scholarly journals T174. ANTIPSYCHOTICS AND THE MICROBIOME

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S297-S298
Author(s):  
Anderson Chen ◽  
Taeyang Park ◽  
Kevin Li ◽  
Lynn Delisi

Abstract Background Gut microbial diversity is influenced by many factors including aging and environmental factors and it has an important implication on various physiologic functions and disease processes. Studying microbial communities and its diversity may be used as a predictor or biomarker for disease development. Methods In-depth literature review was conducted of literature within the last 5 years via database search of Pubmed, PsycInfo, EMBASE, and Google Scholar with Boolean combinations of the following keywords: antipsychotics AND (microbiome OR “metabolic syndrome”), microbiome AND (gender OR aging). Results 2,360 articles were initially retrieved. 27 articles remained after excluding for non-English articles and relevance. Notable findings include that patients treated with both risperidone and olanzapine have less diverse microbiomes with a higher ratio of Firmicutes to Bacteroidetes. Additionally, patients treated with olanzapine have been shown to have increased actinobacteria and increased ratio of Firmicutes to Bacteroidetes. The ratio of Firmicutes to Bacteroidetes correlates directly to the extent of olanzapine induced weight gain. Patients concurrently treated with olanzapine and antibiotics not only stopped weight gain but also reversed it. This has been a target of potential medication intervention, specifically focused on antagonism of histamine-1 and -3 receptors which is speculated to inhibit the askewed Firmicutes to Bacteroidetes ratio. Similarly, the gender differences in relative microbiome levels of Bacteroidetes are suspected to correlate to the increased olanzapine induced weight gain seen in women versus men. Additionally, patients with schizophrenia who were treated with Bifidobacterium breve A1, a probiotic supplement, showed improvements in their affective, positive, and negative symptoms. Discussion There is a large paucity of research into the relationship between the microbiome and psychotropic medications. This dynamic should be further studied within multiple populations to better understand the gut biome’s effects on psychiatric disorders.

1986 ◽  
Vol 1 (2) ◽  
pp. 108-122 ◽  
Author(s):  
Nancy C. Andreasen ◽  
William M. Grove

SummaryMost investigators concur that schizophrenia is probably a heterogeneous group of disorders that share the common features of psychotic symptoms, partial response to neuroleptics, and a relatively poor outcome. The subdivision of schizophrenia into two subtypes, positive versus negative, has achieved wide acceptance throughout the world during recent years. This distinction has heuristic and theoretical appeal because it unites phenomenology, pathophysiology, and etiology into a single comprehensive hypothesis.In spite of its wide appeal, the distinction has a number of problems. These include the failure to distinguish between symptom syndromes and diseases; failure to deal with the mixed patient; failure to take longitudinal course into account; and failure to address conceptually and methodologically the distinction between positive and negative symptoms.This paper focuses primarily on the conceptual basis for two instruments designed to measure positive and negative symptoms, the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS), originally described in 1982. Since their description, these scales have been used in a variety of other centers. These scales are based on the hypothesis that negative symptoms represent a deficit or diminution in normal psychological functions wliile positive symptoms represent an excess or distortion of normal functions. Reliability data are now available from Italy, Spain, and Japan which suggest that these scales can be used reliably in cultural settings outside the United States. The results of these studies are summarized in this paper. In addition, a replication study involving a new sample of 117 schizophrenics collected at the University of Iowa is described. In this second study of the SANS and SAPS, internal consistency is found to be quite high in the SANS. Thus negative symptoms appear to be more internally correlated with one another than are positive symptoms. The implications of this result are discussed. A principal components analysis is used to explore the relationship between positive and negative symptoms. While the study reported in 1982 suggested that positive and negative symptoms are negatively correlated, in the present study they appear to be uncorrelated. Overall, the results suggest that the SANS and SAPS are useful comprehensive instruments for the evaluation of positive and negative symptoms. The relationship between these symptoms and external validators such as cognitive functioning or CT scan abnormalities will be reported in a subsequent investigation.


2008 ◽  
Vol 38 (8) ◽  
pp. 1141-1146 ◽  
Author(s):  
P. Whitty ◽  
M. Clarke ◽  
O. McTigue ◽  
S. Browne ◽  
M. Kamali ◽  
...  

