Schizophrenia Bulletin最新文献

{"title":"Fixation Task: A Simple Eye Movement Task Reveals an Impairment in Schizophrenia","authors":"Vanteemar S Sreeraj, H V Raghuram, Swarna Buddha Nayok, Aditi Subramaniam, Harleen Chhabra, Gaurav Bhalerao, Anushree Bose, Sri Mahaveer Agarwal, Sunil Kalmady, Venkataram Shivakumar, Samuel B Hutton, Ganesan Venkatasubramanian","doi":"10.1093/schbul/sbaf093","DOIUrl":"https://doi.org/10.1093/schbul/sbaf093","url":null,"abstract":"Background Fixation stability (FS) is a basic substrate of visuomotor processing that can be assessed by tracking eye movements during a simple, easy-to-perform task of gazing at a visual stimulus. We studied FS with and without distractors for its potential as an endophenotype marker in antipsychotic-naïve/free schizophrenia (SCZ), SCZ first-degree relatives (FDRs), and healthy controls (HC). Method Monocular high-frequency eye tracking data were recorded during a fixation stability task in 69 antipsychotic-naïve/free SCZ, 49 FDRs, and 76 HCs. The task required maintenance of gaze on a central circular target while ignoring an identical peripheral distractor, when present, at near/farther distances on either side. Fixation stability across the groups and the effect of laterality and distance of the distractor effect were analyzed using ANCOVA and RMANCOVA. Result SCZ had significantly higher fixation frequency, saccade amplitude, and scanpath length compared to the other groups, even in trials without distractors (ηp2 = 0.05–0.07). Introducing distractors resulted in further worsening of performance in SCZ (ηp2 = 0.09–0.23). First-degree relatives showed impairment in median fixation duration (ηp2 = 0.13). Higher saccade amplitudes and scanpath lengths (both ηp2 = 0.09) were noted in trials with farther distractors across the groups. A significant interaction effect of the laterality * group was noted on scanpath length (ηp2 = 0.03). Discussion FS impairment was noted in antipsychotic naïve/free SCZ, and it worsened with the introduction of distractors. An inversed laterality effect (rightward-bias) of distractor was noted in SCZ and their FDRs, suggesting a possible association of attenuation/reversal of visual functional asymmetry with SCZ vulnerability. Future studies should evaluate FS as illness markers across different clinical stages.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"26 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144622439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of CYP2D6 Genotypes and Phenotypes on the Plasma Levels and Clinical Response to Aripiprazole.","authors":"Cécile Gras, Marianna Piras, Setareh Ranjbar, Claire Grosu, François R Girardin, Frederik Vandenberghe, Nicolas Ansermot, Carole Grandjean, Stefan Kaiser, Franziska Gamma, Kerstin Jessica Plessen, Armin von Gunten, Philippe Conus, Séverine Crettol, Chin B Eap","doi":"10.1093/schbul/sbaf076","DOIUrl":"https://doi.org/10.1093/schbul/sbaf076","url":null,"abstract":"<p><strong>Background: </strong>The antipsychotic aripiprazole is mainly metabolized by the cytochrome P450 (CYP) 2D6. The main objective of this study was to evaluate the influence of CYP2D6 phenotypes on aripiprazole plasma levels and treatment duration.</p><p><strong>Design: </strong>466 patients treated with aripiprazole for up to 12 months and with at least one aripiprazole plasma level in steady-state condition were selected. CYP2D6 genotypes and phenoconversion to poor metabolizer status due to strong CYP2D6 inhibition were considered. Aripiprazole plasma level-to-dose ratios and treatment duration up to discontinuation, defined as switching to another psychotropic drug and/or stopping the follow-up, were analyzed using robust linear models and Cox regression, respectively. Akaike variable selection was applied.</p><p><strong>Results: </strong>CYP2D6 poor metabolizers (genetically determined n = 19 and phenoconverted, n = 52) showed higher aripiprazole concentration-to-dose (P < .001) and aripiprazole plus dehydroaripiprazole concentration-to-dose (P < .001) ratios when compared to normal metabolizers (n = 255). CYP2D6 extreme metabolizers (ie, poor and ultrarapid metabolizers) had higher risk of treatment discontinuation versus intermediate and normal metabolizers after 3, 6, and 12 months of treatment (HR: 2.08, 1.75, 1.59, respectively; P = .013, P = .019, and P = .047, respectively). For a pharmacogenetic-guided treatment, the number of patients needed to genotype to prevent 1 patient from aripiprazole discontinuation was 15.