Nutritional psychiatry in the treatment of psychotic disorders: Current hypotheses and research challenges

Teasdale, Scott; Mörkl, Sabrina; Müller-Stierlin, Annabel

doi:10.1016/j.bbih.2020.100070

Cited by 31 publications

(20 citation statements)

References 115 publications

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“…While these pioneering studies had a major influence on our understanding of the role of gut microbes in mammalian behavior, few of their findings have been translatable into the diagnosis or treatment of human psychiatric disorders to [ 12 ]. However, as diet has a major influence on human gut microbial composition and function, the notion that diet in addition to direct effect of macro and micronutrients on the brain could play a causative role in gut microbiome alterations with impacts on human emotional and cognitive function, has become an exciting research topic in psychiatry, and the term Nutritional Psychiatry has been proposed [ 11 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders

Horn¹,

Mayer²,

Chen

et al. 2022

Transl Psychiatry

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There is emerging evidence that diet has a major modulatory influence on brain-gut-microbiome (BGM) interactions with important implications for brain health, and for several brain disorders. The BGM system is made up of neuroendocrine, neural, and immune communication channels which establish a network of bidirectional interactions between the brain, the gut and its microbiome. Diet not only plays a crucial role in shaping the gut microbiome, but it can modulate structure and function of the brain through these communication channels. In this review, we summarize the evidence available from preclinical and clinical studies on the influence of dietary habits and interventions on a selected group of psychiatric and neurologic disorders including depression, cognitive decline, Parkinson’s disease, autism spectrum disorder and epilepsy. We will particularly address the role of diet-induced microbiome changes which have been implicated in these effects, and some of which are shared between different brain disorders. While the majority of these findings have been demonstrated in preclinical and in cross-sectional, epidemiological studies, to date there is insufficient evidence from mechanistic human studies to make conclusions about causality between a specific diet and microbially mediated brain function. Many of the dietary benefits on microbiome and brain health have been attributed to anti-inflammatory effects mediated by the microbial metabolites of dietary fiber and polyphenols. The new attention given to dietary factors in brain disorders has the potential to improve treatment outcomes with currently available pharmacological and non-pharmacological therapies.

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Section: Introductionmentioning

confidence: 99%

Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders

Horn¹,

Mayer²,

Chen

et al. 2022

Transl Psychiatry

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“…The development process has highlighted a further gap requiring investigation. To date, no dietary assessment tool or method has been validated specifically in people with SMI [36][37][38]. Given the symptomology and cognitive barriers frequently experienced by people with SMI, it cannot be assumed that currently available tools and methods are accurate and reliable.…”

Section: Discussionmentioning

confidence: 99%

The Development of a Nutrition Screening Tool for Mental Health Settings Prone to Obesity and Cardiometabolic Complications: Study Protocol for the NutriMental Screener

Teasdale

Moerkl

Moetteli

et al. 2021

IJERPH

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People living with serious mental illness (SMI) experience physical health complications at disproportionate rates to people without an SMI. Unhealthy dietary intake and disordered eating behaviors are key driving factors. There is a lack of valid nutrition-risk screening tools targeted to mental health services, and typically used nutrition-risk screening tools are not suitable for mental health services. This paper details the rationale and study protocol for development and validation of the NutriMental screener, a tool for use in clinical practice to identify service users who are at risk for common nutrition issues experienced by this population group and trigger referral to a specialist clinician. The development process includes five phases. Phase I is the development of nutrition-related domains of interest from screening tools used in mental health services. Phase II involves a literature review and service-user interviews to identify additional domains. Phase III consists of international workshops with relevant clinicians and persons with SMI to gain a consensus on questions to be included in the draft tool. Phase IV involves conducting multinational feasibility and preliminary validation studies. Phase V consists of performing formal validation studies. The development of a nutrition-risk screening tool for mental health services is a necessary step to help rectify the physical-health disparities and life-expectancy gap for people with SMI.

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“…This was the first prospective observational study in Korea, so we had no a priori variables of interest except for childhood trauma, and included variables based on a review of the literature on recovery. The scales surveyed at baseline were the Big Five Inventory (BFI-10) [45][46][47][48] , Brief Core Schema Scales (BCSS) 49,50 , Brief Resilience Scale (BRS) 45,46,51 , Brooding Scale (BS) 52 , Diet History Questionnaire (DHQ) 53,54 , Early Trauma Inventory Self Report-Short Form (ETISR-SF) 55 , Family Adaptability and Cohesion Evaluation Scales III (FACES-III) 56,57 , Family Intimacy (FI, 5-point Likert scale), Physical Activity Rating (PAR) 58,59 , and the Korean version of the Subjective Well-being Under Neuroleptics-Short Form (K-SWN) 60,61 . The BS consisting of 11 items measures the degree of rumination about past negative events.…”

Section: Assessmentsmentioning

confidence: 99%

Three-year outcomes and predictors for full recovery in patients with early-stage psychosis

Rami

Lee

et al. 2022

Schizophr

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In the present study, various outcomes over 3-year period in patients with early stage psychosis including remission, recovery, relapse and medication adherence were investigated. Predictor for full recovery at year 3 was also examined. Three-year follow-up data in 534 patients with schizophrenia spectrum disorders (SSD) and psychotic disorder not otherwise specified (PNOS) were examined for overall outcome trajectories. The data of completers at year 3 (n = 157) were used to identify predictors for recovery using logistic regression. The rates of symptomatic remission and full recovery at 6-, 12-, 24-, and 36-month follow-up were 76.10, 69.20, 79.50, and 79.10%, and 22.80, 26.40, 28.60, and 39.60%, respectively. The rates of drop-out and relapse at 6-, 12-, 24-, and 36-month follow-up were 25.4, 29.5, 38.6, and 51.1%, and 3.7, 8.9, 19.0, and 38.9%, respectively. The rates of good adherence and prescription of Long-Acting Injectable Antipsychotics (LAIA) at 6-, 12-, 24- and 36-month follow-up were 87.8, 88.0, 91.9, and 93.9%, and 18.3, 21.7, 22.0, and 25.5%, respectively. Significant predictors for full recovery were duration of untreated psychosis (DUP), family intimacy and physical activity. We observed similar or better results on remission, recovery, and relapse rates compared to other previous studies. Effective psychosocial intervention should be provided to shorten the gap between remission and recovery rates and to address DUP, family issues, and exercise to enhance recovery.

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Nutritional psychiatry in the treatment of psychotic disorders: Current hypotheses and research challenges

Cited by 31 publications

References 115 publications

Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders

Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders

The Development of a Nutrition Screening Tool for Mental Health Settings Prone to Obesity and Cardiometabolic Complications: Study Protocol for the NutriMental Screener

Three-year outcomes and predictors for full recovery in patients with early-stage psychosis

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