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[PMID]:28456857
[Au] Autor:Schultze-Lutter F; Hubl D; Schimmelmann BG; Michel C
[Ad] Endereço:University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Haus A, 3000, Bern, Switzerland. frauke.schultze-lutter@kjp.unibe.ch.
[Ti] Título:Age effect on prevalence of ultra-high risk for psychosis symptoms: replication in a clinical sample of an early detection of psychosis service.
[So] Source:Eur Child Adolesc Psychiatry;26(11):1401-1405, 2017 Nov.
[Is] ISSN:1435-165X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Higher frequencies of perceptual and lesser clinical significance of non-perceptual attenuated psychotic symptoms (APS) have been reported by 8- to 15-year-old of the general population compared to 16- to 40-year-old. We examined if such an age-effect can also be detected in a clinical never-psychotic sample (N = 133) referred to a specialized service for clinical suspicion of developing psychosis. APS and brief intermittent psychotic symptoms (BIPS) were assessed using items P1-P3 and P5 (non-perceptual), and P4 (perceptual) of the Structured Interview for Psychosis-Risk Syndromes, current axis-I disorders with the Mini-International Neuropsychiatric Interview, and psychosocial functioning with the Social and Occupational Functioning Assessment Scale. In the sample, 64% reported APS (61%) or BIPS (7%); any perceptual APS/BIPS was reported by 43% and any non-perceptual APS/BIPS by 44%. In correspondence to the results in the general population sample, perceptual but not non-perceptual APS/BIPS were significantly more frequent in younger age groups below the age of 16 (8-12 years: odds ratio (OR) = 4.7 (1.1-19.5); 13-15 years: OR = 2.7 (0.9-7.7); 20-24-year-old as reference group). An age-effect of APS/BIPS on the presence of any current axis-I disorder (59%) or functional difficulties (67%) was not detected. However, when onset requirements of APS criteria (onset/worsening in past year) were met, the likelihood of a psychiatric diagnosis increased significantly with advancing age. Overall, the replicated age-effect on perceptual APS/BIPS in this clinical sample highlights the need to examine ways to distinguish clinically relevant perceptual APS/BIPS from perceptual aberrations likely remitting over the course of adolescence.
[Mh] Termos MeSH primário: Transtornos Psicóticos/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Criança
Diagnóstico Precoce
Feminino
Seres Humanos
Masculino
Prevalência
Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE
[do] DOI:10.1007/s00787-017-0994-y


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[PMID]:29231022
[Au] Autor:Li CH; Huang LN; Zhang MC; He M
[Ad] Endereço:Shanghai Xuhui Mental Health Center, Shanghai 200232, China.
[Ti] Título:[Forensic Psychiatric Assessment for Organic Personality Disorders after Craniocerebral Trauma].
[So] Source:Fa Yi Xue Za Zhi;33(2):158-161, 2017 Apr.
[Is] ISSN:1004-5619
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVES: To explore the occurrence and the differences of clinical manifestations of organic personality disorder with varying degrees of craniocerebral trauma. METHODS: According to the International Classification of Diseases-10, 396 subjects with craniocerebral trauma caused by traffic accidents were diagnosed, and the degrees of craniocerebral trauma were graded. The personality characteristics of all patients were evaluated using the simplified Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI). RESULTS: The occurrence rate of organic personality disorder was 34.6% while it was 34.9% and 49.5% in the patients with moderate and severe craniocerebral trauma, respectively, which significantly higher than that in the patients (18.7%) of mild craniocerebral trauma ( <0.05). Compared with the patients without personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences ( <0.05) in the patients of mild craniocerebral trauma with personality disorder; the neuroticism, extraversion, agreeableness and conscientiousness scores showed significantly differences ( >0.05) in the patients of moderate and severe craniocerebral trauma with personality disorder. The agreeableness and conscientiousness scores in the patients of moderate and severe craniocerebral trauma with personality disorder were significantly lower than that of mild craniocerebral trauma, and the patients of severe craniocerebral trauma had a lower score in extraversion than in the patients of mild craniocerebral trauma. CONCLUSIONS: The severity of craniocerebral trauma is closely related to the incidence of organic personality disorder, and it also affects the clinical features of the latter, which provides a certain significance and help for forensic psychiatric assessment.
