Calgary Depression Scale For Schizophrenia Research Articles

Metabolic syndrome associations with neurocognitive function in first-episode schizophrenia spectrum disorders

We examined the associations between metabolic syndrome (MetS) and neurocognitive function in patients with first-episode schizophrenia spectrum disorders (FES) compared to controls assessed using the Repeatable Battery for the Assessment of Neuropsychological Status. In patients, psychopathology was assessed using the Positive and Negative Syndrome Scale and Calgary Depression Scale for Schizophrenia. First, we found illness- and domain-specific associations between the individual MetS features and neurocognitive performance in patients, but not in controls. Second, body mass index and total cholesterol levels were lower in patients than controls, which in turn correlated with increased global psychopathology severity and cognitive deficits. Third, negative symptoms moderated the association between low HDL cholesterol and poorer immediate verbal memory performance in patients. Our findings suggest that distinct lipid profile alterations are associated with cognitive performance and psychopathology severity in patients with FES. Further studies are needed to explore the associations of MetS with neurocognition over time, as well as how these relationships are affected by socio-demographic and clinical factors, including depression, anxiety, and related psychopathology.

Association between cytokines and suicidality in patients with psychosis: A multicentre longitudinal analysis

Suicide is a common cause of death in all phases of schizophrenia spectrum disorder, particularly in the youngest patients. Clinical measures have demonstrated limited value in suicide prediction, spurring the search for potential biomarkers. The causes of suicidal behaviour are complex, but the immune system seems to be involved as it reflects or even causes mental suffering. We aimed to identify cytokines with associations to suicidality in a sample of patients with symptoms of active psychosis. Patients with schizophrenia spectrum disorder (N = 144) participating in a semi-randomized antipsychotic drug trial (the BeSt InTro study) were assessed with the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS) at eight visits across 12 months. The Clinical Global Impression for Severity of Suicidality scale (CGI-SS) was used for assessing suicidality. Serum concentrations of tumour necrosis factor (TNF)-alpha, interferon (IFN)-gamma, interleukin (IL)-1beta, IL-2, IL-4, IL-6, and IL-10 were measured using immunoassays. A logistic regression model was used to investigate the association between cytokine levels and suicidality. To enhance clinical significance, the CGI-SS scores were dichotomized into two groups before analyses: low (=1) and high (≥2) risk for suicidality. Both uni- and multi-variate analyses revealed an inverse correlation between IL-2 and IL-10 serum levels and suicidality, where lower cytokine concentrations of IL-2 and IL-10 were associated with higher suicidality scores. The results were consistent when adjusted for depression and substance use. These results indicate that inflammatory processes are linked to the risk of suicidality in patients with schizophrenia spectrum disorders.

The mediating role of psychological flexibility in the relationship between psychotic symptom severity and depression in individuals diagnosed with schizophrenia.

INTRODUCTION: Psychological flexibility may help people diagnosed with schizophrenia (PWS) cope with their psychotic symptoms and reduce their depressive symptoms, but the mechanism of this effect is unclear. To investigate whether psychological flexibility mediates the relationship between psychotic symptom severity and depression in PWS. A cross-sectional study was conducted, in which a total of 111 PWS were assessed with DSM-5 Clinician-Rated Dimensions of Psychosis Symptom Severity, Calgary Depression Scale for Schizophrenia and Acceptance and Action Questionnaire. Data analysis was performed using SPSS 25 and PROCESS macro. Significant correlations were found between psychotic symptoms, depression and psychological flexibility. Psychological flexibility partially mediated the relationship between psychotic symptom severity and depression. Psychological flexibility could weaken the impact of psychotic symptom severity on depression in PWS. Higher psychotic symptoms were associated with lower psychological flexibility and higher depression. Interventions to improve psychological flexibility may prevent depressive symptoms in PWS. Psychiatric nurses can use psychological flexibility as a goal for evaluation and intervention.

Evaluation of the Relationship between Disability and Disease Severity, Cognitive Functions, and Insight in Patients with Schizophrenia.

