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Merrill RM, Song D. Mental illness and sleep disorders among women with gynecological problems. J Psychosom Obstet Gynaecol 2024; 45:2354330. [PMID: 38823418 DOI: 10.1080/0167482x.2024.2354330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/05/2024] [Indexed: 06/03/2024] Open
Abstract
This retrospective cohort study identifies differences between rates of selected mental illnesses and sleep disorders according to eight gynecological problems. Analyses utilize medical claims data for adult employees of a large corporation during 2017-2021. Women with a gynecological problem (most notably pain, endometriosis, pelvic inflammation and bleeding) are significantly more likely to experience mental illness. Several gynecological problems are also significantly associated with sleep disorders. Women with a gynecological problem (vs. none) are 50% more likely to have a mental health problem and 44% more likely to have a sleep disorder after adjusting for age, marital status, dependent children and year. The largest differences between higher (%) mental illness and sleep disorders appear for hyperplasia (6% vs. 45%), cancer (11% vs. 68%), pelvic inflammation (46% vs. 79%) and pain (79% vs. 43%), respectively. On the other hand, the rate of having one or more gynecological problems ranges from 7.1% for women with no mental illness or sleep disorder to 20.6% for women with schizophrenia. Understanding the association between gynecological problems, mental illness and sleep disorders can help clinicians more effectively identify and treat patients.
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Affiliation(s)
- Ray M Merrill
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - Dajeong Song
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT, USA
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Nikolić T, Bogosavljević MV, Stojković T, Kanazir S, Lončarević-Vasiljković N, Radonjić NV, Popić J, Petronijević N. Effects of Antipsychotics on the Hypothalamus-Pituitary-Adrenal Axis in a Phencyclidine Animal Model of Schizophrenia. Cells 2024; 13:1425. [PMID: 39272997 PMCID: PMC11394463 DOI: 10.3390/cells13171425] [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: 07/19/2024] [Revised: 08/16/2024] [Accepted: 08/21/2024] [Indexed: 09/15/2024] Open
Abstract
Schizophrenia (SCH) is a mental disorder that requires long-term antipsychotic treatment. SCH patients are thought to have an increased sensitivity to stress. The dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, observed in SCH, could include altered levels of glucocorticoids, glucocorticoid receptors (GRs), and associated proteins. The perinatal administration of phencyclidine (PCP) to rodents represents an animal model of SCH. This study investigated the effects of perinatal PCP exposure and subsequent haloperidol/clozapine treatment on corticosterone levels measured by ELISA and the expression of GR-related proteins (GR, pGR, HSP70, HSP90, FKBP51, and 11β-Hydroxysteroid dehydrogenase-11β-HSD) determined by Western blot, in different brain regions of adult rats. Six groups of male rats were treated on the 2nd, 6th, 9th, and 12th postnatal days (PN), with either PCP or saline. Subsequently, one saline and one PCP group received haloperidol/clozapine from PN day 35 to PN day 100. The results showed altered GR sensitivity in the rat brain after PCP exposure, which decreased after haloperidol/clozapine treatment. These findings highlight disturbances in the HPA axis in a PCP-induced model of SCH and the potential protective effects of antipsychotics. To the best of our knowledge, this is the first study to investigate the effects of antipsychotic drugs on the HPA axis in a PCP animal model of SCH.
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Affiliation(s)
- Tatjana Nikolić
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | | | - Tihomir Stojković
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Selma Kanazir
- Department of Neurobiology, Institute for Biological Research, University of Belgrade, 11000 Belgrade, Serbia
| | - Nataša Lončarević-Vasiljković
- iNOVA4Health, NOVA Medical School|Faculdade Ciências Médicas, NMS|FCM, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 1169-056 Lisbon, Portugal
| | - Nevena V Radonjić
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Jelena Popić
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 0G4, Canada
| | - Nataša Petronijević
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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Hill M, Velíková M, Hovorková T, Bulant J, Janšáková K, Valeš K. Steroidomics in Men with Schizophrenia. Int J Mol Sci 2024; 25:8729. [PMID: 39201417 PMCID: PMC11354902 DOI: 10.3390/ijms25168729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/29/2024] [Accepted: 08/02/2024] [Indexed: 09/02/2024] Open
Abstract
Schizophrenia is associated with numerous abnormalities, including imbalances in all hormonal axes, among which steroids play a major role. Steroidomic studies therefore represent a promising tool for early diagnosis and appropriate treatment of schizophrenia. A total of 51 adult male schizophrenics aged 27 (22, 34) years (shown as median with quartiles) and 16 healthy controls (HCs) aged 28 (25, 32) years were enrolled into this study. Our results showed the effective differentiation of men with schizophrenia from controls based on steroidomic profiles. We also found an altered metabolic pathway from pregnenolone and its sulfate (PREG/S) to cortisol in schizophrenics with several metabolic bottlenecks such as lower PREG levels due to increased PREG sulfation and/or suppressed PREGS desulfation and attenuated conversion of 17-hydroxy-PREG to 17-hydroxy-progesterone, as well as the results suggestive of suppressed CYP11B1 activity. In contrast, steroid molar ratios suggested two counterregulatory steps involving increased conversion of PREG/S to 17-hydroxy-PREG/S and decreased conversion of cortisol to cortisone, which may maintain unchanged basal cortisol levels but may not ensure a sufficient cortisol response to stress. Our data also indicated a trend to higher 7α-, 7β-, and 16α-hydroxylation that may counteract the autoimmune complications and proinflammatory processes accompanying schizophrenia. Finally, a possible suppression of HSD17B3 activity was suggested, resulting in decreased circulating testosterone levels with increased androstenedione levels.
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Affiliation(s)
- Martin Hill
- Department of Steroids and Proteofactors, Institute of Endocrinology, Narodni 139/8, 110 00 Prague, Czech Republic; (M.V.); (T.H.); (J.B.)
| | - Marta Velíková
- Department of Steroids and Proteofactors, Institute of Endocrinology, Narodni 139/8, 110 00 Prague, Czech Republic; (M.V.); (T.H.); (J.B.)
| | - Tereza Hovorková
- Department of Steroids and Proteofactors, Institute of Endocrinology, Narodni 139/8, 110 00 Prague, Czech Republic; (M.V.); (T.H.); (J.B.)
| | - Josef Bulant
- Department of Steroids and Proteofactors, Institute of Endocrinology, Narodni 139/8, 110 00 Prague, Czech Republic; (M.V.); (T.H.); (J.B.)
| | - Katarína Janšáková
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, 811 08 Bratislava, Slovakia;
| | - Karel Valeš
- National Institute of Mental Health, Topolova 748, 250 67 Klecany, Czech Republic;
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, 100 00 Prague, Czech Republic
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Fukutomi M, Carlson BA. Coordinated changes in sensorimotor integration underlie behavioral change through evolution and plasticity: A case study in weakly electric mormyrid fish. Sci Prog 2024; 107:368504241269438. [PMID: 39106354 PMCID: PMC11307337 DOI: 10.1177/00368504241269438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Affiliation(s)
- Matasaburo Fukutomi
- Division of Biology, Department of Biological Sciences, School of Science, Hokkaido University, Sapporo, Japan
| | - Bruce A Carlson
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
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Komuro J, Kaneko H, Suzuki Y, Okada A, Fujiu K, Takeda N, Jo T, Morita H, Senoo K, Node K, Yasunaga H, Ieda M, Komuro I. Sex Differences in the Relationship Between Schizophrenia and the Development of Cardiovascular Disease. J Am Heart Assoc 2024; 13:e032625. [PMID: 38411545 PMCID: PMC10944025 DOI: 10.1161/jaha.123.032625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/11/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND There are few data on sex differences in the association between schizophrenia and the development of cardiovascular disease (CVD). We sought to clarify the relationship of schizophrenia with the risk of developing CVDs and to explore the potential modification effect of sex differences. METHODS AND RESULTS We conducted a retrospective analysis using the JMDC Claims Database between 2005 and 2022. The study population included 4 124 508 individuals aged 18 to 75 years without a history of CVD or renal replacement therapy. The primary end point is defined as a composite end point that includes myocardial infarction, angina pectoris, stroke, heart failure, atrial fibrillation, and pulmonary thromboembolism. During a mean follow-up of 1288±1001 days, we observed 182 158 composite end points. We found a significant relationship of schizophrenia with a greater risk of developing composite CVD events in both men and women, with a stronger association observed in women. The hazard ratio for the composite end point was 1.63 (95% CI, 1.52-1.74) in women and 1.42 (95% CI, 1.33-1.52) in men after multivariable adjustment (P for interaction=0.0049). This sex-specific difference in the association between schizophrenia and incident CVD was consistent for angina pectoris, heart failure, and atrial fibrillation. CONCLUSIONS Our analysis using a large-scale epidemiologic cohort demonstrated that the association between schizophrenia and subsequent CVD events was more pronounced in women than in men, suggesting the clinical importance of addressing schizophrenia and tailoring the CVD prevention strategy based on sex-specific factors.
