Schizophrenia Research最新文献

{"title":"The associations between duration of untreated psychosis, growth factors, and neurocognition in patients with drug-naïve schizophrenia","authors":"","doi":"10.1016/j.schres.2024.09.011","DOIUrl":"10.1016/j.schres.2024.09.011","url":null,"abstract":"<div><h3>Background</h3><p>Cognitive impairment is a core feature of schizophrenia with unclear mechanisms, particularly neurocognition. The objective of this study was to investigate the association between duration of untreated psychosis (DUP) and neurocognition, as well as potential biological mechanisms.</p></div><div><h3>Methods</h3><p>A total of 219 patients were recruited in this study. DUP was measured in years, reflecting the untreated period. Neurocognition was assessed by the MATRICS Consensus Cognitive Battery (MCCB). The plasma concentrations of three growth factors, vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor (BDNF), and epidermal Growth Factor (EGF) were detected by enzyme-linked immunosorbent assay in 128 patients. Multiple linear regression analysis was used to analyze the association between DUP, growth factors, and neurocognition.</p></div><div><h3>Results</h3><p>Our findings showed that DUP was significantly negatively correlated with speed of processing and reasoning and problem-solving in all patients (<em>N</em> = 219, <em>P</em> &lt; 0.05). Five years was defined as cut-off point for long and short DUP group in the present study. Only in the short DUP patients, DUP was strongly associated with visual learning and neurocognition (<em>P</em> &lt; 0.05). In patients with growth factor (<em>N</em> = 128), DUP was independently associated with speed of processing, verbal learning, and neurocognition (<em>P</em> &lt; 0.05). Further, plasma concentrations of VEGF, BDNF, and EGF were all significantly correlated with neurocognition (<em>P</em> &lt; 0.05). Additionally, we found a potential trend of correlation between DUP and BDNF (<em>P</em> = 0.061).</p></div><div><h3>Conclusion</h3><p>Our study provides insights into a negative correlation between DUP and neurocognition, and BDNF may serve as a potential biological mechanism.</p></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Switching a combination of first- and second-generation antipsychotic polypharmacy to antipsychotic monotherapy in long-term inpatients with schizophrenia and related disorders. The SwAP trial II: Results on side effects","authors":"","doi":"10.1016/j.schres.2024.09.007","DOIUrl":"10.1016/j.schres.2024.09.007","url":null,"abstract":"<div><h3>Objective</h3><p>This study examined the effects of switching antipsychotic polypharmacy (APP) to antipsychotic monotherapy (APM) on various side effects in inpatients with schizophrenia. Side effects of interest included psychic, autonomic, and sexual symptoms, as well as metabolic side effects and movement disorders.</p></div><div><h3>Method</h3><p>A 9-month parallel randomized open-label clinical trial was conducted involving 136 chronic inpatients from two psychiatric hospitals in the Netherlands. Participants were randomly assigned to either a STAY or a SWITCH group. The SWITCH group underwent a 3-month tapering-off period in which either first-generation or second-generation antipsychotic medication was discontinued, followed by APM. Patients were assessed at baseline and at follow-up assessments at 3, 6, and 9 months. Psychic, neurological, autonomic, and sexual side effects were evaluated using the UKU Rating Scale, while movement disorders were measured with the St. Hans Rating Scale. Various metabolic parameters were also recorded.</p></div><div><h3>Results</h3><p>In the STAY group, side effects remained generally stable over time, except for a slight reduction in sexual desire. In contrast, the SWITCH group experienced significant reductions in psychic and autonomic symptoms, as well as improvements in akathisia, parkinsonism, and dyskinesia. There were no changes in dystonia, paresthesia, epilepsy, or sexual symptoms for this group. Notably, the SWITCH group also showed significant reductions in BMI and body weight.</p></div><div><h3>Conclusion</h3><p>Switching APP to APM in long-term inpatients reduces the severity of various side effects, including movement disorders and metabolic side effects.