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Guo Z, Wang J, Jing T, Fu L. Investigating the interpretability of schizophrenia EEG mechanism through a 3DCNN-based hidden layer features aggregation framework. Comput Methods Programs Biomed 2024; 247:108105. [PMID: 38447316 DOI: 10.1016/j.cmpb.2024.108105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/07/2024] [Accepted: 02/26/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND AND OBJECTIVE Electroencephalogram (EEG) signals record brain activity, with growing interest in quantifying neural activity through complexity analysis as a potential biological marker for schizophrenia. Presently, EEG complexity analysis primarily relies on manual feature extraction, which is subjective and yields varied findings in studies involving schizophrenia and healthy controls. METHODS This study aims to leverage deep learning methods for enhanced EEG complexity exploration, aiding early schizophrenia screening and diagnosis. Our proposed approach utilizes a three-dimensional Convolutional Neural Network (3DCNN) to extract enhanced data features for early schizophrenia identification and subsequent complexity analysis. Leveraging the spatiotemporal capabilities of 3DCNN, we extract advanced latent features and employ knowledge distillation to reintegrate these features into the original channels, creating feature-enhanced data. RESULTS We employ a 10-fold cross-validation strategy, achieving the average accuracies of 99.46% and 98.06% in subject-dependent experiments on Dataset 1(14SZ and 14HC) and Dataset 2 (45SZ and 39HC). The average accuracy for subject-independent is 96.04% and 92.67% on both datasets. Feature extraction and classification are conducted on both the re-aggregated data and the original data. Our results demonstrate that re-aggregated data exhibit superior classification performance and a more stable training process after feature extraction. In the complexity analysis of re-aggregated data, we observe lower entropy features in schizophrenic patients compared to healthy controls, with more pronounced differences in the temporal and frontal lobes. Analyzing Katz's Fractal Dimension (KFD) across three sub-bands of lobe channels reveals the lowest α band KFD value in schizophrenia patients. CONCLUSIONS This emphasizes the ability of our method to enhance the discrimination and interpretability in schizophrenia detection and analysis. Our approach enhances the potential for EEG-based schizophrenia diagnosis by leveraging deep learning, offering superior discrimination capabilities and richer interpretive insights.
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Affiliation(s)
- Zhifen Guo
- College of Information Science and Engineering, Northeastern University, Shenyang, China.
| | - Jiao Wang
- College of Information Science and Engineering, Northeastern University, Shenyang, China.
| | - Tianyu Jing
- College of Information Science and Engineering, Northeastern University, Shenyang, China.
| | - Longyue Fu
- College of Information Science and Engineering, Northeastern University, Shenyang, China.
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202
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Smith LC, Mateos AC, Due AS, Bergström J, Nordentoft M, Clemmensen L, Glenthøj LB. Immersive virtual reality in the treatment of auditory hallucinations: A PRISMA scoping review. Psychiatry Res 2024; 334:115834. [PMID: 38452499 DOI: 10.1016/j.psychres.2024.115834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND A large group of psychiatric patients suffer from auditory hallucinations (AH) despite relevant treatment regimens. In mental health populations, AH tend to be verbal (AVH) and the content critical or abusive. Trials employing immersive virtual reality (VR) to treat mental health disorders are emerging. OBJECTIVE The aim of this scoping review is to provide an overview of clinical trials utilizing VR in the treatment of AH and to document knowledge gaps in the literature. METHODS PubMed, Cochrane Library, and Embase were searched for studies reporting on the use of VR to target AH. RESULTS 16 papers were included in this PRISMA scoping review (ScR). In most studies VR therapy (VRT) was employed to ameliorate treatment resistant AVH in schizophrenia spectrum disorders. Only two studies included patients with a diagnosis of affective disorders. The VRT was carried out with the use of an avatar to represent the patient's most dominant voice. DISCUSSION The research field employing VR to treat AH is promising but still in its infancy. Results from larger randomized clinical trials are needed to establish substantial evidence of therapy effectiveness. Additionally, the knowledge base would benefit from more profound qualitative data exploring views of patients and therapists.
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Affiliation(s)
- Lisa Charlotte Smith
- VIRTU Research Group, Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark; Department of Clinical Medicine (DK), University of Copenhagen, Denmark.
| | - Ana Collados Mateos
- VIRTU Research Group, Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark
| | - Anne Sofie Due
- VIRTU Research Group, Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark
| | - Joanna Bergström
- Department of Computer Science (DK), University of Copenhagen, Denmark
| | - Merete Nordentoft
- Department of Clinical Medicine (DK), University of Copenhagen, Denmark; Research Unit (CORE), Capital Region (DK), Mental Health Center Copenhagen, Denmark
| | - Lars Clemmensen
- VIRTU Research Group, Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark
| | - Louise Birkedal Glenthøj
- VIRTU Research Group, Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark; Department of Psychology (DK), University of Copenhagen, Denmark
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203
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Torregrossa LJ, Liu J, Armstrong K, Heckers S, Sheffield JM. Interplay between childhood trauma, bodily self-disturbances, and clinical phenomena in schizophrenia spectrum disorders: A network analysis. Schizophr Res 2024; 266:107-115. [PMID: 38394867 DOI: 10.1016/j.schres.2024.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/06/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Bodily self-disturbances have long been considered central to schizophrenia. Exposure to childhood trauma has been linked to the development of both psychosis and bodily self-disturbances, yet little work has examined the role of bodily self-disturbances in the relationship between childhood trauma and schizophrenia symptomatology. This study uses network analysis to bridge this gap. METHODS Networks were constructed to examine relationships between schizophrenia symptoms (Positive and Negative Symptom Scale; PANSS), bodily self-disturbances (Perceptual Aberration Scale; PAS), and self-reported exposure to childhood trauma (Childhood Trauma Questionnaire, Short-Form; CTQ-SF) in 152 people with a schizophrenia-spectrum disorder. Shortest path and bridge analyses were conducted to assess the role of bodily self-disturbances in linking childhood trauma to schizophrenia symptomatology. Three networks were constructed: 1) PAS, childhood trauma, and PANSS sub-scale composites (positive, negative, general); 2) PAS, childhood trauma, and positive symptoms, 3) PAS, childhood trauma, and distress symptoms. RESULTS Shortest path analysis revealed that bodily self-disturbances were on the shortest path between childhood trauma and positive and general symptoms (Network 1), between trauma and hallucinations (Network 2), and between trauma and depression (Network 3). Bodily self-disturbances were also found to serve as a bridge between childhood trauma and positive symptoms of schizophrenia, particularly delusions and hallucinations. CONCLUSIONS Using a novel, data-driven approach, we showed that bodily self-disturbances play a key role in linking childhood trauma to positive and co-morbid affective symptoms of schizophrenia. Threat experiences (i.e., abuse) specifically relate to bodily self-disturbances and psychotic symptoms.
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Affiliation(s)
- Lénie J Torregrossa
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, United States of America.
| | - Jinyuan Liu
- Vanderbilt University Medical Center, Department of Biostatistics, United States of America
| | - Kristan Armstrong
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, United States of America
| | - Stephan Heckers
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, United States of America
| | - Julia M Sheffield
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, United States of America
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204
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Jeng SL, Tu MJ, Lin CW, Lin JJ, Tseng HH, Jang FL, Lu MK, Chen PS, Huang CC, Chang WH, Tan HP, Lin SH. Machine learning for prediction of schizophrenia based on identifying the primary and interaction effects of minor physical anomalies. J Psychiatr Res 2024; 172:108-118. [PMID: 38373372 DOI: 10.1016/j.jpsychires.2024.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/21/2024]
Abstract
In the neurodevelopmental model of schizophrenia, minor physical anomalies (MPAs) are considered neurodevelopmental markers of schizophrenia. To date, there has been no research to evaluate the interaction between MPAs. Our study built and used a machine learning model to predict the risk of schizophrenia based on measurements of MPA items and to investigate the potential primary and interaction effects of MPAs. The study included 470 patients with schizophrenia and 354 healthy controls. The models used are classical statistical model, Logistic Regression (LR), and machine leaning models, Decision Tree (DT) and Random Forest (RF). We also plotted two-dimensional scatter diagrams and three-dimensional linear/quadratic discriminant analysis (LDA/QDA) graphs for comparison with the DT dendritic structure. We found that RF had the highest predictive power for schizophrenia (Full-training AUC = 0.97 and 5-fold cross-validation AUC = 0.75). We identified several primary MPAs, such as the mouth region, high palate, furrowed tongue, skull height and mouth width. Quantitative MPA analysis indicated that the higher skull height and the narrower mouth width, the higher the risk of schizophrenia. In the interaction, we further identified that skull height and mouth width, furrowed tongue and skull height, high palate and skull height, and high palate and furrowed tongue, showed significant two-item interactions with schizophrenia. A weak three-item interaction was found between high palate, skull height, and mouth width. In conclusion, we found that the two machine learning methods showed good predictive ability in assessing the risk of schizophrenia using the primary and interaction effects of MPAs.
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Affiliation(s)
- Shuen-Lin Jeng
- Department of Statistics, Institute of Data Science, and Center for Innovative FinTech Business Models, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Jun Tu
- Department of Statistics, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Wei Lin
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jin-Jia Lin
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan
| | - Huai-Hsuan Tseng
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fong-Lin Jang
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan
| | - Ming-Kun Lu
- Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
| | - Po-See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Chun Huang
- Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Wei-Hung Chang
- Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Hung-Pin Tan
- Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
| | - Sheng-Hsiang Lin
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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205
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Cai B, Zhu Y, Liu D, Li Y, Bueber M, Yang X, Luo G, Su Y, Grivel MM, Yang LH, Qian M, Stone WS, Phillips MR. Use of the Chinese version of the MATRICS Consensus Cognitive Battery to assess cognitive functioning in individuals with high risk for psychosis, first-episode schizophrenia and chronic schizophrenia: a systematic review and meta-analysis. Lancet Reg Health West Pac 2024; 45:101016. [PMID: 38699289 PMCID: PMC11064724 DOI: 10.1016/j.lanwpc.2024.101016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/18/2023] [Accepted: 01/10/2024] [Indexed: 05/05/2024]
Abstract
More than one hundred studies have used the mainland Chinese version of the MATRICS Consensus Cognitive Battery (MCCB) to assess cognition in schizophrenia, but the results of these studies, the quality of the reports, and the strength of the evidence provided in the reports have not been systematically assessed. We identified 114 studies from English-language and Chinese-language databases that used the Chinese MCCB to assess cognition in combined samples of 7394 healthy controls (HC), 392 individuals with clinical high risk for psychosis (CHR-P), 4922 with first-episode schizophrenia (FES), 1549 with chronic schizophrenia (CS), and 2925 with schizophrenia of unspecified duration. The mean difference (MD) of the composite MCCB T-score (-13.72) and T-scores of each of the seven cognitive domains assessed by MCCB (-14.27 to -7.92) were significantly lower in individuals with schizophrenia than in controls. Meta-analysis identified significantly greater cognitive impairment in FES and CS than in CHR-P in six of the seven domains and significantly greater impairment in CS than FES in the reasoning and problem-solving domain (i.e., executive functioning). The only significant covariate of overall cognitive functioning in individuals with schizophrenia was a negative association with the severity of psychotic symptoms. These results confirm the construct validity of the mainland Chinese version of MCCB. However, there were significant limitations in the strength of the evidence provided about CHR-P (small pooled sample sizes) and the social cognition domain (inconsistency of results across studies), and the quality of many reports (particularly those published in Chinese) was rated 'poor' due to failure to report sample size calculations, matching procedures or methods of handling missing data. Moreover, almost all studies were cross-sectional studies limited to persons under 60 with at least nine years of education, so longitudinal studies of under-educated, older individuals with schizophrenia are needed.
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Affiliation(s)
- Bing Cai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yikang Zhu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongyang Liu
- School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Yaxi Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Marlys Bueber
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuezhi Yang
- The Fifth People's Hospital, Nanning, Guangxi, China
| | - Guoshuai Luo
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, China
| | - Ying Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Margaux M. Grivel
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
| | - Lawrence H. Yang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Min Qian
- Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - William S. Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Michael R. Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
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206
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Cai M, Ji Y, Zhao Q, Xue H, Sun Z, Wang H, Zhang Y, Chen Y, Zhao Y, Zhang Y, Lei M, Wang C, Zhuo C, Liu N, Liu H, Liu F. Homotopic functional connectivity disruptions in schizophrenia and their associated gene expression. Neuroimage 2024; 289:120551. [PMID: 38382862 DOI: 10.1016/j.neuroimage.2024.120551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/18/2024] [Accepted: 02/19/2024] [Indexed: 02/23/2024] Open
Abstract
It has been revealed that abnormal voxel-mirrored homotopic connectivity (VMHC) is present in patients with schizophrenia, yet there are inconsistencies in the relevant findings. Moreover, little is known about their association with brain gene expression profiles. In this study, transcription-neuroimaging association analyses using gene expression data from Allen Human Brain Atlas and case-control VMHC differences from both the discovery (meta-analysis, including 9 studies with a total of 386 patients and 357 controls) and replication (separate group-level comparisons within two datasets, including a total of 258 patients and 287 controls) phases were performed to identify genes associated with VMHC alterations. Enrichment analyses were conducted to characterize the biological functions and specific expression of identified genes, and Neurosynth decoding analysis was performed to examine the correlation between cognitive-related processes and VMHC alterations in schizophrenia. In the discovery and replication phases, patients with schizophrenia exhibited consistent VMHC changes compared to controls, which were correlated with a series of cognitive-related processes; meta-regression analysis revealed that illness duration was negatively correlated with VMHC abnormalities in the cerebellum and postcentral/precentral gyrus. The abnormal VMHC patterns were stably correlated with 1287 genes enriched for fundamental biological processes like regulation of cell communication, nervous system development, and cell communication. In addition, these genes were overexpressed in astrocytes and immune cells, enriched in extensive cortical regions and wide developmental time windows. The present findings may contribute to a more comprehensive understanding of the molecular mechanisms underlying VMHC alterations in patients with schizophrenia.
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Affiliation(s)
- Mengjing Cai
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yuan Ji
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Qiyu Zhao
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Hui Xue
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Zuhao Sun
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - He Wang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yijing Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yayuan Chen
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yao Zhao
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yujie Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Minghuan Lei
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Chunyang Wang
- Department of Scientific Research, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Chuanjun Zhuo
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Nankai University Affiliated Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Nana Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China.
| | - Huaigui Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China.
| | - Feng Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China.
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207
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Mäkipelto V, Tuulio-Henriksson A, Hakulinen C, Niemelä S, Lähteenvuo M, Wegelius A, Kieseppä T, Isometsä E, Tiihonen J, Kampman O, Lahdensuo K, Mazumder A, Suvisaari J, Holm M. Association of antidepressant and benzodiazepine use, and anticholinergic burden with cognitive performance in schizophrenia. Schizophr Res 2024; 266:118-126. [PMID: 38401410 DOI: 10.1016/j.schres.2024.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 12/01/2023] [Accepted: 02/17/2024] [Indexed: 02/26/2024]
Abstract
Schizophrenia is characterized by cognitive impairment affecting everyday functioning. Earlier research has hypothesized that antidepressants may associate with better cognitive functioning, but results are mixed. This study explored the association between antidepressant use and cognitive performance in terms of reaction time and visual learning in a clinical sample. In addition, we examined benzodiazepine use and anticholinergic burden. Study participants were drawn from the SUPER-Finland cohort, collected among patients with psychotic illnesses in 2016-2018 throughout Finland (n = 10,410). The analysis included adults with a schizophrenia diagnosis (F20) and results from a cognitive assessment (n = 3365). Information about medications and psychosocial factors were gathered through questionnaire and interview. Cognitive performance was assessed with the Cambridge Neuropsychological Test Automated Battery (CANTAB) with two subtests measuring reaction time and visual learning. Almost 36 % of participants used at least one antidepressant. The use of antidepressants in general was not associated with performance in the reaction time and visual learning tasks. However, the use of SNRI antidepressants was associated with a faster reaction time. Benzodiazepine use and a higher anticholinergic burden were associated with poorer performance in both tests. The results strengthen earlier findings that there is no association between antidepressant use in general and cognitive performance in schizophrenia. However, the association of SNRI medications with a faster reaction time warrants further research. Moreover, the results suggest that more attention should be paid to the anticholinergic burden of the medications used by patients with schizophrenia, as well as avoiding continuous benzodiazepine use.