: This study aims to examine the clinical characteristics, cognitive functions, and levels of insight, which are thought to be related to disability in schizophrenia patients, and to determine which variable will guide the clinician to predict the disability. : Participants were 102 individuals with schizophrenia aged 18-60. All participants completed the social functioning scale and the Beck cognitive insight scale. To determine the severity of disability, World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) scale was conducted. Positive and negative syndrome scale, Calgary depression scale for schizophrenia, trail making tests and Stroop test were performed. : The regression analysis indicated that high income, increased education level, and fewer hospitalization variables had significant negative effects (p ＜ 0.05) on the WHODAS overall score, explaining 20.8% of the variance. The duration of trail-making test form A, PANSS total score, and Stroop 3 duration variables had significant positive effects (p ＜ 0.05) on the WHODAS score, explaining 49.3% of the total variance. Increased levels of education, higher income, and higher cognitive insight were found to be associated with less disability. Increased severity of disease and some deterioration in the mental field were found to be related to high disability. : In this research, the predictors of disability in individuals with schizophrenia, level of education, and income are among the predictors of disability, and disease severity seems to be more related to the impairment of cognitive functions. Interventions and treatments that support the psychosocial functionality should be planned rather than symptom-oriented treatment approaches.

Correlation of allostatic load and perceived stress with clinical features in first-episode schizophrenia

BackgroundStress plays an important role in the etiology of schizophrenia. However, the mechanisms by which chronic physiological stress and perceived stress relate to the clinical features of schizophrenia may differ. We aimed to elucidate the relationships among chronic physiological stress indexed by allostatic load (AL), perceived stress, and clinical symptoms in individuals with first-episode schizophrenia (FES). MethodsIndividuals with FES (n = 90, mean age = 28.26years old, 49%female) and healthy controls (111, 28.88, 51%) were recruited. We collected data of 13 biological indicators to calculate the AL index, assessed subjective stress with the Perceived Stress Scale-14 (PSS-14), and compared AL and perceived stress between groups. Patients with FES were also evaluated with the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS). ResultsIndividuals with FES had higher AL and PSS score than healthy controls. There were no significant correlations between AL and PSS score in either patients or controls. Among individuals with FES, the AL index was associated with the severity of positive symptoms, while the PSS score was positively associated with CDSS score. Both elevated AL and PSS were correlated with the occurrence of schizophrenia. ConclusionsPhysiological stress, as reflected by AL, may be more related to positive symptoms, while perceived stress appear to be associated with depressive symptoms in individuals with FES. Longitudinal studies are necessary to explore the relationships between interventions for different stressor types and specific clinical outcomes in FES.

Investigation of the effect of goal-oriented dance movement therapy on depressive symptoms in people with schizophrenia: a rater-blinded randomised controlled study

Background/Aims Depression is a common symptom in schizophrenia and can negatively affect treatment. The aim of this study was to examine the effects of goal‑oriented dance or movement therapy on depressive symptoms in individuals diagnosed with schizophrenia. Methods The study was designed as a randomised controlled rater‑blinded study, in which 32 individuals diagnosed with schizophrenia were randomly assigned to either the intervention (dance movement therapy) group or control group. The intervention consisted of twice‑weekly goal‑oriented dance movement therapy sessions, with each session lasting approximately 40–50 minutes, for a total of 8 weeks. Depressive symptoms were evaluated using the Calgary Depression Scale for Schizophrenia. Results The depressive symptoms before and after the intervention were compared. No significant differences between groups were observed at baseline. There was no change in the control group, whereas a significant improvement on depressive symptoms was observed in the total Calgary Depression Scale for Schizophrenia score in the dance movement therapy group after the intervention. Conclusions Goal‑oriented dance movement therapy is an effective treatment for the depressive symptoms in schizophrenia patients in addition to conventional treatments. Although the results are favourable, further studies are needed to test its effectiveness. Implications for practice In the traditional treatment of schizophrenia, it is important to evaluate depression and support the treatment with approaches such as dance movement therapy.

Exploring the relationship of cognitive function with and without COVID-19 recovered schizophrenic patients.

The Coronavirus disease 2019 (COVID-19) is linked to the deterioration of cognitive function among individuals suffering from schizophrenia. The purpose of this study was to compare the cognitive performance of schizophrenic patients before and after COVID-19. A longitudinal cohort study involving a sample of 219 individuals diagnosed with schizophrenia was enrolled between June 2022 and May 2023. The participants were split into two groups infected with COVID-19 (n = 165) and not infected with COVID-19 (n = 54). The data were gathered via a questionnaire on demographic characteristics, the Brief Assessment of Cognition in Schizophrenia (BACS), the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), the Activities of Daily Living (ADL) scale, and the Insomnia Severity Index (ISI). The repeated-measures ANOVA showed that Among patients diagnosed with COVID-19, there was a deterioration in global cognitive function (before COVID-19 = -2.45 vs. after COVID-19 = -3.02, p = 0.007), working memory (before COVID-19 = -2.76 vs. after COVID-19 = -3.34, p < 0.00 1), motor speed (before COVID-19 = -1.64 vs. after COVID-19 = -2.12, p < 0.001), attention and speed of information processing (before COVID-19 = -1.93 vs. after COVID-19 = -1.16, p = 0.008). multi-variable analysis showed that several factors as having a secondary grade of education (β = 0.434), experiencing insomnia (β = 0.411)and the interaction between COVID-19 diagnosis and cognition at baseline (β = 0.796) were significantly associated with cognitive deficits. At the same time, no significant associations were found between global cognition and clinical symptoms, autonomy, or depression (p > 0.05). The COVID-19 pandemic has significantly impacted various cognitive functions, such as verbal memory, working memory, and global cognition. Insomnia has been identified as the predominant determinant of cognitive impairment, alongside the confirmation of a COVID-19 diagnosis. Additional research is imperative to elucidate the diversification of cognitive functionality observed in individuals diagnosed with schizophrenia who have acquired COVID-19.

