25% of patients are treatment refractory. 2 Despite these prognostic trajectories, clinicians have made great efforts to improve the prognosis of FEP patients by enlarging the percentage of the first and second groups. Previous studies have consistently shown that a better prognosis is related to a shorter duration of untreated psychosis (DUP), suggesting that the earlier introduction of antipsychotic treatment yields a better prognostic outcome. 2-4 Although antipsychotic medications can relieve the positive symptoms, prominent adverse effects, such as extrapyramidal symptoms or metabolic syndrome, reduce the quality of life as well as treatment adherence. 5-7 Therefore, predicting the prognosis from the FEP state would provide valuable information for both the clinicians and patients in deciding whether to provide less or more intensive treatment from the beginning of the intervention. To date, efforts to predict the prognosis of FEP using clini

Objective This study aims to examine the effect of giving probiotic adjuvant therapy on improving clinical symptoms & IL-6 levels in patients with schizophrenia.Methods This research was a double-blind, placebo-controlled trial conducted at Dadi Psychiatric Hospital, South Sulawesi Province, Indonesia in November–December 2021. The sample of the research was patients with schizophrenia undergoing hospitalization who received therapeutic doses of risperidone with a total of 21 samples in each treatment and control group. Research subjects were measured with Positive and Negative Syndrome Scale (PANSS) at baseline, 2nd, 4th, and 6th weeks. The treatment group received one capsule/12 hours/oral of probiotics for six weeks and the control group received 1 capsule/12 hours/oral placebo for 6 weeks. In addition, two measurements of IL-6 using enzyme-linked immunosorbent assay were performed in both groups, namely at the beginning of week 0 and the end of the 6th week.Results We found the decrease in the PANSS value which described the improvement in clinical symptoms of the schizophrenic group after receiving therapeutic doses of antipsychotics and probiotic capsules or the treatment group as well as the schizophrenia group receiving therapeutic doses of antipsychotics and placebo capsules or the control group.Conclusion Improvements in clinical symptoms and decreased levels of IL-6 in the group of patients with schizophrenia who received risperidone with probiotic adjuvant therapy were better than in the group of patients with schizophrenia who received risperidone without probiotics as adjuvant therapy.

BACKGROUND: The ongoing coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus-2. The COVID-19 pandemic has also had an impact on mental health, including those with schizophrenia (SCH). There were 131 inpatient schizophrenic patients who were confirmed positive for COVID-19 at Dadi Makassar Hospital, South Sulawesi, Indonesia, but all of these patients did not experience any clinical symptoms of COVID-19. Chlorpromazine as an antipsychotic also has antiviral and anti-inflammatory effects in schizophrenic patients with COVID-19, and the schizophrenic neuroinflammatory is very likely to occur in patients with COVID-19 infection. AIM: The researchers tried to examine the effectiveness of chlorpromazine on serum TNF-values in schizophrenic patients with COVID-19. METHODS: This research is a nested case–control study. The study was conducted on schizophrenic patients with mild and asymptomatic cases of COVID-19 at Dadi Mental Hospital with a sample of 40 patients compared to 42 schizophrenic patients who were not COVID-19. Study subjects received chlorpromazine 100 mg/day for 4 weeks. Serum tumor necrosis factor-alpha (TNF-α) concentrations were measured by enzyme-linked immunosorbent assays when COVID-19 was first confirmed and after 4 weeks. Positive and negative syndrome scale (PANSS) and clinical global impression SCH (CGI-SCH) examinations were also performed to measure the clinical symptoms of SCH. RESULTS: The comparison of baseline TNF-serum levels that increased in the schizophrenic group with COVID-19 was 9.33 pg/ml higher, compared to the schizophrenic group without COVID-19. The decrease in TNF-levels in the schizophrenic group with COVID-19 of 7.96 pg/ml (p < 0.001) indicated an improvement in TNF-serum levels at week 4. Meanwhile, there was no significant decrease in serum TNF- levels in the non-COVID-19 schizophrenic group (p > 0.05). CONCLUSION: The serum TNF-value of schizophrenic patients with COVID-19 is higher than schizophrenic patients without COVID-19. Coadministration of chlorpromazine, antipsychotics, and COVID-19 therapy reduces serum TNF- values in schizophrenic patients with COVID-19. The administration of chlorpromazine and antipsychotic in therapeutic doses reduced the total PANSS and CGI-SCH values.