Background/PurposeThere is evidence for low endogenous antioxidant levels and oxidative imbalance in patients with schizophrenia. A previous open-label study with α-lipoic acid (ALA), a potent antioxidant, improved patients' negative and cognitive symptoms and markers of lipid peroxidation. Here we report the results of a randomized double-blind, placebo-controlled study to verify the response of patients with schizophrenia to adjunctive treatment with ALA (100 mg/d) in a 4-month follow-up.MethodsWe conducted a 16-week, double-blind, placebo-controlled study of ALA at 100 mg/d dosages. We compared negative and positive symptoms, cognitive function, extrapyramidal symptoms, body mass index, and oxidative/inflammatory parameters between placebo and control groups.ResultsWe found no significant improvement in body mass index, cognition, psychopathology, antipsychotic adverse effects, or oxidative stress and inflammation in the experimental group compared with placebo. The whole group of patients improved in several measures, indicating a strong placebo effect in this population. A surprising finding was a significant decrease in red blood cells, white blood cells, and platelets in the group treated with ALA.ConclusionsThe decrease in red blood cells, white blood cells, and platelet counts requires further investigation and attention when prescribing ALA for patients with schizophrenia.

Spirituality and altruism may be critical coping strategies to minimize emotional pain during period of crisis. Here we aim to investigate how spirituality and altruism are related and whether they influence medical students' levels of stress during the COVID-19 pandemic. Data were collected when most Brazilian states had already been promoting social isolation in response to the COVID-19 pandemic using self-reported measures: the Perceived Stress Scale 4, the Self-Spirituality Rating Scale, and Altruistic Attitudes Scale, in an online questionnaire.  We found moderate levels of perceived stress, moderate to high levels spirituality, as well as high levels of altruistic attitudes. Reported stress was higher among participants with a previous diagnosis of mental disorder and women, while more altruistic individuals were less vulnerable to it. Most participants attributed their stress symptoms to the COVID-19 pandemic or to the social isolation and participants with higher level of stress were less able to study during the pandemic. Spirituality correlated positively with altruistic thoughts and emotions, but only participants who act altruistically reported lower levels of stress. Our results indicate that the mental health status before the COVID-19 pandemic is related to the actual level of stress and suggest that altruism may allow for collective coping of emotional burden during the health crisis.

Background We explored the relationship between symptoms, cognitive performance, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) (three markers of inflammation), and antipsychotic dose (in chlorpromazine units) in male and female patients with schizophrenia. Methods We conducted a cross-sectional analysis in patients with schizophrenia of the complete blood count and the results of neuropsychological testing, using the Welch t-test to compare groups and the Pearson test for correlations. Results We found that the NLR and the PLR are higher among women with schizophrenia when compared with men. In women, the NLR and the PLR correlate positively with antipsychotic drug dose and inversely with a working memory test (Direct Digit Span). Higher doses of antipsychotics are associated with worse working and semantic memory and mental flexibility in the women in our sample. Conclusion Higher doses of antipsychotics were associated with worse working and semantic memory and mental flexibility in women with schizophrenia. No such correlations were present in men, suggesting that, in female patients, cognitive performance deteriorates as the antipsychotic dose is increased, a finding that could be mediated by inflammatory mechanisms, given the demonstrated relationship to biomarkers of inflammation – e.g., the NLR and the PLR. Trial registration NCT03788759 (ClinicalTrials.gov).

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When psychosocial stress overcomes people’s coping capacity, spirituality and altruism may become necessary to minimize psychological damage. This study analyzed self-reported measures of stress, spirituality and altruism of 1105 Brazilian Medical students during the Covid-19 pandemic. We found moderate levels of perceived stress, moderate to high levels spirituality, as well as high levels of altruistic attitudes. Reported stress was higher among participants with a previous diagnosis of mental disorder and women. Spirituality correlated positively with altruistic thoughts and emotions, but only altruism was inversely related to stress. Future research should explore the role of spirituality and altruism in stress management.

Introdução: A Doença de Alzheimer (DA) representa o tipo mais frequente de demência em idosos. Objetiva-se descrever o perfil dos aplicativos disponíveis para DA e avaliar a preferência dos usuários dentre os perfis. Métodos: Foi feita uma pesquisa na plataforma Google Play Store™, utilizando o unitermo "Alzheimer", por aplicativos direcionados a pacientes com DA, cuidadores ou profissionais da saúde. Analisou-se as variáveis downloads e avaliações. Foram aplicados testes Chi-quadrado, a fim de verificar a independência entre os dados. Foi feita também análise qualitativa dos principais mecanismos destacados em aplicativos. Resultados: Em relação à população geral de aplicativos, os que contêm exercícios para memória são significativamente mais representativos em número de downloads, quando comparado aos que tratam de prevenção. Não houve diferença estatística entre os perfis em avaliações. As principais abordagens dos aplicativos voltados para pacientes foram exercícios para memória, daqueles para cuidadores, ferramentas informativas, e daqueles para profissionais da saúde, mecanismos de auxílio na prática clínica. Conclusão: Aplicativos para auxílio na DA são muito populares, apresentando diferentes abordagens. Estudos posteriores são necessários para analisar a capacidade técnica e a acessibilidade dos portadores de DA e dos cuidadores para utilização dos aplicativos disponíveis. Palavras-Chave: Aplicativos. Doença de Alzheimer. Ferramentas Digitais.