Schizophrenia Bulletin最新文献

{"title":"Association between the Korea-Polyenvironmental Risk Score and Clinical Outcomes in Schizophrenia Spectrum Disorders","authors":"Ariana Setiani, Ling Li, Thi Hung Le, Fatima Zahra Rami, Young-Chul Chung","doi":"10.1093/schbul/sbaf090","DOIUrl":"https://doi.org/10.1093/schbul/sbaf090","url":null,"abstract":"Background Evidence suggests that environmental factors increase the risk of psychosis development and influence the prognosis of psychotic disorders. This study examined the discriminative validity of the Korea-Polyenvironmental Risk Score (K-PERS) in differentiating patients with schizophrenia spectrum disorders (SSDs) from healthy controls (HCs). In addition, we evaluated its associations with baseline clinical characteristics and short-term clinical outcomes. Study Design Data were obtained from participants of the Korea Early Psychosis Study, who were assessed using K-PERS and underwent clinical evaluations at baseline and at 2, 6, and 12 months. Matched HCs were recruited for comparison. Psychopathology, cognitive functioning, and socio-occupational functioning were assessed using the Positive and Negative Syndrome Scale (PANSS), Prospective and Retrospective Memory Questionnaire (PRMQ), and Social and Occupational Functioning Assessment Scale (SOFAS). Treatment response, remission, and recovery were evaluated based on predefined criteria. Results A total of 224 subjects with SSD and 203 HC were enrolled in this study. K-PERS-I and K-PERS-II demonstrated good predictive performance, with area under the curve values of 0.738 and 0.754, respectively. At baseline, K-PERS-I and K-PERS-II were significantly associated with depressive and negative symptoms, PRMQ scores, SOFAS scores, and various self-reported measures. Importantly, several individual item scores or total score of K-PERS predicted treatment response, remission, or recovery. Conclusions K-PERS has a good discriminative ability for identifying SSDs within the general population. Furthermore, K-PERS is associated with symptom severity, cognitive performance, and socio-occupational functioning, and it significantly influences the illness course.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"604 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304814","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":"A Randomized Controlled Trial of an Extension for Community Healthcare Outcomes (ECHO) Tele-mentoring Program to Increase Clozapine Utilization","authors":"Deanna L Kelly, Jared Hunt, Gopal Vyas, Matthew Glassman, Clayton H Brown, Li Juan Fang, Heidi J Wehring, Raymond C Love, Elaine Weiner, Gloria Reeves, Megan J Ehret, Frederick C Nucifora, Robert W Buchanan, Sophie Lanzkron, Brian Barr, Charles M Richardson, Ikwunga Wonodi, Ann Marie Kearns, Nicole Leistikow, Fang Liu, Sharon Pugh, Heather A Adams, Julie Kreyenbuhl","doi":"10.1093/schbul/sbaf067","DOIUrl":"https://doi.org/10.1093/schbul/sbaf067","url":null,"abstract":"Background and Hypothesis To determine whether a tele-mentoring program increases clozapine utilization by improving prescriber knowledge and perceived competence in clozapine management. Study Design In a cluster-randomized controlled design, we tested the effectiveness of an Extension for Community Healthcare Outcomes (ECHO) model-based intervention, consisting of 26 biweekly didactic and case-based tele-mentoring sessions, vs enhanced treatment as usual (eTAU), in which both conditions received access to a consultation phone line and a point of care device for on-site hematologic monitoring. Prescribers completed baseline and 12-month assessments of clozapine knowledge and competence, and prescription records were used to evaluate the effects of ECHO on prescribing and treatment persistence. Study Results 266 prescribers from 43 mental health treatment settings throughout Maryland were enrolled. Prescribers randomized to ECHO demonstrated a significant increase in clozapine knowledge compared to eTAU (P < .001), and competence increased significantly in those who attended 14 or more tele-mentoring sessions (P = .017). ECHO did not increase the likelihood of clozapine prescribing during follow-up (P = .70). While there was a 17% lower hazard of clozapine discontinuation among patients of prescribers randomized to ECHO, this did not reach statistical significance (P = .72). Conclusions A statewide tele-mentoring program increased prescriber knowledge and competence in clozapine prescribing among those attending most ECHO sessions. Median time to clozapine discontinuation was double in the ECHO group, however, neither this nor rates of prescribing were statistically significantly different from control. Additional support is needed to motivate clozapine prescribing beyond providing education and increasing confidence in clozapine management.