The role of immuno-inflammatory abnormalities in neuroprogression

Immuno-inflammatory dysfunction has become a well-consolidated contributor to mental illness pathophysiology. A consistent body of evidence supports the involvement of the immune system in symptomatic expression during acute episodes of severe mental illnesses, but also suggests that this system is involved in longitudinal trajectories of disease. Several explanations have been proposed as possible causes of immune-inflammatory abnormalities in severe mental illnesses, including genetic factors, environmental factors, and complex phenomena such as the premature ageing of the immune system (immunosenescence). Considering the heterogeneity in illness trajectories and the remarkable interindividual variation of immune parameters in individuals with mental illness, it is possible that, for each individual, a unique set of factors operates in a complex interaction of causative and moderator agents. A personalized approach to the role of inflammation in neuroprogression is probably the future for prevention and development of disease-modifying interventions.

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Acute Cerebellitis and Myeloradiculitis Associated With SARS-CoV-2 Infection in Common Variable Immunodeficiency—A Case Report

The Neurohospitalist ◽

10.1177/19418744211050215 ◽

2021 ◽

pp. 194187442110502

Author(s):

Hernan Nicolas Lemus ◽

Miryam Alkayyali ◽

Eonjung Kim ◽

Charlotte Cunnigham-Rundles ◽

Dewitt Pyburn ◽

...

Keyword(s):

Immune System ◽

Common Variable Immunodeficiency ◽

Clinical Course ◽

Adaptive Immune System ◽

Complex Interaction ◽

Cns Injury ◽

Adaptive Immune ◽

The Brain ◽

Common Variable

The role of the adaptive immune system in mediating COVID-19 is largely unknown. Therefore, it is difficult to predict the clinical course in patients with common variable immunodeficiency (CVID), a disease characterized by dysfunctional lymphocytes and impaired antibody production. We report a case of SARS-CoV-2 infection presenting as isolated neurological symptoms in a patient with CVID. The patient subsequently improved following steroids, intravenous immunoglobulin, and convalescent plasma (CP). The latter has been shown to be safe and efficacious in treating COVID-19 in patients with primary immunodeficiency. Recent data suggest that the mechanism of CNS injury in COVID-19 may be due to immunological dysregulation rather than direct viral-mediated injury. This case exemplifies the complex interaction between the brain, the immune system, and the SARS-CoV-2 virus.

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People Never See Us Living Well: An Appraisal of the Personal Stories About Mental Illness in a Prospective Print Media Sample

Australian & New Zealand Journal of Psychiatry ◽

10.1080/j.1440-1614.2005.01566.x ◽

2005 ◽

Vol 39 (4) ◽

pp. 281-287 ◽

Cited By ~ 32

Author(s):

R. G. Nairn ◽

J. H. Coverdale

Keyword(s):

Mental Illness ◽

Mass Media ◽

Mental Disorder ◽

Print Media ◽

Psychiatric Patients ◽

National Sample ◽

Mental Illnesses ◽

Living Well ◽

Personal Strengths

Objective: Having found no discussions of self-depictions offered by psychiatric patients in the mass media we sought such items in a prospective national sample of print media and analysed how those speakers portrayed themselves. Method: As part of a larger study of media depictions of mental illnesses in print media all items with any mental health or illness aspect that appeared in a New Zealand publication over a four-week period were collected. The resulting collection of 600 items ranged from news briefs to full-page newspaper articles. From that set we selected and analysed items in which a person identified as having been a psychiatric patient or as having a mental disorder was either quoted by the reporter who had interviewed them, or personally described their experiences. Employing both propositional analyses and discourse analysis we explored how the speakers were positioned and identified patterns or themes in their construction of living with a mental illness. Results: Only five articles (0.8%) met our criteria for a person with a mental disorder being reported directly. In those items the journalists had positioned the speakers as credible, expert sources who, in representing their lives and experiences, drew on five clusters of resources, that we titled: Ordinariness/Living Well; Vulnerability; Stigma; Crisis; and Disorder/ Treatment. Ordinariness/Living Well foregrounded the role of personal strengths in living well and in overcoming adversity, particularly that associated with being stigmatized. We identified that theme as central to the ways in which these speakers depicted themselves as recognizably human and understandable. Conclusion: The findings are preliminary but these depictions are different from those reported by most researchers. Unlike those depictions, these speakers provided accessible and recognizably human self-portrayals. That finding intensifies our concern that most researchers appear to be unaware that these consumer voices are largely absent from mass media depictions of mental illnesses.

