Schizophrenia Bulletin最新文献

{"title":"Relational Memory in Psychosis: Learning Trajectories and Associative Inference.","authors":"Aslıhan İmamoğlu, Suzanne Avery, Kristan Armstrong, Stephan Heckers","doi":"10.1093/schbul/sbaf188","DOIUrl":"10.1093/schbul/sbaf188","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Schizophrenia is characterized by relational memory impairments that disrupt the ability to form novel inferences based on prior knowledge. The current study examined three aspects of relational memory impairments in psychosis. First, do relational memory deficits reflect specific difficulties in learning across repeated exposures? Second, can associative inference deficits be explained by a more general deficit in paired associate learning? Third, are relational memory deficits specific to schizophrenia or do they extend to affective psychosis?</p><p><strong>Study design: </strong>We studied persons with schizophrenia spectrum disorders (n = 244), persons with affective psychosis (n = 77), and healthy control participants (n = 186) with the Associative Inference Paradigm. Participants learned overlapping (A-B, B-C) and non-overlapping (D-E) pairs across multiple training blocks and were later tested on both directly studied (e.g., D-E) and inferred (i.e., A-C) associations.</p><p><strong>Study results: </strong>Persons with psychosis exhibited slower learning, a lower learning ceiling, and increased forgetting when compared to healthy control participants. Critically, associative inference impairments were disproportionally greater in schizophrenia and persisted even after accounting for paired-associate learning deficits.</p><p><strong>Conclusions: </strong>Our results reveal that relational memory impairments in psychosis reflect difficulties in learning and retaining associations and that their integration, necessary to form novel inferences, is especially impaired.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145392592","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":"Testing the Transportability of the Psychosis Metabolic Risk Calculator in Canada (Quebec): International External Validation Study.","authors":"Sébastien Brodeur, Olivier Corbeil, Laurent Béchard, Maxime Huot-Lavoie, Charles Desmeules, Dominic Oliver, Andrea De Micheli, Emanuele F Osimo, Rachel Upthegrove, Golam M Khandaker, Graham K Murray, Fanny Lajeunesse-Trempe, Gloria Cheung, Josiane Courteau, Chantale Thériault, Marc-André Roy, Marie-France Demers, Benjamin I Perry","doi":"10.1093/schbul/sbaf174","DOIUrl":"10.1093/schbul/sbaf174","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Cardiometabolic morbidity largely explains premature mortality in people with psychotic disorders and is detectable from psychosis onset. Currently, no accurate cardiometabolic risk prediction tool exists for young people with first-episode psychosis (FEP). The Psychosis Metabolic Risk Calculator (PsyMetRiC) aims to bridge this gap, but its accuracy and potential clinical usefulness in North American populations remain unverified.</p><p><strong>Study design: </strong>The external validity of PsyMetRiC, developed in the United Kingdom to predict the risk of incident metabolic syndrome (MetS) up to 6 years after a FEP, was assessed using the data from the Quebec Psychosis Early Intervention Clinic. PsyMetRiC comprises 2 penalized logistic regression models: a full-model including age, sex, ethnicity, body mass index (BMI), smoking status, prescription of metabolically-active antipsychotic medication, high-density lipoprotein (HDL), and triglyceride concentrations; and a partial-model excluding biochemical predictors. Patients aged 16-35 years, diagnosed with FEP between 2004 and 2023 without pre-existing MetS, and with>12 months follow-up were included. Predictive performance of PsyMetRiC was assessed by discrimination (C-statistic), calibration (calibration plots), and clinical usefulness (decision curve analysis). The race and ethnicity predictor was refined to better represent the North American population.</p><p><strong>Study results: </strong>Among 559 included patients (mean age 24.1 years ±4.1; 22.5% female), 18.2% developed MetS during a mean follow-up of 1.7 ± 1.3 years. Compared with the UK development cohort, the Canadian sample exhibited a higher BMI, lower HDL cholesterol, lower triglycerides, lower blood glucose, and lower systolic blood pressure. Discrimination performance was acceptable (full model C = 0.74, 95% CI, 0.70-0.77; intercept = 0.225; slope = 1.278; partial model C = 0.70, 95% CI, 0.67-0.74; intercept = -0.555; slope = 0.993). After updating the model with a race and ethnicity predictor calibrated to locally representative categories, performance improved slightly (full model C = 0.74, 95% CI, 0.71-0.77; intercept = 0.000; slope = 1.001; partial model C = 0.71, 95% CI, 0.68-0.74; intercept = 0.001; slope = 1.005).