Schizophrenia Bulletin最新文献

{"title":"Vocal Markers of Schizophrenia: Assessing the Generalizability of Machine Learning Models and Their Clinical Applicability.","authors":"Alberto Parola, Emil Trenckner Jessen, Astrid Rybner, Marie Damsgaard Mortensen, Stine Nyhus Larsen, Arndis Simonsen, Jessica Mary Lin, Yuan Zhou, Huiling Wang, Katja Koelkebeck, Konstantinos Sechidis, Vibeke Bliksted, Riccardo Fusaroli","doi":"10.1093/schbul/sbaf124","DOIUrl":"10.1093/schbul/sbaf124","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Machine learning (ML) models have been argued to reliably predict diagnosis and symptoms of schizophrenia based on voice data only. However, it is unclear to what extent such ML markers would generalize to different clinical samples and different languages, a crucial assessment to move toward clinical applicability. In this study, we systematically assessed the generalizability of current ML models of vocal markers of schizophrenia across contexts and languages.</p><p><strong>Study design: </strong>We trained models relying on a large cross-linguistic dataset (Danish, German, Chinese) of 217 patients with schizophrenia and 221 controls, and used a conservative pipeline to minimize overfitting. We tested the models' generalizability on: (Q1) new participants, speaking the same language; (Q2) new participants, speaking a different language; (Q3-Q4) further, we assessed whether training on data with multiple languages would improve generalizability using Mixture of Expert (MoE) and multilingual models.</p><p><strong>Results: </strong>Model performance was comparable to state-of-the-art findings (F1-score ~0.75) within the same language; however, models did not generalize well-showing a substantial decrease-when tested on new languages. The performance of MoE and multilingual models was generally low (F1-score ~0.50).</p><p><strong>Conclusions: </strong>Overall, the cross-linguistic generalizability of vocal markers of schizophrenia is limited. We argue that more emphasis should be placed on collecting large open cross-linguistic datasets to systematically test the generalizability of voice-based ML models, and on identifying more precise mechanisms of how the clinical features of schizophrenia are expressed in language and voice, and how different languages vary in that expression.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875018","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":"Individuals with High Social Anhedonia but not Schizophrenia Exhibited Altered Empathy in Daily Life.","authors":"Jie Gu, Xuemei Ding, Juan Yang, Xue Meng, Wenting Hu, Xu Li, Yanyu Wang, Yi Wang, Simon S Y Lui, Raymond C K Chan","doi":"10.1093/schbul/sbaf136","DOIUrl":"10.1093/schbul/sbaf136","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Despite empathic abnormalities exhibited in both clinical and subclinical samples of schizophrenia (SCZ) in the laboratory, understanding of their empathy in the real world remains limited. This study applied the experience sampling method (ESM) to investigate empathy in people with SCZ and high social anhedonia (SocAnh), as well as its associations with social pleasure and emotional states in daily life.</p><p><strong>Study design: </strong>Thirty-one participants with SCZ, 31 individuals with high SocAnh, and 32 healthy controls completed a 7-day ESM survey (10 surveys per day) to assess empathy, social pleasure, and emotional states in daily life. The empathic accuracy task was used to measure empathy accuracy (EA) in the laboratory. Multilevel regression models were estimated to examine group differences of the ESM variables and their associations.</p><p><strong>Study results: </strong>Compared to controls, people with SCZ showed lower EA but comparable cognitive and affective empathy in daily life, whereas Individuals with high SocAnh exhibited similar EA but lower affective empathy in daily life. Positive association between social pleasure and empathy was found across 3 groups. Empathy for positive emotions predicted increased positive emotional states in individuals with high SocAnh and controls, but not in people with SCZ. Positive emotional states predicted greater empathy in individuals with high SocAnh, which was not observed in the other 2 groups.</p><p><strong>Conclusions: </strong>Our findings revealed altered empathy in daily life among people at-risk for SCZ but not in clinical patients, shedding light on a better understanding of social cognitive changes in SCZ spectrum.