scholarly journals Glutamate Level’s in Blood Serum of Patients with Schisophrenic Spectrum and Bipolar Affective Disorder

Psychiatry ◽  
2020 ◽  
Vol 18 (3) ◽  
pp. 22-31
Author(s):  
A. A. Seregin ◽  
L. P. Smirnova ◽  
E. M. Dmitrieva ◽  
S. N. Vasil’eva ◽  
A. V. Semke ◽  
...  

The objective: the involvement of glutamatergic neurotransmitter systems in the pathogenesis of schizophrenic spectrum disorders and BD has been repeatedly proven. But today, there are no methods available to evaluate the glutamate metabolism in patients with mental disorders. The paper presents differences in the level of glutamate in the blood serum of patients with a schizophrenic spectrum disorder, bipolar disorder, and healthy individuals.Patients and methods: the study included 224 people. 179 patients were presented with paranoid schizophrenia, simple schizophrenia, schizotypal disorder, acute polymorphic disorder, schizoaffective disorder and BD.Results: in this work shows that the level of glutamate in patients in all studied groups is statistically significantly higher than in healthy individuals, except for acute polymorphic psychotic disorder. Serum glutamate concentration in patients with schizotypal disorder is 1.6 times higher than in healthy individuals. The significant differences in glutamate levels were detected in patients with schizotypal disorder and OCD (p = 0.045), and patients with paranoid schizophrenia (p = 0.012). The concentration of glutamate is also increased in patients with simple schizophrenia compared to patients with paranoid schizophrenia (p = 0.039). In addition, it was observed a glutamate increase in healthy individuals compared in patients with a continuous course of schizophrenia (p = 0.001), in patients with an episodic course with progressive deficit (p = 0.0211) and in patients with a schizophrenia duration of more than 12 years.Conclusions: thus, the concentrations of glutamate in the blood serum of patients are depending on the severity of the course of schizophrenia and maybe an additional paraclinical criterion for the diagnosis of schizotypal disorder.

2020 ◽  
Vol 5 (1) ◽  
pp. 60-64
Author(s):  
L. A. Ivanova

Background. Suicidal behavior in schizophrenia correlates with the severity of productive and negative personality symptoms.Aims. Study of the clinic, the effectiveness of psychopharmacotherapy of paranoid schizophrenia and schizotypal disorder with the presence of suicidal behavior.Material and methods. Patients with paranoid schizophrenia, episodic type of course (n = 19) and schizotypal disorder (n = 15) were studied, in the clinical picture of which various variants of suicidal behavior were revealed. Clinicalpsychopathological, clinical-anamnestic, and psychometric methods were used.Results. Suicidal behavior in patients with an actual attack of paranoid schizophrenia was represented by suicidal intentions to avoid persecution (42.1 %), exposure to “voices” with an order to end their lives (36.8 %), and suicidal attempts (21.1 %). In patients with schizotypal disorder, suicidal thoughts were detected (84.6 %) in the form of loss of meaning in life, and suicidal attempts (15.4 %). Psychopharmacotherapy of suicidal behavior in schizophrenia and schizotypal disorder included the use of antipsychotics (atypical and traditional), antidepressants, tranquilizers, and normotimics. Among patients with paranoid schizophrenia, a decrease in the overall score of the PANSS scale was detected by day 14 of therapy (p < 0.05). The effectiveness of therapy was due to the reduction of delirium, verbal hallucinosis, and deactualization of suicidal behavior. Among patients with schizotypal disorder, a statistically significant decrease in the overall score of the PANSS scale was observed by 21 days of therapy (p < 0.05). The favorable dynamics was characterized by a decrease in manifestations of depression, suicidal thoughts, loss of interests.Conclusion. Combined therapy (antipsychotic, antidepressant, normotimic) helps reduce mental disorders and suicidal tendencies in patients with schizophrenia and schizophrenic spectrum disorders.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1437.2-1438
Author(s):  
T. Kvlividze ◽  
V. Polyakov ◽  
В. Zavodovsky ◽  
Y. Polyakova ◽  
L. Seewordova ◽  
...  

