstrates that one carbon metabolism and vitamin D deficiency can play a role in the aetiology of OCD.
Collapse
Affiliation(s)
- Erman Esnafoğlu
- Department of Child and Adolescent Psychiatry, Training and Research Hospital, Faculty of Medicine, Ordu University, Ordu, Turkey.
| | - Elif Yaman
- Department of Pediatry, Training and Research Hospital, Faculty of Medicine, Ordu University, Ordu, Turkey
| |
Collapse
|
16
|
da Silva VC, de Oliveira AC, D’Almeida V. Homocysteine and Psychiatric Disorders. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2017. [DOI: 10.1177/2326409817701471] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | - Vânia D’Almeida
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| |
Collapse
|
17
|
Zhilyaeva TV, Sergeeva AV, Blagonravova AS, Kasimova LN. [Psychopathological characteristics and social functioning of the schizophrenic patients with the T allele of the MTHFR677C>T polymorphism]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 116:5-11. [PMID: 28091495 DOI: 10.17116/jnevro20161161115-11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIM To compare the severity of psychopathological symptoms and characteristics of personal and social functioning in patients with schizophrenia, carriers of different alleles of the MTHFR677C>T polymorphism. MATERIAL AND METHODS One hundred and fifty patients diagnosed with schizophrenia were genotyped for the MTHFR677C>T polymorphism, some of them were examined using psychometric scales and tests (PANSS, SANS, PSP, CDSS, a battery of cognitive tests etc). RESULTS AND CONCLUSION Patients with the MTHFR677T variant had greater severity of negative symptoms regardless of psychometric instruments used in the study, greater severity of schizophrenia disorder in whole measured with the PANSS General psychopathological symptoms subscale, higher scores on the PANSS cognitive cluster and lower levels of personal and social functioning measured with the PSP compared to the patients with the MTHFR677CС genotype. The results of psychometric testing are in line with significant differences of MTHFR677T allele carriers from those with the MTHFR677CС genotype in the number of disable patients and the use of different types of psychiatric services. The differences were not related to sex, age, illness duration and depressive symptoms measured with CDSS and PANSS «depression/anxiety» factor.
Collapse
Affiliation(s)
- T V Zhilyaeva
- Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russia
| | - A V Sergeeva
- Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russia
| | | | - L N Kasimova
- Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russia
| |
Collapse
|
18
|
Lower folate levels in schizophrenia: A meta-analysis. Psychiatry Res 2016; 245:1-7. [PMID: 27521746 DOI: 10.1016/j.psychres.2016.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 03/01/2016] [Accepted: 03/02/2016] [Indexed: 11/23/2022]
Abstract
This meta-analysis aimed to estimate the association between folate level and schizophrenia in order to provide the evidence for the treatment of schizophrenia. Data were extracted from all the studies meeting our inclusion and exclusion criteria. The association between the folate level and schizophrenia was evaluated by the standardized mean difference (SMD) and 95% confidence interval (CI). The 20 published articles of our meta-analysis included 1463 (53.4%) cases and 1276 (46.6%) controls. The folate level was significantly lower in schizophrenia cases than in healthy controls. Subgroup analysis showed the folate level was lower in cases from Asia subgroup than in healthy controls. Sensitivity analysis showed that the current results were credible and reliable and the funnel plots indicated no publication bias in our meta-analysis. Our study indicates that schizophrenia patients may have lower folate levels. More epidemiological and laboratory studies are still needed to confirm whether it is necessary to supplement folate in schizophrenia patients.
Collapse
|
19
|
Wang D, Zhai JX, Liu DW. Serum folate levels in schizophrenia: A meta-analysis. Psychiatry Res 2016; 235:83-9. [PMID: 26652840 DOI: 10.1016/j.psychres.2015.11.045] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 10/18/2015] [Accepted: 11/24/2015] [Indexed: 02/03/2023]
Abstract
To clarify the relationship between serum folate and schizophrenia (SZ) risk, the meta-analysis was conducted. PubMed, Embase, and Web of Science were searched without language restrictions. Weighted mean difference (WMD) as a summary statistic was used in this meta-analysis. Subgroup analyses by publication language (English and non-English), ethnicity (Caucasian, Asian, African, Latino, and mixed population), duration (acute, chronic, patients including both acute and chronic SZ, and not mentioned about either chronic or acute), measurement time (before drugs using and after drugs using), gender (male and female) and age (<50 years old and >50 years old) were performed. Power analysis was also conducted to detect the reliability of the meta-analyses' results. In summary, the subgroups which failed to detect significant decreased associations were always with lower statistic power and could not be confirmed. The results supported that decreased serum folate was associated with SZ risk in total studies and subgroups of English publications, Caucasians, Asians, acute SZ patients, measurement after drugs using in SZ patients, and age<50 with the great enough powers, respectively. In conclusion, the present meta-analysis found that folate deficiency is associated to SZ, and subgroups which did not reach enough statistical power need further investigation in the future.