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875017","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":"The Relation Between Aggression and Psychotic-Like Experiences in Help-Seeking Adolescents: The Role of Threat/Control-Override Symptoms.","authors":"Samantha L Redman, Steven C Pitts, Jordan DeVylder, Bruce G Link, Lindsay V Healey, Sarah Kopelovich, Vijay A Mittal, Elizabeth Cauffman, Pamela Rakhshan Rouhakhtar, Gloria M Reeves, Jason Schiffman","doi":"10.1093/schbul/sbaf113","DOIUrl":"https://doi.org/10.1093/schbul/sbaf113","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Psychosis is a heterogeneous phenomenon that emerges across a severity spectrum. Attenuated psychotic symptoms, or psychotic-like experiences (PLEs), reflect potential risk factors for formal psychosis and other clinical outcomes. There has historically been a widespread misconception that individuals who experience symptoms of psychosis are dangerous and prone to aggressive behavior. However, empirical evidence reveals only a modest link between psychosis and aggression. The existing associations are sometimes linked to a set of psychotic symptoms known as threat/control-override (TCO) symptoms that are often amenable to treatment. Despite research linking TCO symptoms and aggressive behavior in formal psychosis samples, studies in populations with PLEs are lacking. In line with the TCO model, we hypothesized that a subset of PLEs representing threat perception and control would have unique positive associations on aggression in the sample.</p><p><strong>Study design: </strong>The present study examined the relation between PLEs and aggression in help-seeking adolescents (n = 129). Psychotic-like experiences were assessed by parent/caregiver report (Prime Screen-Revised-Parent/Caregiver Version), and aggression was measured using a parent-rated assessment of adolescent behavior (Behavioral Assessment System for Children, Second Edition).</p><p><strong>Study results: </strong>Results supported study hypotheses, revealing small, independent effects of threat perception and control, in addition to a significant combined effect of these variables (TCO) on aggression.</p><p><strong>Conclusions: </strong>Findings support the use of symptom-specific measures of PLEs, including those aligning with the TCO model, to investigate the relation between attenuated psychotic symptomatology and aggression.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862394","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":"Weight Loss in Veterans with Schizophrenia and Multimorbidity Prescribed Semaglutide: Results From a National Retrospective Cohort Study.","authors":"Julia Browne, Wen-Chih Wu, Lan Jiang, Thomas A Bayer, Zachary J Kunicki, Matthew Thompson, Melanie L Bozzay, Alyssa N De Vito, Matthew D Howe, Mriganka Singh, Jennifer M Primack, John E McGeary, Ritesh Maharaj, Catherine M Kelso, Noah S Philip, Benjamin D Greenberg, James L Rudolph","doi":"10.1093/schbul/sbaf143","DOIUrl":"https://doi.org/10.1093/schbul/sbaf143","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>People with schizophrenia are at heightened risk for physical multimorbidity and premature death. Semaglutide improves cardiometabolic outcomes, yet research is limited among individuals with schizophrenia. This study explored weight loss in Veterans with schizophrenia and physical multimorbidity (ie, heart failure and diabetes) prescribed semaglutide and compared weight changes to those in Veterans without schizophrenia. We hypothesized that those with schizophrenia would experience less weight loss compared to those without schizophrenia.</p><p><strong>Study design: </strong>This retrospective cohort study examined national data from the Department of Veterans Affairs. The cohort included Veterans who filled a semaglutide prescription between 2018 and 2023 and had diagnoses of heart failure and diabetes. Body weight was examined one year prior to and one year following the first semaglutide prescription. Linear regression with inverse probability of treatment weighting (IPTW) was used to examine the relationship between schizophrenia status and one-year change in weight, accounting for hospital, demographic, clinical, and healthcare utilization factors.