Schizophrenia (Heidelberg, Germany)最新文献

{"title":"Author Correction: Efficacy of xanomeline and trospium chloride in schizophrenia: pooled results from three 5-week, randomized, double-blind, placebo-controlled, EMERGENT trials.","authors":"Inder Kaul, Sharon Sawchak, Amy Claxton, Colin Sauder, Howard H Hassman, Rishi Kakar, David P Walling, Leslie Citrome, Haiyuan Zhu, Andrew C Miller, Stephen K Brannan","doi":"10.1038/s41537-025-00595-0","DOIUrl":"https://doi.org/10.1038/s41537-025-00595-0","url":null,"abstract":"","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"44"},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659974","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":"Adaptation of the virtual assessment of mentalizing ability and evaluation of its utility and psychometric properties in Chinese individuals on the schizophrenia spectrum.","authors":"Yuan Cao, Winnie W Y So, Yi Wang, Ding-Ding Hu, Yi Xie, Jie Gu, Raymond C K Chan, David H K Shum","doi":"10.1038/s41537-025-00594-1","DOIUrl":"https://doi.org/10.1038/s41537-025-00594-1","url":null,"abstract":"<p><p>Schizophrenia is associated with impairments in theory of mind (ToM), the ability to understand and attribute mental states. However, the nature of the deficits across ToM subconstructs (viz., first- and second-order cognitive ToM, and first- and second-order affective ToM) remains unclear, partly due to assessment issues. The current study aimed to first adapt an ecologically valid ToM assessment tool, namely, the Virtual Assessment of Mentalizing Ability (VAMA), for use among healthy Chinese individuals (Study 1). We then compared 39 schizophrenia patients with 37 controls, and 48 individuals with high social anhedonia (SA) with 54 individuals with low SA (Study 2) using the adapted version of VAMA and Yoni Task. Results of Study 1 showed that the adapted VAMA demonstrated acceptable reliability (item-total correlation and test-retest reliability for total score, r = 0.731, p_FDR < 0.01) and construct validity (main effect of Order and Type). In Study 2, schizophrenia patients performed significantly worse than controls, making more \"hypermentalizing\" and \"no mentalizing\" ToM errors. Moreover, hypermentalizing error in the patient group was found to be significantly associated with their negative symptoms (r = 0.388, p_FDR < 0.05). Interestingly, the VAMA results differed from those of the Yoni Task, possibly due to differences in task complexity. Finally, individuals with high SA showed impairments in second-order cognitive ToM compared to the controls. Overall, our findings suggest that the VAMA can be adapted for use in China, and is sensitive to ToM impairments in clinical and at-risk groups. Limitations on the psychometric properties were discussed.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"43"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652421","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":"Predictors of relapse after discontinuing antipsychotics in patients with schizophrenia spectrum disorders.","authors":"Ling Li, Thi Hung Le, Woo Sung Kim, Soyolsaikhan Odkhuu, Chae Yeong Kang, Ariana Setiani, EunJin Jeon, Fatima Zahra Rami, Young-Chul Chung","doi":"10.1038/s41537-025-00592-3","DOIUrl":"10.1038/s41537-025-00592-3","url":null,"abstract":"<p><p>We studied 61 patients with schizophrenia spectrum disorders who discontinued medication after achieving symptomatic remission. Over 3 years, relapse rates were significantly higher in those not meeting full recovery (p = 0.006) or remission (p < 0.001) criteria, with rates up to twice as high. Significant differences between relapsed and maintained groups included age at onset (p = 0.004), age at discontinuation (p = 0.009), and proportions meeting full recovery (p = 0.001) or remission (p = 0.003). Univariate Cox regression identified older age of onset (p = 0.038), lack of full recovery (p = 0.008) or remission (p = 0.001), and higher positive symptom score (p = 0.018) as predictors of relapse. In multivariate analysis, only full remission remained significant (p = 0.002). Our findings suggest that in making decision about discontinuation, applying more strict approaches, i.e., full recovery or remission criteria and detailed assessment of positive symptoms are critical and essential.