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Affiliation(s)
- Ville Mäkipelto
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | | | - Christian Hakulinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Welfare State Research and Reform, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, Finland
| | - Markku Lähteenvuo
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland
| | - Asko Wegelius
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, University of Helsinki, Finland
| | - Tuula Kieseppä
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, University of Helsinki, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki, Finland
| | - Jari Tiihonen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
| | - Olli Kampman
- Department of Psychiatry, University of Turku, Finland; Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland; The Pirkanmaa Wellbeing Services County, Department of Psychiatry, Tampere, Finland; Department of Clinical Sciences, Psychiatry, Umeå University, Umeå SE-90187, Sweden; The Wellbeing Services County of Ostrobothnia, Department of Psychiatry, Finland
| | - Kaisla Lahdensuo
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Finland; Mehiläinen, Helsinki, Finland
| | - Atiqul Mazumder
- Department of Psychiatry, University of Turku, Finland; Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Jaana Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Minna Holm
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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208
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Çabuk T, Sevim N, Mutlu E, Yağcıoğlu AEA, Koç A, Toulopoulou T. Natural language processing for defining linguistic features in schizophrenia: A sample from Turkish speakers. Schizophr Res 2024; 266:183-189. [PMID: 38417398 DOI: 10.1016/j.schres.2024.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/26/2023] [Accepted: 02/17/2024] [Indexed: 03/01/2024]
Abstract
Natural language processing (NLP) provides fast and accurate extraction of features related to the language of schizophrenia. We utilized NLP methods to test the hypothesis that schizophrenia is associated with altered linguistic features in Turkish, a non-Indo-European language, compared to controls. We also explored whether these possible altered linguistic features were language-dependent or -independent. We extracted and compared speech in schizophrenia (SZ, N = 38) and healthy well-matched control (HC, N = 38) participants using NLP. The analysis was conducted in two parts. In the first one, mean sentence length, total completed words, moving average type-token ratio to measure the lexical diversity, and first-person singular pronoun usage were calculated. In the second one, we used parts-of-speech tagging (POS) and Word2Vec in schizophrenia and control. We found that SZ had lower mean sentence length and moving average type-token ratio but higher use of first-person singular pronoun. All these significant results were correlated with the Thought and Language Disorder Scale score. The POS approach demonstrated that SZ used fewer coordinating conjunctions. Our methodology using Word2Vec detected that SZ had higher semantic similarity than HC and K-Means could differentiate between SZ and HC into two distinct groups with high accuracy, 86.84 %. Our findings showed that altered linguistic features in SZ are mostly language-independent. They are promising to describe language patterns in schizophrenia which proposes that NLP measurements may allow for rapid and objective measurements of linguistic features.
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Affiliation(s)
- Tuğçe Çabuk
- Department of Psychology, National Magnetic Resonance Research Center (UMRAM) & Aysel Sabuncu Brain Research Center, Bilkent University, Bilkent, 06800 Ankara, Turkey.
| | - Nurullah Sevim
- Department of Electrical and Electronics Engineering, National Magnetic Resonance Research Center (UMRAM), Bilkent University, Bilkent, 06800 Ankara, Turkey
| | - Emre Mutlu
- Department of Psychiatry, Hacettepe University, Faculty of Medicine, Sıhhiye, 06230 Ankara, Turkey
| | - A Elif Anıl Yağcıoğlu
- Department of Psychiatry, Hacettepe University, Faculty of Medicine, Sıhhiye, 06230 Ankara, Turkey.
| | - Aykut Koç
- Department of Electrical and Electronics Engineering, National Magnetic Resonance Research Center (UMRAM), Bilkent University, Bilkent, 06800 Ankara, Turkey.
| | - Timothea Toulopoulou
- Department of Psychology, National Magnetic Resonance Research Center (UMRAM) & Aysel Sabuncu Brain Research Center, Bilkent University, Bilkent, 06800 Ankara, Turkey; 1(st) Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.
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209
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Warren N, O'Gorman C, Horgan I, Weeratunga M, Halstead S, Moussiopoulou J, Campana M, Yakimov V, Wagner E, Siskind D. Inflammatory cerebrospinal fluid markers in schizophrenia spectrum disorders: A systematic review and meta-analysis of 69 studies with 5710 participants. Schizophr Res 2024; 266:24-31. [PMID: 38364730 DOI: 10.1016/j.schres.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 12/03/2023] [Accepted: 02/10/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND There is increasing evidence of immune dysregulation and neuroinflammation occurring in schizophrenia. The aim of this study is to combine studies on routine CSF parameters, as well as cytokines and inflammatory proteins, in individuals with schizophrenia spectrum disorders. METHODS CSF parameters were summated and inverse variance meta-analyses using a random effects model were performed comparing mean difference or odds ratios. Between study heterogeneity was assessed using the I2 statistic. Quality assessment and sensitivity analyses were performed. RESULTS There were 69 studies of 5710 participants, including 3180 individuals with schizophrenia spectrum disorders. Averaged CSF parameters were within normal limits, however, between 3.1 % and 23.5 % of individual cases with schizophrenia spectrum disorders had an abnormal CSF result: Protein (abnormal in 23.5 % cases), albumin (in 18.5 %), presence of oligoclonal bands (in 9.3 %), white blood cell count (in 3.6 %), and IgG levels (3.1 %). Meta-analysis of 55 studies with non-psychiatric controls demonstrated a significant increase in CSF total protein (MD: 3.50, CI: 0.12-6.87), albumin ratio (MD: 0.55, CI: 0.02-0.09), white cell count (MD: 0.25, CI: 0.05-0.46), IL-6 (SMD: 0.53, CI: 0.29 to 0.77) and IL-8 (SMD: 0.56, CI: 0.11 to 1.01). Sensitivity analysis did not alter findings. CONCLUSION Abnormal CSF parameters, cytokines and inflammatory proteins were found in a significant proportion of individuals with schizophrenia spectrum disorders. This may indicate alterations to blood brain barrier function and permeability, CSF flow dynamics or neuroinflammation. Further research is needed to explore these potential mechanisms.
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Affiliation(s)
- Nicola Warren
- The University of Queensland, Faculty of Medicine, Brisbane, Australia; Metro South Addiction and Mental Health Service, Metro South Health, Brisbane, Australia.
| | - Cullen O'Gorman
- The University of Queensland, Faculty of Medicine, Brisbane, Australia; Department of Neurology, Metro South Health, Brisbane, Australia
| | | | | | - Sean Halstead
- The University of Queensland, Faculty of Medicine, Brisbane, Australia
| | - Joanna Moussiopoulou
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Mattia Campana
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Vladislav Yakimov
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Elias Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Dan Siskind
- The University of Queensland, Faculty of Medicine, Brisbane, Australia; Metro South Addiction and Mental Health Service, Metro South Health, Brisbane, Australia
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210
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Lorimer B, Traviss-Turner G, Hill A, Baker S, Gilbody S, Peckham E. Factors associated with low fruit and vegetable consumption among people with severe mental ill health. Soc Psychiatry Psychiatr Epidemiol 2024; 59:725-729. [PMID: 37314491 PMCID: PMC10264868 DOI: 10.1007/s00127-023-02514-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/15/2023]
Abstract
Severe mental ill health (SMI) is associated with excess mortality, and poor diet is one associated modifiable risk factor. This study investigated factors associated with low consumption of fruit and vegetables among people with SMI (N = 9914). A total of 8.4% of participants ate no portions per day, while only 15% ate 5 + portions. Individuals who never consumed fruit and vegetables or ate < 5 portions per day were more likely to be male, younger than 65, unemployed, experience poorer general health, or perceive health as unimportant. Poor diet is common among people with SMI and tailored dietary improvement interventions are required.
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Affiliation(s)
- Ben Lorimer
- Department of Health Sciences, University of York, York, UK.
| | | | - Andrew Hill
- School of Medicine, University of Leeds, Leeds, UK
| | - Sarah Baker
- York St John University, York, UK
- York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Simon Gilbody
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, York, UK
| | - Emily Peckham
- Department of Health Sciences, University of York, York, UK
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211
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Chen M, Xia X, Kang Z, Li Z, Dai J, Wu J, Chen C, Qiu Y, Liu T, Liu Y, Zhang Z, Shen Q, Tao S, Deng Z, Lin Y, Wei Q. Distinguishing schizophrenia and bipolar disorder through a Multiclass Classification model based on multimodal neuroimaging data. J Psychiatr Res 2024; 172:119-128. [PMID: 38377667 DOI: 10.1016/j.jpsychires.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/22/2024]
Abstract
This study aimed to identify neural biomarkers for schizophrenia (SZ) and bipolar disorder (BP) by analyzing multimodal neuroimaging. Utilizing data from structural magnetic resonance imaging (sMRI), diffusion tensor imaging (DTI), and resting-state functional magnetic resonance imaging (rs-fMRI), multiclass classification models were created for SZ, BP, and healthy controls (HC). A total of 113 participants (BP: 31, SZ: 39, and HC: 43) were recruited under strict enrollment control, from which 272, 200, and 1875 features were extracted from sMRI, DTI, and rs-fMRI data, respectively. A support vector machine (SVM) with recursive feature elimination (RFE) was employed to build the models using a one-against-one approach and leave-one-out cross-validation, achieving a classification accuracy of 70.8%. The most discriminative features were primarily from rs-fMRI, along with significant findings in sMRI and DTI. Key biomarkers identified included the increased thickness of the left cuneus cortex and decreased regional functional connectivity strength (rFCS) in the left supramarginal gyrus as shared indicators for BP and SZ. Additionally, decreased fractional anisotropy in the left superior fronto-occipital fasciculus was suggested as specific to BP, while decreased rFCS in the left inferior parietal area might serve as a specific biomarker for SZ. These findings underscore the potential of multimodal neuroimaging in distinguishing between BP and SZ and contribute to the understanding of their neural underpinnings.
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Affiliation(s)
- Ming Chen
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Mental Health Institute, Guangdong ProvincialPeople's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Xiaowei Xia
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhuang Kang
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhinan Li
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jiamin Dai
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Junyan Wu
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Cai Chen
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yong Qiu
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Department of Psychiatry, Mindfront Caring Medical, Guangzhou, China
| | - Tong Liu
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China
| | - Yanxi Liu
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ziyi Zhang
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Department of Medical Division, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Qingni Shen
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Sichu Tao
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zixin Deng
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ying Lin
- Department of Psychology, Sun Yat-sen University, Guangzhou, China.
| | - Qinling Wei
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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212
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Luo G, Bai F, Qu X, Jing Y, Wang S, Xuekelaiti Z, Yao C, Li M, Li J. The relationship between serum prolactin levels and cognitive function in drug-naïve schizophrenia patients: a cross-sectional study. J Neural Transm (Vienna) 2024; 131:385-391. [PMID: 38277043 DOI: 10.1007/s00702-024-02748-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/16/2024] [Indexed: 01/27/2024]
Abstract
This study aimed to investigate the association between serum prolactin levels and psychiatric symptoms and cognitive function in drug-naïve schizophrenia patients. The study recruited 91 drug-naïve schizophrenia patients and 67 healthy controls. Sociodemographic and clinical data were collected, and cognitive function was assessed using the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB). Serum prolactin levels were measured, and statistical analyses were performed to examine the relationship between prolactin levels, clinical symptoms, and cognitive function. The study found that drug-naïve schizophrenia patients had severe cognitive deficits compared to healthy controls across all seven domains of the MCCB. However, no correlation was found between these patients' serum prolactin levels and clinical severity or cognitive function. The drug-naïve schizophrenia patients had significant cognitive deficits compared to healthy controls. However, there was no significant relationship between prolactin levels and symptomatology and cognition in drug-naïve schizophrenia patients.
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Affiliation(s)
- Guoshuai Luo
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Fengfeng Bai
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Xuehui Qu
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Yifan Jing
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Shuo Wang
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Zaimina Xuekelaiti
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Cong Yao
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Meijuan Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Jie Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China.
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213
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Byrne JF, Healy C, Föcking M, Heurich M, Susai SR, Mongan D, Wynne K, Kodosaki E, Woods SW, Cornblatt BA, Stone WS, Mathalon DH, Bearden CE, Cadenhead KS, Addington J, Walker EF, Cannon TD, Cannon M, Jeffries C, Perkins D, Cotter DR. Plasma complement and coagulation proteins as prognostic factors of negative symptoms: An analysis of the NAPLS 2 and 3 studies. Brain Behav Immun 2024; 119:188-196. [PMID: 38555993 DOI: 10.1016/j.bbi.2024.03.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION Negative symptoms impact the quality of life of individuals with psychosis and current treatment options for negative symptoms have limited effectiveness. Previous studies have demonstrated that complement and coagulation pathway protein levels are related to later psychotic experiences, psychotic disorder, and functioning. However, the prognostic relationship between complement and coagulation proteins and negative symptoms is poorly characterised. METHODS In the North American Prodrome Longitudinal Studies 2 and 3, negative symptoms in 431 individuals at clinical high-risk for psychosis (mean age: 18.2, SD 3.6; 42.5 % female) were measured at multiple visits over 2 years using the Scale of Psychosis-Risk Symptoms. Plasma proteins were quantified at baseline using mass spectrometry. Four factors were derived to represent levels of proteins involved in the activation or regulation of the complement or coagulation systems. The relationships between standardised protein group factors and serial measurements of negative symptoms over time were modelled using generalised least squares regression. Analyses were adjusted for baseline candidate prognostic factors: negative symptoms, positive symptoms, functioning, depressive symptoms, suicidal ideation, cannabis use, tobacco use, antipsychotic use, antidepressant use, age, and sex. RESULTS Clinical and demographic prognostic factors of follow-up negative symptoms included negative, positive, and depressive symptoms, functioning, and age. Adjusting for all candidate prognostic factors, the complement regulators group and the coagulation regulators group were identified as prognostic factors of follow-up negative symptoms (β: 0.501, 95 % CI: 0.160, 0.842; β: 0.430, 95 % CI: 0.080, 0.780 respectively. The relationship between complement regulator levels and negative symptoms was also observed in NAPLS2 alone (β: 0.501, 95 % CI: -0.037, 1.039) and NAPLS3 alone, additionally adjusting for BMI (β: 0.442, 95 % CI: 0.127, 0.757). CONCLUSION The results indicate that plasma complement and coagulation regulator levels are prognostic factors of negative symptoms, independent of clinical and demographic prognostic factors. These results suggest complement and coagulation regulator levels could have potential utility in informing treatment decisions for negative symptoms in individuals at risk.
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Affiliation(s)
- Jonah F Byrne
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland; SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland.
