Publications by authors named "Olivia Patsalos"

11 Publications

  • Page 1 of 1

Reduced MIP-1β as a Trait Marker and Reduced IL-7 and IL-12 as State Markers of Anorexia Nervosa.

J Pers Med 2021 Aug 20;11(8). Epub 2021 Aug 20.

Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.

Alterations in certain inflammatory markers have been found in individuals with anorexia nervosa (AN). However, their relation to clinical characteristics has not been extensively explored, nor is it clear whether they are trait or state features of the disorder. This cross-sectional study measured serum concentrations of 36 inflammatory markers in people with acute AN ( = 56), recovered AN (rec-AN; = 24) and healthy controls (HC; = 51). The relationship between body mass index (BMI), eating disorder psychopathology, depression symptoms and inflammatory markers was assessed. Statistical models controlled for variables known to influence cytokine concentrations (i.e., age, ethnicity, smoking status and medication usage). Overall, most inflammatory markers including pro-inflammatory cytokines were unchanged in AN and rec-AN. However, in AN and rec-AN, concentrations of macrophage inflammatory protein (MIP)-1β were lower than HCs. Interleukin (IL)-7 and IL-12/IL-23p40 were reduced in AN, and concentrations of macrophage-derived chemokine, MIP-1α and tumor necrosis factor-α were reduced in rec-AN compared to HC. In conclusion, a reduction in MIP-1β may be a trait marker of the illness, whereas reductions in IL-7 and IL-12/IL-23p40 may be state markers. The absence of increased pro-inflammatory cytokines in AN is contradictory to the wider literature, although the inclusion of covariates may explain our differing findings.
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http://dx.doi.org/10.3390/jpm11080814DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399452PMC
August 2021

Attitudes Surrounding Music of Patients With Anorexia Nervosa: A Survey-Based Mixed-Methods Analysis.

Front Psychiatry 2021 2;12:639202. Epub 2021 Jun 2.

Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.

Anorexia nervosa (AN) is one of the main eating disorders. It has the highest mortality of all psychiatric disorders, and the success rates of current therapies are not fully satisfactory. Thus, there is a need for novel interventions. We investigated the attitudes surrounding music of 41 patients with clinically-diagnosed AN as well as their thoughts on the potential therapeutic uses of music using a questionnaire of 50 questions. Free text responses were qualitatively analyzed for reoccurring themes with NVivo 12 software. Yes/no questions and questions of best fit were analyzed using the IBM SPSS Statistics version 25. The most prevalent theme was the positive effect of music. Most patients reported that listening to music evokes varying emotions in them (83%) which may be of positive or negative nature. Similarly, patients associated certain music with particular positive, but also with particular negative memories. A majority of patients stated that music helps to distract them (85%), helps with loneliness (59%) and helps them feel more connected to others (58%). This data indicates that people with AN make nonclinical use of music which seems to elicit positive as well as negative emotions and memories. Patients felt music is beneficial with regard to important aspects of AN, such as emotional problems, loneliness, and relationship difficulties. Most of them would also like to attend music therapy.
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http://dx.doi.org/10.3389/fpsyt.2021.639202DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8206484PMC
June 2021

Cytokines and Water Distribution in Anorexia Nervosa.

Mediators Inflamm 2021 2;2021:8811051. Epub 2021 Apr 2.

Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.

In patients with anorexia nervosa (AN), decreased intracellular (ICW), extracellular (ECW), and total body water (TBW) as well as changes in serum cytokine concentrations have been reported. In this exploratory study, we measured body composition and serum cytokine levels in patients with AN ( = 27) and healthy controls (HCs; = 13). Eating disorder symptom severity was assessed using the Eating Disorder Examination-Questionnaire (EDE-Q). Body composition was determined by bioimpedance analysis (BIA) which provided information on ICW, ECW, and TBW. Following blood collection, 27 cytokines and chemokines were quantified using multiplex ELISA-based technology: Eotaxin, Eotaxin-3, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon- (IFN-) , interleukin- (IL-) 1, IL-1, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12/IL-23p40, IL-12p70, IL-13, IL-15, IL-16, IL-17A, interferon -induced protein- (IP-) 10, macrophage inflammatory protein- (MIP-) 1, MIP-1, monocyte chemoattractant protein- (MCP-) 1, MCP-4, thymus and activation-regulated chemokine (TARC), TNF-, and TNF-. ICW, ECW, and TBW volumes were significantly lower in patients with AN than in HCs. In the whole sample, GM-CSF, MCP-4, and IL-4 were positively, whereas IFN-, IL-6, and IL-10 were negatively associated with all three parameters of body water. In AN participants, we found a statistically significant negative correlation of IL-10 with ICW, ECW, and TBW. Our results suggest an interaction between body water and the cytokine system. Underlying mechanisms are unclear but may involve a loss of water from the gut, kidneys, or skin due to AN-associated inflammatory processes.
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http://dx.doi.org/10.1155/2021/8811051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035023PMC
April 2021

