Schizophrenia (Heidelberg, Germany)最新文献

{"title":"Predictors of conversion to psychosis and mortality in first-episode substance-induced psychosis: a nationwide register-based study in South Korea.","authors":"Yan-Hong Piao, Thi-Hung Le, Ling Li, Ariana Setiani, Soyolsaikhan Odkhuu, Woo-Sung Kim, Shahida Nazir, Yong-Suk Jang, Young-Chul Chung","doi":"10.1038/s41537-026-00760-z","DOIUrl":"https://doi.org/10.1038/s41537-026-00760-z","url":null,"abstract":"<p><strong>Objective: </strong>Substance-induced psychosis (SIP) is associated with a substantial risk of progression to schizophrenia spectrum disorders (SSD), bipolar disorder (BD), and premature mortality. However, evidence from Asia, particularly South Korea (SK), remains limited.</p><p><strong>Methods: </strong>We conducted a retrospective, nationwide, population-based cohort study using the Korean National Health Insurance Claims Database (2003-2012) with follow-up through 2017. Individuals aged 18-60 years with a first episode of SIP (FE-SIP) were identified after excluding those with ICD-10 codes for substance use disorders (SUD; F10-F19) and other neuropsychiatric disorders (F00-F09, F20-F29, F30.x, F31.x, F32.3, or F33.3) during a 1-year washout. Incidence was estimated using national census data. Conversion to first-episode psychosis (FEP-SSD or -BD) was examined using cumulative incidence function and Cox regression. Standardized mortality ratios (SMRs) were calculated against the general population and a SUD reference cohort.</p><p><strong>Results: </strong>A total of 2244 individuals with FE-SIP were identified. The average annual incidence proportion was 0.7 per 100,000, peaking in 2005. Over a median follow-up of 9.3 years, 655 individuals (33.2%) converted to FEP, with cumulative conversion rates of 23.3% at 5 years, and 28.8% at 10 years. Younger age, female sex, disability, longer initial hospitalization, and use of other stimulants were significant predictors of conversion. All-cause mortality was markedly elevated (SMR 33.3 vs general population; SMR 1.49 vs SUD cohort), particularly among young men.</p><p><strong>Conclusions: </strong>Despite a low incidence of FE-SIP in SK, the risks of conversion to FE-SSD/FE-BD and premature mortality are substantial. Findings underscore the need for early detection, psychoeducation, and integrated care tailored to high-risk individuals, especially within the first two years after diagnosis.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial disruptions and the embodied Self in schizophrenia: toward a developmental framework.","authors":"Andrea Raballo, Antonio Preti, Michele Poletti","doi":"10.1038/s41537-026-00749-8","DOIUrl":"https://doi.org/10.1038/s41537-026-00749-8","url":null,"abstract":"<p><p>Converging evidence indicates that schizophrenia reshapes the embodied structure of subjectivity, profoundly altering how individuals experience their bodies and surrounding space. This Perspective proposes a neurodevelopmental framework linking measurable distortions of personal space (PS) and peripersonal space (PPS) to deeper phenomenological disruptions of lived spatiality. Experimental findings consistently show an enlarged PS and a contracted PPS, maybe reflecting an excessive feeling of overexposure as well as a diminished sense of possible spatial enactment of bodily capacities. These anomalies likely stem from early neurodevelopmental disturbances in multisensory integration and sensorimotor learning. Phenomenological psychopathology further reveals how such spatial disorganization manifests as instability in self-world boundaries and a pervasive sense of altered atmosphere. Integrating neurodevelopmental, cognitive, and experiential dimensions provides a unified account of how schizotaxic vulnerability unfolds into spatial and Self-disturbances. This approach reframes embodiment and spatiality as developmental interfaces between neural processes and subjective transformation in schizophrenia.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes of psychological and biological stress parameters in individuals with schizophrenia spectrum disorders participating in a mindfulness-based group therapy.","authors":"Marco Zierhut, Sarah Koop, Niklas Bergmann, Inge Hahne, Ingmar Conell, Julia Kraft, Alice Braun, Mareike Bayer, Thi Minh Tam Ta, Julian Hellmann-Regen, Neil Thomas, Stephan Ripke, Malek Bajbouj, Eric Hahn, Kerem Böge","doi":"10.1038/s41537-026-00759-6","DOIUrl":"https://doi.org/10.1038/s41537-026-00759-6","url":null,"abstract":"<p><p>This study investigates changes in stress parameters in individuals with schizophrenia spectrum disorders participating in mindfulness-based group therapy (MBGT). N = 45 participants were randomised to MBGT or Treatment as Usual over four weeks. Before and after each session, psychological and biological stress markers by self-rating scales and cortisol saliva samples were