Schizophrenia Bulletin最新文献

{"title":"Experiencing Psychosis and Shame: A Systematic Review and Meta-analysis of the Strength and Patterns of Association.","authors":"Kimberley Davies, Julia M Lappin, Chloe Gott, Zachary Steel","doi":"10.1093/schbul/sbae139","DOIUrl":"10.1093/schbul/sbae139","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Shame has been linked to the experience of psychosis, with implications for clinical outcomes, however, a meta-analysis of the relationship has not yet been conducted. This systematic review and meta-analysis aimed to examine the strength of the association between shame and psychosis, and any variations between clinical and non-clinical populations and shame type (internal vs external shame).</p><p><strong>Study design: </strong>Searches were conducted in CINAHL, EMBASE, PsycInfo, PubMed, Scopus, and Web of Science from the inception of the e-databases until July 2023. For inclusion, studies reported a quantitative association between psychosis and shame, or data that could be used to identify a relationship. From 11 372 unique retrieved records, 40 articles met the inclusion criteria and 38 were included in the meta-analyses.</p><p><strong>Study results: </strong>A significant large pooled estimate of the psychosis-shame association was identified (Zr = 0.36, [95% CI: 0.28, 0.44], P < .001), indicating that higher levels of shame were associated with greater severity of psychotic symptoms. The strength of the association was similar across clinical and non-clinical populations, however, differed by type of shame and psychosis symptom measured. External shame was strongly associated with paranoia suggesting possible confounding. Only a minority of studies met the highest quality criteria.</p><p><strong>Conclusions: </strong>Shame is strongly associated with the severity of psychotic symptoms in clinical and non-clinical populations. Given the overlap with paranoia, measurement of external shame alone is not advised. Larger studies in clinical populations, with measures of a range of psychosis symptoms, are needed to better understand the relationship between shame and specific symptoms.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1296-1311"},"PeriodicalIF":4.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036808","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":"Defining Urbanicity in the Context of Psychosis Research: A Qualitative Systematic Literature Review.","authors":"Franco Mascayano, Jiwon Lee, Xinyu Yang, Zeyu Li, Rodrigo Casanueva, Viviana Hernández, Javiera Burgos, Ana Carolina Florence, Lawrence H Yang, Ezra Susser","doi":"10.1093/schbul/sbae157","DOIUrl":"10.1093/schbul/sbae157","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Numerous studies have found that being born or raised in urban environments increases the odds of developing psychosis in Northern and Western Europe. However, available research from Southern Europe, Latin America, and Asia has reported null results. A limitation in most studies to date is the inadequate characterization of urban and rural life components that may contribute to varying psychosis risk across regions.</p><p><strong>Study design: </strong>To deepen our understanding of the different concepts and measures of urbanicity and related factors in psychosis research, we conducted a qualitative systematic literature review extracting information from studies published between 2000 and 2024.</p><p><strong>Study results: </strong>Sixty-one articles met the inclusion and exclusion criteria and were used in the thematic analysis. The analysis revealed that urbanicity lacked a single, coherent definition across studies and regions. Three major categories of themes were developed from the analysis: (1) Urbanicity comprises several interconnected constructs, (2) Urbanicity measurements vary between countries from the Global North and the Global South, and (3) Urbanicity operates through key neighborhood-level mechanisms.</p><p><strong>Conclusions: </strong>Future research on urbanicity and psychosis should consider the potential limitations of urbanicity's conceptualization and operationalization and aim to address these limitations by focusing on contextual, historical, and community-level factors, utilizing locally validated measures, and employing mixed-method designs.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1312-1327"},"PeriodicalIF":4.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406745","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":"\"Schizophrenia, Consciousness, and the Self\" Twenty Years Later: Revisiting the Ipseity-Disturbance Model and the Developmental Nature of Self-Disorder in the Schizophrenia Spectrum.","authors":"Andrea Raballo, Mads Gram Henriksen, Michele Poletti, Josef Parnas","doi":"10.1093/schbul/sbaf071","DOIUrl":"10.1093/schbul/sbaf071","url":null,"abstract":"<p><p>Self-disorders (SD) designate a pattern of non-psychotic anomalous self-experiences, which specifically aggregate in clinical and subclinical forms of schizophrenia spectrum disorders (SSD), including familial high-risk configurations. SD have been corroborated as a valuable, quantitatively tractable, trait phenotype for indexing genetic liability to SSD, and, as a risk phenotype, they offer critical insights into the nature of these complex conditions which precede and shape the development of more overt clinical manifestations (including schizotypal features and positive, negative, and disorganized symptoms). In the last three decades, the concept of self-disorders has evolved from early clinical observations to a well-defined research domain, offering a nuanced understanding of schizophrenia spectrum vulnerabilities and holding promise for improving diagnostic accuracy, enhancing prognostic assessments, offering novel targets for intervention, and advancing our understanding of the schizophrenia spectrum.