</p></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognition of schizophrenia and quality of treatment during the COVID-19 pandemic: A Danish nationwide study","authors":"","doi":"10.1016/j.schres.2024.09.001","DOIUrl":"10.1016/j.schres.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic may have exacerbated the state of ill-health among patients with schizophrenia. We examined the number of patients diagnosed with schizophrenia, the number of hospital admissions and outpatient contacts and the quality of treatment during the pandemic in comparison with the previous years.</p></div><div><h3>Methods</h3><p>We identified patients ≥18 years old registered in the Danish Schizophrenia Registry from 2016 to 2022. Using a generalized linear model, we estimated prevalence ratios (PR) and 95 % confidence intervals (CI) for each variable of interest.</p></div><div><h3>Results</h3><p>A minor reduction in the number of new cases, admissions and outpatient contacts was seen during the first lockdown; however, there was no overall change across the pandemic period compared with the pre-pandemic period. We found no change in the proportion of patients who were interviewed using a diagnostic tool (37.0 % during pandemic vs 37.9 % pre-pandemic; PR = 0.87; 95 % CI 0.68–1.12) or received family intervention (57.7 % vs 57.1 %; PR = 0.97; 95 % CI 0.81–1.15), and no decrease was observed in the proportion of patients assessed for social support. Furthermore, no change in the proportion of patients re-admitted within 30 days (35.9 % vs 35.0 %; PR = 0.96; 95 % CI 0.88–1.07) or screened for suicide risk in relation to discharge (55.2 % vs 56.8 %; PR = 0.96; 95 % CI 0.97–1.09) was observed.</p></div><div><h3>Conclusions</h3><p>Recognition and treatment of schizophrenia was minimally affected during the first lockdown, but across the pandemic period no overall change was observed. The quality of treatment of schizophrenia was unchanged.</p></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue highlights","authors":"","doi":"10.1016/S0920-9964(24)00416-X","DOIUrl":"10.1016/S0920-9964(24)00416-X","url":null,"abstract":"","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S092099642400416X/pdfft?md5=ab934627c336e802f287b3bc26101ab8&pid=1-s2.0-S092099642400416X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous neural activity underlying neutral and happy speech recognition in noise and its association with psychiatric symptoms in patients with schizophrenia","authors":"","doi":"10.1016/j.schres.2024.09.012","DOIUrl":"10.1016/j.schres.2024.09.012","url":null,"abstract":"<div><h3>Background</h3><p>Deficits in speech and emotion perception are intertwined with psychiatric symptoms. How the happy prosody embedded in speech affects target speech-in-noise recognition (TSR) and relates to psychiatric symptoms in patients with schizophrenia (SCHs) remains unclear. This study examined spontaneous brain activity underlying happy TSR and its association with psychiatric symptom dimensions in SCHs.</p></div><div><h3>Methods</h3><p>Fifty-four SCHs and 59 healthy control participants (HCs) underwent the TSR task, Positive and Negative Syndrome Scale (PANSS) assessment, and magnetic resonance imaging scanning. Multivariate analyses of partial least squares (PLS) regression were used to explore the associations between whole-brain fractional amplitude of low-frequency fluctuations (fALFF), happy-neutral TSR (target pseudo-sentences were uttered in happy and neutral prosodies), and five PANSS factor scores (excitement/hostility, depression/anxiety, cognition, positive, and negative).</p></div><div><h3>Results</h3><p>The happy prosody did not alter TSR or TSR changing rates in either SCHs or HCs. SCHs exhibited lower happy and neutral TSR than HCs. A fALFF PLS component (including precentral/postcentral gyrus, Subcallosal Cortex, several temporal regions, and cerebellum) was associated with happy and neutral TSR. SCHs demonstrated higher PLS fALFF scores and PLS TSR scores than HCs. In SCHs, PLS fALFF scores were correlated with the PANSS positive factor score, and PLS TSR scores were correlated with the PANSS cognition factor score.</p></div><div><h3>Conclusions</h3><p>The positive-psychiatric-symptoms-related spontaneous activity profile was associated with happy and neutral TSR, contributing to the cognition psychiatric symptoms dimension. The findings suggest the potential to improve positive and cognitive symptoms by enhancing happy and neutral TSR in schizophrenia based on neuroplasticity.