The primary cause of chronic autoimmune diseases is elusive both in somatic medicine and psychiatry. Examples of such conditions are rheumatoid arthritis and schizophrenic disorders. Immune disturbances occur in both diseases, but it is difficult to combine them into a meaningful pathogenetic model. The immunological hypothesis of schizophrenia is based on non-specific changes in the cytokine system and exponents of chronic inflammation in some patients. In rheumatoid arthritis the cytokine network is much better known than in schizophrenia, and interleukin-6, tumor necrosis factor or Janus kinases became a target of treatment. Microbiome dysbiosis and disturbances of the blood-gut barrier may be a new hypothesis of the pathogenesis of somatic and psychiatric diseases. The purpose of this narrative review was to show, using the example of two chronic diseases -rheumatoid arthritis and schizophrenic disorders -that disturbances in the blood barrier of the intestine can be a common mechanism of somatic and mental disorders. The paper presents the current state of knowledge on the hypothetical relationship between microbiome dysbiosis and the pathogenesis of schizophrenia and rheumatoid arthritis. In conclusion, in the light of discoveries regarding the microbiome-gut-brain axis the immunological model of rheumatoid arthritis and schizophrenia formation may gain importance and contribute to the creation of new strategies for causal treatment of these still incurable diseases.
The case of a 72-year-old woman with a history of 40 years of epilepsy and medication-refractory severe depression is described. Despite the chronicity of the present depressive episode, mild MRI pathology and somatic complications, especially pneumonia and drug-induced hyponatraemia, we observed rapid and complete remission of depressive symptoms in the course of ECT. Neither cognitive impairment nor a perceptible influence on the neurological illness was seen, and no increase in seizure threshold has been observed during the course of 2 years maintenance ECT treatment. This article is offered in an attempt to enrich the clinical literature in this field and therefore encourage psychiatrists to consider ECT and MECT as a safe and efficacious option in epileptic patients with major depressive disorder.
Sexual dysfunctions in people with schizophrenia are more severe than in the general population and are an important element in the treatment of schizophrenia. The mechanism of sexual dysfunction in patients treated for schizophrenia may be related to the side effects of antipsychotic drugs (hyperprolactinemia, suppression of the reward system), but it may also be related to the pathogenesis of schizophrenia itself. The aim of the study was to present the possibility of using amantadine in the treatment of sexual dysfunction in schizophrenia without the concomitant hyperprolactinemia. In an open and naturalistic case series study, five men treated for schizophrenia in a stable mental state were described. All patients reported a prolonged lack of sexual desire and sexual activity prior to treatment with amantadine. After exclusion of hyperprolactinemia, patients received amantadine 100 mg in the evening. Sexual dysfunction was assessed using subscales of the 14-point Short Form of the Changes in Sexual Functioning Questionnaire (CSFQ-14). On subsequent visits after 1, 2 and 3 months of administration of amantadine, an improvement in sexual functioning was observed in all patients. Although this is only the preliminary report, amantadine may become a new indication for the treatment of sexual dysfunction in schizophrenia patients.
in preventing cardiovascular consequences. Dysbiosis disrupts the integrity of the intestinal barrier, contributing to general inflammation. This process is associated with metabolic disorders, sugar metabolism and obesity. A case report. A description of a 24-year-old patient suffering from paranoid schizophrenia is presented. Due to the lack of mental state improvement and periods of lack of cooperation, pharmacotherapy was modified many times. Finally, remission was achieved after the use of clozapine with paroxetine. The patient was diagnosed with metabolic syndrome. A probiotic sealing the blood-intestines barrier was added to the treatment. After 3 months of using the probiotic, normalisation of the level of glycemia, total cholesterol, LDL, lowering of the level of insulin, and reduction in the level of insulin resistance were observed. Conclusions. The introduction of a probiotic with properties sealing the blood-intestines barrier to the treatment may result in a reduction in the risk parameters of the metabolic syndrome. It is advisable to conduct further research to confirm the above observations. StreSzczenieWstęp. Ryzyko zespołu metabolicznego u pacjentów chorujących na schizofrenię jest znacząco wyższe niż w populacji ogólnej. Konsekwencją tego faktu jest skrócenie AbStrActIntroduction. The risk of metabolic syndrome in patients with schizophrenia is significantly higher than in the general population. The consequence of this fact is the shortening of life in this group of patients by as much as 20-25%. The search for methods leading to the reduction of metabolic syndrome risk factors is essential Case report / Opis przypadkuThe beneficial effect of a probiotic sealing the intestinal barrier on the reduction of metabolic syndrome risk parameters -a case report Korzystny wpływ probiotyku uszczelniającego barierę jelitową na obniżenie parametrów ryzyka zespołu metabolicznego -opis przypadku
IntroductionPatients suffering from schizophrenia have a higher risk of premature death. An unhealthy lifestyle contributes to increased risk of cardiovascular diseases, metabolic syndromes, suicides among them. In addition to the use of selected therapy with a restriction metabolic risk has become important to influence non-pharmacological factors such as proper diet, introducing the principles of a healthy lifestyle. A diet rich in fiber, the DASH diet, the Mediterranean diet may become beneficial in terms of lowering parameters metabolic, cardiovascular and immune related to premature mortality in schizophrenia.Patients suffering from schizophrenia have a higher risk of premature death. An unhealthy lifestyle contributes to increased risk of cardiovascular diseases, metabolic syndromes, suicides among them. In addition to the use of selected therapy with a restriction metabolic risk has become important to influence non-pharmacological factors such as proper diet, introducing the principles of a healthy lifestyle. A diet rich in fiber, the DASH diet, the Mediterranean diet may become beneficial in terms of lowering parameters metabolic, cardiovascular and immune related to premature mortality in schizophrenia.ObjectivesThe objective of this study was to evaluate the influence of the lifestyle on the metabolic parameters in schizophreniaMethodsIn our study, we assessed the influence of diet, nutritional knowledge and lifestyle on parameters of metabolic syndrome (cholesterol, triglicerydes, glucose) in patients with schizophrenia.ResultsIn the results we have found positive co-relations between unhealthy diet and lifestyle and lack of knowledge on proper nutrition and increased parameters of metabolic syndrome. Groups BMI (Std. Dev) Cholesterol HDL mg/dl Triglicerides mg/dl Insuline resistaneceInsuline uU/mlStudy group30,58(4,44)45,63(7,34)177,32(108,76)4,68(4,64)19.77(17,35)Control Group26,00(3,39)54,32(14,07)111,47(57,48)2,1(!,21)9,01(4,97)ConclusionsDietary intervention may become one of the therapeutic goals in schizophrenia.Disclosure of InterestNone Declared
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