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1187-1192"},"PeriodicalIF":4.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143486","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":"Interpretable LLM-Based Detection of Loose Associations Using Synthetic Speech Data in Early Psychosis.","authors":"Enrique Gutiérrez, Carlos Quesada, Emily DeFraites, Danielle J Harper, Amar D Mandavia","doi":"10.1093/schbul/sbaf125","DOIUrl":"https://doi.org/10.1093/schbul/sbaf125","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Loose Associations (LA) in speech are key indicators of psychosis risk, notably in schizophrenia. Current detection methods are hampered by subjective evaluation, small samples, and poor generalizability. We hypothesize that combining Large Language Models (LLMs) with machine learning techniques could enhance objective identification of LA through improved semantic and probabilistic linguistic measures.</p><p><strong>Study design: </strong>We propose a novel and reproducible workflow for generating synthetic conversational instances of LA using LLMs, guided by linguistic theory and validated through clinical expert review. This synthetic dataset forms the basis for model training and is complemented by an independently collected dataset for evaluation. Features extracted included traditional clause similarity measures alongside novel surprisal metrics quantifying semantic coherence and unexpected lexical shifts. A parsimonious and interpretable Light Gradient Boosting Machine model was trained using only four features.</p><p><strong>Study results: </strong>The final model achieved high accuracy (83.46%; 95% CI: 82.96-83.95) on the synthetic dataset and robust performance on an independent set (82.36%; 95% CI: 81.94-82.78, AUC: 0.868). Our model outperformed baselines, including similarity-only models and prior thought disorder detection workflows. SHapley Additive exPlanations analysis confirmed the interpretability of the selected features, highlighting semantic coherence and word surprisal as key discriminators.</p><p><strong>Conclusions: </strong>Our approach demonstrates that LLM-derived linguistic features substantially enhance the objective, scalable detection of LA. The resulting model achieves high accuracy with minimal complexity, facilitating clinical applicability and interpretability. Future research should integrate additional lexical and contextual dimensions to further refine the identification of thought disorders, ultimately supporting early psychosis intervention.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001448","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":"Psychosocial and Demographic Factors Associated with Physical Multimorbidity in Severe Mental Illness: A Systematic Review","authors":"Erin G Lawrence, Uzma Zahid, Abigail C Thomson, Robin Lau, Laura Havers, Federica Biotti, Monica Acosta Pereira, Mark C Freestone, Irene Gonzalez-Calvo, Brent Elliott, Kamaldeep Bhui, Georgina M Hosang","doi":"10.1093/schbul/sbaf128","DOIUrl":"https://doi.org/10.1093/schbul/sbaf128","url":null,"abstract":"Background and Hypothesis People with severe mental illness (SMI), such as schizophrenia and bipolar disorder have a reduced life expectancy. This is largely due to physical multimorbidity (MM), defined as the coexistence of two or more physical health conditions. This systematic review identifies which psychosocial and demographic factors are associated with MM in SMI. Study Design Embase, PubMed, and PsychINFO were searched with no limits on publication date or study design. Studies were eligible for inclusion if they assessed the impact of psychosocial and/or demographic factors on MM outcomes among people with SMI. Study Results Thirty studies met the inclusion criteria for this review. The strongest predictors of MM were childhood maltreatment (odds ratios [OR] up to 8.70 [95% CI 2.49-30.33]), female gender (OR up to 2.47 [95% CI 1.35-4.50]), older age (OR up to 1.60 [95% CI 1.31-1.96]), and ethnicity (e.g. OR up to 2.09 [95% CI 1.81-2.42] for Black Caribbean groups relative to White British groups). Predictors with mixed evidence included educational attainment, employment status, socioeconomic status, marital status, urbanicity, deprivation, country of origin, healthcare access, and global functioning. Conclusions The findings highlight psychosocial factors (e.g. childhood maltreatment) and demographic factors (e.g. older age) that may contribute to MM, which has strong clinical implications. Some factors are modifiable (e.g. education) and can inform risk prevention strategies for MM in SMI, mitigating risks of premature mortality. Future research should use consistent definitions of MM for cross-study comparisons and assess additional risk factors, their interactions, and underlying mechanisms.