Collapse
Affiliation(s)
- Dan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China; Library, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
| | - Jun-Xia Zhai
- Department of Novelty Retrieval, Institute of Hebei Medical Information, Shijiazhuang 050071, Hebei Province, China
| | - Dian-Wu Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China.
| |
Collapse
|
20
|
Takano Y, Ozeki Y, Sekine M, Fujii K, Watanabe T, Okayasu H, Shinozaki T, Aoki A, Akiyama K, Homma H, Shimoda K. Multi-regression analysis revealed a relationship between l-serine and methionine, a component of one-carbon metabolism, in the normal control but not in the schizophrenia. Ann Gen Psychiatry 2016; 15:23. [PMID: 27588034 PMCID: PMC5007820 DOI: 10.1186/s12991-016-0113-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 08/22/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Alterations in one-carbon metabolism (OCM) have been observed in patients with schizophrenia (SZ), but a comprehensive study of OCM has not yet been conducted. A carbon atom is transferred from l-serine to methionine during OCM, but the relationship between l-serine and methionine in SZ is not yet known. We investigated the relationship between l-serine and methionine to obtain a comprehensive understanding of OCM in SZ. METHODS We recruited forty-five patients with SZ and thirty normal controls (NC). Whole blood, plasma, and DNA specimens were obtained from all participants. Plasma l-serine, d-serine, glycine, methionine, and total homocysteine levels were measured using high-performance liquid chromatography. Plasma vitamin B12 and total folate were measured using a chemiluminescent protein-binding immunoassay. Clinical symptoms were estimated using the positive and negative syndrome scale (PANSS). The methylenetetrahydrofolate reductase (MTHFR) C667T genotype and A298C genotype, which are involved in MTHFR activity, were determined using the TaqMan genotyping assay system. RESULTS Analysis of variance was used to confirm that the SZ cohort has higher plasma homocysteine levels and lower plasma folate levels than the NC group. Multi-regression analysis revealed a relationship between l-serine and methionine in the NC group but not in the SZ group. The MTHFR genotype did not affect the relationship between l-serine and methionine in each group. The total PANSS score was significantly related to d-serine and folate levels and to age. Positive PANSS scores were significantly related to both glycine and sex. In addition, both glycine and d-serine were significantly correlated with negative PANSS scores. CONCLUSIONS We found impairment of the relationship between l-serine and methionine in SZ. Clinical symptoms of SZ were partially correlated with the OCM components. These findings contributed to our understanding of OCM alteration in SZ and may explain why the alteration occurs.
Collapse
Affiliation(s)
- Yumiko Takano
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| | - Yuji Ozeki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan ; Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masae Sekine
- Laboratory of Biomolecular Science, Graduate School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan
| | - Kumiko Fujii
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| | - Takashi Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| | - Hiroaki Okayasu
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| | - Takahiro Shinozaki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| | - Akiko Aoki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Mibu, Tochigi Japan
| | - Hiroshi Homma
- Laboratory of Biomolecular Science, Graduate School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| |
Collapse
|
21
|
Abstract
OBJECTIVE After the discovery of 'homocystinuria syndrome', many studies have suggested that high blood levels of homocysteine may be associated with schizophrenia. The aim of this study was to analyse the association between hyperhomocysteinaemia and schizophrenia. METHODS In a population of inpatients suffering from exacerbated schizophrenic disorders (N=100), we evaluated homocysteine levels the day after their admission to an acute psychiatric ward and compared it with that of a non-patient control group (N=110), matched for age and gender. We statistically analysed the correlation between homocysteine levels and selected variables: gender, age, years of illness and number of previous psychiatric admissions as well as Brief Psychiatric Rating Scale, Positive Negative Syndrome Scale and Global Assessment Functioning (GAF) Scores. RESULTS We observed elevated homocysteine levels (an increase of 7.84 µM on average per patient) in 32% of the patients, but we did not find any statistically significant difference between the homocysteine levels of our patients and controls. Hyperhomocysteinaemia presented a positive statistically significant correlation with years of illness (p<0.005) and a negative statistically significant correlation with GAF score (p<0.001), but not with other clinical variables. CONCLUSIONS Hyperhomocysteinaemia, which occurred in our schizophrenia patients with poor social and relational functioning after many years of illness, could represent an effect of altered lifestyle due to psychosis, but not a specific marker for schizophrenia.
