Efficacy of Pediococcus Acidilactici as add-on to Antipsychotic Drugs on Metabolic Syndrome Disturbances in First-episode Psychosis and Schizophrenia Spectrum Disorders.

• Total cholesterol

Description: Measurement of total cholesterol in the blood. Includes LDL, HDL, and other fractions. It is a general marker of cardiovascular risk.

Units: mg/dL

Ranges:

Desirable: < 200 mg/dL

High limit: 200-239 mg/dL

High: ≥ 240 mg/dL

• LDL cholesterol (Low-Density Lipoprotein)

Description: Known as "bad cholesterol." High levels are associated with atherosclerosis and cardiovascular disease.

Units: mg/dL

Ranges:

Optimal: < 100 mg/dL

Near optimal: 100-129 mg/dL

High limit: 130-159 mg/dL

High: 160-189 mg/dL

Very high: ≥ 190 mg/dL

• HDL cholesterol (High-Density Lipoprotein)

Description: Known as "good cholesterol." Helps remove cholesterol from the arteries.

Units: mg/dL

Ranges:

Low (cardiovascular risk):

Men: < 40 mg/dL

Women: < 50 mg/dL

Adequate/protective: ≥ 60 mg/dL

• Triglycerides

Description: Type of fat in the blood related to energy metabolism. High values are associated with metabolic syndrome and cardiovascular risk.

Units: mg/dL

Ranges (fasting):

Normal: < 150 mg/dL

High limit: 150-199 mg/dL

High: 200-499 mg/dL

Very high: ≥ 500 mg/dL

• Plasma glucose

Description: Blood glucose concentration, a key indicator of carbohydrate metabolism.

Units: mg/dL

Ranges (fasting):

Normal: 70-99 mg/dL

Impaired fasting glucose (prediabetes): 100-125 mg/dL

Diabetes: ≥ 126 mg/dL

• Insulin

Description: Hormone produced by the pancreas that regulates glucose uptake by tissues.

Units: µU/mL (or mIU/L)

Ranges (fasting):

Approximate normal: 2-25 µU/mL

Elevated values may suggest insulin resistance.

• Glycosylated hemoglobin (HbA1c)

Description: Reflects the average blood glucose level over the past 2-3 months.

Units: %

Ranges:

Normal: < 5.7%

Prediabetes: 5.7-6.4%

Diabetes: ≥ 6.5%

• HOMA-R (or HOMA-IR)

Description: Index that estimates insulin resistance, calculated from fasting glucose and insulin.

Formula:

HOMA-IR = Insulin (µU/mL) × Glucose (mg/dL) / 405

Units: No units (index)

Guideline ranges:

Normal: < 2.0

Mild insulin resistance: 2.0-2.9

Significant insulin resistance: ≥ 3.0

Positive and Negative Symptoms

• Positive and Negative Syndrome Scale (PANSS)

Description: A widely used clinical scale for assessing the severity of positive and negative symptoms and general psychopathology in schizophrenia and other psychotic disorders.

Structure: 30 items divided into:

Positive subscale (7 items)

Negative subscale (7 items)

General psychopathology (16 items)

Scoring: Each item is scored from 1 (absent) to 7 (extreme).

Ranges:

Total score: 30-210

The higher the score, the greater the symptom severity.

Guideline interpretation (total):

Mild: ~58-75

Moderate: ~75-95

Severe: >95

• Brief Negative Symptoms Scale (BNSS)

Description: Instrument designed specifically to assess negative symptoms in detail.

Domains assessed (6):

Anhedonia

Asociality

Avolition

Affective flattening

Alogia

Lack of emotional distress

Structure: 13 items

Scoring: Items scored from 0 (absent) to 6 (severe).

Total range: 0-78

Interpretation:

Higher scores indicate greater severity of negative symptoms.

Cognitive symptoms 3. Screening for Cognitive Impairment in Psychiatry (SCIP)

Description: Brief test for detecting cognitive impairment in psychiatric patients.

Domains assessed:

Verbal learning

Working memory

Verbal fluency

Processing speed

Delayed memory

Duration: ~15 minutes

Scoring: Approximate total scale 0-100 (depending on version).

Interpretation:

Lower scores indicate greater cognitive impairment.

Cut-off points adjusted for age and educational level are used.

