Serum interleukin 1 alpha and interleukin 2 levels in patients with schizophrenia

It has been suggested that altered interleukin (IL) regulation may be involved in the pathogenesis of schizophrenia. In this cross-sectional, case-controlled study, patients with schizophrenia and a control group of healthy subjects, matched by age, sex and body mass index, were evaluated. The levels of IL-1alpha and IL-2 in blood serum were measured by enzyme-linked immunosorbent assay. The fasting serum IL-2 levels were significantly higher in patients with schizophrenia compared with the control subjects, but there was no difference between the fasting serum levels of IL-1alpha in patients with schizophrenia and the control subjects. Our results suggest that patients with schizophrenia have altered IL-2, but not IL-1alpha, regulation

Turkish patients with treatment-resistant schizophrenia

Background: Several lines of evidence suggest that clozapine is more effective than both first- and second-generation antipsychotic drugs in treatment-resistant schizophrenia (TRS). However, clinicians appear to be hesitant to prescribe this drug. it would therefore be extremely valuable if predictors of response to clozapine could be identified. The aim of this study was to evaluate the predictive factors of clinical responses to clozapine in a group of Turkish patients with TRS.Methods: This was a 16-week uncontrolled open study carried out among 97 TRS patients (80 males and 17 females; DSM-IV diagnosis). All patients fulfilled the criteria for refractory schizophrenia according to the UK guidelines for the National Institute of Clinical Excellence (NICE). After all previous antipsychotic medications had run their course, the patients were started on clozapine according to a standardized titration and dosage schedule. Psychopathology was evaluated before the initiation of clozapine therapy and once every 4 weeks using the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment for Positive Symptoms, and the Scale for the Assessment of Negative Symptoms.Results: Of the TRS patients on clozapine, 55.7% achieved a clinical response, defined as at least a 20% decrease in BPRS. We observed a favorable effect of clozapine on both positive and negative symptoms. Logistic regression analysis showed that a good clozapine response was more likely when schizophrenia began at a later age, when negative symptoms were severe, and when patients had an early response at 4 weeks.Conclusion: A combination of demographic, baseline clinical, and acute treatment response variables may accurately predict response to clozapine in TRS. Priority should be given to initiating clozapine at the earliest phase of TRS, especially for patients with evident negative symptoms. (C) 2007 Elsevier Inc. All rights reserved

Association between antibodies to multiple infectious and food antigens and new onset schizophrenia among US military personnel

Introduction: Multiple studies have documented immune activation in many individuals with schizophrenia suggesting that antigens capable of generating a prolonged immune response may be important environmental factors inmany cases of this disorder.While existing studies have found single-agent associations of antibodies to food and neurotropic infectious agents with schizophrenia, a simultaneous examination of multiple agents may shed light on agent interactions or possible etiopathogenic pathways. Methods: We used traditional regression and novel statistical techniques to examine associations of single and combined infectious and food antigens with schizophrenia. We tested 6106 serum samples from 855 cases and 1165 matched controls. Results: Higher antibody levels to casein were borderline significant in the prediction of schizophrenia (HR=1.08, p=0.06). Study participantswith higher cytomegalovirus (CMV) IgG antibody levels had a reduced risk of developing schizophrenia (HR=0.90; p=0.02). While IgG antibodies to gliadin, Toxoplasma gondii, vaccinia, measles, and human herpesvirus-6 (HHV-6) showed no significant independent associations with schizophrenia, the increase in antibody levels to several combinations of agents, to include casein, measles, CMV, T. gondii and vaccinia, was predictive of an 18–34% increase in the risk of developing schizophrenia. Conclusion: Certain patterns of antibodies, involving some agents, were predictive of developing schizophrenia, with the magnitude of association rising when the level of antibodies increased to two or more agents. A heightened antibody response to a combination of several infectious/food antigens might be an indicator of an altered immune response to antigenic stimuli

Comparison of the classification ratios of four depression rating scales commonly used in Turkey

Objective: According to literature more than 20 depression scales are in use in Turkey. Considering that depression is a popular area of study, it may not seem abnormally unusual that there are so many measuring scales available. However, so many measuring instruments may lead to a problem of different sensitivity levels and raise the question of whether or not all the instruments have the same sensitivity in measuring the particular entity. The purpose of this study is to compare the four commonly used self-report scales adapted into Turkish, namely CES-Depression Scale, Beck Depression Inventory, the Zung Self-Rating Depression Scale, and the Hospital Anxiety and Depression Scale (depression subscale) by cross-validation. Method: These depression scales had been applied to three hundred and forty-one subjects and total scores of the subjects for each scale have been obtained. Next, the sample group was divided into two according to group averages of total scale scores. Normative scores and cut-off scores have not been considered because the study objective was to compare these scales on a theoretical basis. The groups below and above average for each of the four scales have been compared by the ROC curve analyzes. Results: The results showed that the total score of Beck Depression Inventory had been grouped correctly by the Zung Self-Rating Depression Scale at a ratio of 0.871, the Hospital Anxiety and Depression Scale (depression subscale) at a ratio of 0.885, and by CES-Depression Scale at a ratio of 0.874. The total score of CES-Depression Scale had been correctly grouped by Beck Depression Inventory at a ratio of 0.871, the Zung Self-Rating Depression Scale at a ratio of 0.869, and by the Hospital Anxiety and Depression Scale (depression subscale) at a ratio of 0.862. The total score of the Zung Self-Rating Depression Scale has been correctly grouped by the Hospital Anxiety and Depression Scale depression subscale at a ratio of 0.848, Beck Depression Inventory at a ratio of 0.872, and by CES-Depression Scale at a ratio of 0.878. The total score of the Hospital Anxiety and Depression Scale (depression subscale) has been correctly grouped by the Zung Self-Rating Depression Scale at a ratio of 0.848, Beck Depression Inventory at a ratio of 0.889, and by CES-Depression Scale at a ratio of 0.887. Conclusion: The overall results showed that the scales cross-validated with ratios ranging from 0.85 to 0.89. The classifying ratios obtained by ROC analysis were similar across four depression scales

Recent advances in psychoneuroimmunology: inflammation in psychiatric disorders

Psychiatric disorders are common and complex and their precise biological underpinnings remain elusive. Multiple epidemiological, molecular, genetic and gene expression studies suggest that immune system dysfunction may contribute to the risk for developing psychiatric disorders including schizophrenia, bipolar disorder, and major depressive disorder. However, the precise mechanisms by which inflammation-related events confer such risk are unclear. In this review, we examine the peripheral and central evidence for inflammation in psychiatric disorders and the potential molecular mechanisms implicated including inhibition of neurogenesis, apoptosis, the HPA-axis, the role of brain-derived neurotrophic factor and the interplay between the glutamatergic, dopaminergic and serotonergic neurotransmitter systems