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland; Department of Psychology, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Meike Heurich
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, United Kingdom
| | - Subash Raj Susai
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - David Mongan
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland; Centre for Public Health, Queen's University Belfast, United Kingdom
| | - Kieran Wynne
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Eleftheria Kodosaki
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, United Kingdom
| | - Scott W Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | - William S Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA; Mental Health Service 116d, Veterans Affairs San Francisco Health Care System, San Francisco, CA, USA
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California, Los Angeles, CA, USA
| | | | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, USA
| | - Tyrone D Cannon
- Departments of Psychology and Psychiatry, Yale University, New Haven, CT, USA
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland; SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland; Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
| | - Clark Jeffries
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Diana Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - David R Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland; SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland; Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
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214
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Mølgaard SN, Nielsen MØ, Roed K, Nielsen J. Clinical experiences of guided tapering of antipsychotics for patients with schizophrenia- a case series. BMC Psychiatry 2024; 24:240. [PMID: 38553687 PMCID: PMC10981298 DOI: 10.1186/s12888-024-05699-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/19/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND 80% of patients value information on treatment options as an important part of recovery, further patients with a history of psychotic episodes feel excluded from decision making about their antipsychotic treatment, and on top of that, mental health staff is prone to be reluctant to support shared decision making and medication tapering for patients with schizophrenia. This case series aims to demonstrate the tapering of antipsychotic medication and how guided tapering affects the patient's feeling of autonomy and psychiatric rehabilitation. CASE PRESENTATION We present six patients diagnosed with schizophrenia (International Classification of Mental and Behavioral Disorders- 10th Edition codes F20.0-5, F20.7-9) who underwent professionally guided tapering in our clinic. The clinic aims to guide the patients to identify the lowest possible dose of antipsychotic medication in a safe setting to minimise the risk of severe relapse. Two patients completely discontinued their antipsychotic medication, two suffered a relapse during tapering, one chose to stop the tapering at a low dose, and one patient with treatment resistant schizophrenia, which is still tapering down. CONCLUSIONS Reducing the antipsychotic dose increased emotional awareness in some patients (n = 4) helping them to develop better strategies to handle stress and increased feelings of recovery. Patients felt a greater sense of autonomy and empowerment during the tapering process, even when discontinuation was not possible. Increased awareness in patients and early intervention during relapse may prevent severe relapse. IMPACT AND IMPLICATIONS Some patients with schizophrenia might be over medicated, leading to unwanted side effects and the wish to reduce their medication. The patients in our study illustrate how guided tapering of antipsychotic medication done jointly with the patient can lead to improved emotional awareness and the development of effective symptom management strategies. This may in turn lead to a greater sense of empowerment and identity and give life more meaning, supporting the experience of personal recovery.
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Affiliation(s)
- Sofie Norlin Mølgaard
- Mental Health Center Glostrup, Copenhagen University Hospital, Unit for complicated schizophrenia, Glostrup, Denmark.
| | - Mette Ødegaard Nielsen
- Mental Health Center Glostrup, Copenhagen University Hospital, Unit for complicated schizophrenia, Glostrup, Denmark
| | - Kickan Roed
- Mental Health Centre Glostrup, Copenhagen University Hospital- Mental Health Services CPH, Centre for Applied Research in Mental Health Care, Glostrup, Denmark
| | - Jimmi Nielsen
- Mental Health Center Glostrup, Copenhagen University Hospital, Unit for complicated schizophrenia, Glostrup, Denmark
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215
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Cohen-Laroque J, Grangier I, Perez N, Kirschner M, Kaiser S, Sabé M. Positive and negative symptoms in methamphetamine-induced psychosis compared to schizophrenia: A systematic review and meta-analysis. Schizophr Res 2024; 267:182-190. [PMID: 38554698 DOI: 10.1016/j.schres.2024.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 03/06/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND The clinical profiles of methamphetamine-induced psychosis (MIP) and schizophrenia are largely overlapping making differentiation challenging. In this systematic review and meta-analysis, we aim to compare the positive and negative symptoms of MIP and schizophrenia to better understand the differences between them. STUDY DESIGN In accordance with our pre-registered protocol (CRD42021286619), we conducted a search of English-language studies up to December 16th, 2022, in PubMed, EMBASE, and PsycINFO, including stable outpatients with MIP and schizophrenia. We used the Newcastle-Ottawa Scale to measure the quality of cross-sectional, case-control, and cohort studies. STUDY RESULTS Of the 2052 articles retrieved, we included 12 studies (6 cross-sectional, 3 case-control, and 2 cohort studies) in our meta-analysis, involving 624 individuals with MIP and 524 individuals with schizophrenia. Our analysis found no significant difference in positive symptoms between the two groups (SMD, -0.01; 95%CI, -0.13 to +0.11; p = 1). However, individuals with MIP showed significantly less negative symptoms compared to those with schizophrenia (SMD, -0.35; 95CI%, -0.54 to -0.16; p = 0.01; I2 = 54 %). Our sensitivity analysis, which included only studies with a low risk of bias, did not change the results. However, our meta-analysis is limited by its cross-sectional approach, which limits the interpretation of causal associations. Furthermore, differences in population, inclusion criteria, methodology, and drug exposure impact our findings. CONCLUSIONS Negative symptoms are less prominent in individuals with MIP. While both groups do not differ regarding positive symptoms, raises the possibility of shared and partly different underlying neurobiological mechanisms related to MIP and schizophrenia.
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Affiliation(s)
| | - Inès Grangier
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Natacha Perez
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Switzerland
| | - Matthias Kirschner
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Switzerland
| | - Stefan Kaiser
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Switzerland
| | - Michel Sabé
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Switzerland.
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216
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Baum ML, Wilton DK, Fox RG, Carey A, Hsu YHH, Hu R, Jäntti HJ, Fahey JB, Muthukumar AK, Salla N, Crotty W, Scott-Hewitt N, Bien E, Sabatini DA, Lanser TB, Frouin A, Gergits F, Håvik B, Gialeli C, Nacu E, Lage K, Blom AM, Eggan K, McCarroll SA, Johnson MB, Stevens B. CSMD1 regulates brain complement activity and circuit development. Brain Behav Immun 2024; 119:317-332. [PMID: 38552925 DOI: 10.1016/j.bbi.2024.03.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/29/2024] [Accepted: 03/26/2024] [Indexed: 04/16/2024] Open
Abstract
Complement proteins facilitate synaptic elimination during neurodevelopmental pruning, but neural complement regulation is not well understood. CUB and Sushi Multiple Domains 1 (CSMD1) can regulate complement activity in vitro, is expressed in the brain, and is associated with increased schizophrenia risk. Beyond this, little is known about CSMD1 including whether it regulates complement activity in the brain or otherwise plays a role in neurodevelopment. We used biochemical, immunohistochemical, and proteomic techniques to examine the regional, cellular, and subcellular distribution as well as protein interactions of CSMD1 in the brain. To evaluate whether CSMD1 is involved in complement-mediated synapse elimination, we examined Csmd1-knockout mice and CSMD1-knockout human stem cell-derived neurons. We interrogated synapse and circuit development of the mouse visual thalamus, a process that involves complement pathway activity. We also quantified complement deposition on synapses in mouse visual thalamus and on cultured human neurons. Finally, we assessed uptake of synaptosomes by cultured microglia. We found that CSMD1 is present at synapses and interacts with complement proteins in the brain. Mice lacking Csmd1 displayed increased levels of complement component C3, an increased colocalization of C3 with presynaptic terminals, fewer retinogeniculate synapses, and aberrant segregation of eye-specific retinal inputs to the visual thalamus during the critical period of complement-dependent refinement of this circuit. Loss of CSMD1 in vivo enhanced synaptosome engulfment by microglia in vitro, and this effect was dependent on activity of the microglial complement receptor, CR3. Finally, human stem cell-derived neurons lacking CSMD1 were more vulnerable to complement deposition. These data suggest that CSMD1 can function as a regulator of complement-mediated synapse elimination in the brain during development.
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Affiliation(s)
- Matthew L Baum
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Department of Genetics, Harvard Medical School, Boston, MA 02115, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; MD-PhD Program of Harvard & MIT, Harvard Medical School, Boston, MA 02115, USA
| | - Daniel K Wilton
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Rachel G Fox
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Alanna Carey
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Yu-Han H Hsu
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Ruilong Hu
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Henna J Jäntti
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Jaclyn B Fahey
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Allie K Muthukumar
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Nikkita Salla
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - William Crotty
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Department of Stem Cell and Regenerative Biology and Harvard Stem Cell Institute, Harvard University, Cambridge, MA 02138, USA
| | - Nicole Scott-Hewitt
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Elizabeth Bien
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - David A Sabatini
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Toby B Lanser
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Arnaud Frouin
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Frederick Gergits
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | | | - Chrysostomi Gialeli
- Division of Medical Protein Chemistry, Department of Translational Medicine, Lund University, S-214 28 Malmö, Sweden; Cardiovascular Research - Translational Studies Research Group, Department of Clinical Sciences, Lund University, S-214 28 Malmö, Sweden
| | - Eugene Nacu
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Kasper Lage
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Anna M Blom
- Division of Medical Protein Chemistry, Department of Translational Medicine, Lund University, S-214 28 Malmö, Sweden
| | - Kevin Eggan
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Department of Stem Cell and Regenerative Biology and Harvard Stem Cell Institute, Harvard University, Cambridge, MA 02138, USA
| | - Steven A McCarroll
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Matthew B Johnson
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Beth Stevens
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Howard Hughes Medical Institute, USA.
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Odenigbo N, Nkemjika S, Atolagbe A, Nwabueze C, Olwit C, Lawrence J, Olupona T. Donepezil-induced bradycardia in a schizophrenic patient with comorbid neurocognitive disorder: a case report and review of the literature. J Med Case Rep 2024; 18:129. [PMID: 38532522 PMCID: PMC10967060 DOI: 10.1186/s13256-024-04454-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 02/12/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Trials of cholinergic and glutamatergic agents have improved cognition and memory for the geriatric schizophrenic population. Donepezil is an acetylcholinesterase inhibitor that improves cognition by preventing postsynaptic degradation of hippocampal acetylcholine in patients with mild-to-moderate dementia. Donepezil has been attributed to some adverse effects, especially gastrointestinal symptoms. However, cardiovascular adverse effects are not common as there remains a dearth of literature regarding donepezil-induced bradycardia. CASE REPORT Hence, we present the case of a 70-year-old Hispanic female with past psychiatry history of schizophrenia who developed bradycardia and syncope following the commencement of low-dose donepezil in the inpatient unit and subsequent resolution with cessation. She had no prior cardiovascular symptoms or diagnosis. DISCUSSION Considering there is no baseline cardiac monitoring requirement guideline for patients on Donepezil treatment, pre-assessment electrocardiogram is advised before the commencement of acetylcholinesterase inhibitors. Finally, routine monitoring of vital signs for at least the first 72 hours following the start of donepezil might be good proactive practice for all psychiatrists. Extending this practice to inpatient and outpatient service settings will be worthwhile.
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Affiliation(s)
- Nkolika Odenigbo
- Department of Psychiatry, Interfaith Medical Center, Brooklyn, NY, USA
| | - Stanley Nkemjika
- Department of Psychiatry, Interfaith Medical Center, Brooklyn, NY, USA
| | - Ayodele Atolagbe
- Department of Psychiatry, Interfaith Medical Center, Brooklyn, NY, USA
| | | | - Connie Olwit
- Department of Nursing, Makere University, Kampala, Uganda.
| | - Jeffery Lawrence
- Department of Psychiatry, Interfaith Medical Center, Brooklyn, NY, USA
| | - Tolulope Olupona
- Department of Psychiatry, Interfaith Medical Center, Brooklyn, NY, USA
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218
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Gao YN, Wang R, Gu G, Chung R, Olfson M. Inpatient antipsychotic medication switching and rehospitalization risk among patients with schizophrenia-spectrum disorders. Schizophr Res 2024; 267:165-172. [PMID: 38547719 DOI: 10.1016/j.schres.2024.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/08/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE To describe patterns of antipsychotic switching among patients hospitalized for schizophrenia and to correlate antipsychotic switching with hospital readmission risk. METHODS We identified 3295 patients with index hospitalizations for schizophrenia or schizoaffective disorder from New York State Medicaid claims 2017-2018 who had filled at least one prescription for an antipsychotic in both the 44 days (one month +14 day grace period) prior to and after their admission. We identified patients who had kept or switched any of their antipsychotic medication between the pre- and post-periods surrounding their index hospitalization. We compared the kept and switched any groups, adjusting for patient characteristics. RESULTS Of patients who had filled antipsychotic prescriptions in both the 44 days prior to and after their hospitalization, 1599 (48.6 %) had switched at least one antipsychotic and 1215 (36.8 %) had switched their primary antipsychotic. Switching any antipsychotic was associated with increased hazards of readmission, HR = 1.21, 95%CI 1.09-1.35, which was slightly concentrated during the first 90 days after hospital discharge. CONCLUSIONS Switching antipsychotic medications during hospitalization occurs commonly and is associated with higher rehospitalization risk following hospital discharge.
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Affiliation(s)
- Y Nina Gao
- Department of Psychiatry, Vagelos College of Physicians & Surgeons Columbia University and New York State Psychiatric Institute, New York, United States of America.
| | - Rui Wang
- New York State Office of Mental Health, Albany, New York, United States of America
| | - Gyojeong Gu
- New York State Office of Mental Health, Albany, New York, United States of America
| | - Rakkoo Chung
- New York State Office of Mental Health, Albany, New York, United States of America
| | - Mark Olfson
- Departments of Psychiatry and Epidemiology, Columbia University, New York and New York State Psychiatric Institute, New York, United States of America
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Andersen MF, Roed K, Sørensen V, Riis A, Rafn BS, Ebdrup BH, Midtgaard J. Required elements for an educational programme for lay exercise instructors in charge of community-based exercise targeting young adults with schizophrenia spectrum disorders - A stakeholder focus group study. BMC Psychiatry 2024; 24:228. [PMID: 38532355 PMCID: PMC10967036 DOI: 10.1186/s12888-024-05648-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/28/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Exercise plays a crucial role in addressing the increased cardiometabolic morbidity and premature mortality in people with schizophrenia spectrum disorders. When delivered in community-based settings, exercise may also reduce loneliness, while promoting overall physical activity behaviours. Skilled instructors are essential to deliver effective community-based exercise; however, knowledge about their roles and required training is lacking. We aim to explore various stakeholders' perspectives regarding lay exercise instructors' roles, and the required elements in an educational programme supporting the delivery of community-based exercise for young adults with SSD. METHODS We used semi-structured homogeneous focus groups with representatives from different stakeholder groups (i.e., including representatives of clinical staff within mental health, physiotherapists, exercise instructors, young adults with schizophrenia spectrum disorders, and relatives of individuals with schizophrenia spectrum disorders) targeted or affected by a community-based exercise intervention. Data were analysed using qualitative content analysis. RESULTS We conducted six focus groups comprising a total of 30 individuals representing five different stakeholder groups The analysis identified three categories: (i) awareness and understanding of mental illness, i.e., providing basic knowledge to dispel common myths and stigma regarding mental illness (ii) protecting youth identity, i.e., supporting the feeling of being more than just a patient, and (iii) promoting exercise as a shared activity, i.e., a communal pursuit, fostering personal growth among participants, their peers and the instructors. CONCLUSIONS An educational programme for lay exercise instructors delivering community-based exercise targeting young adults with SSD should empower the instructors to assume the role of guardians of an inclusive exercise culture. Educational elements identified were adapted and integrated into an educational programme implemented and evaluated as a part of the Vega trial. Our results may be transferable to the education of lay workers in mental health care where the aim is to facilitate sustainable, recreational, community-based activities.
