Patients with Schizophrenia Undergoing Gastric Bypass Surgery: a Case Series Study.

PURPOSE: Obesity affects approximately 45-55% of persons with schizophrenia and is more difficult to manage in these individuals than in the general population, apart from being an additional factor for morbidity and premature mortality. Although bariatric surgery is considered the most effective long-term treatment for severe obesity, there are few reports on the outcomes of this procedure in persons with schizophrenia. This study aimed to evaluate weight loss and psychiatric symptoms in persons with obesity and schizophrenia after bariatric surgery. MATERIALS AND METHODS: Five persons with schizophrenia and moderate to severe obesity who underwent bariatric surgery were followed up for 2 years. Anthropometric data were collected, and psychiatric symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS), which assessed the pre- and postoperative occurrence and severity of symptoms of schizophrenia. RESULTS: The mean body mass index before surgery was 43.5 ± 5.2 kg/m2 and decreased to 28.1 ± 1.9 kg/m2 1 year postoperatively. The mean percentage of total postoperative weight loss was 30.7 ± 6.8% after 6 months, 34.7 ± 7.9% after 1 year, and 34.3 ± 5.5% after 2 years. Before surgery, all subjects were in remission based on the PANSS. Postoperative evaluations showed that the participants had no relapse of psychiatric symptoms (p > 0.05 for the three PANSS dimensions throughout the follow-up period). There were no considerable changes in their medication regimens. CONCLUSIONS: These findings suggest that bariatric surgery may be a viable treatment option for stable patients with schizophrenia if they have a preoperative assessment and close management and involvement by mental health professionals throughout the course of treatment.

Serum brain-derived neurotrophic factor and cortical thickness are differently related in patients with schizophrenia and controls.

Brain-derived neurotrophic factor (BDNF) has been implicated in neuronal plasticity, a key process related to the pathophysiology of schizophrenia. However, the relationship of peripheral levels of BDNF to cortical thickness and subcortical structures has not been extensively investigated. This study aims to investigate the relationship of peripheral serum BDNF levels to cortical thickness and volumes of the hippocampus and amygdala. Twenty-nine patients with schizophrenia and 32 healthy controls were included in this study. Structural magnetic resonance imaging (MRI) scans obtained in a 1.5 T scanner were performed in all subjects. Images were processed using Freesurfer software. Blood samples were collected on the same day of the MRI scan for BDNF peripheral levels. Vertex-wise analysis revealed significantly thinner cortex in patients compared with controls. BDNF levels and cortical thickness showed different patterns of correlation for patients and healthy controls in one cluster in the right hemisphere distributed across the supramarginal, postcentral, and inferior frontal cortices.

Gene expression analysis in blood of ultra-high risk subjects compared to first-episode of psychosis patients and controls.

OBJECTIVES: This study aimed to investigate peripheral blood gene expression in ultra-high-risk subjects (UHR) compared to first-episode psychosis individuals (FEP) and healthy controls (HC). METHODS: We enrolled 22 UHR, 66 FEP and 67 HC and investigated the expression of 12 genes using Taqman assays. We used the Univariate General Linear Model, as well as Bonferroni correction for multiple comparisons. RESULTS: We found that UFD1L (ubiquitin fusion degradation 1 like (yeast)) gene was upregulated in UHR group compared to HC and FEP (P = 3.44 × 10-6 ; P = 9.41 × 10-6). MBP (myelin basic protein) was downregulated in UHR compared to FEP (P = 6.07 × 10-6). DISC1 (disrupted in schizophrenia 1) was also upregulated in UHR compared to FEP but lost statistical significance when corrected for age. CONCLUSIONS: These genes are directly related to neurodevelopmental processes and have been associated to schizophrenia. Recent findings described that DISC1 overexpression can disrupt MBP expression, thus, we think that these alterations in UHR individuals could be associated with a common process. UFD1L showed a different pattern of expression only for UHR group, suggesting that they can be under an acute endoplasmatic reticulum stress, demanding elevated levels of Ufd1. Further studies can improve knowledge on disease progression and putative targets to preventive strategies.