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"29 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144910989","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":"Predictors and Moderators of Long-Term Outcome of Persons at Clinical High Risk for Psychosis: Methods and Preliminary Data","authors":"Kristin S Cadenhead, Leda Kennedy, Heline Mirzakhanian, Jean Addington, Carrie E Bearden, Tyrone D Cannon, Ricardo E Carrión, Matcheri Keshavan, Daniel H Mathalon, Diana O Perkins, William Stone, Elaine F Walker, Scott W Woods","doi":"10.1093/schbul/sbaf133","DOIUrl":"https://doi.org/10.1093/schbul/sbaf133","url":null,"abstract":"Background and Hypothesis Despite significant advances in our understanding of the clinical high risk (CHR) for psychosis state, the longer-term outcomes (5+ years) and the trajectory of diagnoses, symptoms, and psychosocial function have been seldom investigated. Objective Here we describe the methods for “Predictors and Moderators of Long-Term Outcome of Persons at Clinical High Risk for Psychosis,” an ongoing study that is being conducted across North American Prodrome Longitudinal Studies sites that included n = 2184 past participants (1999-2018). Study Design The aims are to: (1) perform long-term assessments of individuals who previously met CHR criteria, (2) determine the 5+ year psychotic conversion rate and use previously collected longitudinal clinical, functional, neurocognitive, and biomarker data to predict longer term outcomes, and (3) investigate predictors of long-term clinical/functional outcome in CHR participants who did not convert to psychosis. Study Results Preliminary results from the first n = 504 participants demonstrate that 60% of those who previously met CHR criteria are still symptomatic. Eighteen percent of past participants converted to psychosis, half in the original studies and the remainder since last evaluated. Of those who converted to psychosis, the majority met criteria for an affective psychosis, consistent with the high rate of affective disorders (70%) in the non-converted group. An additional 7% of past participants died, substantially higher than the general population. Conclusions These early data highlight the potential of how this dataset, when combined with baseline data, can be used to answer new questions about the life course of high-risk youth and how we might intervene early to improve their long-term outcome.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"13 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144901647","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":"Late-Onset Neutropenia in Clozapine Users: Unrelated or Drug-Induced? A Case-Registry Analysis of Incidence, Characteristics, and Rechallenge Attempts","authors":"Aviv Segev, Risha Govind, Ebenezer Oloyede, Cecilia Casetta, Megan Pritchard, Amelia Jewell, Matthew Broadbent, Harsimran Kaur Makan, David Taylor, James MacCabe","doi":"10.1093/schbul/sbaf148","DOIUrl":"https://doi.org/10.1093/schbul/sbaf148","url":null,"abstract":"Background and Hypothesis Clozapine treatment carries a risk of blood dyscrasias (BD) and requires indefinite monitoring in many jurisdictions, a major factor in its under-utilization. Although previous studies suggest BD risk is highest early in treatment, BD events have also been reported after many years. This study compares early vs late (&amp;gt;6 months) suspected blood dyscrasias (SBD) and examines rechallenge outcomes as a marker for clozapine-related causation. Study Design A retrospective analysis of electronic health records from a large UK mental health service gathered demographic data, characteristics of SBD events, and outcomes of clozapine rechallenge, defined as reinitiation after SBD-related discontinuation. These variables were compared between early- and late-onset SBD groups using a 6-month treatment duration cutoff. Study Results Of 130 patients with SBD leading to clozapine cessation, 59 had early-onset SBD. The incidence rate before 6 months was 5.54% per year vs 0.53% after 6 months, reflecting an incidence rate ratio of 10.4. Early-onset patients were younger, received lower clozapine doses, and had fewer concurrent antipsychotics. Of 81 rechallenge attempts, 71 (87.7%) were successful, with a mean follow-up of 2.5 years. No significant differences in characteristics or rechallenge outcomes were found between the early- and late-onset groups. Conclusions Though less frequent, late-onset SBD shares similar characteristics with early-onset SBD and has a comparable risk of recurrence on clozapine rechallenge. Vast majority of clozapine rechallenges are successful, including early-onset BD, suggesting they are not clozapine-induced. However, clozapine-induced BD, defined by recurrence upon rechallenge, may rarely occur even after years of treatment.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"7 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898162","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":"Decoding Psychosis Risk: Neuroanatomical Correlates of the NAPLS-2 Calculator in the PRONIA Cohort.","authors":"Lisa-Maria Neuner, Clara Weyer, Lana Kambeitz-Ilankovic, Alexandra Korda, Dominic Dwyer, Linda A Antonucci, Joseph Kambeitz, Rachel Upthegrove, Raimo K R Salokangas, Jarmo Hietala, Christos Pantelis, Rebekka Lencer, Stephen J Wood, Paolo Brambilla, Stefan Borgwardt, Alessandro Bertolino, Georg Romer, Eva Meisenzahl, Udo Dannlowski, Peter Falkai, Tyrone D Cannon, Nikolaos Koutsouleris, Lisa Hahn","doi":"10.1093/schbul/sbaf135","DOIUrl":"https://doi.org/10.1093/schbul/sbaf135","url":null,"abstract":"<p><strong>Background: </strong>Identifying neuroanatomical correlates of clinical prediction models may offer pathophysiological insights into the clinical high-risk states for psychosis (CHR-P) and unveil new therapeutic targets for early intervention.