Schizophrenia (Heidelberg, Germany)最新文献

{"title":"Antipsychotic treatment in schizophrenia: balancing relapse prevention and functional recovery.","authors":"Jan P A M Bogers","doi":"10.1038/s41537-025-00697-9","DOIUrl":"10.1038/s41537-025-00697-9","url":null,"abstract":"","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"154"},"PeriodicalIF":4.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12712057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776757","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":"Benefits and risks of antipsychotic discontinuation in people with first and multi-episode psychotic disorders or with schizophrenia: why, when, how and in whom?","authors":"Christoph U Correll, Jose M Rubio, John M Kane","doi":"10.1038/s41537-025-00700-3","DOIUrl":"10.1038/s41537-025-00700-3","url":null,"abstract":"","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"151"},"PeriodicalIF":4.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12712082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776687","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":"Helping people to discontinue antipsychotics: if, when and how.","authors":"Joanna Moncrieff, Mark Abie Horowitz","doi":"10.1038/s41537-025-00695-x","DOIUrl":"10.1038/s41537-025-00695-x","url":null,"abstract":"<p><p>The default position in the treatment of psychotic conditions is that lifelong treatment is required after multiple episodes, with some portion of patients able to stop after a single episode. However, there are reasons to question this consensus, including that not everyone who stops antipsychotics relapses, the protective effects of antipsychotics may have been exaggerated due to the possibility that withdrawal itself is associated with adverse effects, including relapse, there is little evidence that antipsychotics target a pathological mechanism and their adverse effects may outweigh their benefits for some users. Recent pragmatic trials that employ a gradual reduction strategy give mixed results. They highlight that relapse is still a potential risk, but there may be gains in terms of social functioning in the long-term. There are no consistent factors that enable identification of people who might be able to discontinue antipsychotics more successfully, suggesting this option should be more widely offered. A gradual, hyperbolic approach to tapering has been proposed to reduce the adverse effects of withdrawal and relapse on stopping-approximated, for example, by reductions of 5-10% of the most recent dose every month. Patients should be supported to make decisions about long-term antipsychotic treatment based on weighing up the pros and cons of antipsychotic effects, in the light of the evidence base and the individual's priorities. Given that increasing duration of treatment is likely to increase the risk of withdrawal on stopping, long-term antipsychotic treatment should be minimized where possible.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"149"},"PeriodicalIF":4.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776668","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":"Three dimensions of speech coherence in people with early psychosis and their family members.","authors":"Derya Çokal, Abdulrahman Aloraini, Claudio Flores Palominos, Cemal Demirlek, Burcu Verim, Berna Yalınçetin, Emre Bora, Wolfram Hinzen","doi":"10.1038/s41537-025-00703-0","DOIUrl":"10.1038/s41537-025-00703-0","url":null,"abstract":"<p><p>Fundamental to coherence in discourse is referential structure - identifying entities through noun phrases (NPs, e.g. a man; that large cat) and tracking them in discourse. But coherence is also mediated by conceptual-semantic structure, as tracked through semantic similarity relations between words, and by predictability (\"perplexity\"). Alterations in speech coherence have long been noted in schizophrenia spectrum disorders (SSD) along all three of these dimensions. These are likely connected, but have largely been studied in isolation. This study targeted them together, in Turkish-speaking people with a first episode of psychosis (FEP, n = 53), youths at ultra-high risk (UHR, n = 64) of SSD, people with a family history of psychosis (FHP, N = 39), and 34 neurotypical controls (NC). In FEP, we confirmed a pattern previously attested in chronic SSD, of fewer definite NPs (e.g., this bald man), more \"bare\" NPs-i.e., lacking functional elements such as this/a -, and an unexpected random distribution of indefinite NPs; moreover, referential anomalies (unclarities of reference) were more prevalent in all groups relative to NC. FEP and UHR also showed higher word-to-word semantic similarity, and FEP larger image-to-text bimodal semantic distance, mirroring a pattern previously attested in English. NP-related variables related to both semantic similarity and perplexity, with crucially different correlational patterns seen for definite vs. indefinite NPs. Together, these results substantiate crosslinguistic evidence of a referential disturbance in early psychosis, partially extending to the extended schizophrenia phenotype, while additionally supporting that referential structure is closely integrated with conceptual semantics and the probabilistic structure of speech.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":"2"},"PeriodicalIF":4.