Niacin skin flushing response in patients with schizophrenia: Associations with the efficacy of modified electroconvulsive therapy and clinical symptoms

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-04-15 DOI:10.1016/j.jpsychires.2025.04.025

Bingbing Sui , Shuhui Li , Pingsheng Wang , Xiaoyue Li , Mingyue Sun , Yangying Bu , Zixiang Li , Wenwen Miao , Lei Cai , Jiawei Xi , Chuanfu Song , Wenli Zhu

{"title":"Niacin skin flushing response in patients with schizophrenia: Associations with the efficacy of modified electroconvulsive therapy and clinical symptoms","authors":"Bingbing Sui , Shuhui Li , Pingsheng Wang , Xiaoyue Li , Mingyue Sun , Yangying Bu , Zixiang Li , Wenwen Miao , Lei Cai , Jiawei Xi , Chuanfu Song , Wenli Zhu","doi":"10.1016/j.jpsychires.2025.04.025","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Schizophrenia (SZ) is a group of chronic neurodevelopmental disorders, and antipsychotic medication is the main clinical treatment. However, approximately one-third of patients demonstrate inadequate response to these medications, which is termed treatment-resistant schizophrenia (TRS). The primary objective of this study was to explore the clinical characteristics of patients with TRS, including positive, negative, general psychotic symptoms and niacin skin flushing response (NSFR), which is considered an auxiliary diagnostic biomarker for SZ, and the improvement of these characteristics after modified electroconvulsive therapy (MECT).</div></div><div><h3>Methods</h3><div>This study included 32 patients with TRS, who received MECT combined with antipsychotic medication (SZ-MECT group), and 30 patients with non-treatment-resistant SZ (N-TRS), who received antipsychotic medication alone (SZ-N group). We assessed disease severity with the Positive and Negative Syndrome Scale (PANSS) and NSFR at baseline and at weeks 2, 4, and 6 in all patients.</div></div><div><h3>Results</h3><div>At baseline, the SZ-MECT group had greater PANSS scores (<em>P</em> < 0.0001) and a more blunted NSFR (<em>P</em> = 0.020) than the SZ-N group did, and the PANSS-TOTAL scores were negatively correlated with the NSFR scores (r = −0.361, <em>P</em> = 0.0039). At week 6 after treatment, the SZ-MECT group presented significantly improved PANSS scores (<em>P</em> < 0.0001) and NSFR blunting (<em>P</em> = 0.010) that were comparable with those in the SZ-N group.</div></div><div><h3>Conclusion</h3><div>Compared with patients with N-TRS, patients with TRS presented more severe clinical symptoms and a more blunted NSFR, which significantly improved after MECT treatment. The NSFR may have good clinical application potential as an auxiliary assessment of severity and MECT efficacy in patients with schizophrenia.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"186 ","pages":"Pages 226-234"},"PeriodicalIF":3.7000,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of psychiatric research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022395625002602","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

Schizophrenia (SZ) is a group of chronic neurodevelopmental disorders, and antipsychotic medication is the main clinical treatment. However, approximately one-third of patients demonstrate inadequate response to these medications, which is termed treatment-resistant schizophrenia (TRS). The primary objective of this study was to explore the clinical characteristics of patients with TRS, including positive, negative, general psychotic symptoms and niacin skin flushing response (NSFR), which is considered an auxiliary diagnostic biomarker for SZ, and the improvement of these characteristics after modified electroconvulsive therapy (MECT).

Methods

This study included 32 patients with TRS, who received MECT combined with antipsychotic medication (SZ-MECT group), and 30 patients with non-treatment-resistant SZ (N-TRS), who received antipsychotic medication alone (SZ-N group). We assessed disease severity with the Positive and Negative Syndrome Scale (PANSS) and NSFR at baseline and at weeks 2, 4, and 6 in all patients.

Results

At baseline, the SZ-MECT group had greater PANSS scores (P < 0.0001) and a more blunted NSFR (P = 0.020) than the SZ-N group did, and the PANSS-TOTAL scores were negatively correlated with the NSFR scores (r = −0.361, P = 0.0039). At week 6 after treatment, the SZ-MECT group presented significantly improved PANSS scores (P < 0.0001) and NSFR blunting (P = 0.010) that were comparable with those in the SZ-N group.

Conclusion

Compared with patients with N-TRS, patients with TRS presented more severe clinical symptoms and a more blunted NSFR, which significantly improved after MECT treatment. The NSFR may have good clinical application potential as an auxiliary assessment of severity and MECT efficacy in patients with schizophrenia.

查看原文本刊更多论文

精神分裂症患者烟酸皮肤潮红反应：与改良电休克治疗的疗效和临床症状的关系

目的精神分裂症（SZ）是一组慢性神经发育障碍，抗精神病药物是主要的临床治疗手段。然而，约有三分之一的患者对这些药物反应不足，这被称为耐药精神分裂症（TRS）。本研究的主要目的是探讨 TRS 患者的临床特征，包括阳性、阴性、一般精神病性症状和烟酸皮肤潮红反应（NSFR）（NSFR 被认为是 SZ 的辅助诊断生物标志物），以及改良电休克疗法（MECT）后这些特征的改善情况。方法这项研究纳入了32名TRS患者，他们在接受MECT治疗的同时还接受了抗精神病药物治疗（SZ-MECT组）；还纳入了30名非耐药性SZ（N-TRS）患者，他们在接受MECT治疗的同时还接受了抗精神病药物治疗（SZ-N组）。结果与SZ-N组相比，基线时SZ-MECT组的PANSS评分更高（P <0.0001），NSFR更迟钝（P = 0.020），PANSS-TOTAL评分与NSFR评分呈负相关（r = -0.361，P = 0.0039）。治疗后第 6 周，SZ-MECT 组的 PANSS 评分（P <0.0001）和 NSFR 变钝（P = 0.010）明显改善，与 SZ-N 组相当。NSFR作为精神分裂症患者严重程度和MECT疗效的辅助评估指标，可能具有良好的临床应用潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;