Schizophrenia Research最新文献

{"title":"Machine learning for novel phenotyping in schizophrenia","authors":"Natalie Bareis ,&nbsp;Yuanjia Wang ,&nbsp;Mark Olfson ,&nbsp;Tobias Gerhard ,&nbsp;Lisa Dixon ,&nbsp;T. Scott Stroup","doi":"10.1016/j.schres.2025.08.011","DOIUrl":"10.1016/j.schres.2025.08.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Heterogeneity among people diagnosed with schizophrenia-spectrum disorders (schizophrenia) and high prevalence of co-occurring disorders makes identification of optimal treatments difficult. This study identified behavioral health phenotypes using machine learning with Medicaid claims of adults with schizophrenia. We compared the phenotypes' clinical outcomes and psychotropic medication prescription patterns for clinical validity.</div></div><div><h3>Methods</h3><div>Using national Medicaid claims from January 2010 – December 2012 we identified 249,006 adults ages 18–64, with ≥ 1 inpatient and/or ≥ 2 outpatient claims with principal or secondary diagnoses of schizophrenia (ICD9 295.xx) in 2010. Latent Dirichlet Allocation (LDA) incorporated their behavioral health co-occurring disorders in 2010 to identify behavioral health phenotypes, validated using 5-fold cross validation. Pairwise comparisons among each phenotype of psychotropic medication types, and likelihoods of any behavioral health inpatient admission or emergency department (ED) visit in 2011 were conducted.</div></div><div><h3>Results</h3><div>LDA with 5-fold cross validation identified 5 behavioral health phenotypes we labeled depression, substance use, mania-mixed mood, anxiety-paranoid, and conduct disorder-developmentally delayed; a sixth phenotype had no co-occurring disorders. Likelihoods of behavioral health inpatient admissions and ED visits were significantly different between the phenotypes. Psychotropic medications prescribed to the phenotypes were distinct. Post-hoc analyses using the same methods with 2017 Medicaid claims of 383,849 adults identified comparable phenotypes.</div></div><div><h3>Conclusions</h3><div>This study demonstrated the feasibility of using machine learning with claims data to identify behavioral health phenotypes among individuals with schizophrenia. Future pharmacoepidemiologic investigations addressing confounding bias will compare effectiveness of treatments for each phenotype, informing efforts to identify personalized treatments for people with schizophrenia.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"285 ","pages":"Pages 19-26"},"PeriodicalIF":3.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144997451","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 relationship between age of onset, peripheral plasma protein markers and social cognition in first-episode drug-naïve schizophrenia","authors":"Qiao Su ,&nbsp;Yijie Liu ,&nbsp;Lijie Ji ,&nbsp;Xiaoxiao Sun ,&nbsp;Zhenning Feng ,&nbsp;Ying Xu ,&nbsp;Boxuan Zhou ,&nbsp;Yuying Qiu ,&nbsp;Meijuan Li ,&nbsp;Jie Li","doi":"10.1016/j.schres.2025.08.019","DOIUrl":"10.1016/j.schres.2025.08.019","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between age of onset and social cognition in schizophrenia (SCZ), as well as the role of peripheral plasma protein markers in this connection, remains unclear. This study aims to investigate these associations in first-episode drug-naïve SCZ.</div></div><div><h3>Methods</h3><div>A total of 171 SCZ patients were enrolled and categorized into non-late-onset and late-onset groups based on their age of onset, which was recorded at enrollment. Social cognition was evaluated using the MATRICS Consensus Cognitive Battery (MCCB). The expression levels of HLA-DPB1 (human leukocyte antigen-DPβ1), KRT4 (keratin 4), and NOTCH4 (NOTCH homologous protein 4) were measured via enzyme-linked immunosorbent assay (ELISA). Their relationships were analyzed using partial correlation analysis and mediation effects model.</div></div><div><h3>Results</h3><div>Late-onset SCZ patients had better social cognition than non-late-onset patients (<em>P</em> &lt; 0.05). Age of onset was positively correlated with social cognition in both groups (<em>P</em> &lt; 0.05). In the non-late-onset group, KRT4 and NOTCH4 were associated with social cognition, and in the late-onset group, only KRT4 was linked to social cognitive performance (<em>P</em> &lt; 0.05). Notably, age of onset was found to correlate with NOTCH4 expression in both groups (<em>P</em> &lt; 0.05). Additionally, mediation analysis revealed that in the non-late-onset group, the relationship between age of onset and social cognition was mediated by NOTCH4 (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Our study revealed a positive correlation between age of onset and social cognition, in which NOTCH4 may play a mediating role, especially in the non-late onset group of SCZ patients.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"285 ","pages":"Pages 11-18"},"PeriodicalIF":3.