Exploring depression in people with schizophrenia spectrum disorders: A cross-sectional analysis of the clinical relationship with Positive and Negative Syndrome Scale dimensions.

Evidence on the relationship of depression with clinical dimensions of schizophrenia remains limited. This cross-sectional study aimed at exploring the association of depression with the Positive and Negative Syndrome Scale (PANSS) dimensions in people with schizophrenia spectrum disorders (SSD). Trained assessors administered PANSS to measure core symptoms of schizophrenia and the Calgary Depression Scale for Schizophrenia (CDSS) to measure depressive features. Multiple logistic regression analyses were carried out to analyse the association of depression with PANSS overall score and related dimensions. We included 231 inpatients with SSD (mean age:42.4±12.9 years; males: 58.9%; mean PANSS overall score:82.5±20.1; drug-free or naïve: 39.3%), including 78 (33.8%) with clinically significant depressive symptoms. Depression was associated with higher overall (regression coefficient [coeff.], standard error [SE]: 0.029, 0.008; p<0.001) and General Psychopathology (coeff., SE: 0.118, 0.023; p<0.001) PANSS scores. We found an inverse relationship between depression and positive symptoms (coeff., SE: -0.088, 0.028; p=0.002). No association between depressive and negative symptoms was estimated. Despite some limitations, our study shows that people affected by SSD with depressive features are likely to show more overall and general psychopathology symptoms, though lower positive symptoms. Additional studies are needed to explore the generalizability of our findings.

A Conceptual Analysis of Post-psychotic Depression

"The conundrum of post-psychotic depression (PPD) is still present in the psychiatric literature, for more than a century since it was first described by Mayer-Gross. After a short existence in the DSM-IV and ICD-10, this nosological construct was excluded from newer versions of the mental disorders classifications. Therefore, an exploratory analysis of the PPD concept was considered useful both from clinical and theoretical perspectives. There is a high prevalence of depressive symptoms in patients with schizophrenia spectrum disorders (SSD) and, although not all of them represent cases of PPD, they are considered risk factors for suicide. The arguments and contra-arguments for/against PPD were reviewed, and the potential pharmacological interventions for this disorder were analyzed. The explored evidence indicates that PPD is worth further investigation, and in order to differentiate it from schizoaffective disorder, negative symptoms of SSD, or depressive manifestations within the acute psychotic episodes, clearly defined criteria should be found. The use of validated scales, like the Calgary Depression Scale for Schizophrenia and the InterSePT Scale for Suicidal Thinking, is recommended for the initial assessment of depression and suicidal risk in patients with SSD, but also for their monitoring during the acute and maintenance phases. Besides the administration of combined, antidepressant and antipsychotic treatment, the use of clozapine, and the recommendation to initiate treatment for SSD with atypical antipsychotics whenever possible, there is a dearth of studies exploring specific interventions for PPD. Future studies are expected to address the validity of the nosological construct of PPD and the most adequate therapeutic and prophylactic interventions in patients with SSD."

Associations between negative and positive automatic thoughts and clinical variables in patients with schizophrenia

This study investigated the relationships between negative and positive automatic thoughts and clinical variables in patients with schizophrenia. The participants included 36 patients with schizophrenia (male = 16; female = 20; age = 42.86 ± 9.40) who were outpatients in the Department of Psychiatry at Tokushima University Hospital. We used the Automatic Thoughts Questionnaire-Revised (ATQ-R), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Brief Assessment of Cognition in Schizophrenia (BACS) to assess negative and positive automatic thoughts, positive and negative symptoms, depressive symptoms, and neurocognition, respectively. Spearman rank correlation coefficients were calculated to determine the relationships between negative and positive automatic thoughts and clinical variables. No relationship was observed between negative and positive automatic thoughts. Negative automatic thoughts were related to depressive symptoms. Positive automatic thoughts were related to neurocognition. We therefore surmise that each automatic thought might have different clinical features and outcomes, and should therefore be treated accordingly.