Background:Interest in highly specialized tissue cytokines contributed to the discovery of new biologically active molecules. Nesfatin-1 (NF) - discovered in 2006 as an anorexigenic factor. NF-1 is believed to be involved in the regulation of energy homeostasis by regulating appetite and water intake. The role of NF-1 in the pathogenesis of inflammatory diseases is poorly understood. Recently, studies have found a relationship between an increased level of NF-1 and inflammatory markers in various pathologies.Objectives:Study of the level of nesfatin-1 in the blood serum of healthy people, determination of the correlation between the level of NF-1 with the severity of clinical symptoms and classic markers of inflammation in patients with RA.Methods:120 persons were examined: 90 patients with RA and 30 healthy people. All patients underwent a complete clinical and laboratory examination. Plasma NF-1 levels were determined using commercial test systems (RaiBiotech, cat # EIA-NESF) according to the manufacturer’s instructions. Patients with various forms of RA were comparable in age to the group of healthy individuals. Statistical processing of clinical examination data was carried out using the “STATISTICA 10.0 for Windows” software package. Quantitative data were processed statistically using the parametric Student’s t-test, qualitative data using the non-parametric chi-square test. The significance of differences between groups was determined using analysis of variance. The results were considered statistically significant at p <0.05.Results:The average level of NF-1 in blood serum in healthy individuals was 31.79 ± 3.21 ng / ml (M ± σ). The level of normal NF-1 values in healthy individuals, defined as M ± 2σ, ranged from 25.3 to 37.83 ng / ml. There was no significant difference in the levels of circulating NF-1 and BMI in healthy individuals and patients with RA (p> 0.05). The inverse relationship of a lower level of NF-1 with an increase in BMI was not significant.Group 1 (66 patients with RA) with increased serum NF-1 levels (> 37.83 ng / ml), and group 2 (44 patients) with normal values (<37.83 ng / ml). A high level of NF-1 was characteristic for patients with high activity according to DAS28, RF seropositive, ACCP-positive, with extra-articular manifestations, who had been ill for 10 years or more. A reliable relationship between the level of NF-1 in the blood serum and laboratory parameters of RA activity - ESR, CRP, was shown, and secondary synovitis was more common. Our data show a direct correlation between the NF-1 level of the pro-inflammatory markers of RA.Conclusion:The positive correlation between the level of NF-1 and classical markers of inflammation, such as CRP and ESR, confirms the involvement of NF-1 in the pathophysiology of inflammation in RA. This is also evidenced by the correlation of a high level of NF-1 in the blood serum with a more severe clinical picture of RA. It is known that NF-1 can promote the release of pro-inflammatory cytokines such as interleukin-8 (IL-8), interleukin-6 (IL-6), and macrophage inflammatory protein-1a (MIP-1a) in the chondrocytes of RA patients.It is necessary to further study the role of NF-1 in the pathogenesis of systemic inflammatory reactions and the possibility of targeting pro-inflammatory cytokines, the possibility of regulating the level of NF-1 by drugs.References:[1]Kvlividze T.Z., Zavodovsky B.V., Akhverdyan Yu.R. Kvlividze T.Z., Zavodovsky B.V., Akhverdyan Yu.R., Polyakova Yu.V., Sivordova L.E., Yakovlev A.T., Zborovskaya I.A. Serum nesfatin -1 as a marker of systemic inflammation in rheumatoid arthritis. Klinicheskaya Laboratornaya Diagnostika (Russian Clinical Laboratory Diagnostics). 2019; 64 (1): 53-56 (in Russ.).Disclosure of Interests:None declared


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 297.2-297
Author(s):  
Y. Akhverdyan ◽  
E. Papichev ◽  
В. Zavodovsky ◽  
L. Seewordova ◽  
J. Polyakova