</p><p><strong>Study results: </strong>The sample comprised n = 36 482 Veterans with physical multimorbidity (n = 559 with schizophrenia). The schizophrenia sample lost 3.1% of their baseline weight (raw weight loss = 8.7 pounds) and the sample without schizophrenia lost 4.7% of baseline weight (raw weight loss = 12.1 pounds). IPTW-adjusted regression analyses demonstrated significantly lower percent weight loss for those with schizophrenia compared to those without schizophrenia (Estimate = -0.85, 95% confidence intervals (CIs): -1.63, -0.07).</p><p><strong>Conclusions: </strong>Semaglutide appears to confer weight loss in Veterans with schizophrenia and multimorbidity, albeit at slightly lower amounts than those without schizophrenia.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862395","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":"Reevaluating Clozapine-Induced QT Prolongation.","authors":"Timothy Tanzer, Rebecca Hanisch, Chloe Yap, Nicola Warren, Michael Barras, Steve Kisely, Katherine Isoardi, Kiana Kosari, Dan Siskind","doi":"10.1093/schbul/sbaf114","DOIUrl":"https://doi.org/10.1093/schbul/sbaf114","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Clozapine is the most effective medicine for treatment-resistant schizophrenia, but is limited by adverse events, including potential QT prolongation which can lead to life-threatening arrhythmias. Studies linking clozapine and corrected QT (QTc) prolongation may overestimate this risk due to high rates of clozapine-associated tachycardia. We investigated whether trough clozapine plasma levels are independently associated with QT prolongation after accounting for heart rate.</p><p><strong>Study design: </strong>We conducted a retrospective, cross-sectional analysis of inpatients treated with clozapine at a tertiary hospital between 2017 and 2023. Trough clozapine plasma levels, and 12-lead electrocardiograms were extracted from electronic medical records. QT intervals were manually measured and corrected using Bazett's, Fredericia, Hodges' formulae, and the QT nomogram. Multivariable regression and causal mediation were used to test the association between clozapine plasma level, heart rate, and QTc.</p><p><strong>Study results: </strong>Among 313 patients, Bazett's correction classified 27.5% as having prolonged QTc, whereas only one patient (0.3%) exceeded the at-risk threshold using Fredericia, Hodges, or the QT nomogram. Clozapine plasma level correlated with Bazett's-corrected QT (QTcB) (P = .02), but not after adjustment for heart rate (P = .75). Mediation analysis showed that heart rate significantly mediated the relationship between clozapine plasma level and QTcB intervals (P < .001).</p><p><strong>Conclusions: </strong>Apparent clozapine-induced QTc prolongation is largely an artifact of tachycardia and over-correction by Bazett's formula. The Fredericia and Hodges formulae, and the QT nomogram provide a more reliable assessment of torsadogenic risk and prevent unnecessary discontinuation or dose reductions of clozapine.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862376","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":"Knitting Together Recovery: Weaving Together a Life.","authors":"Rebecca Miller","doi":"10.1093/schbul/sbaf118","DOIUrl":"https://doi.org/10.1093/schbul/sbaf118","url":null,"abstract":"","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837583","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":"Autophagy in Schizophrenia: A Continuum From Developmental Vulnerability to Progressive Neuronal Stress? A Scoping Review.","authors":"Andreas S Lappas, Maria Ioannou, Myrto T Samara, Nikos G Christodoulou","doi":"10.1093/schbul/sbaf130","DOIUrl":"https://doi.org/10.1093/schbul/sbaf130","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Autophagy, the cell's primary degradation and recycling system, is essential for neuronal homeostasis. A structured synthesis of studies directly investigating autophagy in schizophrenia (SCZ) is lacking. This scoping review aimed to map the available evidence directly assessing autophagy processes in SCZ.</p><p><strong>Study design: </strong>We systematically searched Medline (via Ovid), Embase, and PsycINFO from inception to February 2025. Twenty-four eligible studies-encompassing clinical cohorts, postmortem brain tissue, animal and cellular SCZ-relevant models-were thematically analyzed.