Collapse
|
22
|
Song X, Fan X, Li X, Kennedy D, Pang L, Quan M, Chen X, Gao J, Zhang W, Zhang J, Lv L. Serum levels of BDNF, folate and homocysteine: in relation to hippocampal volume and psychopathology in drug naïve, first episode schizophrenia. Schizophr Res 2014; 159:51-5. [PMID: 25128453 DOI: 10.1016/j.schres.2014.07.033] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 07/15/2014] [Accepted: 07/25/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The present study was to examine serum levels of brain-derived neurotrophic factor (BDNF), folate, homocysteine (Hcy), and their relationships with hippocampal volume and psychopathology in drug naïve, first episode schizophrenia. METHOD Drug naïve, first episode schizophrenia patients and healthy controls were enrolled in the study. Serum levels of BDNF, folate and Hcy were measured using enzyme-linked immunosorbent assay (ELISA), electrochemiluminescence immunoassay (ECLIA), and enzymatic cycling method respectively. Hippocampus was parcellated and bilateral hippocampal volumes were measured using FreeSurfer. RESULTS Forty-six patients with drug naïve, first episode schizophrenia (SZ group) and 30 healthy controls (control group) were enrolled. The SZ group had significantly lower serum levels of BDNF and folate, and significantly higher serum levels of Hcy compared with the control group (p=0.013, p<0.001, p=0.003 respectively). There were no significant differences in hippocampal volumes between the two groups (ps>0.2). Within the SZ group, there were significant positive relationships between serum levels of BDNF and both left and right hippocampal volumes (r=0.327, p=0.026; r=0.338, p=0.022 respectively). In contrast, such relationships did not exist in the control group. Within the SZ group, there were significant negative relationships between serum levels of folate and PANSS-total scores and PANSS-negative symptom scores (r=0.319, p=0.031; r=0.321, p=0.030 respectively); and there was a positive relationship between serum levels of Hcy and PANSS-total scores (r=0.312, p=0.035). Controlling for potential confounding variables resulted in similar findings. CONCLUSIONS Drug naïve, first episode schizophrenia presents decreased serum levels of BDNF, folate and increased serum levels of Hcy, which may play an important role in the neurodevelopmental process and clinical manifestation of schizophrenia.
Collapse
Affiliation(s)
- Xueqin Song
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China; Henan Province Biological Psychiatry Key Laboratory, Xinxiang Medical University, Xinxiang, China; Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Xiaoduo Fan
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Xue Li
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China
| | - David Kennedy
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Lijuan Pang
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China
| | - Meina Quan
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Xumei Chen
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China
| | - Jinsong Gao
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China
| | - Wei Zhang
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China
| | - Jianjiang Zhang
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China
| | - Luxian Lv
- Henan Province Biological Psychiatry Key Laboratory, Xinxiang Medical University, Xinxiang, China; Henan Province Mental Hospital, The Second Affiliated Hospital/Xinxiang Medical University, Xinxiang, China.
| |
Collapse
|
23
|
Nishi A, Numata S, Tajima A, Kinoshita M, Kikuchi K, Shimodera S, Tomotake M, Ohi K, Hashimoto R, Imoto I, Takeda M, Ohmori T. Meta-analyses of blood homocysteine levels for gender and genetic association studies of the MTHFR C677T polymorphism in schizophrenia. Schizophr Bull 2014; 40:1154-63. [PMID: 24535549 PMCID: PMC4133669 DOI: 10.1093/schbul/sbt154] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Previous studies suggest that elevated blood homocysteine levels and the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism are risk factors for schizophrenia. However, the effects of gender and MTHFR C677T genotypes on blood homocysteine levels in schizophrenia have not been consistent. We first investigated whether plasma total homocysteine levels were higher in patients with schizophrenia than in controls with stratification by gender and by the MTHFR C677T genotypes in a large cohort (N = 1379). Second, we conducted a meta-analysis of association studies between blood homocysteine levels and schizophrenia separately by gender (N = 4714). Third, we performed a case-control association study between the MTHFR C677T polymorphism and schizophrenia (N = 4998) and conducted a meta-analysis of genetic association studies based on Japanese subjects (N = 10 378). Finally, we assessed the effect of plasma total homocysteine levels on schizophrenia by a mendelian randomization approach. The ANCOVA after adjustment for age demonstrated a significant effect of diagnosis on the plasma total homocysteine levels in all strata, and the subsequent meta-analysis for gender demonstrated elevated blood homocysteine levels in both male and female patients with schizophrenia although antipsychotic medication might influence the outcome. The meta-analysis of the Japanese genetic association studies demonstrated a significant association between the MTHFR C677T polymorphism and schizophrenia. The mendelian randomization analysis in the Japanese populations yielded an OR of 1.15 for schizophrenia per 1-SD increase in plasma total homocysteine. Our study suggests that increased plasma total homocysteine levels may be associated with an increased risk of schizophrenia.
