Neuroprotective effect of hesperidin and its combination with coenzyme Q10 on an animal model of ketamine-induced psychosis: behavioral changes, mitochondrial dysfunctions, and oxidative stress

Background Psychosis is a complex mental illness divided by positive symptoms, negative symptoms, and cognitive decline. Clinically available medicines are associated with some serious side effects which limit their use. Treatment with flavonoids has been associated with delayed onset and development, decreased risk, or increased improvement of various neuropsychiatric disorders including psychosis with negligible side effects. Therefore, the present study was aimed to investigate the protective effects of hesperidin (flavonoid) alone or its combination with coenzyme Q10 against ketamine-induced psychotic symptoms in mice. Results Ketamine (50 mg/kg, i.p.) was given for 21 days to induce psychosis in Laca mice of either sex. Locomotor activity and stereotypic behaviors, immobility duration (forced swim test), and increased transfer latency (elevated plus maze) were performed to test the effect of hesperidin (50 mg/kg, 100 mg/kg, 200 mg/kg, p.o.) and coenzyme Q10 (20 mg/kg, 40 mg/kg, p.o.) and combination of hesperidin + coenzyme Q10 followed by biochemical and mitochondrial complexes assays. For 21 days, ketamine (50 mg/kg, i.p.) administration significantly produced increased locomotor activity and stereotypic behaviors (positive symptoms), increased immobility duration (negative symptoms) and cognitive deficits (increases transfer latency) weakens oxidative defense and mitochondrial function. Further, 21 days’ administration of hesperidin and coenzyme Q10 significantly reversed the ketamine-induced psychotic behavioral changes and biochemical alterations and mitochondrial dysfunction in the discrete areas (prefrontal cortex and hippocampus) of mice brains. The potential effect of these drugs was comparable to olanzapine treatment. Moreover, the combination of hesperidin with coenzyme Q10 and or a combination of hesperidin + coenzyme Q10 + olanzapine treatment did not produce a significant effect compared to their per se effect in ketamine-treated animals. Conclusions The study revealed that hesperidin alone or in combination with coenzyme Q10 could reduce psychotic symptoms and improve mitochondrial functions and antioxidant systems in mice, suggesting neuroprotective effects against psychosis.

Psychosomatic symptoms in patients suffering from morphea

Objective. To study the features of psychosomatic pathology in patients with morphea.Materials and methods. We used the Symptom Check List-90 Revised (SCL-90-R) to assess patterns of phychological signs in 95 patients suffering from morphea. The control group included 30 respondents without the skin pathology.Results. The patients with morphea revealed higher values in the Global Severity Index (GSI), Positive Symptom Distress Index (PSDI), Positive Symptoms Total (PST). The group of the patients with morphea showed higher distress levels according to the somatization, obsessive and compulsive disorders, depression, anxiety scales.Conclusion. Patients with morphea have a wider range of psychosomatic symptoms. The prevalent characteristics of psychosomatic changes are somatization, obsessive and compulsive disorders, depression, anxiety.

Benefits of Social Contact in Individuals With Psychotic Symptoms: Do Closeness of the Contact and Empathic Skills Make the Difference?

Objectives: Social contact is known to be beneficial for humans’ mental health. Individuals with psychotic symptoms (PS) tend to show poorer social and interpersonal functioning. However, in this patient population, social contact may be crucial for their mental wellbeing and treatment success. Additionally, closeness of social contact (familiar versus less familiar others), rather than only the presence or absence of social contacts, may play an important role. Empathy may heighten the beneficial effects of social/close contact on mental health, facilitating interactions. We investigated the association between social contact and closeness of contact on mental health, defined as positive symptoms, positive affect and negative affect in PS and control participants, with empathy as a moderator.Methods: Participants were 16–30 years old. Information regarding social/close contact and mental health was obtained using the experience sampling method in individuals with PS (n = 29) and healthy controls (n = 28). Empathy was measured using a self-report questionnaire.Results: Social contact was associated with higher positive affect in the total sample. Contact with close as opposed to less close others was related to better mental health: It was associated with lower positive symptoms in the PS group, and with more positive affect in the total sample. Empathy moderated the association between closeness of contact and positive affect in the total sample, in which the combination of higher levels of empathy combined with the presence of close contact was associated with higher positive affect in the total sample. However, the direct association between empathy and positive affect was not significant per group of contact.Conclusion: The results suggest that social contact, but especially contact with a close other is important for mental health outcomes: Contact with close others is beneficial for positive affect in the total sample and for positive symptoms in individuals with PS.