Sarcosine May Induce EGF Production or Inhibit the Decline in EGF Concentrations in Patients with Chronic Schizophrenia (Results of the PULSAR Study).

Sarcosine (N-methylglycine), a glutamatergic modulator, reduces the primary negative symptoms of schizophrenia. These beneficial changes might be mediated by trophic factors such as epidermal growth factor (EGF). We assessed associations between initial serum EGF levels or changes in serum EGF levels and symptom severity during the addition of sarcosine to stable antipsychotic treatment and thereby evaluated the associations between glutamatergic modulation, clinical changes and peripheral EGF concentrations. Fifty-eight subjects with a diagnosis of chronic schizophrenia with dominant negative symptoms, stably treated with antipsychotics, completed a prospective 6-month, randomized, double-blind, placebo-controlled study. Subjects received orally 2 g of sarcosine (n = 28) or placebo (n = 30) daily. Serum EGF levels and symptom severity (using the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS)) were assessed at baseline, 6-week and 6-month follow-up. Augmentation antipsychotic treatment with sarcosine had no effect on EGF serum levels at any time points. Only the sarcosine group showed a significant improvement in negative symptoms, general psychopathology subscales and the overall PANSS score. We found a reduction in serum EGF levels in the placebo group, but levels in the sarcosine remained stable during the study. Our data indicate that improvement in negative symptoms due to sarcosine augmentation is not directly mediated by EGF, but effective treatment may induce the production or block the decrease in EGF concentrations, which indicates the neuroprotective effect of treatment and confirms the relationship between neuroprotection and EGF levels.

Association between suicidal ideation and cognitive function in young patients with schizophrenia spectrum disorder.

Suicide is a major concern for patients with recent-onset schizophrenia. We hypothesized that preserved cognitive function might be associated with a higher level of suicidality in patients with schizophrenia. We investigated the associations between cognitive function and suicidal ideation (SI) in young patients recently diagnosed with a psychotic disorder. This study analyzed data from a naturalistic clinical cohort study that comprised 402 patients with schizophrenia spectrum disorder. Patients with a treatment duration of ≤5 years and an age range of 15-39 years were enrolled. Participants were categorized into two groups based on SI as assessed by the Columbia Suicidal Severity Rating Scale. We collected demographic and clinical data and administered psychiatric, neurocognitive, and social cognitive measures. Among participants, 52% reported experiencing SI. Patients with SI were significantly younger and had a longer duration of untreated psychosis (DUP) than those without it. The Positive and Negative Syndrome Scale-general psychopathology score was significantly higher in the SI group. Scores on the Calgary Depression Scale for Schizophrenia, Perceived Stress Scale, Beck Depression Inventory (BDI), and Beck Hopelessness Scale were significantly higher among patients with SI, while scores on the Subjective Well-being Under Neuroleptics-Short Form and Brief Resilience Scale were significantly lower compared to those without it. Patients with SI demonstrated significantly higher scores on the verbal and visual learning test, false belief task, picture stories task, and Controlled Oral Word Association Test. They also completed the Trail Making Test (TMT) parts A and B in significantly less time than those without it. After adjusting for age, DUP, and scores on the BDI, group differences in scores on the verbal and visual learning tests, TMT (parts A and B), and the false belief task, and the picture story task remained significant. Our results suggest that along with traditional risk factors, better cognitive function may also be a major risk factor for suicidality in patients with schizophrenia. Providing psychological support and cognitive interventions is essential for young patients with recent-onset schizophrenia spectrum disorders, particularly those with high levels of depression, hopelessness, perceived stress, low resilience, and good cognitive function.

Inflammatory markers of symptomatic remission at 6 months in patients with first-episode schizophrenia

