TianHong Zhang, LiHua Xu, YanYan Wei, XiaoChen Tang, RanPiao Gan, Dan Zhang, ZhengHui Yi, XiaoHua Liu, HaiChun Liu, ZiXuan Wang, Tao Chen, Jin Gao, Qiang Hu, LingYun Zeng, ChunBo Li, JiJun Wang
{"title":"烟酸诱发的早期精神病患者皮肤潮红模式的有效性和程度。","authors":"TianHong Zhang, LiHua Xu, YanYan Wei, XiaoChen Tang, RanPiao Gan, Dan Zhang, ZhengHui Yi, XiaoHua Liu, HaiChun Liu, ZiXuan Wang, Tao Chen, Jin Gao, Qiang Hu, LingYun Zeng, ChunBo Li, JiJun Wang","doi":"10.4088/JCP.24m15559","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> Niacin-induced skin flushing response (NSFR) attenuation is a well documented biomarker for psychosis and has also been used in studies of bipolar affective disorder. It appears not only in later stages but also in first episodes and in clinical high-risk (CHR) stages.</p><p><p><b>Methods:</b> NSFR tests were conducted on healthy controls (HC), CHR individuals, and first-episode psychosis (FEP) patients from January 2019 to March 2024. The tests involved applying niacin patches at different concentrations and recording skin responses at multiple time points. A newly introduced slope variable was used to evaluate response efficiency. CHR participants were followed for 3 years to assess the predictive value of NSFR efficiency and attenuation degree for psychosis onset.</p><p><p><b>Results:</b> This study included 98 CHR individuals (mean age: 18.4 years, 42.9% male), 54 FEP patients (24.7 years, 50% male), and 61 HC (25.8 years, 54.1% male). Over the 3-year follow-up, 23 (23.5%) CHR individuals converted to psychosis. CHR individuals showed NSFR attenuation levels between those of FEP patients and HC. Lower response efficiency was associated with a higher risk of developing psychosis, specifically at 10<sup>-4</sup> M and 10<sup>-2</sup> M concentrations (<i>P</i> = .001 and <i>P</i> = .039, respectively). The area under the curve for predicting psychosis onset using slope values at 10<sup>-2</sup> M was 0.645 (<i>P</i> = .034). For discriminating CHR from HC, significant factors included slope at 10<sup>-3</sup> M concentration (<i>P</i> = .006), total scores at 5 minutes (<i>P</i> = .001) and 15 minutes (<i>P</i> = .005), and total scores at 10<sup>-3</sup> M (<i>P</i> = .002) and 10<sup>-2</sup> M (<i>P</i> = .001). For discriminating FEP from HC, significant factors were the slope at 10<sup>-4</sup> M concentration (<i>P</i> = .023), total score at 5 minutes (<i>P</i> = .003), and total score at 10<sup>-3</sup> M concentration (<i>P</i> = .040).</p><p><p><b>Conclusions:</b> NSFR efficiency is a sensitive marker for early psychosis risk, highlighting the need for precise and comprehensive detection methods.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficiency and Extent of Niacin-Induced Skin Flushing Patterns in Early Stages of Psychosis.\",\"authors\":\"TianHong Zhang, LiHua Xu, YanYan Wei, XiaoChen Tang, RanPiao Gan, Dan Zhang, ZhengHui Yi, XiaoHua Liu, HaiChun Liu, ZiXuan Wang, Tao Chen, Jin Gao, Qiang Hu, LingYun Zeng, ChunBo Li, JiJun Wang\",\"doi\":\"10.4088/JCP.24m15559\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Objective:</b> Niacin-induced skin flushing response (NSFR) attenuation is a well documented biomarker for psychosis and has also been used in studies of bipolar affective disorder. It appears not only in later stages but also in first episodes and in clinical high-risk (CHR) stages.</p><p><p><b>Methods:</b> NSFR tests were conducted on healthy controls (HC), CHR individuals, and first-episode psychosis (FEP) patients from January 2019 to March 2024. The tests involved applying niacin patches at different concentrations and recording skin responses at multiple time points. A newly introduced slope variable was used to evaluate response efficiency. CHR participants were followed for 3 years to assess the predictive value of NSFR efficiency and attenuation degree for psychosis onset.