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"42"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627028","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":"Association between white blood cell counts and the efficacy on cognitive function after rTMS intervention in schizophrenia.","authors":"Suzhen Ye, Bailing Wang, Heling Sui, Meihong Xiu, Fengchun Wu","doi":"10.1038/s41537-025-00590-5","DOIUrl":"10.1038/s41537-025-00590-5","url":null,"abstract":"<p><p>rTMS has shown some effect in improving cognitive functions in patients with schizophrenia. However, these findings were controversial, and specific mechanisms of action and optimal therapeutic parameters still require further investigation. This study aimed to examine predictive biomarkers of the efficacy of rTMS in cognitive improvement in schizophrenia. A secondary analysis of a previous randomized, controlled trial was performed. Fifty-six patients were allocated to the active rTMS and 28 to the sham group. Patients received 6 weeks of treatment and were followed up for 18 weeks. Cognition was assessed and blood biomarkers were measured in all patients. In patients with schizophrenia, there was a significant interaction between time and group on immediate memory. Furthermore, this study found that after controlling for confounders, patients with higher baseline white blood cell (WBC) counts showed less improvement in immediate memory after rTMS than patients with lower WBC counts. Linear regression analysis showed that WBC counts were associated with immediate memory improvement after rTMS treatment. Our results reveal that WBC counts at baseline correlated with the response to rTMS in patients with schizophrenia. Patients with higher baseline WBC counts improved less after rTMS intervention than those with lower WBC counts.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"41"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598191","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":"Characterization of cardiac autonomic dysfunction in acute Schizophrenia: a cluster analysis of heart rate variability parameters.","authors":"Alexander Refisch, Andy Schumann, Yubraj Gupta, Steffen Schulz, Andreas Voss, Berend Malchow, Karl-Jürgen Bär","doi":"10.1038/s41537-025-00589-y","DOIUrl":"10.1038/s41537-025-00589-y","url":null,"abstract":"<p><p>Underlying biological mechanisms leading to the dramatically increased cardiac mortality in patients with schizophrenia (SCZ) are largely unknown. Cardiac autonomic dysfunction (CADF), which has been extensively described in patients with SCZ, represents an important physiological link to cardiovascular disease (CVD). This study investigated the prevalence of CADF in patients with SCZ using HRV across multiple domains (time and frequency, nonlinear dynamics, complexity measures, symbolic dynamics, and segmented Poincaré plot analysis). HRV-based clustering classified 119 SCZ patients as having or not having CADF based on deviations from 119 age- and sex-matched healthy controls. Our findings showed that approximately half of the patients had normal cardiac autonomic function, while the other half had significant abnormalities. The severity of CADF correlated with age, body mass indes (BMI), disease duration, and symptom severity. About half of SCZ patients have significant CADF, which increases their risk for cardiac events. These findings highlight the potential of HRV-based biomarkers in improving CVD risk prediction and stratification in SCZ. Future research should explore integrating HRV analysis with other biomarkers to enhance early detection and intervention strategies.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"40"},"PeriodicalIF":3.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588455","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":"Weaker beta desynchronization indicates impaired emotion recognition in schizophrenia.","authors":"Gábor Csukly, Hajnalka Molnár, Csilla Marosi, Zsuzsanna Fodor, Kinga Farkas","doi":"10.1038/s41537-025-00591-4","DOIUrl":"10.1038/s41537-025-00591-4","url":null,"abstract":"<p><p>In schizophrenia, deficits in social cognition, such as facial emotion identification, have a significant impact on patient's daily functioning and quality of life. We analyzed the beta event-related desynchronization (ERD) associated with emotional facial displays to understand better both phase-locked (i.e., neural activity and corresponding EEG response have a fixed latency after the stimulus onset) and non-phase-locked, induced (i.e. the latency of the response is not fixed) electrophysiological correlates of emotion recognition. 128 channels of EEG data from 37 patients with schizophrenia and 40 healthy controls were analyzed. Study groups were matched by sex age, and education. Participants had to identify facial displays of happiness, sadness, and neutral faces from the 'Karolinska Directed Emotional Faces (KDEF)' database. The time window of 300-700 ms was chosen to analyze spectral perturbation in the beta range associated with the presented emotional faces. Beta desynchronization was observed in both groups. We observed weaker beta ERD in patients. Weaker beta desynchronization correlated with poorer emotion recognition performance in the same time window in the patient group with a maximum correlation at the frontocentral region. Our main finding is that impaired emotion processing in patients with schizophrenia manifested as weaker beta desynchronization when perceiving faces reflecting sad and happy emotions or neutral facial expressions. Furthermore, less prominent beta desynchronization was associated with poorer emotion recognition performance in patients.