Neuroinflammation contributes to the pathophysiology of various mental illnesses including schizophrenia. We investigated peripheral inflammatory cytokines as a biomarker for predicting symptomatic remission in patients with first-episode schizophrenia. The study included 224 patients aged 15–60 years who fulfilled the criteria for schizophrenia spectrum disorder with a treatment duration ≤6 months. Serum levels of tumor necrosis factor (TNF) -α, interferon-γ, interleukin (IL)-1α, IL-1β, IL-6, IL-8, IL-10, and IL-12 were measured. Psychotic symptoms, depressive symptoms, and general functioning were assessed using the Positive and Negative Syndrome Scale, Beck Depression Inventory (BDI), Calgary Depression Scale for Schizophrenia, and Personal and Social Performance scale, respectively. Duration of untreated psychosis (DUP) was also recorded. We investigated the factors associated with remission for each sex in logistic regression analysis. In total, 174 patients achieved remission at the 6-month follow-up (females, 83.5%; males, 70.9%). Remission was associated with older age and lower BDI scores in male patients and with lower TNF-α levels and shorter DUP in female patients. Our findings suggest that peripheral inflammatory cytokines may impede early symptomatic remission in female patients with schizophrenia. In addition, depressive symptoms in males and long DUP in females may be poor prognostic factors for early remission in patients with first-episode psychosis.

Dimensional characteristics of persistent negative symptoms in schizophrenia and their relationships with schizotypy in first-degree relatives

Purpose of the article Schizophrenia with persistent negative symptoms (PNS) may have different characteristics regarding negative symptom dimensions and heritability patterns. This study aimed to investigate the dimensional characteristics of PNS and their relationships with schizotypal features in first-degree relatives (FDRs). Materials and methods The study included 142 patients, 142 FDRs, and 71 healthy controls (HC). Patients were evaluated with the Positive and Negative Symptom Scale (PANSS), Brief Negative Symptom Scale (BNSS), Calgary Depression Scale for Schizophrenia (CDSS), and Simpson-Angus Scale (SAS). Schizotypy Personality Questionnaire was applied to FDR and HC groups. Clinical symptoms were compared between primary-PNS, secondary-PNS, and non-PNS groups. In addition, schizotypy scores were compared between FDRs and HCs. Then, the relationship between the symptoms of the patients in the PNS group and the schizotypy scores of their relatives was evaluated by multiple regression analysis. Results All negative symptom dimension scores were similar in primary-PNS and secondary-PNS and lowest in non-PNS. PNS-FDR had higher in all schizotypy scores than non-PNS-FDR and HC, except for lack of close friends and social anxiety. In the PNS group, positive symptom severity and PANSS experiential deficit scores significantly predicted positive and negative schizotypy scores in relatives. Negative schizotypy was associated with asociality. Conclusions The PNS is likely a subtype in which the genetic basis of negative symptoms is stronger and is associated with genetic abnormalities shared by positive and negative schizotypy dimensions in relatives. Family-based genetic studies will be beneficial in enlightening the genetic etiology of PNS.

Expression of ANK3 moderates the association between childhood trauma and affective traits in severe mental disorders

Exposure to early life trauma increases the risk of psychopathology later in life. Here we investigated if ANK3 mRNA levels influence the relationship between childhood trauma experiences and clinical characteristics in mental disorders. A sample of 174 patients with bipolar disorder and 291 patients with schizophrenia spectrum disorder were included. Patients were diagnosed using the Structured Clinical Interview for DSM-IV, and childhood trauma was assessed using the childhood trauma questionnaire. Age at illness onset and number of psychotic and affective episodes were assessed from interview and medical records. Current depressive symptoms were measured using the calgary depression scale for schizophrenia and the inventory for depressive symptomatology. ANK3 expression was analyzed in whole blood using the Illumina HumanHT-12 v4 Expression BeadChip. Analyses were carried out with the Process adjusted for confounders. Within the total sample, patients with both high ANK3 expression and with the most severe childhood sexual abuse had more manic/hypomanic episodes and an earlier age at onset of the first episode. ANK3 mRNA levels also moderated the relationship between emotional neglect and manic/hypomanic episodes. Our results suggest that ANK3 expression levels moderate the association between specific types of childhood trauma and affective traits in mental disorders.

Global Improvements and Psychiatric Stability in Adults with Tardive Dyskinesia: Post Hoc Analyses of Two Long-Term Valbenazine Studies (P11-11.010)