</p><p><strong>Study design: </strong>We used the North American Prodrome Longitudinal Study (NAPLS-2) risk calculator to obtain psychosis risk scores for 315 CHR-P (M = 23.85, SD = ± 5.64; female: 164) and 295 recent-onset depression (M = 25.11, SD = ± 6.21; female: 144) patients from the Personalized Prognostic Tools for Early Psychosis Management (PRONIA) cohort. Voxel-based morphometry was employed to examine associations between risk scores, gray matter volume (GMV), and white matter volume (WMV). Post-hoc, we used eigenvariate extraction to explore network-level alterations associated with significant regions. Moderation analyses were conducted to understand the influence of individual NAPLS-2 risk variables on these networks (False Discovery Rate-corrected).</p><p><strong>Study results: </strong>Reduced hippocampal GMV (${k}_E$ = 847 voxels) and cerebellar WMV (${k}_E$ = 10 423 voxels) were associated with higher risk scores. Post-hoc analyses revealed parallel structural alterations between these regions and the entorhinal cortex, anterior cingulate cortex, thalamus, anterior limb of the internal capsule, and pons. Moderation analyses showed that family risk (first-degree relative with psychotic disorder), verbal memory, and social functioning significantly influenced structural patterns.</p><p><strong>Conclusions: </strong>Our results provide evidence for neuroanatomical correlates of the NAPLS-2 model, with alterations in hippocampal circuits suggesting a key prognostic role in the development of neurocognitive and psychosocial deficits across diagnostic boundaries. Future longitudinal studies incorporating multimodal imaging techniques should validate these findings as potential biomarkers for psychosis risk.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967219","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":"Digital Therapeutics for People with Schizophrenia Spectrum Disorders: A Systematic Literature Review of Their Effect on Symptoms and Functioning","authors":"Daniel Fulford, Christoph U Correll, Philip D Harvey, Alex S Cohen","doi":"10.1093/schbul/sbaf134","DOIUrl":"https://doi.org/10.1093/schbul/sbaf134","url":null,"abstract":"Background and Hypothesis Digital therapeutics (DTs; health software to treat/alleviate a disease/condition) may provide accessible evidence-based care to people with schizophrenia spectrum disorders (SSDs). This systematic literature review (SLR) investigated whether people with SSD find DTs acceptable and can use them effectively; whether DTs are effective and generally safe; and if DT use can impact functioning, quality of life (QoL), and other outcomes. Study Design This PROSPERO-registered SLR (CRD42023476545) was conducted to identify articles assessing DTs in adults with SSD. Databases (MEDLINE/Embase/PsycINFO/Cochrane-SR/ClinicalTrials.gov/WHO International Clinical Trials Registry) and key congresses were searched up to January 28, 2024. Screening was completed by 2 reviewers, each blinded to the other’s decisions, and article summaries were extracted. Study Results Of 886 unique citations, 115 eligible citations provided 38 unique primary studies with results and 10 linked citations. Engagement and satisfaction with DTs were generally high. Among 24 studies assessing the effectiveness of DT use on negative and positive symptoms, cognitive performance, mood, depression and/or anxiety, medication adherence, recovery, and general/other symptoms, 17 had ≥1 outcome showing significant change versus comparator/baseline; 24 had ≥1 outcome showing no significant difference. DTs were generally safe. Of 24 studies reporting real-world functioning, QoL, and other outcomes, 11 reported ≥1 significant outcome; 24 reported ≥1 outcome showing no difference versus comparator/baseline. Conclusions People with SSD can use DTs effectively and find them acceptable. Although effectiveness outcomes varied across/within studies, DTs may provide an acceptable strategy for delivering accessible, generally safe, evidence-based care to people with SSD.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"47 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898164","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":"Ketogenic Diet as Protection for Deprescribing Antipsychotics","authors":"Jann E Schlimme","doi":"10.1093/schbul/sbaf127","DOIUrl":"https://doi.org/10.1093/schbul/sbaf127","url":null,"abstract":"People with schizophrenia or schizoaffective disorder are almost always treated with continued use of antipsychotics. Tapering of antipsychotics is very often associated with a recurrence of symptoms within a year. This applies particularly to the final steps of reduction from very small doses. Ketosis seems to offer protection against psychotic relapses in these final steps. I report a case series that supports this thesis. Two effects of antipsychotics that disappear after discontinuation of the medication and can be replaced by ketosis could possibly be responsible for this: effects on the mesolimbic system against the background of insufficient GABAergic inhibition in the prefrontal cortex and mesolimbic system; effects on the microglia against the background of increased unspecific neuroinflammation.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"17 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898228","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}