</p></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin-resistance as a modifiable pathway to cognitive dysfunction in schizophrenia: A systematic review","authors":"","doi":"10.1016/j.schres.2024.09.008","DOIUrl":"10.1016/j.schres.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><p>Cognitive deficits are difficult to treat and negatively influence quality of life and functional outcomes of persons with schizophrenia. In the last twenty years, extensive literature demonstrated that persons with diabetes and insulin resistance (IR) also display cognitive deficits. Being type 2 diabetes (T2DM) and IR highly frequent in persons with schizophrenia, it is plausible to hypothesize that these conditions might play a role in determining dyscognition. If that is the case, acting on glucose dysmetabolism may eventually improve cognitive functioning. This review aims at: 1. evaluating the association between IR or T2DM and cognitive dysfunction in schizophrenia; 2. reviewing the evidence that pharmacological treatment of IR or T2DM may improve dyscognition in schizophrenia.</p></div><div><h3>Methods</h3><p>Two systematic searches were conducted in PubMed, PsycInfo, and Scopus. We followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.</p></div><div><h3>Results</h3><p>From the first search we included 17 studies, 8 on the effects of T2DM and 9 on the effects of IR-other prediabetes measures on cognition in persons with schizophrenia. From the second search we included 12 studies investigating the effect on cognition of glucose (4 studies), insulin (2 studies), metformin (2 studies), PPAR-γ agonists (2 studies), GLP-1 agonist (1 study), bromocriptine (1 study).</p></div><div><h3>Conclusions</h3><p>T2DM was associated with worse cognitive function in persons with schizophrenia, while IR was less strongly associated with cognitive dysfunction. Evidence regarding the efficacy of glucose-lowering medications on cognition in schizophrenia is inconclusive, yet methodological issues likely contribute to explain conflicting results.</p></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The neuromuscular basis of functional impairment in schizophrenia: A scoping review","authors":"","doi":"10.1016/j.schres.2024.09.002","DOIUrl":"10.1016/j.schres.2024.09.002","url":null,"abstract":"<div><p>Patients with schizophrenia exhibit functional impairments in their locomotory tasks, which decreases their quality of life. Due to the limited current research, the neuromuscular mechanisms behind the functional impairments in patients is not fully understood. Thus, this review aims to summarize the neuromuscular mechanisms that underlie these deficits in daily functioning. These deficits are speculated to stem from abnormalities at various levels from neurons through to the skeletal muscles. The neurological abnormalities are exhibited as lower motor neuron dysfunction whereas the skeletal muscle pathology is shown as increased muscle fibre (type 1 and type 2) atrophy, reduction in maximal force generation, and increased strength loss per decade. Although antipsychotics effectively reduce positive symptoms, functional impairments remain unresolved. Both endurance and resistance training have shown potential benefits in alleviating deficits in daily functioning by increasing muscular strength, increasing fat-free mass, and preserving neuromuscular properties from degradation. In summary, the review elucidates various possible mechanisms for the onset of functional impairment experienced by patients with schizophrenia and highlights the potential utility of endurance and resistance training to alleviate these deficits in daily functioning.</p></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S092099642400402X/pdfft?md5=49705a90362234f2dad12540659ec2ed&pid=1-s2.0-S092099642400402X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of KarXT on negative symptoms in acute schizophrenia: A post hoc analysis of pooled data from 3 trials","authors":"","doi":"10.1016/j.schres.2024.08.001","DOIUrl":"10.1016/j.schres.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><p>Currently approved antipsychotics do not adequately treat negative symptoms (NS), which are a major determinant of functional disability in schizophrenia. KarXT, an M₁ /M₄ preferring muscarinic receptor agonist, has shown efficacy as a broad-spectrum monotherapy for the treatment of schizophrenia in participants with acute psychosis. Post hoc analyses evaluated the possibility that NS improve independently of positive symptoms with KarXT in a subgroup of participants with moderate-to-severe NS and no predominance of positive symptoms.