<h3>Objective:</h3> To evaluate global improvements and psychiatric status in patients with tardive dyskinesia (TD) who received long-term treatment with valbenazine, a highly selective VMAT2 inhibitor approved for TD. <h3>Background:</h3> Effective and comprehensive TD treatment requires reducing patients’ abnormal involuntary movements without compromising their psychiatric stability. This can be especially challenging when patients have complex psychiatric conditions that require multiple medications. <h3>Design/Methods:</h3> KINECT 3 and KINECT 4 study participants received valbenazine (40 or 80 mg, once-daily) for 48 weeks; concomitant medications needed to manage medical and psychiatric conditions were allowed. Data from these studies were pooled and analyzed by participants’ primary psychiatric diagnosis: schizophrenia/schizoaffective disorder (“SCHZ”) or mood disorder (“MD”). The percentages of participants who met the threshold for global response (rating of “much improved” or better) for the Clinical Global Impression of Change-Tardive Dyskinesia (CGI-TD) and Patient Global Impression of Change (PGIC) were analyzed at Week 48. Psychiatric symptom scales included: Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) [SCHZ subgroup]; Young Mania Rating Scale (YMRS) and Montgomery-Åsberg Depression Rating Scale (MADRS) [MD subgroup]; Columbia-Suicide Severity Rating Scale [all participants]. <h3>Results:</h3> After 48 weeks of valbenazine, &gt;75% of participants in the SCHZ subgroup met response thresholds per clinician assessment (CGI-TD= 79.7%) and self-report (PGIC=78.0%). Mean changes from baseline (CFB) to Week 48 for PANSS scores (positive symptoms [−0.7], negative symptoms [−0.6], general psychopathology [−1.9], total [−3.2]) and CDSS total score (−0.5) indicated maintenance of psychiatric stability throughout valbenazine treatment. The MD subgroup achieved similar rates of global response (CGI-TD=77.6%, PGIC=84.5%), with mean CFB in YMRS total score (−1.0) and MADRS total score (+0.3) indicating maintenance of psychiatric stability. No emergence of suicidal ideation/behavior was observed. <h3>Conclusions:</h3> Patients with TD who received long-term treatment with once-daily valbenazine met rigorous thresholds for clinician- and self-reported global improvement without compromising their psychiatric stability. <b>Disclosure:</b> Andrew Cutler has received personal compensation for serving as an employee of Neuroscience Education Institute. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alfasigma. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alkermes. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Intra-Cellular Therapies. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Andrew Cutler has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for MedAvante-ProPhase. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Noven. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Otsuka. Andrew Cutler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sage Therapeutics. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sunovion. Andrew Cutler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Supernus. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Andrew Cutler has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AbbVie. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Axsome. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BioXcel. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boehringer Ingelheim. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerevel. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Corium. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Karuna. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neumora. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Relmada. Andrew Cutler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Janssen. Andrew Cutler has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for COMPASS Pathways. Andrew Cutler has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for AbbVie. Andrew Cutler has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Alkermes. Andrew Cutler has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Intra-Cellular Therapies. Andrew Cutler has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Ironshore. Andrew Cutler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lundbeck. Andrew Cutler has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Neurocrine. Andrew Cutler has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Noven. Andrew Cutler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Otsuka. Andrew Cutler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sunovion. Andrew Cutler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Supernus. Andrew Cutler has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Teva. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Axsome. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for BioXcel. Andrew Cutler has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Corium. Andrew Cutler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Janssen. Andrew Cutler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Tris. Andrew Cutler has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Neuroscience Education Institute. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AbbVie (Allergan). Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Acadia. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Adamas. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alfasigma. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alkermes. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Axsome. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Boehringer Ingleheim. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Corium. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eisai. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Evidera. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Impel. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Janssen. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lilly. An immediate family member of Rakesh Jain has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neos Therapeutics. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurocrine Biosciences. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Osmotica. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Otsuka. An immediate family member of Rakesh Jain has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Otsuka. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pamlab. An immediate family member of Rakesh Jain has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pamlab. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sage Therapeutics. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Shire. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sunovion. An immediate family member of Rakesh Jain has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sunovion. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Supernus. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Takeda. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Transcend Therapeutics. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AbbVie (Allergan). Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alkermes. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Axsome. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Corium. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eisai. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Indivior. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Intra-Cellular Therapies. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Ironshore. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Janssen. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lilly. An immediate family member of Rakesh Jain has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lilly. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lundbeck. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Merck. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neos Therapeutics. Rakesh Jain has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Neurocrine Biosciences. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Otsuka. An immediate family member of Rakesh Jain has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Otsuka. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Pamlab. An immediate family member of Rakesh Jain has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pamlab. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Pfizer. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Shire. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sunovion. An immediate family member of Rakesh Jain has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sunovion. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Takeda. Rakesh Jain has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Teva. Rakesh Jain has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Tris Pharmaceuticals. Rakesh Jain has received research support from AbbVie (Allergan). Rakesh Jain has received research support from Lilly. Rakesh Jain has received research support from Lundbeck. Rakesh Jain has received research support from Otsuka. Rakesh Jain has received research support from Pfizer. Rakesh Jain has received research support from Shire. Rakesh Jain has received research support from Takeda. Dr. Bloom has received personal compensation for serving as an employee of Neurocrine Biosciences. Dr. Bloom has stock in Neurocrine. Mr. Siegert has received personal compensation for serving as an employee of Neurocrine Biosciences. Mr. Siegert has stock in Neurocrine Biosciences. Leslie Lundt has received personal compensation for serving as an employee of Neurocrine Biosciences, Inc.