assessed in the active group (n = 22). Oxytocin was assessed before and after the first and last sessions. Results indicated significant reductions in general stress, symptom-related distress and cortisol levels. Oxytocin showed increases during the first session and decreases during the last session. Exploratory analyses showed correlations between psychological and biological stress markers, and between stress reduction and changes in self-reported negative symptoms. MBGT may provide stress relief in patients with SSD with potential associations with negative symptoms. The study did not include a session-specific control group. Further studies with larger samples and corresponding control conditions are warranted to test causality.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"12 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperdynamic microtubule-based structural changes in Monocyte-Derived-Neuronal-like cells from patients with schizophrenia.","authors":"Alfredo Bellon, Alonso Cortez-Resendiz, Lauren N Forrest, Omar Elmarasi, Janani Iyer, Anjali Iyer, Chachrit Khunsriraksakul, Dajiang Liu, L Elliot Hong, Therese M Jay, Marie-Odile Krebs, Anne Hosmalin","doi":"10.1038/s41537-026-00751-0","DOIUrl":"https://doi.org/10.1038/s41537-026-00751-0","url":null,"abstract":"<p><p>A consistent postmortem finding in schizophrenia (SCZ) is reduction in dendrites' size. However, neurons with larger dendritic trees have also been encountered. In vitro experiments with neurons and neuronal-like cells coming directly from patients with SCZ showed similar results, evidencing at times more extensions and at others less arborizations. The process of extending and retracting neuronal outgrowths depends on microtubules polymerization and depolymerization. The possibility that microtubule polymerization/depolymerization is related to defects in the neuronal structure comes from several microtubular anomalies reported in SCZ such as its abnormal distribution in the cytoplasm, irregular shape of microtubules and even absence of these cytoskeletal components in dendrites. Moreover, microtubules in olfactory neuroepithelial cells from patients with SCZ were resistant to depolymerization. But whether deficits in microtubules are associated with abnormalities in the neuronal structure has never been investigated in living cells coming directly from patients. Therefore, we studied dynamic neurostructural changes in Monocyte-Derived-Neuronal-like cells (MDNCs) from 12 controls and 13 patients with SCZ. First, we showed that human neuroprogenitor cells and MDNCs have comparable neurostructural plasticity. Then, we investigated whether colchicine, a microtubular stabilizing and depolymerizing agent, disrupts dynamic neurostructural changes. The lowest concentration of colchicine tested, stopped dynamic neurostructural changes in MDNCs from controls, while cells from patients with SCZ continued to extend and retract neuronal outgrowths. Following, we investigated if antipsychotics impact dynamic structural changes, but our results were inconclusive. Our data indicate that, under certain circumstances, neuronal-like cells from patients with SCZ evidenced hyperdynamic microtubule-based neurostructural changes and consequently, link deficits in microtubules with anomalies in the neuronal shape. While other potential confounders are unlikely to have influenced our results, the effects of medications cannot be excluded.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood levels of D-aspartate oxidase, D-amino acid oxidase, serine racemase, and pLG72 are influenced by diagnoses of schizophrenia and autism spectrum disorder.","authors":"Elisa Maffioli, Francesco Errico, Zoraide Motta, Raffaella di Vito, Joshua Grana, Elisa De Grandis, Silvia Boeri, Claudio Bruno, Maria Pia Riccio, Felice Iasevoli, Michele Di Maio, Tommaso Nuzzo, Carmela Bravaccio, Sveva Bagnasco, Monica Gelzo, Giuseppe Castaldo, Andrea de Bartolomeis, Armando Negri, Loredano Pollegioni, Gabriella Tedeschi, Alessandro Usiello","doi":"10.1038/s41537-026-00758-7","DOIUrl":"https://doi.org/10.1038/s41537-026-00758-7","url":null,"abstract":"<p><p>Free D-serine (D-Ser) and D-aspartate (D-Asp) are increasingly recognized as key modulators of glutamatergic NMDA receptor-dependent neurotransmission, whose dysfunction has been implicated in neuropsychiatric conditions, including schizophrenia (SCZ) and autism spectrum disorder (ASD). The metabolism of these D-amino acids is tightly regulated by specific enzymes: serine racemase (SR) for D-Ser synthesis and degradation, and D-amino acid oxidase (DAAO) and D-aspartate oxidase (DASPO) for D-Ser and D-Asp degradation, respectively. The primate-specific protein pLG72 further modulates the activity of DAAO and DASPO. In this multicenter study, we employed a mass spectrometry (MS)-based approach to quantify SR, DAAO, DASPO, and pLG72 levels in serum