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Affiliation(s)
- Martin Færch Andersen
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark.
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark.
| | - Kickan Roed
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Victor Sørensen
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Allan Riis
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
- Center for General Practice, Aalborg University, Aalborg, Denmark
| | - Bolette Skjødt Rafn
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
- Late Effects Research Center (CASTLE), Department of Oncology, Danish Cancer Society National Cancer Survivorship, Copenhagen University Hospital- Rigshospitalet, Copenhagen, Denmark
| | - Bjørn Hylsebeck Ebdrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Faculty of Health and Medical Science, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Julie Midtgaard
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Science, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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220
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Lyu X, Chi Y, Wang Z, Shao X, Zhang G, Li C, Dong C, Wang X, Li X, Zhu C, Xu X, Du X. Abnormal ambiguous facial expression recognition in Chinese patients with schizophrenia. BMC Psychiatry 2024; 24:226. [PMID: 38532335 DOI: 10.1186/s12888-024-05685-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Patients with schizophrenia (SCZ) exhibit difficulties deficits in recognizing facial expressions with unambiguous valence. However, only a limited number of studies have examined how these patients fare in interpreting facial expressions with ambiguous valence (for example, surprise). Thus, we aimed to explore the influence of emotional background information on the recognition of ambiguous facial expressions in SCZ. METHODS A 3 (emotion: negative, neutral, and positive) × 2 (group: healthy controls and SCZ) experimental design was adopted in the present study. The experimental materials consisted of 36 images of negative emotions, 36 images of neutral emotions, 36 images of positive emotions, and 36 images of surprised facial expressions. In each trial, a briefly presented surprised face was preceded by an affective image. Participants (36 SCZ and 36 healthy controls (HC)) were required to rate their emotional experience induced by the surprised facial expressions. Participants' emotional experience was measured using the 9-point rating scale. The experimental data have been analyzed by conducting analyses of variances (ANOVAs) and correlation analysis. RESULTS First, the SCZ group reported a more positive emotional experience under the positive cued condition compared to the negative cued condition. Meanwhile, the HC group reported the strongest positive emotional experience in the positive cued condition, a moderate experience in the neutral cued condition, and the weakest in the negative cue condition. Second, the SCZ (vs. HC) group showed longer reaction times (RTs) for recognizing surprised facial expressions. The severity of schizophrenia symptoms in the SCZ group was negatively correlated with their rating scores for emotional experience under neutral and positive cued condition. CONCLUSIONS Recognition of surprised facial expressions was influenced by background information in both SCZ and HC, and the negative symptoms in SCZ. The present study indicates that the role of background information should be fully considered when examining the ability of SCZ to recognize ambiguous facial expressions.
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Affiliation(s)
- Xiaoli Lyu
- Affiliated WuTaiShan Hospital of Medical College of Yangzhou University, 225003, Yangzhou, Jiangsu, China
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China
| | - Yuyan Chi
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China
| | - Zhenyu Wang
- Wujiang District Mental Rehabilitation Hospital, 215200, Suzhou, Jiangsu, China
| | - Xinyan Shao
- School of Educational Science, Yangzhou University, 225002, Yangzhou, Jiangsu, China
| | - Guangya Zhang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China
| | - Chuanwei Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China
| | - Chenglong Dong
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China
| | - Xuqin Wang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China
| | - Xin Li
- Wujiang District Mental Rehabilitation Hospital, 215200, Suzhou, Jiangsu, China
| | - Chuanlin Zhu
- School of Educational Science, Yangzhou University, 225002, Yangzhou, Jiangsu, China.
| | - Xiaofeng Xu
- Affiliated WuTaiShan Hospital of Medical College of Yangzhou University, 225003, Yangzhou, Jiangsu, China.
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China.
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221
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Elam HB, Perez SM, Donegan JJ, Eassa NE, Lodge DJ. Knockdown of Lhx6 during embryonic development results in neurophysiological alterations and behavioral deficits analogous to schizophrenia in adult rats. Schizophr Res 2024; 267:113-121. [PMID: 38531158 DOI: 10.1016/j.schres.2024.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 12/15/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024]
Abstract
A decreased expression of specific interneuron subtypes, containing either the calcium binding protein parvalbumin (PV) or the neurotransmitter somatostatin (SST), are observed in the cortex and hippocampus of both patients with schizophrenia and rodent models used to study the disorder. Moreover, preclinical studies suggest that this loss of inhibitory function is a key pathological mechanism underlying the symptoms of schizophrenia. Interestingly, decreased expression of Lhx6, a key transcriptional regulator specific to the development and migration of PV and SST interneurons, is seen in human postmortem studies and following multiple developmental disruptions used to model schizophrenia preclinically. These results suggest that disruptions in interneuron development in utero may contribute to the pathology of the disorder. To recapitulate decreased Lhx6 expression during development, we used in utero electroporation to introduce an Lhx6 shRNA plasmid and knockdown Lhx6 expression in the brains of rats on gestational day 17. We then examined schizophrenia-like neurophysiological and behavioral alterations in the offspring once they reached adulthood. In utero Lhx6 knockdown resulted in increased ventral tegmental area (VTA) dopamine neuron population activity and a sex-specific increase in locomotor response to a psychotomimetic, consistent with positive symptomology of schizophrenia. However, Lhx6 knockdown had no effect on social interaction or spatial working memory, suggesting behaviors associated with negative and cognitive symptom domains were unaffected. These results suggest that knockdown of Lhx6 during development results in neurophysiological and behavioral alterations consistent with the positive symptom domain of schizophrenia in adult rats.
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Affiliation(s)
- Hannah B Elam
- Department of Pharmacology and Center for Biomedical Neuroscience, University of Texas Health Science Center, San Antonio, TX 78229, USA.
| | - Stephanie M Perez
- Department of Pharmacology and Center for Biomedical Neuroscience, University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Jennifer J Donegan
- Department of Pharmacology and Center for Biomedical Neuroscience, University of Texas Health Science Center, San Antonio, TX 78229, USA; Department of Psychiatry and Behavioral Sciences, Dell Medical School at UT Austin, Austin, TX, USA
| | - Nicole E Eassa
- Department of Pharmacology and Center for Biomedical Neuroscience, University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Daniel J Lodge
- Department of Pharmacology and Center for Biomedical Neuroscience, University of Texas Health Science Center, San Antonio, TX 78229, USA; South Texas Veterans Health Care System, Audie L. Murphy Division, San Antonio, USA
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Mehta DD, Siddiqui S, Ward HB, Steele VR, Pearlson GD, George TP. Functional and structural effects of repetitive transcranial magnetic stimulation (rTMS) for the treatment of auditory verbal hallucinations in schizophrenia: A systematic review. Schizophr Res 2024; 267:86-98. [PMID: 38531161 DOI: 10.1016/j.schres.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 02/26/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Auditory verbal hallucinations (AVH) are a disabling symptom for people with schizophrenia (SCZ), and do not always respond to antipsychotics. Repetitive transcranial magnetic stimulation (rTMS) has shown efficacy for medication-refractory AVH, though the underlying neural mechanisms by which rTMS produces these effects remain unclear. This systematic review evaluated the structural and functional impact of rTMS for AVH in SCZ, and its association with clinical outcomes. METHODS A systematic search was conducted in Medline, PsychINFO, and PubMed using terms for four key concepts: AVH, SCZ, rTMS, neuroimaging. Using PRISMA guidelines, 18 studies were identified that collected neuroimaging data of an rTMS intervention for AVH in SCZ. Risk of bias assessments was conducted. RESULTS Low frequency (<5 Hz) rTMS targeting left hemispheric language processing regions may normalize brain abnormalities in AVH patients at structural, functional, electrophysiological, and topological levels, with concurrent symptom improvement. Amelioration of aberrant neural activity in frontotemporal networks associated with speech and auditory processing was commonly observed, as well as in cerebellar and emotion regulation regions. Neuroimaging analyses identified neural substrates with direct correlations to post-rTMS AVH severity, propounding their use as therapeutic targets. DISCUSSION Combined rTMS-neuroimaging highlights the multidimensional alterations of rTMS on brain activity and structure in treatment-resistant AVH, which may be used to develop more efficacious therapies. Larger randomized, sham-controlled studies are needed. Future studies should explore alternate stimulation targets, investigate the neural effects of high-frequency rTMS and evaluate long-term neuroimaging outcomes.
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Affiliation(s)
- Dhvani D Mehta
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Hartford Hospital and Department of Psychiatry and Behavioural Sciences, Yale University, New Haven, CT, USA; Department of Psychiatry, University of Toronto, Canada; Addictions Division and Institute for Mental Health Policy and Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
| | - Salsabil Siddiqui
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Hartford Hospital and Department of Psychiatry and Behavioural Sciences, Yale University, New Haven, CT, USA; Department of Psychiatry, University of Toronto, Canada; Addictions Division and Institute for Mental Health Policy and Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Heather B Ward
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Hartford Hospital and Department of Psychiatry and Behavioural Sciences, Yale University, New Haven, CT, USA; Department of Psychiatry, University of Toronto, Canada; Addictions Division and Institute for Mental Health Policy and Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Vaughn R Steele
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Hartford Hospital and Department of Psychiatry and Behavioural Sciences, Yale University, New Haven, CT, USA; Department of Psychiatry, University of Toronto, Canada; Addictions Division and Institute for Mental Health Policy and Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Godfrey D Pearlson
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Hartford Hospital and Department of Psychiatry and Behavioural Sciences, Yale University, New Haven, CT, USA; Department of Psychiatry, University of Toronto, Canada; Addictions Division and Institute for Mental Health Policy and Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Tony P George
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Hartford Hospital and Department of Psychiatry and Behavioural Sciences, Yale University, New Haven, CT, USA; Department of Psychiatry, University of Toronto, Canada; Addictions Division and Institute for Mental Health Policy and Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
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223
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Lho SK, Kim T, Moon SY, Kim M, Kwon JS. Alteration in left frontoparietal connectivity correlates with impaired cognitive reappraisal in early psychosis. Schizophr Res 2024; 267:130-137. [PMID: 38531160 DOI: 10.1016/j.schres.2024.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/08/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Impaired cognitive reappraisal is a notable symptom of early psychosis, but its neurobiological basis remains underexplored. We aimed to identify the underlying neurobiological mechanism of this impairment by using resting-state functional connectivity (FC) analyses focused on brain regions related to cognitive reappraisal. METHODS Resting-state functional magnetic resonance images were collected from 36 first-episode psychosis (FEP) patients, 32 clinical high-risk (CHR) individuals, and 48 healthy controls (HCs). Whole-brain FC maps using seed regions associated with cognitive reappraisal were generated and compared across the FEP, CHR and HC groups. We assessed the correlation between resting-state FC, reappraisal success ratio, positive symptom severity and social functioning controlling for covariates. RESULTS FEP patients showed higher FC between the left superior parietal lobe and left inferior frontal gyrus than HCs. Higher FC between the left superior parietal lobe and left inferior frontal gyrus negatively correlated with the reappraisal success ratio in the FEP group after controlling for covariates. Lower FC correlated with lower positive symptom severity and improved global functioning in the FEP group. CONCLUSIONS Alteration in left frontoparietal connectivity reflects impaired cognitive reappraisal in early psychosis, and such alteration correlates with increased positive symptoms and decreased global functioning. These findings offer a potential path for interventions targeting newly emerging symptoms in the early stages of psychosis.
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Affiliation(s)
- Silvia Kyungjin Lho
- Department of Psychiatry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Taekwan Kim
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Sun-Young Moon
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Public Health Service, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jun Soo Kwon
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
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224
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Zhou R, Ye M, OuYang X, Zhang S, Zheng S, Wang R, Cao P, Yang K, Zhou X. Insomnia and aggression in stable schizophrenic patients: The mediating role of quality of life. Schizophr Res 2024; 267:122-129. [PMID: 38531159 DOI: 10.1016/j.schres.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/24/2024] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
Aggression in schizophrenia patients is an issue of concern. Previous studies have shown that aggression in schizophrenia patients may be related to insomnia and quality of life to different extents. This study aimed to explore the potential mediating role of quality of life in the relationship between aggression and insomnia among schizophrenia patients. Demographic factors affecting aggression in schizophrenia patients were also explored. PATIENTS AND METHODS A total of 781 stable patients aged 18-75 who met the ICD10 diagnosis of "schizophrenia" completed the completed questionnaire. Aggression was assessed using the Modified Overt Aggression Scale (MOAS), sleep was assessed using the Insomnia Severity Index Scale (ISI), and quality of life was assessed using the five Likert options. Descriptive statistics and correlation analysis examined the correlation between aggression and other variables. The mediating role of quality of life in the association between insomnia and aggression was examined by pathway analysis. RESULTS A total of 781 patients participated in this study, and approximately 16 % of the schizophrenia patients were aggressive. According to the mediation analysis, the direct effect of insomnia on aggression was 0.147, and the mediating effect of quality of life on insomnia and aggression was 0.021. Specifically, for the four dimensions of the MOAS, the direct effects of insomnia on verbal aggression, aggression toward property, and aggression toward oneself were 0.028, 0.032, and 0.023, respectively, with mediating effects of 0.003, 0.007, and 0.006, respectively, and no mediating effect on physical aggression was found. CONCLUSION This study showed that insomnia significantly influenced aggression in schizophrenia patients. Quality of life significantly mediated insomnia and aggression and played a vital role in moderating aggression. Therefore, we suggest that in the future, improving aggression in schizophrenia patients, while paying attention to the importance of sleep, could start with improving quality of life to address this problem from multiple perspectives.
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Affiliation(s)
- Ruochen Zhou
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, People's Republic of China; Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China
| | - Mengting Ye
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, People's Republic of China; Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China
| | - Xu OuYang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, People's Republic of China; Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China
| | - ShaoFei Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, People's Republic of China; Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China
| | - SiYuan Zheng
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, People's Republic of China; Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China
| | - Ruoqi Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, People's Republic of China; Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China
| | - Panpan Cao
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, People's Republic of China; Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China
| | - Kefei Yang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, People's Republic of China; Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, People's Republic of China
| | - Xiaoqin Zhou
- Department of Psychology and Sleep Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei City, People's Republic of China; School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, People's Republic of China.
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Narita Z, Hazumi M, Kataoka M, Usuda K, Nishi D. Association between discrimination and subsequent psychotic experiences in patients with COVID-19: A cohort study. Schizophr Res 2024; 267:107-112. [PMID: 38531157 DOI: 10.1016/j.schres.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 01/20/2024] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
Although cross-sectional studies have suggested that discrimination has a negative impact on the mental health of patients with COVID-19, no cohort studies with longitudinal data have established a causal relationship. Therefore, this study aimed to investigate the association between COVID-19-related discrimination and subsequent psychotic experiences in individuals who had contracted the disease. Secondary outcomes were PTSD symptoms, psychological distress, and suicidal ideation. We utilized inverse probability weighting and marginal structural models with robust standard errors to analyze the association, accounting for confounders and loss to follow-up. In a sensitivity analysis, we evaluated the robustness of the estimates to potential unmeasured confounding by analyzing E-values. Of 7760 participants who had contracted COVID-19, 5971 were included after excluding those with missing sociodemographic data. Of these, 1736 (29.1 %) reported experiencing COVID-19-related discrimination. Of the 2559 participants who completed the study, 253 (9.9 %) reported having at least one psychotic experience. Participants who reported experiencing any COVID-19-related discrimination showed a higher risk of subsequent psychotic experiences compared with participants without such discrimination (risk difference 6.6 %, 95 % CI 4.0 %-9.9 %; risk ratio 1.82, 95 % CI 1.42-2.47). A negative impact was also found in suicidal ideation, PTSD symptoms, and psychological distress. E-values demonstrated the robustness of some of the observed associations to unmeasured confounding. The study found that COVID-19-related discrimination was associated with subsequent psychotic experiences and other mental health outcomes in individuals who had contracted the disease. A study focusing on prevention strategies, such as an anti-discrimination campaign, is warranted.
