Schizophrenia Bulletin最新文献

{"title":"Potential Delayed Positive Effects of tDCS on Improving Introspective Accuracy in Social Cognition in Schizophrenia","authors":"Linlin Fan, Emily Bass, Hans Klein, Cassi Springfield, Sven Vanneste, Amy E Pinkham","doi":"10.1093/schbul/sbaf014","DOIUrl":"https://doi.org/10.1093/schbul/sbaf014","url":null,"abstract":"Background and Hypothesis Impairments in introspective accuracy (IA) are prominent among schizophrenia patients and detrimentally affect daily functioning, making IA a potential therapeutic target. Recent research highlights the role of the right rostrolateral prefrontal cortex (rlPFC) in IA and suggests that transcranial direct current stimulation (tDCS) to this region may improve it. Therefore, we tested whether applying tDCS to the right rlPFC could enhance IA for schizophrenia patients and explored the potential order/delayed effects. Study Design A randomized, double-blind, sham-controlled crossover design was used. Patients with a schizophrenia spectrum disorder (N = 40) underwent 2 tDCS sessions targeting right rlPFC (one was active stimulation and the other was sham) about a week apart. After each session, participants completed executive function and emotion recognition tasks for evaluating IA. Study Results When ignoring order effects, tDCS did not affect performance, IA, or confidence ratings across 3 tasks, except for increased confidence ratings in the cognitive task after active stimulation versus sham. However, considering order effects revealed significant interaction effects between condition and order for both task performance and IA. The group receiving active stimulation at visit 1 (Active First) generally improved over time in both cognitive and social cognitive task performance and in social cognitive IA, specifically for emotion recognition ability. In contrast, the group receiving sham stimulation at visit 1 (Sham First) showed no change in performance or IA over time. Conclusions Our findings provide preliminary evidence for potential positive, but delayed, effects of tDCS in improving task performance and IA in schizophrenia.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"35 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546280","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":"Parent-Rated Schizotypy and Clinician-Rated Psychotic Experiences in Early Adolescence as Predictors of Schizophrenia Diagnosis by Middle Adulthood.","authors":"Kirstie J M O'Hare, Richie Poulton, Richard J Linscott","doi":"10.1093/schbul/sbad158","DOIUrl":"10.1093/schbul/sbad158","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Subclinical psychotic symptoms (also known as psychotic experiences comprising positive features only, and schizotypy comprising positive, negative, and disorganized features) are important markers of schizophrenia liability. Different assessment methods detect different sources of meaningful variance and are vulnerable to different biases and sources of measurement error. Whereas interview-rated psychotic symptoms in childhood are known to predict adult schizophrenia diagnosis, the predictive value of parent-rated psychotic symptoms remains unknown. We tested whether clinician-rated psychotic symptoms and parent-rated positive, negative, and disorganized schizotypy in early adolescence are nonredundant predictors of schizophrenia diagnosis by age 38 years.</p><p><strong>Study design: </strong>In a representative birth cohort (n = 1037) from Dunedin, New Zealand, psychotic symptoms were assessed by clinical interview at age 11 years, schizotypy was assessed by parent or caregiver ratings at ages 13- and 15 years, and lifetime schizophrenia diagnosis was assessed throughout adulthood until age 38 years. We tested for redundancy using bootstrapped multivariable logistic regression.</p><p><strong>Study results: </strong>Clinician-rated psychotic symptoms at age 11 predicted adult schizophrenia diagnosis (OR = 2.68, 95% CI = 1.42, 5.06), as did parent-rated total schizotypy (OR = 1.83, 95% CI = 1.42, 2.36). In univariable models, clinician-rated psychotic experiences and parent-rated positive, negative, and disorganized schizotypy were significant predictors of schizophrenia diagnosis. In multivariable models where clinician- and parent-rated scores were entered, only parent-rated negative and disorganized schizotypy did not predict adult schizophrenia diagnosis.</p><p><strong>Conclusions: </strong>Parent-rated schizotypy and clinician-rated subclinical psychotic symptoms are valid, nonredundant indicators of lifetime risk for schizophrenia.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"51 Supplement_2","pages":"S107-S114"},"PeriodicalIF":5.