Background: Anorexia nervosa (AN) is a life-threatening disease with a low effectiveness of treatment. The high relapse and mortality rate indicate new treatment approaches are needed. Here, we represent the protocol for randomized clinical trial (RCT) of transcranial direct current stimulation (tDCS) efficiency in the AN treatment. The main purpose of the 3-week RCT is to determine the effect of tDCS on the mental state and advances in nutritional rehabilitation in patients with AN.Methods: 50 female inpatients (13-25 years old, body mass index (BMI) 17.5 kg/m2 or less) will be randomly allocated into groups: active (n=25) and sham (n=25) tDCS. Thirty 25-minute tDCS sessions (applied current at 2mA) will be given to DLPFC (F3 anode/F4 cathode) twice a day for 3 weeks on working days parallel to treatment as usual. The primary outcome measures include changes in symptoms related to eating disorders, as assessed by the Eating Attitudes Test (EAT-26), following tDCS sessions over a 3-week trial period. The secondary outcome measures include changes in: brain bioelectric activity, anthropometric measurements, mood, nutritional status, neurocognition, psychological symptoms, selected biological markers related to stress, food intake, inflammation and neurotrophins.Discussion: This paper describes the evaluation of a 3-week tDCS-based intervention for AN patients. The study design was developed by a multidisciplinary research team to assess the treatment effect, taking into account various types of variables. This approach could help in better understanding the potential therapeutic tDCS strategy in AN.Clinical trial registration: www.ClinicalTrials.gov, identifier NCT05814458.

Adverse childhood experiences (ACEs) have a long-lasting effect on both physical and mental health. The aim of this study was to assess the consequences of ACEs and experienced stress on depression and the role of biological disturbances in this relationship in a student population. Potential participants filled out a screening questionnaire; 60 of 126 students met the inclusion criteria and were tested for the severity of stress and depressive symptoms, ACEs, dietary habits, and serum concentrations of biological markers. Depressive symptoms were related to a younger age (p = 0.012), a higher severity of stress (p = 0.001), ACEs (p = 0.007), and lower triglyceride (p = 0.01) and cortisol concentrations (p = 0.01). An inverse relationship between the triglyceride concentration and emotional abuse (R = −0.38) and emotional neglect (R = −0.33) was found. Occludin was positively associated with physical abuse (R = 0.31). Cortisol was inversely associated with emotional abuse (R = −0.35). Emotional neglect was associated with lipopolysaccharide binding protein (R = 0.38) and insulin levels (R = −0.31). The most promising multi-panel of biomarkers for recognizing mood symptoms included triglycerides, tight junction protein 1, and cortisol (cut-offs of ≤ 95.5 mg/dL, 0.72 ng/mL, and 134.63 ng/mL, respectively). This study confirmed the association between ACEs and depressive symptoms and the importance of psychological stress in developing mood disorders. ACEs could affect biological dysregulation. Some of the biological markers could be helpful in early detection of depression.

Background/Objectives: Anorexia nervosa (AN) is a chronic eating disorder with the highest mortality rate among psychiatric conditions. Malnutrition and starvation lead to long-term impairments in metabolic processes, hormonal regulation, and immune function, offering potential diagnostic and prognostic value. This study aimed to identify immune–metabolic–hormonal markers associated with treatment response and nutritional rehabilitation. Methods: Fifty hospitalized female patients with AN were included. Anthropometric measurements and venous blood samples were collected at admission and discharge, following partial nutritional recovery. Blood analyses included complete blood count, serum levels of total cholesterol, LDL and HDL, triglycerides, glucose, NT-pro-BNP, TSH, free thyroxine (fT4), sodium, chloride, potassium, calcium, iron, and vitamin D. Composite immune-inflammatory indices calculated were neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR); neutrophil-to-high-density lipoprotein (NHR), monocyte-to-high-density lipoprotein (MHR), platelet-to-high-density lipoprotein (PHR) and lymphocyte-to-high-density lipoprotein (LHR) ratios; systemic immune-inflammation (SII), and systemic inflammation response (SIRI) indexes. Results: Responders (R) and non-responders (NR) differed significantly at baseline in levels of sodium, chloride, fT4, monocyte count, MCV, NLR, MLR, SII, and SIRI (all: R < NR; p < 0.05). Predictive ability for treatment response was confirmed by AUC values (95%CI): sodium = 0.791 (0.622–0.960), chloride = 0.820 (0.690–0.950), fT4 = 0.781 (0.591–0.972), monocytes = 0.785 (0.643–0.927), MCV = 0.721 (0.549–0.892), NLR = 0.745 (0.578–0.913), MLR = 0.785 (0.643–0.927), SII = 0.736 (0.562–0.911), SIRI = 0.803 (0.671–0.935). The lower levels of inflammation and chloride are particularly predictive of better nutritional recovery, accounting for 26% of the variability in treatment response. Conclusions: The study demonstrated important insights into the hematological, metabolic, hormonal, and immune-inflammatory mechanisms associated with nutritional recovery in AN.

