“…2 . Figure 2 also shows the results of (baseline) blood compounds in drug-naïve first-episode patients with schizophrenia or MDD compared with healthy controls, as published in a previous meta-analysis (Çakici et al, 2020 ). Fig.…”
Section: Resultsmentioning
confidence: 92%
“…BDNF, brain-derived neurotrophic factor; CRP, C-reactive protein; IL, interleukin; MDD, major depressive disorder; P , p value; TNF α , tumor necrosis factor alpha. *Baseline levels in drug-naïve first-episode patients measured before treatment compared with healthy controls (Çakici et al, 2020). …”
Section: Resultsmentioning
confidence: 99%
“… Forest plot showing effect sizes of the change of TNF α following treatment in drug-naïve first-episode schizophrenia and MDD. Baseline levels in drug-naïve first-episode schizophrenia (Hedges' g = 0.48; p = 0.002) and MDD (Hedges' g = 1.21; p < 0.001) patients measured before treatment compared with healthy controls (Çakici et al, 2020 ). Diamonds illustrate the effect sizes of change, the middle of each diamond represents the effect size, the width of the lines depicts the width of the 95% CI, and the width of the summary effect size diamond depicts the overall 95% CI.…”
Section: Resultsmentioning
confidence: 99%
“…BDNF, among other neurotrophic factors, contribute to maintaining the plasticity of neurons and is therefore a key component for cognition (Benraiss, Chmielnicki, Lerner, Roh, & Goldman, 2001 ; Pencea, Bingaman, Wiegand, & Luskin, 2001 ). There is meta-analytic evidence that BDNF is decreased in both schizophrenia and MDD present from disease-onset (Çakici et al, 2020 ; Fernandes et al, 2015 ; Molendijk et al, 2014 ).…”
Section: Discussionmentioning
confidence: 99%
“…In this meta-analysis, we observed an increase of fasting glucose levels following treatment in drug-naïve first-episode schizophrenia patients, but not in those with MDD. Meta-analytic evidence has confirmed an altered glucose homeostasis is already present in schizophrenia from disease onset (Çakici et al, 2020;Greenhalgh et al, 2017;Kucukgoncu et al, 2019;Perry et al, 2016;Pillinger et al, 2017), even in drug-naïve patients (Çakici et al, 2020). Indeed, long before the advent of antipsychotics an increased incidence of diabetes among schizophrenia patients has been described (Kohen, 2004).…”
Background
This meta-analysis on peripheral blood compounds in drug-naïve first-episode patients with either schizophrenia or major depressive disorder (MDD) examined which compounds change following psychopharmacological treatment.
Methods
The Embase, PubMed and PsycINFO databases were systematically searched for longitudinal studies reporting measurements of blood compounds in drug-naïve first-episode schizophrenia or MDD.
Results
For this random-effects meta-analysis, we retrieved a total of 31 studies comprising 1818 schizophrenia patients, and 14 studies comprising 469 MDD patients. Brain-derived neurotrophic factor (BDNF) increased following treatment in schizophrenia (Hedges' g (g): 0.55; 95% confidence interval (CI) 0.39–0.70; p < 0.001) and MDD (g: 0.51; CI 0.06–0.96; p = 0.027). Interleukin (IL)-6 levels decreased in schizophrenia (g: −0.48; CI −0.85 to −0.11; p = 0.011), and for MDD a trend of decreased IL-6 levels was observed (g: −0.39; CI −0.87 to 0.09; p = 0.115). Tumor necrosis factor alpha (TNFα) also decreased in schizophrenia (g: −0.34; CI −0.68 to −0.01; p = 0.047) and in MDD (g: −1.02; CI −1.79 to −0.25; p = 0.009). Fasting glucose levels increased only in schizophrenia (g: 0.26; CI 0.07–0.44; p = 0.007), but not in MDD. No changes were found for C-reactive protein, IL-1β, IL-2 and IL-4.
Conclusions
Psychopharmacological treatment has modulating effects on BDNF and TNFα in drug-naïve first-episode patients with either schizophrenia or MDD. These findings support efforts for further research into transdiagnostic preventive strategies and augmentation therapy for those with immune dysfunctions.