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Affiliation(s)
- Jin Komuro
- The Department of Cardiovascular MedicineThe University of TokyoTokyoJapan
- Department of CardiologyKeio University School of MedicineTokyoJapan
| | - Hidehiro Kaneko
- The Department of Cardiovascular MedicineThe University of TokyoTokyoJapan
- The Department of Advanced CardiologyThe University of TokyoTokyoJapan
| | - Yuta Suzuki
- The Department of Cardiovascular MedicineThe University of TokyoTokyoJapan
- Center for Outcomes Research and Economic Evaluation for HealthNational Institute of Public HealthSaitamaJapan
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle‐Related Diseases, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Katsuhito Fujiu
- The Department of Cardiovascular MedicineThe University of TokyoTokyoJapan
- The Department of Advanced CardiologyThe University of TokyoTokyoJapan
| | - Norifumi Takeda
- The Department of Cardiovascular MedicineThe University of TokyoTokyoJapan
| | - Taisuke Jo
- The Department of Health Services ResearchThe University of TokyoTokyoJapan
| | - Hiroyuki Morita
- The Department of Cardiovascular MedicineThe University of TokyoTokyoJapan
| | - Keitaro Senoo
- Department of Cardiac Arrhythmia Research and Innovation, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
- Department of Cardiovascular Medicine, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Koichi Node
- Department of Cardiovascular MedicineSaga UniversitySagaJapan
| | - Hideo Yasunaga
- The Department of Clinical Epidemiology and Health Economics, School of Public HealthThe University of TokyoTokyoJapan
| | - Masaki Ieda
- Department of CardiologyKeio University School of MedicineTokyoJapan
| | - Issei Komuro
- The Department of Cardiovascular MedicineThe University of TokyoTokyoJapan
- International University of Health and WelfareTokyoJapan
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Holter KM, Lekander AD, Pierce BE, Sands LP, Gould RW. Use of Quantitative Electroencephalography to Inform Age- and Sex-Related Differences in NMDA Receptor Function Following MK-801 Administration. Pharmaceuticals (Basel) 2024; 17:237. [PMID: 38399452 PMCID: PMC10892193 DOI: 10.3390/ph17020237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Sex- and age-related differences in symptom prevalence and severity have been widely reported in patients with schizophrenia, yet the underlying mechanisms contributing to these differences are not well understood. N-methyl-D-aspartate (NMDA) receptor hypofunction contributes to schizophrenia pathology, and preclinical models often use NMDA receptor antagonists, including MK-801, to model all symptom clusters. Quantitative electroencephalography (qEEG) represents a translational approach to measure neuronal activity, identify targetable biomarkers in neuropsychiatric disorders and evaluate possible treatments. Abnormalities in gamma power have been reported in patients with schizophrenia and correspond to psychosis and cognitive impairment. Further, as gamma power reflects cortical glutamate and GABA signaling, it is highly sensitive to changes in NMDA receptor function, and NMDA receptor antagonists aberrantly increase gamma power in rodents and humans. To evaluate the role of sex and age on NMDA receptor function, MK-801 (0.03-0.3 mg/kg, SC) was administered to 3- and 9-month-old male and female Sprague-Dawley rats that were implanted with wireless EEG transmitters to measure cortical brain function. MK-801-induced elevations in gamma power were observed in 3-month-old male and female and 9-month-old male rats. In contrast, 9-month-old female rats demonstrated blunted maximal elevations across a wide dose range. Importantly, MK-801-induced hyperlocomotor effects, a common behavioral screen used to examine antipsychotic-like activity, were similar across all groups. Overall, sex-by-age-related differences in gamma power support using qEEG as a translational tool to evaluate pathological progression and predict treatment response across a heterogeneous population.
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Affiliation(s)
| | | | | | | | - Robert W. Gould
- Department of Translational Neuroscience, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (K.M.H.)
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Palacios-Hernández B, Ramírez-Alvarado G, Téllez-Alanís B, Lino-González AL, Penagos-Rivera M, Hernández-Galván A. Hormones, psychotic disorders, and cognition in perinatal women: a mini review. Front Psychiatry 2024; 14:1296638. [PMID: 38250263 PMCID: PMC10797067 DOI: 10.3389/fpsyt.2023.1296638] [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: 09/19/2023] [Accepted: 12/04/2023] [Indexed: 01/23/2024] Open
Abstract
Previous scientific evidence has shown a relationship between hormones and the onset and relapse of perinatal psychotic disorders (PPD) in women during pregnancy, childbirth, and the postpartum period. In healthy women the interaction between hormones and cognitive changes has been confirmed mainly in memory, attention, and executive function during pregnancy and postpartum, which respond to adaptive demands related to parenting tasks. In women with psychotic episodes there is a significant impairment in several cognitive functions, but studies of the perinatal period are limited. The objective of this mini review is to analyze the main findings to identify whether hormonal changes interact with the onset of PPD and cognitive impairment in perinatal women. The studies included samples of women with psychosis, risk of developing psychosis, bipolar psychosis, schizoaffective psychosis, and psychotic symptoms, during pregnancy and postpartum. Findings contributed to knowledge about five hypotheses regarding the relationship between hormones in the perinatal period and the appearance of PPD. Nevertheless, this review did not find reports of evidence of a relationship between hormonal production and cognitive function among women with clinically diagnosed PPD, suggesting a research gap. Clinical implications of assessing hormonal production and cognitive function in PPD are discussed. Although the evidence identified is scarce and heterogeneous, the findings call for further research with clinical samples on the role of hormones in perinatal psychotic disorders, especially as they relate to the study of cognition. This will promote more consistent evidence and understanding of PPD etiopathology that can guide early and effective multidisciplinary interventions.
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Affiliation(s)
- Bruma Palacios-Hernández
- Cuerpo Académico “Cognición y Afectos” (UAEMor CA-81), Centro de Investigación Transdisciplinar en Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
| | - Gabriela Ramírez-Alvarado
- Escuela de Estudios Superiores del Jicarero, Universidad Autónoma del Estado de Morelos, Jojutla de Juárez, Mexico
| | - Bernarda Téllez-Alanís
- Cuerpo Académico “Cognición y Afectos” (UAEMor CA-81), Centro de Investigación Transdisciplinar en Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
- Facultad de Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
| | - Ana Luisa Lino-González
- Cuerpo Académico “Cognición y Afectos” (UAEMor CA-81), Centro de Investigación Transdisciplinar en Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
- Investigación Biomédica Neurociencias Clínica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Tlalpan, Mexico
| | - Miriam Penagos-Rivera
- Cuerpo Académico “Cognición y Afectos” (UAEMor CA-81), Centro de Investigación Transdisciplinar en Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
| | - Adela Hernández-Galván
- Cuerpo Académico “Cognición y Afectos” (UAEMor CA-81), Centro de Investigación Transdisciplinar en Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
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Xiu M, Hao M, Liu C, Sun M, Lang X. Glucose Metabolism and Sex Hormones in Male Patients with Medication-naïve First-episode Schizophrenia: A Large-scale Cross-sectional Study. Curr Neuropharmacol 2024; 22:2263-2270. [PMID: 38549523 PMCID: PMC11337684 DOI: 10.2174/1570159x22666240212141602] [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: 10/17/2023] [Revised: 11/23/2023] [Accepted: 12/17/2023] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Schizophrenia (SCZ) usually begins in early adult life. The underlying molecular mechanisms of SCZ remain unclear. There is evidence for the involvement of abnormalities in metabolic and endocrine systems in SCZ, even in drug-naïve first-episode schizophrenia patients (DNFES). However, the association between impaired regulation of glucose metabolism and sex hormones was not studied in SCZ. This study aimed to evaluate the interrelationship between sex hormones and high fasting glucose levels in male DNFES patients. METHODS A total of 99 patients with SCZ were recruited, and fasting glucose, fasting insulin, the insulin resistance index (HOMA-IR), and sex hormones were measured. RESULTS We found that some male patients with SCZ had abnormal levels in glucose metabolism parameters and gonadal hormones that were not within the normal range. Linear regression analysis adjusted for age, waist circumference, and body mass index showed that testosterone levels were negatively associated with fasting insulin in male patients (β = -0.21, t = -2.2, p = 0.03). CONCLUSION Our findings confirm the abnormalities in glucose metabolism parameters and gonadal hormones at the onset of the illness in male DNFES patients with SCZ. In addition, there was an interaction effect between abnormal glucose metabolism and sex hormones in male patients.