Background:The main mechanism of the effect of fetuin-A (FeA) on bone metabolism is its ability to bind calcium and proteins of the TGF-β family. It has been proven that the optimal concentration of TGF-β is necessary for the differentiation of bone tissue, and a high concentration inhibits bone mineralization. Thus, adequate osteogenesis is based on a complex balance between FeA and TGF-β levels. It can be assumed that the determination of the FeA level in the blood of patients with rheumatoid arthritis (RA) will help to optimize the diagnosis and predict the severity of osteoporosis (OP).Objectives:to study the possibility of predicting the development of osteoporosis and osteoporetic fractures in patients with RA, depending on the level of FeA in blood serum.Methods:We examined two groups of patients (52 patients with RA complicated by OP, 58 patients with RA without OP) and 30 apparently healthy individuals. The age of the surveyed ranged from 18 to 72 years, the average duration of the disease was 7.53±0.89 years. In both groups, the FeA level was determined by an indirect enzyme-linked immunosorbent assay using a commercial test. Bone mineral density (BMD) was also measured in both groups (Lunar DPX-NT GE).Results:The average FeA level in the group of RA patients was lower than in the group of conventionally healthy individuals (731.21±109.9 μg/ml and 812.9±76.2 μg/ml, respectively; F=13.34; p=0,0004). The normal FeA level was calculated using the formula M±2σ in the group of apparently healthy individuals and ranged from 653.55 μg/ml to 972.19 μg/ml.A decreased level of FeA was found in 20 patients (86.96%) in the group of patients with OP and only in 3 (13.04%) patients with RA who did not suffer from OP (p<0.001). It can be concluded that patients with RA and a low concentration of FeA in the blood serum have a higher risk of developing OP.In the group of patients with normal FeA level, osteoporetic fractures were observed in 12 (13.79%) patients and were absent in 75 (86.21%) patients (p<0.001). Thus, RA patients with normal serum FeA levels have a lower risk of osteoporetic fractures.We also found a positive significant correlation between the level of FeA and BMD in the femoral neck area. In the group of patients with a reduced FeA level (23 people), the mean BMD values were 0.732±0.022 g/cm2, and in the group of patients with a normal FeA level (87 patients) - 0.890±0.014 g/cm2 (p<0.001, F=27.663). The obtained values are in agreement with the literature data on the effect of the serum FeA concentration on the BMD values.Conclusion:We consider it expedient to determine the serum FeA concentration in patients with RA. At a FeA level of 653.55 μg/ml and below, a higher risk of developing OP and osteoporetic fractures can be predicted. In this case, the patient is shown a standard examination for osteoporosis. At values of 653.55 μg/ml and above, a more expectant management of the patient is allowed. Thus, by determining the serum concentration of FeA, it is possible to implement an integrated approach to the patient and to optimize the schemes for the diagnosis of OP in patients with RA.Disclosure of Interests:None declared


1990 ◽  
Vol 69 (1) ◽  
pp. 147-154 ◽  
Author(s):  
B. Hoop ◽  
M. R. Masjedi ◽  
V. E. Shih ◽  
H. Kazemi

