Treatment Of Schizophrenia Spectrum Disorders Research Articles

A Conceptual Analysis of Post-psychotic Depression

"The conundrum of post-psychotic depression (PPD) is still present in the psychiatric literature, for more than a century since it was first described by Mayer-Gross. After a short existence in the DSM-IV and ICD-10, this nosological construct was excluded from newer versions of the mental disorders classifications. Therefore, an exploratory analysis of the PPD concept was considered useful both from clinical and theoretical perspectives. There is a high prevalence of depressive symptoms in patients with schizophrenia spectrum disorders (SSD) and, although not all of them represent cases of PPD, they are considered risk factors for suicide. The arguments and contra-arguments for/against PPD were reviewed, and the potential pharmacological interventions for this disorder were analyzed. The explored evidence indicates that PPD is worth further investigation, and in order to differentiate it from schizoaffective disorder, negative symptoms of SSD, or depressive manifestations within the acute psychotic episodes, clearly defined criteria should be found. The use of validated scales, like the Calgary Depression Scale for Schizophrenia and the InterSePT Scale for Suicidal Thinking, is recommended for the initial assessment of depression and suicidal risk in patients with SSD, but also for their monitoring during the acute and maintenance phases. Besides the administration of combined, antidepressant and antipsychotic treatment, the use of clozapine, and the recommendation to initiate treatment for SSD with atypical antipsychotics whenever possible, there is a dearth of studies exploring specific interventions for PPD. Future studies are expected to address the validity of the nosological construct of PPD and the most adequate therapeutic and prophylactic interventions in patients with SSD."

Сariprazine in the treatment of schizophrenia spectrum disorders in a hospital setting

The aim of the study was to evaluate the possibility of using cariprazine for the treatment of productive and negative symptoms in schizophrenic spectrum disorders in a hospital setting.Materials and methods: A group of 35 patients with leading productive and negative symptoms in patients with schizophrenic spectrum disorders treated in a psychiatric hospital constituted the material of the study. The condition of patients was objectified according to the Clinical Global Impression Scale (CGI-S and CGI-I) and the Positive and Negative Syndrome Scale (PANSS) — at the beginning of the study and in dynamics on the 30th and 60th day of treatment. The mean PANSS score at the beginning of the study was 94.45±14.49 points. After the drug administration, the patients were followed up for up to 60 days.Results: Cariprazine was administered both as first-line treatment and after prior therapy. The dose range was from 1.5 mg to 6 mg daily. In 3 patients (8.57%), cariprazine therapy was discontinued due to the development of adverse events or worsening of the condition. The remaining 32 patients (91.43%) showed positive dynamics.Conclusions: The study showed high efficacy of cariprazine when administered for the treatment of productive and negative symptoms in schizophrenic spectrum disorders in a hospital setting. The drug was well tolerated in the majority of patients.

Efficacy of immersive extended reality (XR) interventions on different symptom domains of schizophrenia spectrum disorders. A systematic review.

Extended reality (XR) is an umbrella term for virtual reality (VR) and augmented reality (AR), both novel vectors for therapeutic intervention modalities. In VR, head-mounted devices (HMD) allow interaction with three-dimensional virtual environments and simulated avatars, while AR overlaps virtual, simulated objects to observe physical reality. Treatment through immersive VR has been studied in psychiatry, including patients suffering from schizophrenia spectrum disorders, while there has not been much attention to AR technologies in psychiatry. Our systematic review aimed to examine the currently available literature regarding the treatment efficacy of immersive VR or AR technologies on different symptom domains of schizophrenia spectrum disorders, screen for potential adverse effects, and gather data on the technological and human resource requirements of such interventions to help guide future research. We conducted a systematic literature review with database searches carried out between 9/2021 and 8/2022 through PubMed, Scopus, EBSCOhost Academic Search Premier, and Web of Science. We identified 2,157 records, 214 were assessed further for eligibility and 12 met inclusion criteria. All included articles studied immersive VR and none used AR technology. Included studies were heterogenous in nature, including AVATAR therapy (3) and CBT-based (5) VR interventions, as well as cognitive (2), social (1), and relaxation (1) training through VR. The comparison groups were either passive controls (waitlist and treatment as usual), therapeutic interventions (CBT and Integrated psychological treatment), passive VR environments, or traditional, comparable, non-virtual treatment modalities (social roleplay and progressive muscle relaxation training). Pooled together, the included studies on VR show positive treatment effects in all major symptom domains of schizophrenia spectrum disorders with hardly any adverse effects related to the intervention modalities. In this review, we have showcased how different symptom domains can be targeted through VR interventions, highlighting VR as a potential new vector for a diverse range of psychosocial therapeutic modalities that allow for completely new possibilities in the treatment of schizophrenia spectrum disorders. VR technology still requires more research and validation. Our review also shows that there are currently no studies examining AR technology in the treatment of schizophrenia spectrum disorders, indicating a distinctive research gap.