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Affiliation(s)
- Meihong Xiu
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Meng Hao
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Cai Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Maodi Sun
- North University of China, Taiyuan, China
| | - Xiaoe Lang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
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Abstract
Hormonal fluctuations in the perimenopause are associated with an array of physical and psychological symptoms. Those with pre-existing mental disorders may experience changes to their symptoms and response to treatment during the perimenopausal and postmenopausal periods and may also be at risk of poorer longer-term physical health outcomes in menopause. The transition towards menopause may be compounded by the oestradiol-suppressing effect of many psychotropics on the hypothalamopituitary-gonadal axis. A collaborative approach between primary care and secondary mental health services is an opportunity for proactive discussion of symptoms and support with management of the perimenopause. This may involve lifestyle measures and/or hormone replacement therapy, which can both lead to improvements in well-being and mental and physical health.
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Frota IJ, de Oliveira ALB, De Lima DN, Costa Filho CWL, Menezes CEDS, Soares MVR, Chaves Filho AJM, Lós DB, Moreira RTDA, Viana GDA, Campos EDM, Vasconcelos SMM, Seeman MV, Macêdo DS, Sanders LLO. Decrease in cognitive performance and increase of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios with higher doses of antipsychotics in women with schizophrenia: a cross-sectional study. BMC Psychiatry 2023; 23:558. [PMID: 37532985 PMCID: PMC10394759 DOI: 10.1186/s12888-023-05050-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/24/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND We explored the relationship between symptoms, cognitive performance, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) (three markers of inflammation), and antipsychotic dose (in chlorpromazine units) in male and female patients with schizophrenia. METHODS We conducted a cross-sectional analysis in patients with schizophrenia of the complete blood count and the results of neuropsychological testing, using the Welch t-test to compare groups and the Pearson test for correlations. RESULTS We found that the NLR and the PLR are higher among women with schizophrenia when compared with men. In women, the NLR and the PLR correlate positively with antipsychotic drug dose and inversely with a working memory test (Direct Digit Span). Higher doses of antipsychotics are associated with worse working and semantic memory and mental flexibility in the women in our sample. CONCLUSION Higher doses of antipsychotics were associated with worse working and semantic memory and mental flexibility in women with schizophrenia. No such correlations were present in men, suggesting that, in female patients, cognitive performance deteriorates as the antipsychotic dose is increased, a finding that could be mediated by inflammatory mechanisms, given the demonstrated relationship to biomarkers of inflammation - e.g., the NLR and the PLR. TRIAL REGISTRATION NCT03788759 (ClinicalTrials.gov).
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Affiliation(s)
- Ilgner Justa Frota
- Neuropsychopharmacology and Translational Psychiatry Laboratory, Drug Research and Development Center, Faculty of Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo, 1000 - Rodolfo Teófilo, Fortaleza, CE, Postal Code 60430-275, Brazil.
| | - Alissandra Lima Barbosa de Oliveira
- Neuropsychopharmacology and Translational Psychiatry Laboratory, Drug Research and Development Center, Faculty of Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo, 1000 - Rodolfo Teófilo, Fortaleza, CE, Postal Code 60430-275, Brazil
| | - David Nunes De Lima
- Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | | | | | - Michelle Verde Ramo Soares
- Neuropsychopharmacology and Translational Psychiatry Laboratory, Drug Research and Development Center, Faculty of Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo, 1000 - Rodolfo Teófilo, Fortaleza, CE, Postal Code 60430-275, Brazil
| | - Adriano José Maia Chaves Filho
- Neuropsychopharmacology and Translational Psychiatry Laboratory, Drug Research and Development Center, Faculty of Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo, 1000 - Rodolfo Teófilo, Fortaleza, CE, Postal Code 60430-275, Brazil
| | - Deniele Bezerra Lós
- Neuropsychopharmacology and Translational Psychiatry Laboratory, Drug Research and Development Center, Faculty of Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo, 1000 - Rodolfo Teófilo, Fortaleza, CE, Postal Code 60430-275, Brazil
| | - Roberta Tavares de Araújo Moreira
- Neuropsychopharmacology and Translational Psychiatry Laboratory, Drug Research and Development Center, Faculty of Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo, 1000 - Rodolfo Teófilo, Fortaleza, CE, Postal Code 60430-275, Brazil
| | - Glautemberg de Almeida Viana
- Laboratory of Clinical and Toxicological Analysis, Department of Pharmacy, Federal University of Ceará, Fortaleza, Brazil
| | - Eugênio de Moura Campos
- Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Silvânia Maria Mendes Vasconcelos
- Neuropsychopharmacology and Translational Psychiatry Laboratory, Drug Research and Development Center, Faculty of Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo, 1000 - Rodolfo Teófilo, Fortaleza, CE, Postal Code 60430-275, Brazil
| | - Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Danielle S Macêdo
- Neuropsychopharmacology and Translational Psychiatry Laboratory, Drug Research and Development Center, Faculty of Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo, 1000 - Rodolfo Teófilo, Fortaleza, CE, Postal Code 60430-275, Brazil
| | - Lia Lira Olivier Sanders
- Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
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DuMont M, Agostinis A, Singh K, Swan E, Buttle Y, Tropea D. Sex representation in neurodegenerative and psychiatric disorders' preclinical and clinical studies. Neurobiol Dis 2023:106214. [PMID: 37385457 DOI: 10.1016/j.nbd.2023.106214] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/10/2023] [Accepted: 06/26/2023] [Indexed: 07/01/2023] Open
Abstract
Many studies show the importance of biological sex for the onset, progression, and response to treatment in brain disorders. In line with these reports, health agencies have requested that all trials, both at the clinical and preclinical level, use a similar number of male and female subjects to correctly interpret the results. Despite these guidelines, many studies still tend to be unbalanced in the use of male and female subjects. In this review we consider three neurodegenerative disorders: Alzheimer's disease, Parkinson's disease, Amyotrophic lateral sclerosis, and three psychiatric disorders: Depression, Attention Deficit Hyperactivity Disorder, and Schizophrenia. These disorders were chosen because of their prevalence and their recognized sex-specific differences in onset, progression, and response to treatment. Alzheimer's disease and Depression demonstrate higher prevalence in females, whereas Parkinson's Disease, Amyotrophic lateral sclerosis, Attention Deficit Hyperactivity Disorder, and schizophrenia show higher prevalence in males. Results from preclinical and clinical studies examining each of these disorders revealed sex-specific differences in risk factors, diagnostic biomarkers, and treatment response and efficacy, suggesting a role for sex-specific therapies in neurodegenerative and neuropsychiatric disorders. However, the qualitative analysis of the percentage of males and females enrolled in clinical trials in the last two decades shows that for most of the disorders, there is still a sex bias in the patients' enrolment.
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Affiliation(s)
- Mieke DuMont
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Kiran Singh
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Evan Swan
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Yvonne Buttle
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Daniela Tropea
- Department of Psychiatry and Trinity Translational Medicine Institute (TTMI), Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Dublin, Ireland; FutureNeuro, the SFI Research Centre for Chronic and Rare Neurological Diseases.
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Tiwari S, Prasad R, Wanjari MB, Sharma R. Understanding the Impact of Menopause on Women With Schizophrenia-Spectrum Disorders: A Comprehensive Review. Cureus 2023; 15:e37979. [PMID: 37223185 PMCID: PMC10202668 DOI: 10.7759/cureus.37979] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/22/2023] [Indexed: 05/25/2023] Open
Abstract
Menopause is a physiological event in women's lives that typically transpires in midlife, denoting the cessation of ovarian function and ultimately leading to the end of reproductive capacity. However, women with schizophrenia-spectrum disorders may encounter unique challenges during this period because of the interaction between hormonal changes and their pre-existing mental health conditions. This literature review aims to investigate the consequences of menopause on women with schizophrenia-spectrum disorders, including modifications in symptomatology, cognitive function, and quality of life. Potential interventions will also be examined, including hormone replacement therapy and psychosocial support. The study findings suggest that menopause can worsen symptoms, such as hallucinations and delusions, and may also impair cognitive function, resulting in memory and executive function difficulties. Nevertheless, hormone replacement therapy and psychosocial support could offer potential avenues to manage symptoms and improve the quality of life for women with schizophrenia-spectrum disorders during menopause.