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557890","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":"Genetic Susceptibility to the Environment Moderates the Impact of Childhood Experiences on Psychotic, Depressive, and Anxiety Dimensions.","authors":"Neus Barrantes-Vidal, Pilar Torrecilla, Patricia Mas-Bermejo, Sergi Papiol, Marian J Bakermans-Kranenburg, Marinus H van IJzendoorn, Alexia Jolicoeur-Martineau, Thomas R Kwapil, Araceli Rosa","doi":"10.1093/schbul/sbad130","DOIUrl":"10.1093/schbul/sbad130","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Gene-by-environment (GxE) studies in psychosis have exclusively focused on negative exposures. However, evidence supports the resilience-enhancing effect of positive factors on psychosis outcome. The Differential Susceptibility (DS) model proposes that common genetic variants may confer not only disproportionate responsiveness to negative environments, but also greater sensitivity to positive, resilience-enhancing conditions. This study is the first to apply the DS model to the expression of subclinical psychosis, employing polygenic risk scores of environmental sensitivity (PRS-ES). PRS-ES were hypothesized to moderate, in a DS manner, associations between childhood adversity and psychosis, affective, and anxiety dimensions in young adults. An exploratory goal examined whether PRS for psychotic-like experiences (PRS-PLE) also showed DS patterns.</p><p><strong>Study design: </strong>PRS, schizotypy, PLE, depression, anxiety, and childhood adversity ratings were obtained for 197 nonclinical young adults. LEGIT software for testing competitive-confirmatory GxE models was employed.</p><p><strong>Study results: </strong>Results largely supported DS: Individuals high on PRS-ES showed increased subclinical psychosis, depression, and anxiety if they had experienced elevated childhood adversity, and lower symptoms if exposed to low levels of adversity as compared with those with low PRS-ES. Similarly, PRS-PLE moderated the effect of adversity on PLE, positive schizotypy, and depression following the DS model, but only PRS-ES moderation on PLE survived statistical correction.</p><p><strong>Conclusions: </strong>Our results suggest that genetic DS to the environment is relevant to psychosis, depression, and anxiety. Current debates on reconceptualization of genetic \"risk\" and resilience may benefit from this insight that support optimistic views on preventative efforts for early detection and intervention.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"51 Supplement_2","pages":"S95-S106"},"PeriodicalIF":5.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557887","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":"Neuroscience of Schizotypy: A Translational Perspective From Phenotype to Genetics and Brain Networks.","authors":"Igor Nenadić","doi":"10.1093/schbul/sbaf008","DOIUrl":"10.1093/schbul/sbaf008","url":null,"abstract":"","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"51 Supplement_2","pages":"S61-S63"},"PeriodicalIF":5.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557888","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":"Is it Possible To Identify Patients After Their First Hospitalization for a Psychotic Disorder Who Do Not Use Anti-Psychotics and are Not Later Rehospitalized?","authors":"Amir Krivoy, Jari Tiihonen, Johnatan Nissan, Arad Dotan, Dana Arnheim, Noa Menkes-Caspi, Sharon Taub, Heli Tuppurainen, Ellenor Mittendorfer-Rutz, Michael Davidson, John M Davis, Mark Weiser, Heidi Taipale","doi":"10.1093/schbul/sbaf011","DOIUrl":"https://doi.org/10.1093/schbul/sbaf011","url":null,"abstract":"<p><strong>Background: </strong>Guidelines issued by professional organizations recommend that all patients with psychotic disorders who have had several psychotic relapses, continue maintenance anti-psychotic treatment. However, some patients discontinue anti-psychotics and do not later relapse. This study attempted to characterize those patients with psychotic disorders early in their disease not taking maintenance antipsychotics, who were not later hospitalized.</p><p><strong>Study design: </strong>This population-based cohort study combined registry data on patients diagnosed in their first psychotic episode (ICD 10 code: F20-29) from Sweden (n = 20 848), and Israel (n = 10 045), and followed them for up to 7 years for re-hospitalization or death. Multivariate analyses assessed sociodemographic and clinical risk factors predicting rehospitalization or death in patients with one hospitalization and did not fill prescriptions for antipsychotics; results from Sweden and Israel were then meta-analyzed.</p><p><strong>Study results: </strong>The main analysis of this paper included 1611 patients from Sweden and 1607 from Israel. Male gender (adjusted hazard ratio [aHR], 1.57; 95% confidence interval [CI], 1.16-2.13) and a diagnosis of narrowly defined schizophrenia (F20.0-F20.9; aHR, 1.85; 95% CI, 1.55-2.2) were associated with increased risk of a second hospitalization or death among those who did not use antipsychotics. No sociodemographic or clinical characteristics were associated with a decreased risk of a second hospitalization or death.