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Affiliation(s)
- Zui Narita
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Megumi Hazumi
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Mayumi Kataoka
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kentaro Usuda
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Daisuke Nishi
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan; Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Tokyo, Japan.
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226
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Pelizza L, Leuci E, Leucci AC, Quattrone E, Azzali S, Pupo S, Plazzi E, Paulillo G, Pellegrini P, Menchetti M. Diagnostic shift in first episode psychosis: Results from the 2-year follow-up of the "Parma Early Psychosis" program. Schizophr Res 2024; 267:99-106. [PMID: 38531162 DOI: 10.1016/j.schres.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 01/17/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Although the stability of current diagnostic criteria for people with First Episode Psychosis (FEP) is essential for treatment, it still remains poorly investigated. As its examination necessarily requires a prospective evaluation of diagnostic trajectories, the aims of the current longitudinal investigation were: (a) to assess diagnostic changes in an Italian FEP population treated within an "Early Intervention in Psychosis" service during a 2-year follow-up period, and (b) to identify potential sociodemographic and clinical moderators of diagnostic instability at entry. METHODS All participants were FEP individuals, aged 12-35 years. Their primary diagnosis was formulated both at baseline and at the end of the follow-up. At entry, they also completed the Positive And Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF) scale. As measure of diagnostic stability, the Kappa statistic was first calculated. The associations of diagnostic shift with baseline sociodemographic and clinical characteristics were then analyzed using a logistic model with the diagnostic change as dependent variable. Finally, a propensity score was calculated, based on logistic analysis results. RESULTS 221 (50.1 %) FEP participants changed their initial diagnosis. The highest prospective diagnostic stability was found for initial diagnosis of schizophrenia (93.9 %) and affective spectrum psychoses (92.4 %). Diagnostic instability was high for initial diagnosis of brief psychotic disorder (100 %), schizophreniform disorder (100 %) and psychotic disorder not otherwise specified (92.1 %). The best predictors of diagnostic change were previous contact with neuropsychiatry services, shorter duration of untreated psychosis and higher baseline levels of disorganization. CONCLUSIONS Diagnostic stability is crucial for treatment and clinical decision making. Addressing instability in FEP diagnoses and detecting its moderators at entry are important challenges for future diagnostic development of early psychosis.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Biomedical and Neuromotor Sciences, "Alma Mater Studiorum" Università di Bologna, Bologna, BO, Italy; Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy.
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
| | - Anna Caterina Leucci
- Department of Biomedical and Neuromotor Sciences, "Alma Mater Studiorum" Università di Bologna, Bologna, BO, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, RE, Italy
| | - Simona Pupo
- Pain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, PR, Italy
| | - Enrico Plazzi
- Department of Biomedical and Neuromotor Sciences, "Alma Mater Studiorum" Università di Bologna, Bologna, BO, Italy
| | - Giuseppina Paulillo
- Pain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, PR, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, "Alma Mater Studiorum" Università di Bologna, Bologna, BO, Italy
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227
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Zuo C, Yang X, Wu X, Fan R, Liu J, Xiang H, Li Y, Zhao X, Liu X, Liu Y. Medication non-adherence and self-inflicted violence behaviors among 185,800 patients with schizophrenia in the community: a 12-year cohort study. BMC Med 2024; 22:136. [PMID: 38523268 PMCID: PMC10962179 DOI: 10.1186/s12916-024-03354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/13/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Despite the importance of medication adherence in treatment effectiveness, little is known about the association between medication non-adherence and self-inflicted violence behaviors. We aimed to assess whether medication non-adherence increased the risk of self-inflicted violence behaviors among schizophrenics in communities (hypothesis 1) and whether the dose-response relationship existed (hypothesis 2). METHODS This 12-year cohort study in western China recruited 292,667 community-dwelling schizophrenics. The proportion of regular medication (PRM) was calculated by dividing the time of "regular adherence" by the total time of antipsychotic treatment during follow-up period as an indicator of medication adherence. For hypothesis 1, medication adherence was designated as a binary variable with a threshold of 0.8 (PRM); for hypothesis 2, medication adherence was specified as five-category and continuous variables, respectively. Inverse probability weighting and mixed effects Cox proportional hazards models were conducted for confounders control and survival analyses. RESULTS One hundred eighty-five thousand eight hundred participants were eligible for the final analyses, with a mean age of 47.49 years (SD 14.55 years), of whom 53.6% were female. For hypothesis 1, the medication non-adherence group (PRM < 0.8) had a lower risk of suicide (HR, 0.527, 95% CI, 0.447-0.620), an increased risk of NSSI (HR, 1.229, 95% CI, 1.088-1.388), and non-significant risk of attempted suicide compared with adherence group (PRM ≥ 0.8). For hypothesis 2, the lowest medication adherence (PRM < 0.2) was associated with increased risks of suicide attempt (HR, 1.614, 95% CI, 1.412-1.845), NSSI (HR, 1.873, 95% CI, 1.649-2.126), and a decreased risk of suicide (HR, 0.593, 95% CI, 0.490-0.719). The other non-adherence groups had lower risks for all three self-inflicted violence behaviors. The associations between medication adherence in continuous-variable and three outcomes were consistent with the categorical medication adherence results. CONCLUSIONS Almost no medication taken as prescribed was associated with an increased risk of suicide attempt and NSSI. However, medication adherence did not appear to prevent completed suicide. Besides, patients with moderate adherence had a lower incidence of suicide attempt and NSSI. These findings highlight the need for a more detailed portrayal of medication adherence and the need to be vigilant for suicide intent in schizophrenics with good medication adherence who may be overlooked previously.
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Affiliation(s)
- Chuanlong Zuo
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, China
| | - Xianmei Yang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, No. 190, Jiannan East Road, Mianyang, Sichuan, 621000, China
| | - Xiangrui Wu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, China
| | - Ruoxin Fan
- Sichuan Mental Health Center, The Third Hospital of Mianyang, No. 190, Jiannan East Road, Mianyang, Sichuan, 621000, China
| | - Jun Liu
- Sichuan Mental Health Center, The Third Hospital of Mianyang, No. 190, Jiannan East Road, Mianyang, Sichuan, 621000, China
| | - Hu Xiang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, No. 190, Jiannan East Road, Mianyang, Sichuan, 621000, China
| | - Yang Li
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, China
| | - Xing Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, China
| | - Xiang Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, China.
| | - Yuanyuan Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, China.
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228
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Fayedeh F, Khorashadizadeh S, Yousefi M, Abbasifar S, Erfanian N, Rafiee M, Ghasemi F. CTLA-4 expression and polymorphisms in Schizophrenia; a systematic review of literature. Mol Biol Rep 2024; 51:431. [PMID: 38520576 DOI: 10.1007/s11033-024-09299-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 01/29/2024] [Indexed: 03/25/2024]
Abstract
Schizophrenia constitutes a severe psychiatric disorder with detrimental impacts on individuals, their support systems, and the broader economy. Extensive research has revealed a notable association between variations in the Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) gene and an increased susceptibility to schizophrenia.This study represents the first systematic review of the literature investigating the impact of CTLA-4 polymorphisms and expression on the development and progression of schizophrenia.Our investigation involved a comprehensive search strategy, using a combination of title, abstract, and MESH terms in four databases, including PubMed, Scopus, Web of Science, and Google Scholar, until August 29th, 2023. The complete texts of the identified records were obtained and rigorously assessed based on predefined exclusion and inclusion criteria. Out of the numerous records, a total of 88 were identified through the databases. 10 studies met the criteria; therefore, their quality was assessed and included in this systematic study. The records were then categorized into polymorphism and expression groups. Our investigation emphasizes an association between rs3087243, rs231779, rs231777, rs16840252, rs5742909, and rs231775 polymorphisms and the development of schizophrenia. The results demonstrate a correlation between CTLA-4 polymorphisms and schizophrenia, compelling the need for further research to thoroughly examine the role of CTLA-4 in schizophrenia and other psychiatric disorders.
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Affiliation(s)
- Farzad Fayedeh
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Mohammad Yousefi
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Sara Abbasifar
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Nafiseh Erfanian
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Mitra Rafiee
- Cellular and Molecular Research Center, Department of Immunology, Birjand University of Medical Sciences, Birjand, Iran.
| | - Fahimeh Ghasemi
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran.
- Department of Medical Biotechnology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran.
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Majuri T, Nerg I, Huikari S, Rissanen I, Jääskeläinen E, Miettunen J, Korhonen M. Productivity costs of schizophrenia spectrum and other psychotic disorders by friction cost and human capital methods: The Northern Finland Birth Cohort 1966. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02652-y. [PMID: 38517515 DOI: 10.1007/s00127-024-02652-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/07/2024] [Indexed: 03/24/2024]
Abstract
PURPOSE Psychotic disorders are associated with substantial productivity costs; however no previous studies have compared these between schizophrenia spectrum (SSD) and other psychotic disorders (OP). The human capital method (HCM) and the friction cost method (FCM) are the two most common approaches to assess productivity costs. The HCM focuses on employees' perspectives on the costs, whereas the FCM demonstrates employers' perspectives. Studies comparing these methods when estimating the productivity costs of psychoses are lacking. METHODS Utilizing the Northern Finland Birth Cohort 1966 with linkages to national registers, we compared the adjusted productivity costs of SSD (n = 216) and OP (n = 217). The productivity costs were estimated from ages 18 to 53 including projections to statutory retirement age using the FCM and HCM. RESULTS When estimated via the HCM, productivity losses were higher for SSD (€193,940) than for OP (€163,080). However, when assessed using the FCM, costs were significantly lower for SSD (€2,720) than for OP (€4,430). Productivity costs varied by sex and various clinical and occupational factors. CONCLUSION This study highlights how productivity costs vary by psychosis diagnosis. These differences should be noted when planning interventions. The low FCM estimates indicate the need of interventions before or during the early phases of psychoses. From a societal perspective, interventions are needed, particularly for those with highest HCM productivity losses, such as males with SSD. Besides psychiatric services, the roles of social services, employment agencies and occupational health care should be considered when helping individuals with psychoses to working life.
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Affiliation(s)
- Tuomas Majuri
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, Oulu, Finland.
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland.
| | - Iiro Nerg
- Department of Economics, Accounting and Finance, University of Oulu, Oulu, Finland
| | - Sanna Huikari
- Department of Economics, Accounting and Finance, University of Oulu, Oulu, Finland
| | - Ina Rissanen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Erika Jääskeläinen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marko Korhonen
- Department of Economics, Accounting and Finance, University of Oulu, Oulu, Finland
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230
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Sun Y, Yu H, Wang Z, Zhang J, Zhou Y, Cui W, Jiang W. Relationship between medication burden and medication experience in stable patients with schizophrenia: the mediating effect of medication belief. BMC Nurs 2024; 23:197. [PMID: 38519927 PMCID: PMC10958954 DOI: 10.1186/s12912-024-01882-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/19/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Individuals with schizophrenia require prolonged antipsychotic medication treatment. But more than 50% of individuals with schizophrenia experience adverse medication experiences during their antipsychotic treatments. Such individuals often adjust or discontinue medication, leading to disease relapse and impaired social functioning. Psychiatric nurses should pay close attention to the medication experiences of individuals with schizophrenia. This research explore the relationship between medication burden and medication experience, as well as the mediating effect of medication belief in stable patients with schizophrenia. METHODS A convenience sample of hospitalized stable patients with schizophrenia were selected from Daqing Third Hospital and Baiyupao Hospital from September 2023 to December 2023. A survey was conducted with them using a questionnaire consisting of general information questionnaire, The Subjective Well-being Under Neuroleptic Treatment Scale(SWN), The Living with Medicines Questionnaire(LMQ), Beliefs about Medicines Questionnaire-Specific (BMQ-Specific). Pearson correlation analysis was used to explore the correlation between LMQ, BMQ-Specific and SWN scores, and multiple linear regression analysis was used to explore the influencing factors of medication experience in patients with schizophrenia. AMOS 24.0 was used to construct the structural equation modeling(SEM), and the mediation effect of the SEM was tested using Bootstrap method. RESULTS According to the sample size calculation requirements of structural equation model, a total of 300 samples were required in this study, and 400 effective questionnaires were actually collected in this study, which met the sample size requirements for constructing structural equation models. Bootstrap test showed that the mediation effect was significant. The total effect of medication burden on medication experience was significant (Z=-12.146, 95%CI (-0.577, -0.417), P < 0.001). The indirect effect of medication burden on medication experience, that is, the mediating effect of medication belief was significant (Z=-4.839, 95%CI (-0.217, -0.096), P < 0.001). The direct effect of medication burden on medication experience was significant (Z=-7.565, 95%CI (-0.437, -0.257), P < 0.001). This model belongs to partial mediation model. CONCLUSIONS Psychiatric nurses can enhance the patients' medication experience by reducing medication burden and strengthening medication beliefs. Therefore, the results also provide theoretical references and decision-making foundations for psychiatric nursing professionals to develop appropriate management strategies for individuals with schizophrenia.
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Affiliation(s)
- Yujing Sun
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hong Yu
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Zhengjun Wang
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Jing Zhang
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
| | - Yuqiu Zhou
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Wenming Cui
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
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231
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Ketcham E, Schooler NR, Severe JB, Buckley PF, Miller BJ. Longitudinal study of insomnia, suicidal ideation, and psychopathology in schizophrenia. Schizophr Res 2024; 267:34-38. [PMID: 38518475 DOI: 10.1016/j.schres.2024.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/18/2024] [Accepted: 03/18/2024] [Indexed: 03/24/2024]
Abstract
OBJECTIVE Insomnia is a common comorbidity in schizophrenia. Increasing cross-sectional evidence suggests an association between insomnia and suicidal ideation (SI) and symptom severity in schizophrenia. We investigated longitudinal associations over 3 months between insomnia, suicidal ideation, and symptom severity in a group of patients with chronic schizophrenia. METHOD We performed a secondary analysis of data from n = 305 participants from the Preventing Relapse Oral Antipsychotics Compared to Injectables Evaluating Efficacy (PROACTIVE) schizophrenia trial using regression models. RESULTS The prevalence of moderate-to-severe insomnia was 17.7 % at baseline and 13.6 % at 3 months, respectively. The prevalence of SI was 22 % at baseline and 22.5 % at 3 months. After controlling for potential confounders, improved SI from baseline to 3 months was associated with both baseline moderate-to-severe insomnia (OR = 3.81, 95 % CI 1.11-13.12, p = 0.034) and improvement in insomnia (OR = 3.50, 95 % CI 1.23-9.92, p = 0.013). Worsening SI from baseline to 3 months was associated with worsening insomnia (OR = 3.50, 95 % CI 1.23-9.92, p = 0.013), but not baseline insomnia. Improvement in BPRS total score from baseline to 3 months was associated with improvement in insomnia (β = 0.17, p = 0.029), but not baseline insomnia. CONCLUSION Insomnia is common in patients with chronic schizophrenia and insomnia showed significant associations with SI and psychopathology. Clinicians should consider insomnia when assessing suicide risk in patients with schizophrenia.