Diet, Obesity, and Depression: A Systematic Review.

J Pers Med 2021 Mar 3;11(3). Epub 2021 Mar 3.

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.

Background: Obesity and depression co-occur in a significant proportion of the population. Mechanisms linking the two disorders include the immune and the endocrine system, psychological and social mechanisms. The aim of this systematic review was to ascertain whether weight loss through dietary interventions has the additional effect of ameliorating depressive symptoms in obese patients.

Methods: We systematically searched three databases (Pubmed, Medline, Embase) for longitudinal clinical trials testing a dietary intervention in people with obesity and depression or symptoms of depression.

Results: Twenty-four longitudinal clinical studies met the eligibility criteria with a total of 3244 included patients. Seventeen studies examined the effects of calorie-restricted diets and eight studies examined dietary supplements (two studies examined both). Only three studies examined people with a diagnosis of both obesity and depression. The majority of studies showed that interventions using a calorie-restricted diet resulted in decreases in depression scores, with effect sizes between ≈0.2 and ≈0.6. The results were less clear for dietary supplements.

Conclusions: People with obesity and depression appear to be a specific subgroup of depressed patients in which calorie-restricted diets might constitute a promising personalized treatment approach. The reduction of depressive symptoms may be related to immunoendocrine and psychosocial mechanisms.
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http://dx.doi.org/10.3390/jpm11030176DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999659PMC
March 2021

Hippocampal volume, function, and related molecular activity in anorexia nervosa: A scoping review.

Expert Rev Clin Pharmacol 2020 Dec 25;13(12):1367-1387. Epub 2020 Nov 25.

Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology & Neuroscience ,UK.

Introduction: Anorexia nervosa (AN) is a serious and persistent eating disorder, characterized by severe dietary restriction and weight loss, with a third of patients developing a  severe-enduring form. The factors contributing to this progression are poorly understood, although there is evidence for impairments in neural structures such as the hippocampus, an area particularly affected by malnutrition and chronic stress.

Areas Covered: This study aimed to map the evidence for alterations in hippocampal volume, function, and related molecular activity in anorexia nervosa. PubMed, PsycINFO, and Web of Science were searched for studies related to hippocampal function and integrity using a range of methodologies, such as neuropsychological paradigms, structural and functional magnetic resonance imaging, and analysis of blood components.

Expert Opinion: Thirty-nine studies were included in this review. The majority were neuroimaging studies, which found hippocampus-specific volumetric and functional impairments. Neuropsychological studies showed evidence for a specific memory and learning impairments. There was some evidence for molecular abnormalities (e.g. cortisol), although these were few studies. Taken together, our review suggests that the hippocampus might be a particular region of interest when considering neurobiological approaches to understanding AN. These findings warrant further investigation and may lead to novel treatment approaches.
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http://dx.doi.org/10.1080/17512433.2020.1850256DOI Listing
December 2020

Effects of IL-6 Signaling Pathway Inhibition on Weight and BMI: A Systematic Review and Meta-Analysis.

Int J Mol Sci 2020 Aug 31;21(17). Epub 2020 Aug 31.

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.

