There is a need to identify new treatment options for depression with its comorbidities. Depression often coexists with liver steatosis and the two may share a pathophysiological overlap, including inflammation and microbiota changes. Probiotics might represent a safe option as an adjunctive therapy in patients with depression and possible liver steatosis. The paper presents the secondary analysis of a clinical trial of the effect of probiotic supplementation on the levels of non-invasive markers of liver steatosis and fibrosis in adult patients with depressive disorders. The research had a two-arm, parallel-group, prospective, randomized, double-blind, controlled design on probiotics in depression. 116 participants received a probiotic preparation containing Lactobacillus helveticus Rosell®-52 and Bifidobacterium longum Rosell®-175 over 60 days. Here, data from 92 subjects was analyzed. The following were assessed: alanine aminotransferase (ALT), alanine aminotransferase/aspartate aminotransferase (ALT/AST) ratio, Hepatic Steatosis Index, Framingham Steatosis Index, as well as non-invasive biomarkers of liver fibrosis (AST to Platelet Ratio Index, Fibosis-4 Index), or baseline socio-demographic, clinical, and laboratory parameters. The probiotics did not influence liver steatosis and fibrosis parameters compared with placebo (p = 0.940 for HSI). However, the subgroup analysis revealed significant differences in liver-related parameters when stratified by the main diagnosis group (better improvement in steatosis indices after probiotics in depressive episode than mixed depression and anxiety disorder patients) or psychotropic medications use (better improvement in ALT-based indices after probiotics in antidepressant-treated subjects than those non-antidepressant-treated). The interplay between probiotics, medications, clinical and metabolic profiles of depression, and the changes in liver-related parameters has been discussed. Multiple factors may modulate the postulated hepatoprotective properties of probiotics efficacy in patients with depression. Further studies with larger sample sizes, different probiotic strains, and longer intervention period are necessary to assess the real significance of probiotics for liver health in this population. NCT04756544.

(1) Background: Depression, metabolic alternations, and liver diseases are highly comorbid. Studies have shown that probiotics might be helpful in the treatment of the above-mentioned states. The aim of this secondary analysis was to search for possible predictors of probiotics’ efficacy on liver-related outcome measures. (2) Methods: Data from 92 subjects from a randomized clinical trial on the effect of probiotics on depression were analyzed. The shift in liver steatosis and fibrosis indices was assessed in the context of baseline immunometabolic, psychometric, dietary, and intestinal permeability factors. Correlation analysis and linear regression models were used. (3) Results: A total of 30% of the variance of the improvement in the score of the aspartate transferase to platelet ratio index was explained by probiotic use, higher pre-intervention triglycerides, cholesterol, C-reactive protein levels, increased cereal intake, and a lower consumption of sweets. Then, the model of the change in alanine transferase indicated that probiotics were efficient when used by subjects with higher basal levels of intestinal permeability markers. (4) Conclusions: Probiotics being used along with a healthy diet may provide additional benefits, such as decreased cardiovascular risk, for patients with measures consistent with the immunometabolic form of depression. Probiotic augmentation may be useful for liver protection among subjects with a suspected “leaky gut” syndrome. ClinicalTrials.gov: NCT04756544.

Introduction:Metabolic-associated Fatty Liver Disease (MAFLD) is a term for Non-alcoholic Fatty Liver Disease (NAFLD) that highlights its association with components of the Metabolic Syndrome (MetS). MAFLD is becoming a clinically significant problem due to its increasing role in the pathogenesis of cryptogenic cirrhosis of the liver.Material and methods:The resulting work is a review of the most important information on the risk of MAFLD development in the context of the use of particular groups of psychotropic drugs. The study presents the epidemiology, with particular emphasis on the population of psychiatric patients, pathophysiology and scientific reports analyzing the effect of the psychotropic medications on MAFLD development.Results:The drugs that can have the greatest impact on the development of MAFLD are atypical antipsychotics, especially olanzapine, and mood stabilizers (MS) - valproic acid (VPA). Their effect is indirect, mainly through dysregulation of organism’s carbohydrate and lipid metabolism.Conclusions:The population of psychiatric patients is particularly vulnerable to the development of MAFLD. At the root of this disorder lies the specificity of mental disorders, improper dietary habits, low level of physical activity and tendency to addictions. Also, the negative impact of the psychotropic drugs on the systemic metabolism indirectly contributes to the development of MAFLD. In order to prevent fatty liver disease, it is necessary to monitor metabolic and liver parameters regularly, and patients should be screened by ultrasound examination of the liver. There are also important preventive actions from the medical professionals, including education of patients and sensitizing to healthy lifestyle.

Introduction: Adolescent idiopathic scoliosis is a common type of scoliosis among adolescents. A significant problem is the coexistence of depressive and anxiety disorders. However, the causes of this condition are not fully recognized. Thus, it seems reasonable to search for possible risk factors that may trigger mental disorder occurrence. Material and methods: This is a literature narrative review concentrating on the influence of the adolescent idiopathic scoliosis on the development of depression and anxiety disorders among adolescents, as well as possible therapeutic interventions. Google Scholar, Medline, PubMed and Science Direct databases were searched throughout January 2024 for relevant original and review articles from 2000 to 2024, using the following keywords: “adolescent idiopathic scoliosis”, “anxiety”, “body image”, “bracing”, “chronic disease”, “depression”, “mental disorders”, “pain”, “peer relationship”, “physical activity”, “pulmonary function”, “sleep disorders”, “surgery”, “treatment”. Manuscripts in other language than Polish or English were excluded from the search. To ensure the appropriate quality of this review, the Scale for the Assessment of Narrative Review Articles was used. Results: Chronic pain, sleep disorders, pulmonary function impairment, perception of the disease as a chronic somatic disease, disturbed body image, lack of social interactions, physical activity limitation and applied methods of treatment may lead to the depressive and anxiety disorders development in the adolescent idiopathic scoliosis course. Conclusions: Biological and psychosocial factors contribute to the pathogenesis of depressive and anxiety disorders among patients with adolescent idiopathic scoliosis. Their identification should help create a comprehensive plan of treatment, which may effectively maximize therapeutic outcomes in the context of both scoliosis and mental disorders. Keywords: depression, risk factors, anxiety, adolescent idiopathic scoliosis, mental health

Non-suicidal self-injuries (NSSI) constitute a significant problem among children and adolescents, especially during the global burden of mental disorders worldwide. Moreover, such behaviors are perceived as a risk factor for the suicidal behaviors occurrence in the future. Thus, it would appear necessary to search for effective forms of their treatment. A pharmacological approach may play a supportive role. This study is a narrative review summarizing scientific reports on possible pharmacological support treatment of NSSI among children and adolescents. Internet scientific bases were searched for literature, including original research, review articles and case reports. There are many possible pharmacological interventions that may reduce the incidence of self-harm behaviors. Antihistamines and neuroleptics can be used successfully in the acute phase. In turn, second-generation antipsychotics and potentially naltrexone seem to be the most effective in long-term treatment. Although psychotherapy is the basic form of NSSI treatment, a psychopharmacological approach may play an essential role in reducing the incidence of self-harm behaviors. Nevertheless, the use of psychotropic medications is prohibited in most cases and may be limited due to their side effects. Moreover, there is a need to validate their efficiency in next studies to gather strong evidences concerning their widespread use.

Purpose Schizophrenia is a chronic condition that is associated with various comorbidities, including metabolic ones. Particular attention has been paid to the metabolic dysfunction-associated steatotic liver disease (MASLD), the liver equivalent of the metabolic syndrome. It is postulated that...