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Affiliation(s)
- Evan Ketcham
- Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Nina R Schooler
- SUNY Downstate Health Sciences Center, Brooklyn, NY, United States
| | | | - Peter F Buckley
- Chancellor's Office, University of Tennessee Health Sciences Center, Memphis, TN, United States
| | - Brian J Miller
- Medical College of Georgia, Augusta University, Augusta, GA, United States; Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States.
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Schulte EC, Schulze TG. How do lipids fit into the picture of severe mental health disorders? A missing pathophysiologic link or just a consequence of behavior and treatment. Eur Neuropsychopharmacol 2024; 83:27-29. [PMID: 38518409 DOI: 10.1016/j.euroneuro.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Eva C Schulte
- Department of Psychiatry and Psychotherapy, University Hospital, Faculty of Medicine, University of Bonn, Bonn, Germany; Institute of Human Genetics, University Hospital, Faculty of Medicine, University of Bonn, Bonn, Germany; Institute of Psychiatric Phenomics & Genomics, LMU University Hospital, LMU Munich, Munich, Germany.
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics & Genomics, LMU University Hospital, LMU Munich, Munich, Germany; Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, United States; Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, United States; German Center for Mental Health (DZPG), partner site Munich, Germany
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González-Peñas J, Alloza C, Brouwer R, Díaz-Caneja CM, Costas J, González-Lois N, Gallego AG, de Hoyos L, Gurriarán X, Andreu-Bernabeu Á, Romero-García R, Fañanas L, Bobes J, Pinto AG, Crespo-Facorro B, Martorell L, Arrojo M, Vilella E, Guitiérrez-Zotes A, Perez-Rando M, Moltó MD, Buimer E, van Haren N, Cahn W, O'Donovan M, Kahn RS, Arango C, Pol HH, Janssen J, Schnack H. Accelerated Cortical Thinning in Schizophrenia is Associated With Rare and Common Predisposing Variation to Schizophrenia and Neurodevelopmental Disorders. Biol Psychiatry 2024:S0006-3223(24)01170-3. [PMID: 38521159 DOI: 10.1016/j.biopsych.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 02/22/2024] [Accepted: 03/05/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Schizophrenia is a highly heritable disorder characterized by increased cortical thinning throughout the lifespan. Studies have reported a shared genetic basis between schizophrenia and cortical thickness. However, no genes whose expression is related to abnormal cortical thinning in schizophrenia have been identified. METHODS We conducted linear mixed models to estimate the rates of accelerated cortical thinning across 68 regions from the Desikan-Killiany atlas in individuals with schizophrenia compared to healthy controls from a large longitudinal sample (NCases = 169 and NControls = 298, aged 16-70 years). We studied the correlation between gene expression data from the Allen Human Brain Atlas and accelerated thinning estimates across cortical regions. We finally explored the functional and genetic underpinnings of the genes most contributing to accelerated thinning. RESULTS We described a global pattern of accelerated cortical thinning in individuals with schizophrenia compared to healthy controls. Genes underexpressed in cortical regions exhibiting this accelerated thinning were downregulated in several psychiatric disorders and were enriched for both common and rare disrupting variation for schizophrenia and neurodevelopmental disorders. In contrast, none of these enrichments were observed for baseline cross-sectional cortical thickness differences. CONCLUSIONS Our findings suggest that accelerated cortical thinning, rather than cortical thickness alone, serves as an informative phenotype for neurodevelopmental disruptions in schizophrenia. We highlight the genetic and transcriptomic correlates of this accelerated cortical thinning, emphasizing the need for future longitudinal studies to elucidate the role of genetic variation and the temporal-spatial dynamics of gene expression in brain development and aging in schizophrenia.
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Affiliation(s)
- Javier González-Peñas
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.
| | - Clara Alloza
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Rachel Brouwer
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus. Amsterdam, VU University Amsterdam, Amsterdam, The Netherlands
| | - Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Javier Costas
- Instituto de Investigación Sanitaria (IDIS) de Santiago de Compostela, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Galicia, Spain
| | - Noemí González-Lois
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Ana Guil Gallego
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Lucía de Hoyos
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Xaquín Gurriarán
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Álvaro Andreu-Bernabeu
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Rafael Romero-García
- Department of Psychiatry, University of Cambridge UK; Department of Medical Physiology and Biophysics, Instituto de Biomedicina de Sevilla (IBiS), HUVR/CSIC/Universidad de Sevilla/CIBERSAM, ISCIII, Sevilla, Spain
| | - Lourdes Fañanas
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Julio Bobes
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Faculty of Medicine and Health Sciences - Psychiatry, Universidad de Oviedo, ISPA, INEUROPA. Oviedo, Spain
| | - Ana González Pinto
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; BIOARABA Health Research Institute, OSI Araba, University Hospital, University of the Basque Country, Vitoria, Spain
| | - Benedicto Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain
| | - Lourdes Martorell
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, Reus, Spain
| | - Manuel Arrojo
- Instituto de Investigación Sanitaria (IDIS) de Santiago de Compostela, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Galicia, Spain
| | - Elisabet Vilella
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, Reus, Spain
| | - Alfonso Guitiérrez-Zotes
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, Reus, Spain
| | - Marta Perez-Rando
- Fundación Investigación Hospital Clínico de Valencia, INCLIVA, Valencia, Spain; Unidad de Neurobiología, Instituto de Biotecnología y Biomedicina (BIOTECMED), Universitat de València,Valencia, Spain
| | - María Dolores Moltó
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Unidad de Neurobiología, Instituto de Biotecnología y Biomedicina (BIOTECMED), Universitat de València,Valencia, Spain; Department of Genetics, Universitat de València, Campus of Burjassot, Valencia, Spain
| | - Elizabeth Buimer
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Neeltje van Haren
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands; Altrecht Mental Health Institute, Altrecht Science, Utrecht, The Netherlands
| | - Michael O'Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - René S Kahn
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Hilleke Hulshoff Pol
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hugo Schnack
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
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Kumar P, Roy RN, Prajapati S. Labyrinthine and Neuroscientific Impact of Schizophrenia in the Criminal Justice System. Int Tinnitus J 2024; 27:231-237. [PMID: 38507639 DOI: 10.5935/0946-5448.20230035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Schizophrenia, a complex neuropsychiatric condition, manifests with severe neurobiological and psychosocial symptoms, including psychosis, cognitive dysfunction, and social withdrawal. Neuroscience links these symptoms to synaptic malfunctions and neurotransmitter dysregulation, leading to a profound disconnection from reality. The disorder significantly affects cognitive, affective, and behavioral functions, causing considerable neuropsychological distress and functional impairments. The interplay of schizophrenia with the criminal justice system is complex, often exacerbating psychiatric stigma and introducing challenging neuroethical dilemmas. From neuroscientific perspective, schizophrenia symptoms are classified into 'positive' (hyperfunctioning or distortion of normal mental processes) and 'negative' (reduction or loss of mental functions). Each category presents distinct medico-legal challenges. Studies, including those from the Clinical Antipsychotic Trials of Intervention Effectiveness, highlight the importance of identifying neurobiological and psychosocial factors that increase the risk of criminal justice involvement, stressing the necessity of addressing concurrent disorders like substance use disorders. This convergence underscores the need for a delicate balance between therapeutic interventions and legal responsibility, advocating for policy reforms and neuroscience-based research initiatives. Such efforts are crucial for improving the management of schizophrenia within the criminal justice system, focusing on both the medical and societal aspects of the disorder.
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Affiliation(s)
- Prashant Kumar
- MATS Law School, MATS University, Raipur, Chhattisgarh (India)
| | - Rana Navneet Roy
- Hidayatullah National Law University, Raipur, Chhattisgarh (India)
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235
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Castelnovo A, Casetta C, Cavallotti S, Marcatili M, Del Fabro L, Canevini MP, Sarasso S, D'Agostino A. Proof-of-concept evidence for high-density EEG investigation of sleep slow wave traveling in First-Episode Psychosis. Sci Rep 2024; 14:6826. [PMID: 38514761 PMCID: PMC10958040 DOI: 10.1038/s41598-024-57476-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
Schizophrenia is thought to reflect aberrant connectivity within cortico-cortical and reentrant thalamo-cortical loops, which physiologically integrate and coordinate the function of multiple cortical and subcortical structures. Despite extensive research, reliable biomarkers of such "dys-connectivity" remain to be identified at the onset of psychosis, and before exposure to antipsychotic drugs. Because slow waves travel across the brain during sleep, they represent an ideal paradigm to study pathological conditions affecting brain connectivity. Here, we provide proof-of-concept evidence for a novel approach to investigate slow wave traveling properties in First-Episode Psychosis (FEP) with high-density electroencephalography (EEG). Whole-night sleep recordings of 5 drug-naïve FEP and 5 age- and gender-matched healthy control subjects were obtained with a 256-channel EEG system. One patient was re-recorded after 6 months and 3 years of continuous clozapine treatment. Slow wave detection and traveling properties were obtained with an open-source toolbox. Slow wave density and slow wave traveled distance (measured as the line of longest displacement) were significantly lower in patients (p < 0.05). In the patient who was tested longitudinally during effective clozapine treatment, slow wave density normalized, while traveling distance only partially recovered. These preliminary findings suggest that slow wave traveling could be employed in larger samples to detect cortical "dys-connectivity" at psychosis onset.
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Affiliation(s)
- Anna Castelnovo
- Sleep Medicine Unit, Neurocenter of Italian Switzerland, Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland.
- Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland.
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - Cecilia Casetta
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Via A. Di Rudinì 8, 20142, Milan, Italy
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Simone Cavallotti
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Via A. Di Rudinì 8, 20142, Milan, Italy
| | - Matteo Marcatili
- Psychiatric Department, ASST Monza, San Gerardo Hospital, Monza, Italy
| | - Lorenzo Del Fabro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Maria Paola Canevini
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Via A. Di Rudinì 8, 20142, Milan, Italy
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Via G.B. Grassi 74, 20157, Milan, Italy.
| | - Armando D'Agostino
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Via A. Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
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236
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Dollfus S, Letourneur F, Métivier L, Moulier V, Rothärmel M. Self-assessment scale of auditory verbal hallucinations (SAVH): A novel tool for patients with schizophrenia. Schizophr Res 2024; 267:19-23. [PMID: 38513330 DOI: 10.1016/j.schres.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/18/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND A scale for self-assessment of auditory verbal hallucinations (SAVH) was developed for patients, and this study aimed to validate the scale by investigating its psychometric properties. METHODS Forty one patients with schizophrenia or schizoaffective disorders (DSM-5) self-assessed their hallucinations using nine SAVH questions. Each question was scored from 0 to 5, indicating the severity of the symptoms. Patients were also evaluated with the Brief Psychiatric Rating Scale (BPRS), Auditory Hallucination Rating Scale (AHRS), and Birchwood Insight Scale (BIS). The psychometric properties of the SAVH were assessed by the face, internal consistency, construct, convergent and discriminant validities. RESULTS SAVH scores were used to examine the psychometric properties. Cronbach's α and Guttman's Lambda-6 were 0.67 and 0.73 respectively. Significant correlations were observed between SAVH and AHRS total scores, as well as BPRS hallucinatory behavior subscores. No significant correlations were found between total SAVH scores and (i) levels of insight or (ii) negative BPRS subscores. Factor analysis on SAVH revealed three factors accounting for 59.3 % of the variance. Most patients found the questions clear, appropriate, and of adequate length. CONCLUSIONS SAVH demonstrated good psychometric properties, suggesting its utility in assessing auditory verbal hallucinations (AVH). This self-assessment could be valuable in evaluating AVH treatment efficacy, monitoring AVH, and empowering patients.
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Affiliation(s)
- Sonia Dollfus
- Inserm UMR-S 1237 PhIND, Presage team, GIP Cyceron, 14000 Caen, France; Normandie Univ, UNICAEN, UFR de Médecine, 14000 Caen, France; CHU de Caen, Service de Psychiatrie, 14000 Caen, France; Fédération Hospitalo-Universitaire (FHU) A2M2P- CHU, Caen 14000, France.
| | - Florian Letourneur
- Normandie Univ, UNICAEN, UFR de Médecine, 14000 Caen, France; CHU de Caen, Service de Psychiatrie, 14000 Caen, France; Fédération Hospitalo-Universitaire (FHU) A2M2P- CHU, Caen 14000, France
| | - Lucie Métivier
- Inserm UMR-S 1237 PhIND, Presage team, GIP Cyceron, 14000 Caen, France; Normandie Univ, UNICAEN, UFR de Médecine, 14000 Caen, France; Fédération Hospitalo-Universitaire (FHU) A2M2P- CHU, Caen 14000, France
| | - Virginie Moulier
- Centre Hospitalier du Rouvray, Service Hospitalo-Universitaire de Psychiatrie, Centre Thérapeutique d'Excellence, 76300 Sotteville-lès-Rouen, France; Unité de Recherche Clinique (URC), EPS Ville Evrard, Neuilly-sur-Marne, France
| | - Maud Rothärmel
- Inserm UMR-S 1237 PhIND, Presage team, GIP Cyceron, 14000 Caen, France; Centre Hospitalier du Rouvray, Service Hospitalo-Universitaire de Psychiatrie, Centre Thérapeutique d'Excellence, 76300 Sotteville-lès-Rouen, France; Fédération Hospitalo-Universitaire (FHU) A2M2P- CHU, Caen 14000, France
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Haddad NM, De Jesus LP, Serpa M, Van De Bilt M, Talib L, Costa A, Gattaz W, Loch AA. Endocannabinoid system alterations in schizophrenia: association with cannabis use and antipsychotic medication. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01788-x. [PMID: 38502208 DOI: 10.1007/s00406-024-01788-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/24/2024] [Indexed: 03/21/2024]
Abstract
Determining peripheral modulation of the endocannabinoid system (ECS) may be important for differentiating individuals with schizophrenia. Such differentiation can also be extended to subgroups of individuals, those who use cannabis and antipsychotic medications, particularly those who are treatment resistant. Patients and controls were recruited from the outpatient clinic of the Psychosis Group of the University of São Paulo, Brazil. A final sample of 93 individuals was divided into 3 groups: patients with schizophrenia using clozapine (treatment-resistant) (n = 29), patients with schizophrenia using another antipsychotic (n = 31), and controls (n = 33). By measuring the proteins and metabolites involved in the ECS pathways in the peripheral blood, AEA (anandamide), 2-AG (2-arachidonoyl ethanolamine), and CB2 receptor (peripheral) were quantified. Individuals reporting lifetime cannabis use had lower 2-AG plasma levels (p = 0.011). Regarding the CB2 receptor, the values of patients with schizophrenia and controls were similar, but those of patients using antipsychotics other than clozapine differed (p = 0.022). In generalized linear models to control for confounders, the use of cannabis remained the only factor that significantly influenced 2-AG levels. The relationship for non-clozapine antipsychotics as the only factor related to CB2 changes was marginally significant. We found for the first time that cannabis use and non-clozapine antipsychotic medication are potentially involved in the modulation of the ECS, specifically influencing 2-AG endocannabinoid and CB2 receptor levels. More studies regarding the ECS are needed since it has been increasingly related to the physiopathology of schizophrenia.