Prevalence and Correlates of Extrapyramidal Side Effects Among Patients with Schizophrenia Spectrum Disorders on Typical and Atypical Antipsychotics

Background: Antipsychotic medication for the treatment of schizophrenia spectrum disorders are associated with adverse effects with extrapyramidal side effects constituting one of the most notable effects associated with poor medication adherence and poor quality of life. Aims: The study aims to compare the prevalence of extrapyramidal side effects (EPSE), among patients with schizophrenia spectrum disorders on typical and atypical antipsychotic medications. The secondary aim is to determine the association of extra-pyramidal side effects with socio-clinical variables. Methodology: A cross-sectional hospital-based study with systematic random sampling recruitment of 340 participants and 303 completed the study. Variables with significant association on chi square analysis were subjected to logistic regression analysis. Results: The overall prevalence of extrapyramidal side effects among patients with schizophrenia spectrum disorder on antipsychotic medication was 42.6 %. The prevalence of tardive dyskinesia, parkinsonism and akathisia were 7.9 %, 38.6 and 3.6 %, respectively. The prevalence of extra-pyramidal side effects due to use of typical, atypical and combination drug was 44.4 %, 51.2 % and 34.5 %, respectively with haloperidol (59.4 %) and risperidone (71.4 %) having the greatest effect. Being elderly was associated with tardive dyskinesia, duration of treatment, severity of illness and type of illness with parkinsonism and severity of illness with akathisia. Conclusion: The findings of this study support the high prevalence of extrapyramidal side effects from either using typical and atypical antipsychotic medications. Therefore, Clinicians should discuss on these side effects and proffer possible solutions with their patients prior to commencement of antipsychotic medications in order to promote medication adherence.

Turning the Spotlight on Apathy: Identification and Treatment in Schizophrenia Spectrum Disorders.

Among negative symptoms, apathy is central to the impairments in real-life functioning in schizophrenia spectrum disorders (SSD). Thus, optimizing treatment for apathy appears key to improve outcomes. In treatment research, however, negative symptoms are typically studied as a unifactorial construct. We, therefore, aim to shed necessary light on the status of apathy identification and treatment in SSD.

Psychotic disorders in young patients with Prader-Willi syndrome: A case report and literature review

IntroductionPrader-Willi syndrome (PWS) is a genetic disorder with an estimated prevalence of 1:25,000. PWS results from defective gene expression on the paternal copy of chromosome 15. In 70% of the cases it is a deletion that means that part of the paternal chromosome 15 is missing. Maternal uniparental disomy (mUPD) is present in 25% of cases. Typical clinical features of PWS are dysmorphism, hypotonia, hyperphagia, hypogonadism and developmental delay. In addition, the syndrome is accompanied by various psychiatric symptoms that are often insufficiently known within the psychiatric field. Regarding the relationship between PWS and schizophrenia spectrum disorders (SSDs), individuals with mUPD appear to have a 3 to 4 times higher risk of psychotic symptoms than those with the deletion subtype. Psychotic episodes have an atypical presentation with recurrent episodes of confusion and rapidly fluctuating psychotic and mood symptoms.ObjectivesTo describe an unusual clinical case in order to determine the management regarding clinical approach, and provide an overview of psychotic episodes in patients with PWS for the general practitioner with the most up-to-date information on workup and management.MethodsWe report a case involving a 13-year-old woman with PWS (mUPD of chromosome 15) and mild intellectual disability (IQs 59), who presented psychotic symptomatology in the form of disorganized behavior, delusional ideation, auditory hallucinations, self-referentiality and suspicion. Parents reported that these symptoms started two days prior the day of consultation. No environmentals stressors were identified and no recent treatment changes were made. Patient’s medication consists in 150 mg sertraline per day due to anxiety control and aid in emotional and behavioral regulation.ResultsGiven the diagnostic approach of a psychotic episode (PE) in a patient with PWS, it was decided to offer 0.5mg risperidone per day, in an increasing pattern until reaching a final dose of 1.25 mg per day, presenting a global remission of the psychotic symptomatology.Recommendations for patients with PWS presenting PE are based upon systematic reviews. Patients with PWS, especially mUPD subjects, are at risk for SSDs and mood disorders. Antipsychotics (APs) are the gold standard in the treatment of SSDs, and some authors have suggested that APs protect patients with previous psychotic symptoms from relapse. It is unknown whether there is a protective effect of APs in mUPD patients who have not previously exhibited psychotic signs.ConclusionsPWS represents a good example of a genetic disease with behavioral and psychiatric symptoms that may be challenging to treat with psychotropic medications. For a better understanding of psychiatric problems in adults with PWS, longitudinal studies with careful and standardized follow-up of psychiatric symptoms in PWS are necessary.Disclosure of InterestNone Declared