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Forensic Psychiatry

10.1093/med/9780190610999.003.0017 ◽

2017 ◽

Author(s):

Sheku Magona ◽

Tara Straka

Keyword(s):

Mental Illness ◽

Justice System ◽

Mental Illnesses ◽

The Public ◽

People With Mental Illness ◽

Fitness To Stand Trial ◽

Criminal Procedure Law ◽

Serious Mental Illnesses ◽

Public Psychiatrists

Law enforcement, lawmakers, and the public are increasingly concerned about how people with mental illness are treated within the criminal justice system. This chapter focuses on the role of public psychiatrists in the provision of timely evaluation, expertise, and care for individuals in custody—particularly for individuals with serious mental illnesses. A case-based discussion illuminates important aspects of the legal and health care challenges facing individuals at the time of arrest, arraignment, incarceration, trial, and community re-entry. The chapter discusses mental hygiene law, criminal procedure law, advocacy, and the formation of policy with an emphasis on fitness to stand trial. Appropriate diversion of individuals with mental illness from incarceration, and its role in helping these individuals to achieve recovery, is explored in detail.

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Probiotics in Treatment of Viral Respiratory Infections and Neuroinflammatory Disorders

Molecules ◽

10.3390/molecules25214891 ◽

2020 ◽

Vol 25 (21) ◽

pp. 4891

Author(s):

Roghayeh Shahbazi ◽

Hamed Yasavoli-Sharahi ◽

Nawal Alsadi ◽

Nafissa Ismail ◽

Chantal Matar

Keyword(s):

Immune System ◽

Gut Microbiota ◽

Respiratory Infections ◽

Influenza Virus Infection ◽

Mental Illnesses ◽

Host Immune System ◽

Health Crisis ◽

Viral Respiratory Infections ◽

Viral Respiratory

Inflammation is a biological response to the activation of the immune system by various infectious or non-infectious agents, which may lead to tissue damage and various diseases. Gut commensal bacteria maintain a symbiotic relationship with the host and display a critical function in the homeostasis of the host immune system. Disturbance to the gut microbiota leads to immune dysfunction both locally and at distant sites, which causes inflammatory conditions not only in the intestine but also in the other organs such as lungs and brain, and may induce a disease state. Probiotics are well known to reinforce immunity and counteract inflammation by restoring symbiosis within the gut microbiota. As a result, probiotics protect against various diseases, including respiratory infections and neuroinflammatory disorders. A growing body of research supports the beneficial role of probiotics in lung and mental health through modulating the gut-lung and gut-brain axes. In the current paper, we discuss the potential role of probiotics in the treatment of viral respiratory infections, including the COVID-19 disease, as major public health crisis in 2020, and influenza virus infection, as well as treatment of neurological disorders like multiple sclerosis and other mental illnesses.

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The Role of the Immune System in Nevirapine-Induced Subclinical Liver Injury of a Rat Model

ISRN Pharmaceutics ◽

10.5402/2012/932542 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 8

Author(s):

Zanelle Bekker ◽

Andrew Walubo ◽

Jan B. du Plessis

Keyword(s):

Immune System ◽

Liver Injury ◽

Rat Model ◽

Chronic Phase ◽

Therapeutic Strategies ◽

Cell Swelling ◽

Sprague Dawley ◽

Immune Parameters ◽

Sprague Dawley Rats

In this study, the role of the immune system in nevirapine- (NVP-) induced subclinical liver injury was investigated by observing for changes of some immune parameters during the initial stages of NVP-induced hepatotoxicity in a rat model. In the acute phase, two test-groups of 10 Sprague-Dawley rats each were administered with bacterial lipopolysaccharide (LPS) or saline (S) intraperitoneally, followed by oral NVP, after which 5 rats from each group were sacrificed at 6 and 24 hours. For the chronic phase, two groups of 15 rats each received daily NVP, and on days 7, 14, and 21, five rats from each group were administered with either LPS or S, followed by that day’s NVP dose, and were sacrificed 24 hours later. NVP caused liver injury up to seven days and progressively increased IL-2 and IFN-γ levels and lymphocyte count over the 21 days. NVP-induced liver injury was characterized by apoptosis and degeneration changes, while, for LPS, it was cell swelling, leukostasis, and portal inflammation. Coadministration of NVP and LPS attenuated NVP-induced liver injury. In conclusion, the immune system is involved in NVP toxicity, and the LPS effects may lay the clue to development of therapeutic strategies against NVP-induced hepatotoxicity.

