Positive And Negative Symptom Scale Scores Research Articles

Peripheral blood complement factors C2 and C3 as biomarkers of clinical efficacy in patients with first-episode schizophrenia after aripiprazole treatment

ObjectiveThe objective of this study was to identify serum complement factor-based biomarkers indicative of clinical efficacy in patients with first-episode schizophrenia (SCZ) following treatment with aripiprazole.MethodsThe retrospective study cohort comprised 40 patients diagnosed with first-episode SCZ (SCZ group) and 40 healthy individuals (control group). Quantitative analyses were conducted on five complement factors, namely complement component 1 (C1), C2, C3, C4, and the 50% hemolytic complement (CH50). Baseline serum complement factor levels were compared between the SCZ and control groups. Patients diagnosed with SCZ underwent a 4-week treatment regimen with aripiprazole. The severity of psychiatric symptoms in these patients was assessed using the Positive and Negative Symptom Scale (PANSS) and the Brief Psychiatric Rating Scale-18 Item Version (BPRS). Comparative analyses were conducted on PANSS and BPRS scores, as well as serum complement factor levels, both prior to (pre-treatment group) and following aripiprazole administration (post-treatment group). Pearson’s correlation test was employed to evaluate the relationships between changes in serum complement factor levels and the reduction rates of PANSS/BPRS scores.ResultsAt baseline, patients with SCZ exhibited significantly elevated levels of C1, C2, C3, C4, and CH50 compared to the control group (P < 0.05). Moreover, following treatment, there was a significant reduction in the PANSS total score, positive symptom score, negative symptom score, and BPRS score in the post-treatment group compared to the pre-treatment group (P < 0.05). Furthermore, patients in the post-treatment group exhibited a significant reduction in serum levels of C2, C3, and C4, alongside a significant increase in the serum level of CH50 compared to those in the pre-treatment group (P < 0.05). Additionally, the baseline serum C2 levels and the variations in serum C2 levels pre- and post-treatment exhibited a negative correlation with the reduction rate of PANSS/BPRS scores (P < 0.05). Similarly, both the baseline serum C3 levels and the changes in serum C3 levels pre- and post-treatment were negatively correlated with the reduction rate of PANSS/BPRS scores (P < 0.05).ConclusionBaseline serum levels of C2 and C3, as well as their variations pre- and post-treatment, may serve as biomarkers for predicting clinical efficacy in patients with first-episode SCZ undergoing treatment with aripiprazole.

Neuropeptide Y in first-episode schizophrenia: is there any sex differences in the pathogeneses of schizophrenia?

This study investigated relationships between Neuropeptide Y levels and severity of psychiatric symptoms in first-episode schizophrenia patients, and explore the sexual heterogeneity in them. We recruited 115 first-episode schizophrenia patients and 58 matched healthy controls, and measured serum Neuropeptide Y levels of them at baseline and again after 10 weeks of risperidone treatment in patient group. Patients were also evaluated with the Positive and Negative Symptoms Scale (PANSS) to reveal the severity of symptoms. 95 patients completed the whole experiment. We find that mean Neuropeptide Y levels at baseline were significantly higher in patients than in controls (p<0.001), no matter in males or females. In males, there are positive correlations between Neuropeptide Y levels and PANSS scores at baseline (p<0.01), and between the change of them (p<0.05). However, we do not find these correlations in female patients. Furthermore, the interaction terms of NPY × sex were highly significant taking PANSS as dependent variable(p<0.001). Neuropeptide Y plays a significant role in the pathogenesis of schizophrenia. In male patients, Neuropeptide Y is positively correlated with the severity of symptoms, while this correlation is not found in females. Continued efforts are needed to determine the sexual dimorphism in pathogeneses of schizophrenia.

Heart rate variability in schizophrenia: A comparative analysis before and after electroconvulsive therapy.