Psychodynamic psychotherapy for schizophrenia spectrum disoders: a case presentation and systematic review

IntroductionPsychodynamic psychotherapy emphasizes the unique history, subjectivity, and psychological complexity of each individual. The core principles in the psychodynamic treatment of schizophrenia spectrum disorders (SSD) includes a stable (yet flexible) frame; attention to countertransference; and clarification of experiences, emotions, and relationships including giving psychotic symptoms context in internal and external object relationships.ObjectivesThis study has two aims. First, to present the progress of a patient with chronic schizophrenia treated with psychodynamic psychotherapy. Second, to provide a systematic review of comparative trials that have included psychodynamic psychotherapy as treatment for SSD.MethodsThe case presentation includes information from the therapist’s notes, video footage, and the electronic health record. The systematic review will be conducted in November and December, 2022, and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The databases of MEDLINE, EMBASE, and PsycInfo will be searched for literature.ResultsL, a 25-year-old woman, was diagnosed with paranoid schizophrenia five years prior to starting psychodynamic psychotherapy at an outpatient unit for SSD. L grew up with a close relationship with her mother, father, and sister. She was bullied in school and clearly remembered being told by her classmates that she was “just L”. When therapy began L had been living with her boyfriend for six months. Voice hallucinations were one of the most interfering symptoms. The most present voice, M, was both her best friend and worst enemy. During psychotic breakdowns M could take control of L’s body. L was incapable of making her own decisions. Small and big decisions were consulted with a family member or the hallucinatory voices. L attended 33 psychotherapy sessions from October, 2020 to November, 2021. In the first six months, sessions were weekly and afterwards biweekly due to L feeling significantly better and she wanted to have more time to study. L benefitted from the structure and clarifying questions from the therapist. Most notably, she broke up with her boyfriend. She started dating and found a new boyfriend. At this point the voice hallucinations and psychotic breakdowns were reduced considerably. In the termination phase the themes were feeling insecure, relationships, and how having been bullied affected her as an adult.Results from the systematic review are not available at the time of submission.ConclusionsIn the present case, psychodynamic psychotherapy was an effective treatment of psychotic symptoms as well as childhood trauma and interpersonal conflicts for an individual with paranoid schizophrenia. It speaks for a broad application of psychodynamic psychotherapy in the treatment of SSD as the therapy both assesses and treats psychotic and non-psychotic symptoms.Disclosure of InterestNone Declared

Pharmacological treatment of early psychosis: risks and benefits

AbstractPsychiatry has changed a lot during the last decades and lot of effort has been made to ensure that treatment of schizophrenia spectrum disorders is in line with modern science of medicine. Therefore, in everyday practice the psychiatrist is in a constant process of decision making when to start pharmacological treatment of early psychosis and with what dosage. The lecture will include evidence-based treatment options, the aspects of clinical practice and the power of shared decision-making in psychiatry.Disclosure of InterestNone Declared

A Systematic Review on Add-On Psychotherapy in Schizophrenia Spectrum Disorders.