</p><p><strong>Conclusions: </strong>Based on registry data, it was not possible to characterize, in a clinically meaningful way, those patients who can safely discontinue anti-psychotic medications and not be re-hospitalized or die. Male gender and a diagnosis of narrowly defined schizophrenia were associated with an increased risk of later relapse.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469005","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":"Considerations for Streamlining the Pathway Toward Approval of a Cognition Enhancer for Schizophrenia","authors":"Keith H Nuechterlein, Michael F Green, Stephen R Marder","doi":"10.1093/schbul/sbae190","DOIUrl":"https://doi.org/10.1093/schbul/sbae190","url":null,"abstract":"Given the difficulties of developing cognitive enhancers for schizophrenia and demonstrating their efficacy, we welcome a review of the measurement procedures and the clinical trial design recommendations developed through the collaboration of academics, industry, National Institute of Mental Health (NIMH), and U.S.A. Food and Drug Administration (FDA) representatives during the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) process. We provide a perspective from investigators who helped to lead the MATRICS initiative. We acknowledge some of the practical challenges in the use of the MATRICS Consensus Cognitive Battery (MCCB) while pointing out that others are overstated. We suggest that a brief MCCB might be used in phase III trials when phase II results had shown no negative impact on any MCCB cognitive domain. The complexities of requiring a functional co-primary measure are discussed. For clinical trial research design to evaluate monotherapies that might have both antipsychotic and cognition-enhancing properties, we agree that the original MATRICS design recommendations may need to be revised, as those recommendations focused on the evaluation of potential adjunctive cognitive enhancers. Horan et al provide a thoughtful summary of the current challenges in obtaining approval for a new drug designed to enhance cognition in schizophrenia.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"65 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470668","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":"Towards Enhancing Drug Development Methodology to Treat Cognitive Impairment Associated With Schizophrenia and Other Neuropsychiatric Conditions: Insights From 2 Decades of Clinical Trials","authors":"William P Horan, Amir Kalali, Stephen K Brannan, Wayne Drevets, Matthew Leoni, Atul Mahableshwarkar, William J Martin, Srinivas Rao, Corey Reuteman-Fowler, Colin Sauder, Adam Savitz, Jaskaran Singh, Jane Tiller, Gary Walker, Jens R Wendland, Philip D Harvey","doi":"10.1093/schbul/sbae151","DOIUrl":"https://doi.org/10.1093/schbul/sbae151","url":null,"abstract":"Cognitive impairment is a core feature and leading cause of functional disability in schizophrenia and other neuropsychiatric disorders. The Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative in the early 2000s marked a pivotal moment for drug development, establishing consensus on methodology for treatment studies, including assessment strategies and trial designs, for cognitive impairment associated with schizophrenia (CIAS). Despite extensive industry-sponsored and academic drug development efforts over the last 2 decades using these strategies no pharmacological treatments have been approved for CIAS. Drawing on pharmaceutical industry experience and scientific developments since the MATRICS initiative, we review lessons learned about the practical and operational complexities of conducting large-scale CIAS clinical trials. Based on this collective experience, we identify elements of the MATRICS guidelines that may warrant reconsideration and suggest some new approaches to streamline the drug development pathway, without weakening standards for evidence. Our goal is to initiate an open exchange among all stakeholders about possible enhancements to drug development methodology that optimize our ability to develop new treatments for cognitive impairment in schizophrenia and other neuropsychiatric disorders.