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144997452","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":"Minority stress and schizophrenia-like experiences in sexual and gender minority adults","authors":"L.A. Hammer ,&nbsp;C.R. Springfield ,&nbsp;M.T. Russell ,&nbsp;B. Twilbeck ,&nbsp;L. Ostermiller ,&nbsp;A.K. Fergerson ,&nbsp;K.A. Bonfils","doi":"10.1016/j.schres.2025.09.003","DOIUrl":"10.1016/j.schres.2025.09.003","url":null,"abstract":"","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"285 ","pages":"Pages 27-29"},"PeriodicalIF":3.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004948","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":"Reduced levels of vascular endothelial growth factor were associated with psychopathology in youth with first-episode schizophrenia","authors":"Ju-Wei Hsu ,&nbsp;Li-Chi Chen ,&nbsp;Wei-Chen Lin ,&nbsp;Ya-Mei Bai ,&nbsp;Shih-Jen Tsai ,&nbsp;Mu-Hong Chen","doi":"10.1016/j.schres.2025.08.020","DOIUrl":"10.1016/j.schres.2025.08.020","url":null,"abstract":"<div><h3>Background</h3><div>Youth is a critical period for brain development, yet first-episode schizophrenia (FES) during this stage remains understudied, particularly concerning the role of vascular endothelial growth factor (VEGF) in schizophrenia-related psychopathology and cognitive dysfunction.</div></div><div><h3>Methods</h3><div>This study enrolled 32 youth (ages 12–24) with FES and 35 age−/sex-matched healthy controls. Serum VEGF levels were measured using enzyme-linked immunosorbent assay. Clinical symptoms were evaluated with the Positive and Negative Syndrome Scale (PANSS); executive function was assessed using the Wisconsin Card Sorting Test (WCST). Generalized linear models were applied to assess VEGF levels between patients and controls and to examine an association between VEGF levels and PANSS scores.</div></div><div><h3>Results</h3><div>Youth with FES exhibited significantly lower VEGF levels compared to controls (<em>p</em> = 0.002). VEGF levels were negatively associated with PANSS disorganization scores (B = −0.12, p = 0.002) and positively associated with PANSS emotional distress scores (B = 0.17, <em>p</em> = 0.035). No significant associations were found between VEGF levels and WCST parameters.</div></div><div><h3>Conclusion</h3><div>Reduced levels of VEGF may be a biomarker of FES. Our findings further suggest that VEGF levels may reflect specific aspects of schizophrenia pathology, particularly disorganization and emotional distress. Further research is needed to clarify the mechanistic role of VEGF in cognitive and emotional processes in FES and its potential as a therapeutic target.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"284 ","pages":"Pages 269-274"},"PeriodicalIF":3.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988601","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":"Patterns of service utilization and its relation to outcome in a first-episode psychosis program","authors":"Gili Hoter Ishay ,&nbsp;David Roe","doi":"10.1016/j.schres.2025.08.009","DOIUrl":"10.1016/j.schres.2025.08.009","url":null,"abstract":"<div><div>NAVIGATE is a comprehensive, manual-based intervention developed in the United States for young people experiencing first-episode psychosis (FEP). It comprises four core components: medication management, individual resilience training (IRT), supported employment and education (SEE), and a family psychoeducation program (FEP). This study aimed to describe NAVIGATE utilization patterns in Israel and their relationships to outcomes. Demographic and diagnostic information, service-utilization data, and functioning and symptom ratings were collected from clinical registries of 135 individuals who participated in NAVIGATE at three Israeli clinics from 2017 through 2021. The sample was mostly (72 %) men (<em>M</em> = 23.9 years old, <em>SD</em> = 5.4) who, on average, engaged in the program for more than 1 year. The IRT component was the most frequently attended (<em>M</em> = 25 sessions, <em>SD</em> = 24.9). Participants who attended more sessions in any component(s) showed higher functional and symptomatic improvement. Session intensity (by session intervals) was significant only for SEE: the more intensity, the more functioning and symptoms improved. Three distinct service-utilization clusters were identified: low use of all components; high IRT and low use of others; and moderate IRT, high FEP, and low others. The third cluster showed the highest improvement, but all clusters correlated with improved outcomes. The NAVIGATE program in Israel yield significant clinical and functional improvements across service-use patterns even when attendance was lower than the full offering. That a comprehensive, team-based intervention delivered flexibly can accommodate the rapidly changing needs of young people with FEP is encouraging, with important implications for policy and practice.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"284 ","pages":"Pages 256-262"},"PeriodicalIF":3.