BackgroundThe outcome of schizophrenia appears to be more favourable than once thought. However, methodological issues, including the reliance on diagnosis at first presentation have limited the validity of outcome studies to date.MethodWe conducted a first-episode follow-up study of 97 patients with DSM-IV schizophrenia over the first 4 years of illness. First presentation and follow-up assessments were compared using paired t tests and a forced-entry regression analysis was used to determine prognostic variables.ResultsThere were significant improvements in positive and negative symptoms and global assessment of functioning between first presentation and follow-up. At first presentation, fewer negative symptoms (t=−3.40, p<0.01), more years spent in education (t=3.25, p<0.01), and a shorter duration of untreated psychosis (DUP) (t=−2.77, p<0.01) significantly predicted a better outcome at follow-up.ConclusionsThe outcome of schizophrenia may not be as pessimistic as once thought and most patients did not display a downward deteriorating course of illness. This study supports the relationship between DUP and outcome beyond the early stages of illness.


1996 ◽  
Vol 168 (6) ◽  
pp. 702-708 ◽  
Author(s):  
Owen Yuen ◽  
Michael P. Caligiuri ◽  
Richard Williams ◽  
Ruth A. Dickson

BackgroundControversy surrounds the relationship between tardive dyskinesia (TD) and symptoms of schizophrenia. While some studies reported that negative symptoms of schizophrenia may be a risk factor for TD, others reported a relationship between TD and positive symptoms.MethodEighty-four patients were studied, of whom 47 met criteria for TD. Clinical and instrumental procedures were used to increase the sensitivity of our assessments of the presence and severity of TD. Stepwise logistic and linear regression procedures were used to identify demographic variables, psychopathology, and motor parameters associated with the presence and severity of TD.ResultsA 3-factor model consisting of age, clinical tremor, and negative symptoms explained 25% of the variance in clinical TD severity. A 6-factor model consisting of female gender, instrumental and clinical measures of parkinsonism, positive, and negative symptoms explained 49% of the variance in severity of instrumentally derived dyskinesia.ConclusionsThese results suggest that the presence of TD may be associated with positive symptoms; that the severity of TD may be related to negative symptoms; and that the relationship between negative symptoms and TD severity may be influenced by the presence of parkinsonism.


2008 ◽  
Vol 193 (3) ◽  
pp. 203-209 ◽  
Author(s):  
Thomas R. E. Barnes ◽  
Verity C. Leeson ◽  
Stanley H. Mutsatsa ◽  
Hilary C. Watt ◽  
Sam B. Hutton ◽  
...  

BackgroundIn first-episode schizophrenia, longer duration of untreated psychosis (DUP) predicts poorer outcomes.AimsTo address whether the relationship between DUP and outcome is a direct causal one or the result of association between symptoms and/or cognitive functioning and social functioning at the same time point.MethodSymptoms, social function and cognitive function were assessed in 98 patients with first-episode schizphrenia at presentation and 1 year later.ResultsThere was no significant clinical difference between participants with short and long DUP at presentation. Linear regression analyses revealed that longer DUP significantly predicted more severe positive and negative symptoms and poorer social function at 1 year, independent of scores at presentation. Path analyses revealed independent direct relationships between DUP and social function, core negative symptoms and positive symptoms. There was no significant association between DUP and cognition.ConclusionsLonger DUP predicts poor social function independently of symptoms. The findings underline the importance of taking account of the phenomenological overlap between measures of negative symptoms and social function when investigating the effects of DUP.


2007 ◽  
Vol 24 (4) ◽  
pp. 145-148 ◽  
Author(s):  
Richard Lawoyin ◽  
Keith Gaynor ◽  
Barbara Dooley ◽  
Elizabeth Lawlor ◽  
Mary Clarke ◽  
...  

AbstractObjectives: To examine the relationship between cognitive deficits, the duration of untreated psychosis (DUP) and positive and negative symptoms in a first episode psychosis sample.Method: We assessed a consecutive sample of first episode psychosis participants from a catchment area service with a comprehensive neuropsychology battery, a family and service-user based measure of DUP and measures of symptomatology.Results: Using correlations and stepwise linear regressions, we found strong relationships between measures of DUP and positive symptomatology. We found that positive and negative symptoms were associated with different time periods within DUP. However, we did not find evidence of a relationship between DUP and cognitive factors.Conclusions: There was no evidence of a relationship between DUP and cognitive deterioration. However, there does appear to be evidence of a relationship between positive symptoms and aspects of DUP. These results highlight the importance of the heterogeneity of DUP and the potential to reduce positive symptoms through early intervention.


