Schizophrenia bulletin open最新文献

{"title":"Pulvinar and Ventral Thalamic Nuclei Changes Occur Early Along the Psychosis Spectrum.","authors":"Ciaran Browne, Anurag Nasa, Linda Kelly, Sahar Riaz, Vitallia Sooknarine, Michael O'Connor, Orla Mitchell, Emma O'Hora, An Hsu, Ahmad Almulla, Areej Gazzaz, Conan Brady, Colm Healy, Erik O'Hanlon, Michael Connaughton, Mary Cannon, Darren William Roddy","doi":"10.1093/schizbullopen/sgaf016","DOIUrl":"10.1093/schizbullopen/sgaf016","url":null,"abstract":"<p><strong>Background: </strong>Psychosis may be conceptualized as a spectrum disorder, with psychotic experiences (PEs), fleeting, subtle symptoms not warranting clinical presentation-at its mildest end. The thalamus, particularly its pulvinar region, is implicated in coordinating cortical synchrony and attention, and may contribute to psychosis. Reduced pulvinar volumes have been observed in severe psychosis and in individuals lower on the spectrum. This study examines thalamic nuclei changes in young adolescents with PEs.</p><p><strong>Methods: </strong>A community-based sample of 95 adolescents aged 11-13 years (53 with PEs, 42 healthy controls) underwent magnetic resonance imaging (MRI), with thalamic nuclei volumes calculated using Freesurfer. Magnetic resonance imaging (MRI) was repeated at 2- and 5-year follow-up. Analyses of covariance and linear mixed-effects (LME) models assessed group-wise differences at each timepoint (TP) and longitudinally. Individual nuclei were recombined into anatomical composites (eg, pulvinar, ventral) for targeted analysis.</p><p><strong>Results: </strong>Compared with controls, adolescents with PEs had significantly smaller left pulvinar composite volumes at TP2 (<i>P</i> = .01) and TP3 (<i>P</i> = .019). Linear mixed-effects revealed a significant longitudinal reduction in left pulvinar volume (<i>P</i> = .008, false discovery rate [FDR]-corrected) and a significant increase in left ventral volumes (<i>P</i> = .013, FDR-corrected).</p><p><strong>Conclusions: </strong>Thalamic changes linked to higher-risk psychotic states appear detectable in nonclinical adolescents with subthreshold PEs. This divergence from normative developmental trajectories may indicate early alterations in neural circuits governing attention, cortical synchrony, and dopaminergic function. Identifying such early deviations could refine our understanding of psychosis vulnerability. Replication in larger, more diverse cohorts is warranted to confirm these preliminary findings and assess their predictive value.</p>","PeriodicalId":94380,"journal":{"name":"Schizophrenia bulletin open","volume":"6 1","pages":"sgaf016"},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194219","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":"Obstacles, Opportunities, and Ethical Considerations for Genomic Investigations of Individuals Continuously Hospitalized with Treatment-resistant Schizophrenia.","authors":"Richard C Josiassen, Rose Mary Xavier, Tyler E Dietterich, Matthew K Harner, Dawn M Filmyer, Cassie Houpt, Maya L Lichtenstein, Martilias Farrell, Rita A Shaughnessy, Gabriel Lazaro-Munoz, Jonathan S Berg, Patrick F Sullivan","doi":"10.1093/schizbullopen/sgaf019","DOIUrl":"10.1093/schizbullopen/sgaf019","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>The overarching objective when studying schizophrenia is the development of generalizable knowledge that improves patient health and/or increases our comprehension of their illness. To fully achieve this objective, investigations need to reflect the <i>full range of individual variation</i> found within this heterogeneous population. But individuals committed to state psychiatric institutions have been routinely excluded from research because of concerns that they may not be able to understand or provide adequately informed consent. While reasonable, we believe this approach has enabled policies that support implicit bias, contribute to health care disparities, and limit our knowledge of disease mechanisms and treatment.