• MATRICS Consensus Cognitive Battery (MCCB)

Description: Standardized reference battery for assessing cognition in schizophrenia.

Domains assessed (7):

Processing speed

Attention/vigilance

Working memory

Verbal learning

Visual learning

Reasoning and problem solving

Social cognition

Score:

T scores (mean = 50, SD = 10)

Interpretation:

T < 40: below-average performance

T 40-60: normal range

T > 60: above-average performance

• Cognitive Reserve Assessment Scale in Health (CRASH)

Description: Scale designed to estimate cognitive reserve, considering premorbid and sociocultural factors.

Areas assessed:

Educational level

Occupation

Cognitive and leisure activities

Premorbid intellectual level

Score: Composite index (no units).

Interpretation:

Higher scores indicate greater cognitive reserve, associated with a better functional prognosis.

Affective symptoms 6. Calgary Depression Scale for Schizophrenia (CDSS)

Description: Specific scale for assessing depressive symptoms in patients with schizophrenia, differentiating them from negative or extrapyramidal symptoms.

Structure: 9 items

Scoring: Items from 0 (absent) to 3 (severe).

Total range: 0-27

Interpretation:

≥ 6 points suggests the presence of clinically significant depression.

Motor symptoms 7. Simpson-Angus Scale (SAS)

Description: Instrument for assessing extrapyramidal symptoms, especially antipsychotic-induced parkinsonism.

Structure: 10 items

Scoring: Items from 0 (normal) to 4 (severe).

Total score: Average of items or total sum.

Interpretation:

Higher scores indicate greater severity of motor symptoms.

Overall functioning 8. Global Assessment of Functioning Scale (GAF)

Description: Global scale that assesses psychological, social, and occupational functioning.

Range: 0-100

Interpretation:

91-100: superior functioning

71-90: minimal symptoms

51-70: mild symptoms

31-50: severe symptoms

≤ 30: severe impairment of functioning

• Weight

Description: Measurement of the individual's total body mass.

Units: kilograms (kg)

Reference ranges:

There are no universal "normal" ranges, as weight must be interpreted in relation to height, sex, and body composition. It is mainly used to calculate BMI.

• Height

Description: Body length measured in an upright position, from the soles of the feet to the top of the head.

Units: centimeters (cm) or meters (m)

Reference ranges:

Variable depending on sex, age, and ethnicity; used primarily to calculate BMI.

• Body Mass Index (BMI)

Description: Indirect indicator of body fat that relates weight to height.

Formula:

BMI = weight (kg)/height (m)2

Units: kg/m²

Ranges (WHO):

Underweight: < 18.5 kg/m²

Normal weight: 18.5-24.9 kg/m²

Overweight: 25.0-29.9 kg/m²

Grade I obesity: 30.0-34.9 kg/m²

Obesity grade II: 35.0-39.9 kg/m²

Obesity grade III: ≥ 40 kg/m²

• Waist circumference

Description: Measurement of abdominal circumference, used as an indicator of visceral fat and cardiometabolic risk.

Units: centimeters (cm)

Cut-off points (cardiometabolic risk):

Men: ≥ 102 cm

Women: ≥ 88 cm (Some European criteria use ≥94 cm in men)

• Heart rate

Description: Number of heartbeats per minute at rest.

Units: beats per minute (bpm)

Ranges (resting, adults):

Normal: 60-100 bpm

Bradycardia: < 60 bpm

Tachycardia: > 100 bpm

• Blood pressure

Description: Force exerted by blood against arterial walls, expressed as systolic/diastolic pressure.

Units: millimeters of mercury (mmHg)

Ranges (clinical guidelines):

Normal: < 120 / < 80 mmHg

Elevated: 120-129 / < 80 mmHg

Grade 1 hypertension: 130-139 / 80-89 mmHg

Grade 2 hypertension: ≥ 140 / ≥ 90 mmHg

• Skin folds (Skinfold thickness)

Description: Measurement of subcutaneous adipose tissue thickness using a skinfold caliper; allows estimation of body fat percentage.

Units: millimeters (mm)

Common measurement sites:

Triceps

Subscapular

Suprailiac

Abdominal

Thigh

Reference ranges:

There are no universal values; results are interpreted:

By summing skinfolds

By applying predictive equations (e.g., Durnin-Womersley, Jackson-Pollock)

Interpretation:

Higher values indicate greater subcutaneous adiposity.