“…2 . Figure 2 also shows the results of (baseline) blood compounds in drug-naïve first-episode patients with schizophrenia or MDD compared with healthy controls, as published in a previous meta-analysis (Çakici et al, 2020 ). Fig.…”
Section: Resultsmentioning
confidence: 92%
“…BDNF, brain-derived neurotrophic factor; CRP, C-reactive protein; IL, interleukin; MDD, major depressive disorder; P , p value; TNF α , tumor necrosis factor alpha. *Baseline levels in drug-naïve first-episode patients measured before treatment compared with healthy controls (Çakici et al, 2020). …”
Section: Resultsmentioning
confidence: 99%
“… Forest plot showing effect sizes of the change of TNF α following treatment in drug-naïve first-episode schizophrenia and MDD. Baseline levels in drug-naïve first-episode schizophrenia (Hedges' g = 0.48; p = 0.002) and MDD (Hedges' g = 1.21; p < 0.001) patients measured before treatment compared with healthy controls (Çakici et al, 2020 ). Diamonds illustrate the effect sizes of change, the middle of each diamond represents the effect size, the width of the lines depicts the width of the 95% CI, and the width of the summary effect size diamond depicts the overall 95% CI.…”
Section: Resultsmentioning
confidence: 99%
“…BDNF, among other neurotrophic factors, contribute to maintaining the plasticity of neurons and is therefore a key component for cognition (Benraiss, Chmielnicki, Lerner, Roh, & Goldman, 2001 ; Pencea, Bingaman, Wiegand, & Luskin, 2001 ). There is meta-analytic evidence that BDNF is decreased in both schizophrenia and MDD present from disease-onset (Çakici et al, 2020 ; Fernandes et al, 2015 ; Molendijk et al, 2014 ).…”
Section: Discussionmentioning
confidence: 99%
“…In this meta-analysis, we observed an increase of fasting glucose levels following treatment in drug-naïve first-episode schizophrenia patients, but not in those with MDD. Meta-analytic evidence has confirmed an altered glucose homeostasis is already present in schizophrenia from disease onset (Çakici et al, 2020;Greenhalgh et al, 2017;Kucukgoncu et al, 2019;Perry et al, 2016;Pillinger et al, 2017), even in drug-naïve patients (Çakici et al, 2020). Indeed, long before the advent of antipsychotics an increased incidence of diabetes among schizophrenia patients has been described (Kohen, 2004).…”
Background
This meta-analysis on peripheral blood compounds in drug-naïve first-episode patients with either schizophrenia or major depressive disorder (MDD) examined which compounds change following psychopharmacological treatment.
Methods
The Embase, PubMed and PsycINFO databases were systematically searched for longitudinal studies reporting measurements of blood compounds in drug-naïve first-episode schizophrenia or MDD.
Results
For this random-effects meta-analysis, we retrieved a total of 31 studies comprising 1818 schizophrenia patients, and 14 studies comprising 469 MDD patients. Brain-derived neurotrophic factor (BDNF) increased following treatment in schizophrenia (Hedges' g (g): 0.55; 95% confidence interval (CI) 0.39–0.70; p < 0.001) and MDD (g: 0.51; CI 0.06–0.96; p = 0.027). Interleukin (IL)-6 levels decreased in schizophrenia (g: −0.48; CI −0.85 to −0.11; p = 0.011), and for MDD a trend of decreased IL-6 levels was observed (g: −0.39; CI −0.87 to 0.09; p = 0.115). Tumor necrosis factor alpha (TNFα) also decreased in schizophrenia (g: −0.34; CI −0.68 to −0.01; p = 0.047) and in MDD (g: −1.02; CI −1.79 to −0.25; p = 0.009). Fasting glucose levels increased only in schizophrenia (g: 0.26; CI 0.07–0.44; p = 0.007), but not in MDD. No changes were found for C-reactive protein, IL-1β, IL-2 and IL-4.