Cigarette Smoking and Schizophrenia: Etiology, Clinical, Pharmacological, and Treatment Implications

Recent data suggests that the prevalence of smoking in schizophrenia remains high. While reports suggest that smoking increases the risk of developing schizophrenia, the potential causative role of smoking in this relationship needs further investigation. Smokers with schizophrenia are more likely to have more intense positive symptoms and lower cognitive function, but diminished intensity of extrapyramidal side effects than nonsmoking patients with schizophrenia. They were also more likely to exhibit aggressive behaviour compared to nonsmokers, which could suggest higher levels of baseline aggression. The significant cost associated with regular tobacco expenditure can detract from investment in key domains. Large-scale trials have shown that pharmacotherapy for smoking cessation is effective and does not worsen the risk of developing neuropsychiatric symptoms compared to placebo. Electronic cigarette use among schizophrenia patients is high, and there is emerging evidence supportive of its efficacy. Future improvements include large-scale trials assessing the utility, efficacy, and safety of electronic cigarettes in schizophrenia patients.

Interplay among positive and negative symptoms, neurocognition, social cognition, and functional outcome in clinically stable patients with schizophrenia: a network analysis

Background: Schizophrenia has a broad range of interrelated symptoms and impairment in functioning. The objective of the study was to explore the interplay between positive symptoms, negative symptoms, neurocognition, social cognition and functional outcome in patients with schizophrenia using network analysis. Methods: Participants were 64 clinically stable patients with schizophrenia. Psychopathologic, neurocognition, social cognition, and functional outcome were measured using the Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, Addenbrooke’s Cognitive Examination III, Faces test, Reading the Mind in the Eyes test, and Personal Social Performance scale. Results: The network analysis suggested that functional outcome was the most central in the network followed by avolition and asociality. Functioning was directly connected to avolition, asociality, blunted affect, neurocognition and emotion recognition. The positive symptoms were the most remote and therefore the least important node. Conclusion: The high centrality of functioning suggests the need for improving of everyday life skills for patients with schizophrenia. Moreover, treatment of specific negative symptoms, neurocognition and emotion recognition could also enhance functional outcome.

Schizophrenia Patients Show Largely Similar Salience Signaling Compared to Healthy Controls in an Observational Task Environment

Recent evidence suggests that the aberrant signaling of salience is associated with psychotic illness. Salience, however, can take many forms in task environments. For example, salience may refer to any of the following: (1) the valence of an outcome, (2) outcomes that are unexpected, called reward prediction errors (PEs), or (3) cues associated with uncertain outcomes. Here, we measure brain responses to different forms of salience in the context of a passive PE-signaling task, testing whether patients with schizophrenia (SZ) showed aberrant signaling of particular types of salience. We acquired event-related MRI data from 29 SZ patients and 23 controls during the performance of a passive outcome prediction task. Across groups, we found that the anterior insula and posterior parietal cortices were activated to multiple different types of salience, including PE magnitude and heightened levels of uncertainty. However, BOLD activation to salient events was not significantly different between patients and controls in many regions, including the insula, posterior parietal cortices, and default mode network nodes. Such results suggest that deficiencies in salience processing in SZ may not result from an impaired ability to signal salience per se, but instead the ability to use such signals to guide future actions. Notably, no between-group differences were observed in BOLD signal changes associated with PE-signaling in the striatum. However, positive symptom severity was found to significantly correlate with the magnitudes of salience contrasts in default mode network nodes. Our results suggest that, in an observational environment, SZ patients may show an intact ability to activate striatal and cortical regions to rewarding and non-rewarding salient events. Furthermore, reduced deactivation of a hypothesized default mode network node for SZ participants with high levels of positive symptoms, following salient events, point to abnormalities in interactions of the salience network with other brain networks, and their potential importance to positive symptoms.

Keberfungsian Keluarga Dalam Merawat Anggota Keluarga Dengan Skizofrenia: Literature Review