</p><p><p><b>Results:</b> This study included 98 CHR individuals (mean age: 18.4 years, 42.9% male), 54 FEP patients (24.7 years, 50% male), and 61 HC (25.8 years, 54.1% male). Over the 3-year follow-up, 23 (23.5%) CHR individuals converted to psychosis. CHR individuals showed NSFR attenuation levels between those of FEP patients and HC. Lower response efficiency was associated with a higher risk of developing psychosis, specifically at 10<sup>-4</sup> M and 10<sup>-2</sup> M concentrations (<i>P</i> = .001 and <i>P</i> = .039, respectively). The area under the curve for predicting psychosis onset using slope values at 10<sup>-2</sup> M was 0.645 (<i>P</i> = .034). For discriminating CHR from HC, significant factors included slope at 10<sup>-3</sup> M concentration (<i>P</i> = .006), total scores at 5 minutes (<i>P</i> = .001) and 15 minutes (<i>P</i> = .005), and total scores at 10<sup>-3</sup> M (<i>P</i> = .002) and 10<sup>-2</sup> M (<i>P</i> = .001). For discriminating FEP from HC, significant factors were the slope at 10<sup>-4</sup> M concentration (<i>P</i> = .023), total score at 5 minutes (<i>P</i> = .003), and total score at 10<sup>-3</sup> M concentration (<i>P</i> = .040).</p><p><p><b>Conclusions:</b> NSFR efficiency is a sensitive marker for early psychosis risk, highlighting the need for precise and comprehensive detection methods.</p>\",\"PeriodicalId\":50234,\"journal\":{\"name\":\"Journal of Clinical Psychiatry\",\"volume\":\"86 3\",\"pages\":\"\"},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2025-07-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4088/JCP.24m15559\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4088/JCP.24m15559","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Efficiency and Extent of Niacin-Induced Skin Flushing Patterns in Early Stages of Psychosis.
Objective: Niacin-induced skin flushing response (NSFR) attenuation is a well documented biomarker for psychosis and has also been used in studies of bipolar affective disorder. It appears not only in later stages but also in first episodes and in clinical high-risk (CHR) stages.
Methods: NSFR tests were conducted on healthy controls (HC), CHR individuals, and first-episode psychosis (FEP) patients from January 2019 to March 2024. The tests involved applying niacin patches at different concentrations and recording skin responses at multiple time points. A newly introduced slope variable was used to evaluate response efficiency. CHR participants were followed for 3 years to assess the predictive value of NSFR efficiency and attenuation degree for psychosis onset.
Results: This study included 98 CHR individuals (mean age: 18.4 years, 42.9% male), 54 FEP patients (24.7 years, 50% male), and 61 HC (25.8 years, 54.1% male). Over the 3-year follow-up, 23 (23.5%) CHR individuals converted to psychosis. CHR individuals showed NSFR attenuation levels between those of FEP patients and HC. Lower response efficiency was associated with a higher risk of developing psychosis, specifically at 10-4 M and 10-2 M concentrations (P = .001 and P = .039, respectively). The area under the curve for predicting psychosis onset using slope values at 10-2 M was 0.645 (P = .034). For discriminating CHR from HC, significant factors included slope at 10-3 M concentration (P = .006), total scores at 5 minutes (P = .001) and 15 minutes (P = .005), and total scores at 10-3 M (P = .002) and 10-2 M (P = .001). For discriminating FEP from HC, significant factors were the slope at 10-4 M concentration (P = .023), total score at 5 minutes (P = .003), and total score at 10-3 M concentration (P = .040).
Conclusions: NSFR efficiency is a sensitive marker for early psychosis risk, highlighting the need for precise and comprehensive detection methods.
期刊介绍：
For over 75 years, The Journal of Clinical Psychiatry has been a leading source of peer-reviewed articles offering the latest information on mental health topics to psychiatrists and other medical professionals.The Journal of Clinical Psychiatry is the leading psychiatric resource for clinical information and covers disorders including depression, bipolar disorder, schizophrenia, anxiety, addiction, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder while exploring the newest advances in diagnosis and treatment.
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