The Indirect Effect of Depression between Nightmares and Well-Being in Lebanese Patients with Schizophrenia

Background. Because nightmares seem to be associated with depression in schizophrenia, detecting them early in therapeutic practice might be critical to ensuring effective avoidance of the development of depressive symptomatology. This helps promote well-being and improve the patient’s quality of life and illness prognosis. Therefore, the aim of this study was to examine the indirect effect of depression between nightmares and well-being in a Lebanese sample of patients with schizophrenia. Method. This monocentric cross-sectional study, conducted in July 2022, enrolled patients with chronic schizophrenia admitted to the Psychiatric Hospital of the Cross. Data were collected from a total of 148 participants through face-to-face interviews. The questionnaire included a nightmares measure, PSYRATS, Calgary depression scale for schizophrenia, PTSD checklist for DSM-5, the digit span subset, and WHO-5Well-Being Index. Results. The presence of nightmares was significantly associated with more depression, whereas higher depression was significantly associated with lower well-being. It is noteworthy that the presence of nightmares was not directly associated with well-being. Conclusion. Nightmares lead indirectly to lower well-being in schizophrenia patients, with depression serving as a mediating factor in this association. This suggests that interventions aiming at improving dream content may also have a beneficial effect in reducing depression in schizophrenia leading therefore to better well-being of the patients.

Polygenetic risk scores and phenotypic constellations of obsessive–compulsive disorder in clozapine-treated schizophrenia

Obsessive–compulsive symptoms (OCS) are frequently observed in individuals with schizophrenia (SCZ) treated with clozapine (CLZ). This study aimed to analyze prevalence of OCS and obsessive–compulsive disorder (OCD) in this subgroup and find possible correlations with different phenotypes. Additionally, this is the first study to examine polygenetic risk scores (PRS) in individuals with SCZ and OCS. A multicenter cohort of 91 individuals with SCZ who were treated with CLZ was recruited and clinically and genetically assessed. Symptom severity was examined using the Positive and Negative Symptom Scale (PANSS), Clinical Global Impression Scale (CGI), the Calgary Depression Scale for Schizophrenia (CDSS), Global Assessment of Functioning Scale (GAF) and Yale–Brown Obsessive–Compulsive Scale (Y-BOCS). Participants were divided into subgroups based on phenotypic OCS or OCD using Y-BOCS scores. Genomic-wide data were generated, and PRS analyses were performed to evaluate the association between either phenotypic OCD or OCS severity and genotype-predicted predisposition for OCD, SCZ, cross-disorder, and CLZ/norclozapine (NorCLZ) ratio, CLZ metabolism and NorCLZ metabolism. OCS and OCD were frequent comorbidities in our sample of CLZ-treated SCZ individuals, with a prevalence of 39.6% and 27.5%, respectively. Furthermore, the Y-BOCS total score correlated positively with the duration of CLZ treatment in years (r = 0.28; p = 0.008) and the PANSS general psychopathology subscale score (r = 0.23; p = 0.028). A significant correlation was found between OCD occurrence and PRS for CLZ metabolism. We found no correlation between OCS severity and PRS for CLZ metabolism. We found no correlation for either OCD or OCS and PRS for OCD, cross-disorder, SCZ, CLZ/NorCLZ ratio or NorCLZ metabolism. Our study was able to replicate previous findings on clinical characteristics of CLZ-treated SCZ individuals. OCS is a frequent comorbidity in this cohort and is correlated with CLZ treatment duration in years and PANSS general psychopathology subscale score. We found a correlation between OCD and PRS for CLZ metabolism, which should be interpreted as incidental for now. Future research is necessary to replicate significant findings and to assess possible genetic predisposition of CLZ-treated individuals with SCZ to OCS/OCD. Limitations attributed to the small sample size or the inclusion of subjects on co-medication must be considered. If the association between OCD and PRS for CLZ metabolism can be replicated, it should be further evaluated if CYP1A2 alteration, respectively lower CLZ plasma level, is relevant for OCD development.

