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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1190

Shared mechanisms linking schizophrenia and metabolic syndrome: inflammation, microbiota, and the gut–brain axis

SHARED MECHANISMS BETWEEN SCHIZOPHRENIA AND METABOLIC SYNDROME: INFLAMMATION, MICROBIOTA AND THE GUT–BRAIN AXIS

The relationship between schizophrenia and metabolic syndrome cannot be explained solely by medication side effects or lifestyle; shared bidirectional mechanisms involving inflammation, oxidative stress, and the gut–brain axis call for an integrated, transdiagnostic model of care.

This review aims to examine the shared pathophysiological mechanisms underlying the strong association between schizophrenia and metabolic syndrome (MetS), focusing on inflammation, microbiota, and the gut–brain axis. A narrative literature review was conducted, covering studies that examined the relationships among schizophrenia, metabolic syndrome, inflammation, oxidative stress, and alterations in the gut microbiota. The poster notes that schizophrenia is strongly associated with metabolic syndrome, leading to high cardiovascular morbidity and a 15- to 20-year reduction in life expectancy. Beyond secondary medication effects and lifestyle factors, it proposes a bidirectional pathophysiology mediated by shared mechanisms such as inflammation, hypothalamic–pituitary–adrenal axis dysregulation, oxidative stress, and neuroendocrine changes. It describes how gut dysbiosis and increased intestinal permeability facilitate bacterial endotoxemia, which triggers systemic inflammation (TNF-alpha, IL-6), leading to microglial activation and neurodevelopmental dysfunction, while the same process also contributes to metabolic syndrome through insulin resistance and adiposity. Clinical implications include early metabolic screening beginning with the first psychotic episode, optimization of antipsychotic regimens to reduce metabolic burden, diet, exercise, and psychoeducation. Microbiota-targeted therapies, such as probiotics, prebiotics, and fecal microbiota transplantation (FMT), are described as potentially offering dual benefits for both symptom control and metabolic regulation. Nevertheless, the review emphasizes that routine metabolic assessment remains underused in clinical practice, despite being essential to improving early intervention, reducing hospital admissions, and improving prognosis. In conclusion, the findings support a transition toward a transdiagnostic and interdisciplinary model of care. Future research should refine diagnostic tools, identify early biomarkers, and develop treatments that simultaneously target psychiatric and metabolic symptoms.

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