Acta Neuropsychiatrica

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ISSN / EISSN : 0924-2708 / 1601-5215
Published by: Cambridge University Press (CUP) (10.1017)
Total articles ≅ 1,963
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Acta Neuropsychiatrica pp 1-28;

Background The treatment of mania in bipolar disorders needs to be more efficient, as the manic condition creates severe problems for the patient when it comes to work, finances, relationships, and health. This proof-of-concept study examines to what extent casein glycomacropeptide (CGMP) may reduce the precursors of dopamine, phenylalanine, and tyrosine, in plasma, and therefore be a potential new intervention to treat acute manic episodes. Method The study was designed as a double-blind randomised dose-response study of CGMP (with added leucine and tryptophan) in 15 healthy men, receiving 3 different doses of CGMP with an interval of at least 14 days. Results Administration of CGMP produced a dose dependent depletion of plasma aromatic amino acids. The total area under the curve of plasma ratios of phenylalanine-tyrosine compared to the level of leucine-isoleucine-valine-tryptophan was CGMP(20g): 3.648 [SE:0.3281]; CGMP(40g): 2.368 [SE:0.1858]; CGMP(60g)1.887 [SE:0.2591]. A comparison of the groups showed a dose dependent statistical difference, with a One-Way ANOVA summary (Dunnett) F= 11.87, p= 0.0003, CGMP 20g vs CGMP 40g, p= 0.0042, CGMP 20g vs CGMP 60g, p= 0.0002. No significant side effects were observed. Conclusions This study demonstrate CGMP is a well-tolerated and effective mixture, and that 60 g CGMP produced the highest depletion of plasma aromatic amino acids (phenylalanine and tyrosine). The effect seems to be highest after 3-4 hours. We therefore conclude that this dose should be the one considered for future studies involving CGMP in humans.
Miranda Stiernborg, Paschalis Efstathopoulos, , Catharina Lavebratt,
Acta Neuropsychiatrica pp 1-19;

Objective: Since the NAD+-dependent histone deacetylases sirtuin-1 (SIRT1) and sirtuin-2 (SIRT2) are critically involved in epigenetics, endocrinology and immunology and affect the longevity in model organisms, we investigated their expression in brains of 3 month old and 14-15 month old rat model of depression Flinders Sensitive Line (FSL) and control Flinders Resistant Line (FRL) rats. In view of the dysregulated NPY system in depression we also studied NPY in young and old FSL to explore the temporal trajectory of depressive-like-ageing interaction. Methods: Sirt1, Sirt2 and Npy mRNA were determined using qRT-PCR in prefrontal cortex (PFC) from young and old FSL and FRL, and in hippocampi from young FSL and FRL. Results: PFC. Sirt1 expression was decreased in FSL (p=0.001). An interaction between age and genotype was found (p=0.032); young FSL had lower Sirt1 with respect to both age (p=0.026) and genotype (p=0.001). Sirt2 was lower in FSL (p=0.003). Npy mRNA was downregulated in FSL (p=0.001) but did not differ between the young and old rat groups. Hippocampus. Sirt1 was reduced in young FSL compared to young FRL (p=0.005). There was no difference in Sirt2 between FSL and FRL. Npy levels were decreased in hippocampus of young FSL compared to young FRL (p=0.003). Effects of ageing could not be investigated due to loss of samples. Conclusions: i. This is the first demonstration that SIRT1 and SIRT2 are changed in brain of FSL, a rat model of depression ; ii. The changes are age dependent; iii. Sirtuins are potential targets for treatment of age-related neurodegenerative diseases.
Bilgin Kaygisiz, Sule Aydin, Engin Yildirim, Ahmet Musmul, Kevser Erol, Fatma Sultan Kilic
Acta Neuropsychiatrica pp 1-27;