[Mh] Termos MeSH primário: Traumatismos Craniocerebrais/patologia
Transtornos da Personalidade/psicologia
Transtornos Psicóticos/psicologia
[Mh] Termos MeSH secundário: Seres Humanos
Personalidade
Transtornos da Personalidade/fisiopatologia
Inventário de Personalidade
Transtornos Psicóticos/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2017.02.010


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[PMID]:29205970
[Au] Autor:Xu WJ; Ji P
[Ad] Endereço:Criminal Police Brigade of Liyang Public Security Bureau, Liyang 213300, China.
[Ti] Título:[Retrospective Analysis of 17 Family Homicide Cases].
[So] Source:Fa Yi Xue Za Zhi;32(6):431-433, 2016 Dec.
[Is] ISSN:1004-5619
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVES: To summarize the characteristics of family homicide cases and to provide reference for the analysis and prevention of such cases. METHODS: Seventeen solved family homicide cases in Liyang from 2004 to 2014 were investigated. The original registration information, record of scene investigation, corpse inspection report and case situation were analyzed statistically. RESULTS: The characteristics of the 17 family homicides cases showed that most victims were female and most suspects were male, and spouse infidelity and suspected spouse infidelity have higher proportion in the motives for the killings. Murders by patients with psychosis, camouflage murders and murder-suicides occupied a certain proportion in the family homicide cases. CONCLUSIONS: The family homicide cases are correlated with the family factors such as extramarital sexual intercourse and murder by patients with psychosis. Some suspects suicided after murder. The tools for committing crimes have the features of simplicity, randomness and easy source availability.
[Mh] Termos MeSH primário: Homicídio
Motivação
[Mh] Termos MeSH secundário: Cadáver
Vítimas de Crime
Família
Feminino
Seres Humanos
Masculino
Transtornos Psicóticos
Estudos Retrospectivos
Suicídio
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2016.06.009


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[PMID]:29179831
[Au] Autor:Chee GL; Wynaden D; Heslop K
[Ad] Endereço:School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia. Electronic address: Johnathan.Chee@health.wa.gov.au.
[Ti] Título:Improving metabolic monitoring rate for young people aged 35 and younger taking antipsychotic medications to treat a psychosis: A literature review.
[So] Source:Arch Psychiatr Nurs;31(6):624-633, 2017 12.
[Is] ISSN:1532-8228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Young people aged 35 and younger who are taking antipsychotic medications to treat a psychosis are a high risk for developing metabolic syndrome due to the adverse effects of the medications. This paper reports the finding of a review of literature to identify interventions to improve metabolic monitoring rates in this group. A review of 478 studies identified 15 articles which met the inclusion criteria. Five articles reported single-intervention studies and the remaining integrated two or more interventions to improve uptake level of metabolic monitoring. As metabolic syndrome can be detected early through metabolic monitoring in young people taking antipsychotics, early intervention is important to improve their physical health trajectory.
[Mh] Termos MeSH primário: Antipsicóticos/efeitos adversos
Síndrome Metabólica/etiologia
Transtornos Psicóticos/complicações
[Mh] Termos MeSH secundário: Antipsicóticos/uso terapêutico
Seres Humanos
Transtornos Psicóticos/tratamento farmacológico
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antipsychotic Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29179820
[Au] Autor:Penno SJ; Hamilton B; Petrakis M
[Ad] Endereço:St. Vincent's Hospital (Melbourne), Mental Health Service, Melbourne, Australia.
[Ti] Título:Early Intervention in Psychosis: Health of the Nation Outcome Scales (HoNOS) Outcomes From a Five-Year Prospective Study.
[So] Source:Arch Psychiatr Nurs;31(6):553-560, 2017 12.