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Affiliation(s)
- Swasti Tiwari
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Roshan Prasad
- Medicine and Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mayur B Wanjari
- Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ranjana Sharma
- Medical Surgical Nursing, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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13
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Chen Z, Li X, Cui X, Zhang L, Liu Q, Lu Y, Wang X, Shi H, Ding M, Yang Y, Li W, Lv L. Association of CTNND2 gene polymorphism with schizophrenia: Two-sample case-control study in Chinese Han population. Int J Psychiatry Med 2023:912174231164669. [PMID: 36930964 DOI: 10.1177/00912174231164669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
OBJECTIVES Genetic factors play an important role in the etiology of schizophrenia (SZ). Catenin Delta 2 (CTNND2) is one of the genes regulating neuronal development in the brain. It is unclear whether CTNND2 is involved in SZ. With the hypothesis that CTNND2 may be a risk gene for SZ, we performed a case-control association analysis to investigate if CTNND2 gene single nucleotide polymorphisms (SNPs) are implicated in SZ in a Han Chinese northern population. MATERIALS AND METHODS We recruited subjects from 2010 to 2022 from the Han population of northern Henan and divided them into two case-control samples, including a discovery sample (SZ = 528 and control = 528) and replication sample (SZ = 2458 and control = 6914). Twenty-one SNPs were genotyped on the Illumina BeadStation 500G platform using GoldenGate technology and analyzed by PLINK. Positive and Negative Syndrome Scale (PANSS) was used to assess clinical symptoms. RESULTS Rs16901943, rs7733427, and rs2168878 SNPs were associated with SZ (Chi2 = 7.484, 11.576, and 5.391, respectively, df = 1; p = 0.006, 0.00067, and 0.02, respectively) in two samples. Rs10058868 was associated with SZ in male patients in the discovery sample (Chi2 = 6.264, df = 1, p = .044). Only rs7733427 survived Bonferroni correction. Linkage disequilibrium block three haplotypes were associated with SZ in the discovery and total sample. PANSS analysis of the four SNPs implicated rs10058868 and rs2168878 with symptoms of depression and excitement, respectively, in the SZ patients. CONCLUSION Four SNPs were identified as being correlated with SZ. The CTNND2 gene may be involved in susceptibility to SZ.
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Affiliation(s)
- Zhaonian Chen
- 34727The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Xiaojing Li
- 34727The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Xiangzheng Cui
- 34727The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Luwen Zhang
- 34727The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Qing Liu
- 34727The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Yanli Lu
- 34727The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Xiujuan Wang
- 34727The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Han Shi
- 34727The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Minli Ding
- 34727The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Yongfeng Yang
- 34727The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Wenqiang Li
- 34727The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Luxian Lv
- 34727The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
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14
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Exploring a Possible Interplay between Schizophrenia, Oxytocin, and Estrogens: A Narrative Review. Brain Sci 2023; 13:brainsci13030461. [PMID: 36979271 PMCID: PMC10046503 DOI: 10.3390/brainsci13030461] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
Schizophrenia is characterized by symptoms of psychosis and sociocognitive deficits. Considering oxytocin’s antipsychotic and prosocial properties, numerous clinical, and preclinical studies have explored the neuropeptide’s therapeutic efficacy. Sex differences in the clinical course of schizophrenia, as well as in oxytocin-mediated behaviors, indicate the involvement of gonadal steroid hormones. The current narrative review aimed to explore empirical evidence on the interplay between schizophrenia psychopathology and oxytocin’s therapeutic potential in consideration of female gonadal steroid interactions, with a focus on estrogens. The review was conducted using the PubMed and PsychINFO databases and conforms to the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines. The results suggest a potential synergistic effect of the combined antipsychotic effect of oxytocin and neuroprotective effect of estrogen on schizophrenia. Consideration of typical menstrual cycle-related hormonal changes is warranted and further research is needed to confirm this assumption.
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15
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Bakola M, Peritogiannis V, Stuckler D, Kitsou KS, Gourzis P, Hyphantis T, Jelastopulu E. Who is coercively admitted to psychiatric wards? Epidemiological analysis of inpatient records of involuntary psychiatric admissions to a University General Hospital in Greece for the years 2008-2017. Int J Soc Psychiatry 2023; 69:267-276. [PMID: 35232289 DOI: 10.1177/00207640221081793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Involuntary psychiatric admissions are a widely used practice despite ethical concerns about coercion. There are particular concerns that vulnerable groups, such as single, unemployed or racial minorities, may be more subjected to such practices. AIM We aimed to investigate the social patterns of involuntary psychiatric admissions from 2008 to 2017 at University General Hospital in Ioannina, Greece. METHOD We retrospectively assessed inpatient records from 2008 to 2017 of patients admitted to the Department of Psychiatry of the Ioannina University General Hospital, Northwestern Greece. Alternative patients of alternative years were selected for inclusion; this yielded 332 patients involuntarily admitted, corresponding to 28.5% of total involuntary psychiatric admissions. RESULTS Over the 10-year period, the overall numbers of annual involuntary psychiatric admissions remained relatively stable, as did the length of hospital stay (mean = 23.8 days). The most common disorder upon admission was schizophrenia spectrum disorders, accounting for approximately two-thirds of all admissions, followed by mood disorders (about 20%). There was evidence that people who lacked social support or experienced financial hardship were more greatly represented among those admitted: 70.2% of admitted patients were single and 64.8% were unemployed. Most patients had been admitted to the psychiatric ward in the past (64.2%). CONCLUSION Our study indicates potentially worrisome evidence that patients who are in vulnerable positions are at elevated likelihood of being involuntarily admitted to psychiatric wards. Future research is needed to evaluate the socio-demographic patterning of involuntary admissions in other European countries.
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Affiliation(s)
- Maria Bakola
- Postgraduate Program of Public Health, Medical School, University of Patras, Greece
| | - Vaios Peritogiannis
- Mobile Mental Health Unit of the Prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece
| | - David Stuckler
- Department of Social and Political Sciences, University of Bocconi, Milan, Italy
| | | | - Philippos Gourzis
- Department of Psychiatry, Medical School, University of Patras, Greece
| | - Thomas Hyphantis
- Department of Psychiatry, Division of Medicine, School of Health Sciences, University of Ioannina, Greece
| | - Eleni Jelastopulu
- Department of Public Health, Medical School, University of Patras, Greece
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16
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Review of Male and Female Care Needs in Schizophrenia: A New Specialized Clinical Unit for Women. WOMEN 2023. [DOI: 10.3390/women3010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Women with schizophrenia require health interventions that differ, in many ways, from those of men. The aim of this paper is to review male and female care needs and describe a newly established care unit for the treatment of women with schizophrenia. After reviewing the literature on the differentiated needs of men and women with schizophrenia, we describe the new unit’s assessment, intervention, and evaluation measures. The program consists of (1) individual/group patient/family therapy, (2) therapeutic drug monitoring and adherence checks, (3) perinatal mental health, (4) medical liaison, (5) suicide prevention/intervention, (6) social services with special focus on parenting, domestic abuse, and sexual exploitation, (7) home-based services, (8) peer support, (9) occupational therapies (physical activity and leisure programs), and (10) psychoeducation for both patients and families. Still in the planning stage are quality evaluation of diagnostic assessment, personalized care, drug optimization, health screening (reproductive health, metabolic syndrome, cardiovascular health, cancer, menopausal status), and patient and family satisfaction with services provided. Woman-specific care represents an important resource that promises to deliver state-of-the-art treatment to women and, ideally, prevent mental illness in their offspring.
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17
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Witt KM, Harper DN, Ellenbroek BA. Dopamine D1 receptor and effort-based decision making in rats: The moderating effect of sex. Prog Neuropsychopharmacol Biol Psychiatry 2023; 120:110651. [PMID: 36191805 DOI: 10.1016/j.pnpbp.2022.110651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/18/2022]
Abstract
Dopamine is a modulating factor in effort-based decision-making, and emerging evidence from pharmacological research suggests that the dopamine D1 receptor is the primary regulator. Given the limited selectivity of pharmacological tools, we further explored this hypothesis using dopamine D1 mutant (DAD1-/-) rats which have a specific genetic reduction in functional D1 receptors. Moreover, given the strong focus on males in neuroscience research in general and in the role of D1 receptors in effort-based learning, we compared both sexes in the present study. Adult male and female DAD1-/- mutant rats and wild type controls were trained to press a lever for a reinforcer. Once trained, subjects completed multiple fixed ratio, progressive ratio, and operant effort-choice (concurrent progressive ratio/chow feeding task [PROG/chow]) experiments. We predicted that DAD1-/- mutant rats would press the lever significantly less than controls across all experiments, have lower breakpoints, and consume more freely available food. As predicted, DAD1-/- mutant rats (regardless of sex) pressed the lever significantly less than controls and had lower breakpoints. Interestingly, there was a sex * genotype interaction for acquisition rates of lever pressing and change in breakpoints with free food available. Only 31% of DAD1-/- mutant males acquired lever pressing while 73% of DAD1-/- mutant females acquired lever pressing. Additionally, DAD1-/- mutant males had significantly larger decreases in breakpoints when free food was available. These findings extend the pharmacological research suggesting that the dopamine D1 receptor modulates decisions based on effort, which has implications for the development of treatment targeting amotivation in neuropsychiatric disorders. The sex * genotype interaction highlights the importance of including both sexes in future research, especially when there are sex differences in incidences and severity of neuropsychiatric disorders.