Glutamate stimulates resting ventilation by altering neural excitability centrally. Hypoxia increases central ventilatory drive through peripheral chemoreceptor stimulation and may also alter cerebral perfusion and glutamate metabolism locally. Therefore the effect of hypoxia and peripheral chemodenervation on cerebrospinal fluid (CSF) transfer rate of in vivo tracer amidated central nervous system glutamate was studied in intact and chemodenervated pentobarbital-anesthetized dogs during normoxia and after 1 h of hypoxia induced with 10 or 12% O2 in N2 breathing at constant expired ventilation and arterial CO2 tension. Chemodenervation was performed by bilateral sectioning of the carotid body nerves and cervical vagi. CSF transfer rates of radiotracer 13NH4+ and [13N]glutamine synthesized via the reaction, glutamate + NH4(+)----glutamine, in brain glia were measured during normoxia and after 1 h of hypoxia. At normoxia, maximal glial glutamine efflux rate jm = 103.3 +/- 11.2 (SE) mumol.l-1.min-1 in all animals. After 1 h of hypoxia in intact animals, jm = 78.4 +/- 10.0 mumol.l-1.min-1. In denervated animals, jm was decreased to 46.3 +/- 4.3 mumol.l-1.min-1. During hypoxia, mean cerebral cortical glutamate concentration was higher in denervated animals (9.98 +/- 1.43 mumol/g brain tissue) than in intact animals (7.63 +/- 1.82 mumol/g brain tissue) and corresponding medullary glutamate concentration tended to be higher in denervated animals. There were no differences between mean glutamine and gamma-aminobutyric acid concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)


1980 ◽  
Vol 188 (3) ◽  
pp. 873-880 ◽  
Author(s):  
G Baverel ◽  
C Genoux ◽  
M Forissier ◽  
M Pellet

1. The pathways and the fate of glutamate carbon and nitrogen were investigated in isolated guinea-pig kidney-cortex tubules. 2. At low glutamate concentration (1 mM), the glutamate carbon skeleton was either completely oxidized or converted into glutamine. At high glutamate concentration (5 mM), glucose, lactate and alanine were additional products of glutamate metabolism. 3. At neither concentration of glutamate was there accumulation of ammonia. 4. Nitrogen-balance calculations and the release of 14CO2 from L-[1-14C]glutamate (which gives an estimation of the flux of glutamate carbon skeleton through alpha-oxoglutarate dehydrogenase) clearly indicated that, despite the absence of ammonia accumulation, glutamate metabolism was initiated by the action of glutamate dehydrogenase and not by transamination reactions as suggested by Klahr, Schoolwerth & Bourgoignie [(1972) Am. J. Physiol. 222, 813-820] and Preuss [(1972) Am. J. Physiol. 222, 1395-1397]. Additional evidence for this was obtained by the use of (i) amino-oxyacetate, an inhibitor of transaminases, which did not decrease glutamate removal, or (ii) L-methionine DL-sulphoximine, an inhibitor of glutamine synthetase, which caused an accumulation of ammonia from glutamate. 5. Addition of NH4Cl plus glutamate caused an increase in both glutamate removal and glutamine synthesis, demonstrating that the supply of ammonia via glutamate dehydrogenase is the rate-limiting step in glutamine formation from glutamate. NH4Cl also inhibited the flux of glutamate through glutamate dehydrogenase and the formation of glucose, alanine and lactate. 6. The activities of enzymes possibly involved in the glutamate conversion into pyruvate were measured in guinea-pig renal cortex. 7. Renal arteriovenous-difference measurements revealed that in vivo the guinea-pig kidney adds glutamine and alanine to the circulating blood.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S283-S283
Author(s):  
Seemab Rasool ◽  
Paster Venan

