Schizophrenia Bulletin最新文献

{"title":"Analyzing Generative AI and Machine Learning in Auto-Assessing Schizophrenia's Negative Symptoms.","authors":"Chih-Min Liu, Yi-Hsuan Chan, Ming-Yang Ho, Chen-Chung Liu, Ming-Hsuan Lu, Yi-An Liao, Ming-Hsien Hsieh, Yufeng Jane Tseng","doi":"10.1093/schbul/sbaf102","DOIUrl":"https://doi.org/10.1093/schbul/sbaf102","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Traditional assessments of schizophrenia's negative symptoms rely on subjective and time-consuming psychiatric interviews. To provide more objective and efficient evaluations, this study examines the efficacy of an automated system utilizing generative AI (GenAI) and machine learning (ML) to assess negative symptoms of schizophrenia, including expression (EXP) and motivation and pleasure (MAP) domains.</p><p><strong>Study design: </strong>A semi-structured interview protocol based on the Clinical Assessment Interview for Negative Symptoms was used to conduct interviews with schizophrenia patients. An experienced senior psychiatrist carried out these interviews, which were audio- and video-recorded, at the National Taiwan University Hospital between July 2022 and August 2023. An ML-based system analyzed visual and audio data for EXP assessment, while GenAI analyzed interview transcripts for MAP assessment.</p><p><strong>Study results: </strong>The study cohort consisted of 69 males and 91 females with a mean age of 41.68 years (SD = 10.46). The ML-based EXP assessment showed moderate to substantial reliability, with an intraclass correlation coefficient (3, 1) (ICC3,1) of 0.65 and a weighted kappa of 0.62. The GenAI-based MAP assessment demonstrated good reliability, with an ICC3,1 of 0.82 and a weighted kappa of 0.77. The system achieved strong linear correlations with clinician ratings (Pearson's correlation coefficient ≥ 0.54) and maintained low error rates (mean absolute error ≤ 0.81; root mean square error ≤ 1.16) for each assessment item.</p><p><strong>Conclusions: </strong>The study demonstrates the efficacy of GenAI and ML in the automated assessment of schizophrenia's negative symptoms, highlighting their potential to enhance the consistency and efficiency of clinical evaluations.</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":"144837578","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":"Lessons Learned from Checking Evidence.","authors":"Jason Jepson","doi":"10.1093/schbul/sbaf109","DOIUrl":"https://doi.org/10.1093/schbul/sbaf109","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":"144837584","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":"Understanding Anticipatory Anhedonia in Schizophrenia and Depression: Linking Reward Representation Maintenance from a Transdiagnostic Perspective.","authors":"Zheng Xia, Jing-Wen Yang, Ling-Ling Wang, Peng-Yuan Yang, Si-Lu Chen, Han-Shan Jiang, Qin-Yu Lv, Zheng-Hui Yi, Chao Yan","doi":"10.1093/schbul/sbaf112","DOIUrl":"https://doi.org/10.1093/schbul/sbaf112","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Anticipatory anhedonia is common in both schizophrenia (SCZ) and major depressive disorder (MDD). Under the transdiagnostic framework of the Research Domain Criteria, this study investigated how reward representation maintenance relates to anticipatory pleasure in patients with SCZ and MDD.</p><p><strong>Study design: </strong>We recruited 61 SCZ patients, 60 MDD patients, and 77 age-matched healthy controls (HCs). All the participants completed the Reward Representation Maintenance Task, which was designed to measure the capacity of reward representation maintenance and anticipatory pleasure.</p><p><strong>Study results: </strong>Mixed-design analyses of covariance (ANCOVAs) revealed the significant group difference in mismatch rate (MR; F(2,194) = 14.24, P < .001, partial η2 = 0.130) while maintaining reward representation, with both SCZ (P < .001) and MDD (P < .001) patients exhibiting higher MR than HC group. When anticipating rewards, MDD patients showed fewer number of button press (NBR) than HC when facing large rewards (P < .001). SCZ patients slightly differed by showing a significant decrease in NBR for large rewards (P < .001) and an increase for small rewards (P = .006) compared to HC. Additionally, higher MR in both SCZ and MDD patients was significantly associated with a reduced level of NBR of large rewards.</p><p><strong>Conclusions: </strong>Our findings suggest that the common dysfunction in reward representation maintenance may contribute to the emergence of anticipatory anhedonia in SCZ and MDD patients, though there remains nuances. These insights advance our comprehension of the cognitive foundations of anticipatory anhedonia and lay the groundwork for a transdiagnostic approach to comprehend anhedonia effectively.