</p><p><strong>Conclusions: </strong>This study provides the first external validation of PsyMetRiC in a North American sample. Further research is essential before routine clinical implementation, but PsyMetRiC offers promise as a tool for early detection of cardiometabolic risk in early psychosis, guiding personalized treatments to diminish long-term physical health impacts.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373082","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":"Protein Disulfide Isomerase A3, a Stress Response Gene, Is Associated with Cognitive Impairment in Schizophrenia and Linked to Inflammatory Activation.","authors":"Xi Su, Xiaoyun Fan, Jinming Li, Ranran Li, Jiewei Liu, Yongfeng Yang, Meng Song, Minglong Shao, Yong Han, Qing Liu, Luwen Zhang, Chuansheng Wang, Luxian Lv, Wenqiang Li","doi":"10.1093/schbul/sbaf194","DOIUrl":"10.1093/schbul/sbaf194","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Protein disulfide isomerase A3 (PDIA3), a critical regulator of endoplasmic reticulum stress, was identified as a risk gene in schizophrenia (SZ). This implies the role of PDIA3 in SZ-associated immune dysregulation.</p><p><strong>Study design: </strong>We integrated Psychiatric Genomics Consortium and PsychENCODE expression quantitative trait loci data, employing summary data-based Mendelian randomization analyses to investigate PDIA3-SZ associations. Clinical characterization and C-reactive protein (CRP)-based inflammatory profiling were analyzed in people with SZ categorized by PDIA3 genotypes. Plasma PDIA3 levels were quantified and correlated with clinical profiles, CRP concentrations, and white matter density. Hierarchical linear regression with mediation modeling characterized PDIA3-CRP-cognitive interactions. Finally, LOC14 (a PDIA3 inhibitor) was administered in mice to elucidate its role in SZ-related pathobiology.</p><p><strong>Study results: </strong>PDIA3 was identified as a robust SZ risk factor, and people with SZ carrying the risk A allele of rs7174732 in PDIA3 gene exhibit more severe cognitive impairment and a trend toward higher plasma CRP levels. Plasma PDIA3 in people with SZ was positively correlated with cognition and white matter density of the hippocampus, and negatively correlated with CRP levels. Furthermore, decreased plasma PDIA3 level in people with SZ was a significant predictor of worse working memory, and CRP acted as a mediator with an 16.2% effect. Inhibition of PDIA3 in mice was associated with increased anxiety, impaired cognition, and increased power in low-frequency signals in vivo, alongside activated inflammatory responses and regulated SZ-related biological pathways.</p><p><strong>Conclusions: </strong>We established a PDIA3-CRP-cognitive interaction network in SZ.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401680","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":"Resilience Pathways in Psychosis.","authors":"Sophia Vinogradov","doi":"10.1093/schbul/sbaf190","DOIUrl":"10.1093/schbul/sbaf190","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Risk factors for psychosis spectrum disorders have been studied for many years, but recent research has begun to focus on resilience factors that protect against illness onset and mitigate illness course. Understanding resilience pathways will help us to apply interventions that can prevent psychosis and/or significantly improve illness trajectory.</p><p><strong>Study design: </strong>Recent studies emphasize two complementary approaches for identifying resilience pathways: (1) At the population genetics level-by examining how the effect of psychosis risk genes may be counterbalanced by genetically determined resilience factors with identifiable mechanisms of action; and (2) At the individual trajectory level-by determining what protects against transitioning into psychosis for high-risk individuals or against worse outcomes for those with established illness.</p><p><strong>Study results: </strong>Findings from distinctly different research approaches converge on the brain's neurocognitive, social cognitive, and metacognitive capacities as key resilience factors for psychosis spectrum disorders.</p><p><strong>Conclusions: </strong>Neurocognitive, social cognitive, and metacognitive capacities-as experienced within an individual's social context-can buffer the effects of stress exposure on vulnerable individuals by enabling adaptive behavioral strategies and modulating maladaptive neurophysiologic responses. Resilience-promoting interventions that target these factors include: fostering safe and supportive social contexts for individuals at risk for or experiencing psychosis; developing their cognitive health knowledge and interpersonal skills; applying scalable interventions to improve cognition and social cognition; and offering resilience training focused on metacognitive strategies.