Energy Metabolism in Psychiatric Disorders: An Integrated Approach between Family and Community Medicine, Psychiatry, and Psychology
Abstract
Sâmela Locatelli Ferreira Silva, Larissa Lauretto, Fernanda Lourenço Faggioni, Ticiane Guilherme Brito, Amanda Rumi Kato Yamamura, Vinicius Malta do Nascimento, Breno Nunes Nogueira, Lais Erbiste Neto, Isabelle Oliveira Tomaz, Deborah Vaz Ferreira, Leonardo Nonato Carvalho, Patrick Torres Nascimento, Andrea Pereira da Silva, Rian Rodrigues Braganca, Andreza Thatila Assuncao e Medeiros, Milena dos Santos de Lima, Elieser Araujo Camargo, Marco Aurelio Silva Couto, Regilane da S Batista, Daniel Freitas dos Santos, Flavia Eduarda Pereira Januario, Ana Nascimento Girotto, Maria Victoria Abuchaim Campos, Giovana de Souza Campos, Roselene de O Carvalho, Nicole Oliveira Jordao, Enrico Coelho Fredini, Giovana Casarini Yamashiro, Guilherme Pio Vilela, Amanda Batista Ferreira da Silva, Jose Eduardo Boza Silva, Juliana Fontes Beltran Paschoal, Mateus Soares Santos Araujo and Thiago Augusto Rochetti Bezerra
Psychiatric disorders have a multifactorial etiology and have increasingly been associated with metabolic and bioenergetic changes that go beyond traditional models focused exclusively on neurotransmission. The aim of this study was to analyze the relationships between energy metabolism and psychiatric disorders, emphasizing the main biochemical mechanisms involved and their potential diagnostic, prognostic, and therapeutic implications in primary and secondary health care. An integrative literature review was conducted, covering publications from 2021 to 2026, retrieved from the PubMed/ MEDLINE, Scopus, Web of Science, PsycINFO, and SciELO databases. Evidence was analyzed primarily related to major depressive disorder, bipolar disorder, and schizophrenia. The results demonstrated that alterations in mitochondrial function, oxidative phosphorylation, ATP production, glucose and lipid metabolism, oxidative stress, neuroinflammation, immunometabolism, and insulin resistance are associated with the disorders under investigation. Mitochondrial dysfunction emerged as a possible transdiagnostic mechanism, interacting with reactive oxygen species, inflammatory processes, and alterations in neuronal plasticity. Metabolomics has shown potential for identifying biomarkers and characterizing biological phenotypes, although its clinical application still depends on further standardization and validation. Strategies targeting energy metabolism-including nutritional interventions, antioxidants, mitochondrial modulators, and metabolic therapies-have shown promising, though still heterogeneous, results. It was concluded that energy metabolism constitutes a relevant component in the contemporary understanding of psychiatric disorders and that its integration into care may facilitate more individualized approaches. The coordination between primary and secondary care has proven to be fundamental for the screening and management of cardiometabolic changes, monitoring the effects of psychotropic medications, and promoting comprehensive mental health care.