</p><p><strong>Study results: </strong>Findings indicated impaired autophagy in SCZ, implicating it in 3 main processes: (1) disrupted neurodevelopment/synaptic pruning, (2) lysosomal dysfunction/proteostasis, (3) compromised mitochondrial turnover/metabolic homeostasis. Antipsychotic treatment showed variable effects, with some agents partially restoring autophagic markers, whereas others heightened dysfunction. Transcriptomic studies identified autophagy-related gene signatures with potential diagnostic relevance. Synthesizing these findings, impaired autophagy emerged as a possible mechanistic link between early neurodevelopmental vulnerability and progressive cellular stress, which may underlie disease progression in some cases.</p><p><strong>Conclusions: </strong>Autophagy dysfunction may contribute to both early neurodevelopmental and later progressive cellular changes in SCZ. However, much of the current evidence derives from cross-sectional studies, peripheral biomarkers or animal models, with limited direct evidence from the human central nervous system. These limitations constrain causal interpretation. Even so, autophagy represents a promising therapeutic target, with potential to support early neural development and prevent progressive cellular decline. Longitudinal, multimodal studies integrating peripheral and central autophagy markers with clinical outcomes are needed to clarify autophagy's role in SCZ pathophysiology and treatment.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848569","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":"The Association of Antipsychotic Treatment and Side Effects With Societal Recovery and Happiness: A Naturalistic Cohort Study of People in Long-term Care for a Psychotic Disorder.","authors":"Stijn Crutzen, Shiral Gangadin, Ken Ho Hua, Ellen Visser, Frederike Jörg, Gerdina Hendrika Maria Pijnenborg, Lisette van der Meer, Wim Veling, Stynke Castelein","doi":"10.1093/schbul/sbaf122","DOIUrl":"https://doi.org/10.1093/schbul/sbaf122","url":null,"abstract":"<p><strong>Background: </strong>Antipsychotics are used to manage symptoms and reduce the risk of relapse. However, the antipsychotic side effects are associated with a lower quality of life and are seen as major barriers to achieving societal recovery by antipsychotic users. In this study, we investigate the association of side effects, antipsychotic dose, and antipsychotic polypharmacy with societal recovery and happiness.</p><p><strong>Study design: </strong>Data were used from a large, naturalistic, longitudinal cohort of people using an antipsychotic in long-term care (Pharmacotherapy Monitoring and Outcome Survey [PHAMOUS], 2013-2021). The association between subjective antipsychotic side-effect burden (measured with the Subjective Response to Antipsychotics questionnaire), antipsychotic dose, and antipsychotic polypharmacy with societal recovery and happiness was investigated using mixed-effect linear regression models. In an exploratory analysis, the associations between individual side effects with societal recovery and happiness were assessed.</p><p><strong>Study results: </strong>Data from 5971 observations nested in 2490 participants were used. The subjective antipsychotic side-effect burden, total antipsychotic dose, and antipsychotic polypharmacy were significantly negatively associated with societal recovery. Subjective antipsychotic side-effect burden and total antipsychotic dose were significantly negatively associated with happiness, but antipsychotic polypharmacy was not. Cognitive, mood, and physical anticholinergic side effects were most strongly negatively associated with societal recovery. Mood-, sedation-, cognitive-, and sexual-related side effects were most strongly negatively associated with happiness.</p><p><strong>Conclusions: </strong>These results show that side effects and a higher dose of antipsychotic medication are negatively associated with societal functioning and happiness. Future research should focus on whether dose reduction is beneficial for societal recovery and happiness in the long-term.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837585","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":"The Effects of Antipsychotics on Two Month Cortical Thickness and Two Year Clinical Outcomes Among Populations at Clinical High Risk for Psychosis.","authors":"Wensi Zheng, Lihua Xu, Dan Zhang, Wenjun Su, Yanyan Wei, Huiru Cui, Yawen Hong, Jinyang Zhao, Xiaochen Tang, Zhenying Qian, Hao Hu, Mengqing Xia, Qian Guo, Chunbo Li, Jinhong Wang, Tianhong Zhang, Zhenhua Ge, Yingying Tang, Jijun Wang","doi":"10.1093/schbul/sbaf111","DOIUrl":"https://doi.org/10.1093/schbul/sbaf111","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Antipsychotics (APs) are often used among individuals with clinical high risk (CHR) for psychosis and affect cortical thickness (CT). Whether clinical and CT changes after initial AP use correlate with long-term clinical outcomes remains largely unknown.