</p><p><strong>Study design: </strong>This article provides brief reviews of (1) ethical considerations when recruiting individuals with severely treatment-resistant psychotic symptoms for research, (2) the impact their condition has on decision-making capacity, and finally (3) we provide a first-hand narrative of our experience conducting a genomic study of involuntarily hospitalized individuals and the opportunities/obstacles we encountered.</p><p><strong>Study results: </strong>Evidence from published literature shows that cognitive impairment, rather than severity of psychopathology, is the greatest threat to decisional capacity. Ethical safeguards and practical considerations have been developed, including (1) institutional/local research committee review and approval, (2) confidentiality, (3) informed consent, (4) assessment of capacity, and (5) community engagement. Our experience demonstrates that carefully selected involuntarily committed individuals can be included in research.</p><p><strong>Conclusions: </strong>With ethical safeguards, these individuals deserve the opportunity to volunteer for research regarding the mental illness that has profoundly shaped their lives-to do otherwise is discriminatory.</p>","PeriodicalId":94380,"journal":{"name":"Schizophrenia bulletin open","volume":"6 1","pages":"sgaf019"},"PeriodicalIF":2.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234705","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":"\"A Connected Community\": Evaluating the Use of Project ECHO to Support the Implementation of an Evidence-Based Early Psychosis Care Model.","authors":"Monica Choi, Nitha Angelina Vincent, Rakshita Kathuria, Kiran Jassal, Emily Panzarella, Sarah Bromley, Katelyn Browne, Tom Domjancic, Janet Durbin, George Foussias, Nicole Kozloff, Paul Kurdyak, Tony Lai, Carol Maxwell, Anita Mohan, Christopher Koegl, Marleine Saliba, Eva Serhal, Aristotle Voineskos, Laura Williams, Sanjeev Sockalingam","doi":"10.1093/schizbullopen/sgaf018","DOIUrl":"https://doi.org/10.1093/schizbullopen/sgaf018","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>The <i>Early Psychosis Intervention-Spreading Evidence-Based Treatment</i> (EPI-SET) is a study evaluating the implementation and impact of NAVIGATE, a manualized model of care for first episode psychosis in geographically diverse EPI programs in Ontario. Project Extension for Community Health Outcomes (ECHO), a virtual training and capacity-building model, was used to support the NAVIGATE implementation for participating programs. We evaluated ECHO EPI-SET in supporting this implementation.</p><p><strong>Methods: </strong>Using Moore's Evaluation Framework for Continuing Education, attendance and biweekly surveys were used to evaluate clinician engagement and satisfaction with ECHO. A self-reported survey was used to assess self-efficacy across core competencies, determine whether ECHO changed their practice, and describe the nature of any changes. Semi-structured interviews focusing on participants' experience with ECHO EPI-SET were analyzed using thematic analysis.</p><p><strong>Results: </strong>A total of 92 participants from 6 EPI sites participated across 3 cycles of ECHO EPI-SET. Mean satisfaction ratings were high (>4/5 on a Likert scale). Participants who worked longer at their sites reported higher rates of self-efficacy. The interviews identified 5 major themes: creating a community of practice; supporting NAVIGATE; change in practice/application; implementation support; and strengths and areas for improvement.</p><p><strong>Conclusions: </strong>This is the first published evaluation of using ECHO in supporting the implementation of a model of EPI care. Participation in ECHO was associated with high levels of clinician satisfaction, engagement, and self-efficacy. Qualitative data suggest that ECHO supported the development of a community of practice, learning, and practice change and may be a helpful tool to support future implementations of NAVIGATE.</p>","PeriodicalId":94380,"journal":{"name":"Schizophrenia bulletin open","volume":"6 1","pages":"sgaf018"},"PeriodicalIF":2.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260465","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":"The Voices of Schizophrenia as One's Own Thoughts and What to Do About Them.","authors":"Anna Cornelia Beyer","doi":"10.1093/schizbullopen/sgaf014","DOIUrl":"10.1093/schizbullopen/sgaf014","url":null,"abstract":"","PeriodicalId":94380,"journal":{"name":"Schizophrenia bulletin open","volume":"6 1","pages":"sgaf014"},"PeriodicalIF":2.