Schizophrenia spectrum disorders represent a varied class of mental illnesses characterised by psychosis. In addition to negative and positive symptoms, a significant lack of insight often hinders the therapeutic process. We performed an overview of the existing literature concerning these disorders to summarise the state of knowledge in the psychotherapies applied to treating psychotic symptoms. We searched the PubMed database, including randomised controlled and clinical trials, including 17 studies conducted on 1203 subjects. Psychotherapy of schizophrenia spectrum disorders can improve social functioning and positive symptoms, as well as many other symptomatic areas, and could therefore be considered a helpful adjunctive treatment of schizophrenia spectrum disorders. Among cognitive-behavioural therapies and the newest derived approaches, there is evidence that they can improve different psychotic symptoms. On the other hand, psychodynamic psychotherapies can have a positive influence on psychotic symptoms as well. Further studies are needed to identify better-tailored treatment protocols for schizophrenia spectrum disorders.

An Optimized Version of the Positive and Negative Symptoms Scale (PANSS) for Pediatric Trials

The accepted primary outcome measure for evaluating psychotic symptoms is decades old, long, and initially designed for adults. Surprisingly, the psychometric properties of primary outcome measures have never been reported for a pediatric sample using modern methods. The present study's aim is to use a pediatric sample to evaluate the psychometrics of the most used primary outcome measure in pediatric schizophrenia trials, the Positive and Negative Syndrome Scale (PANSS). To evaluate the factor structure, item characteristics, and treatment sensitivity of the PANSS in a pediatric sample, secondary analyses of PANSS data at baseline and weekly throughout an 8-week randomized double-blind study of 3 antipsychotic agents (registered and previously published) were conducted. Subjects were 118 youths receiving outpatient psychiatric treatment for schizophrenia spectrum disorders (mean age= 14.26 years, SD= 2.41 years). A 10-item short form, keeping 2 strongest items for each factor, had r= 0.89 with the full-length scale. Each of the five 2-item subscales has alphas ranging from 0.66 to 0.84. Item Response Theory (IRT) found that the 10-item scale and 2-item subscores had high reliability across the severity range typical of those for clinical trials. Criterion validity was high, with equal sensitivity to clinical changes over time. A 10-item PANSS version eliminates weaker items in the pediatric population while preserving coverage of 5 factors and similar sensitivity to clinical changes over time. It thus may be more appropriate for subsequent pediatric trials, and for clinical use when time and efficiency are paramount.

Inflammatory monocyte gene signature predicts beneficial within group effect of simvastatin in patients with schizophrenia spectrum disorders in a secondary analysis of a randomized controlled trial

Immune dysregulation has been reported in schizophrenia spectrum disorders (SSD). In the past decade, several trials using anti-inflammatory agents for treatment of SSD have been completed, with so far limited success. One such anti-inflammatory agent used is simvastatin. A recent, large-scale, randomized controlled trial with simvastatin augmentation failed to show improvement in the predefined primary outcome. However, baseline inflammatory profiles were not taken into account. Here we employed a data-driven clustering approach to investigate whether patients with an inflammatory monocyte gene signature respond better to add-on simvastatin treatment than those without such a signature, over a treatment period of 2 years. In 61 patients (60 randomized, 1:1 placebo:simvastatin) and healthy controls, a previously validated monocyte gene expression signature was assessed using quantitative polymerase chain reaction. Resulting delta cycle threshold values were used to identify patient clusters. Two major patient clusters with either up- or downregulated pro-inflammatory factors were detected. Linear mixed models showed a significant three-way interaction between the inflammatory cluster, treatment, and time for psychotic symptoms. Only patients treated with simvastatin who were in the inflammatory group, showed a consistent improvement: symptom severity gradually decreased after 3 months and reached significance after 12 and 24 months compared to baseline (p.adj<0.05). The effects were small, and overall between-group effects were not significant. Here, we show that patient stratification based on inflammatory gene expression might be useful to select appropriate treatment augmentation for patients with SSD, highlighting the need for precision medicine approaches. Our findings corroborate the results of the primary analyses, showing that in the overall group, simvastatin was not effective; however, at the individual level the treatment might make a difference.

11.1 Toward an Optimized Version of the Positive and Negative Syndrome Scale (PANSS) for Pediatric Trials

11.1 Toward an Optimized Version of the Positive and Negative Syndrome Scale (PANSS) for Pediatric Trials

Is modafinil an effective adjunct to standard care in the treatment of schizophrenia-spectrum disorders?