Conclusions
Psychopharmacological treatment has modulating effects on BDNF and TNFα in drug-naïve first-episode patients with either schizophrenia or MDD. These findings support efforts for further research into transdiagnostic preventive strategies and augmentation therapy for those with immune dysfunctions.
IMPORTANCE Heterogeneous evidence exists for the association between COVID-19 and the clinical outcomes of patients with mental health disorders. It remains unknown whether patients with COVID-19 and mental health disorders are at increased risk of mortality and should thus be targeted as a high-risk population for severe forms of COVID-19.OBJECTIVE To determine whether patients with mental health disorders were at increased risk of COVID-19 mortality compared with patients without mental health disorders.DATA SOURCES For this systematic review and meta-analysis, MEDLINE, Web of Science, and Google Scholar were searched from inception to February 12, 2021. Bibliographies were also searched, and the corresponding authors were directly contacted. The search paradigm was based on the following combination: (mental, major[MeSH terms]) AND (COVID-19 mortality[MeSH terms]). To ensure exhaustivity, the term mental was replaced by psychiatric, schizophrenia, psychotic, bipolar disorder, mood disorders, major depressive disorder, anxiety disorder, personality disorder, eating disorder, alcohol abuse, alcohol misuse, substance abuse, and substance misuse.STUDY SELECTION Eligible studies were population-based cohort studies of all patients with identified COVID-19 exploring the association between mental health disorders and mortality.DATA EXTRACTION AND SYNTHESIS Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was used for abstracting data and assessing data quality and validity. This systematic review is registered with PROSPERO.
MAIN OUTCOMES AND MEASURESPooled crude and adjusted odds ratios (ORs) for the association of mental health disorders with mortality were calculated using a 3-level random-effects (study/country) approach with a hierarchical structure to assess effect size dependency.RESULTS In total, 16 population-based cohort studies (data from medico-administrative health or electronic/medical records databases) across 7 countries (1 from Denmark, 2 from France, 1 from Israel, 3 from South Korea, 1 from Spain, 1 from the UK, and 7 from the US) and 19 086 patients with mental health disorders were included. The studies covered December 2019 to July 2020, were of good quality, and no publication bias was identified. COVID-19 mortality was associated with an increased risk among patients with mental health disorders compared with patients without mental health disorders according to both pooled crude OR (1.75 [95% CI, 1.40-2.20]; P<.05) and adjusted OR (1.38 [95% CI, 1.15-1.65]; P<.05). The patients with severe mental health disorders had the highest ORs for risk of mortality (crude OR: 2.26 [95% CI, 1.18-4.31]; adjusted OR: 1.67 [95% CI, 1.02-2.73]).
CONCLUSIONS AND RELEVANCEIn this systematic review and meta-analysis of 16 observational studies in 7 countries, mental health disorders were associated with increased COVID-19-related mortality. Thus, patients with mental health disorders should have been targeted as a high-risk population for severe forms of COVID-19,...
ObjectivesTo investigate the role of Brain derived neurotrophic factor (BDNF) in the psychotic symptoms in first‐episode patients with schizophrenia and whether BDNF levels were associated with the improvement of psychotic symptoms after risperidone treatment.Methods89 schizophrenia patients and 90 healthy controls were recruited, the schizophrenia patients were assigned into early response or early non‐response groups at 2 weeks based on improvement in the positive and negative symptoms scale (PANSS) total score. All patients were treated with risperidone for 2 weeks, their serum BDNF levels were compared at baseline and after 2 weeks treatment.ResultsWe found that patients had lower BDNF levels, compared to controls at baseline. After 2 weeks of treatment of risperidone, BDNF levels were significantly increased and psychotic symptoms were decreased in early response group. Correlation analysis showed that the change of BDNF levels after treatment was correlated with the change of PANSS total score. Further regression analysis showed that the change in BDNF levels was an independent predictor for the improvement in psychotic symptoms.ConclusionsOur findings reveal that the level of BDNF was lower in first‐episode schizophrenic patients, moreover, the changes in serum BDNF levels may have a predictive effect on the early improvement in psychotic symptoms in the first 2 weeks.
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