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Affiliation(s)
- Kate M Witt
- Behavioural Neurogenetics Group, Victoria University of Wellington, PO Box 600, Wellington, New Zealand
| | - David N Harper
- Behavioural Neurogenetics Group, Victoria University of Wellington, PO Box 600, Wellington, New Zealand
| | - Bart A Ellenbroek
- Behavioural Neurogenetics Group, Victoria University of Wellington, PO Box 600, Wellington, New Zealand.
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18
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Fišar Z. Biological hypotheses, risk factors, and biomarkers of schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2023; 120:110626. [PMID: 36055561 DOI: 10.1016/j.pnpbp.2022.110626] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 12/19/2022]
Abstract
Both the discovery of biomarkers of schizophrenia and the verification of biological hypotheses of schizophrenia are an essential part of the process of understanding the etiology of this mental disorder. Schizophrenia has long been considered a neurodevelopmental disease whose symptoms are caused by impaired synaptic signal transduction and brain neuroplasticity. Both the onset and chronic course of schizophrenia are associated with risk factors-induced disruption of brain function and the establishment of a new homeostatic setpoint characterized by biomarkers. Different risk factors and biomarkers can converge to the same symptoms of schizophrenia, suggesting that the primary cause of the disease can be highly individual. Schizophrenia-related biomarkers include measurable biochemical changes induced by stress (elevated allostatic load), mitochondrial dysfunction, neuroinflammation, oxidative and nitrosative stress, and circadian rhythm disturbances. Here is a summary of selected valid biological hypotheses of schizophrenia formulated based on risk factors and biomarkers, neurodevelopment, neuroplasticity, brain chemistry, and antipsychotic medication. The integrative neurodevelopmental-vulnerability-neurochemical model is based on current knowledge of the neurobiology of the onset and progression of the disease and the effects of antipsychotics and psychotomimetics and reflects the complex and multifactorial nature of schizophrenia.
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Affiliation(s)
- Zdeněk Fišar
- Charles University and General University Hospital in Prague, First Faculty of Medicine, Department of Psychiatry, Czech Republic.
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19
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Avramescu RG, Flores C. We're not in Kansas anymore: ectopic dopaminergic terminals as an explanation for the positive symptoms in psychiatric pathology. J Psychiatry Neurosci 2023; 48:E74-E77. [PMID: 36810305 PMCID: PMC9949873 DOI: 10.1503/jpn.230015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Affiliation(s)
- Radu Gabriel Avramescu
- From the Douglas Mental Health University Institute, Montréal, Que., Canada (Avramescu, Flores); and the Department of Psychiatry and Department of Neurology and Neurosurgery, McGill University, Montréal, Que., Canada (Flores)
| | - Cecilia Flores
- From the Douglas Mental Health University Institute, Montréal, Que., Canada (Avramescu, Flores); and the Department of Psychiatry and Department of Neurology and Neurosurgery, McGill University, Montréal, Que., Canada (Flores)
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20
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Johansen IT, Steen NE, Rødevand L, Werner MCF, Lunding SH, Hjell G, Ormerod MBEG, Agartz I, Melle I, Lagerberg TV, Nerhus M, Andreassen OA. Sex-specific associations between metabolic hormones, severe mental disorders and antipsychotic treatment. Psychoneuroendocrinology 2022; 146:105927. [PMID: 36152455 DOI: 10.1016/j.psyneuen.2022.105927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/03/2022] [Accepted: 09/12/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Metabolic dysregulation has been associated with severe mental disorders (SMD) and with antipsychotic (AP) treatment, but the role of sex is unknown. To identify possible sex-related processes linked to SMD and AP treatment, we investigated sex differences in associations between hormones involved in metabolic regulation in patients with SMD compared to healthy controls (HC) and AP treatment. METHODS We included patients with SMD (N = 1753) and HC (N = 1194) and measured hormones involved in metabolic regulation (insulin, cortisol, thyroid-stimulating hormone (TSH), thyroxine, leptin, adiponectin, testosterone, sex hormone-binding globulin (SHBG), prolactin). Patients were grouped according to use of first-generation AP (N = 163), second-generation AP (N = 1087) or no use of AP (N = 503). Hormones were used one by one as dependent variables in multiple regression analyses with interactions between sex and SMD patients versus HC, and between sex and AP treatment, followed by analyses in males and females separately. RESULTS We found significant interactions between sex and SMD patients versus HC for testosterone, SHBG and adiponectin, with significantly higher testosterone and lower adiponectin levels in females. Furthermore, we found significant interaction between sex and AP groups for TSH, testosterone and insulin, with significantly lower TSH levels in AP-treated females, and lower testosterone and higher insulin levels in AP-treated males. CONCLUSIONS Our findings suggest sex differences in metabolic hormones related to both SMD and AP treatment, indicating sex-dependent mechanisms. Clinicians should be aware of potential sex-specific metabolic changes during AP treatment and experimental studies are warranted to clarify the underlying mechanisms.
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Affiliation(s)
- Ingrid T Johansen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Nils Eiel Steen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn Rødevand
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Maren C F Werner
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Synve H Lunding
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gabriela Hjell
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry, Ostfold Hospital, Graalum, Norway
| | - Monica B E G Ormerod
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institute & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trine V Lagerberg
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mari Nerhus
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Akershus University Hospital, Division of Mental Health Services, Department for Special Psychiatry, Lorenskog, Norway
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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21
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Nolan LN, Hughes L. Premenstrual exacerbation of mental health disorders: a systematic review of prospective studies. Arch Womens Ment Health 2022; 25:831-852. [PMID: 35867164 DOI: 10.1007/s00737-022-01246-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/12/2022] [Indexed: 11/29/2022]
Abstract
Mental health disorders can be exacerbated during periods of hormonal fluctuation (e.g. pregnancy, menopause), and the risk factors for sensitivity to these fluctuations are similar to those of mental disorders (e.g. trauma). However, the extent to which hormonal fluctuations during the menstrual cycle impact symptoms of preexisting mental disorders remains unclear. Prospective methodology is considered the gold standard for measuring symptoms across the menstrual cycle. Thus, the aim of the review was to address this knowledge gap by summarising all available studies prospectively measuring symptoms of mental disorders across the menstrual cycle. A systematic review with narrative synthesis was conducted; meta-analysis was precluded due to methodological heterogeneity of included studies. Electronic databases MEDLINE, Embase, PyschINFO and CINAHL were systematically searched from inception. Risk of bias for individual studies was assessed using a modified version of the Newcastle-Ottawa Scale. The search identified 629 studies from which 35 met inclusion criteria. There was clear evidence of symptom exacerbation during the perimenstrual phase for psychotic disorders, panic disorder, eating disorders, depression and borderline personality disorder. Less consistent evidence was found for anxiety, and a different pattern of symptom exacerbation was observed in bipolar disorder. Sample size and methodology varied considerably amongst studies. Overall, there was mixed evidence for perimenstrual exacerbation across mental disorders, which could be partly explained by methodological limitations of the studies. However, hormonal fluctuations during the menstrual cycle may exacerbate psychiatric symptoms in a subgroup of individuals who are hormone sensitive.