</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":"144837587","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":"Awakening, Recalibrating, Hibernating, and Unfreezing Reality.","authors":"Helene Cæcilie Mørck","doi":"10.1093/schbul/sbaf108","DOIUrl":"https://doi.org/10.1093/schbul/sbaf108","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":"144837579","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":"Managing Schizophrenia in Paris.","authors":"Jason Jepson","doi":"10.1093/schbul/sbaf129","DOIUrl":"https://doi.org/10.1093/schbul/sbaf129","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":"144848570","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":"Engaging People Who Have Deeply Embedded, Fixed, and Entrenched Psychosis: The Role of Peer Workers.","authors":"Ben Gray, Matthew Sisto, Renee Conley, India Sisto","doi":"10.1093/schbul/sbaf120","DOIUrl":"https://doi.org/10.1093/schbul/sbaf120","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":"144837581","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":"Exploring the Role of Stigma and Reduced Facial Expressions in Shaping First Impressions of Individuals with Schizophrenia.","authors":"Mathilde Parisi, Ludovic Marin, Juliette Lozano-Goupil, Tifenn Fauviaux, Victor Vattier, Delphine Capdevielle, Stéphane Raffard","doi":"10.1093/schbul/sbaf104","DOIUrl":"https://doi.org/10.1093/schbul/sbaf104","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>First impressions are rapid judgments based on limited information, significantly influencing one's willingness to interact. Social difficulties in schizophrenia may stem from negative first impressions formed by healthy individuals. We hypothesized that healthy individuals would quickly develop negative first impressions of those with schizophrenia, driven in part by reduced facial expressions and stigma.</p><p><strong>Study design: </strong>Twenty individuals with schizophrenia and 20 age- and sex-matched healthy controls were filmed responding to a question for 30 seconds. Three hundred participants from the general population rated their first impressions of the 40 video recordings. The diagnosis of individuals with schizophrenia was either retained, disclosed, or misrepresented as autistic. To isolate the effect of facial expressions, stimuli were presented without sound using a point light display.</p><p><strong>Study results: </strong>Individuals with schizophrenia received more negative first impression ratings than healthy controls, and higher negative symptoms were linked to poorer first impression ratings. OpenFace analysis confirmed that facial expressions significantly shaped impressions, particularly mouth movement. Additionally, ratings worsened when participants' schizophrenia diagnosis was disclosed, highlighting the harmful impact of stigma. Conversely, when mislabeled as having autism, first impression ratings improved.</p><p><strong>Conclusions: </strong>This study highlights the compounded negative effects of facial expressions and schizophrenia-related stigma on first impressions. Given their significant influence on social interactions, future research should explore strategies to mitigate these effects.</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":"144837582","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 International Psychosis Epidemiology Consortium Virtual Databank-A Platform for Data Harmonization and Federated Analysis of Psychosis Cohorts.","authors":"Vera Brink, Natalia Tiles-Sar, Hannah Jongsma, Catheleine van Driel, Craig Morgan, Bart Lestestuiver, Ellen Visser, Erwin Veermans, Morris A Swertz, Erna van 't Hag, Carsten Hjorthøj, Merete Nordentoft, Nikolai Albert, Stynke Castelein, Wim Veling","doi":"10.1093/schbul/sbaf094","DOIUrl":"https://doi.org/10.1093/schbul/sbaf094","url":null,"abstract":"<p><strong>Background: </strong>Harmonization of research methodology, measures, and existing cohort data is needed to advance the field of psychosis epidemiology. The International Psychosis Epidemiology Consortium (IPEC) has been initiated to create a data-sharing platform for psychosis cohorts globally and provide infrastructure for data harmonization. This profile paper describes the design and data harmonization process, and the technical, ethical, and legal steps taken to set up the IPEC virtual databank, as well as the organizational structure we developed for IPEC.</p><p><strong>Study design: </strong>An international group of researchers, collaborating in the Schizophrenia International Research Society-Epidemiology Research Harmonization Group, drafted inclusion and exclusion criteria for participating cohorts and selected, among others, sociodemographic, socioeconomic, and clinical variables for harmonization. Drawing upon current guidelines for data harmonization, a guideline specifically for psychosis cohorts and a software architecture for federated analysis were developed. Finally, as proof of principle, all steps of data harmonization were applied to 2 cohorts, and summary statistics on core variables were calculated.</p><p><strong>Study results: </strong>A platform for remote and nondisclosive analyses of multisite individual-level data and a data catalog with information on IPEC's variables and harmonization procedures were built. The 6-step design, harmonization procedure, ethical and legal procedures, future organizational structure and how to join IPEC were described. Data harmonization of variables of the 2 proof-of-principle cohorts was successful.</p><p><strong>Conclusions: </strong>IPEC has created a virtual databank for individual-level data of psychosis cohorts and implemented a technical infrastructure for remote federated analysis. This databank facilitates future large-scale collaborative international psychosis epidemiology research.