</p><p><strong>Conclusion: </strong>CYP2D6 poor metabolism was associated with increased aripiprazole and aripiprazole plus dehydroaripiprazole concentrations-to-dose. CYP2D6 extreme phenotypes were associated with increased risk of treatment discontinuation over 1 year of treatment. This finding supports the applicability of pre-emptive CYP2D6 genotyping, which is expected to decrease aripiprazole adverse events and inefficacy that would probably lead to treatment discontinuation.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central Obesity-related Brain Alterations Predict Cognitive Impairments in First Episode of Psychosis.","authors":"Marian Kolenič, Sean R McWhinney, Maya Selitser, Nicole Šafářová, Katja Franke, Kristyna Vochoskova, Katherine Burdick, Filip Španiel, Tomas Hajek","doi":"10.1093/schbul/sbaf101","DOIUrl":"https://doi.org/10.1093/schbul/sbaf101","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Cognitive impairment is a key contributor to disability and poor outcomes in schizophrenia, yet it is not adequately addressed by currently available treatments. Thus, it is important to search for preventable or treatable risk factors for cognitive impairment. Here, we hypothesized that obesity-related neurostructural alterations will be associated with worse cognitive outcomes in people with first episode of psychosis (FEP).</p><p><strong>Study design: </strong>This observational study presents cross-sectional data from the Early-Stage Schizophrenia Outcome project. We acquired T1-weighted 3D MRI scans in 440 participants with FEP at the time of the first hospitalization and in 257 controls. Metabolic assessments included body mass index (BMI), waist-to-hip ratio (WHR), serum concentrations of triglycerides, cholesterol, glucose, insulin, and hs-CRP. We chose machine learning-derived brain age gap estimate (BrainAGE) as our measure of neurostructural changes and assessed attention, working memory and verbal learning using Digit Span and the Auditory Verbal Learning Test.</p><p><strong>Study results: </strong>Among obesity/metabolic markers, only WHR significantly predicted both, higher BrainAGE (t(281)=2.53, p=0.012) and worse verbal learning (t(290) = -2.51, P = .026). The association between FEP and verbal learning was partially mediated by BrainAGE (average causal mediated effects, ACME = -0.04 [-0.10, -0.01], P = .022) and the higher BrainAGE in FEP was partially mediated by higher WHR (ACME = 0.08 [0.02, 0.15], P = .006).</p><p><strong>Conclusions: </strong>Central obesity-related brain alterations were linked with worse cognitive performance already early in the course of psychosis. These structure-function links suggest that preventing or treating central obesity could target brain and cognitive impairments in FEP.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Electronic Health Records to Identify Medical Presentation for Self-harm as a Predictor of Psychotic or Bipolar Disorders: A Systems-level Alternative to the Clinical High-risk Approach.","authors":"Rebecca Cooper, Rashmi Sahasrabudhe, Karmel W Choi, Ian Kelleher, Maria Jalbrzikowski","doi":"10.1093/schbul/sbaf098","DOIUrl":"https://doi.org/10.1093/schbul/sbaf098","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>We examined associations between medical presentation for self-harm and subsequent diagnosis of a psychotic or bipolar disorder in a sample from the United States. Nordic registry studies have identified hospital (inpatient/emergency department) presentation of self-harm as a risk factor for developing psychotic or bipolar disorder, but it is unknown if this relationship exists within the United States and whether this relationship extends to outpatient settings.</p><p><strong>Study design: </strong>We extracted electronic health records of individuals aged 8-29 years from Boston Children's Hospital (October 2015-August 2023), which included 155 590 individuals (mean age = 12.67 years, 52.6% female). We used Kaplan-Meier and Cox Proportional Hazard analyses to assess time-to-event associations between medical presentation for self-harm and a subsequent new diagnosis of a psychotic or bipolar disorder.</p><p><strong>Study results: </strong>Self-harm presentation to any type of medical setting was associated with increased likelihood of developing a psychotic or bipolar disorder (Hazard Ratio [HR] = 4.99, 95% confidence interval (CI), 3.33-7.47, P = 5.65e-15). 5.8% of those who presented at an outpatient setting with self-harm were later diagnosed with psychotic or bipolar disorder (HR = 3.60, 95% CI, 2.12-6.09, P = 1.88e-06). Among individuals who presented to inpatient/emergency department settings with self-harm, 19.6% were later diagnosed with a psychotic or bipolar disorder (HR = 10.8, 95% CI, 5.98-19.6, P = 3.47e-15).