Objective: Acetylcholinesterase inhibitors are the focus of interest in the management of schizophrenia. We aimed to investigate the effects of acute galangin administration, a flavonoid compound with acetylcholinesterase inhibiting activity, on schizophrenia-associated cognitive deficits in rats and schizophrenia models in mice. Methods: Apomorphine-induced prepulse inhibition (PPI) disruption for cognitive functions, nicotinic, muscarinic and serotonergic mechanism involvement, and brain acetylcholine levels were investigated in Wistar rats. Apomorphine-induced climbing, MK-801-induced hyperlocomotion, and catalepsy tests were used as schizophrenia models in Swiss albino mice. The effects of galangin were compared with acetylcholinesterase inhibitor donepezil, and typical and atypical antipsychotics haloperidol and olanzapine, respectively. Results: Galangin (50,100 mg/kg) enhanced apomorphine-induced PPI disruption similar to donepezil, haloperidol, and olanzapine (p<0.05). This effect was not altered in the combination of galangin with the nicotinic receptor antagonist mecamylamine (1 mg/kg), the muscarinic receptor antagonist scopolamine (0.05 mg/kg), or the serotonin-1A receptor antagonist WAY-100635 (1 mg/kg) (p>0.05). Galangin (50,100 mg/kg) alone increased brain acetylcholine concentrations(p0.05). Galangin (50 mg/kg) decreased apomorphine-induced climbing and MK-801-induced hyperlocomotion similar to haloperidol and olanzapine (p<0.05), but did not induce catalepsy, unlike them. Conclusion: We suggest that galangin may help enhance schizophrenia-associated cognitive deficits, and nicotinic, muscarinic cholinergic and serotonin-1A receptors are not involved in this effect. Galangin also exerted an antipsychotic-like effect without inducing catalepsy and may be considered as an advantageous antipsychotic agent.
, Parisa Farshadfar, Maral Haghnegahdar, Ali Alavi-Shoushtari, Vahid Ghanbarinezhad
Acta Neuropsychiatrica pp 1-25;

Backgrounds Identification of a new axis of angiotensin converting enzyme 2 (ACE2)/angiotensin (1–7)/Mas receptor, in the renin-angiotensin system (RAS), has opened a new insight regarding the role of RAS and angiotensin in higher brain functions. ACE 2 catabolizes angiotensin II and produces angiotensin (1-7), an agonist of Mas receptor. Mice lacking the Mas receptor (angiotensin1-7 receptor) exhibit anxiety-like behaviors. The present study was conducted to test the hypothesis of the involvement of ACE2 genetic variant (G8790A) on response to Selective Serotonin Reuptake Inhibitors (SSRIs). Methods In a randomized control trial, two hundred newly diagnosed Iranian patients with major depressive disorder (MDD) completed 6 weeks of fluoxetine or sertraline treatment. Patients with a reduction of 50% or more in the Hamilton Rating Scale for Depression (HAM-D) score were considered responsive to treatment. G8790A polymorphism was determined in extracted DNAs using restriction fragment length polymerase chain reaction (PCR-RFLP) method. Results The A allele as well as AA and GA genotypes were significantly associated with better response to SSRIs (P=0.008; OR= 3.4; 95%CI=1.4-8.5 and P=0.027; OR=3.3, 95%CI=1.2-9.2 respectively). Moreover, patients with GA and AA genotypes responded significantly better to sertraline (P=0.0002; OR=9.1; 95%CI=2.4-33.7). The A allele was significantly associated with better response to sertraline (P=0.0001; OR=7.6; 95%CI=2.5-23.3). Conclusions In conclusion our results confirm the role of G8790A in response to some SSRIs.
Acta Neuropsychiatrica pp 1-6;

Background: The coronavirus disease 2019 (COVID-19) pandemic and the necessary social isolation and distancing measures – that were adopted to prevent spreading the virus, including the suspension of university classes – negatively impacted the mental health of young adults. The aim of the current study was to investigate whether returning to online classes, even not presential, during the social isolation of the COVID-19 pandemic, affected the mental health of university students. Methods: Forty students (10 men and 30 women) (age, 22.3 ± 3.8 years; body mass, 62.5 ± 17.8 kg; height, 165.6 ± 8.7 cm) from undergraduate health courses participated in the study. The students answered a self-administered questionnaire designed to gather personal and quarantine information as well as information about the frequency of depression (PHQ-9) and anxiety (GAD-7) symptoms. The questionnaire was answered before and after the return to online classes. Results: There was a significantly lower frequency of depression symptoms after the return to online classes (Z = −2.27; p = 0.02). However, there was no difference in anxiety symptoms before and after returning to online classes (Z = −0.51; p = 0.61). Conclusions: Return to online classes positively impacted the mental health (decrease of frequency of depression symptoms) of university students. Future studies are needed to observe whether the changes observed after returning to school are maintained over time.
Ante Silić, , , Marc De Hert, Dalibor Karlović
Acta Neuropsychiatrica pp 1-24;