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"5 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296010","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":"Shared Genetic Networks in Schizophrenia and Bipolar Disorder: Hippocampal Volume-Mediated Neurobiological Mechanisms","authors":"Qing Du, Minglan Yu, Lu Shi, Rui Fan, Kezhi Liu, Bo Xiang","doi":"10.1093/schbul/sbaf092","DOIUrl":"https://doi.org/10.1093/schbul/sbaf092","url":null,"abstract":"Background Studies have shown similarities in clinical symptoms and biological markers between schizophrenia (SCZ) and bipolar disorder (BD). However, the impact of these shared genetic factors on the diseases remains poorly understood. Study Design We utilized the hippocampus volume (HIPV) as an auxiliary phenotype for identifying pleiotropic genetic loci associated with BD and SCZ. Using conditional/conjunctional false discovery rate approach to evaluate overlap in common genetic variants. We established co-expression networks of the overlapping genes in SCZ and BD using BrainSpan’s transcriptomes, and performed the gene-set analysis of each gene subnetwork with symptoms in SCZ. Results We identified several loci shared between SCZ and left HIPV (n = 8) and right HIPV (n = 13), BD and left HIPV (n = 1), and right HIPV (n = 3). Twenty-two and 70 candidate genes mapped by shared loci for BD and SCZ, respectively, and 20 overlapping genes in SCZ and BD. Functional enrichment analysis pointed to the 20 genes being associated with 16p11.2 proximal deletion syndrome. According to the brain transcriptome data, it was found that the 20 genes were enriched for the transcriptional co-expression profile in prenatal primary auditory cortex, inferolateral temporal cortex, inferior parietal cortex, and medial prefrontal cortex. Further gene-set analysis uncovered that the genes in the subnetwork of medial prefrontal cortex were significantly associated with negative symptom in SCZ. Conclusions The study indicated that SCZ and BD shared a genetic basis with HIPV, and the genetic overlaps suggested shared neurobiological mechanisms between the 2 disorders.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"5 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278346","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":"Cerebellar–Basal Ganglia Dysconnectivity in Schizophrenia: Insights into Motivational Deficits","authors":"Xuan Wang, Xiao-dong Guo, Xin-lu Cai, Bing-jie Huang, Yi Wang, Cheng-cheng Pu, Xin Yu, Simon S Y Lui, Raymond C K Chan","doi":"10.1093/schbul/sbaf087","DOIUrl":"https://doi.org/10.1093/schbul/sbaf087","url":null,"abstract":"Background and Hypothesis Motivational deficits are core negative symptoms of schizophrenia (SCZ), which have been linked to disruptions in reward network. Recent evidence suggests the cerebellum’s role in motivational and hedonic processing. This study examined its connectivity with the reward network in SCZ and hypothesized that decreased connectivity would be found in SCZ patients and correlated with severe negative symptoms. Study Design This study employed a cross-sample validation approach using 2 independent cohorts (Sample 1: NSCZ = 62, NHC = 61; Sample 2: NSCZ = 53, NHC = 55). Resting-state functional connectivity was assessed using network-based analysis to identify disrupted subnetworks, followed by seed-based connectivity analysis to localize specific connections. Effective connectivity was assessed using spectral Dynamic Causal Modeling (DCM) for inferring the directional influences of abnormal connectivity related to amotivation or anhedonia. Study Results Network-based analysis in Sample 1 identified a disrupted subnetwork between the cerebellum (lobules VI, VIIb, VIII) and basal ganglia (putamen, caudate, pallidum) in SCZ, with cerebellar–pallidal connectivity associated with amotivation. Seed-based analysis in Sample 2 revealed reduced putamen/caudate-lobule VI connectivity, correlating with amotivation and anhedonia symptoms in SCZ. Spectral DCM indicated reduced excitatory input from cerebellum to the basal ganglia in Sample 1, but such results could not be replicated in Sample 2. Conclusions Our findings highlighted the role of cerebellum–basal ganglia connectivity in the pathophysiology of SCZ, particularly in relation to amotivation and anhedonia. This pathway may be a putative target for neuromodulation to ameliorate negative symptoms of SCZ.