Schizophrenia is a confusing and disabling clinical syndrome. Mental illness and madness are popular stigmas that describe the psychological disorder of schizophrenia. The distance between the patients and society, in general, causes the stigma. In schizophrenia, there are or two symptoms, namely positive symptoms and negative symptoms. Positive symptoms include anything over the normal range. Negative symptoms include various behavioral deficits such as flat affect, asociality, and apathy. To analyze functions of the family in caring for family members with schizophrenia and characteristics of the families in a literature review. This research was a literature review research. The articles were from online databases, namely Google Scholar and PubMed. Five articles matched the research inclusion criteria. The analysis of the articles used the Hawker instrument. Among six dimensions of the family functioning from the five articles that have been reviewed in the literature, only the role dimension was stated to be a healthy dimension. The other five dimensions were declared unhealthy in the family functioning. The characteristics of family members obtained from the five articles are gender, marital status, education level. The most common gender is male. Most of the respondents are married. Most respondents are junior high school graduates. Based on the results, it can be concluded that family functioning is declared unhealthy. Only the role dimension is declared healthy in the functioning of the family. The other dimensions are declared unhealthy in the functioning of the family.Keywords: Family functioning, Family, Schizophrenia. AbstrakSkizofrenia salah satu sindrom klinis yang membingungkan dan melumpuhkan. Penyakit mental dan kegilaan stigma popular yang menggambarkan gangguan psikologis skizofrenia. Gejala dari skizofrenia yang jauh dari masyarakat pada umumnya menyebabkan stigma tersebut. Pada orang dengan gangguan skizofrenia terdapat atau dibagi menjadi dua gejala yaitu gejala positif dan gejala negatif. Gejala positif meliputi sesuatu yang berlebihan dari rentang normal dan gejala negatif meliputi berbagai deficit perilaku seperti afek datar, asosialitas dan sikap apatis. Menganalisis gambaran keberfungsian keluarga dalam merawat anggota keluarga dengan skizofrenia dan karakteristik keluarga dengan anggota keluarga skizofreniasecara literatur review. Penelitian ini adalah penelitian literature review. Hasil pencarian artikel dari database online yaitu gogle scholar dan Pubmed yang didapatkan 5 artikel yang sesuai dengan kriteria inklusi penelitian. Analisa telaah kritis terhadap 5 artikel menggunakan instrumen Hawker. Darikeenamdimensi dalam keberfungsian keluarga dari kelima artikel yang telah di literature review hanya dalam dimensi peran dinyatakan sehat dalam keberfungsian keluarga. Kelima dimensi lainnya dinyatakan tidak sehat dalam keberfungsian keluarga. Karakteristik anggota keluarga yang didapatkan dari 5 artikel yaitu jenis kelamin, status pernikahan, tingkat pendidikan. Jenis kelamin paling banyak yaitu laki-laki. Responden paling banyak responden berstatus sudah menikah. Responden paling banyak yaitu berpendidikan akhir SMP. Gambaran keberfungsian keluarga dalam merawat anggota keluarga dengan skizofrenia, berdasarkan dari hasil pembahasan dapat disimpulkan bahwa keberfungsian keluarga dinyatakan tidaksehat hasil literature review pada fungsi umum ke-5 artikel dinyatakan tidak sehat dalam keberfungsian keluarga, namun jika dilihat dari setiap dimensi dalam keberfungsian keluarga hanya pada dimensi peran yang dinyatakan sehat dalam keberfungsian keluarga, pada dimensi lainnya dinyatakan tidak sehat dalam keberfungsian keluarga.Kata kunci: Keberfungsian keluarga, Keluarga, Skizofrenia

Clinical and hospitalisation predictors of COVID-19 in the first month of the pandemic, Portugal

COVID-19 mainly presents as a respiratory disease with flu‐like symptoms, however, recent findings suggest that non-respiratory symptoms can occur early in the infection and cluster together in different groups in different regions. We collected surveillance data among COVID-19 suspected cases tested in mainland Portugal during the first wave of the pandemic, March-April 2020. A multivariable logistic-regression analysis was performed to ascertain the effects of age, sex, prior medical condition and symptoms on the likelihood of testing positive and hospitalisation. Of 25,926 COVID-19 suspected cases included in this study, 5,298 (20%) tested positive. Symptoms were grouped into ten clusters, of which two main ones: one with cough and fever and another with the remainder. There was a higher odds of a positive test with increasing age, myalgia and headache. The odds of being hospitalised increased with age, presence of fever, dyspnoea, or having a prior medical condition although these results varied by region. Presence of cough and other respiratory symptoms did not predict COVID-19 compared to non-COVID respiratory disease patients in any region. Dyspnoea was a strong determinant of hospitalisation, as well as fever and the presence of a prior medical condition, whereas these results varied by region.

PREDICTORS OF THERAPEUTIC RESPONSE AND LENGTH OF HOSPITALIZATION IN PATIENTS WITH SCHIZOPHRENIA DURING PHARMACOTHERAPY

Topicality. Search for scientifically based criteria for symptomatic remission and outcomes in schizophrenia is an urgent problem in modern psychiatry. Aim. To determine predictors of therapeutic response and duration of hospitalization during the course of psychopharmacotherapy in patients with schizophrenia. Material and methods. Clinical and metric examination using scales for assessing severity of positive (SAPS, PSYRATS, BABS) and negative (SANS, NSA-5) symptoms was performed in 157 patients with a diagnosis of schizophrenia twice: on admission to hospital and after the course of psychopharmacotherapy. The model for predicting therapeutic response was built using logistic regression, the model for predicting duration of hospitalization was built using linear regression using metrically justified criteria for achieving a significantly low level of severity of positive and negative symptoms as criteria for a significant therapeutic response. Results. The predictors were determined that increase and decrease likelihood of therapeutic response for scales for assessing positive and negative symptoms in patients with schizophrenia during the course of psychopharmacotherapy. Conclusions. Therapeutic response prediction models for scales for assessing the severity of positive symptoms and scales for the severity of negative symptoms are of good quality and high diagnostic value.