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"52 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128509","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":"Can We Detect the Undetected? Comparing the Prodromes of Individuals with First Episode Psychosis Detected and Undetected by Clinical High-Risk for Psychosis Services: An Electronic Health Record Study.","authors":"Maisie Inns, Madison Gill, Maite Arribas, Yanakan Logeswaran, Amedeo Minichino, Thomas J Reilly, Andrea De Micheli, Jai L Shah, Philip McGuire, Paolo Fusar-Poli, Dominic Oliver","doi":"10.1093/schbul/sbaf201","DOIUrl":"10.1093/schbul/sbaf201","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>The majority of first episode psychosis (FEP) patients are undetected (DET-) by clinical high-risk for psychosis (CHR-P) services prior to onset and therefore do not receive preventive care for psychosis. We compared features of the psychosis prodrome (symptoms and substance use) between DET- and FEP patients detected by CHR-P services (DET+) to determine whether they share a common prodromal phase.</p><p><strong>Study design: </strong>Retrospective Reporting of Studies Conducted Using Observational Routinely Collected Health Data statement-compliant electronic health record cohort study. We extracted 65 prodromal features (symptoms and substance use before FEP onset) using natural language processing to assess the presence, duration, and first presentation of the psychosis prodrome and occurrences of features across the prodrome. Duration and feature occurrences were compared between DET+ and DET- individuals using Mann-Whitney U tests and Wilcoxon Effect Size, while presence and first presentation were compared using logistic regression.</p><p><strong>Study results: </strong>A total of 1545 FEP patients (n = 119 DET+ [mean age 28.7 years; SD = 9.4; 61.6% male]) were included. There were no significant differences in the presence (DET + =85.0%, DET- = 85.6%, P = .83) or duration (DET + =18.8 months, DET- = 18.4 months, P = .89) of the psychosis prodrome. There were no significant differences in first presentation of psychotic symptoms between groups (Pcorr > .05). Frequency of occurrences of thought broadcasting (r = 0.07, Pcorr = .04) was higher and hostility (r = 0.08, Pcorr = .04) lower in DET+ compared to DET- across the prodrome, though effect sizes were small.</p><p><strong>Conclusions: </strong>DET+ and DET- individuals experience similar psychosis prodromes prior to FEP onset. DET- individuals can likely be identified earlier if detection strategies are improved.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565149","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":"Prevalence, Correlates, and Treatment Gap of Schizophrenia Among Adults in Bangladesh: Findings From a Nationwide Household Survey.","authors":"Ahsan Aziz Sarkar, Md Faruq Alam, Mohammad Tariqul Alam, Helal Uddin Ahmed, Niaz Mohammad Khan, Munshi Mohammad Jalal Uddin","doi":"10.1093/schbul/sbaf195","DOIUrl":"10.1093/schbul/sbaf195","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Schizophrenia contributes significantly to the global burden of disease; however, the data from low- and middle-income countries (LMICs) remain limited. Bangladesh, characterized by distinct sociodemographic and nutritional risk patterns, provides a critical context for understanding the epidemiology of schizophrenia in such settings. We hypothesized that the prevalence of schizophrenia would be higher among individuals residing in rural areas and those with lower levels of education and economic status.</p><p><strong>Study design: </strong>We conducted a cross-sectional, nationwide household (HH) survey as part of the Bangladesh National Mental Health Survey 2019. A stratified, multi-stage random sampling approach was used to recruit 7270 adults aged 18 years and older. Participants were initially screened using the 24-item Self-Reporting Questionnaire. Those screening positive underwent diagnostic assessment by trained psychiatrists using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria.</p><p><strong>Study results: </strong>The weighted prevalence of schizophrenia among adults was 0.6% (95% confidence interval: 0.4%-0.9%). Multivariate analyses revealed that schizophrenia was significantly associated with unemployment, a family history of mental illness, a family history of suicidal behavior and being divorced or separated. The prevalence did not differ between age, sex, residence (urban vs. rural), income, or educational level. Among individuals diagnosed with schizophrenia, 39.3% had received treatment.