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Affiliation(s)
| | - Liz Hughes
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
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22
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Sex and gender differences in symptoms of early psychosis: a systematic review and meta-analysis. Arch Womens Ment Health 2022; 25:679-691. [PMID: 35748930 DOI: 10.1007/s00737-022-01247-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/12/2022] [Indexed: 11/02/2022]
Abstract
First-episode psychosis (FEP) can be quite variable in clinical presentation, and both sex and gender may account for some of this variability. Prior literature on sex or gender differences in symptoms of psychosis have been inconclusive, and a comprehensive summary of evidence on the early course of illness is lacking. The objective of this study was to conduct a systematic review and meta-analysis of the literature to summarize prior evidence on the sex and gender differences in the symptoms of early psychosis. We conducted an electronic database search (MEDLINE, Scopus, PsycINFO, and CINAHL) from 1990 to present to identify quantitative studies focused on sex or gender differences in the symptoms of early psychosis. We used random effects models to compute pooled standardized mean differences (SMD) and risk ratios (RR), with 95% confidence intervals (CI), for a range of symptoms. Thirty-five studies met the inclusion criteria for the systematic review, and 30 studies were included in the meta-analysis. All studies examined sex differences. Men experienced more severe negative symptoms (SMD = - 0.15, 95%CI = - 0.21, - 0.09), whereas women experienced more severe depressive symptoms (SMD = 0.21, 95%CI = 0.14, 0.27) and had higher functioning (SMD = 0.16, 95%CI = 0.10, 0.23). Women also had a lower prevalence of substance use issues (RR = 0.65, 95%CI = 0.61, 0.69). Symptoms of early psychosis varied between men and women; however, we were limited in our ability to differentiate between biological sex and gender factors. These findings may help to inform early detection and intervention efforts to better account for sex and gender differences in early psychosis presentation.
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23
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Markers of Schizophrenia—A Critical Narrative Update. J Clin Med 2022; 11:jcm11143964. [PMID: 35887728 PMCID: PMC9323796 DOI: 10.3390/jcm11143964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/17/2022] Open
Abstract
Schizophrenia is a long-term mental disease, associated with functional impairment. Therefore, it is important to make an accurate diagnosis and implement the proper treatment. Biomarkers may be a potential tool for these purposes. Regarding advances in biomarker studies in psychosis, the current symptom-based criteria seem to be no longer sufficient in clinical settings. This narrative review describes biomarkers of psychosis focusing on the biochemical (peripheral and central), neurophysiological, neuropsychological and neuroimaging findings as well as the multimodal approach related with them. Endophenotype markers (especially neuropsychological and occulomotor disturbances) can be currently used in a clinical settings, whereas neuroimaging glutamate/glutamine and D2/D3 receptor density changes, as well as immunological Th2 and PRL levels, seem to be potential biomarkers that need further accuracy tests. When searching for biochemical/immunological markers in the diagnosis of psychosis, the appropriate time of body fluid collection needs to be considered to minimize the influence of the stress axis on their concentrations. In schizophrenia diagnostics, a multimodal approach seems to be highly recommended.
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24
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Samandra R, Haque ZZ, Rosa MGP, Mansouri FA. The marmoset as a model for investigating the neural basis of social cognition in health and disease. Neurosci Biobehav Rev 2022; 138:104692. [PMID: 35569579 DOI: 10.1016/j.neubiorev.2022.104692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 01/23/2023]
Abstract
Social-cognitive processes facilitate the use of environmental cues to understand others, and to be understood by others. Animal models provide vital insights into the neural underpinning of social behaviours. To understand social cognition at even deeper behavioural, cognitive, neural, and molecular levels, we need to develop more representative study models, which allow testing of novel hypotheses using human-relevant cognitive tasks. Due to their cooperative breeding system and relatively small size, common marmosets (Callithrix jacchus) offer a promising translational model for such endeavours. In addition to having social behavioural patterns and group dynamics analogous to those of humans, marmosets have cortical brain areas relevant for the mechanistic analysis of human social cognition, albeit in simplified form. Thus, they are likely suitable animal models for deciphering the physiological processes, connectivity and molecular mechanisms supporting advanced cognitive functions. Here, we review findings emerging from marmoset social and behavioural studies, which have already provided significant insights into executive, motivational, social, and emotional dysfunction associated with neurological and psychiatric disorders.
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Affiliation(s)
- Ranshikha Samandra
- Cognitive Neuroscience Laboratory, Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
| | - Zakia Z Haque
- Cognitive Neuroscience Laboratory, Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
| | - Marcello G P Rosa
- Department of Physiology and Neuroscience Program, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia; ARC Centre for Integrative Brain Function, Monash University, Australia.
| | - Farshad Alizadeh Mansouri
- Cognitive Neuroscience Laboratory, Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia; ARC Centre for Integrative Brain Function, Monash University, Australia.
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25
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Influence of Menstrual Cycle Length and Age at Menarche on Symptoms, Cognition, Social Cognition, and Metacognition in Patients with First-Episode Psychosis. WOMEN 2022. [DOI: 10.3390/women2020015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A protective effect has traditionally been attributed to estrogen in psychotic disorders. The aim of this study was to investigate cumulative lifetime estrogen by assessing the menstrual cycle length, age at menarche, and years of difference between the onset of psychotic symptoms and the age of menarche, measuring their effects on symptoms, cognition, social cognition, and metacognition. As it was not possible to directly measure cumulative estrogen levels over the lifetime of a patient, the study sample was composed of 42 women with first-episode psychosis; estrogen levels were inferred by the menstrual cycle length, age at menarche, and years of difference between the onset of psychotic symptoms and menarche. All patients were assessed with a battery of questionnaires using the BDI, PSYRATS, PANSS, STROOP, TAVEC, WSCT, IPSAQ, and BCIS questionnaires. The results related to menstrual cycle length showed a relationship with memory; specifically, shorter cycles with semantic strategies (p = 0.046) and longer cycles with serial strategies in the short term (p = 0.005) as well as in the long term (p = 0.031). The results also showed a relationship with perseverative errors (p = 0.035) and self-certainty (p = 0.049). Only personalized bias (p = 0.030) was found to be significant in relation to the age at menarche. When analyzing the differences in years of difference between the age at menarche and the onset of psychotic symptoms, the results indicated lower scores in women with a smaller difference between both events in memory (short-term (p = 0.050), long-term (p = 0.024), intrusions (p = 0.013), and recognition (p = 0.043)) and non-perseverative errors (p = 0.024). No relationship was found between symptoms and menstrual characteristics. The investigatory outcomes seem to indicate a relationship between estrogen cumulative effects and the memory domain. More in-depth investigations in the field are necessary in order to improve personalized treatment in women with psychosis.
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Rhoades R, Solomon S, Johnson C, Teng S. Impact of SARS-CoV-2 on Host Factors Involved in Mental Disorders. Front Microbiol 2022; 13:845559. [PMID: 35444632 PMCID: PMC9014212 DOI: 10.3389/fmicb.2022.845559] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Abstract
COVID-19, caused by SARS-CoV-2, is a systemic illness due to its multiorgan effects in patients. The disease has a detrimental impact on respiratory and cardiovascular systems. One early symptom of infection is anosmia or lack of smell; this implicates the involvement of the olfactory bulb in COVID-19 disease and provides a route into the central nervous system. However, little is known about how SARS-CoV-2 affects neurological or psychological symptoms. SARS-CoV-2 exploits host receptors that converge on pathways that impact psychological symptoms. This systemic review discusses the ways involved by coronavirus infection and their impact on mental health disorders. We begin by briefly introducing the history of coronaviruses, followed by an overview of the essential proteins to viral entry. Then, we discuss the downstream effects of viral entry on host proteins. Finally, we review the literature on host factors that are known to play critical roles in neuropsychiatric symptoms and mental diseases and discuss how COVID-19 could impact mental health globally. Our review details the host factors and pathways involved in the cellular mechanisms, such as systemic inflammation, that play a significant role in the development of neuropsychological symptoms stemming from COVID-19 infection.
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Affiliation(s)
- Raina Rhoades
- Department of Biology, Howard University, Washington, DC, United States
| | - Sarah Solomon
- Department of Biology, Howard University, Washington, DC, United States
| | - Christina Johnson
- Department of Biology, Howard University, Washington, DC, United States
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27
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Dion-Albert L, Bandeira Binder L, Daigle B, Hong-Minh A, Lebel M, Menard C. Sex differences in the blood-brain barrier: Implications for mental health. Front Neuroendocrinol 2022; 65:100989. [PMID: 35271863 DOI: 10.1016/j.yfrne.2022.100989] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/07/2022] [Accepted: 02/19/2022] [Indexed: 12/13/2022]
Abstract
Prevalence of mental disorders, including major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SZ) are increasing at alarming rates in our societies. Growing evidence points toward major sex differences in these conditions, and high rates of treatment resistance support the need to consider novel biological mechanisms outside of neuronal function to gain mechanistic insights that could lead to innovative therapies. Blood-brain barrier alterations have been reported in MDD, BD and SZ. Here, we provide an overview of sex-specific immune, endocrine, vascular and transcriptional-mediated changes that could affect neurovascular integrity and possibly contribute to the pathogenesis of mental disorders. We also identify pitfalls in current literature and highlight promising vascular biomarkers. Better understanding of how these adaptations can contribute to mental health status is essential not only in the context of MDD, BD and SZ but also cardiovascular diseases and stroke which are associated with higher prevalence of these conditions.