[Is] ISSN:1532-8228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Over the last two decades, mental health services internationally have shifted towards intervening early in psychosis. The critical period for intervention is estimated to be five-years and many specialised programs target early psychosis. AIM/QUESTION: This prospective cohort study aimed to evaluate five-year outcomes from an early psychosis program (EPP) that adopted an integrated model, providing nursing and multidisciplinary community mental healthcare to clients aged 16-65years, beyond the typical age range of 16-25years. METHOD: We examined one routine outcome measure, the Health of the Nation Outcome Scales (HoNOS) across episodes of care for clients receiving EPP over a 5year period (n=239), comparing these results with HoNOS outcomes in an Australian national dataset for all public mental health clients. RESULTS: HoNOS improvements were highly significant from intake to discharge and from review to discharge for EPP clients, and these compared well with national outcome performance. CONCLUSION: There is potential for mental health nurses and other clinicians to significantly improve client symptoms and functioning, in a model of early psychosis treatment beyond a youth focus.
[Mh] Termos MeSH primário: Diagnóstico Precoce
Avaliação de Resultados (Cuidados de Saúde)/métodos
Transtornos Psicóticos/terapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Austrália
Prática Clínica Baseada em Evidências
Feminino
Seres Humanos
Estudos Longitudinais
Masculino
Serviços de Saúde Mental/utilização
Meia-Idade
Estudos Prospectivos
Enfermagem Psiquiátrica
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29341067
[Au] Autor:Soares-Weiser K; Maayan N; Bergman H
[Ad] Endereço:Cochrane Editorial Unit, Cochrane, St Albans House, 57 - 59 Haymarket, London, UK, SW1Y 4QX.
[Ti] Título:Vitamin E for antipsychotic-induced tardive dyskinesia.
[So] Source:Cochrane Database Syst Rev;1:CD000209, 2018 01 17.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Antipsychotic (neuroleptic) medication is used extensively to treat people with chronic mental illnesses. Its use, however, is associated with adverse effects, including movement disorders such as tardive dyskinesia (TD) - a problem often seen as repetitive involuntary movements around the mouth and face. Vitamin E has been proposed as a treatment to prevent or decrease TD. OBJECTIVES: The primary objective was to determine the clinical effects of vitamin E in people with schizophrenia or other chronic mental illness who had developed antipsychotic-induced TD.The secondary objectives were:1. to examine whether the effect of vitamin E was maintained as duration of follow-up increased;2. to test the hypothesis that the use of vitamin E is most effective for those with early onset TD (less than five years) SEARCH METHODS: We searched the Cochrane Schizophrenia Group Trials Register (July 2015 and April 2017), inspected references of all identified studies for further trials and contacted authors of trials for additional information. SELECTION CRITERIA: We included reports if they were controlled trials dealing with people with antipsychotic-induced TD and schizophrenia who remained on their antipsychotic medication and had been randomly allocated to either vitamin E or to a placebo, no intervention, or any other intervention. DATA COLLECTION AND ANALYSIS: We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assumed that people who left early had no improvement. We assessed risk of bias and created a 'Summary of findings' table using GRADE. MAIN RESULTS: The review now includes 13 poorly reported randomised trials (total 478 people), all participants were adults with chronic psychiatric disorders, mostly schizophrenia, and antipsychotic-induced TD. There was no clear difference between vitamin E and placebo for the outcome of TD: not improved to a clinically important extent (6 RCTs, N = 264, RR 0.95, 95% CI 0.89 to 1.01, low-quality evidence). However, people allocated to placebo may show more deterioration of their symptoms compared with those given vitamin E (5 RCTs, N = 85, RR 0.23, 95% CI 0.07 to 0.76, low-quality evidence). There was no evidence of a difference in the incidence of any adverse effects (9 RCTs, N = 205, RR 1.21, 95% CI 0.35 to 4.15, very low-quality evidence), extrapyramidal adverse effects (1 RCT, N = 104, MD 1.10, 95% CI -1.02 to 3.22, very low-quality evidence), or acceptability of treatment (measured by participants leaving the study early) (medium term, 8 RCTs, N = 232, RR 1.07, 95% CI 0.64 to 1.80, very low-quality evidence). No trials reported on social confidence, social inclusion, social networks, or personalised quality of life, outcomes designated important to patients. There is no trial-based information regarding the effect of vitamin E for those with early onset of TD. AUTHORS' CONCLUSIONS: Small trials of limited quality suggest that vitamin E may protect against deterioration of TD. There is no evidence that vitamin E improves symptoms of this problematic and disfiguring condition once established. New and better trials are indicated in this under-researched area, and, of the many adjunctive treatments that have been given for TD, vitamin E would be a good choice for further evaluation.