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"39"},"PeriodicalIF":3.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588460","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":"Core beliefs in psychosis: a systematic review and meta-analysis.","authors":"A Jorovat, R Twumasi, A Mechelli, A Georgiades","doi":"10.1038/s41537-025-00577-2","DOIUrl":"10.1038/s41537-025-00577-2","url":null,"abstract":"<p><p>Increasing interest is growing for the identification of psychological mechanisms to account for the influence of trauma on psychosis, with core beliefs being proposed as a putative mediator to account for this relationship. A systematic review (n = 79 studies) was conducted to summarise the existing evidence base regarding the role of core beliefs/schemas in psychosis, Clinical High-Risk (CHR), and non-clinical samples with Psychotic-Like Experiences (PLEs). Compared to Healthy Controls (HCs), individuals with psychosis experiencing Auditory Hallucinations or Persecutory Delusions had significantly higher scores for negative self and negative other-beliefs and significantly lower scores for positive self and positive other-beliefs. This pattern of core beliefs was also observed for CHR individuals. In contrast, the core belief profile for grandiose delusions was in the opposite direction: higher positive self and positive other-beliefs and lower negative self-beliefs. In non-clinical samples, several factors mediated the relationship between Traumatic Life Events (TLEs) and PLEs, such as greater perceived stress, dissociation, external locus of control, and negative self and negative other-beliefs. Compared to HCs, meta-analyses revealed statistically significant large effects for negative self and negative other-beliefs in Schizophrenia. In CHR, statistically significant large and moderate effects were found for negative self and negative other-beliefs, respectively, along with a moderate negative effect for positive self-beliefs. Core beliefs were found to play a significant role in the development and maintenance of positive symptoms of psychosis. The development of psychosocial interventions that explicitly target negative self and other-beliefs, whilst also enhancing positive self-beliefs are warranted and would innovate CBTp practices.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"38"},"PeriodicalIF":3.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574826","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":"Along-tract white matter abnormalities and their clinical associations in recent-onset and chronic schizophrenia.","authors":"Sung Woo Joo, Hyeongyu Park, Jihyu Park, Jungsun Lee","doi":"10.1038/s41537-025-00586-1","DOIUrl":"10.1038/s41537-025-00586-1","url":null,"abstract":"<p><p>Structural impairments in white matter tracts are well-documented in schizophrenia, though their clinical implications remain limited. Most previous studies using diffusion-weighted magnetic resonance imaging (dMRI) and tractography relied on averaged diffusion indices, potentially obscuring localized changes in white matter tracts. Tractometry enables the investigation of localized changes at specific points along white matter tracts. We used dMRI and centerline tractometry to examine along-tract white matter abnormalities in 55 patients with recent-onset schizophrenia, 69 with chronic schizophrenia, and 77 healthy controls. Fractional anisotropy (FA) and peak length were measured at individual points along tract trajectories. Group differences in diffusion indices and their associations with clinical variables, including the Positive and Negative Syndrome Scale (PANSS), were analyzed using linear mixed models and Spearman's rho. In recent-onset schizophrenia, reduced FA was observed in the genu and splenium of the corpus callosum, along with deviations in peak length across multiple white matter tracts. The peak length of association tracts showed a negative correlation with antipsychotic dose. In chronic schizophrenia, widespread reductions in FA and deviations in peak length were identified across various white matter tracts. Decreased FA in commissural tracts was negatively associated with the PANSS negative score, antipsychotic dose, and illness duration. This study identified along-tract white matter abnormalities in recent-onset and chronic schizophrenia and revealed their associations with clinical symptoms. Localized measurements along tract trajectories enhance the detection of clinically relevant abnormalities compared to traditional methods relying on averaged diffusion indices.