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985194","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":"Baseline Clinical Characterization of Participants in the Accelerating Medicines Partnership Schizophrenia Program.","authors":"Jean Addington, Lu Liu, Monica Chu, Karl Jungert, Nora Penzel, Ofer Pasternak, Emily Farina, Ricardo E Carrion, Cheryl M Corcoran, Vijay A Mittal, Gregory P Strauss, Alison R Yung, Luis Alameda, Celso Arango, Owen Borders, Sylvain Bouix, Nicholas J K Breitborde, Matthew R Broome, Kristin S Cadenhead, Rolando I Castillo-Passi, Eric Yu Hai Chen, Jimmy Choi, Michael J Coleman, Philippe Conus, Covadonga M Diaz-Caneja, Lauren M Ellman, Paolo Fusar Poli, Pablo A Gaspar, Carla Gerber, Louise Birkedal Glenthøj, Leslie E Horton, Christy Lai Ming Hui, Joseph Kambeitz, Lana Kambeitz-Ilankovic, Tina Kapur, Sinead Kelly, Melissa J Kerr, Matcheri S Keshavan, Minah Kim, Sung-Wan Kim, Nikolaos Koutsouleris, Jun Soo Kwon, Kerstin Langbein, Kathryn E Lewandowski, Daniel Mamah, Patricia J Marcy, Daniel H Mathalon, Catalina Mourgues, Merete Nordentoft, Angela R Nunez, Godfrey D Pearlson, Jesus Perez, Diana O Perkins, Albert R Powers, Jack Rogers, Fred W Sabb, Jason Schiffman, Johanna Seitz-Holland, Jai L Shah, Steven M Silverstein, Stefan Smesny, William S Stone, Judy L Thompson, Rachel Upthegrove, Swapna Verma, Jijun Wang, Daniel H Wolf, Tianhong Zhang, Lauren Addamo, Kate Buccilli, Dominic Dwyer, Sophie Todd, Youngsun T Cho, Clara Fontenau, Zailyn Tamayo, Carrie E Bearden, John M Kane, Patrick D McGorry, Rene S Kahn, Martha E Shenton, Scott W Woods, Monica E Calkins","doi":"10.1093/schizbullopen/sgaf012","DOIUrl":"10.1093/schizbullopen/sgaf012","url":null,"abstract":"<p><strong>Background: </strong>This paper focuses on the baseline clinical characterization of the participants in the Accelerating Medicines Partnership Schizophrenia (AMP SCZ) program. The AMP SCZ program is designed to investigate a wide array of clinical variables and biomarkers in a total of 2040 clinical high-risk (CHR) participants and 652 community control (CC) participants.</p><p><strong>Methods: </strong>The dataset analyzed includes 1642 individuals at clinical high risk for psychosis and 519 CCs. Key measures include the Positive Symptoms and Diagnostic Criteria for the Comprehensive Assessment of At-Risk Mental States Harmonized with the Structured Interview for Psychosis-Risk Syndromes, which determined CHR criteria and the severity of attenuated psychotic symptoms (APS). Other measures included the Structured Clinical Interview for DSM-5, scales to assess negative symptoms, depression, suicidal ideation, substance use, social and role functioning, and a selection of patient-reported outcomes.</p><p><strong>Results: </strong>CHR participants presented with more severe ratings on all clinical measures and poorer functioning relative to the CC. There were a few significant small associations between measures of APS and other clinical measures.</p><p><strong>Conclusion: </strong>The results from this study support previous research indicating that CHR individuals face serious clinical challenges beyond the risk of developing psychosis. Findings indicate significant associations among various clinical measures, underscoring the complex nature of the CHR population. Limitations are acknowledged, including the preliminary nature of the data and the need for more in-depth analyses from AMP SCZ papers already in progress. Future work will focus on longitudinal data and further exploration of clinical variables and their relationship with biomarkers.</p>","PeriodicalId":94380,"journal":{"name":"Schizophrenia bulletin open","volume":"6 1","pages":"sgaf012"},"PeriodicalIF":2.