Inhibitors of the IL-6 signaling pathway, such as tocilizumab, are frequently administered for the treatment of immune diseases, e.g., rheumatoid arthritis and multicentric Castleman's disease. The aim of this systematic review and meta-analysis was to ascertain the effects of IL-6 pathway inhibitors on weight and body mass index (BMI). Using PRISMA guidelines, we systematically reviewed relevant articles from three databases (PubMed, OVID, EMBASE). A random effects model was used to estimate standardized mean change (SMCC). Ten studies with a total of 1531 patients were included in the meta-analysis for weight and ten studies with a total of 1537 patients were included in the BMI meta-analysis. The most commonly administered IL-6 pathway inhibitor was tocilizumab. IL-6 pathway inhibitors were associated with increases in weight (SMCC = 0.09, = 0.016, 95% CI [0.03, 0.14]) and BMI (SMCC = 0.10, = 0.0001, 95% CI [0.05, 0.15]). These findings suggest that the IL-6 pathway is involved in weight regulation. Modulating IL-6 signaling may be a potential future therapeutic avenue used as an adjunct for the treatment of disorders associated with weight changes, such as cancer cachexia and anorexia nervosa.
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http://dx.doi.org/10.3390/ijms21176290DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7504579PMC
August 2020

Impact of TNF-α Inhibitors on Body Weight and BMI: A Systematic Review and Meta-Analysis.

Front Pharmacol 2020 15;11:481. Epub 2020 Apr 15.

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.

Objective: The aim of this systematic review and meta-analysis of longitudinal studies was to ascertain to effects of TNF-α inhibitor therapy on body weight and BMI.

Methods: Three databases (PubMed, OVID, and EMBASE) were systematically searched from inception to August 2018. We identified prospective, retrospective, and randomized controlled studies in adults with immune-mediated inflammatory diseases treated with TNF-α inhibitors based on pre-specified inclusion criteria. A random-effects model was used to estimate standardised mean change (SMCC).

Results: Twenty-six longitudinal studies with a total of 1,245 participants were included in the meta-analysis. We found evidence for a small increase in body weight (SMCC = 0.24, p = .0006, 95% CI [0.10, 0.37]) and in BMI (SMCC = 0.26, p < .0001, 95% CI [0.13, 0.39]). On average, patients gained 0.90kg (SD = 5.13) under infliximab, 2.34kg (D = 5.65) under etanercept and 2.27kg (SD = 4.69) during treatment with adalimumab within the duration of the respective studies (4-104 weeks).

Conclusion: Our results yield further support the for the view that TNF-α inhibitors increase body weight and BMI as a potential side effect. Modulating cytokine signaling could be a future therapeutic mechanism to treat disorders associated with weight changes such as anorexia nervosa.
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http://dx.doi.org/10.3389/fphar.2020.00481DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174757PMC
April 2020

Phosphatidylcholine Containing Long Chain Omega-3 Fatty Acids: a Treatment Adjunct for Patients with Anorexia Nervosa?

Psychiatr Danub 2020 ;32(1):55-59

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 103 Denmark Hill, London SE5 8AF, UK.

Background: Anorexia nervosa (AN) is a serious mental disorder with a high mortality rate and often a chronic course. In contrast to many other common mental disorders, there is no drug therapy approved for AN.

Methods: We performed a narrative literature review to consider whether a choline-containing molecule, such as phosphatidylcholine (PC), with an omega (ω)-3 long chain polyunsaturated fatty acid (LCPUFA) could be a potential future medicinal treatment for AN.

Results: Choline and LCPUFAs have individually shown benefit for mental health. Case series and pilot studies suggest ω-3 LCPUFAs may be effective in eating disorders. However, pharmacodynamic and pharmacokinetic considerations suggest a greater benefit from the combination of both components.

Conclusion: The combination of a choline-containing molecule with an ω-3 LCPUFA may be clinically effective and well tolerated. This idea is supported by the current literature on the role of inflammation, the microbiome, the gut-brain-axis, hormonal, neurotransmitter and intracellular signalling, and on the structure and fluidity of nerve cells membranes in patients with AN.
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http://dx.doi.org/10.24869/psyd.2020.55DOI Listing
April 2020

Cytokine Research in Depression: Principles, Challenges, and Open Questions.

Front Psychiatry 2019 7;10:30. Epub 2019 Feb 7.

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.

