Deanna L Kelly's research while affiliated with University of Maryland Medical Center and other places

Publications (265)

Article
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The pivotal tryptophan (TRP) metabolite kynurenine is converted to several neuroactive compounds, including kynurenic acid (KYNA), which is elevated in the brain and cerebrospinal fluid of people with schizophrenia (SZ) and may contribute to cognitive abnormalities in patients. A small proportion of TRP is metabolized to serotonin and further to 5-...
Article
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The negative relationship between schizophrenia (SCZ) and rheumatoid arthritis (RA) has been observed for 85 years, but the mechanisms driving this association are unknown. This study analyzed differences in profiles of cytokines (IL-1β, IL-Ra, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IFNγ, TNFα), selected genes (HLA-DRB1, IL1RN, HP2), and antibodi...
Article
Introduction Patients with severe mental illness are falsely characterized as aggressive by the media, perpetuating stigma. While exaggerated, some patients with severe mental illness are more aggressive without treatment. Clozapine may have a unique anti-aggressive effect in patients with schizophrenia-related disorders, independent of antipsychot...
Article
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Background: Many medications used to treat schizophrenia and bipolar I disorder are linked to hyperprolactinemia. The effects of cariprazine, a dopamine D3/D2 receptor partial agonist, on prolactin levels in patients with schizophrenia or bipolar I disorder were evaluated. Methods: Effects on prolactin were evaluated using pooled data from rando...
Article
Schizophrenia is a severe mental disorder with various medical comorbidities and early mortality. Hyperprolactinemia is common in women and its impact on sexual function, galactorrhea and amenorrhea is well known. This paper evaluates the risk of 25-hydroxy vitamin D deficiency and other metabolic related laboratory abnormalities in women with schi...
Article
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Sedentary behavior contributes to a shortened life expectancy in individuals with schizophrenia-spectrum disorders (SSDs), highlighting the need for effective interventions to improve health. This study examined whether reduced ecological momentary assessment (EMA) measures of sedentary activities were observed in individuals with SSDs who particip...
Article
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Correction to guideline. This international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by a...
Article
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This international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by agranulocytosis or myocard...
Article
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Growing evidence implicates an association between psychosocial stress and oxidative stress (OxSt) although there are not yet reliable biomarkers to study this association. We used a Trier Social Stress Test (TSST) and compared the response of a healthy control group (HC; N=10) against the response of a schizophrenia group (SCZ; N=10) that is expec...
Article
Sexual dysfunction is one of the most bothersome adverse drug effects seen in men and women taking antipsychotic medications and negatively impacts medication adherence. Antipsychotic medications are associated with hyperprolactinemia, which is known to contribute to sexual and hormonal side effects in men. However, testosterone also plays a key fa...
Article
Biology uses well-known redox mechanisms for energy harvesting (e.g., respiration), biosynthesis, and immune defense (e.g., oxidative burst), and now we know biology uses redox for systems-level communication. Currently, we have limited abilities to "eavesdrop" on this redox modality, which can be contrasted with our abilities to observe and actuat...
Article
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Although approximately 20% of adults in the United States experience a mental health condition annually, there continues to be a gap in the provision of care because of a shortage of behavioral health providers. The National Council for Behavioral Health Medical Director Institute has recommended that the number of board certified psychiatric pharm...
Article
One strategy to address hyperprolactinemia and associated sexual side effects in patients receiving antipsychotics is switching to an antipsychotic not associated with prolactin elevation (eg, aripiprazole). This post hoc analysis assessed prolactin concentrations and sexual side effects in an open-label prospective study of switching long-acting i...
Article
Background: Clozapine is an effective antipsychotic for treatment-resistant schizophrenia. One limitation of clozapine use is required monitoring of absolute neutrophil count (ANC) because of the risk of clozapine-induced neutropenia. Standard monitoring requires venous blood draws, which is a significant barrier to clozapine use. Methods: This...
Article
Background: A significant proportion of people with schizophrenia are characterized by impaired ability to socially engage with others. The development of effective interventions for social functioning remains a central therapeutic challenge. Cognitive-behavioral social skills training (CBSST) has been found to improve social functioning in schizo...