[Mh] Termos MeSH primário: Antipsicóticos/efeitos adversos
Discinesia Induzida por Medicamentos/tratamento farmacológico
Vitamina E/uso terapêutico
Vitaminas/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Progressão da Doença
Discinesia Induzida por Medicamentos/etiologia
Seres Humanos
Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos
Transtornos Psicóticos/tratamento farmacológico
Ensaios Clínicos Controlados Aleatórios como Assunto
Esquizofrenia/tratamento farmacológico
Vitamina E/efeitos adversos
Vitaminas/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Antipsychotic Agents); 0 (Vitamins); 1406-18-4 (Vitamin E)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD000209.pub3


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[PMID]:28460793
[Au] Autor:Kawakami Y; Itoh Y
[Ad] Endereço:Department of Pediatrics, Nippon Medical School, Bunkyo-ku, Tokyo, Japan; Department of Pediatrics, Nippon Medical School Tama Nagayama Hospital, Tama-shi, Tokyo, Japan. Electronic address: kawakami@nms.ac.jp.
[Ti] Título:Forced Normalization: Antagonism Between Epilepsy and Psychosis.
[So] Source:Pediatr Neurol;70:16-19, 2017 May.
[Is] ISSN:1873-5150
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The antagonism between epilepsy and psychosis has been discussed for a long time. Landolt coined the term "forced normalization" in the 1950s to describe psychotic episodes associated with the remission of seizures and disappearance of epileptiform activity on electroencephalograms in individuals with epilepsy. Since then, neurologists and psychiatrists have been intrigued by this phenomenon. However, although collaborative clinical studies and basic experimental researches have been performed, the mechanism of forced normalization remains unknown. In this review article, we present a historical overview of the concept of forced normalization, and discuss potential pathogenic mechanisms and clinical diagnosis. We also discuss the role of dopamine, which appears to be a key factor in the mechanism of forced normalization.
[Mh] Termos MeSH primário: Epilepsia/complicações
Epilepsia/psicologia
Transtornos Psicóticos/etiologia
[Mh] Termos MeSH secundário: Eletroencefalografia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  8 / 32352 MEDLINE  
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[PMID]:29212505
[Au] Autor:Endres D; Huzly D; Dersch R; Stich O; Berger B; Schuchardt F; Perlov E; Venhoff N; Hellwig S; Fiebich BL; Erny D; Hottenrott T; Tebartz van Elst L
[Ad] Endereço:Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. dominique.endres@uniklinik-freiburg.de.
[Ti] Título:Do patients with schizophreniform and bipolar disorders show an intrathecal, polyspecific, antiviral immune response? A pilot study.
[So] Source:Fluids Barriers CNS;14(1):34, 2017 Dec 07.