The aim of this study was to investigate autonomic nervous system imbalance in schizophrenia by comparing heart rate variability (HRV) between patients with schizophrenia and healthy controls, and to assess changes in HRV in patients before and after electroconvulsive therapy (ECT). HRV was compared between patients with schizophrenia (n = 17) and age- and gender-matched healthy controls (n = 34). Changes in HRV were also assessed in patients pre- and post-ECT. Additionally, the relationship between HRV and Positive and Negative Symptom Scale (PANSS) scores in patients with schizophrenia was investigated. Patients with schizophrenia showed significantly lower high-frequency (HF) and low-frequency (LF) power compared with healthy controls, with a trend towards a higher LF/HF ratio. Following ECT, HF power increased significantly while the LF/HF ratio decreased significantly, resulting in no significant differences between patients and controls for these HRV parameters. The associations between HRV and symptoms observed before ECT were largely diminished after ECT, with only changes in the LF component correlating with changes in PANSS scores. Following ECT, we observed a shift in autonomic balance from sympathetic dominance towards increased parasympathetic activity and a state more closely resembling that in healthy controls.

Olanzapine vs. magnesium valproate vs. lamotrigine in anti-N-methyl-D-aspartic acid receptor encephalitis: a retrospective study

BackgroundThis study aimed to compare the impact of olanzapine, magnesium valproate, and lamotrigine as adjunctive treatments for anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. And it is expected to add supporting points related to the rebalance of neurotransmitters in the brain through adjuvant therapy in the clinical management of anti-NMDAR encephalitis.MethodsThis retrospective study included patients diagnosed with anti-NMDAR encephalitis who received standardized immunotherapy at Hunan Brain Hospital between January 2018 and December 2020.ResultsCompared to the olanzapine group, both the magnesium valproate and lamotrigine groups showed lower scores on the positive and negative symptom scale (PANSS) total score after 3 weeks of treatment (all P < 0.05). The Montreal Cognitive Assessment Scale (MoCA) scores in the magnesium valproate and lamotrigine groups were significantly higher than in the olanzapine group after 3 weeks and 3 months of treatment (all P < 0.05). After 3 months of treatment, the proportions of patients with a modified Rankin scale score (mRS) of 0–1 in the magnesium valproate and lamotrigine groups were significantly higher than in the olanzapine group (all P < 0.05). The electroencephalogram (EEG) abnormality ranks at 3 months were significantly lower in the magnesium valproate and lamotrigine groups compared with the olanzapine group (all P < 0.05). Furthermore, the Glx/Cr ratio significantly decreased after 3 months of treatment (all P < 0.05) in the magnesium valproate and lamotrigine groups, while the Glx/Cr ratio in the olanzapine group showed no significant change (P > 0.05).ConclusionCompared with olanzapine, the addition of magnesium valproate or lamotrigine to immunotherapy might be associated with a lower PANSS score, higher MoCA score, and lower mRS score. The improvement of neurological functions and cognitive function may be related to the decreased Glx/Cr ratio.

Clinical study of dance art therapy on hospitalized patients with chronic schizophrenia.

To explore the effect of dance art on the treatment of hospitalized patients with chronic schizophrenia. In a prospective randomized controlled study conducted from June 2019 to June 2020, 120 patients from Shanghai Pudong New Area Mental Health Center were divided into intervention (n = 60) and control (n = 60) groups using a random number table. Control patients received standard drug treatment and nursing care, while the intervention group underwent dance art therapy sessions for 90 minutes twice weekly, in addition to standard care. Treatment outcomes after 6 and 12 weeks were measured using the positive and negative symptom scale (PANSS), Wisconsin Card Sorting Test (WCST), Montreal Cognitive Assessment Scale (MoCA), and body mass index (BMI). This study involved 120 male patients with chronic schizophrenia, aged 30 to 60 years. After 6 and 12 weeks, the intervention group showed a greater reduction in PANSS scores (intervention group: from 49.02 ± 2.53 to 37.02 ± 1.83, control group: from 49.08 ± 2.59 to 44.91 ± 2.35, P < .05). In the WCST, the intervention group exhibited a higher increase in classification completion and correct answers, and a greater decrease in errors (P < .05). MoCA scores improved significantly in the intervention group compared to the control group (P < .05). BMI decreased in both groups, with a more pronounced reduction in the intervention group (intervention group: from 26.47 ± 1.05 kg/m² to 22.87 ± 0.73 kg/m², control group: from 26.50 ± 1.03 kg/m² to 26.22 ± 0.80 kg/m², P < .05). Based on routine drug treatment and routine nursing care, dance art has a better clinical effect in treating hospitalized patients with chronic schizophrenia, which can improve cognitive function, alleviate clinical symptoms, and reduce BMI.