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12775532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776689","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":"Antipsychotic discontinuation in schizophrenia: rational or reckless?","authors":"Robert B Zipursky, Ofer Agid, Gary Remington","doi":"10.1038/s41537-025-00698-8","DOIUrl":"10.1038/s41537-025-00698-8","url":null,"abstract":"","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"150"},"PeriodicalIF":4.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12712088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776666","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":"Special feature on antipsychotic discontinuation in schizophrenia.","authors":"David Taylor","doi":"10.1038/s41537-025-00696-w","DOIUrl":"10.1038/s41537-025-00696-w","url":null,"abstract":"","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"152"},"PeriodicalIF":4.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776745","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 metabolic syndrome, diabetes mellitus, inflammation and cognitive dysfunctions in schizophrenia: a cross-sectional analysis.","authors":"Alexander Kancsev, Marie Anne Engh, András Attila Horváth, Péter Hegyi, Oguz Kelemen, Szabolcs Kéri","doi":"10.1038/s41537-025-00694-y","DOIUrl":"10.1038/s41537-025-00694-y","url":null,"abstract":"<p><p>Metabolic syndrome (MetS) and diabetes mellitus (DM) are frequent in schizophrenia (SCZ) and have been linked to cognitive impairment and low-grade inflammation. In this cross-sectional study of adults with DSM-5 SCZ (N = 218; SCZ = 103, SCZ+MetS = 62, SCZ + DM = 53), we quantified interleukine-6 (IL-6) and C-Reactive Protein (CRP) and evaluated their associations with Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) cognitive domains and routine metabolic measures using multivariable models. Results revealed that SCZ + DM showed lower attention and delayed memory scores than SCZ and SCZ+MetS. No between-group differences were observed for immediate memory, visuospatial function, or language. IL-6 was highest in SCZ + DM, intermediate in SCZ + MetS, and lowest in SCZ. CRP did not differ significantly between groups. Across the cohort, higher IL-6 and fasting glucose were associated with lower attention and delayed memory. We conclude that DM status and higher IL-6 were most consistently associated with poorer attention and delayed memory in SCZ. Given the cross-sectional design, these findings reflect associations and may be influenced by treatment and residual confounding. Longitudinal studies with broader cytokine panels are warranted.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"148"},"PeriodicalIF":4.1,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12708724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770270","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":"Analysis of conceptual overlap among formal thought disorder rating scales in psychosis: a systematic semantic synthesis.","authors":"Alban Voppel, Silvia Ciampelli, Tilo Kircher, Peter F Liddle, Raffael Massuda, Frederike Stein, Sunny X Tang, Manaan Kar Ray, Sohee Park, Lena Palaniyappan","doi":"10.1038/s41537-025-00712-z","DOIUrl":"10.1038/s41537-025-00712-z","url":null,"abstract":"<p><p>Measuring Formal Thought Disorder (FTD), a common, cross-diagnosed symptom dimension across mental disorders, is plagued by numerous inconsistencies. Clinicians use either FTD-specific scales or items from generic scales. While these tools are based on extensive clinical observations, they suffer from inconsistent terminology. Different scales may use the same term for distinct concepts or different terms for the same concept. This lack of conceptual standardization prevents the identification of underlying FTD subconstructs. By using natural language processing, we compared the definitions, labeling and overlap of FTD symptoms, i.e., the definitions of single items, across psychopathological scales. We used a three-pronged validation approach to analyze semantic clusters of single definitions of FTD scale psychopathological items. First, we used sentence-BERT to divide 30 Thought and Language Disorder scale (TALD) items into positive or negative FTD clusters, validating this approach by checking for correspondence with published factor-analytic divisions (approach validation). Second, we created a sparse item-to-item similarity matrix from 103 items across seven scales to identify semantically converging cross-scale FTD items; a clinician-researcher described the resulting four clusters, and we compared our automated classification with that of six blinded experts to establish expert-machine semantic correspondence. Finally, we analyzed data from 98 participants (49 healthy controls and 49 schizophrenia/affective psychosis), identifying the highest-correlating Clinical Language Disorder Scale (CLANG) item for each Thought, Language and Communication (TLC) scale item and mapping these to our BERT-derived clusters to establish data-level correspondence. When assigning TALD items to BERT-derived positive or negative FTD groupings, we observed a 73% match with prior factor analyses. The BERT-informed clustering of cross-scale items highlighted four coherent FTD groupings: (1) muddled communication & incomprehension, (2) abrupt topic shifts, (3) inconsistent narrative structure, (4) restricted speech. Expert raters showed moderate-to-high overlap (Fleiss' kappa = 0.617) with computational clusters. A binomial test indicated that at the level of individual participants, correlations among CLANG-TLC item pairs were significantly more likely than chance to fall into the expected semantic cluster (p < 0.001). FTD rating scales measure overlapping, semantically related constructs that drive item-level correlations. Semantic clustering acts as a novel method to harmonize multi-scale data and pinpoint discrepancies between expert and machine classifications. Computational linguistics has the potential to improve consistency across rating scales especially when measuring complex constructs such as FTD.