[Is] ISSN:2045-8118
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We previously described inflammatory cerebrospinal fluid (CSF) alterations in a subgroup of patients with schizophreniform disorders and the synthesis of polyspecific intrathecal antibodies against different neurotropic infectious pathogens in some patients with bipolar disorders. Consequently, we have measured the prevalence of a positive MRZ reaction (MRZR)-a marker for a polyspecific, antiviral, intrathecal, humoral immune response composed of three antibody indices for the neurotropic viruses of measles (M), rubella (R), and varicella zoster (Z)-in these patients. METHODS: We analyzed paired CSF and serum samples of 39 schizophreniform and 39 bipolar patients. For comparison, we used a group of 48 patients with other inflammatory neurological disorders (OIND) and a cohort of 203 multiple sclerosis (MS) patients. RESULTS: We found a positive MRZR in two patients with schizophreniform disorders (5.1%); both suffered from schizodepressive disorders without any other signs suggestive of MS. None of the bipolar patients (0%) and four members of the OIND group (8.3%) showed a positive MRZR. In the MS cohort, a positive MRZR was found significantly more frequently [in 99 patients (48.8%)] than in the other patient groups (p > 0.001). In summary, we did not find a positive MRZR in a relevant subgroup of patients with schizophreniform or bipolar disorders. CONCLUSIONS: Our results indicate that the MRZR is highly specific to MS. Nevertheless, two schizodepressive patients also had a positive MRZR. This finding corresponds to the few MRZR-positive patients with OIND or other autoimmune disorders with central nervous involvement, implicating that the MRZR specificity for MS is high, but not 100%.
[Mh] Termos MeSH primário: Anticorpos Antivirais/líquido cefalorraquidiano
Transtorno Bipolar/imunologia
Transtornos Psicóticos/imunologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Projetos Piloto
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Viral)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1186/s12987-017-0082-1


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[PMID]:28470892
[Au] Autor:Berk L; Hallam KT; Venugopal K; Lewis AJ; Austin DW; Kulkarni J; Dodd S; de Castella A; Fitzgerald PB; Berk M
[Ad] Endereço:Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Vic., Australia.
[Ti] Título:Impact of irritability: a 2-year observational study of outpatients with bipolar I or schizoaffective disorder.
[So] Source:Bipolar Disord;19(3):184-197, 2017 May.
[Is] ISSN:1399-5618
[Cp] País de publicação:Denmark
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Many people experience irritability when manic, hypomanic, or depressed, yet its impact on illness severity and quality of life in bipolar and schizoaffective disorders is poorly understood. This study aimed to examine the relationship between irritability and symptom burden, functioning, quality of life, social support, suicidality, and overall illness severity in a naturalistic cohort of people with bipolar I or schizoaffective disorder. METHODS: We used data from 239 adult outpatients with bipolar I or schizoaffective disorder in the Bipolar Comprehensive Outcomes Study (BCOS) - a non-interventional observational study with a 2-year follow-up period. Baseline demographic and clinical characteristics of participants with and without irritability were compared. A mixed-model repeated measures analysis was conducted to examine the longitudinal effect of irritability on clinical and quality-of-life variables over follow-up using significant baseline variables. RESULTS: At baseline, 54% of participants were irritable. Baseline irritability was associated with illness severity, mania, depression, psychotic symptoms, suicidality, poor functioning, and quality of life, but not diagnosis (schizoaffective/bipolar disorder). Participants with irritability were less likely to have a partner and perceived less adequate social support. On average, over follow-up, those with irritability reported more symptoms, functional impairment, and suicidality. Furthermore, the effects of irritability could not be fully explained by illness severity. CONCLUSIONS: Irritability was associated with more negative symptomatic, functional, and quality-of-life outcomes and suicidality. The identification, monitoring, and targeted treatment of irritability may be worth considering, to enhance health and wellbeing outcomes for adults with bipolar and schizoaffective disorders.