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"260 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278347","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":"Setd1a Loss-of-function Disrupts Epigenetic Regulation of Ribosomal Genes via Altered DNA Methylation","authors":"Nicholas E Clifton, Stefania Policicchio, Emma M Walker, Isabel Castanho, Matthew L Bosworth, Kirtikesav S Saravanaraj, Joe Burrage, Jeremy Hall, Emma L Dempster, Eilis Hannon, Anthony R Isles, Jonathan Mill","doi":"10.1093/schbul/sbaf091","DOIUrl":"https://doi.org/10.1093/schbul/sbaf091","url":null,"abstract":"Background and Hypothesis SETD1A, a histone methyltransferase, is implicated in schizophrenia through rare loss-of-function mutations. While SETD1A regulates gene expression via histone H3K4 methylation, its influence on broader epigenetic dysregulation remains incompletely understood. We explored the hypothesis that SETD1A haploinsufficiency contributes to neurodevelopmental disruptions associated with schizophrenia risk via alterations in DNA methylation. Study Design We profiled DNA methylation in the frontal cortex of Setd1a+/− mice across prenatal and postnatal development using Illumina Mouse Methylation arrays. Differentially methylated positions and regions were identified, and their functional relevance was examined through gene and biological annotation. We integrated these findings with transcriptomic and proteomics datasets, and assessed mitochondrial complex I activity to explore potential downstream functional effects. Study Results Setd1a haploinsufficiency resulted in widespread hypomethylation of genes related to ribosomal function and RNA processing that persisted across all developmental stages. Setd1a-targeted promoter regions and noncoding small nucleolar RNAs were also enriched for differentially methylated sites. Despite the downregulation of mitochondrial gene expression, the same genes were not differentially methylated, and complex I activity in Setd1a+/− mice did not differ significantly from controls. Genes overlapping hypomethylated regions were enriched for common genetic associations with schizophrenia. Conclusions Our findings suggest that SETD1A haploinsufficiency disrupts the epigenetic regulation of ribosomal pathways. These results provide insight into an alternative mechanism through which genetic variation in SETD1A influences developmental and synaptic plasticity, contributing to schizophrenia pathophysiology.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"39 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268721","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":"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":"https://doi.org/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":""},"PeriodicalIF":5.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing Asymmetry Reduction in Psychosis: Cingulate Folding and Gyrification Covariance in Patients with Auditory Hallucinations.","authors":"Shun-Chin Jim Wu, Héloïse de Vareilles, Samantha C Mitchell, Atheer Al-Manea, Jane Garrison, Michail Mamalakis, Jon S Simons, Arnaud Cachia, Jean-François Mangin, Stener Nerland, Lynn Mørch-Johnsen, Ingrid Agartz, John Suckling, Graham K Murray","doi":"10.1093/schbul/sbaf086","DOIUrl":"https://doi.org/10.1093/schbul/sbaf086","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Prior research links a shorter paracingulate sulcus (PCS) to hallucinations in schizophrenia, but its symmetry hemispheric specificity and relevance to bipolar disorders remain unclear. We hypothesized that reduced PCS asymmetry and interhemispheric gyrification covariance in salience and auditory networks are associated with lifetime auditory hallucinations (AH) in psychotic spectrum disorders.</p><p><strong>Study design: </strong>We compared patients with and without AH, and healthy controls, focusing on PCS asymmetry in five ordinal classes, sulcal length and depth, and interhemispheric gyrification covariance.