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"30 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470693","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":"Twenty Years of the NIMH Measurement and Treatment Research to Improve Cognition in Schizophrenia.","authors":"James Gold","doi":"10.1093/schbul/sbae230","DOIUrl":"10.1093/schbul/sbae230","url":null,"abstract":"","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472911","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":"Impact of Early Auditory Processing on Negative Symptom Response to Cognitive Remediation for Schizophrenia.","authors":"Alice M Saperstein, Ryan Brennan, Min Qian, Daniel C Javitt, Alice Medalia","doi":"10.1093/schbul/sbaf017","DOIUrl":"https://doi.org/10.1093/schbul/sbaf017","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Early auditory processing (EAP) has increasingly become a focus of efforts to identify markers of treatment response in people with schizophrenia spectrum disorders. Assessment of baseline need provides an opportunity for cognitive remediation (CR) programs that include EAP training to personalize treatment and optimize its impact. CR has been shown to help reduce negative symptoms, but less is known about how EAP tailoring may influence this relationship. This study hypothesized a differential benefit of EAP training on negative symptom reduction for those with and without baseline EAP deficits as defined by performance on the Tone Matching Test.</p><p><strong>Study design: </strong>150 outpatient adults diagnosed with schizophrenia or schizoaffective disorder were classified as having intact (44.7%) or impaired (55.3%) EAP and were randomly assigned to CR that either included EAP training (N = 77) or did not (N = 73). Negative symptom improvement was measured via the Positive and Negative Syndrome Scale posttreatment and 3 months later.</p><p><strong>Study results: </strong>CR resulted in significant negative symptom improvement in the sample overall. Only EAP impaired participants demonstrated significant negative symptom benefit from EAP training. EAP impaired participants who did not receive embedded auditory training had near-zero reductions in negative symptom severity.</p><p><strong>Conclusions: </strong>These findings extend prior research on cognitive remediation as treatment for negative symptoms in people with schizophrenia spectrum disorders. Accumulating evidence suggests that routine assessment of EAP is critical for personalizing and optimizing a response to CR that is clinically significant for both cognitive and negative symptoms.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472909","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":"Plasma Metabolic Characteristics and Potential Biomarker Combinations in Schizophrenia Patients With Tardive Dyskinesia.","authors":"Chenghao Lu, Yeqing Dong, Dan Qi, Nannan Liu, Yanzhe Li, Jinghui Chi, Xinxu Wang, Min Zeng, Feng Liu, Shen Li, Jie Li","doi":"10.1093/schbul/sbaf006","DOIUrl":"https://doi.org/10.1093/schbul/sbaf006","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>The pathogenesis of tardive dyskinesia (TD) remains unclear, involving multiple biological pathways. This study aimed to explore biomarkers of TD through untargeted metabolomics for the early identification of TD.</p><p><strong>Study design: </strong>This study recruited 84 schizophrenia (SZ) patients with TD and 160 SZ patients without TD. TD diagnosis was based on the Schooler-Kane criteria, and the severity of TD and psychiatric symptoms were assessed using the Abnormal Involuntary Movement Scale and the Positive and Negative Syndrome Scale. Fasting blood samples were collected from all patients and subjected to untargeted metabolomics analysis using Ultra-high-performance liquid chromatography-high resolution mass spectrometry, allowing for the quantification and profiling of 699 metabolites. Data were analyzed with orthogonal partial least squares discriminant analysis, and receiver-operating characteristic curves.</p><p><strong>Study results: </strong>In TD, 57 metabolites exhibited significant changes (variable importance of projection > 1, false discovery rate-adjusted P < .05), primarily involving amino acids and lipids. These changes predominantly affected the phenylalanine, tyrosine, and tryptophan pathway (impact = 0.5, P = .0252), as well as the phenylalanine metabolism pathway (impact = 0.36, P = .0498). N-Acetyl-l-phenylalanine (B = 2.249, t = 4.56, P < .001, 95% CI, 1.302-3.286) and Succinylcarnitine (AcCa(4:0-DC)) (B = 1.009, t = 3.07, P = .002, 95% CI, 0.362-1.656) are negatively related to the total abnormal involuntary movement scale score. Additionally, 5 differential metabolites had area under the curve (AUC) values greater than 0.7 for diagnosing TD, with the combined diagnostic capability exceeding 0.8 (AUC = 0.817, 95% CI, 0.759-0.875).</p><p><strong>Conclusions: </strong>In TD, disruptions in amino acid and lipid metabolism were predominantly observed. Amino acids and lipid metabolites may be involved in the development of TD. Additionally, a biomarker panel composed of amino acids and lipids can be used for the differential diagnosis of TD.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469010","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}