Preprint
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This study investigates the speech articulatory coordination in schizophrenia subjects exhibiting strong positive symptoms (e.g.hallucinations and delusions), using a time delay embedded correlation analysis. We show that the schizophrenia subjects with strong positive symptoms and who are markedly ill pose complex coordination patterns in facial a...
Conference Paper
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This study investigates the speech articulatory coordination in schizophrenia subjects exhibiting strong positive symptoms (e.g. hallucinations and delusions), using a time delay embedded correlation analysis. We show that the schizophrenia subjects with strong positive symptoms and who are markedly ill pose complex coordination patterns in facial...
Preprint
Full-text available
This study investigates the speech articulatory coordination in schizophrenia subjects exhibiting strong positive symptoms (e.g. hallucinations and delusions), using two distinct channel-delay correlation methods. We show that the schizophrenic subjects with strong positive symptoms and who are markedly ill pose complex articulatory coordination pa...
Article
This study investigates clinically valid signals about psychiatric symptoms in social media data, by rating severity of psychiatric symptoms in donated, de-identified Facebook posts and comparing to in-person clinical assessments. Participants with schizophrenia (N=8), depression (N=7), or who were healthy controls (N=8) also consented to the colle...
Article
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Schizophrenia is a challenging mental health disorder [1]. While various antipsychotics have [...]
Article
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This work presents the development of an electrochemical microsystem for antipsychotic clozapine treatment monitoring in schizophrenia patients. In our previous work, we demonstrated clozapine detection directly in spiked whole blood samples of a healthy volunteer using a chitosan-carbon nanotube-modified microelectrode with external counter and re...
Article
Background: Despite adequate antipsychotic treatment, most people with schizophrenia continue to exhibit persistent positive and negative symptoms and cognitive impairments. The current study was designed to examine the efficacy and safety of adjunctive anti-inflammatory combination therapy for these illness manifestations. Methods: Thirty-nine...
Article
Background: Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia. Although serum clozapine levels can help guide treatment, they are underutilized owing to requirements for frequent venous blood draws and lack of immediate results. Methods: Clozapine levels measured with a novel immunoassay technology (which enable...
Article
Objective: The quantification of antipsychotic levels in blood, also known as therapeutic drug monitoring (TDM), is a potentially useful tool of modern personalized therapy that can be applied to augment antipsychotic use and dosing decisions. The application of TDM for antipsychotics can be helpful in numerous challenging clinical scenarios, such...
Article
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Background Clozapine is one of the most underused medications in psychiatry for many reasons including mandatory blood testing, fear of serious side-effects, lack of patient adherence. A critical barrier to adoption could be addressed with the ability to measure clozapine at point-of-care (POC) from a fingerstick. Current practice of clozapine meas...
Article
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Background Clozapine is an effective antipsychotic for treatment-resistant schizophrenia that requires monitoring of the Absolute Neutrophil Count (ANC) due to the potential of clozapine induced neutropenia. Standard monitoring requires a routine venous draw which is considered one of the most significant barriers to patients starting or continuing...
Article
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The calcium-binding protein S100b is secreted by glial cells in the brain and is also expressed by melanocytes. In nanomolar concentrations, S100b is considered to be a neurotrophic factor, but in micromolar concentrations, it is thought to reflect CNS injury and inflammation. Seen as a potential biomarker in traumatic brain injury, meta-analytic d...
Article
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Schizophrenia is a complex mental illness characterized by positive and negative symptoms. Antipsychotic medications are the main treatment for this condition; however, many patients have only a partial response. All currently available antipsychotics involve modulation of the dopamine system, although the underlying pathophysiology of this illness...
Article
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Prior studies examining the impact of oxytocin on negative symptoms in schizophrenia have yielded mixed results. The current study explored whether oxytocin can improve more proximal indicators of social affiliation as indicated by changes in behavior, language and subjective indices of social affiliation among individuals with schizophrenia spectr...
Article
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Antipsychotic clozapine is the most effective medication currently available for schizophrenia. However, clozapine is dramatically underutilized due to its harsh side effects that are not effectively monitored. By continuously monitoring clozapine blood levels, such as use of an implantable glucometer, which has transformed diabetes management, the...