SUMMARYAntipsychotics are the cornerstone of schizophrenia management but they are not adequate in treating the negative and cognitive symptoms of the illness. The Cochrane review discussed in this commentary examines the safety and effectiveness of the wakefulness-promoting agent, modafinil, as an adjunct to standard care in the mitigation of negative and cognitive symptoms of schizophrenia. Add-on modafinil, compared to add-on placebo and standard treatment, did not result in a clear benefit. Due to the heterogenous body of evidence, the quality of which ranged from very low to moderate, the review's conclusions are equivocal.

Symptom monitoring based on digital data collection during inpatient treatment of schizophrenia spectrum disorders – A feasibility study

Digital acquisition of patients’ self-reports on individual risk factors and symptom severity represents a promising, cost-efficient, and increasingly prevalent approach for standardized data collection in psychiatric clinical routine. Yet, studies investigating digital data collection in patients with a schizophrenia spectrum disorder (PSSDs) are scarce. The objective of this study was to explore the feasibility of digitally acquired self-report assessments of risk and symptom profiles at the time of admission into inpatient treatment in an age-representative sample of hospitalized PSSDs. We investigated the required support, the data entry pace, and the subjective user experience. Findings were compared with those of patients with an affective disorder (PADs). Of 82 PSSDs who were eligible for inclusion, 59.8% (n=49) agreed to participate in the study, of whom 54.2% (n=26) could enter data without any assistance. Inclusion rates, drop-out rates, and subjective experience ratings did not differ between PSSDs and PADs. Patients reported high satisfaction with the assessment. PSSDs required more support and time for the data entry than PADs. Our results indicate that digital data collection is a feasible and well-received method in PSSDs. Future clinical and research efforts on digitized assessments in psychiatry should include PSSDs and offer support to reduce digital exclusion.

Antipsychotics for schizophrenia spectrum disorders with catatonic symptoms.

Antipsychotics for schizophrenia spectrum disorders with catatonic symptoms.

A collection of medical findings using machine learning and their relevance to psychiatry

The rapid increase in the amount of available data within the field of psychiatry makes modern statistical analysis methods increasingly important. Machine learning offers a possibility to identify complex relationships within large data sets and to support scientific work. The following article presents a brief overview of machine learning and exemplary discusses first clinically relevant results of such analyses on a patient collective of a forensic psychiatric institution with focus on treatment of schizophrenia spectrum disorders.

Impact of early onset of chronic physical multimorbidities on schizophrenia spectrum disorder treatment outcome

IntroductionDespite of the heightened risks and burdens of physical comorbidities across the entire schizophrenia spectrum disorders (SSD), relatively little is known about physical multimorbidity (CPM) in this population. The study’s main objective was to explore the differences in the CPM prevalence between SSD patients and the general population (GEP).ObjectivesThe primary outcome was to explore the difference in CPM prevalence in the younger SSD and GEP groups (&lt;35 years).The secondary outcome was the number of psychiatric readmissions.MethodsThis nested cross-sectional study enrolled 343 SSD patients and 620 GEP participants.ResultsYounger SSD patients had more than three-fold higher odds for CPM than GEP. We also demonstrated an association between the presence of CPM and the number of psychiatric admissions in the SSD population independently of possible confounders. We did not observe significant interaction of CPM and age in the prediction of clozapine use. Younger women with SSD had statistically significant, almost four-fold higher odds of CPM than women from GEP.ConclusionsThis study suggests that women with SSD are at increased physical comorbidity risk compared to men, particularly early in the course of psychiatric illness. Our results highlight the importance of addressing physical health from the first contact with a mental health service to preserve general health, and provide the best possible treatment outcome. Treatment of SSD must be customized to meet the needs of patients with different physical multimorbidity patterns.DisclosureNo significant relationships.

Compassion-based approaches: a systematic review of their effectiveness and acceptability in schizophrenia spectrum disorders

The purpose of this systematic literature review is to provide an exhaustive summary of current research to explore the prospects of compassion-based approaches in treating persons with Schizophrenia Spectrum Disorders (SSD). Thereby, studies investigating the relationship between clinical parameters and self-compassion in SSD, as well as the acceptability, feasibility, and effects of compassion-based approaches for individuals with SSD were considered. The review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and checklist. Eight studies were included for qualitative synthesis. The results indicate an important role of self-compassion for several clinical parameters, including negative associations to positive symptoms, negative symptoms, cognitive disorganization, and emotional distress. All studies reported good acceptability and feasibility. Regarding the clinical effectiveness of compassion-based approaches, a variety of clinical benefits, such as improvements of mood, affect regulation, positive symptoms, negative symptoms, cognitive disorganization, and variables relating to psychological recovery were found in individuals with SSD. It is concluded that compassion-based approaches are a promising form of intervention in the treatment of SSD. However, further research, especially randomized controlled trials, in this field is needed to understand the full potential of compassion-based approaches for individuals with SSD.