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Affiliation(s)
- Laurence Dion-Albert
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada
| | - Luisa Bandeira Binder
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada
| | - Beatrice Daigle
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada
| | - Amandine Hong-Minh
- Smurfit Institute of Genetics, Trinity College Dublin, Lincoln Place Gate, Dublin 2, Ireland
| | - Manon Lebel
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada
| | - Caroline Menard
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada.
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Ferrer-Quintero M, Fernández D, López-Carrilero R, Birulés I, Barajas A, Lorente-Rovira E, Luengo A, Díaz-Cutraro L, Verdaguer M, García-Mieres H, Gutiérrez-Zotes A, Grasa E, Pousa E, Huerta-Ramos E, Pélaez T, Barrigón ML, Gómez-Benito J, González-Higueras F, Ruiz-Delgado I, Cid J, Moritz S, Sevilla-Llewellyn-Jones J, Ochoa S. Males and females with first episode psychosis present distinct profiles of social cognition and metacognition. Eur Arch Psychiatry Clin Neurosci 2022; 272:1169-1181. [PMID: 35802165 PMCID: PMC9508015 DOI: 10.1007/s00406-022-01438-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/23/2022] [Indexed: 12/01/2022]
Abstract
Deficits in social cognition and metacognition impact the course of psychosis. Sex differences in social cognition and metacognition could explain heterogeneity in psychosis. 174 (58 females) patients with first-episode psychosis completed a clinical, neuropsychological, social cognitive, and metacognitive assessment. Subsequent latent profile analysis split by sex yielded two clusters common to both sexes (a Homogeneous group, 53% and 79.3%, and an Indecisive group, 18.3% and 8.6% of males and females, respectively), a specific male profile characterized by presenting jumping to conclusions (28.7%) and a specific female profile characterized by cognitive biases (12.1%). Males and females in the homogeneous profile seem to have a more benign course of illness. Males with jumping to conclusions had more clinical symptoms and more neuropsychological deficits. Females with cognitive biases were younger and had lower self-esteem. These results suggest that males and females may benefit from specific targeted treatment and highlights the need to consider sex when planning interventions.
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Affiliation(s)
- M. Ferrer-Quintero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Departament de Psicologia Social I Psicologia Quantitativa, Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - D. Fernández
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain ,Fundació Sant Joan de Déu, Esplugues de Llobregat Barcelona, Spain ,Serra Húnter Fellow. Department of Statistics and Operations Research (DEIO), Universitat Politècnica de Catalunya BarcelonaTech (UPC), Barcelona, 08028 Spain ,Institute of Mathematics of UPC - BarcelonaTech (IMTech), Universitat Politècnica de Catalunya, Barcelona, 08028 Spain
| | - R. López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain ,Fundació Sant Joan de Déu, Esplugues de Llobregat Barcelona, Spain
| | - I. Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Departament de Psicologia Social I Psicologia Quantitativa, Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain
| | - A. Barajas
- Departament de Psicologia, Facultat de Psicologia Clínica I de La Salut. Serra Hunter Fellow, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Barcelona, Spain ,Department of Research, Centre d’Higiene Mental Les Corts, Barcelona, Spain
| | - E. Lorente-Rovira
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain ,Psychiatry Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - A. Luengo
- Psychiatry Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - L. Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,COMSAL research group, FPCEE, Blanquerna Ramon Llull University, Barcelona, Spain
| | - M. Verdaguer
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Departament de Psicologia, Facultat de Psicologia Clínica I de La Salut. Serra Hunter Fellow, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Barcelona, Spain ,Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - H. García-Mieres
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - A. Gutiérrez-Zotes
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain ,Hospital Universitari Institut Pere Mata, Institut d’Investigació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, Reus, Spain
| | - E. Grasa
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain ,Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - E. Pousa
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain ,Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain ,Salut Mental Parc Taulí. Sabadell (Barcelona), Hospital Universitari–UAB Universitat Autònoma de Barcelona, Barcelona, Spain ,Neuropsiquiatria I Addicions, Hospital del Mar. IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - E. Huerta-Ramos
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - T. Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - M. L. Barrigón
- Departament of Psychiatry, University Hospital Virgen del Rocio, Seville, Spain ,Psychiatry Service, Area de Gestión Sanitaria Sur Granada, Motril, Granada, Spain
| | - J. Gómez-Benito
- Departament de Psicologia Social I Psicologia Quantitativa, Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain , GEIMAC, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | | | - I. Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Malaga Norte, Malaga, Spain
| | - J. Cid
- Mental Health and Addiction Research Group. IdiBGi. Institut d’Assistencia Sanitària, Girona, Spain
| | - S. Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - J. Sevilla-Llewellyn-Jones
- Institute of Psychiatry and Mental Health, Health Research Institute (IdISSC), Clinico San Carlos Hospital, Madrid, Spain
| | | | - S. Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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González-Rodríguez A, Monreal Ortiz JA. COVID-19 and physical health of women with severe mental illness. MEDICINA CLÍNICA (ENGLISH EDITION) 2022; 158:24-26. [PMID: 34901444 PMCID: PMC8648614 DOI: 10.1016/j.medcle.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Fisher VL, Ortiz LS, Powers AR. A computational lens on menopause-associated psychosis. Front Psychiatry 2022; 13:906796. [PMID: 35990063 PMCID: PMC9381820 DOI: 10.3389/fpsyt.2022.906796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/07/2022] [Indexed: 11/21/2022] Open
Abstract
Psychotic episodes are debilitating disease states that can cause extreme distress and impair functioning. There are sex differences that drive the onset of these episodes. One difference is that, in addition to a risk period in adolescence and early adulthood, women approaching the menopause transition experience a second period of risk for new-onset psychosis. One leading hypothesis explaining this menopause-associated psychosis (MAP) is that estrogen decline in menopause removes a protective factor against processes that contribute to psychotic symptoms. However, the neural mechanisms connecting estrogen decline to these symptoms are still not well understood. Using the tools of computational psychiatry, links have been proposed between symptom presentation and potential algorithmic and biological correlates. These models connect changes in signaling with symptom formation by evaluating changes in information processing that are not easily observable (latent states). In this manuscript, we contextualize the observed effects of estrogen (decline) on neural pathways implicated in psychosis. We then propose how estrogen could drive changes in latent states giving rise to cognitive and psychotic symptoms associated with psychosis. Using computational frameworks to inform research in MAP may provide a systematic method for identifying patient-specific pathways driving symptoms and simultaneously refine models describing the pathogenesis of psychosis across all age groups.
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Affiliation(s)
- Victoria L Fisher
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States
| | - Liara S Ortiz
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States
| | - Albert R Powers
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States
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Psychosis in Women: Time for Personalized Treatment. J Pers Med 2021; 11:jpm11121279. [PMID: 34945748 PMCID: PMC8705671 DOI: 10.3390/jpm11121279] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/24/2021] [Accepted: 11/28/2021] [Indexed: 01/21/2023] Open
Abstract
Early detection and prompt treatment of psychosis is of the utmost importance. The great variability in clinical onset, illness course, and response to pharmacological and psychosocial treatment is in great part gender-related. Our aim has been to review narratively the literature focusing on gender related differences in the psychoses, i.e., schizophrenia spectrum disorders. We searched the PubMed/Medline, Scopus, Embase, and ScienceDirect databases on 31 July 2021, focusing on recent research regarding sex differences in early psychosis. Although women, compared to men, tend to have better overall functioning at psychotic symptom onset, they often present with more mood symptoms, may undergo misdiagnosis and delay in treatment and are at a higher risk for antipsychotic drug-induced metabolic and endocrine-induced side effects. Furthermore, women with schizophrenia spectrum disorders have more than double the odds of having physical comorbidities than men. Tailored treatment plans delivered by healthcare services should consider gender differences in patients with a diagnosis of psychosis, with a particular attention to early phases of disease in the context of the staging model of psychosis onset.
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Szeliga A, Stefanowski B, Meczekalski B, Snopek M, Kostrzak A, Smolarczyk R, Bala G, Duszewska A, Smolarczyk K, Maciejewska-Jeske M. Menopause in women with schizophrenia, schizoaffective disorder and bipolar disorder. Maturitas 2021; 152:57-62. [PMID: 34674808 DOI: 10.1016/j.maturitas.2021.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/28/2021] [Accepted: 07/06/2021] [Indexed: 01/07/2023]
Abstract
The transition to menopause, usually occurring between the ages of 40 and 55, is a time when women are particularly vulnerable. When preexisting mental illness is present, symptoms are often amplified during this period. Moreover, women with mental illnesses experience menopausal symptoms similarly to healthy women. In this narrative review we summarize the current data regarding menopause in women with schizophrenia, schizoaffective disorder, and bipolar disorder, as well as current standards of management and care. The management of chronic disease in women suffering from severe mental illness is also considered.