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Affiliation(s)
- Natalia Mansur Haddad
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil.
| | - Leonardo Peroni De Jesus
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
| | - Mauricio Serpa
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - Martinus Van De Bilt
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - Leda Talib
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - Alana Costa
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
| | - Wagner Gattaz
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - Alexandre Andrade Loch
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
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Semler E, Herpich F, Zellner L, Zwick S, Zwanzger P, Brunnauer A. The impact of aerobic endurance training on cognitive performance in schizophrenic inpatients in a clinical routine setting. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01773-4. [PMID: 38502204 DOI: 10.1007/s00406-024-01773-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 01/28/2024] [Indexed: 03/21/2024]
Abstract
The primary aim of this study was to investigate the impact of aerobic endurance training in schizophrenic inpatients on cognitive performance in a clinical routine setting. Of secondary interest was the influence on psychopathological symptoms. A total of 31 schizophrenic inpatients were randomly assigned to receive either controlled endurance training or occupational therapy. The experimental group underwent endurance training of 20-30 min each, 3 times per week for a total of up to 22 training sessions. The control group received about 90 min of occupational therapy, 2-3 times per week for up to 22 sessions. Cognitive performance was assessed via an extensive neuropsychological examination before randomization and prior to discharge. Significant improvements in cognitive functions and psychopathology could be shown in both groups. For verbal memory functions (short-term memory, working memory, and learning performance), there was a significant advantage for the aerobic endurance training group. Physical exercise is a feasible, easy-to-implement add-on therapy for schizophrenic patients in a clinical routine setting with positive effects on verbal memory functions. Besides, it seems important to fill the gap between inpatient and outpatient health care, providing physical training supply for this patient group.
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Affiliation(s)
- Elisa Semler
- Department of Neuropsychology, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, kbo-Inn-Salzach-Klinikum, Wasserburg/Inn, Germany
| | - Florian Herpich
- Department of Neuropsychology, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, kbo-Inn-Salzach-Klinikum, Wasserburg/Inn, Germany
| | - Leonhard Zellner
- Department of Neuropsychology, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, kbo-Inn-Salzach-Klinikum, Wasserburg/Inn, Germany
| | - Sarah Zwick
- Department of Neuropsychology, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, kbo-Inn-Salzach-Klinikum, Wasserburg/Inn, Germany
| | - Peter Zwanzger
- Department of Neuropsychology, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, kbo-Inn-Salzach-Klinikum, Wasserburg/Inn, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University Munich, Munich, Germany
| | - Alexander Brunnauer
- Department of Neuropsychology, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, kbo-Inn-Salzach-Klinikum, Wasserburg/Inn, Germany.
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University Munich, Munich, Germany.
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239
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Mohammadzadeh A, Khanghah AS, Ojarood MV. Unsuccessful suicidal attempts by sewing needle introducing to chest: Removing 17 ones from the right ventricle and breast tissue in two stages; case report and literature review. Int J Surg Case Rep 2024; 118:109551. [PMID: 38579596 PMCID: PMC11004868 DOI: 10.1016/j.ijscr.2024.109551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/10/2024] [Accepted: 03/14/2024] [Indexed: 04/07/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Penetrating cardiac injuries among the whole injuries confronting the trauma surgeon is more alarming. The introduction of needles as an attempt to inflict self-injury has rarely been described, so we only found 34 reported cases reviewing the available English literature since 1967. CASE PRESENTATION We have reported a case of a 35-year-old depressed female who had introduced 17 sewing needles through her chest wall, causing myocardial puncture and mastitis; underwent exploratory sternotomy and mammoplasty in two stages and survived. CLINICAL DISCUSSION Penetrating cardiac trauma is rare enough for surgeons to deal with direct injuries by sewing needles. Penetrating wounds in the "cardiac box" anatomic area" should elicit the highest concern for potential cardiac injury. The mentioned region is demarcated superiorly by the clavicles, inferiorly by the xiphoid, and the nipples laterally in an area of the anterior thorax. CONCLUSION Anterior aspect penetrating traumas to the cardiac box myocardial injuries should be in mind, and immediate and proper intervention should be needed. Ventricles, for their anatomical condition, are exposed to be injured.
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Affiliation(s)
- Alireza Mohammadzadeh
- Department of Cardiothoracic Surgery, Imam Hospital, Ardabil University of Medical Sciences, Ardabil, Iran; Imam Hospital, Basij Square, Ardabil, Iran
| | - Ali Samady Khanghah
- Department of Surgery, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran; Fatemi hospital, Imam Ave, Ardabil, Iran.
| | - Mohammad Vakili Ojarood
- Fatemi hospital, Imam Ave, Ardabil, Iran; Department of Thoracic Surgery, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.
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Barry S, Jarskog LF, Xia K, Torpunuri RS, Wu X, Zeng X. Racial Disparities in Clozapine Prescription Patterns Among Patients With Schizophrenia. Psychiatr Serv 2024:appips20230226. [PMID: 38500451 DOI: 10.1176/appi.ps.20230226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
OBJECTIVE Previous research has suggested that demographic factors affect the likelihood of a patient with schizophrenia receiving a clozapine prescription. The authors aimed to determine the impact of race, social determinants of health, gender, rurality, and care patterns on clozapine prescription rates. METHODS This cross-sectional observational study used structured electronic health records data from 3,160 adult patients diagnosed as having schizophrenia between October 1, 2015, and November 30, 2021, in a multifacility health system. The social vulnerability index (SVI) was used to quantify social determinants of health. Descriptive data analysis, logistic regression, and sensitivity analysis were conducted to identify differences between patients with schizophrenia who received a clozapine prescription and those who received antipsychotic medications other than clozapine. RESULTS Overall, 401 patients with schizophrenia were given a clozapine prescription during the study period, and 2,456 received antipsychotics other than clozapine. Results of the logistic regression indicated that White race (OR=1.71, compared with Black race), community minority status and language SVI score (OR=2.97), and increased treatment duration (OR=1.36) were significantly associated with a higher likelihood of clozapine prescription; gender, rurality, age at first diagnosis, and ethnicity did not influence the likelihood of receiving clozapine. CONCLUSIONS Black patients with schizophrenia had a lower likelihood of receiving a clozapine prescription compared with White patients, even after analyses accounted for demographic variables, social determinants of health, and care access patterns. Given the effectiveness of clozapine in managing treatment-resistant schizophrenia, it is crucial for future research to better understand the factors contributing to this treatment disparity.
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Affiliation(s)
- Spenser Barry
- Department of Psychology, University of North Carolina Wilmington, Wilmington (Barry); Carolina Health Informatics Program (Torpunuri) and Department of Biostatistics (Wu), University of North Carolina at Chapel Hill, Chapel Hill; North Carolina Psychiatric Research Center (Jarskog, Zeng) and Mental Health Informatics and Analytics Core (Xia, Zeng), Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill
| | - L Fredrik Jarskog
- Department of Psychology, University of North Carolina Wilmington, Wilmington (Barry); Carolina Health Informatics Program (Torpunuri) and Department of Biostatistics (Wu), University of North Carolina at Chapel Hill, Chapel Hill; North Carolina Psychiatric Research Center (Jarskog, Zeng) and Mental Health Informatics and Analytics Core (Xia, Zeng), Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill
| | - Kai Xia
- Department of Psychology, University of North Carolina Wilmington, Wilmington (Barry); Carolina Health Informatics Program (Torpunuri) and Department of Biostatistics (Wu), University of North Carolina at Chapel Hill, Chapel Hill; North Carolina Psychiatric Research Center (Jarskog, Zeng) and Mental Health Informatics and Analytics Core (Xia, Zeng), Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill
| | - Rohit Simha Torpunuri
- Department of Psychology, University of North Carolina Wilmington, Wilmington (Barry); Carolina Health Informatics Program (Torpunuri) and Department of Biostatistics (Wu), University of North Carolina at Chapel Hill, Chapel Hill; North Carolina Psychiatric Research Center (Jarskog, Zeng) and Mental Health Informatics and Analytics Core (Xia, Zeng), Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill
| | - Xiaoyu Wu
- Department of Psychology, University of North Carolina Wilmington, Wilmington (Barry); Carolina Health Informatics Program (Torpunuri) and Department of Biostatistics (Wu), University of North Carolina at Chapel Hill, Chapel Hill; North Carolina Psychiatric Research Center (Jarskog, Zeng) and Mental Health Informatics and Analytics Core (Xia, Zeng), Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill
| | - Xiaoming Zeng
- Department of Psychology, University of North Carolina Wilmington, Wilmington (Barry); Carolina Health Informatics Program (Torpunuri) and Department of Biostatistics (Wu), University of North Carolina at Chapel Hill, Chapel Hill; North Carolina Psychiatric Research Center (Jarskog, Zeng) and Mental Health Informatics and Analytics Core (Xia, Zeng), Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill
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241
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Marega J, Bah HT. Burdening caregivers of patients with schizophrenia at Edward Francis Small Teaching Hospital, The Gambia. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02634-0. [PMID: 38498148 DOI: 10.1007/s00127-024-02634-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Deinstitutionalization of persons living with mental illness has led to many patients residing in communities with family members and shifting the burden of care and caregiving from hospitals to homes. The aim of the study was to determine the burden on caregivers of patients with schizophrenia at Edward Francis Small Teaching Hospital (EFSTH). METHODS This was a descriptive cross-sectional study design with a sample consisting of 161 randomly selected caregivers of patients with schizophrenia. The GHQ-12 questionnaire was used to determine the general health status of the caregivers. The caregivers' burden was assessed using the Zarit Burden Scale. The data were collected using the researcher-administered method. The collected data were analyzed with IBM SPSS Version 20 using descriptive statistics, mean differences, and the general linear model (GLM). RESULTS The main findings of this study were that caregivers experienced a significantly high level of burden. Most of them experienced high levels of physical (70%), psychological (93.2%), social (78.3%) and financial (55.3%) burdens. Employment status, specifically unemployment status and belonging to the Wolof ethnic group, was a significant predictor of the level of financial burden on the caregivers. Similarly, the total score for social burden was also significantly greater among unemployed caregivers. Educational level was a significant predictor of the total score on the psychological and physical burden scale. CONCLUSION The caregivers of patients with schizophrenia at EFSTH are experiencing a high level of burden as a result of their caregiving role, which affects their health, and this calls for urgent intervention.
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Affiliation(s)
- Jarra Marega
- Department of Psychiatry, Edward Francis Small Teaching Hospital, C/O Edward Francis Small Teaching Hospital, No. 2 Marina Parade, Banjul, The Gambia
| | - Haddy Tunkara Bah
- Department of Nursing and Reproductive Health, University of The Gambia, C/O School of Medicine and Allied Health Sciences, Banjul, The Gambia.
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242
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Thongsalab J, Yunibhand J, Uthis P. Navigating personal recovery: multinomial logistic regression analysis of schizophrenia outcomes in community-dwelling individuals. Gen Psychiatr 2024; 37:e101325. [PMID: 38510927 PMCID: PMC10952847 DOI: 10.1136/gpsych-2023-101325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/31/2024] [Indexed: 03/22/2024] Open
Abstract
Background Schizophrenia is a chronic mental disorder affecting individuals globally, emphasising the significance of personal recovery in mental healthcare. Understanding the recovery stages and the associated factors can provide essential insights for targeted interventions. Aims This study aimed to discern the stages of personal recovery in Thai patients with schizophrenia and elucidate the associated factors with each stage. Methods A multistage sampling technique was employed, selecting 231 patients with schizophrenia from mental health outpatient departments of general and psychiatric hospitals. Data collected from March to May 2023 included screening for psychotic symptoms using the Brief Psychiatric Rating Scale and six self-report questionnaires-Stage of Recovery Scale, Beck Cognitive Insight Scale, Brief Resilience Scale, Family Support, Therapeutic Relationship-Patients Version and Social Support Questionnaire-along with personal data sheets. Pearson correlation and multinomial logistic regression were performed. Results The predominant personal recovery stage among participants was stage 3, 'living with disabilities', comprising 42.4% of the participants. Key factors contributing to personal recovery, explaining approximately 38.4% of the variance, included resilience, family support, therapeutic alliance, hospitalisations since onset and recovery-oriented nursing service utilisation. Logit equations for stages 3 and 4 are as follows: stage 3 (living with disability): logit=-4.44+0.74×resilience+0.07×therapeutic alliance+0.02×recovery-oriented nursing service utilisation; stage 4 (living beyond disability): logit=-11.57-0.05×hospitalisation since onset+1.96×resilience+0.11×family support+0.06×therapeutic alliance. Conclusion The findings emphasise the significance of mental health nursing interventions. In conjunction with recovery-oriented nursing services, strengthening resilience, therapeutic alliances and family support may accelerate personal recovery and reduce hospitalisations among individuals with schizophrenia.
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Affiliation(s)
| | | | - Penpaktr Uthis
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
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243
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Oyaci Y, Yildirim YE, Aytac HM, Pehlivan S, Cetinay Aydin P. EXPRESS: The relationship of the methylation status and polymorphism of glucocorticoid receptor gene (NR3C1) with attempted suicide or non-suicidal self-injury patients in schizophrenia. J Investig Med 2024:10815589241242715. [PMID: 38494341 DOI: 10.1177/10815589241242715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
We aim to investigate the methylation of NR3C1 gene promotor and NR3C1 BclI polymorphism in schizophrenia (SCZ) patients with attempted suicide or non-suicidal self-injury (NSSI). A sample of 112 patients with SCZ were included in the study. SCID-I was used to confirm the diagnosis according to DSM-IV-TR criteria. The patients were evaluated by data forms that had sociodemographic, suicidal behavior, and NSSI information. Methylation-specific PCR was used to identify the methylation of the NR3C1 gene. The analysis of the BclI polymorphism of the NR3C1 gene was evaluated by using the PCR-RFLP. Our results revealed that although the NR3C1 gene methylation was not statistically significantly different, there was a significant difference in NR3C1 genotype distribution between the SCZ groups with and without attempted suicide. SCZ patients carrying the CC genotype had a lower risk of attempted suicide (OR: 0.421; 95% Cl: 0.183-0.970; p=.040), while having the GG genotype in SCZ patients was associated with a higher risk of attempted suicide (OR: 3.785; 95% Cl: 1.107-12.945; p=.042). Additionally, due to NSSI in SCZ patients, there were no significant differences in NR3C1 gene methylation and NR3C1 genotype distribution between the groups. We propose that the NR3C1 BclI polymorphism may be associated with attempted suicide in Turkish patients diagnosed with SCZ.
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Affiliation(s)
- Yasemin Oyaci
- Institute of Graduate Studies in Health Sciences, Istanbul University, Istanbul, Turkey
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Turkey
| | - Yusuf Ezel Yildirim
- University of Health Sciences Department of Psychiatry, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Hasan Mervan Aytac
- Istanbul University, Institute of Graduate Studies in Health Sciences, Fatih, Turkey
- Department of Psychiatry, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sacide Pehlivan
- Institute of Graduate Studies in Health Sciences, Istanbul University, Istanbul, Turkey
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Turkey
| | - Pinar Cetinay Aydin
- University of Health Sciences Department of Psychiatry, Bakirkoy Research and Trainings Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
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244
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Ruffalo ML, Kottapalli M, Anbukkarasu P. Empathy in the Care of Individuals With Schizophrenia: A Vital Element of Treatment. Am J Psychother 2024; 77:30-34. [PMID: 38093661 DOI: 10.1176/appi.psychotherapy.20230022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2024]
Abstract
Although therapist empathy has long been recognized as one of the most important ingredients of successful psychotherapy, its role in the treatment of schizophrenia has been neglected, relative to the treatment of other psychiatric disorders. In this article, the authors aimed to explore historical and modern conceptions of the use of empathy in work with patients with schizophrenia, review the research on empathy as applied generally in psychotherapy and as it pertains to this population, and offer a case study demonstrating empathy's instrumental role in the management of schizophrenia. Empathic understanding of patients with schizophrenia has relevance across treatment settings: in psychotherapy, on inpatient psychiatric units, in the emergency department, and at home with family or caregivers. An empathic understanding of the psychological process occurring in schizophrenia is a vital component of effective treatment.
