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Elevated non-high-density lipoprotein cholesterol (non-HDL-C) is a significant risk factor for atherosclerotic cardiovascular diseases, particularly in individuals with metabolic syndrome (MetS) and major psychiatric disorders (MPDs), who may experience metabolic side effects of psychopharmacological treatments. We evaluated the cholesterol-lowering effects of an experimental pasta characterized by a high content of phytosterols, arabinoxylans, polyunsaturated and monounsaturated fatty acids, and vitamin E in individuals with MetS, with and without MPDs.
Methods
In a double-blind, randomized trial, 298 participants with MetS were assigned to consume either experimental or conventional pasta for 3 months. Non-HDL-C levels were measured at baseline and follow-up. A polygenic risk score for hypercholesterolemia (TC-PRS) was calculated to assess any genetic influence on the intervention’s efficacy. The cholesterol-lowering effect of the experimental pasta was also tested in vitro by exposing human hepatocarcinoma cells, which developed lipid storage alterations due to olanzapine (OLZ) exposure, to an extract of the flour mixture used to prepare the experimental pasta.
Results
The participants who consumed the experimental pasta exhibited a significantly greater reduction in serum non-HDL-C levels compared to the control group (p = 0.001). No significant interaction between pasta variety and the TC-PRS on non-HDL-C changes was found. The extract from the experimental flour mixture significantly reduced both the number and size of lipid droplets in HepG2 cells treated with OLZ.
Conclusions
These results indicate that a low-impact lifestyle intervention may offer a practical strategy for improving the cholesterol profile and mitigating cardiovascular risk in patients with MetS, with and without an MPD.
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.
Depressive disorders confer a high risk for substance abuse, physical illness, early pregnancy and poor vocational, academic and psychosocial functioning. The longer an episode of major depressive disorder (MDD) in school-aged children or adolescents persists, the greater the risk for long-lasting impairment in school, social or family domain. Looking at mood states and depressive syndromes from a psycho-pharmacological point of view shows remarkable differences, but also similarities between childhood/adolescence and adulthood. This chapter discusses these, providing an overview of the present state of pharmacological treatment of depressive syndromes in young people. Antidepressant medication in childhood and adolescence is indicated in cases of severe depressive symptomatology which are unresponsive to psycho-therapeutic interventions. For patients requiring pharmacotherapy, selective serotonin reuptake inhibitors (SSRIs) are the initial antidepressants of choice. Several psychopharmacological strategies are recommended for adults: optimization, augmentation or combination, and switching to the same or a different class of medications.
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