Poster
Poster presented during the Psych Congress in San Diego, CA - October 3-6, 2019. In a post hoc analyses of patients with bipolar I disorder, mean prolactin changes were small and generally similar for cariprazine and placebo
Article
Accumulating evidence implicates oxidative stress in a range of diseases, yet no objective measurement has emerged that characterizes the global nature of oxidative stress. Previously, we reported a measurement that employs the moderately strong oxidant iridium (Ir) to probe the oxidative damage in a serum sample and reported that in a small study...
Article
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Background: Approximately one-third of people with schizophrenia have elevated levels of anti-gliadin antibodies of the immunoglobulin G type (AGA IgG) — a higher rate than seen in healthy controls. We performed the first double-blind clinical trial of gluten-free versus gluten-containing diets in a subset of patients with schizophrenia who were p...
Article
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Biology is well-known for its ability to communicate through (i) molecularly-specific signaling modalities and (ii) a globally-acting electrical modality associated with ion flow across biological membranes. Emerging research suggests that biology uses a third type of communication modality associated with a flow of electrons through reduction/oxid...
Article
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To estimate 20-year mortality risk in people with schizophrenia treated with second-generation antipsychotics (SGA) and examine the effects of cigarette smoking on mortality. Of the 1199 individuals with schizophrenia in the study, estimated 20-year all-cause mortality risk by Kaplan Meier Curve was 30% and leading causes of death included 27% card...
Article
About one third of people with schizophrenia have elevated IgG antibodies to gliadin (AGA IgG) and increased inflammation. Understanding the mechanism by which this immune response occurs is critical to the development of personalized treatments. We examined gut permeability and mimicry to the glutamate receptor as possible mechanisms related to hi...
Article
Background Cognitive behavior therapy for psychosis (CBTp) has been used with patients with schizophrenia for well over fifty years. Previous evaluations of CBTp have emphasized change in global scores of psychosis as the primary (if not the only) outcome, neglecting evaluation of change in patient distress and functioning. This method of practice...
Article
Background Hyperprolactinemia is a common side effect of many antipsychotic medications, with the highest rates found with risperidone and paliperidone. Hyperprolactinemia may be asymptomatic or may be associated with adverse effects, such as irregular menses, gynecomastia, osteoporosis, infertility, and sexual dysfunction. These side effects may l...
Article
Background Hyperprolactinemia is a common adverse event associated with antipsychotic treatment, particularly in those treated with risperidone, paliperidone and haloperidol. Adverse consequences are related to elevated prolactin but less is known about contributors to variability seen in women with some people experiencing high levels Prolactin se...
Article
Background Clozapine is an effective antipsychotic for treatment-resistant schizophrenia for which serum levels could guide therapy decisions. It is underutilized because it requires venous draws and several-day determination time with high performance liquid chromatography-tandem mass spectrometry (LC/MS-MS). This project evaluates if clozapine me...
Article
Background Morbidity and premature mortality is high in schizophrenia. Poor diets, low rates of physical activity, substance use, and lack of preventative care predispose patients to poor physical health and comorbid medical diseases. Women with schizophrenia have distinct preventative and physical health needs which poses and even greater burden o...
Article
Background Women with serious mental illnesses like bipolar disorder and schizophrenia are more likely to be tobacco smokers as compared to women without mental illness. Antipsychotic medications may impact craving and nicotine’s rewarding effects via dopaminergic neurotransmitter activity. Differences in pharmacologic profiles and receptor affinit...
Article
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Abstract BACKGROUND: Approximately one-third of people with schizophrenia have elevated levels of anti-gliadin antibodies of the immunoglobulin G type (AGA IgG) — a higher rate than seen in healthy controls. We performed the first double-blind clinical trial of gluten-free versus gluten-containing diets in a subset of patients with schizophrenia wh...
Article
Full-text available
Clozapine is an antipsychotic that exhibits superior efficacy and effectiveness for those with schizophrenia and other serious mental illness. However, its side-effect profile and administrative burdens present challenges to its use. In the United States, the medication is grossly underused even though it may improve outcomes and reduce costs. Curr...