[Mh] Termos MeSH primário: Transtorno Bipolar
Humor Irritável
Transtornos Psicóticos
Qualidade de Vida
[Mh] Termos MeSH secundário: Atividades Cotidianas/psicologia
Adulto
Austrália/epidemiologia
Transtorno Bipolar/diagnóstico
Transtorno Bipolar/epidemiologia
Transtorno Bipolar/psicologia
Estudos de Coortes
Efeitos Psicossociais da Doença
Manual Diagnóstico e Estatístico de Transtornos Mentais
Feminino
Seres Humanos
Masculino
Meia-Idade
Avaliação de Resultados (Cuidados de Saúde)
Pacientes Ambulatoriais/psicologia
Transtornos Psicóticos/diagnóstico
Transtornos Psicóticos/epidemiologia
Transtornos Psicóticos/psicologia
Índice de Gravidade de Doença
Apoio Social
Ideação Suicida
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1111/bdi.12486


  10 / 32352 MEDLINE  
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[PMID]:28463241
[Au] Autor:Wurfel BE; Drevets WC; Bliss SA; McMillin JR; Suzuki H; Ford BN; Morris HM; Teague TK; Dantzer R; Savitz JB
[Ad] Endereço:Laureate Institute for Brain Research, Laureate Institute for Brain Research, Tulsa, OK, USA.
[Ti] Título:Serum kynurenic acid is reduced in affective psychosis.
[So] Source:Transl Psychiatry;7(5):e1115, 2017 May 02.
[Is] ISSN:2158-3188
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A subgroup of individuals with mood and psychotic disorders shows evidence of inflammation that leads to activation of the kynurenine pathway and the increased production of neuroactive kynurenine metabolites. Depression is hypothesized to be causally associated with an imbalance in the kynurenine pathway, with an increased metabolism down the 3-hydroxykynurenine (3HK) branch of the pathway leading to increased levels of the neurotoxic metabolite, quinolinic acid (QA), which is a putative N-methyl-d-aspartate (NMDA) receptor agonist. In contrast, schizophrenia and psychosis are hypothesized to arise from increased metabolism of the NMDA receptor antagonist, kynurenic acid (KynA), leading to hypofunction of GABAergic interneurons, the disinhibition of pyramidal neurons and striatal hyperdopaminergia. Here we present results that challenge the model of excess KynA production in affective psychosis. After rigorous control of potential confounders and multiple testing we find significant reductions in serum KynA and/or KynA/QA in acutely ill inpatients with major depressive disorder (N=35), bipolar disorder (N=53) and schizoaffective disorder (N=40) versus healthy controls (N=92). No significant difference was found between acutely ill inpatients with schizophrenia (n=21) and healthy controls. Further, a post hoc comparison of patients divided into the categories of non-psychotic affective disorder, affective psychosis and psychotic disorder (non-affective) showed that the greatest decrease in KynA was in the affective psychosis group relative to the other diagnostic groups. Our results are consistent with reports of elevations in proinflammatory cytokines in psychosis, and preclinical work showing that inflammation upregulates the enzyme, kynurenine mono-oxygenase (KMO), which converts kynurenine into 3-hydroxykynurenine and quinolinic acid.
[Mh] Termos MeSH primário: Transtornos Psicóticos Afetivos/metabolismo
Ácido Cinurênico/sangue
Quinurenina 3-Mono-Oxigenase/metabolismo
[Mh] Termos MeSH secundário: Adulto
Transtornos Psicóticos Afetivos/sangue
Transtornos Psicóticos Afetivos/fisiopatologia
Transtorno Bipolar/metabolismo
Corpo Estriado/metabolismo
Citocinas/metabolismo
Depressão/metabolismo
Transtorno Depressivo Maior/metabolismo
Feminino
Neurônios GABAérgicos/metabolismo
Seres Humanos
Inflamação/enzimologia
Ácido Cinurênico/metabolismo
Cinurenina/análogos & derivados
Cinurenina/metabolismo
Masculino
Meia-Idade
Transtornos Psicóticos/metabolismo
Ácido Quinolínico/metabolismo
Receptores de N-Metil-D-Aspartato/metabolismo
Esquizofrenia/metabolismo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cytokines); 0 (Receptors, N-Methyl-D-Aspartate); 27723548JL (3-hydroxykynurenine); 343-65-7 (Kynurenine); EC 1.14.13.9 (Kynurenine 3-Monooxygenase); F6F0HK1URN (Quinolinic Acid); H030S2S85J (Kynurenic Acid)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1038/tp.2017.88



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