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985191","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":"Sample Ascertainment and Recruitment Sources in the Accelerating Medicines Partnership Schizophrenia Program.","authors":"Jean Addington, Amy Shalev, Lu Liu, Cari Jahraus, Monica Chu, Emily Farina, Paolo Fusar Poli, Patricia J Marcy, Angela R Nunez, Monica E Calkins, Luis Alameda, Celso Arango, Owen Borders, Sylvain Bouix, Nicholas J K Breitborde, Matthew R Broome, Kristin S Cadenhead, Ricardo E Carrion, Rolando I Castillo-Passi, Eric Yu Hai Chen, Jimmy Choi, Michael J Coleman, Philippe Conus, Cheryl M Corcoran, Covadonga M Diaz-Caneja, Lauren M Ellman, Pablo A Gaspar, Carla Gerber, Louise Birkedal Glenthøj, Leslie E Horton, Christy Lai Ming Hui, Joseph Kambeitz, Lana Kambeitz-Ilankovic, Tina Kapur, Sinead Kelly, Melissa J Kerr, Matcheri S Keshavan, Minah Kim, Sung-Wan Kim, Nikolaos Koutsouleris, Jun Soo Kwon, Kerstin Langbein, Kathryn E Lewandowski, Daniel Mamah, Daniel H Mathalon, Vijay A Mittal, Catalina Mourgues, Merete Nordentoft, Ofer Pasternak, Godfrey D Pearlson, Nora Penzel, Jesus Perez, Diana O Perkins, Albert R Powers, Jack Rogers, Fred W Sabb, Jason Schiffman, Johanna Seitz-Holland, Jai L Shah, Steven M Silverstein, Stefan Smesny, William S Stone, Gregory P Strauss, Judy L Thompson, Rachel Upthegrove, Swapna Verma, Jijun Wang, Daniel H Wolf, Alison R Yung, Tianhong Zhang, Lauren Addamo, Kate Buccilli, Sophie Todd, Dominic Dwyer, Carrie E Bearden, John M Kane, Patrick D McGorry, Rene S Kahn, Martha E Shenton, Scott W Woods","doi":"10.1093/schizbullopen/sgaf013","DOIUrl":"10.1093/schizbullopen/sgaf013","url":null,"abstract":"<p><strong>Background: </strong>This paper presents the recruitment sources of clinical high-risk (CHR) and community controls (CC) from the Accelerating Medicines Partnership Schizophrenia (AMP SCZ) program, which aims to study various clinical variables and biomarkers in 2040 CHR and 652 CC participants.</p><p><strong>Methods: </strong>A total of 1640 CHR and 514 CC had recruitment source data. The Positive Symptoms and Diagnostic Criteria for the Comprehensive Assessment of At-Risk Mental States Harmonized with the SIPS was utilized to assess CHR criteria and severity of attenuated psychotic symptoms (APSs), and the Global Functioning: Social Scale was used for social functioning. Participants were recruited through various methods, including referrals from healthcare providers, schools, and community agencies, and self-referrals via outreach efforts and advertising.</p><p><strong>Results: </strong>Participants were recruited from 13 different sources, with self-referral being the most common for both CHR and CC. Other notable sources included child and youth services and psychiatric hospitals and departments. Regional differences in recruitment patterns were observed across continents. Differences in age, APS, and social functioning for CHR participants were examined in the top 5 recruitment sources. Overall, self-referred individuals were typically older, with less severe APS and higher levels of functioning, whereas those from adult community mental health services had poorer functioning and more severe APS. The remaining recruitment groups fell between these 2 extremes.</p><p><strong>Conclusion: </strong>This paper highlights the diverse recruitment sources for the AMP SCZ program. Self-referral was a significant source, particularly in North America, reflecting changing help-seeking behaviors influenced by the internet and social media. The findings underscore the importance of understanding recruitment sources to optimize future CHR research.</p>","PeriodicalId":94380,"journal":{"name":"Schizophrenia bulletin open","volume":"6 1","pages":"sgaf013"},"PeriodicalIF":2.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985146","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":"Associations Between Blunted Pupillary Constriction and Dilation in Individuals with Schizophrenia: Evidence of a Common Mechanism?","authors":"Christophe Delay, Jan W Brascamp, Jessica Fattal, Matthew Lehet, Beier Yao, Katharine N Thakkar","doi":"10.1093/schizbullopen/sgaf017","DOIUrl":"10.1093/schizbullopen/sgaf017","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Unpacking the pathophysiological mechanisms of schizophrenia is necessary for advancing prediction, prevention, and treatment efforts. Mechanisms can be identified using easy-to-use and scalable clinical biomarkers, which reflect illness processes. Pupillometry is one such biomarker. Blunted dilation related to cognitive demand has been interpreted as a metric of diminished effort in schizophrenia, while blunted constriction to light has been interpreted as a metric of altered autonomic balance in schizophrenia. However, these 2 sets of findings may also reflect a common mechanism of schizophrenia. Therefore, this study aimed to explore the association between blunted cognitive dilation and blunted constriction to light to provide a parsimonious mechanism of autonomic and effort disturbances experienced by individuals with schizophrenia.