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932038","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":"Perceived stigma and self-stigma in young people at ultra-high risk for psychosis: Associations with identity-related, psychological and functional outcomes","authors":"Zoe Waters ,&nbsp;Jeneva L. Ohan ,&nbsp;Yael Perry ,&nbsp;Shelley Baird ,&nbsp;James Kean ,&nbsp;Paul Amminger ,&nbsp;Rebekah Street ,&nbsp;Ashleigh Lin","doi":"10.1016/j.schres.2025.08.013","DOIUrl":"10.1016/j.schres.2025.08.013","url":null,"abstract":"<div><h3>Background and hypothesis</h3><div>Perceived stigma and self-stigma negatively affect identity-related, psychological and functional outcomes among stigmatised populations. There is limited research exploring the impact of stigma among young people at ultra-high risk (UHR) for psychosis. We investigated the association of perceived stigma and self-stigma with these outcomes in young people at UHR.</div></div><div><h3>Methods</h3><div>Young people meeting the UHR criteria (<em>N</em> <strong>=</strong> 61) aged 12—25 years were recruited. Participants completed an online survey including UHR-specific measures of perceived stigma and self-stigma, as well as self-esteem, self-efficacy, self-compassion, psychological distress, perceived stress and disclosure distress. All participants took part in the CanARY trial in which they completed measures of depression, anxiety, attenuated psychotic symptoms, and social and occupational functioning. Multiple regressions explored perceived stigma and self-stigma as predictors of identity-related (i.e., self-esteem, self-efficacy, self-compassion), psychological and functional outcomes.</div></div><div><h3>Results</h3><div>Bivariate correlations between perceived stigma, self-stigma, and all outcomes were in the expected direction and generally moderate in size, except for psychological symptoms (i.e., anxiety, depression, and positive psychotic symptoms). Perceived stigma, but not self-stigma, was positively associated with disclosure distress, For regressions, self-stigma uniquely and negatively predicted self-esteem, psychological distress, and perceived stress.</div></div><div><h3>Conclusions</h3><div>Perceived stigma and self-stigma are related to harmful outcomes among young people at UHR. Self-stigma may be more damaging to self-related aspects, whereas perceived stigma may be more damaging to interactions with others. Understanding the long-term impacts of perceived stigma and self-stigma, and what factors mitigate these experiences, is important for supporting young people at UHR.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"284 ","pages":"Pages 248-255"},"PeriodicalIF":3.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932176","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":"Prediction of long-term outcome by duration of the psychosis prodrome: Mixed effects models reveal continuity across 7 years but variation across quartile splits","authors":"Nnamdi Nkire ,&nbsp;Tara Kingston ,&nbsp;Anthony Kinsella ,&nbsp;Vincent Russell ,&nbsp;John L. Waddington","doi":"10.1016/j.schres.2025.08.016","DOIUrl":"10.1016/j.schres.2025.08.016","url":null,"abstract":"<div><div>While associations between duration of untreated psychosis (DUP) and outcome are robust and have been influential in early intervention, whether similar associations and potential utility exist for the preceding duration of the psychosis prodrome (DPP) remain to be clarified. This study investigated prospectively across seven years: (i) whether DPP is associated with outcome; (ii) whether any prediction by DPP varies across long-term follow-up after initiating treatment; and (iii) whether these relationships vary across gradations of DPP values. Sixty subjects were evaluated for DPP at first episode psychosis (FEP) and for psychopathology and quality of life at both FEP and 7-year follow-up; functionality and service engagement were assessed at follow-up. Data were analysed using mixed-effects models with DPP and DUP included by quartile split. Longer DPP, like DUP, predicted greater severity of negative symptoms and lower quality of life but not positive symptoms; these predictions by longer DPP were stable between FEP and 7-year follow-up and derived from the longest DPP values. For assessments made only at follow-up, longer DPP values did not predict either functionality or service engagement, while the longest DUP values predicted each of these outcomes. DPP and DUP appear to be in part, but not in whole, two sequential moieties of a common process that has been dichotomised at an imprecise threshold along its continuum. Interventions to remediate early features of DPP may particularly benefit the negative symptom-quality of life domain that is a particularly pernicious feature of psychotic illness yet least responsive to antipsychotic drugs.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"284 ","pages":"Pages 263-268"},"PeriodicalIF":3.