1989 ◽  
Vol 155 (S7) ◽  
pp. 41-44 ◽  
Author(s):  
Eve C. Johnstone

It has become customary to classify the typical abnormalities of the mental state of schizophrenic patients into positive and negative features, with reference to behavioural excesses and deficits. Positive features are pathological by their presence and negative features represent the loss of some normal function. Positive features are generally considered to include delusions, hallucinations and positive formal thought disorder (Fish, 1962). Some studies (e.g. Johnstone et al, 1978) have also included incongruity of affect under this heading. Negative features include affective flattening, poverty of speech, retardation, apathy, lack of sociability. There is some evidence that the clinical correlates of positive and negative features may not be the same (Owens & Johnstone, 1980). Some workers (Andreasen & Olsen, 1982) but not others (Pogue-Geile & Harrow, 1984) have found that among schizophrenic patients positive and negative symptoms were negatively correlated. Although the nature of the relationship between positive and negative features is not entirely established and may not be simple (Wing, 1978) certain generalisations may be applied: (a)Positive features are characteristic of earlier and negative of later phases of the illness (Pfohl & Winokur, 1982).(b)The effects of drugs upon positive features are greater than those upon negative features. Thus neuroleptics produce more marked improvement (Johnstone et al, 1978; Angrist et al, 1980) and amphetamine more marked exacerbation (Angrist et al, 1980) of positive than of negative features.(c)Positive features have been said to be relatively variable and negative features relatively stable (Ovchinnikov, 1968; Snezhnevsky, 1968).


2000 ◽  
Vol 41 (1) ◽  
pp. 47 ◽  
Author(s):  
P.B. Fitzgerald ◽  
T. Rolfe ◽  
A. Adams ◽  
N. Corteling ◽  
C.L. Williams ◽  
...  

1996 ◽  
Vol 168 (5) ◽  
pp. 580-587 ◽  
Author(s):  
Marcia Scazufca ◽  
Elizabeth Kuipers

BackgroundFindings that the EE level of a relative may change over time support the idea that EE may represent the circumstances of the relationship between patient and caregiver. The present study examines to what extent EE levels in relatives are related to relatives' burden of care and their perceptions of patients' deficits in social role performance.MethodFifty patients recently admitted to hospital with DSM–III–R diagnoses of schizophrenia or schizophreniform disorder were assessed for positive and negative symptoms. Fifty relatives who were living or were in close contact with these patients were interviewed for the assessment of EE and burden of care, and to provide information about patients' social role performance and social and behaviour problems.ResultsHigh-EE relatives had considerably higher mean scores for burden of care than low-EE relatives (12.5 v. 6.8, respectively, P=0.002), and perceived more deficits in patients' social functioning than low-EE relatives (means: 16.2 v. 6.9, respectively, P=0.004). The employment status of relatives was the only socio-demographic characteristic of relatives and patients associated with EE levels, those who were working being less likely to be high EE. Patients' psychopathology was not associated with EE levels and burden of care.ConclusionsThis study shows that EE and the burden of care are related. EE and burden both measure aspects of the relationship between relatives and patients. These findings suggest that EE and burden of care are more dependent on relatives' appraisal of the patient condition than on patients' actual deficits.


Author(s):  
Anatoly Smulevich ◽  
Dmitry Romanov

The chapter focuses on the relationship of negative and positive symptoms in schizophrenia. Negative symptoms should be evaluated in a relation to positive symptoms both cross-sectionally and long term (prospectively/retrospectively). Two types of long-term interaction between negative and positive symptoms could be distinguished: (1) relatively synchronized, and (2) relatively desynchronized. Synchronization of negative and positive symptoms is characterized by their unidirectional long-term course. Desynchronization is characterized by their bidirectional long-term relations: (1) negative schizophrenia with minimal positive symptoms at the beginning of the disease and further progression of negative symptoms; or (2) schizophrenia with negative symptoms ‘that stopped at the very beginning’, and the later course is characterized by positive symptoms. Considering every single time point of the long-term relationship between negative and positive symptoms (cross-sectionally), the chapter describes the concept of ‘mutual/common syndromes’ (consisting of both positive and negative symptoms) at different stages of schizophrenia, including residual deficit states.


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