Metabolic psychiatry – a new concept of etiopathogenesis and treatment of mental disorders

Metabolic psychiatry, rooted in decades of research and observations in both basic and clinical sciences, highlights connections between metabolic dysfunctions and mental illnesses. This field proposes that factors disrupting and impairing cellular metabolism play an etiopathogenic role in mental disorders. Key elements include brain glucose hypometabolism, neurotransmitter imbalances, oxidative stress, inflammatory processes, and microbiome states. Mitochondrial function has emerged as a central pathogenic factor in these processes. Recent studies over the past decade have demonstrated mitochondrial dysfunction in a range of mental disorders. When mitochondria are impaired, this dysfunction affects brain activity – certain brain areas may become hyperactive, while others may exhibit hypoactivity. Such imbalances lead to distinct clinical presentations, manifesting as psychopathological symptoms like depression or concentration difficulties, and can also drive neurodevelopmental disorders or neurodegeneration. According to the metabolic model, effective treatment of mental disorders should include both the diagnosis of metabolic abnormalities and targeted interventions to correct these imbalances. One of the most utilized treatments in this field is ketogenic therapy, which has shown corrective effects on all the aforementioned pathogenic metabolic factors. This therapy involves a medical intervention through a ketogenic diet, inducing a state of ketosis that is carefully monitored. Encouraging results have been observed, with the ketogenic diet applied across various mental disorders, showing reductions in symptom severity and even remission in some cases. New clinical trials have concluded, and around 20 studies are currently underway, with their findings expected to be published in the coming months.