Background/Objectives: Anorexia nervosa (AN) is a severe disorder with limited treatment efficacy. This interim analysis aimed to assess the preliminary efficacy and safety of transcranial direct current stimulation (tDCS) in reducing core AN symptoms, stress, depression, low self-esteem, and BMI in adolescent females, to determine the rationale for continuing the study. Methods: A single-center, randomized, double-blind, placebo-controlled trial included 20 adolescent females with AN assigned to an active tDCS group (n = 10) or a sham group (n = 10). The intervention involved 30 sessions over three weeks, targeting the dorsolateral prefrontal cortex. Outcomes were assessed at baseline, post-treatment, and follow-up using the Eating Attitudes Test (EAT-26) for eating disorder symptoms, the Perceived Stress Scale (PSS-10) for stress, the Beck Depression Inventory (BDI) for depression, the Rosenberg Self-Esteem Scale (SES) for self-esteem, and body mass index (BMI) measurements. Safety and tolerability were assessed using the tDCS Side Effects Questionnaire. Results: Eating disorder symptoms significantly decreased in the active tDCS group at study end (p = 0.003) and follow-up (p = 0.02), while no significant changes were observed in the sham group. Although BMI increased more in the active group (13.78%) than in the sham group (7.31%), this difference was not statistically significant (p = 0.10). Conclusions: Adverse effects were mild and transient, with no serious safety concerns reported. Based on the results of this interim analysis, the study will proceed due to promising efficacy outcomes and good treatment tolerability.

Purpose: Young adults experience high stress levels, leading to mood disorders. This study investigates the associations between specific fatty acid levels, lipid profiles, inflammatory markers, and emotional well-being among young adults. Methods: Seventy-two young adults aged 18-35...

Introduction: Nutritional psychiatry examines how diet and specific nutrients affect mental health and well-being. The potential role of polyunsaturated fatty acids, especially omega-3 fatty acids (n-3 PUFAs), in the treatment of major depressive disorder (MDD) has gained significant interest in recent years. Objective: To review and present guidelines on the use of omega-3 PUFAs in the treatment of MDD and to highlight recommendations from psychiatric associations worldwide. Method: A comprehensive literature review was conducted using articles from Web of Science, Google Scholar, Medline/ PubMed. The analysis included guidelines and recommendations from psychiatric associations published between 2014 and 2024. Keywords such as polyunsaturated fatty acids, PUFA, nutritional psychiatry, recommendations, guidelines, depressive disorders, and omega-3 were used in the search strategy. Articles in English and Polish were included. Results: Evidence suggests that omega-3 PUFAs, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (especially EPA), can serve as effective adjunctive treatments in combination with standard antidepressant medications, though they are not recommended as monotherapy. Several psychiatric associations, including the International Society of Nutritional Psychiatry Research (ISNPR), the World Federation of Societies of Biological Psychiatry (WFSBP), and the Canadian Network for Mood and Anxiety Treatment (CANMAT), have published guidelines supporting the use of n-3 PUFAs in MDD treatment, particularly in specific populations like pregnant women, the elderly, individuals with raised inflammation, with obesity. Conclusions: The promising findings from multiple studies and the support from scientific psychiatric associations highlight the significant potential of omega-3 PUFAs as a beneficial addition to standard MDD treatments. The growing body of evidence underscores the importance of integrating dietary interventions into mental health care. With continued research and clinical application, n-3 PUFAs could play a crucial role in enhancing treatment outcomes and improving the quality of life for individuals with depressive disorders. Keywords: polyunsaturated fatty acids, PUFA, nutritional psychiatry, depressive disorders, omega-3 supplementation, clinical guidelines, therapeutic interventions