</p><p><strong>Conclusions: </strong>Presentations with self-harm to a medical setting is a robust predictor of psychotic and bipolar disorders in the United States. It is essential to consider a broad range of psychiatric outcomes when evaluating youth presenting to medical settings with self-harm and refrain from limiting clinical focus to diagnoses of depression or borderline personality disorder.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mentalizing Across the Psychosis Continuum in Adolescence and Young Adulthood: A Systematic Review and Narrative Synthesis.","authors":"George Salaminios, Astra Hazlitt, Peter Fonagy, Martin Debbané, Tobias Nolte","doi":"10.1093/schbul/sbaf095","DOIUrl":"https://doi.org/10.1093/schbul/sbaf095","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Mentalizing difficulties have consistently been identified in adult samples across the psychosis continuum. However, the links between mentalizing and psychosis expression during the critical period spanning from adolescence to young adulthood, when the earliest signs of psychosis commonly emerge, remain less clear. The current review aims to synthesize and evaluate existing findings on the presence and role of mentalizing dysfunction at each stage of the psychosis continuum in adolescent and young adult samples.</p><p><strong>Study design: </strong>Electronic databases were used to identify empirical articles examining the links between mentalizing and psychosis expression in community, clinical-high risk for psychosis (CHR-P), first episode psychosis (FEP), and clinical psychosis samples aged 10-25 years. A narrative synthesis approach was used to integrate and evaluate the study findings.</p><p><strong>Results: </strong>Twenty-six eligible studies were identified with a combined sample of 4391 individuals. The synthesis of findings indicates mixed evidence on the links between mentalizing and nonclinical psychotic manifestations in community samples. Most studies with CHR-P samples suggest that mentalizing difficulties are present during the psychosis prodrome and may contribute to its clinical progression. Studies among adolescents and young adults with FEP and those with a previous diagnosis of psychotic disorders indicate that mentalizing impairments are present at the point of conversion and early course of the illness.</p><p><strong>Conclusions: </strong>The findings of the review suggest that mentalizing difficulties can be observed across the psychosis continuum in adolescence and young adulthood, particularly during the prodromal and clinical stages and may constitute valid early intervention targets.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotion Processing and Its Relationship to Social Functioning and Symptoms in Psychotic Disorder: A Systematic Review and Meta-analysis.","authors":"Sean Murrihy, Kate Filia, Sue Cotton, Lisa Phillips, Sarah Youn, Anuradhi Jayasinghe, Anna Wrobel, Eslam M Bastawy, Kelly Allott, Amity Watson","doi":"10.1093/schbul/sbae167","DOIUrl":"10.1093/schbul/sbae167","url":null,"abstract":"<p><strong>Background: </strong>Emotion processing (EP) is impaired in individuals with psychosis and associated with social functioning; however, it is unclear how symptoms fit into this relationship. The aim of this systematic review and meta-analysis was to examine interrelationships between EP, symptoms, and social functioning, test whether different symptom domains mediate the relationship between EP and social functioning, and examine the moderating effects of illness stage and EP task type.</p><p><strong>Study design: </strong>MEDLINE, Embase, and PsycINFO databases were searched for studies that included individuals with psychosis and reported correlations between EP, symptom domains (positive, negative, depressive, and disorganization), and social functioning. Random effects meta-analyses determined the strength of correlations, and subgroup analyses included illness stage and EP task type (lower- vs higher-level processing). Meta-analytic structural equation models tested whether symptom domains mediated the relationship between EP and social functioning.</p><p><strong>Results: </strong>There was a small relationship (r = .18) between EP and social functioning. Positive, negative, and disorganization symptoms mediated this relationship, although indirect effects were small. Higher-level EP tasks were more strongly associated with negative symptoms than lower-level tasks. Relationships between EP and both social functioning and positive symptoms were smaller in the first episode of psychosis than in established illness.