samples from SCZ and ASD patients, along with matched non-psychiatric controls. Enzymatic activity and D-amino acid serum concentrations were also assessed. We identified distinct, disorder-specific alterations in these proteins. In SCZ patients, SR protein levels were elevated despite unchanged activity, while DAAO and pLG72 levels were decreased. Conversely, increased DASPO levels were associated with reduced D-Asp, indicating enhanced catabolism of this endogenous NMDA receptor ligand in SCZ. ASD patients exhibited elevated DAAO and DASPO, with reduced SR levels. Notably, positive correlations between pLG72 and both DAAO and DASPO flavoenzymes were observed in both disorders. These findings highlight the potential of D-amino acid metabolism-related enzymes as biomarkers for SCZ and ASD and provide new insights for future diagnostic and mechanistic investigations in neurodevelopmental disorders.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relating latent factors of reasoning, affect, and cognition to the delusional experience.","authors":"Annalise Halverson, Andrew R Kittleson, Jinyuan Liu, Suzanne Hw So, Julia M Sheffield","doi":"10.1038/s41537-026-00750-1","DOIUrl":"https://doi.org/10.1038/s41537-026-00750-1","url":null,"abstract":"<p><p>Reasoning biases play a crucial role in the formation and maintenance of delusions. In psychosis, it is unclear whether these biases cluster onto similar underlying factors or represent independent constructs. The current study presents data on task-based reasoning biases and self-reported cognitive biases, as well as cognition and affect. Using these data, we aimed to understand mechanisms underlying facets of clinical delusional severity and broader unusual thought content. Participants with schizophrenia-spectrum disorders (SSD; N = 75) were enrolled following hospitalization for an acute psychotic episode. Non-clinical comparison participants (NCC; N = 70) were recruited for comparison of affect, cognition, and reasoning biases. Exploratory factor analysis and multivariable linear regressions were performed in the SSD group only. Core clinical delusions and broader unusual thought content, alongside preoccupation, conviction, and distress were used as outcome measures. SSD participants had more severe reasoning biases, cognitive deficits, and negative affect than NCC. In SSD, factor analysis revealed four latent constructs representing belief updating, cognitive biases, affective disturbances, and general cognitive ability. Affect was significantly associated with delusional preoccupation and distress. Belief updating was the primary factor associated with conviction. Cognitive biases related to the number of unusual beliefs endorsed, but no other aspects of severity. General cognitive ability was unrelated to all facets of delusional severity in our sample. Affective disturbances and belief updating map onto distinct aspects of clinical delusions in SSD; delusion severity is not robustly related to cognitive impairment. Reducing delusional conviction may require treatments focused on how new evidence is integrated into existing beliefs.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new approach for understanding the association between chronic stress in childhood and psychotic symptoms in schizophrenia patients from mediating role of lncRNA.","authors":"Zhiyong Mi, Yan Yan, Lingming Kong","doi":"10.1038/s41537-026-00755-w","DOIUrl":"https://doi.org/10.1038/s41537-026-00755-w","url":null,"abstract":"<p><p>Schizophrenia (SCZ) remains an etiological and therapeutic challenge, this article aims to explore the mediating role of lncRNA between chronic childhood stress and SCZ for providing a scientific basis of SCZ prevention. 200 SCZ patients and 200 healthy controls (HCs) were enrolled by convenience sampling. Positive and Negative Syndrome Scale (PANSS) and Childhood Chronic Stress Questionaire (CCSQ) were employed for mental assessment. lncRNA and cortisol level in peripheral blood were respectively detected by real-time quantitative reverse transcription PCR and enzyme-linked immunosorbent assay. The results showed scores of CCSQ, peer bullying (PB), abuse and neglect (AN), adverse life events (ALE) and cortisol were higher, while ΔCT values of NONHSAT089447 and NONHSAT021545 were lowered in SCZ patients (P < 0.05 or 0.01). Area under the curve of combined receiver operating characteristic curve for NONHSAT089447, NONHSAT021545, NONHSAT041499 was 0.814 with sensitivity and specificity of being 0.650, 0.880, respectively. Correlation analysis suggested scores of CCSQ, PB, AN, ALE as well as cortisol positively and ΔCT values of NONHSAT089447, NONHSAT021545 negatively correlated with scores of PANSS, positive symptom subscale (PSS), negative symptom subscale (NSS), general pathological symptom subscale (GPSS) in SCZ group (P < 0.05 or 0.01). NONHSAT089447 and NONHSAT021545 also played partial mediating roles between chronic childhood stress and psychotic symptoms with accounting proportions of 54.83% and 41.53% for total effect, respectively (P < 0.001). Taken together, we established a new model for SCZ in which exposure to chronic childhood stress could induce pathological process via mediating effects of NONHSAT089447 and NONHSAT021545.