Objective: Major depressive disorder (MDD) is closely related to obesity, inflammation, and insulin resistance, all together being etiologically linked to metabolic syndrome development. The depressive disorder has a neuroendocrinological component, co-influencing the metabolic syndrome, while metabolic syndrome (MetS) is characterized by increased cytokine levels, which are known to cause a depressed mood. This study aimed to establish biological subtypes of the depressive disorder based on researched clinical, laboratory, and anthropometric variables. Methods: We performed a cross-sectional study on a sample of 293 subjects (145 suffering from a depressive disorder and 148 healthy controls). Results were analyzed with multivariate statistical methods as well as with cluster and discriminant analysis. In order to classify depressive disorder on the grounds of laboratory, anthropometric, and clinical parameters, we performed cluster analysis, which resulted in three clusters. Results: The first cluster is characterized by low platelet serotonin, high cortisol levels, high blood glucose levels, high triglycerides levels, high HAMD score, increased waist circumference, high CRP values, and a high number of previous depressive episodes, was named Combined (Metabolic) depression. The inflammatory depression cluster is defined with average platelet serotonin values, normal cortisol, and all other parameter levels, except for increased IL-6 levels. The serotoninergic depression cluster is characterized by markedly low platelet serotonin, and all other parameters are within the normal range. Conclusions: From a biological point of view, depressive disorder is not uniform, and as such, these findings suggest potential clinically useful and generalizable biological subtypes of depressive disorder.
Acta Neuropsychiatrica pp 1-24;

Objective: Smoking is highly prevalent in the psychiatric population, and hospital admittance usually results in partial or complete smoking cessation. Tobacco use is known to affect the metabolism of certain psychoactive drugs, but whether smoking influences the plasma concentration of tricyclic antidepressants (TCAs) remains unclear. This paper investigates the possible effect of smoking on the plasma concentration of TCAs. Methods: A systematic review of the literature available on PubMed and EMBASE as of October 2020 was carried out using PRISMA guidelines. Studies reporting plasma concentrations of any TCA in both a smoking and a non-smoking group were included and compared.10 eligible studies were identified and included. Results: In the eight studies investigating the effect of smoking on amitriptyline and/or nortriptyline, five studies found no significant effect. Two studies investigating the effect of smoking on imipramine found a significant effect and one study investigating the effect of smoking on doxepin found no significant effect. The majority of studies included in this review were influenced by small study populations and other methodical issues. Conclusion: The effect of smoking on the plasma concentration of TCAs is still not entirely clear. There is a possibility that smoking affects the distribution of TCA metabolites, but this is probably not of clinical importance.
, Magdalena Bryniarska, Maciej Jezioro, Daniel Andrysiak, Iwona Filipczak-Bryniarska
Acta Neuropsychiatrica pp 1-5;

The aim of study was to determine factors connected with neuropsychiatric symptoms and anxiety in patients with terminal stomach cancer. We analysed retrospectively 134 terminal stomach cancer patients admitted to Palliative Care Unit. Patients with anxiety had a greater chance for emergency admission, higher Numerical Rating Scale result, occurrence of cachexia and neuropsychiatric symptoms, longer duration of treatment, higher albumin concentration and lower glucose concentration. Patients with neuropsychiatric symptoms had greater chance for emergency admission, higher Performance Status scale note, occurrence of dyselectrolytemia, lower albumin concentration. Patients with those symptoms had more than 7 times greater chance for death. It is important to know factors connected with neuropsychiatric symptoms and anxiety because thanks to that we could avoid those dangerous clinical symptoms.
Katharina von Zedtwitz, Isabelle Matteit, Maike Michel, Bernd Feige, Kimon Runge, Dominik Denzel, Andrea Schlump, Kathrin Nickel, Miriam A. Schiele, Benjamin Berger, et al.
Acta Neuropsychiatrica pp 1-8;

Autoimmune mechanisms are related to disease development in a subgroup of patients with psychosis. The contribution of immunoglobulin G (IgG) antibodies against myelin oligodendrocyte glycoprotein (MOG) is mainly unclear in this context. Therefore, two patients with psychosis and anti-MOG antibodies – detected in fixed cell-based and live cell-based assays – are presented. Patient 1 suffered from late-onset psychosis with singular white matter lesions in magnetic resonance imaging (MRI) and intermittent electroencephalography (EEG) slowing. Patient 2 suffered from a chronic paranoid–hallucinatory disorder with intermittent confusional states, non-specific white matter alterations on MRI, a disorganised alpha rhythm on EEG, and elevated cerebrospinal fluid protein. Both patients had anti-MOG antibody titres of 1 : 320 in serum (reference < 1 : 20). The arguments for and against a causal role for anti-MOG antibodies are discussed. The antibodies could be relevant, but due to moderate titres, they may have caused a rather ‘subtle clinical picture’ consisting of psychosis instead of ‘classical’ MOG encephalomyelitis.
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