</p><p><strong>Study results: </strong>Among 351 patients with schizophrenia or bipolar spectrum disorders (SSD/BSD), 194 (55.3%) had AH, compared to 157 without and 278 healthy controls. We found no significant PCS class asymmetry between hemispheres (V = 6648.5, P = .097) and decreased leftward asymmetry in PCS length (F(2,621) = 3.19, P = .013) in patients with AH, compared with those without and healthy controls. Compared to patients without AH, those with AH showed increased gyrification covariance in the auditory network (F(2,625) = 42.5, P < .001). In the salience network, patients with SSD and AH had increased covariance (F(2,625) = 299, P < .001), while patients with BSD and AH displayed decreased covariance (F(2,625) = 102, P < .001).</p><p><strong>Conclusions: </strong>This study, featuring the largest cohort to date, links the AH trait to replicable reduced leftward PCS asymmetry and altered interhemispheric covariance in psychotic spectrum disorders, supporting theories of reduced asymmetry and altered brain network coordination as part of the mechanistic pathway to psychosis.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235055","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":"Dissecting Sense of Agency in Schizophrenia: A Predictive Coding Perspective.","authors":"Ileana Rossetti, Margherita Adelaide Musco, Lucia Maria Sacheli, Enrico Capuzzi, Massimo Clerici, Alice Caldiroli, Benedetta Demartini, Giovanni Broglia, Veronica Nisticò, Vincenzo Florio, Andreas Conca, Angelo Maravita, Eraldo Paulesu, Laura Zapparoli","doi":"10.1093/schbul/sbaf054","DOIUrl":"https://doi.org/10.1093/schbul/sbaf054","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>A large body of literature suggests that neurocognitive processes underlying the sense of agency are disrupted in schizophrenia. We here tested the sense of agency in schizophrenia patients, by controlling for the potential confounding effect of temporal perception biases, antipsychotics, attentional-executive functioning, and illness duration. We also analyze the role of symptoms such as delusions, hallucinations, and passivity experiences.</p><p><strong>Study design: </strong>We capitalized on the intentional binding phenomenon, an implicit measure of the sense of agency. 30 schizophrenia patients and 30 healthy controls completed 2 tasks. Experimental task participants pressed a switch to turn a light bulb on (active condition) or let their finger be moved by an automated switch (passive condition). They then judged the interval between the action (active or passive) and the lighting of the bulb. Control task participants estimated the time interval between two light flashes presented in sequence. All participants underwent a comprehensive neuropsychological assessment, while schizophrenia patients were also evaluated for positive, negative symptoms, and passivity symptoms.</p><p><strong>Study results: </strong>Control participants showed the expected intentional binding effect, particularly at shorter action-outcome delays. In contrast, the effect was absent in schizophrenia patients. The alteration was significantly moderated by temporal perception biases, hallucinations, and delusions.</p><p><strong>Conclusions: </strong>The study provides the first evidence in favor of the relationship between agency disturbances, symptomatology, and temporal perception biases in schizophrenia while excluding putative confounding factors like neuroleptics. Results are discussed in the light of a recent predictive coding model of the sense of agency.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235044","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":"Prediction of Adolescent Suicide Attempt by Integrating Clinical, Neurocognitive and Geocoded Neighborhood Environment Data","authors":"Elina Visoki, Tyler M Moore, Victor M Ruiz, Joel A Fein, Monica E Calkins, Ruben C Gur, Tami D Benton, Raquel E Gur, Fuchiang R Tsui, Ran Barzilay","doi":"10.1093/schbul/sbaf064","DOIUrl":"https://doi.org/10.1093/schbul/sbaf064","url":null,"abstract":"Background and Hypothesis Suicide attempt is a complex behavior influenced by a combination of factors including clinical, neurocognitive, and environmental. We aimed to leverage multimodal data collected during pre/early adolescence in research settings to predict self-report of suicide attempts by mid-late adolescence reported in