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650337","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":"Influence of CYP2D6 Genotypes and Phenotypes on the Plasma Levels and Clinical Response to Aripiprazole.","authors":"Cécile Gras, Marianna Piras, Setareh Ranjbar, Claire Grosu, François R Girardin, Frederik Vandenberghe, Nicolas Ansermot, Carole Grandjean, Stefan Kaiser, Franziska Gamma, Kerstin Jessica Plessen, Armin von Gunten, Philippe Conus, Séverine Crettol, Chin B Eap","doi":"10.1093/schbul/sbaf076","DOIUrl":"https://doi.org/10.1093/schbul/sbaf076","url":null,"abstract":"<p><strong>Background: </strong>The antipsychotic aripiprazole is mainly metabolized by the cytochrome P450 (CYP) 2D6. The main objective of this study was to evaluate the influence of CYP2D6 phenotypes on aripiprazole plasma levels and treatment duration.</p><p><strong>Design: </strong>466 patients treated with aripiprazole for up to 12 months and with at least one aripiprazole plasma level in steady-state condition were selected. CYP2D6 genotypes and phenoconversion to poor metabolizer status due to strong CYP2D6 inhibition were considered. Aripiprazole plasma level-to-dose ratios and treatment duration up to discontinuation, defined as switching to another psychotropic drug and/or stopping the follow-up, were analyzed using robust linear models and Cox regression, respectively. Akaike variable selection was applied.</p><p><strong>Results: </strong>CYP2D6 poor metabolizers (genetically determined n = 19 and phenoconverted, n = 52) showed higher aripiprazole concentration-to-dose (P < .001) and aripiprazole plus dehydroaripiprazole concentration-to-dose (P < .001) ratios when compared to normal metabolizers (n = 255). CYP2D6 extreme metabolizers (ie, poor and ultrarapid metabolizers) had higher risk of treatment discontinuation versus intermediate and normal metabolizers after 3, 6, and 12 months of treatment (HR: 2.08, 1.75, 1.59, respectively; P = .013, P = .019, and P = .047, respectively). For a pharmacogenetic-guided treatment, the number of patients needed to genotype to prevent 1 patient from aripiprazole discontinuation was 15.</p><p><strong>Conclusion: </strong>CYP2D6 poor metabolism was associated with increased aripiprazole and aripiprazole plus dehydroaripiprazole concentrations-to-dose. CYP2D6 extreme phenotypes were associated with increased risk of treatment discontinuation over 1 year of treatment. This finding supports the applicability of pre-emptive CYP2D6 genotyping, which is expected to decrease aripiprazole adverse events and inefficacy that would probably lead to treatment discontinuation.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637919","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":"Fixation Task: A Simple Eye Movement Task Reveals an Impairment in Schizophrenia","authors":"Vanteemar S Sreeraj, H V Raghuram, Swarna Buddha Nayok, Aditi Subramaniam, Harleen Chhabra, Gaurav Bhalerao, Anushree Bose, Sri Mahaveer Agarwal, Sunil Kalmady, Venkataram Shivakumar, Samuel B Hutton, Ganesan Venkatasubramanian","doi":"10.1093/schbul/sbaf093","DOIUrl":"https://doi.org/10.1093/schbul/sbaf093","url":null,"abstract":"Background Fixation stability (FS) is a basic substrate of visuomotor processing that can be assessed by tracking eye movements during a simple, easy-to-perform task of gazing at a visual stimulus. We studied FS with and without distractors for its potential as an endophenotype marker in antipsychotic-naïve/free schizophrenia (SCZ), SCZ first-degree relatives (FDRs), and healthy controls (HC). Method Monocular high-frequency eye tracking data were recorded during a fixation stability task in 69 antipsychotic-naïve/free SCZ, 49 FDRs, and 76 HCs. The task required maintenance of gaze on a central circular target while ignoring an identical peripheral distractor, when present, at near/farther distances on either side. Fixation stability across the groups and the effect of laterality and distance of the distractor effect were analyzed using ANCOVA and RMANCOVA. Result SCZ had significantly higher fixation frequency, saccade amplitude, and scanpath length compared to the other groups, even in trials without distractors (ηp2 = 0.05–0.07). Introducing distractors resulted in further worsening of performance in SCZ (ηp2 = 0.09–0.23). First-degree relatives showed impairment in median fixation duration (ηp2 = 0.13). Higher saccade amplitudes and scanpath lengths (both ηp2 = 0.09) were noted in trials with farther distractors across the groups. A significant interaction effect of the laterality * group was noted on scanpath length (ηp2 = 0.03). Discussion FS impairment was noted in antipsychotic naïve/free SCZ, and it worsened with the introduction of distractors. An inversed laterality effect (rightward-bias) of distractor was noted in SCZ and their FDRs, suggesting a possible association of attenuation/reversal of visual functional asymmetry with SCZ vulnerability. Future studies should evaluate FS as illness markers across different clinical stages.","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"26 1","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144622439","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}