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Affiliation(s)
- Anna Szeliga
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Bogdan Stefanowski
- First Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland
| | - Blazej Meczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland.
| | - Milena Snopek
- First Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland
| | - Anna Kostrzak
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Roman Smolarczyk
- Department of Gynecological Endocrinology, Warsaw Medical University, 00-315 Warsaw, Poland
| | - Gregory Bala
- Appletree Medical Group, 2150 Robertson Rd., Ottawa, Ontario, Canada
| | - Anna Duszewska
- Division of Histology and Embryology, Department of Morphological Sciences, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, Warsaw, Poland
| | - Katarzyna Smolarczyk
- Department of Dermatology and Venereology, Medical University of Warsaw, Warsaw, Poland.
| | - Marzena Maciejewska-Jeske
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
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González-Rodríguez A, Monreal Ortiz JA. COVID-19 and physical health of women with severe mental illness. Med Clin (Barc) 2021; 158:24-26. [PMID: 34600715 PMCID: PMC8435368 DOI: 10.1016/j.medcli.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Alexandre González-Rodríguez
- Servicio de Salud Mental. Hospital Universitari Mútua de Terrassa. Fundació Docència i Recerca Mútua de Terrassa. Universidad de Barcelona (UB), Terrassa, Barcelona, España.
| | - José Antonio Monreal Ortiz
- Servicio de Salud Mental. Hospital Universitari Mútua de Terrassa. Fundació Docència i Recerca Mútua de Terrassa. Universidad de Barcelona (UB). Instituto de Neurociencias. UAB. CIBERSAM, Terrassa, Barcelona, España
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Juckel G, Manitz MP, Freund N, Gatermann S. Impact of Poly I:C induced maternal immune activation on offspring's gut microbiome diversity - Implications for schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110306. [PMID: 33745977 DOI: 10.1016/j.pnpbp.2021.110306] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/27/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
Background Immunopathological concepts have been intensively discussed for schizophrenia. The polyriboinosinic-polyribocytidylic (PolyI:C) mouse model has been well validated to invasively study this disease. The intestinal microbiome exhibits broad immunological and neuronal activities. The relevance of microbiome alterations in the PolyI:C model to human schizophrenia should be explored. Methods Feces of offspring from mice mothers, who were administered to PolyI:C or NaCl (controls) at ED 9, were collected at PND 30 and 180 (PolyI:C and control mice (N = 32 each; half males and females). This was analyzed for bacterial 16S ribosomal DNA (rDNA) using a gut microbiome polymerase chain reaction (PCR) microarray tool. Results Differences were found in species richness of microbiome between animals of different ages (PND 30 and 180), but also between offspring from PolyI:C vs. NaCl treated mothers. In female mice at PND 30, the abundance of Prevotellaceae and Porphyromonadaceae was lower and that of Lactobacillales was higher, whereas in male mice at the same time point the abundance of four families of the Firmicutes phylum (Clostridia vadinBB60 group, Clostridiales Family XIII, Ruminococcaceae and Erysipelotrichaceae) was increased relative to the control group. Limitations No further analyses of cell types or cytokines involved in autoimmune gut and brain processes. Conclusions These finding seem to be similar to microbiome disturbances in patients with schizophrenia. The differential bacterial findings at day 30 (i.e., similar to the prodromal phase in patients with schizophrenia) correspond to the tremendous activation of the immune system with a strong increase in microglial cells which might be responsible for neuroplasticity reduction in cortical areas in patients with schizophrenia.
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Affiliation(s)
- Georg Juckel
- Dept. of Psychiatry, LWL University Hospital, Ruhr University, Bochum, Germany.
| | - Marie-Pierre Manitz
- Dept. of Psychiatry, LWL University Hospital, Ruhr University, Bochum, Germany
| | - Nadja Freund
- Dept. of Psychiatry, LWL University Hospital, Ruhr University, Bochum, Germany
| | - Sören Gatermann
- Dept. of Psychiatry, LWL University Hospital, Ruhr University, Bochum, Germany
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Kheloui S, Rossi M, Jacmin-Park S, Larocque O, Vallée M, Kerr P, Bourdon O, Juster RP. Psychoneuroendocrine protocol to comprehensively study sexually dimorphic cognition. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 6:100050. [PMID: 35757359 PMCID: PMC9216706 DOI: 10.1016/j.cpnec.2021.100050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 12/23/2022] Open
Abstract
Background A large body of research provides evidence for sex differences in cognitive abilities. These sex differences stem from the interplay between biological sex (e.g., birth-assigned sex, sex hormones) and psychosocial gender (e.g., gender identity, gender-roles, sexual orientation). Literature remains rather mixed with regards to the magnitude of sex and gender effects on cognitive abilities and mental health. Growing evidence shows that sex hormone assessment combined with measures of psychosocial gender may be fundamental to comprehensively understand individual differences in sexually dimorphic cognitive abilities. Objectives This study protocol describes a sexually dimorphic cognitive battery to assess the influence of sex hormones on performance. In parallel, we aim to assess the inter-related effects that biological sex and psychosocial gender-based factors exert on cognition and mental health. Methods Our projected sample includes 180 adult participants who are at least 18 years old. Sub-groups will be recruited based on birth-assigned sex, gender identity, and sexual orientation. Biological measures will be collected via salivary samples throughout testing to include sex hormones (testosterone, estradiol and progesterone) and stress hormones (cortisol). Demographic and psychosocial variables will be measured through self-report questionnaires. Participants will be required to complete eight classic cognitive tasks that assess a variety of cognitive domains in a 2-h testing session. Results and future directions Results from this study provides unique insights into the correlates of cognitive sex differences and gender diversity. This will give us solid ground to further investigate these influences in clinical populations in which sex hormones and cognitive functioning are often altered. Cognition is modulated by multiple sex and gender factors. Cognitive abilities will be assessed among 180 adults representing diverse sexual orientations and gender identities. This protocol aims to nuance the effects of sex hormones in contrast to those of socio-cultural gender.
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Affiliation(s)
- Sarah Kheloui
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Mathias Rossi
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Silke Jacmin-Park
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Ophélie Larocque
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Morgan Vallée
- Department of Sociology, Université du Québec à Montréal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Philippe Kerr
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Olivier Bourdon
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Robert-Paul Juster
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
- Corresponding author. Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal Centre de recherche de l’Institut universitaire en santé mentale de Montréal 7331 Hochelaga Street, H1N 3V2, Montreal, Quebec, Canada.
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Abstract
Introduction: Most medical diagnoses present somewhat differently in men and women, more so at specific periods of life. Treatment effects may also differ. This is true for schizophrenia, where premorbid effects are experienced earlier in life in boys than in girls, and where symptoms and outcomes differ.Areas covered: This review does not cover all the differences that have been reported between men and women but, instead, focuses on the ones that carry important implications for clinical care: effective antipsychotic doses, medication side effects, symptom fluctuation due to hormonal levels, comorbidities, and women's requirements for prenatal, obstetric, postpartum, and parenting support.Expert opinion: Of consequence to schizophrenia, sex-biased genes, epigenetic modifications, and sex steroids all impact the structure and function of the brain. Furthermore, life experiences and social roles exert major sex-specific influences. The co-morbidities that accompany schizophrenia also affect men and women to different degrees. This review offers several examples of sex-specific intervention and concludes that gold standard treatment must look beyond symptoms and address all the physiologic, psychologic, and social role needs of men and women suffering from this psychiatric disorder.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Abstract
A first step towards personalized medicine is to consider whether, for some disorders, the safest and most effective treatment of women needs to differ from standard guideline recommendations developed on the basis of clinical trials conducted, for the most part, in men. A second step is to consider how women’s reproductive stages—pre-pubertal years, menstrual phases, pregnancy trimesters, lactation and postpartum periods, menopausal and postmenopausal/aging status—affect the optimal choice of treatment. This review focuses on these two steps in the treatment of psychosis, specifically schizophrenia. It discusses genetics, precursors and symptoms of schizophrenia, reproductive and associated ethical issues, antipsychotic drug response and adverse effects, substance abuse, victimization and perpetration of violence, and issues of immigration and of co-morbidity. The conclusions, while often based on clinical experience and theoretical considerations rather than strictly on the evidence of randomized controlled trials, are that clinical recommendations need to consider clinical and role differences that exist between men and women and make appropriate correction for age and reproductive status.
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