</p><p><strong>Conclusions: </strong>This study provides the first nationwide HH survey data on schizophrenia in Bangladesh, identifying familial and marital disruptions as key correlates. These findings challenge commonly held assumptions about urbanicity and socioeconomic disadvantage as risk factors in LMIC contexts and highlight the urgent need to address the treatment gap.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422543","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":"Olanzapine Dosing in Women with First-Episode Psychosis: An Age-Based Proxy for Menopausal Status.","authors":"Tara Burke, Karen O'Connor, Iris E Sommer, Dolores Keating, Richard Duffy, Anne Doherty, Brian O'Donoghue","doi":"10.1093/schbul/sbag156","DOIUrl":"10.1093/schbul/sbag156","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Some women experience their first episode of psychosis (FEP) in mid-to-later life, including around menopause. Emerging evidence suggests reduced treatment response at this time. However, menopause is rarely considered in treatment guidelines. This study examined whether women experiencing FEP after menopause were prescribed higher olanzapine doses than younger women, using age as a proxy for menopausal status.</p><p><strong>Study design: </strong>A population-based cohort of individuals aged 18-64 presenting with FEP to a Dublin mental health service over 18 years was analyzed. Participants who received an adequate olanzapine trial (≥6 weeks) for FEP were included. Women were stratified by age: <51 years (assumed premenopausal) and ≥51 years (assumed postmenopausal). Mean maximum daily olanzapine doses were compared. Analyses were repeated in men.</p><p><strong>Study results: </strong>Of 396 individuals presenting with FEP, 218 met inclusion criteria. Women aged ≥51 (n = 16) received higher olanzapine doses compared to younger women (n = 78) (15.3 mg ± 6.4 vs 12.4 mg ± 5.4; mean difference 2.9 mg, 95% CI, -0.10 to 5.99, one-sided P = .029, d = 0.53). No age-related dose differences were observed in men (n = 124).</p><p><strong>Conclusions: </strong>Women presenting with FEP after assumed menopause were prescribed higher olanzapine doses than younger women. This finding should be interpreted cautiously due to the small sample size and inference of menopausal status from age. However, this aligns with emerging evidence suggesting antipsychotic response may reduce following menopause. If replicated, these findings may have important clinical implications for guiding psychosis treatment in mid-life women.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"52 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813895","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":"Mapping 20-Year Global Functioning Trajectories in Schizophrenia Spectrum Disorders.","authors":"Manuel Abella, Helene Gjervig Hansen, Carsten Hjorthøj, Nikolai Albert, Trine Madsen, Merete Nordentoft, Marie Starzer","doi":"10.1093/schbul/sbag117","DOIUrl":"10.1093/schbul/sbag117","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is a leading cause of disability worldwide. Functional outcomes vary widely across individuals, yet evidence on long-term functional trajectories is scarce. We aim to identify 20-year trajectories of global functioning, examine baseline predictors of trajectory membership, and explore distal outcomes.</p><p><strong>Study design: </strong>Three hundred seventy-six participants with a first-episode schizophrenia spectrum disorder from the OPUS randomized controlled trial were included. We applied Latent Growth Mixture Models to identify distinct trajectories of global functioning over 20-years, tested baseline variables as predictors of trajectory membership, and 20-year clinical, cognitive, and quality-of-life outcomes were mapped to explore the distal consequences of following each trajectory.</p><p><strong>Study results: </strong>Three functional trajectories emerged: Functional recovery (21%), maintaining high functioning; Moderate improvement group (37%), with initial gains and later decline; and Impaired functioning group (42%), showing persistent disability. Membership in the impaired trajectory was predicted by the following baseline variables: male sex, older age, schizophrenia diagnosis, higher negative symptom, and not completing high school. At the 20-year follow-up, individuals in the Functional recovery trajectory demonstrated the most favorable outcomes, while those in the Impaired functioning trajectory exhibited the poorest outcomes across all key domains-symptom remission, cognitive performance, psychological quality of life, self-perceived general health, substance use, and suicide ideation.</p><p><strong>Conclusions: </strong>The absence of significant improvement over 2 decades for many patients is alarming and highlights the limitations of current treatment approaches in modifying the functional course of these patients.