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932039","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":"Effect of social resources on readmission prevention and the influence of informal coercion in acute schizophrenia: a retrospective quasi-experimental cohort study","authors":"Hiroyasu Ino ,&nbsp;Akira Akabayashi ,&nbsp;Yoshiyuki Takimoto ,&nbsp;Katsumi Mori ,&nbsp;Eisuke Nakazawa","doi":"10.1016/j.schres.2025.08.021","DOIUrl":"10.1016/j.schres.2025.08.021","url":null,"abstract":"<div><h3>Introduction</h3><div>During hospitalization, social resources are introduced with or without informal coercion as means of supporting the life of people with acute schizophrenia in the community. However, neither the effect of social resources in general on preventing readmission nor that of informal coercion on clinical outcomes is known. We aimed to examine the overall effect of social resources on preventing the readmission of people with acute schizophrenia and the clinical impact of informal coercion.</div></div><div><h3>Methods</h3><div>The present study identified 659 participants with schizophrenia, followed them for two years, and performed survival analyses using inverse probability of treatment weighting Kaplan-Meier and Cox proportional hazards analyses. Participants were first grouped by the social resource introduction. Those who declined the introduction were further categorized into coercive introduction, elicitory introduction, or personal needs groups.</div></div><div><h3>Results</h3><div>Participants in the social resource introduction group had a significantly lower risk of readmission than those in the control group (hazard ratio [HR]: 0.75; 95 % confidence interval [CI]: 0.57–0.99; <em>P</em> = 0.041). The number needed to treat was 7.2. The coercive introduction group showed no readmission risk reduction (HR: 1.53; 95 % CI: 0.75–3.13; <em>P</em> = 0.24) while the elicitory introduction group had a significantly lower risk than the personal needs group (HR: 0.50; 95 % CI: 0.31–0.82; <em>P</em> = 0.006).</div></div><div><h3>Conclusions</h3><div>Introducing social resources can prevent readmission for acute schizophrenia, but coercive introduction may negate this benefit. Medical staff should avoid informal coercion and adopt strategies that elicit motivation when introducing social resources.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"285 ","pages":"Pages 1-10"},"PeriodicalIF":3.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933819","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(25)00314-7","DOIUrl":"10.1016/S0920-9964(25)00314-7","url":null,"abstract":"","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"283 ","pages":"Page A1"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003855","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":"Microstructural alterations of the corpus callosum in affective and non-affective early psychosis: A diffusion magnetic resonance imaging study","authors":"Hossein Sanjari Moghaddam ,&nbsp;Mohammad Hadi Aarabi ,&nbsp;Iman Kiani ,&nbsp;Giulia Cattarinussi ,&nbsp;Shiva Khodadadi ,&nbsp;Sahar Delavari ,&nbsp;Fabio Sambataro","doi":"10.1016/j.schres.2025.08.010","DOIUrl":"10.1016/j.schres.2025.08.010","url":null,"abstract":"<div><h3>Background</h3><div>Early psychosis (EP) is associated with a disrupted integrity of the white matter microstructure of a variety of brain regions, especially the corpus callosum (CC). In this study, we used diffusion-weighted magnetic resonance imaging data of patients with EP and employed diffusion tensor imaging (DTI), free water-corrected diffusion, and neurite orientation dispersion and density imaging (NODDI) to comprehensively assess the white matter microstructure.</div></div><div><h3>Methods</h3><div>106 patients with EP (84 non-affective and 22 affective) and 51 healthy controls (HCs) were included from the Human Connectome Project in the Early Psychosis dataset. We used tract-specific analysis for tractography of three parts of the CC and quantified the diffusion measurements for each segment. CC measurement differences between EP vs. HCs and affective vs. non-affective psychosis were assessed by multivariate analysis of covariance. Principal component analysis was used for dimension reduction of diffusion metrics.</div></div><div><h3>Results</h3><div>EP was associated with disrupted white matter integrity in the body of CC indicated by a lower fractional anisotropy and intracellular volume fraction, alongside increased diffusivity measures. None of the CC subregions showed a significant difference in the genu and splenium of the CC between EP and HC groups or between affective and non-affective subgroups. Furthermore, lower white matter integrity in the genu was marginally associated with increased symptom severity.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that microstructural alterations of white matter fibers crossing CC may underlie the pathophysiology of EP. These findings may contribute to a growing body of evidence pointing to white matter disruption as a potential biomarker of disease vulnerability.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"284 ","pages":"Pages 237-247"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921442","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}