Article
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Social cognition is impaired in patients with schizophrenia and is related to functional outcome. Neither current pharmacologic treatments for psychotic symptoms nor psychosocial interventions robustly improves measures of social cognition. Given this, the development of adjunctive treatments to improve functional outcome is a rational approach to...
Article
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Recent literature suggests that schizophrenia is linked to an abnormal response of the immune system. Interferon-γ is a cytokine that acts as a mediator between immune stimulation and the kynurenine pathway and may be related to cognitive abilities. The objectives of the present study are to determine if serum cytokines are correlated with cognitiv...
Article
Background Individuals with schizophrenia have deficits in social cognition that are associated with poor functional outcome. Unfortunately, current treatments result in only modest improvement in social cognition. Oxytocin, a neuropeptide with pro-social effects, has significant benefits for social cognition in the general population. However, stu...
Article
Immunological abnormalities are increasingly reported in people with schizophrenia, but no clear functional biomarkers associated with genetic correlates of the disease have been found. Regulatory T cells (Tregs) are key immunoregulatory cells involved in the control of inflammatory processes and their functions are directly related to the human le...
Article
Purpose/background: Prolactin-related adverse effects contribute to nonadherence and adverse health consequences, particularly in women with severe mental illness. Treating these adverse effects may improve treatment acceptability, adherence, and long-term outcomes. Methods/procedures: Premenopausal women with a Diagnostic and Statistical Manual...
Article
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Objectives There is growing evidence of both hypothalamic-pituitary-adrenal (HPA) axis and immune system dysfunction in schizophrenia. Additionally, accumulating evidence has linked dysfunction in the kynurenine pathway to schizophrenia as well as to stress and inflammation. The current pilot tested changes in immune, cortisol and kynurenine and ky...
Article
Minocycline, a tetracycline antibiotic, has been studied in multiple clinical trials for its potential effects on the symptoms of schizophrenia. This article reviews the evidence regarding minocycline’s adjunctive use as reported in the published literature, and discusses its potential mechanism of action, safety, and tolerability profile.
Article
The discovery of discriminating molecular biomarkers often couples omics for data acquisition with advanced information processing methods for data analysis. Here, we move information processing upstream for data acquisition and report that a sample's "chemical space" can be actively probed using a tailored sequence of redox-based input signals. Sp...
Article
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Background Deconstructing schizophrenia is important, since different disorders within the syndrome may have distinct pathophysiological mechanisms and treatment targets. Emerging evidence suggests inflammation may play a role in at least a subgroup of people with this illness. One specific subgroup with known inflammation is a group with elevation...
Article
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Popular media often portray people with a mental illness as being aggressive, violent, and incarcerated as a result of their behavior. Despite exaggeration in the media, risks for some aggressive behaviors are in fact higher in individuals with schizophrenia. This is often the case with influence of comorbid substance use disorders. It is essential...
Article
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Clozapine is the sole antipsychotic agent effective for the treatment of refractory schizophrenia. Sixty percent of clozapine-treated patients, however, fail to adequately respond. Minocycline, a tetracycline antibiotic, possesses antiinflammatory and neuroprotective properties that may play a role in schizophrenia. Clozapine is mainly metabolized...
Article
Overweight and obesity in schizophrenia are prevalent, affecting half to three-quarters of people with schizophrenia. Hyperphagia and increased meal size have also been implicated as significant contributors to the weight gain problem. Oxytocin has shown to play a role in appetite control in humans and is considered an anorexigenic peptide. This tw...
Article
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We present a perspective on microsystems integration aspects for concurrent cellular and molecular sensing in a lab-on-a-chip device. While of interest for a range of applications, very few – narrowly focused – examples of such devices can be found in the literature. Here, we approach the challenge from a systems level, considering sensor integrati...
Article
Biology and electronics are both expert at for accessing, analyzing, and responding to information. Biology uses ions, small molecules, and macromolecules to receive, analyze, store, and transmit information, whereas electronic devices receive input in the form of electromagnetic radiation, process the information using electrons, and then transmit...