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From neuroinflammation to neural inference: computational psychiatry meets precision medicine.","authors":"Ghaith K Mansour, Ahmad W Hajjar","doi":"10.1038/s41537-026-00757-8","DOIUrl":"https://doi.org/10.1038/s41537-026-00757-8","url":null,"abstract":"<p><p>Psychosis spectrum disorders exhibit substantial clinical variability, necessitating novel frameworks that transcend traditional symptomatic classification. While polygenic risk accounts for significant heritability, the precise mechanisms translating genetic vulnerability into clinical illness remain elusive. An increasingly compelling hypothesis suggests that immune-related abnormalities link genetic risk with environmental stressors to precipitate neural dysfunction. This review integrates neuroimmunology and computational psychiatry to advance mechanism-driven precision medicine by connecting specific molecular dysfunctions to high-level information processing deficits. We synthesize evidence demonstrating that genetic and environmental risks converge on immune pathways-particularly microglial dysfunction and aberrant synaptic pruning. Functionally, we propose this pathology drives fundamental information processing errors, including maladaptive prior beliefs and reduced sensory precision. Here we highlight the necessity of multi-modal biomarkers and real-time digital phenotyping to stratify patients based on underlying neuro-immune endotypes. Finally, we address the critical challenge of algorithmic bias, emphasizing that proactive, standards-based strategies are required to ensure computational models are equitable and generalizable across diverse global populations. This integrated roadmap offers a path toward a truly personalized, biologically grounded psychiatry.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antipsychotic deprescribing as a problem of care, not compliance.","authors":"Helene Speyer, Marte Ustrup, Mette Ødegaard","doi":"10.1038/s41537-026-00745-y","DOIUrl":"https://doi.org/10.1038/s41537-026-00745-y","url":null,"abstract":"","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between negative symptoms and resting-state functional connectivity within social brain networks among individuals with early psychosis.","authors":"Anna R Knippenberg, Lawrence H Sweet, Lauren Luther, Somin Kim, Gregory P Strauss","doi":"10.1038/s41537-026-00756-9","DOIUrl":"https://doi.org/10.1038/s41537-026-00756-9","url":null,"abstract":"<p><p>Negative symptoms of psychotic disorders are best represented within a hierarchical structure comprising two broad dimensions-Motivation and Pleasure (MAP) and Diminished Expressivity (EXP)-and five lower-level domains. The validity of these two dimensions and five domains is supported by associations with cognitive, psychological, and clinical outcomes. However, few studies have examined whether they are differentiated by distinct neural mechanisms. The current study examined the specificity of associations between the two dimensions and five domains and resting-state functional connectivity (RS-FC) within five large-scale brain networks critical for social behavior. Participants included 125 early psychosis (EP) patients and 58 healthy controls (CN) from the Human Connectome Project-Early Psychosis who completed resting-state functional magnetic resonance imaging (rsfMRI) scans. RS-FC was quantified in five social brain networks: affiliation network, aversion network, perception network, mentalizing network, and mirror network. Early psychosis patients exhibited significantly reduced RS-FC in social brain networks compared to CN, but no specific network was responsible for this effect. Reduced RS-FC in the mirror network was significantly associated with greater asociality, anhedonia, and avolition, while reduced RS-FC in the mirror and mentalizing networks was associated with more severe blunted affect. Findings suggest that some RS-FC networks align with the broader higher-order dimensions, while others align with the lower-level domains. Overall, the pattern of findings suggests that abnormal patterns of resting-state social brain network activation are broadly associated with the MAP dimension and not more selectively related to anhedonia, avolition, or asociality. Thus, findings suggest that the neurobiology of negative symptoms in EP is best captured at the level of the broader higher-order dimensions than the specific lower-level domains that make them up.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}