</p><p><strong>Study design: </strong>We assessed light-induced constriction and cognitive dilation during a double-step task in individuals with schizophrenia (<i>n</i> = 84) and demographically matched healthy controls (HC, <i>n</i> = 69), compared these metrics between groups, and computed their correlation within each group.</p><p><strong>Study results: </strong>Replicating prior findings, dilation and constriction were blunted in schizophrenia relative to HC. Blunted constriction and dilation were positively correlated in schizophrenia but not HC (although the 2 correlations did not differ significantly).</p><p><strong>Conclusions: </strong>Findings provide, for the first time, preliminary support of a common mechanism linking blunted pupil constriction to light and dilation to cognitive demands in schizophrenia. We propose that individuals with schizophrenia may exhibit impaired top-down modulation of autonomic control. Future studies are needed to validate this proposed mechanism.</p>","PeriodicalId":94380,"journal":{"name":"Schizophrenia bulletin open","volume":"6 1","pages":"sgaf017"},"PeriodicalIF":2.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202711","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":"Attachment and Social Functioning in Patients with a Psychosis Spectrum Disorder: A Mediation Study.","authors":"Evelyn van Bussel, Bernice van Aken, Ingrid Willems, Cornelis L Mulder","doi":"10.1093/schizbullopen/sgaf015","DOIUrl":"10.1093/schizbullopen/sgaf015","url":null,"abstract":"<p><strong>Background: </strong>Insecure attachment may increase the risk of impaired social functioning in patients with a psychosis spectrum disorder. However, the pathways by which insecure attachment determines social functioning remain underexplored.</p><p><strong>Aims: </strong>To investigate the effects of insecure (anxious and avoidant) attachment styles on social functioning (defined as satisfaction with role performance) and the role of three candidate mediators (ie, psychotic, depressive, and anxiety symptoms) in patients with psychosis.</p><p><strong>Methods: </strong>Cross-sectional study as part of the UP's multicenter cohort study on recovery from psychotic disorders. Structural equation modeling was used to estimate direct and indirect paths of attachment styles and psychotic, depressive, and anxiety symptoms in relation to social functioning. Analyses were performed using data from a complete Psychosis Attachment Measure sample, <i>N</i> = 287.</p><p><strong>Results: </strong>The final model showed a mediation effect only for depressive symptoms, which appeared stronger for the association between anxious attachment and social functioning (-0.10, 95% CI -0.19 to -0.02) than for the association between avoidant attachment and social functioning (-0.04, 95% CI -0.08 to -0.01).</p><p><strong>Conclusions: </strong>Our results suggest that insecure attachment and depressive symptoms are relevant to improving social functioning in individuals with psychosis.</p>","PeriodicalId":94380,"journal":{"name":"Schizophrenia bulletin open","volume":"6 1","pages":"sgaf015"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202718","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":"Clozapine as a Long-Term Therapeutic Choice: Longitudinal Analysis of Schizophrenia Symptoms in a Naturalistic Setting.","authors":"Rachel K Scheinberg, Zhirui Fu, Laura Scott, Krista K Baker, Arlene Cuerdo, Lilian Zhong, Chloe Bethany, Malaka Harper, Leslie G Nucifora, Allison S Brandt, Russell L Margolis, Gayane Yenokyan, Frederick C Nucifora","doi":"10.1093/schizbullopen/sgaf009","DOIUrl":"10.1093/schizbullopen/sgaf009","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Clozapine remains the gold standard for treatment-resistant schizophrenia (TRS), yet the time course of clinical response in naturalistic settings is not well characterized. We hypothesized that patients initiated on clozapine in an outpatient clinic would demonstrate measurable symptom reduction over time, including delayed response in a subset of patients.