Study on correlations of BDNF, PI3K, AKT and CREB levels with depressive emotion and impulsive behaviors in drug-naïve patients with first-episode schizophrenia

BackgroundThe pathogenesis of schizophrenia is still unknown. Nearly a half of schizophrenic patients have depressive symptoms and even some impulsive behaviors. The definite diagnosis of schizophrenia is an immense challenge. Molecular biology plays an essential role in the research on the pathogenesis of schizophrenia.ObjectiveThis study aims to analyze the correlations of serum protein factor levels with depressive emotion and impulsive behaviors in drug-naïve patients with first-episode schizophrenia.MethodsSeventy drug-naïve patients with first-episode schizophrenia and sixty-nine healthy volunteers from the health check center in the same period participated in this study. In both the patient group and control group, brain-derived neurotrophic factor (BDNF), phosphatidylin-ositol-3-kinase (PI3K), protein kinase B (AKT), and cAMP-response element binding protein (CREB) levels in the peripheral blood were tested by enzyme-linked immunosorbent assay (ELISA). The depressive emotion and impulsive behaviors were evaluated with Chinese versions of the Calgary Depression Scale for Schizophrenia (CDSS) and Short UPPS-P Impulsive Behavior Scale (S-UPPS-P), respectively.ResultsThe serum levels of BDNF, PI3K, and CREB in the patient group were lower than those in the control group, while AKT level, total CDSS score and total S-UPPS-P score were all higher. In the patient group, total CDSS score, and total S-UPPS-P score were both correlated negatively with BDNF, PI3K, and CREB levels but positively with AKT level, and the lack-of-premeditation (PR) sub-scale score was not significantly correlated with BDNF, PI3K, AKT, and CREB levels.ConclusionOur study results showed that the peripheral blood levels of BDNF, PI3K, AKT, and CREB in drug-naïve patients with first-episode schizophrenia were significantly different from those in the control group. The levels of these serum protein factors are promising biomarkers to predict schizophrenic depression and impulsive behaviors.

Treatment Success and Psychiatric Stability in Adults With Tardive Dyskinesia: Post Hoc Analyses of Two Long-Term Valbenazine Studies

AbstractIntroductionTardive dyskinesia (TD) is a persistent and potentially disabling movement disorder associated with exposure to antipsychotics and other dopamine receptor blocking agents. Effective and comprehensive treatment of TD requires reducing patients’ abnormal involuntary movements without disrupting their psychiatric stability. This can be especially challenging when patients have complex psychiatric conditions (e.g., &gt;1 psychiatric diagnosis) and are taking multiple medications. Valbenazine, a highly potent and selective vesicular monoamine transporter 2 (VMAT2) inhibitor, is approved for the once-daily treatment of TD. This post hoc analysis of two long-term studies (KINECT 3, KINECT 4) was conducted to evaluate changes in psychiatric status and clinician- and patient-reported treatment success in study participants who received valbenazine (40 or 80 mg) for 48 weeks.MethodsData from KINECT 3 and KINECT 4 were pooled and analyzed in participants categorized by their primary psychiatric diagnosis: schizophrenia/schizoaffective disorder (“SCHZ”) or mood disorder (“MD”). Concomitant medications needed for managing these and other psychiatric or medical conditions were allowed. Treatment success was defined as achieving a rating of “much improved” or “very much improved” at Week 48, as assessed using the Clinical Global Impression of Change-Tardive Dyskinesia (CGI-TD) and Patient Global Impression of Change (PGIC). Psychiatric stability was monitored using the following scales: Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) in the SCHZ subgroup; Young Mania Rating Scale (YMRS) and Montgomery-Åsberg Depression Rating Scale (MADRS) in the MD subgroup. Suicidal ideation/behavior was monitored using the Columbia-Suicide Severity Rating Scale.ResultsMore than 75% of study participants in the SCHZ subgroup achieved treatment success with valbenazine, based on clinician assessment (CGI-TD, 79.7%) and patient self-report (PGIC, 78.0%). Mean changes from baseline to Week 48 for PANSS scores (positive symptoms [-0.7], negative symptoms [‑0.6], general psychopathology [-1.9], total [-3.2]) and CDSS total score (-0.5) indicated maintenance of psychiatric stability in the SCHZ subgroup. Similar treatment success rates were found in the MD subgroup for both CGI-TD (77.6%) and PGIC (84.5%), with mean changes from baseline in YMRS total score (-1.0) and MADRS total score (+0.3) indicating psychiatric stability was maintained. No emergence of suicidal ideation/behavior was observed during the studies.ConclusionsPooled analyses from two 48-week studies indicate that long-term treatment of TD with once-daily valbenazine resulted in substantial clinician- and patient-reported global improvements in TD, while psychiatric stability was maintained regardless of primary psychiatric condition.FundingNeurocrine Biosciences, Inc.