AimsThere is limited data on the comparison of efficacy between first and second antipsychotic LAIs. One good indicator of efficacy is the rates of hospitalization. Some studies have shown that second generation depot antipsychotics, significantly reduce hospitalizations as compared to conventional depots.Our aim was to compare hospitalizations in patients on first and second generation LAI antipsychotics.MethodA retrospective observational study was done by reviewing the records of all the depot clinics in South Essex, United Kingdom. A list of patients enrolled and receiving LAI antipsychotics was obtained from the 6 depot clinics. Data were collected by going through the electronic records of the patients on the depot clinic lists and taking down the demographics, diagnosis and the hospital admissions. Other variables like comorbid drug abuse were also recorded.ResultAmongst a total of 346 patients 223 (64 %) were males and 123 (36%) were females. Average age was 50.3 (range 21 to 88 years) and 290 (83%) patients were single. An overwhelming majority of patients 299 (87 %) were not in employment. Regarding the diagnosis, the majority, 237 patients were diagnosed with Paranoid Schizophrenia, 49 patients were diagnosed with Schizoaffective disorder, 38 patients were diagnosed with Bipolar affective disorder, 20 patients had a diagnosis of Delusional disorder and only 2 patients had a primary diagnosis of Mental and Behavioral disorders due to substance abuse. Of the total 346 only 17 patients were on a Community treatment Order.Risperidone was the most commonly used second generation LAI at 26%,Aripiprazole in 10% and Paliperidone was used in 5% patients. Olanzapine LAI was only used in 2 patients. Amongst first generation LAIs Zuclopenthixol, Fluclopentixol were both used in 24%, and Haloperidol in 10% patients. 21 % of patients were reported to be actively abusing drugs.65 (32.6%) of the total 200 patients on Ist Generation LAIs had hospital admissions55 (39.8%) of the total 138 patients on 2nd Generation LAIs had hospital admissionsThis difference was not statistically significant (Z test)- P value of 0.082427ConclusionThe results in our observational study are equivocal, both LAIs providing equitable decrease in the hospital admissions albeit with a slightly favourable outcome (not statistically significant though) attributable to the first generation LAIs. There was a high incidence of unemployment and drug abuse in our cohort of patients, thus targeted interventions can be established in rehabilitation of such individuals.


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S305-S305
Author(s):  
Andreas Rosén Rasmussen ◽  
Josef Parnas

Abstract Background Imagination is the formation of ideas or images of something known not to be present to the senses. Clinical psychopathology has few notions addressing this domain apart from obsession and rumination. Some classic psychopathological notions such as Jaspers’ concept of pseudohallucination or the pseudo-obsession are relevant to this area. In a recent research project, informed by contemporary philosophy of mind and phenomenology, we have developed novel concepts targeting subjective disturbances of imagination and fantasy life with a focus on the schizophrenia-spectrum. Patients describe a spatialization of images, i.e., stable imagery with an articulated spatial structure being liable to inspection ‘from afar in the mind’ and often undergoing an autonomous development independently of the will of the patient (‘like watching a movie in the head’). Other notions address tacit, non-psychotic erosions of the demarcation of fantasy life from perception and memory. A broad range of ideations (such as ‘daydreams’, ‘fears’, anticipations, intrusions, paranoid or suicidal ideation) may involve such structural disturbances of experience. Here, we present data from the first, cross-sectional study investigating the distribution of anomalies of imagination in different diagnostic groups and healthy controls as well as their association with positive symptoms, negative symptoms and disorders of basic selfhood. Methods The sample (N=81) included in- and outpatients with schizophrenia or another non-affective psychosis (N=32), outpatients with schizotypal disorder (N=15) or other mental illness (N=16) and healthy controls (N=18). The sample was 70% female with mean age 29.9 (SD 6.8; range 18–42) years. Anomalies of imagination were assessed with the Examination of anomalous fantasy and imagination (EAFI), which is an instrument recently developed in our group for a semi-structured interview exploring these experiences. The EAFI has shown very good reliability with average Kappa of 0.84. Disorders of basic self were assessed with the Examination of anomalous self experience (EASE) and positive, negative and general symptoms with the Positive and Negative Syndrome Scale (PANSS). Results Anomalies of imagination aggregated significantly (p &lt; 0.000, Kruskall-Wallis test) in the schizophrenia-spectrum disorders compared to other mental illness with no significant difference between schizophrenia and schizotypal disorder. The group of healthy controls very rarely reported these anomalies and scored significantly lower (p &lt; 0.000) than all diagnostic groups. In multivariate linear regression analysis (R2 = 0.66), EAFI score was significantly associated with EASE score (β = 0.62, p &lt; 0.000), PANSS positive (β = 0.34, p = 0.01) and PANSS negative (β = 0.29, p = 0.02), but not PANSS general score (β = -0.29, p = 0.07). More than 79% of the schizophrenia-spectrum patients retrospectively reported the onset of these experiences to adolescence or earlier. Discussion The results of this cross-sectional study support that the subjective anomalies of imagination, targeted with the EAFI, are associated with the schizophrenia-spectrum. The association with disorders of basic self, which has been shown to have trait-like characteristics and to predict transition to schizophrenia-spectrum disorders, may reflect that the anomalies of imagination share a common experiential core-structure with self disorders. We suggest that the anomalies of imagination belong to an early onset level of psychopathology in the schizophrenia-spectrum and may have a relevance for differential diagnosis and early detection.