</p><p><strong>Study design: </strong>We conducted a retrospective study of TRS patients (<i>N</i> = 26) newly initiated on clozapine at an outpatient clozapine clinic. Symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) at baseline and follow-up visits. Linear spline regression modeled PANSS trajectories over time. Response was defined as achieving either a ≥ 20% reduction in PANSS total score or a mild level of illness (PANSS score ≤ 58).</p><p><strong>Study results: </strong>Patients demonstrated a mean 18.1-point reduction in PANSS total score during the first year of clozapine treatment, with significant improvements in positive and general psychopathology symptoms. Negative symptoms showed a modest, nonsignificant change. Overall, 20 patients (76.9%) achieved a ≥ 20% PANSS reduction, and 15 (57.7%) reached a mild symptom level. Six patients (23.1%) met response criteria only after 12 months of treatment.</p><p><strong>Conclusions: </strong>In this naturalistic study, clozapine was associated with substantial symptom improvement, particularly within the first year. A subset of patients demonstrated delayed but clinically meaningful response, supporting the continued use of clozapine beyond 12 months. These findings underscore the value of sustained treatment in TRS.</p>","PeriodicalId":94380,"journal":{"name":"Schizophrenia bulletin open","volume":"6 1","pages":"sgaf009"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259820","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":"Differences in Real-world Functioning Between Adoptees With High or Low Risk for Schizophrenia Spectrum Disorders-The Finnish Adoptive Family Study of Schizophrenia.","authors":"Matilda Raiskila, Helinä Hakko, Karl-Erik Wahlberg, Sami Räsänen","doi":"10.1093/schizbullopen/sgaf011","DOIUrl":"10.1093/schizbullopen/sgaf011","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Schizophrenia spectrum disorders are known to affect the patient's functional performance. The functioning of those who are at familial risk for these disorders is less well understood. In this study, we compared the real-world functioning of adoptees with a genetic high-risk (HR) for schizophrenia spectrum disorders with adoptees without this risk (low-risk, LR). We hypothesized that the HR-group would have more difficulties in real-world functioning compared to the LR-group.</p><p><strong>Study design: </strong>The data were based on the Finnish Adoptive Family Study of Schizophrenia project. The study sample included 127 HR- and 130 LR-adoptees. An interview-based method, Strauss-Carpenter Level of Function (SCLF)-scale, was used to measure functional performance in a setup of adoptees living in comparable adoptive families. The SCLF-scale comprises domains for function, symptoms, social contacts, and work. The Structured Interview of Schizotypy was utilized in assessments of possible schizotypal traits of the HR- and LR-adoptees.</p><p><strong>Study results: </strong>No significant differences in the real-world functioning in total scores or scores of any SCLF domains were observed between HR- and LR-adoptees. Of single SCLF items, the HR-adoptees were characterized as being less likely to have achieved formal education and the LR-adoptees needed more help with their own basic needs.</p><p><strong>Conclusions: </strong>No differences were found in the real-world functioning between HR- and LR-populations. This indicates that the real-world functioning does not express one's genetic risk for schizophrenia spectrum disorders. Our findings highlight the importance of considering environmental factors when comparing genetically different groups.</p>","PeriodicalId":94380,"journal":{"name":"Schizophrenia bulletin open","volume":"6 1","pages":"sgaf011"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610800","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}