The associations of cannabis and methamphetamine use with cognitive performance over the first 2 years of treatment in schizophrenia spectrum disorders.

Cognitive deficits are a core feature of schizophrenia, and comorbid substance use may be a contributory factor. Methamphetamine use has been associated with cognitive impairment in schizophrenia, while associations with cannabis use are less clear-cut. This study aimed to investigate the associations of cannabis and methamphetamine use with cognitive performance in first-episode schizophrenia spectrum disorders over the first 2 years of treatment. This was a longitudinal cohort study in 81 patients treated with flupenthixol decanoate according to a standardized protocol over 24 months. Cognitive performance was assessed with the Measurement and Treatment Research to Improve Cognition in Schizophrenia Cognitive Consensus Battery at four time points, and urine testing for cannabis and methamphetamine was conducted at six time points. We used linear mixed-effect models for repeated measures to assess visit-wise changes in composite cognitive scores in patients (n= 91) compared to matched controls without psychiatric or medical disorders (n= 100). Linear regression models were constructed to examine pre-treatment and end-point effects in patients. Compared to controls, patients exhibited greater cognitive impairments at baseline, which improved with treatment, but remained significantly lower throughout. The number of positive methamphetamine, but not cannabis, tests predicted less cognitive improvement in patients. Our findings suggest a negative association between methamphetamine and cognition, but not cannabis.

Association of a Single-Nucleotide Variant rs11100494 of the NPY5R Gene with Antipsychotic-Induced Metabolic Disorders.

Background: The usage of antipsychotics (APs) is the most robust and scientifically based approach in the treatment of schizophrenia spectrum disorders (SSDs). The efficiency of APs is based on a range of target receptors of the central nervous system (CNS): serotoninergic, dopaminergic, adrenergic, histaminergic and cholinergic. Metabolic disorders are the most severe adverse drug reactions (ADRs) and lead to cardiovascular diseases with a high rate of mortality in patients with SSDs. Neuropeptide Y receptor Y5 (NPY5R) is known in the chain of interaction to target receptors for APs, agouti-related peptide receptors and proopiomelanocortin receptors. We studied the association of the single-nucleotide variants (SNVs) rs11100494 and rs6837793 of the NPY5R gene, and rs16147, rs5573, rs5574 of the NPY gene, with metabolic disorders in Russian patients with SSDs. Methods: We examined 99 patients with SSDs (mean age—24.56 years old). The mean duration of APs monotherapy was 8 weeks. The biochemical blood test included levels of glucose, cholesterol, lipoproteins, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein and albumin. Anthropometry included weight, height, waist circumference and hip circumference. We used real-time PCR to study the carriage of major and minor alleles of the SNV rs11100494 (1164C>A) of the NPY5R gene (chromosome localization—4q32.2). Group 1 comprised 25 patients with SSDs taking APs with a change in body weight of more than 6% since the start of APs therapy. Group 2 comprised 74 patients with SSDs taking APs with a change in body weight of less than 6% since the start of APs therapy. Results: We show the significance of genetic risk factors (carriage of major allele C of SNV rs11100494 of the NPY5R gene) for the development of AP-induced weight gain in Russian patients with SSDs. The allele C predisposes to AP-induced weight gain (OR = 33.48 [95% CI: 12.62; 88.82], p-value < 0.001). Additionally, the results of our study demonstrate that first-generation APs (FGAs) are more likely to cause an increase in serum transaminase levels but are less likely to increase body weight. Second-generation APs (SGAs) are more likely to cause weight gain and changes in serum glucose levels. Conclusion: Our study shows the predictive role of the allele C of SNV rs11100494 of the NPY5R gene in the development of AP-induced weight gain. However, we did not find a significant association between biochemical markers and this SNV in Russian patients with SSDs.