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"52 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913398","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":"Stress and Sleep Dynamics in Young Adults with Psychotic-Like Experiences Across Daily Life.","authors":"Błażej Misiak, Paulina Bagrowska, Jerzy Samochowiec, Łukasz Gawęda","doi":"10.1093/schbul/sbag104","DOIUrl":"10.1093/schbul/sbag104","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Psychotic-like experiences (PLEs) confer increased risk for adverse mental health outcomes. Sleep disturbances are associated with PLEs, yet evidence largely relies on retrospective assessments and average sleep parameters, limiting insight into daily-life dynamics. Moreover, the roles of stress exposure in sleep-PLEs associations remain insufficiently understood. This study aimed to address these gaps by examining sleep characteristics, momentary stress, and childhood trauma in relation to PLEs using experience sampling. We hypothesized that individuals with PLEs show poorer and more variable sleep, bidirectional sleep-PLEs associations, stronger stress-related sleep disturbances, and trauma-related alterations in sleep regulation.</p><p><strong>Study design: </strong>Altogether, 99 individuals with PLEs and 102 controls completed the experience sampling across 7 consecutive days.</p><p><strong>Study results: </strong>Individuals with PLEs reported poorer average sleep quality, shorter sleep duration, and greater variability in sleep quality, although differences in sleep quality and its variability were attenuated after adjustment for negative affect. Within the PLEs group, sleep quality, but not sleep duration, showed robust bidirectional within-person associations with PLEs. Daily stress fluctuations were not associated with next-morning sleep, whereas higher between-person stress exposure was related to poorer average sleep quality, with no moderation by PLEs group status. Childhood trauma was not significantly associated with sleep outcomes.</p><p><strong>Conclusions: </strong>Reduced sleep duration might be a stable feature of PLEs independent of negative affect, while sleep quality is dynamically linked to momentary PLEs. Sleep disturbances in individuals with PLEs seem more closely related to symptom dynamics than to momentary stress and distal developmental risk factors.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"52 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851574","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":"Positive and Negative Symptoms Changes in Schizophrenia Patients on Antipsychotic Treatment: a Systematic Review and Dose-Response Meta-analysis.","authors":"Xiao Lin, Spyridon Siafis, Jing Tian, Hui Wu, Christoph U Correll, Johannes Schneider-Thoma, Stefan Leucht","doi":"10.1093/schbul/sbag077","DOIUrl":"10.1093/schbul/sbag077","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Positive and negative symptoms are core features of schizophrenia and key indicators of antipsychotic efficacy. We aimed to explore the relationship between antipsychotic doses and changes in positive/negative symptoms.</p><p><strong>Study design: </strong>We reviewed the Cochrane Schizophrenia Group register (updated on July-26-2024) and prior systematic reviews to identify fixed-dose randomized controlled trials that assessed the monotherapy effects of 21 antipsychotic drugs in acute schizophrenia. The primary outcome measure was the average change in positive and negative symptoms from the studies' baseline to endpoint, calculated using standard mean differences as the effect size metric. Dose-response relationships were analyzed using random-effects meta-analyses with restricted cubic splines.</p><p><strong>Study results: </strong>Finally, a total of 165 studies were identified. 112 studies with 385 dose arms (37 096 participants) reported positive or negative symptoms and were evaluated in meta-analyses. Most antipsychotics showed parallel dose-response curves for positive and negative symptoms, with a smaller magnitude of effect on negative symptoms-except a few drugs, in particular partial dopamine agonists which had at least equal effect sizes for positive and negative symptoms. In most cases both curves declined until reaching an inflection point, then plateaued or efficacy decreased.</p><p><strong>Conclusions: </strong>The effects of antipsychotics on negative symptoms are smaller than those on positive symptoms, at least in studies of mostly acutely exacerbated patients. Nevertheless, the dose-response curves for both types of symptoms are relatively parallel. This information can assist clinicians in dosing antipsychotics and has implications for the understanding of the antipsychotic mechanism.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"52 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851528","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}