</p><p><strong>Conclusions: </strong>The mediating relationship suggests that EP not only influences social dysfunction directly but contributes to negative and disorganization symptoms, which in turn impair social functioning. This pathway suggests that targeting negative and disorganization symptoms may ultimately improve social outcomes for individuals with psychosis. Future research, particularly in early psychosis, is needed to determine other factors impacting these interrelationships.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1054-1071"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Omega-3 Fatty Acids Versus Placebo in Subjects at Ultra-High Risk for Psychosis: The PURPOSE Randomized Clinical Trial.","authors":"Inge Winter-van Rossum, Margot I E Slot, Hendrika H van Hell, Matthijs G Bossong, Gregor Berger, Harald Aschauer, Arija Maat, Susanne Walitza, Orly Lavan, Inmaculada Baeza, Montserrat Dolz, Elena Monducci, Paolo Fiori Nastro, Rune Andreas Kroken, Stephen M Lawrie, Covadonga Martinez Díaz-Caneja, Tobias Renner, Monika Schlögelhofer, Christian Scharinger, Gianfranco Spalletta, Nerisa Banaj, Soraya Otero, Maria Schipper, Dorieke Brink- Kwakkel, Rene S Kahn","doi":"10.1093/schbul/sbae186","DOIUrl":"10.1093/schbul/sbae186","url":null,"abstract":"<p><strong>Background and hypotheses: </strong>In the past 2 decades, substantial effort has been put into research on therapeutic options for people at ultra-high risk (UHR) for developing a first episode of psychosis (FEP), focusing on omega-3 polyunsaturated fatty acids (PUFAs) in preventing transition to psychosis. Despite an initial positive finding, subsequent studies failed to find a beneficial effect. The current study aimed to further investigate the effect of omega-3 PUFAs in UHR, to determine whether this line of research is worth pursuing.</p><p><strong>Study design: </strong>A double-blind, randomized, placebo-controlled study testing the efficacy of 6-month treatment with omega-3 PUFAs in 135 subjects at UHR for FEP, aged 13 to 20 years on the prevention of a transition to psychosis, followed up for 18 months post-treatment. The trial was conducted at 16 general hospitals and psychiatric specialty centers located in 8 European countries and Israel.</p><p><strong>Study results: </strong>There was no beneficial effect of treatment with omega-3 PUFAs compared to placebo; the rate of transition over 2 years did not differ between treatment arms nor was there a difference in change in symptom severity after 6-month treatment. Dropout rates and serious adverse events were similar across the groups.</p><p><strong>Conclusions: </strong>This is the third study that fails to replicate the original finding on the protective effect of omega-3 PUFAs in UHR subjects for transition to psychosis. The accumulating evidence therefore suggests that omega-3 PUFAs do not reduce transition rates to psychosis in those at increased risk at 2 years follow-up.</p><p><strong>Clinical trials: </strong>This trial is registered with ClinicalTrials.gov (NCT02597439; Study Details | Placebo-controlled Trial in Subjects at Ultra-high Risk for Psychosis With Omega-3 Fatty Acids in Europe | ClinicalTrials.gov).</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1082-1091"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Mitochondrial Dysfunction and Cognitive Impairment in Schizophrenia: The Role of Inflammation.","authors":"","doi":"10.1093/schbul/sbae229","DOIUrl":"10.1093/schbul/sbae229","url":null,"abstract":"","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1174"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Idealist to Realist-Designing and Implementing Shared Decision-Making Interventions in the Choice of Antipsychotic Prescription in People Living With Psychosis (SHAPE): A Realist Review (Part 2-Designing SDM Interventions: Optimizing Design and Local Implementation).","authors":"Ita Fitzgerald, Jo Howe, Ian Maidment, Emma Wallace, Yaara Zisman-Ilani, Mikkel Højlund, Sarah O'Dwyer, Ciara Ní Dhubhlaing, Erin K Crowley, Laura J Sahm","doi":"10.1093/schbul/sbaf059","DOIUrl":"10.1093/schbul/sbaf059","url":null,"abstract":"<p><strong>Background: </strong>Shared decision-making (SDM) implementation remains limited in psychosis management, particularly within antipsychotic prescribing. When and why prescribers engage in SDM within these contexts is largely unknown. Part 2 of this 2-part realist review aimed to understand what SDM intervention strategies and local implementation contexts are responsible for successful prescriber engagement and why.