Cytokines have been implicated in the pathology of depression. Currently, the evidence is based on cross-sectional studies and meta-analytic research comparing blood concentrations of T helper type 1 (T1), T helper type 2 (T2), pro-inflammatory or anti-inflammatory cytokines of patients with a depressive disorder to those of healthy controls. Additionally, multiple longitudinal studies have investigated cytokine levels during antidepressant treatment. According to the current literature, it seems that peripheral levels of interleukin (IL)-6, IL-10, IL-12, IL-13, and tumor necrosis factor (TNF)-α are elevated and that interferon (IFN)-γ levels are lower in patients with depression compared to healthy controls. However, the overlap of cytokine values between acutely depressed patients, remitted and recovered patients and healthy controls is considerable. Thus, the discriminative power of cytokine concentrations between depressed and non-depressed people is likely weak. Treatment with certain antidepressants appears to decrease peripheral levels of IL-6, IL-10, and TNF-α. However, weight gain-inducing psychopharmacological substances, such as the antidepressant mirtazapine, have been reported to potentially increase the production of pro-inflammatory cytokines. Even though cytokines are often discussed as biomarkers for depression, they have also been shown to be altered in other psychiatric disorders. Moreover, many environmental, social, psychological, biological, and medical factors are also associated with cytokine changes. Thus, cytokine alterations seem extremely unspecific. The interpretation of the results of these studies remains a challenge because it is unknown which type of cells are most responsible for cytokine changes measured in the blood nor have the main target cells or target tissues been identified. The same cytokine can be produced by multiple cell types, and the same cell can produce various cytokines. Additionally, redundancy, synergy, antagonism, and signaling cascades of cytokine signaling must be considered. Cytokines might not be associated with the diagnosis of depression according to the currently used diagnostic manuals, but rather with specific subtypes of depression, or with depressive symptoms across different psychiatric diagnoses. Therefore, the currently available diagnostic systems may not be the ideal starting point for psychiatric cytokine research.
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http://dx.doi.org/10.3389/fpsyt.2019.00030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374304PMC
February 2019

Water supplementation after dehydration improves judgment and decision-making performance.

Psychol Res 2020 Jul 21;84(5):1223-1234. Epub 2019 Jan 21.

University of East London, Stratford Campus, Water Lane, London, E15 4LZ, UK.

Previous research has shown that dehydration and water supplementation affect mood and cognitive performance in both adults and children on a variety of tasks that assess memory, attention, executive function, and speeded responses. Given the varied effects of water on cognition, this study explored potential effects of water supplementation, hydration status, and thirst on thinking and decision-making tasks. 29 adult participants undertook a battery of cognitive tests on two separate occasions after having fasted from the previous night. On one occasion, they were offered 500 ml of water to drink prior to testing. Measures of urine osmolality confirmed the group-level effectiveness of the dehydration manipulation. Water supplementation was found to improve performance on tasks measuring cognitive reflection in judgement and decision-making. This increase in performance was associated with differences in tasks implicated in inhibition processes. Drinking water after a 12-h dehydration period increased performance in judgement and decision-making tasks, and this was not explained by differences in subjective thirst or attentiveness.
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http://dx.doi.org/10.1007/s00426-018-1136-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271046PMC
July 2020

A systematic review of in vitro cytokine production in eating disorders.

Mol Cell Endocrinol 2019 11 6;497:110308. Epub 2018 Oct 6.

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK.

Background: Eating disorders (EDs) have been associated with alterations in cytokine concentrations and production. This review examines whether in vitro cytokine production (i) is altered in people with EDs compared to healthy participants; and (ii) changes in response to treatment?

Methods: Using PRISMA guidelines, we systematically reviewed articles reporting group comparisons or longitudinal assessments of spontaneous and/or stimulated cytokine production in vitro in people with EDs.

Results: Twelve studies were included. Cross-sectional results were mixed in anorexia nervosa. Only one study measured cytokine production in bulimia nervosa. Two longitudinal studies showed that daily yoghurt consumption increases phytohemagglutinin-stimulated interferon-γ production in anorexia nervosa.

Conclusion: The mixed results could be accounted for by variations in experimental design. Our findings suggest that cytokine production could possibly be modulated through dietary interventions. However, due to the methodological heterogeneity and shortcomings of the included studies, it seems unreasonable to draw further conclusions.
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http://dx.doi.org/10.1016/j.mce.2018.10.006DOI Listing
November 2019
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