Définition de l’état aigu dans la schizophrénie : enquête réalisée auprès des psychiatres français

Evaluating the clinical utility of speech analysis and machine learning in schizophrenia: A pilot study

BACKGROUND

Schizophrenia is a serious mental disorder that significantly impacts social functioning and quality of life. However, current diagnostic methods lack objective biomarker support. While some studies have indicated differences in audio features between patients with schizophrenia and healthy controls, these findings are influenced by demographic information and variations in experimental paradigms. Therefore, it is crucial to explore stable and reliable audio biomarkers for an auxiliary diagnosis and disease severity prediction of schizophrenia.

METHOD

A total of 130 individuals (65 patients with schizophrenia and 65 healthy controls) read three fixed texts containing positive, neutral, and negative emotions, and recorded them. All audio signals were preprocessed and acoustic features were extracted by a librosa-0.9.2 toolkit. Independent sample t-tests were performed on two sets of acoustic features, and Pearson correlation on the acoustic features and Positive and Negative Syndrome Scale (PANSS) scores of the schizophrenia group. Classification algorithms in scikit-learn were used to diagnose schizophrenia and predict the level of negative symptoms.

RESULTS

Significant differences were observed between the two groups in the mfcc_8, mfcc_11, and mfcc_33 of mel-frequency cepstral coefficient (MFCC). Furthermore, a significant correlation was found between mfcc_7 and the negative PANSS scores. Through acoustic features, we could not only differentiate patients with schizophrenia from healthy controls with an accuracy of 0.815 but also predict the grade of the negative symptoms in schizophrenia with an average accuracy of 0.691.

CONCLUSIONS

The results demonstrated the considerable potential of acoustic characteristics as reliable biomarkers for diagnosing schizophrenia and predicting clinical symptoms.

Is schizophrenia associated with an increased risk of chronic kidney disease? A nationwide matched-cohort study

OBJECTIVE

The impact of schizophrenia on vital diseases, such as chronic kidney disease (CKD), has not as yet been verified. This study aims to establish whether there is an association between schizophrenia and CKD.

DESIGN

A nationwide matched cohort study.

SETTING

Taiwan's National Health Insurance Research Database.

PARTICIPANTS

A total of 2338 patients with schizophrenia, and 7014 controls without schizophrenia (1:3), matched cohort for sex, age group, geography, urbanisation and monthly income, between 1 January 2003 and 31 December 2007, based on the International Classifications of Disease Ninth Edition (ICD-9), Clinical Modification codes.

PRIMARY AND SECONDARY OUTCOME MEASURES

After making adjustments for confounding risk factors, a Cox proportional hazards model was used to compare the risk of developing CKD during a 3-year follow-up period from the index date.

RESULTS

Of the 2338-subject case cohort, 163 (6.97%) developed a CKD, as did 365 (5.20%) of the 7014 control participants. Cox proportional hazards regression analysis revealed that patients with schizophrenia were more likely to develop CKD (HR=1.36, 95% CI 1.13 to 1.63; p<0.001). After adjusting for gender, age group, hypertension, diabetes mellitus, hyperlipidaemia, heart disease and non-steroid anti-inflammatory drugs (NSAIDs) usage, the HR for patients with schizophrenia was 1.25 (95% CI 1.04 to 1.50; p<0.05). Neither typical nor atypical antipsychotics was associated an increased risk of CKD in patients with schizophrenia.

CONCLUSIONS

The findings from this population-based retrospective cohort study suggest that schizophrenia is associated with a 25% increase in the risk of developing CKD within only a 3-year follow-up period.

Definitions and drivers of relapse in patients with schizophrenia: a systematic literature review

Relapse in patients with schizophrenia has devastating repercussions, including worsening symptoms, impaired functioning, cognitive deterioration and reduced quality of life. This progressive decline exacerbates the burden of illness on patients and their families. Relapse prevention is identified as a key therapeutic aim; however, the absence of widely accepted relapse definition criteria considerably hampers achieving this goal. We conducted a literature review in order to investigate the reporting of relapses and the validity of hospitalization as a proxy for relapse in patients with schizophrenia. The primary aim was to assess the range and validity of methods used to define relapse in observational or naturalistic settings. The secondary aim was to capture information on factors that predicted or influenced the risk of relapse. A structured search of the PubMed database identified articles that discussed relapse, and hospitalization as a proxy of relapse, in patients with schizophrenia. National and international guidelines were also reviewed. Of the 150 publications and guidelines identified, 87 defined relapse and 62% of these discussed hospitalization. Where hospitalization was discussed, this was as a proxy for, or a component of, relapse in the majority of cases. However, hospitalization duration and type varied and were not always well defined. Scales were used to define relapse in 53 instances; 10 different scales were used and multiple scales often appeared within the same definition. There were 95 references to factors that may drive relapse, including non-adherence to antipsychotic medication (21/95), stress/depression (11/95) and substance abuse (9/95). Twenty-five publications discussed the potential of antipsychotic therapy to reduce relapse rates-continuous antipsychotic therapy was associated with reduced frequency and duration of hospitalization. Non-pharmacological interventions, such as psychoeducation and cognitive behavioural therapy, were also commonly reported as factors that may reduce relapse. In conclusion, this review identified numerous factors used to define relapse. Hospitalization was the factor most frequently used and represents a useful proxy for relapse when reporting in a naturalistic setting. Several factors were reported to increase the risk of relapse, and observation of these may aid the identification of at-risk patients.