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Mental Illness and Amyloid: A Scoping Review of Scientific Evidence over the Last 10 Years (2011 to 2021)

Brain Sciences ◽

10.3390/brainsci11101352 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1352

Author(s):

Gianluca Pandolfo ◽

Fiammetta Iannuzzo ◽

Giovanni Genovese ◽

Antonio Bruno ◽

Giovanni Pioggia ◽

...

Keyword(s):

Mental Illness ◽

Cognitive Impairment ◽

Mental Disorders ◽

Psychiatric Patients ◽

Scientific Evidence ◽

Mental Illnesses ◽

Tau Proteins ◽

Amyloid A ◽

Amyloid Metabolism

Amyloid precursor protein and its derivates represent a central factor in the process of neurodegeneration in Alzheimer’s disease (AD). Since mental illnesses share with AD cognitive impairment, amyloid indicators have been used to explore the unknown pathophysiologic mechanisms underlining psychiatric illness. This work aims to compare the role of amyloid markers, together with tau proteins, among various mental disorders evaluating the possible role of altered amyloid metabolism in the onset and in the course of psychiatric diseases, considering the relationship with cognitive impairment in dementia. This review includes articles written in English, published between 1 January 2011 and 31 January 2021, which evaluated amyloid and tau proteins in psychiatric patients. After screening, 31 studies were included in the review. Results suggest that amyloid metabolism is altered in major psychiatric disorders and that it could be a marker of cognitive impairment. Nevertheless, the role of amyloid in mental diseases seems to be related to neurodevelopmental alteration as well as neurodegeneration processes, like in AD. The role of amyloid in the pathogenesis of mental disorders is still unknown. Amyloid should not be only considered as a marker of cognitive impairment in mental illness, but also for altered neurodevelopment.

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Inflammatory mechanisms, the immune system, and psychiatric illness

Landmark Papers in Psychiatry ◽

10.1093/med/9780198836506.003.0005 ◽

2020 ◽

pp. 81-98

Author(s):

Ozan Toy ◽

Emmalee Boyle ◽

Lynn E. DeLisi

Keyword(s):

Magnetic Resonance Imaging ◽

Mental Illness ◽

Immune System ◽

Psychiatric Illness ◽

Free Water ◽

Epidemiological Studies ◽

Mental Illnesses ◽

Post Mortem ◽

Free Water Content ◽

Magnetic Resonance Imaging Mri

The association between the immune system and mental illnesses has been studied extensively over the years. Specifically, inflammation or abnormalities in immune system factors have been linked to stress, depression, and schizophrenia. The incidence of schizophrenia has been observed to be increased following viral epidemics, and the presence of increased antibodies to viral and other infectious agents has been linked to the illness. In this chapter, the landmark studies supporting the association between inflammation and mental illness are cited, from the early epidemiological studies of viral epidemics, to searches in post-mortem brains for gliosis, to genetic predisposition, and, most recently, to direct evidence of inflammation by measurement of free-water content in magnetic resonance imaging (MRI). Ultimately, medications that restore the immune system may lead to improvement of the major psychiatric disorders.

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Driving, mental illness and the role of the psychiatrist

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700003505 ◽

1998 ◽

Vol 15 (2) ◽

pp. 49-51 ◽

Cited By ~ 5

Author(s):

Peter Elwood

Keyword(s):