</p></div><div><h3>Methods</h3><p>Data were pooled from the three pivotal trials of KarXT monotherapy in people with schizophrenia with an acute exacerbation of psychosis. All 3 studies used similar 5-week randomized, double-blind, placebo-controlled designs (modified intention-to-treat sample <em>N</em> = 640). PANSS criteria proposed in the literature identified a subset of study participants (<em>n</em> = 64) with prominent NS.</p></div><div><h3>Results</h3><p>KarXT was significantly better than placebo on PANSS Marder Negative Factor Scores in the full sample (<em>p</em> &lt; .001; Cohen's d = 0.42) and more so in the prominent NS subgroup (p &lt; .001; Cohen's d = 1.18). Further, the KarXT effect in the NS subgroup remained significant after accounting for changes in positive symptoms, depression/anxiety, disorganization, and hostility.</p></div><div><h3>Conclusions</h3><p>Participants with prominent NS revealed greater improvement of NS following KarXT therapy than the full sample that persisted after accounting for positive and other symptoms. While these findings must be interpreted with caution, they are consistent with the possibility that NS improvements associated with KarXT are not secondary to improvements in other symptom domains and support further investigation in larger, stable outpatient studies.</p></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0920996424003724/pdfft?md5=d1aa8cc4d77e56e17731c26655a7f49c&pid=1-s2.0-S0920996424003724-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting treatment resistance in positive and negative symptom domains from first episode psychosis: Development of a clinical prediction model","authors":"","doi":"10.1016/j.schres.2024.09.010","DOIUrl":"10.1016/j.schres.2024.09.010","url":null,"abstract":"<div><h3>Background</h3><p>Treatment resistance (TR) in schizophrenia may be defined by the persistence of positive and/or negative symptoms despite adequate treatment. Whilst previous investigations have focused on positive symptoms, negative symptoms are highly prevalent, impactful, and difficult to treat. In the current study we aimed to develop easily employable prediction models to predict TR in positive and negative symptom domains from first episode psychosis (FEP).</p></div><div><h3>Methods</h3><p>Longitudinal cohort data from 1027 individuals with FEP was utilised. Using a robust definition of TR, <em>n</em> = 51 (4.97 %) participants were treatment resistant in the positive domain and <em>n</em> = 56 (5.46 %) treatment resistant in the negative domain 12 months after first presentation. 20 predictor variables, selected by existing evidence and availability in clinical practice, were entered into two LASSO regression models. We estimated the models using repeated nested cross-validation (NCV) and assessed performance using discrimination and calibration measures.</p></div><div><h3>Results</h3><p>The prediction model for TR in the positive domain showed good discrimination (AUC = 0.72). Twelve predictor variables (male gender, cannabis use, age, positive symptom severity, depression and academic and social functioning) were retained by each outer fold of the NCV procedure, indicating importance in prediction of the outcome. However, our negative domain model failed to discriminate those with and without TR, with results only just over chance (AUC = 0.56).</p></div><div><h3>Conclusions</h3><p>Treatment resistance of positive symptoms can be accurately predicted from FEP using routinely collected baseline data, however prediction of negative domain-TR remains a challenge. Detailed negative symptom domains, clinical data, and biomarkers should be considered in future longitudinal studies.</p></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0920996424004213/pdfft?md5=efb421067df4b03b9914361a7ac792ca&pid=1-s2.0-S0920996424004213-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hallucinations and the depth-inversion illusion in schizophrenia","authors":"","doi":"10.1016/j.schres.2024.09.006","DOIUrl":"10.1016/j.schres.2024.09.006","url":null,"abstract":"","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}