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":"9"},"PeriodicalIF":4.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12820080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764880","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":"AVATAR therapy for medication-resistant auditory hallucination in patients with psychosis: a systematic review and meta-analysis.","authors":"Tien-Wei Hsu, Ping-Tao Tseng, Chih-Wei Hsu, Fu-Chi Yang, Te-Chang Changchien, Yu-Hsuan Lin, Chih-Sung Liang","doi":"10.1038/s41537-025-00671-5","DOIUrl":"10.1038/s41537-025-00671-5","url":null,"abstract":"<p><p>Auditory hallucination (AH) is a distressing and disabling symptom in patients with schizophrenia spectrum disorder, particularly in those who do not respond to antipsychotics. The aim of this study is to examine the efficacy of AVATAR (Audio Visual Assisted Therapy Aid for Refractory auditory hallucinations) therapy for medication-resistant AH in patients with schizophrenia spectrum disorder. A systematic search was conducted across five major databases for randomized controlled trials (RCTs) investigating AVATAR therapy for patients with medication-resistant AH, with control conditions such as treatment-as-usual (TAU), cognitive behavioral therapy (CBT), or supportive therapy. The primary outcome was AH severity improvement, measured by the Psychotic Symptom Rating Scale-Auditory Hallucination. The secondary outcomes were positive and negative symptoms (assessed using the Positive And Negative Syndrome Scale), quality of life, depression, anxiety, and acceptance (all-cause discontinuation). Additionally, we evaluated the long-term efficacy by examining the sustained effects after treatment discontinuation. Six RCTs (n = 675; 64.7% male; mean age 39.4 [SD 4.8] years) were included. AVATAR therapy was associated with AH improvement (mean difference [MD], -2.97; 95%CI: -4.03, -1.90) and positive symptoms reduction (MD, -1.13; 95%CI: -2.14, -0.11) compared to controls. It also showed efficacy in improving depressive symptoms, anxiety, and quality of life, with small-to-medium effect sizes. The three-month follow-up effects remained consistent with treatment effect at study endpoints across all outcomes. The all-cause discontinuation rate did not differ between AVATAR therapy and controls. Given its potential benefits, clinicians may consider implementing AVATAR therapy for patients with medication-resistant symptoms. However, the development of standardized treatment protocols or manuals is essential to ensure treatment fidelity and guide future clinical and research applications.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":"1"},"PeriodicalIF":4.1,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12770313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752435","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":"Alterations in serum IL-10 and IL-19 levels in drug-naïve first-episode adolescent-onset schizophrenia and their associations with clinical symptoms.","authors":"Haidong Yang, Zhihui Shi, Li Xu, Chenchen Xu, Jing Li, Lingshu Luan, Tingting Jin, Xiaobin Zhang","doi":"10.1038/s41537-025-00711-0","DOIUrl":"10.1038/s41537-025-00711-0","url":null,"abstract":"<p><p>Immune-inflammatory mechanisms in schizophrenia have received widespread attention, but the levels of interleukin-10 (IL-10) and interleukin-19 (IL-19) and their associations with clinical symptoms in adolescent-onset schizophrenia (AOS) remain unclear. This study aimed to investigate serum IL-10 and IL-19 levels in AOS patients and their relationships with clinical symptoms. This cross-sectional study enrolled 83 drug-naïve first-episode AOS patients and 40 healthy controls. Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Compared with healthy controls, AOS patients exhibited significantly decreased serum IL-10 levels (P = 0.007), elevated IL-19 levels (P = 0.014), and an increased IL-19/IL-10 (P < 0.001). Serum IL-10 levels in AOS patients were significantly negatively correlated with PANSS negative factor scores (r = -0.254, P = 0.020) and excitement/hostility factor scores (r = -0.348, P = 0.001), while the IL-19/IL-10 was positively correlated with excitement/hostility factor scores (r = 0.349, P = 0.001). Exploratory stratified analyses revealed significant negative correlations between IL-10 and excitement/hostility factor in both male patients (r = -0.432, P = 0.010) and female patients (r = -0.375, P = 0.009). Additionally, lower IL-10 levels were an independent predictor of AOS (RR = 0.808, 95%CI: 0.714-0.914, P = 0.001). AOS patients demonstrated an immune imbalance characterized by decreased serum IL-10, elevated IL-19 levels, and an increased IL-19/IL-10. IL-10 levels and the IL-19/IL-10 were closely associated with negative and excitement/hostility symptoms in AOS, with this association exhibiting sex differences. These findings suggest that IL-10 and the pro-inflammatory/anti-inflammatory balance may play an important role in the pathophysiological mechanism of AOS.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":" ","pages":"8"},"PeriodicalIF":4.1,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710477","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}