Collapse
Affiliation(s)
- Akira Nishi
- Department of Psychiatry, Course of Integrated Brain Sciences, Medical Informatics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Shusuke Numata
- Department of Psychiatry, Course of Integrated Brain Sciences, Medical Informatics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan;
| | - Atsushi Tajima
- Department of Human Genetics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Makoto Kinoshita
- Department of Psychiatry, Course of Integrated Brain Sciences, Medical Informatics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Kumiko Kikuchi
- Department of Psychiatry, Course of Integrated Brain Sciences, Medical Informatics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Shinji Shimodera
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Kochi, Japan
| | - Masahito Tomotake
- Department of Mental Health, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Kazutaka Ohi
- Department of Psychiatry, Osaka University Graduate school of Medicine, Osaka, Japan
| | - Ryota Hashimoto
- Department of Psychiatry, Osaka University Graduate school of Medicine, Osaka, Japan;,Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Issei Imoto
- Department of Human Genetics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Masatoshi Takeda
- Department of Psychiatry, Osaka University Graduate school of Medicine, Osaka, Japan
| | - Tetsuro Ohmori
- Department of Psychiatry, Course of Integrated Brain Sciences, Medical Informatics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| |
Collapse
|
24
|
Türksoy N, Bilici R, Yalçıner A, Ozdemir YÖ, Ornek I, Tufan AE, Kara A. Vitamin B12, folate, and homocysteine levels in patients with obsessive-compulsive disorder. Neuropsychiatr Dis Treat 2014; 10:1671-5. [PMID: 25228807 PMCID: PMC4164291 DOI: 10.2147/ndt.s67668] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
It is known that elevated serum homocysteine, decreased folate, and low vitamin B12 serum levels are associated with poor cognitive function, cognitive decline, and dementia. Current literature shows that some psychiatric disorders, mainly affective and psychotic ones, can be related to the levels of vitamin B12, folate, and homocysteine. These results can be explained by the importance of vitamin B12, folate, and homocysteine in carbon transfer metabolism (methylation), which is required for the production of serotonin as well as for other monoamine neurotransmitters and catecholamines. Earlier studies focused on the relationship between folate deficiency, hyperhomocysteinemia, and depressive disorders. Although depressive and anxiety disorders show a common comorbidity pattern, there are few studies addressing the effect of impaired one-carbon metabolism in anxiety disorders - especially in obsessive-compulsive disorder (OCD). This study aimed to measure the levels of vitamin B12, folate, and homocysteine specifically in order to see if eventual alterations have an etiopathogenetic significance on patients with OCD. Serum vitamin B12, folate, and homocysteine concentrations were measured in 35 patients with OCD and 22 controls. In addition, the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision, Yale-Brown Obsessive Compulsive Scale, Hamilton Rating Scale for Depression, and Hamilton Rating Scale for Anxiety were conducted for each patient. It was found that vitamin B12 levels were decreased and homocysteine levels were increased in some OCD patients. Homocysteine levels were positively correlated with Yale-Brown compulsion and Yale-Brown total scores. In conclusion, findings of this study suggest that some OCD patients might have vitamin B12 deficiency and higher homocysteine levels.