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S182-S182
Author(s):  
Igor Filipčić ◽  
Ivona Šimunović Filipčić ◽  
Žarko Bajić

Abstract Background Patients with schizophrenia spectrum disorders (SSD) have higher prevalence of chronic physical illness (CPI) and a substantially reduced life expectancy compared with the general population. Despite the increasing amount of research in this area, the effect on psychiatric treatment outcome is still not clear. Some research reported significant associations between several CPIs and different SSD treatment outcomes, whereas the remaining study did not. The objective of the current study is to assess differences in the association of the number of CPI with the overall number of psychiatric rehospitalization in specific SSD diagnosis. Methods We conducted a cross-sectional study of 354 patients diagnosed with SSD (ICD10): 135 schizophrenia, 71 acute and transient psychotic disorder, 57 schizoaffective disorder, 68 unspecified unorganic psychosis, 23 other (persistent delusional disorder, schizotypal disorder). The primary outcome was the association of the number of CPI with the number of psychiatric rehospitalization since the diagnosis, as the surrogate outcome for the treatment success, adjusted for the time from diagnosis, age, and gender of participants. Results Mean number of CPI adjusted for the time from diagnosis, age, and gender was not significantly nor clinically relevantly different between particular SSD diagnosis (F(5,345)=0.70; p=0.620). It was 1.7 in schizophrenia, 1.5 in acute and transient psychotic disorder, 1.4 in schizoaffective disorder, 1.8 in unspecified unorganic psychosis, 1.0 in persistent delusional disorder and 1.9 in schizotypal disorder. The mean number of CPI adjusted for the same three potential confounders was significantly different between particular SSD diagnosis (F(5,345)=2.78; p=0.018). It was 6.7 in schizophrenia, 3.8 in acute and transient psychotic disorder, 7.3 in schizoaffective disorder, 4.8 in unspecified unorganic psychosis. However, the association of the number of CPI with the psychiatric rehospitalizations, adjusted for the previously stated three confounders, was significant and clinically relevant only in participants diagnosed with schizophrenia. In these participants, an increase of one CPI was associated with the 2.3 (95% CI 1.2 to 3.5) more psychiatric rehospitalizations (p&lt;0.001). In participants diagnosed with other specific SSD the association of the number of CPI was not significantly associated with the number of psychiatric rehospitalizations. Moreover, on this particular sample level, it was negative, meaning that more CPI was associated with the lower number of psychiatric rehospitalization in all other SSD except in the case of unspecified nonorganic psychosis. Discussion In this cross-sectional study, we observed that the hypothesis of the effect of the number of CPI on the SSD treatment outcomes is valid only in the case of schizophrenia. Further research is needed to clarify whether additional psychological distress is related to the additional burden of multimorbidity.


2011 ◽  
Vol 15 (1) ◽  
pp. 49-62 ◽  
Author(s):  
Monika Obrębska ◽  
Sandra Nowak

The Level of Dogmatism in Schizophrenia. A Comparative Analysis of Utterance Texts with the Use of the Suitbert Ertel Dogmatism Quotient The paper describes the results of comparative research on the level of dogmatism in the utterance texts of patients diagnosed with paranoid schizophrenia (N=130) and healthy individuals (N=130). The analysis was conducted with the use of the Suitbert Ertel Dogmatism Quotient. The results indicate significant differences between these two groups.


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