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Affiliation(s)
- Mark L Ruffalo
- Department of Psychiatry, University of Central Florida College of Medicine, Orlando (all authors); Department of Psychiatry, Tufts University School of Medicine, Boston (Ruffalo)
| | - Manjula Kottapalli
- Department of Psychiatry, University of Central Florida College of Medicine, Orlando (all authors); Department of Psychiatry, Tufts University School of Medicine, Boston (Ruffalo)
| | - Preethashree Anbukkarasu
- Department of Psychiatry, University of Central Florida College of Medicine, Orlando (all authors); Department of Psychiatry, Tufts University School of Medicine, Boston (Ruffalo)
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245
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Moore J, Castro Y, DiNitto D, Hernandez M, Velasquez M. Sociodemographic and treatment-related determinants of recent substance use among adults with comorbid substance misuse and psychotic disorders discharged from substance use treatment. J Subst Use Addict Treat 2024; 161:209349. [PMID: 38494053 DOI: 10.1016/j.josat.2024.209349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/04/2024] [Accepted: 02/21/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Rates of alcohol and illicit substance use are higher among persons with psychotic disorders relative to the general population. The adverse health and psychological effects of substance use behaviors disproportionately impact persons with psychotic disorders. Prior research has shown that persons with psychotic disorders experience increased difficulty in reducing substance use behaviors, and interventions targeting substance use behavior change among this population have demonstrated limited effectiveness. One reason for this is that little is known about the factors that influence substance use and behavior change among this population. To address these disparities, the present study investigated sociodemographic and treatment-related factors of substance use recurrence among persons with psychotic disorders who received substance use treatment services. METHODS Data came from the 2015-2018 Treatment Episode Dataset-Discharges (TEDS-D). TEDS-D collects annual data on adolescent and adult discharges from state-certified substance use treatment centers in the United States. The study conducted all analyses with a subsample of 1956 adult discharges with a psychotic disorder who received services from an outpatient substance use treatment center for at least one month. χ2 tests of independence and multivariable logistic regression analyses were used to examine associations of sociodemographic and treatment-related characteristics with substance use recurrence while in treatment (α < 0.05 analyses). The study presents results from multivariable logistic regression models as adjusted odds ratios (AORs) with 95 % confidence intervals (CI). RESULTS Those who were age 50 or older, were referred to treatment by the criminal justice system, and attended substance use self-help groups had lower odds of substance use recurrence while in treatment. Sex, educational attainment, employment status, living situation, type of substance use, and treatment history were not significantly associated with substance use recurrence. CONCLUSIONS In designing treatment services, providers should consider whether focusing on sociodemographic, including cultural, factors can affect more positive substance use behavior change and other desired treatment outcomes among those with psychotic disorders and comorbid substance misuse. Further study is needed to identify these factors among specific subpopulations of those with psychotic disorders and substance misuse.
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Affiliation(s)
- John Moore
- Florida State University, College of Social Work, 296 Champions Way, Tallahassee, FL 32304, United States of America.
| | - Yessenia Castro
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, United States of America
| | - Diana DiNitto
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, United States of America
| | - Mercedes Hernandez
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, United States of America
| | - Mary Velasquez
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, United States of America
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246
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Lisoni J, Nibbio G, Baldacci G, Zucchetti A, Cicale A, Zardini D, Miotto P, Deste G, Barlati S, Vita A. Improving depressive symptoms in patients with schizophrenia using bilateral bipolar-nonbalanced prefrontal tDCS: Results from a double-blind sham-controlled trial. J Affect Disord 2024; 349:165-175. [PMID: 38199388 DOI: 10.1016/j.jad.2024.01.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Treating depressive symptoms in patients with schizophrenia is challenging. While transcranical Dicrect Current Stimulation (tDCS) improved other core symptoms of schizophrenia, conflicting results have been obtained on depressive symptoms. Thus, we aimed to expand current evidence on tDCS efficacy to improve depressive symptoms in patients with schizophrenia. METHODS A double-blind RCT was performed with patients randomized to 2 mA active-tDCS or sham-tDCS (15 daily sessions) with a bilateral bipolar-nonbalanced prefrontal placement (anode: left Dorsolateral prefrontal cortex; cathode: right orbitofrontal region). Clinical outcomes included variations of Calgary Depression Scale for Schizophrenia total score (CDSS) and of Depression-hopelessness and Guilty idea of reference-pathological guilt factors. Analysis of covariance was performed evaluating between-group changes over time. The presence/absence of probable clinically significant depression was determined when CDSS > 6. RESULTS As 50 outpatients were included (both groups, n = 25), significant improvements following active-tDCS were observed for CDSS total score (p = 0.001), Depression-hopelessness (p = 0.001) and Guilty idea of reference-pathological guilt (p = 0.03). Considering patients with CDSS>6 (n = 23), compared to sham, active-tDCS significantly improved CDSS total score (p < 0.001), Depression-hopelessness (p = 0.001) but Guilty idea of reference-pathological guilt only marginally improved (p = 0.051). Considering response rates of clinically significant depression, important reductions of CDSS score were observed (78 % of the sample scored ≤6; active-tDCS, n = 23; sham-tDCS, n = 16; p = 0.017). Early wakening item did not significantly change in any group. LIMITATIONS The study lacks a follow-up period and evaluation of tDCS effects on psychosocial functioning. CONCLUSIONS Bilateral bipolar-nonbalanced prefrontal tDCS is a successful protocol for the treatment of depressive symptoms in patients with schizophrenia.
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Affiliation(s)
- Jacopo Lisoni
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy.
| | - Gabriele Nibbio
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Giulia Baldacci
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Andrea Zucchetti
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Andrea Cicale
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Daniela Zardini
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Paola Miotto
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Giacomo Deste
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Stefano Barlati
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Antonio Vita
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
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Zisman-Ilani Y, Parker M, Thomas EC, Suarez J, Hurford I, Bowen A, Calkins M, Deegan P, Nossel I, Dixon LB. Usability and Feasibility of the Antipsychotic Medication Decision Aid in a Community Program for First-Episode Psychosis. Psychiatr Serv 2024:appips20230230. [PMID: 38477836 DOI: 10.1176/appi.ps.20230230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVE Although antipsychotic medications are considered first-line treatment for psychosis, rates of discontinuation and nonadherence are high, and debate persists about their use. This pilot study aimed to explore the usability, feasibility, and potential impact of a shared decision making (SDM) intervention, the Antipsychotic Medication Decision Aid (APM-DA), for decisions about use of antipsychotic medications. METHODS A pilot randomized controlled trial was conducted with 17 participants in a first-episode psychosis program. Nine participants received the APM-DA, and eight received usual care. RESULTS After their appointments, intervention group participants had less decisional conflict and greater satisfaction with decisions than control group participants had. Use of the APM-DA did not increase appointment length. Comparison of the intervention outcomes with the control outcomes was limited because of the small sample. CONCLUSIONS The results support the feasibility and usability of an SDM process via the use of the APM-DA in routine community psychosis care.
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Affiliation(s)
- Yaara Zisman-Ilani
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon)
| | - Morgan Parker
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon)
| | - Elizabeth C Thomas
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon)
| | - John Suarez
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon)
| | - Irene Hurford
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon)
| | - Andrea Bowen
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon)
| | - Monica Calkins
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon)
| | - Patricia Deegan
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon)
| | - Ilana Nossel
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon)
| | - Lisa B Dixon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon)
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248
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Yu K, Zhou H, Chen Z, Lei Y, Wu J, Yuan Q, He J. Mechanism of cognitive impairment and white matter damage in the MK-801 mice model of schizophrenia treated with quetiapine. Behav Brain Res 2024; 461:114838. [PMID: 38157989 DOI: 10.1016/j.bbr.2023.114838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/11/2023] [Accepted: 12/23/2023] [Indexed: 01/03/2024]
Abstract
Schizophrenia has been linked to cognitive impairment and white matter damage in a growing number of studies this year. In this study, we used the MK-801-induced schizophrenia-like mice model to investigate the effects of quetiapine on behavioral changes and myelin loss in the model mice. The subjects selected for this study were C57B6/J male mice, MK-801 (1 mg/kg/d intraperitoneal injection) modeling for 1 week and quetiapine (10 mg/kg/d intraperitoneal injection) treatment for 2 weeks. Behavioral tests were then performed using the three-chamber paradigm test and the Y maze test. Moreover, western blot, immunohistochemistry, and immunofluorescence were conducted to investigate the changes in oligodendrocyte spectrum markers. In addition, we performed some mechanism-related proteins by western blot. Quetiapine ameliorated cognitive impairment and cerebral white matter damage in MK-801 model mice, and the mechanism may be related to the PI3K/AKT pathways. The present study suggests that quetiapine has a possible mechanism for treating cognitive impairment and white matter damage caused by schizophrenia.
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Affiliation(s)
- Kai Yu
- School of Mental Health and the Affiliated Kangning Hospital, Wenzhou Key Laboratory for Basic and Translational Research in Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Han Zhou
- School of Mental Health and the Affiliated Kangning Hospital, Wenzhou Key Laboratory for Basic and Translational Research in Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhuo Chen
- School of Mental Health and the Affiliated Kangning Hospital, Wenzhou Key Laboratory for Basic and Translational Research in Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuying Lei
- School of Mental Health and the Affiliated Kangning Hospital, Wenzhou Key Laboratory for Basic and Translational Research in Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Junnan Wu
- School of Mental Health and the Affiliated Kangning Hospital, Wenzhou Key Laboratory for Basic and Translational Research in Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qianfa Yuan
- Xiamen Xian Yue Hospital, Xiamen, Fujian, China
| | - Jue He
- School of Mental Health and the Affiliated Kangning Hospital, Wenzhou Key Laboratory for Basic and Translational Research in Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China; Institute of Neurological Disease, First Affiliated Hospital, Henan University, Kaifeng, Henan, China.
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249
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Wang W, Zhou L, Hu Q, Gao Y, Wei Y, Tang X, Hu Y, Xu L, Liu H, Wang Z, Chen T, Li C, Wu H, Wang J, Zhang T. Correlative relationship between body mass index and heart rate variability in psychiatric disorders. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01768-1. [PMID: 38470538 DOI: 10.1007/s00406-024-01768-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/19/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVE Indicators of heart rate variability (HRV) have been used to assess the autonomic activity. However, the influence of obesity on HRV in these patients remains to be determined. This study aimed to examine how obesity (measured with the body mass index [BMI]) affects HRV and determine whether the effect varies among different psychiatric disorders. We recruited 3159 consecutive patients, including 1744 with schizophrenia, 966 with mood disorders, and 449 with anxiety disorders. Patients were divided into four groups based on BMI: underweight (< 18.5), normal weight (18.5-23.9), overweight (24-27.9), and obese (≥ 28). The cardiovascular status was assessed using several time- and frequency-based HRV indicators, measured via electrocardiogram signals recorded for 5 min. The mean BMI of the participants was 23.6 ± 4.0. The patients in the overweight and obese groups were 29.4% and 13.6% of the total, respectively. The HRV indicators were higher in underweight and normal-weight patients than in the overweight and obese ones. After stratification based on the psychiatric diagnosis, the patients with mood disorders showed lower HRV than those with schizophrenia or anxiety disorder in the normal-weight group. In contrast, in the overweight and obese groups the patients with mood disorders showed higher HRV than those with the other disorders. The HRV variables were significantly associated with BMI, and higher BMI was associated with higher heart rates and lower HRV. These results indicate that weight gain in psychiatric disorders is associated with an imbalance in autonomic nerve activity. However, the relationship between autonomic activity, weight gain, and psychiatric disorders warrants further investigation.
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Affiliation(s)
- WenZheng Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - LinLin Zhou
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - Qiang Hu
- Department of Psychiatry, Zhen Jiang Mental Health Center, Zhenjiang, People's Republic of China
| | - YuQing Gao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - YanYan Wei
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - XiaoChen Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - YeGang Hu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - LiHua Xu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - HaiChun Liu
- Department of Automation, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - ZiXuan Wang
- Shanghai Xinlianxin Psychological Counseling Center, Shanghai, China
| | - Tao Chen
- Big Data Research Lab, University of Waterloo, Waterloo, ON, Canada
- Labor and Worklife Program, Harvard University, Massachusetts, USA
| | - ChunBo Li
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - HaiSu Wu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China.
| | - JiJun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China.
- Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Beijing, People's Republic of China.
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
| | - TianHong Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China.
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250
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Soleimani N, Iraji A, Belger A, Calhoun VD. A method for estimating dynamic functional network connectivity gradients (dFNG) from ICA captures smooth inter-network modulation. bioRxiv 2024:2024.03.06.583731. [PMID: 38559041 PMCID: PMC10979844 DOI: 10.1101/2024.03.06.583731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Dynamic functional network connectivity (dFNC) analysis is a widely used approach for studying brain function and offering insight into how brain networks evolve over time. Typically, dFNC studies utilized fixed spatial maps and evaluate transient changes in coupling among time courses estimated from independent component analysis (ICA). This manuscript presents a complementary approach that relaxes this assumption by spatially reordering the components dynamically at each timepoint to optimize for a smooth gradient in the FNC (i.e., a smooth gradient among ICA connectivity values). Several methods are presented to summarize dynamic FNC gradients (dFNGs) over time, starting with static FNC gradients (sFNGs), then exploring the reordering properties as well as the dynamics of the gradients themselves. We then apply this approach to a dataset of schizophrenia (SZ) patients and healthy controls (HC). Functional dysconnectivity between different brain regions has been reported in schizophrenia, yet the neural mechanisms behind it remain elusive. Using resting state fMRI and ICA on a dataset consisting of 151 schizophrenia patients and 160 age and gender-matched healthy controls, we extracted 53 intrinsic connectivity networks (ICNs) for each subject using a fully automated spatially constrained ICA approach. We develop several summaries of our functional network connectivity gradient analysis, both in a static sense, computed as the Pearson correlation coefficient between full time series, and a dynamic sense, computed using a sliding window approach followed by reordering based on the computed gradient, and evaluate group differences. Static connectivity analysis revealed significantly stronger connectivity between subcortical (SC), auditory (AUD) and visual (VIS) networks in patients, as well as hypoconnectivity in sensorimotor (SM) network relative to controls. sFNG analysis highlighted distinctive clustering patterns in patients and HCs along cognitive control (CC)/ default mode network (DMN), SC/ AUD/ SM/ cerebellar (CB), and VIS gradients. Furthermore, we observed significant differences in the sFNGs between groups in SC and CB domains. dFNG analysis suggested that SZ patients spend significantly more time in a SC/ CB state based on the first gradient, while HCs favor the DMN state. For the second gradient, however, patients exhibited significantly higher activity in CB/ VIS domains, contrasting with HCs' DMN engagement. The gradient synchrony analysis conveyed more shifts between SM/ SC networks and transmodal CC/ DMN networks in patients. In addition, the dFNG coupling revealed distinct connectivity patterns between SC, SM and CB centroids in SZ patients compared to HCs. To recap, our results advance our understanding of brain network modulation by examining smooth connectivity trajectories. This provides a more complete spatiotemporal summary of the data, contributing to the growing body of current literature regarding the functional dysconnectivity in schizophrenia patients. By employing dFNG, we highlight a new perspective to capture large scale fluctuations across the brain while maintaining the convenience of brain networks and low dimensional summary measures.
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Affiliation(s)
- Najme Soleimani
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, Georgia, USA
| | - Armin Iraji
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, Georgia, USA
| | - Aysenil Belger
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Vince D Calhoun
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, Georgia, USA
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