Collapse
Affiliation(s)
- Nuray Türksoy
- Simurg Psychiatry and Psychotherapy Center, Istanbul, Turkey
| | - Rabia Bilici
- Erenköy State Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey
| | | | - Y Özay Ozdemir
- Erenköy State Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey
| | | | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University, Bolu, Turkey
| | - Ayşe Kara
- Bakırköy State Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey
| |
Collapse
|
25
|
Wood PL. Mass spectrometry strategies for clinical metabolomics and lipidomics in psychiatry, neurology, and neuro-oncology. Neuropsychopharmacology 2014; 39:24-33. [PMID: 23842599 PMCID: PMC3857645 DOI: 10.1038/npp.2013.167] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 07/04/2013] [Indexed: 12/14/2022]
Abstract
Metabolomics research has the potential to provide biomarkers for the detection of disease, for subtyping complex disease populations, for monitoring disease progression and therapy, and for defining new molecular targets for therapeutic intervention. These potentials are far from being realized because of a number of technical, conceptual, financial, and bioinformatics issues. Mass spectrometry provides analytical platforms that address the technical barriers to success in metabolomics research; however, the limited commercial availability of analytical and stable isotope standards has created a bottleneck for the absolute quantitation of a number of metabolites. Conceptual and financial factors contribute to the generation of statistically under-powered clinical studies, whereas bioinformatics issues result in the publication of a large number of unidentified metabolites. The path forward in this field involves targeted metabolomics analyses of large control and patient populations to define both the normal range of a defined metabolite and the potential heterogeneity (eg, bimodal) in complex patient populations. This approach requires that metabolomics research groups, in addition to developing a number of analytical platforms, build sufficient chemistry resources to supply the analytical standards required for absolute metabolite quantitation. Examples of metabolomics evaluations of sulfur amino-acid metabolism in psychiatry, neurology, and neuro-oncology and of lipidomics in neurology will be reviewed.
Collapse
Affiliation(s)
- Paul L Wood
- Metabolomics Unit, Department of Physiology and Pharmacology, DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Math and Science 435, Harrogate, TN 37752, USA
| |
Collapse
|
26
|
Narayan SK, Verman A, Kattimani S, Ananthanarayanan PH, Adithan C. Plasma homocysteine levels in depression and schizophrenia in South Indian Tamilian population. Indian J Psychiatry 2014; 56:46-53. [PMID: 24574558 PMCID: PMC3927245 DOI: 10.4103/0019-5545.124746] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
CONTEXT Hyperhomocysteinemia has been associated with psychiatric diseases in non-Indian populations. OBJECTIVES We aimed to determine if total plasma Homocysteine (Hcys) is associated with schizophrenia or depression in South Indian Tamil patients and if so, to correlate their severity and phenomenology to Hcys levels. SETTINGS AND DESIGN 40 patients each with schizophrenia and depression and 40 healthy controls were recruited from the psychiatry department of a quaternary referral centre. Association between Hcys and psychiatric disorders was determined using a Case- control design. Hcys levels were correlated with age, gender and severity and duration of the disease by appropriate statistical methods using SPSS17. MATERIALS AND METHODS Schizophrenia and depression were defined using ICD10 DCR version. Severity of depression was assessed by Hamilton Depression Rating Scale and that of schizophrenia using Positive and Negative Schizophrenia scales (PANSS). Hcys levels were determined using automated chemiluminiscence immunoassay (74-76). STATISTICAL ANALYSIS Differences between the mean values of plasma homocysteine levels among schizophrenia, depression and control groups were compared using analysis of variants. The association between the severity and duration of schizophrenia and depression and the plasma homocysteine levels were determine using Pearson correlation. CONCLUSIONS In Tamilian population, schizophrenia and depression are associated with total plasma Hcys levels which correlated with the duration and severity of psychosis.
Collapse
Affiliation(s)
- Sunil K Narayan
- Department of Psychiatry, Neurology, Pharmacology and Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Arul Verman
- Department of Psychiatry, Neurology, Pharmacology and Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shivanand Kattimani
- Department of Psychiatry, Neurology, Pharmacology and Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - P H Ananthanarayanan
- Department of Psychiatry, Neurology, Pharmacology and Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Chandrasekaran Adithan
- Department of Psychiatry, Neurology, Pharmacology and Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
27
|
Lu ML, Lin CH, Chen YC, Yang HC, Wu TH. Determination of olanzapine and N-desmethyl-olanzapine in plasma using a reversed-phase HPLC coupled with coulochemical detection: correlation of olanzapine or N-desmethyl-olanzapine concentration with metabolic parameters. PLoS One 2013; 8:e65719. [PMID: 23741510 PMCID: PMC3669135 DOI: 10.1371/journal.pone.0065719] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 04/27/2013] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Olanzapine (OLZ) is one of the most prescribed atypical antipsychotic drugs but its use is associated with unfavorable metabolic abnormalities. N-desmethyl-olanzapine (DMO), one of the OLZ metabolites by CYP1A2, has been reported to have a normalizing action on metabolic abnormalities, but this remains unclear. Our aim was to explore the correlation between the concentrations of OLZ or DMO with various metabolic parameters in schizophrenic patients. METHODS The chromatographic analysis was carried out with a solvent delivery system coupled to a Coulochem III coulometric detector to determine OLZ and DMO simultaneously in OLZ-treated patients. The correlation between the concentration of OLZ or DMO and the metabolic parameters was analyzed by the Spearman rank order correlation method (r s). PRINCIPAL FINDINGS The established analytical method met proper standards for accuracy and reliability and the lower limitation of quantification for each injection of DMO or OLZ was 0.02 ng. The method was successfully used for the analysis of samples from nonsmoking patients (n = 48) treated with OLZ in the dosage range of 5-20 mg per day. There was no correlation between OLZ concentrations and tested metabolic parameters. DMO concentrations were negatively correlated with glucose (r s = -0.45) and DMO concentrations normalized by doses were also negatively correlated with insulin levels (r s = -0.39); however, there was a marginally positive correlation between DMO and homocysteine levels (r s = +0.38). CONCLUSIONS The observed negative correlations between levels of DMO and glucose or insulin suggest a metabolic normalization role for DMO regardless of its positive correlation with a known cardiovascular risk factor, homocysteine. Additional studies of the mechanisms underlying DMO's metabolic effects are warranted.
