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Cardiovascular morbidity and mortality are important problems among patients with schizophrenia. A wide spectrum of reasons, ranging from genes to the environment, are held responsible for causing the cardiovascular risk factors that may lead to shortening the life expectancy of patients with schizophrenia. Here, we have summarized the etiologic issues related with the cardiovascular risk factors in schizophrenia. First, we focused on heritable factors associated with cardiovascular disease and schizophrenia by mentioning studies about genetics–epigenetics, in the first-episode or drug-naïve patients. In this context, the association and candidate gene studies about metabolic disturbances in schizophrenia are reviewed, and the lack of the effects of epigenetic/posttranscriptional factors such as microRNAs is mentioned. Increased rates of type 2 diabetes mellitus and disrupted metabolic parameters in schizophrenia are forcing clinicians to struggle with metabolic syndrome parameters and related issues, which are also the underlying causes for the risk of having cardiometabolic and cardiovascular etiology. Second, we summarized the findings of metabolic syndrome-related entities and discussed the influence of the illness itself, antipsychotic drug treatment, and the possible disadvantageous lifestyle on the occurrence of metabolic syndrome (MetS) or diabetes mellitus. Third, we emphasized on the risk factors of sudden cardiac death in patients with schizophrenia. We reviewed the findings on the arrhythmias such as QT prolongation, which is a risk factor for Torsade de Pointes and sudden cardiac death or P-wave prolongation that is a risk factor for atrial fibrillation. For example, the use of antipsychotics is an important reason for the prolongation of QT and some other cardiac autonomic dysfunctions. Additionally, we discussed relatively rare issues such as myocarditis and cardiomyopathy, which are important for prognosis in schizophrenia that may have originated from the use of antipsychotic medication. In conclusion, we considered that the studies and awareness about physical needs of patients with schizophrenia are increasing. It seems logical to increase cooperation and shared care between the different health care professionals to screen and treat cardiovascular disease (CVD)-risk factors, MetS, and diabetes in patients with psychiatric disorders, because some risk factors of MetS or CVD are avoidable or at least modifiable to decrease high mortality in schizophrenia. We suggested that future research should focus on conducting an integrated system of studies based on a holistic biopsychosocial evaluation.

OBJECTIVES: We aimed to compare altered infl ammatory status between patients with bipolar manic and mixed episodes through neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-tolymphocyte ratio (MLR) levels. BACKGROUND: NLR, PLR, and MLR are systemic infl ammation biomarkers that have recently studied in bipolar disorder (BD) manic and depressive episodes. Immunological biomarker signature of mixed episodes and MLR levels in BD have less been studied. DESIGN AND SETTING: Our study included 48 bipolar patients in a mood episode (28 manic, 20 mixed) and 32 controls. Study-specifi c form including sociodemographic and clinical variables with laboratory fi ndings were fi lled for all participants. METHODS: Red cell distribution width (RDW), mean platelet volume (MPV) neutrophil, lymphocyte and platelet count, NLR, PLR, and MLR were recorded. RESULTS: PLR and MLR were found signifi cantly higher in bipolar patients compared to controls while NLR and MLR were signifi cantly higher in manic patients than in mixed patients. RDW was found higher in mixed episode compared to controls. CONCLUSIONS: One can interpret these fi ndings as MLR would be considered as a novel state biomarker for bipolar mood episodes and greater infl ammatory activation may be involved in mania rather than mixed episode (Tab. 2, Fig. 1, Ref. 35).

Neutrophil and platelet to lymphocyte ratios in people with subjective, mild cognitive impairment and early Alzheimer's disease *P < 0.05. † Kruskal-Wallis test (Mann-Whitney U-test) was used for comparisons between two groups. ‡ One-way ANOVA (Tukey's post-hoc test) was used. AD, mild Alzheimer's disease; HC, healthy controls; MCI, mild cognitive impairment; NLR, neutrophil-lymphocyte ratio; PLR, platelet-lymphocyte ratio; P-value 1 , comparison between AD and HC; P-value 2 , comparison between MCI and HC; P-value 3 comparison between SCD and HC; SCD, subjective cognitive decline. Inflammation in cognitive impairment

In this study, for the first time we revealed a significant decrease in BDNF levels after ECT sessions in acute manic patients. Besides clinical remission after treatment in acute mania, the decrement in BDNF levels does not seem to be related to clinical response. Thus cumulative effects of mood episodes for the ongoing decrease in BDNF levels might be borne in mind despite the achievement of remission and/or more time being required for an increase in BDNF levels after treatment.

After death communications(ADCs) are defined as perceived spontaneous contacts with living individuals by the deceased. This research presents on a subset of data from a recent large international survey of individuals who experienced ADCs and provided systematic information regarding these experiences. In our research we explore the impact of having an ADC on reported spirituality, religiosity, beliefs and attitudes about death and dying and also explore the moderating factors of this impact. We found that having an ADC was perceived as a positive life experience and that it was associated with a reduction in fear of death, belief in life after death and that the deceased could communicate with the living, and increased reported spirituality. Moderating factors include aspects of having or desiring physical contact with the deceased as well as perceiving some emotional reaction to the ADCs. Future directions for research exploration are also provided based on our findings.

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