pediatric settings. We hypothesized that different data types contribute to suicide attempt prediction and that clinical features would be most predictive of future suicide attempts. Study Design We applied machine learning methods to clinical, neurocognitive, and geocoded neighborhood environmental data from the Philadelphia Neurodevelopmental Cohort study (Mean age [SD] = 11.1 [2.2], 53.3% female, 51.4% Black participants) to predict suicide attempt reported ~5 years later in two independent pediatric settings: primary care (n = 922, 5.3% suicide attempt) or emergency department (n = 497, 8.2% suicide attempt). We tested prediction performance using all data versus using subsets of features identified by three feature selection algorithms (Lasso, Relief, Random Forest). Study Results In the primary care sample, suicide attempt prediction using subsets of selected features (predictors) was good, achieving AUC = 0.75, sensitivity/specificity 0.76/0.77. The use of highest-ranking features yielded similar prediction performance in external validation using the independent emergency department sample with AUC = 0.74, sensitivity/specificity 0.66/0.70. Different algorithms identified different high-ranking features, but overall multiple data domains were represented among the highest-ranking features. Besides suicidal ideation, the highest-ranking clinical predictive symptoms were from psychosis or mania spectrum. Conclusions Results suggest that data collected at a single timepoint during preadolescence can inform suicide attempt prediction during mid-late adolescence, in different clinical settings. Findings encourage incorporation of multiple data types including neurocognitive and geocoded data, alongside clinical data, in machine learning suicide attempt prediction pipelines.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"17 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228508","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":"Economic Burden Associated with Negative Symptoms Identified Through Natural Language Processing Among Patients with Schizophrenia in the United States","authors":"Jerome Vaccaro, Mona Nili, Pin Xiang, James K Nelson, Cory Pack, Randall Thompson, Joe Vasey, Joseph Parks","doi":"10.1093/schbul/sbaf073","DOIUrl":"https://doi.org/10.1093/schbul/sbaf073","url":null,"abstract":"Background and Hypothesis The objective of this study was to identify documented negative symptoms of schizophrenia using natural language processing (NLP) and to characterize treatment patterns, healthcare resource utilization (HCRU), and costs among this patient population. Study Design This US retrospective cohort study used electronic health records (EHR) linked to administrative claims data from January 2016 through February 2023. Adult patients (≥ 18 years) with at least 2 schizophrenia diagnosis codes were included. Negative symptoms were identified by NLP. Patient characteristics were assessed in the 12 months preceding the index date (first-documented schizophrenia diagnosis). Treatment patterns, HCRU, and costs were measured over the 12 months after the index date. Study Results A total of 79,326 patients were enrolled in the EHR cohort and 14,992 (18.9%) had documented negative symptoms. Avolition was identified most often (44%) followed by blunted affect (42%). In the EHR cohort, 11,293 patients (14.2%) had linked claims. Patients with documented negative symptoms had more HCRU including days hospitalized, outpatient visits, and all-cause healthcare claims than patients without documented negative symptoms (all P &amp;lt; .001). They also had higher healthcare costs including inpatient, all-cause healthcare, schizophrenia-related costs (P &amp;lt; .001), and outpatient costs (P = .029). Only 34.6% of patients with documented negative symptoms received psychosocial interventions. Conclusions These observational data add to the limited published literature on negative symptoms in patients with schizophrenia in the United States. The association of negative symptoms with low utilization of psychosocial interventions, increased costs, and high healthcare utilization emphasize the need for better management and treatment options for patients with schizophrenia.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"13 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210803","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}