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Feb 2019
Objectives This study was designed to assess the demographic characteristics, prevalence of metabolic syndrome (MetSy) among patients with schizophrenia in Saudi Arabia. Methods This is a disease-oriented and observational study. Schizophrenia was defined by DSM-IV criteria. MetSy were assessed based on the international criteria (NCEP-ATP III and AHA/NHLB). Results 90% of the participants are without a university degree and 56.4% are single. Chronic and acute cases of schizophrenia were 95% and 5%, respectively. The treatment of schizophrenia was combination therapy and monotherapy with percentages of 56% and 44%, respectively. Systolic and diastolic blood pressures were 121.92±11.07 mmHg and 77.29±0.45 mmHg, respectively. Surprisingly, all patients have abnormal HDL. A mean waist circumference of 90.23±14.88 cm for men, and 93.38±15.28 cm for women. The analysis of 101 patients showed a prevalence of the MetSy is 15.8%. Chi-square test of independence showed lack of independency of MetSy on type of therapy. Modeling of MetSy and risk factors was also conducted. Conclusion The metabolic syndrome is greatly established among schizophrenic patients. It signifies a vital hazard for metabolic and cardiovascular ailments. Evaluation of the incidence and examining of the related threats of the metabolic syndrome should be an element of the clinical managing of patients cured with antipsychotics.
Jan 2019
Excessive variability in behavioral performance and neuronal activation is a common finding in studies of schizophrenia. Recent evidence suggests that this may be due to an imbalance in the ratio of excitation to inhibition in brain function, or E/I imbalance. We used computational modeling of visual system activity to determine whether different potential causes of E/I imbalance would generate effects resembling those reported in schizophrenia. Three major findings emerged. First, reductions in retinal and lateral geniculate nucleus signaling initially led to increases in firing rate variability within the context of reduced V1 activation; however, with prolonged adaptation to weakened sensory signaling, compensatory hyper-activation in V1 neurons occurred, but variability was no longer increased. Second, direct increases in V1 excitation, or decreases in inhibition, led to the highest levels of initial activation but not variability; however, with prolonged inhibitory adaptation to increased excitation, overall activity was no longer elevated, but an increase in firing rate variability was observed. Third, the greatest fluctuation in firing rate variability, in response to the same stimulus across increasing contrast levels, was observed with reductions in sensory signaling, but only immediately after model perturbations; with prolonged adaption, the largest fluctuations were associated with increased excitation or reduced inhibition within V1. Implication of these findings are that schizophrenia-related increases in neuronal response variability may arise from at least two sources: 1) weakened sensory signaling and its associated low signal-to-noise ratio; and 2) compensatory but incomplete inhibitory responses to continuous increases in cortical excitation.
Nov 2016
The purpose of this paper is to review the literature linking schizophrenia with chronic inflammation and gluten sensitivity. In addition, the paper discusses the need for dietary interventions that may improve multiple health outcomes for patients. Individuals with schizophrenia are at much greater risk for the development of additional autoimmune disorders. Second generation anti-psychotic medications are the most effective treatment for schizophrenia, but there are numerous potential side effects to the medications. More specifically, individuals with schizophrenia who are treated with SGAs are at increased risk for obesity, diabetes, as well as elevated lipids and blood pressure. An effective evidence-based dietary intervention has the potential to improve numerous outcomes for individuals with schizophrenia.
May 2016 DOI 10.14302/issn.2574-450X.jom-16-1039
Over the last three decades, an epidemic of obesity has markedly affected patients suffering from mental illnesses such as schizophrenia. Antipsychotic medications used to treat schizophrenia are considered as major culprits. The aim of this review is to first consider risk factors, to then outline negative sequelae of obesity for this population, and finally to address timing and content of recommended clinical interventions. Medical databases were searched with the terms “”weight,” “obesity,” and “schizophrenia.” Selection of articles was guided by date of publication; recent papers are preferentially cited. The main findings were that, in addition to antipsychotic medications, socio-economics, lifestyle, immune factors, and circadian rhythms also contribute to obesity risk. A barrier to effective health promotion within psychiatry has been the concern that fears about gaining weight might stop individuals with schizophrenia from taking needed antipsychotic medication. Recommendations, therefore, are to keep the dose of antipsychotic medication as low as possible, avoid polypharmacy, encourage healthy eating and physical activity, address sleep problems and substance use, monitor weight, blood pressure, and metabolic parameters regularly, utilize motivational interviewing techniques and peer support, pay special attention to special needs such as those of women during pregnancy, and include bariatric surgery as a potential intervention. Conclusion: Besides careful attention to medication regimens, the literature supports the active encouragement and support of patient self-management strategies to both prevent and manage obesity in schizophrenia.