Background: In the last decade, there has been growing evidence that an interaction exists between inflammation and the kynurenine pathway in schizophrenia. Additionally, many authors found microglial activation in cases of schizophrenia due to inflammatory mechanisms related mostly to an increase of pro-inflammatory cytokines. In order to gain new insights into the pathophysiology of schizophrenia, it is important to incorporate the latest published evidence concerning inflammatory mechanisms and kynurenine metabolism. This systematic review aims to collect reliable recent findings within the last decade supporting such a theory. Methods: A structured search of electronic databases was conducted for publications between 2008 and 2018 to identify eligible studies investigating patients with schizophrenia/psychosis and the relationship between inflammation and kynurenine pathway. Applicable studies were systematically scored using the NIH Quality Assessment Tools. Two researchers independently extracted data on diagnosis (psychosis/schizophrenia), inflammation, and kynurenine/tryptophan metabolites. Results: Ten eligible articles were identified where seven studies assessed blood samples and three assessed cerebrospinal fluid in schizophrenic patients. Of these articles: Four investigated the relationship between immunoglobulins and the kynurenine pathway and found correlations between IgA-mediated responses and levels of tryptophan metabolites (i.e., kynurenine pathway). Five examined the correlation between cytokines and kynurenine metabolites where three showed a relationship between elevated IL-6, TNF-α concentrations, and the kynurenine pathway. Only one study discovered correlations between IL-8 and the kynurenine pathway. Two studies showed correlations with lower concentrations of IL-4 and the kynurenine pathway. Moreover, this systematic review did not find a significant correlation between CRP (n = 1 study), IFN-γ (n = 3 studies), and the kynurenine pathway in schizophrenia.
The aim of this work was to investigate differences between depressed subjects (PG) and non-depressed healthy control participants (HCG) with regard to fatigue dimensions and inflammation. For this purpose, 43 participants in the PG and 51 participants in the HCG were included in the study. IL-6, IL-1β, TNF-α, IFN-γ, and CRP were assessed in venous blood samples. Fatigue and depression were assessed using the FIS-D and BDI-FS questionnaires. Main results showed higher BDI-FS values in PG. Moreover, PG showed mean differences for fatigue dimensions when compared to the HCG. For the pro-inflammatory markers, a moderate group effect was found between PG and HCG which was mainly caused by IL-6. Correlations between TNF-α and BDI-FS, TNF-α and cognitive fatigue, TNF-α and psychosocial fatigue were found within the PG. In the HCG, correlations were found between IL-6, TNF-α and somatic fatigue, as well as IL-6 and cognitive fatigue. Significant correlations were found between the psychological variables in both groups. All results were controlled for the confounding variables gender, age, BMI and multiple comparisons. These results suggest the presence of inflammation in both depression and fatigue. However, each correlates with different pro-inflammatory parameters, suggesting a biological heterogeneity.
Background: COVID-19 has created a rapid onset health crisis severely affecting different countries, such as Peru. This pandemic also involved social changes, such as the COVID-19 lockdown, which has had negative effects on different aspects of peoples’ mental health. For this reason, the main objective of this work is to establish a model that explains the effects of the COVID-19-lockdown period on the mental health of a population sample in Peru. Methods: In this sense, online questionnaires were carried out using the PHQ-9, GAD-7, and CPDI in 400 participants. To better explain the data, an ordinal logistic regression was carried out. Results: The model showed that the severity of stress due to COVID-19 is positively associated with the variables age (OR = 1.02; CI95 [1.01; 1.04]), depression (OR = 1.29; CI95 [1.14; 1.31]) and anxiety (OR = 1.49; CI95 [1.35; 1.66]), as well as with the presence of a deceased relative due to COVID-19 (OR = 3.53; CI95 [1.43; 8.82]). On the contrary, the presence of a family member who was hospitalized for COVID-19 is negatively correlated with COVID-19 related stress (OR = 0.30; CI95 [0.13; 0.69]). Conclusion: In conclusion, elderly people, having high levels of anxiety or depression, as well as having a deceased relative due to COVID-19 show higher levels of COVID-19 related stress. These factors play an important role in the intervention of future studies that plan to intervene in the mental health of the population affected by the COVID-19 lockdown.
1. The coronavirus disease 2019 (COVID-19) has created a rapid global health crisis, involving different social changes, which brought negative effects in different aspects in the mental health of the population, like the COVID-19 lockdown. The majority of COVID-19 cases concentrate in the region of the Americas, being Peru one of the most affected countries in the region. For this reason, to investigate possible effects related to COVID-19 lockdown, the main objective of this work is to establish a statistical model that could explain through different components the COVID-19 related stress in a population after COVID-19 lockdown of Lima, Peru. In this sense, online questionnaires were carried out in 400 participants, where the values of depressiveness, anxiousness and stress related to COVID-19 were evaluated. Other information related to the participant (e.g. gender, age, district, etc.) was collected through this electronic format. In order to explain the data, an ordinal logistic regression was carried out. From the information obtained, it was found that 35.50% of the participants showed mild stress and 9.30% showed severe stress due to COVID-19. The ordinal logistic regression model showed that the severity of stress due to COVID-19 is positive associated with the variables age, depressiveness and anxiousness, as well with the presence of a deceased relative due to COVID-19. On the other hand, the presence of a family member who was hospitalized for COVID-19 is negatively correlated to the stress produced by COVID-19. Therefore, the data shows that people with older age or who have lost relatives due to COVID-19 show higher levels of stress related to COVID-19. Additionally, participants with higher levels of anxiety and depression are more likely to produce higher levels of stress from COVID-19. These factors play an important role for the intervention of future studies that plan to intervene in the mental health of the population affected by the COVID-19 lockdown.
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