Mental Illness ◽

Adverse Effects ◽

Psychotropic Medication ◽

Mentally Ill ◽

Psychiatric Patients ◽

Descriptive Study ◽

Mental Illnesses ◽

Fitness To Drive ◽

Legal Implications

AbstractObjectives: Drivers with certain mental illnesses are obliged by the Driver & Vehicle Licensing Authority (DVLA) to stop driving and to report their condition. This study aims to quantify the number of psychiatric patients failing to meet the DVLA standards of ‘fitness to drive’ and to record how frequently psychiatrists failed to advise patients of these standards.Method: In this prospective descriptive study, 10 psychiatrists reported by questionnaire the diagnosis and driving status of all patients encountered over a four week period. They recorded their advice given to patients failing to meet the DVLA criteria of ‘fitness to drive’ and advice given when prescribing psychotropic medication.Results: Of 297 patients, 123 (41%) were drivers. 19/123 (13%) of drivers failed to meet the DVLA standards of ‘fitness to drive’. In 9/19 of these cases the psychiatrist did not advise the patient in line with the DVLA guidelines. This was especially the case for alcohol related disorders. Of drivers 49% were prescribed psychotropic medication with potential adverse effects on driving.Conclusions: Driving amongst mentally ill patients appears commonplace. In this study, 13% of drivers were considered by the authorities to be unfit to drive. Psychiatrists frequently used their own judgement when advising patients regarding driving. This arguably contravenes doctors' responsibilities to patients and has potential legal implications for both the patient and psychiatrist.

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Methylated Spirits: Epigenetic Hypotheses of Psychiatric Disorders

CNS Spectrums ◽

10.1017/s1092852900000055 ◽

2010 ◽

Vol 15 (4) ◽

pp. 220-230 ◽

Cited By ~ 18

Author(s):

Stephen M. Stahl

Keyword(s):

Mental Illness ◽

Psychiatric Symptoms ◽

Molecular Switches ◽

Mental Illnesses ◽

Risk Genes ◽

Biochemical Processes ◽

Dna Coding ◽

Brain Circuits ◽

Classical Genetics

Our spirits may be regulated by the methylation of our genes. Methylation, acetylation, and other biochemical processes are the molecular switches for turning genes on and off. There is evidence now that certain behaviors, feelings, and psychiatric symptoms may be modified by turning various genes on or off. If classical genetics is the sequence of DNA that is inherited, then epigenetics is a parallel process determining whether a given gene (ie, a sequence of DNA coding for transcription) is expressed into its RNA or is silenced. Epigenetics is now entering psychiatry with the hypothesis that normal genes as well as risk genes can both contribute to a mental disorder. That is, it has long been hypothesized that when “abnormal” genes with an altered sequence of DNA are inherited as risk genes for a mental illness, these risk genes will make an abnormal gene product in neurons, contributing to inefficient information processing in various brain circuits and creating risk for developing a symptom of a mental illness. Now comes the role of epigenetic actions in mental illnesses.

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The Role of Psychiatrists and Muslim Faith Healers in Mental Health Issues

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v17i1.1037 ◽

2018 ◽

Vol 17 (1) ◽

Author(s):

Zul Azlin Razali ◽

M. Faiz Tahir

Keyword(s):

Mental Illness ◽

Group Discussion ◽

Traditional Healers ◽

Mental Illnesses ◽

Faith Healing ◽

Cultural Value ◽

Health Issues ◽

Islamic Medicine ◽

Religious Perspectives

Following the announcement of Traditional and Complementary Medicine Act 2013, Muslim faith healers are slowly gaining grounds to make their practice mainstream. One of the major characteristics of Muslim faith healers is the strong inclination to attribute mental illnesses to Jinn possession (demonic possession). Unlike other traditional healers, Muslim faith healers’ primary mode of treatment is Ruqyah, an incantation or generally considered as ‘Du’a or prayers. This article is a sharing by a psychiatrist who has been actively engaging with faith healers in order to understand the world of faith healing including the attitude and knowledge of both the healers and clients while attempting to educate them on modern psychiatry based on bio-psycho-socio-spiritual paradigm. The methodology: 1) Involvement in symposium, seminar and focused group discussion, either as participant or as speaker. 2) Collaborating with local spiritual leader to conduct workshop on mental illness in mosques. 3) Writing articles in scientific and popular publications with and without faith healers as the collaborators. 4) Appearing in radio advocating and discussing about the dilemma of mental illness issue from the religious perspectives, and 5) Participate in workshop conducted by Muslim faith healers. As a result, several issues come to the author’s attention. The divisions of Muslim faith healers are rather complicated, for example Malay traditional healers or bomoh should not be categorized in the same group as Muslim faith healers. The oft-quoted ‘Islamic Medicine’ is problematic in view that it is laced with elements of local cultural value and practice which are not necessarily authentically Islamic. Since Malays make up the biggest community in Malaysia, one has to differentiate between Islam and Muslim. Majority of Muslims misunderstood the term Ruqyah as a form of healing exclusively done by the Muslim faith healers. In conclusion, psychiatrists should engage more proactively with faith and spiritual healers in order to curb stigmatization and delay in seeking psychiatric care and treatment.

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