</p><p><strong>Study design: </strong>One hundred and thirty-eight CHRs and 65 healthy controls accepted 2 MRI scans at an interval of 2 months. CHRs were categorized as responders (n = 53) and non-responders (n = 69) based on their response to APs after 2-month treatment. According to 2-year outcomes, they were also subdivided into converters (n = 26) and non-converters (n = 96). The relationships among short-term CT changes, AP effects, and long-term outcomes were explored.</p><p><strong>Study results: </strong>At baseline, CHRs had CT reduction in the right inferior temporal cortex with a correlation with clinical symptoms. At 2 month, CHRs showed steeper gray matter loss in bilateral frontotemporal regions than healthy controls. Cortical thickness change rates of the clusters located in bilateral middle temporal and right lateral orbitofrontal cortex were negatively correlated with the cumulative AP dose. Furthermore, 2-year psychosis conversion rate was significantly higher in non-responders than responders (33.3% vs 5.1%). A random forest model based on demographic, clinical, baseline, and longitudinal CT variables predicted 2-year conversion with an AUC of 0.90 (accuracy: 0.83, sensitivity: 0.78, and specificity: 0.89), with model predictive power driven primarily by symptom and CT variables.</p><p><strong>Conclusions: </strong>These findings contribute valuable insights into the potential impact of early AP treatment on brain morphology and clinical trajectories and highlight the importance of monitoring the initial treatment responses.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837586","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":"Predictive Role of Fixation Stability for Clinical Stages and Conversion in Schizophrenia and Its Correlation with Cognitive Function.","authors":"Yuqing Gu, Yu Li, Lihua Xu, Tianhong Zhang, Huiru Cui, Yanyan Wei, Mengqing Xia, Wenjun Su, Yingying Tang, Xiaochen Tang, Dan Zhang, Xu Liu, Jijun Wang","doi":"10.1093/schbul/sbaf132","DOIUrl":"https://doi.org/10.1093/schbul/sbaf132","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Given that fixation stability is closely linked to cognition, we investigated fixation stability in patients at different stages of schizophrenia, its relationship with cognitive impairments, and its predictive role for conversion to psychosis.</p><p><strong>Study design: </strong>Fixation stability was measured by bivariate contour ellipse area (BCEA), and cognition was assessed by the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery for 75 patients with first-episode schizophrenia (FES), 75 patients with clinical high-risk (CHR) syndrome, and 75 healthy controls (HCs). After a 1-year longitudinal study, CHR follow-up outcomes were classified as CHR-converters and CHR-nonconverters. Diagnostic model for clinical stages and prediction model for conversion were constructed using logistic regression and Cox regression, respectively.</p><p><strong>Study results: </strong>Patients exhibited fixation instability and cognition impairments compared to HC, with impairments increasing from CHR to FES. In CHR, BCEA negatively correlated with Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery scores, but this correlation was absent in FES. Diagnostic model effectively discriminated HC and FES, with an area under the receiver-operating characteristic curve of 0.914. Among 66 CHR followed up for 1 year, 13 have converted to schizophrenia, with a conversion rate of 19.70%. When divided into large and small BCEA groups (33 each), the conversion rate was 27.27% and 12.12%. Conversion prediction model achieved an area under the receiver-operating characteristic curve of 0.708.</p><p><strong>Conclusions: </strong>Our results indicate that fixation instability worsens with schizophrenia progression, which is associated with cognitive impairments. Additionally, BCEA may serve as a biomarker for predicting conversion to psychosis.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848571","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}