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"37"},"PeriodicalIF":3.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574779","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":"Leveraging deep neural network and language models for predicting long-term hospitalization risk in schizophrenia.","authors":"Yihang Bao, Wanying Wang, Zhe Liu, Weidi Wang, Xue Zhao, Shunying Yu, Guan Ning Lin","doi":"10.1038/s41537-025-00585-2","DOIUrl":"10.1038/s41537-025-00585-2","url":null,"abstract":"<p><p>Early warning of long-term hospitalization in schizophrenia (SCZ) patients at the time of admission is crucial for effective resource allocation and individual treatment planning. In this study, we developed a deep learning model that integrates demographic, behavioral, and blood test data from admission to forecast extended hospital stays using a retrospective cohort. By utilizing language models, our developed algorithm efficiently extracts 95% of the unstructured electronic health records data needed for this work, while ensuring data privacy and low error rate. This paradigm has also been demonstrated to have significant advantages in reducing potential discrimination and erroneous dependencies. By utilizing multimodal features, our deep learning model achieved a classification accuracy of 0.81 and an AUC of 0.9. Key risk factors identified included advanced age, longer disease duration, and blood markers such as elevated neutrophil-to-lymphocyte ratio, lower lymphocyte percentage, and reduced albumin levels, validated through comprehensive interpretability analyses and ablation studies. The inclusion of multimodal data significantly improved prediction performance, with demographic variables alone achieving an accuracy of 0.73, which increased to 0.81 with the addition of behavioral and blood test data. Our approach outperformed traditional machine learning methods, which were less effective in predicting long-term stays. This study demonstrates the potential of integrating diverse data types for enhanced predictive accuracy in mental health care, providing a robust framework for early intervention and personalized treatment in SCZ management.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"35"},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569106","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":"Weaker top-down cognitive control and stronger bottom-up signaling transmission as a pathogenesis of schizophrenia.","authors":"Xiaodan Lyu, Tiantian Liu, Yunxiao Ma, Li Wang, Jinglong Wu, Tianyi Yan, Miaomiao Liu, Jiajia Yang","doi":"10.1038/s41537-025-00587-0","DOIUrl":"10.1038/s41537-025-00587-0","url":null,"abstract":"<p><p>The clinical symptoms of schizophrenia are highly heterogeneous, with the most striking symptoms being cognitive deficits and perceptual disturbances. Cognitive deficits are typically linked to abnormalities in top-down mechanisms, whereas perceptual disturbances stem from dysfunctions in bottom-up processing. However, it remains unclear whether schizophrenia is primarily driven by top-down control mechanisms, bottom-up perceptual processes, or their interaction. We hypothesized that abnormal top-down and bottom-up interactions constitute the neural mechanisms of schizophrenia. Considering that autoencoders can identify hidden data features and support vector machines are capable of automatically locating the classification hyperplane, we developed an improved stacked autoencoder-support vector machine (ISAE-SVM) model for diagnosing schizophrenia based on resting-state functional magnetic resonance imaging data. A permutation test was used to identify the 213 most discriminative functional connections from the model's output features. Functional connections linking regions of higher cognitive functions and lower perceptual tasks were extracted to further examine their relevance to clinical symptoms. Finally, spectral dynamic causal modeling (sDCM) was used to analyze the dynamic causal interaction between brain regions corresponding to these functional connections. Our results showed that the ISAE-SVM model achieved an average classification accuracy of 82%. Notably, five resting-state functional connections spanning both cognitive and sensory brain areas were significantly correlated with Positive and Negative Syndrome Scale scores. Furthermore, sDCM analysis revealed weakened top-down regulation and enhanced bottom-up signaling in schizophrenia. These findings support our hypothesis that impaired top-down regulation and enhanced bottom-up signaling contribute to the neural mechanisms of schizophrenia.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"36"},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569111","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}