Collapse
Affiliation(s)
- Mong-Liang Lu
- Department of Psychiatry, Taipei Medical University-Wan Fang Medical Center, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Hui Lin
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Yi-Chuan Chen
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Huai-Chih Yang
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Hua Wu
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
28
|
Dietrich-Muszalska A, Malinowska J, Olas B, Głowacki R, Bald E, Wachowicz B, Rabe-Jabłońska J. The oxidative stress may be induced by the elevated homocysteine in schizophrenic patients. Neurochem Res 2012; 37:1057-62. [PMID: 22270909 PMCID: PMC3321271 DOI: 10.1007/s11064-012-0707-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 01/03/2012] [Accepted: 01/10/2012] [Indexed: 12/14/2022]
Abstract
The mechanisms of oxidative stress in schizophrenic patients are not fully understood. In the present study, we investigated the effect of elevated level of homocysteine (Hcys) on some parameters of oxidative stress, namely thiobarbituric acid reactive substances (TBARS), an index of lipid peroxidation in plasma, the level of carbonyl groups in plasma proteins, as well as the amount of 3-nitrotyrosine in plasma proteins isolated from schizophrenic patients. Patients hospitalised in I and II Psychiatric Department of Medical University in Lodz, Poland were interviewed with special questionnaire (treatment, course of diseases, dyskinesis and other EPS). According to DSM-IV criteria all patients had diagnosis of paranoid type. They were treated with antipsychotic drugs (clozapine, risperidone, olanzapine). Mean time of schizophrenia duration was about 5 years. High-performance liquid chromatography was used to analyse the total level of homocysteine in plasma. Levels of carbonyl groups and 3-nitrotyrosine residues in plasma proteins were measured by ELISA and a competition ELISA, respectively. The lipid peroxidation in plasma was measured by the level of TBARS. Our results showed that in schizophrenic patients the amount of homocysteine in plasma was higher in comparison with the control group. We also observed a statistically increased level of biomarkers of oxidative/nitrative stress such as carbonyl groups or 3-nitrotyrosine in plasma proteins from schizophrenic patients. Moreover, our experiments indicate that the correlation between the increased amount of homocysteine and the oxidative stress exists. Considering the data presented in this study, we suggest that the elevated Hcys in schizophrenic patients may stimulate the oxidative stress.
Collapse
Affiliation(s)
- Anna Dietrich-Muszalska
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka 8/10, 92-216 Lodz, Poland
| | - Joanna Malinowska
- Department of General Biochemistry, University of Lodz, Pomorska 141/3, 90-236 Lodz, Poland
| | - Beata Olas
- Department of General Biochemistry, University of Lodz, Pomorska 141/3, 90-236 Lodz, Poland
| | - Rafal Głowacki
- Department of Environmental Chemistry, University of Lodz, Pomorska 163, 90-236 Lodz, Poland
| | - Edward Bald
- Department of Environmental Chemistry, University of Lodz, Pomorska 163, 90-236 Lodz, Poland
| | - Barbara Wachowicz
- Department of General Biochemistry, University of Lodz, Pomorska 141/3, 90-236 Lodz, Poland
| | - Jolanta Rabe-Jabłońska
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka 8/10, 92-216 Lodz, Poland
| |
Collapse
|