</p><p><strong>Study design: </strong>CINAHL Plus, Cochrane Library, Embase, PsycINFO, PubMed, Scopus, Sociological Abstracts, Web of Science, and Google Scholar were searched for evidence to develop realist program theories explaining relationships between meso- and micro-level contexts and impact on prescriber behaviors.</p><p><strong>Study results: </strong>From 106 included documents, 5 program theories were developed explaining mechanisms responsible for increasing prescriber engagement with desired behaviors, alongside facilitative features within service delivery contexts and workforce development. Key mechanisms included reducing prescriber fear of sole responsibility for harm, reducing the perceived burden of SDM, increasing prescriber confidence in their ability to productively negotiate treatment consultations and their confidence to safely increase patient autonomy within decision-making. These mechanisms should be the focus of those interested in designing SDM interventions to increase prescriber engagement and those responsible for translating results of effective interventions into real-world settings to ensure facilitative contexts are maintained.</p><p><strong>Conclusion: </strong>Intervention strategies that should be prioritized for scale-up include attempting SDM within existing therapeutic relationships, adopting a multidisciplinary team (MDT) responsibility for SDM implementation, and workforce training in skillsets required of effective SDM application. Efforts to standardize psychosis care via MDTs and systematically reduce discontinuity and fragmentation of care are required at policy-level.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"932-948"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Trajectories of Clinical Features in Community Youth With Recurrent Psychosis Spectrum Symptoms: Findings From the Philadelphia Neurodevelopmental Cohort.","authors":"Monica E Calkins, Ellyn R Butler, Tyler M Moore, Arielle Ered, Jerome H Taylor, Lauren K White, Ran Barzilay, Kosha Ruparel, Bart Larsen, Sarah S Shahriar, Tyler E Dietterich, David R Roalf, Daniel H Wolf, Theodore D Satterthwaite, Ruben C Gur, Raquel E Gur","doi":"10.1093/schbul/sbaf075","DOIUrl":"10.1093/schbul/sbaf075","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>In the general population, more severe, recurrent subthreshold psychosis spectrum (PS) symptoms are associated with a heightened risk of poor outcomes. Here, we expanded and temporally extended our prior 2-year follow-up of community youth with recurrent PS symptoms in the Philadelphia Neurodevelopmental Cohort (PNC) by characterizing longer-term trajectories of symptom domains and global functioning compared to youth with other recurrent psychopathology.</p><p><strong>Study design: </strong>The PNC Time 1 included 9498 community youth (age 8-21) recruited from a pediatric healthcare network. A subsample (n = 752) participated in prospective evaluations (mean visits = 2.75; interval range years first:last visit = 0.2:9.3; mean = 4.52 years; age range years first:last visit = 8.1-21.9:9.5-29.9). Youth were classified based on psychopathology at first and last visits. Longitudinal trajectories of symptom domains (positive, negative, disorganized, general) and global functioning were modeled using generalized additive mixed models.</p><p><strong>Study results: </strong>Youth with recurrent PS displayed a nonlinear developmental trajectory of positive psychosis symptoms such that severity increased slowly until the early 20s, and then briefly plateaued before increasing significantly in the late 20s. They also exhibited increases over time in disorganized and negative symptoms, and in general symptoms, which were lower in severity and relatively stable in other groups. Global functioning in recurrent PS declined from moderate to serious impairment over time, compared to youth with recurrent other psychopathology, where higher and more stable functioning was observed.</p><p><strong>Conclusions: </strong>Results underscore that PS symptoms in community adolescents reflect dynamic developmental processes into early adulthood, and support evaluating trajectories of multiple symptom and functional domains.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"858-870"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}