Cognitive Impairments in Drug-Naive Patients With First-Episode Negative Symptom–Dominant Psychosis

Available antipsychotic medications are predominantly used to treat positive symptoms, such as hallucinations and delusions, in patients with first-episode psychosis (FEP). However, treating negative and cognitive symptoms, which are closely related to functional outcomes, remains a challenge. To explore the cognitive characteristics of patients with negative symptom-dominant (NSD) psychosis. This large-scale cross-sectional study of patients with FEP was led by the Shanghai Mental Health Center in China from 2016 to 2021, with participants recruited from 10 psychiatric tertiary hospitals. A comprehensive cognitive assessment was performed among 788 patients with FEP who were drug-naive. Symptom profiles were determined using the Positive and Negative Symptoms Scale (PANSS), and NSD was defined as a PANSS score for negative symptoms higher than that for positive and general symptoms. Positive symptom-dominant (PSD) and general symptom-dominant (GSD) psychosis were defined similarly. Data were analyzed in 2023. Psychotic symptoms were categorized into 3 groups: NSD, PSD, and GSD. Neurocognitive performance, assessed using the Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery. This study included 788 individuals with FEP (median age, 22 [IQR, 17-28] years; 399 men [50.6%]). Patients with NSD exhibited more-pronounced cognitive impairment than did those with PSD or GSD. Specifically, cognitive differences between the NSD and PSD group, as well as between the NSD and GSD group, were most notable in the processing speed and attention domains (Trail Making [F = 4.410; P = .01], Symbol Coding [F = 4.957; P = .007], Verbal Learning [F = 3.198; P = .04], and Continuous Performance [F = 3.057; P = .05]). Patients with PSD and GSD showed no significant cognitive differences. Cognitive impairment was positively associated with the severity of negative symptoms. Most of the cognitive function tests used were able to differentiate patients with NSD from those with PSD and GSD, with significant differences observed across a range of tests, from Brief Visuospatial Memory Test-Revised (χ2 = 3.968; P = .05) to Brief Assessment of Cognition in Schizophrenia symbol coding (χ2 = 9.765; P = .002). The findings of this cross-sectional study of patients with FEP suggest the presence of a clinical subtype characterized by a predominance of negative symptoms and cognitive impairment.

Pharmacogenetic intervention improves treatment outcomes in Chinese adult men with schizophrenia

To investigate the clinical application value of pharmacogenetic testing in individualized drug therapy for adult male patients with schizophrenia. A total of 186 adult patients with schizophrenia were enrolled and randomised into the pharmacogenetic (PGx) intervention group and the standard care group. In the PGx intervention group, PGx testing was performed, and the medication regimen was adjusted according to the results of the pharmacogenomic analysis. In contrast, in the standard care group, patients were treated according to the physician's medication experience. Differences in the primary indicator of schizophrenia, the Positive and Negative Symptom Scale (PANSS), and the secondary efficacy measures, the Clinical Global Impressions–Severity of Illness scale (CGI-SI) and Clinical Global Impressions–Global Improvement (CGI-GI) scale, were compared between the intervention and standard care groups. At baseline, the PGx intervention group consisted of 109 individuals, while the standard care group had 77 participants. After 12 weeks of treatment, 49 individuals withdrew from the PGx group (a dropout rate of 45.0%), and 34 withdrew from the standard care group (a dropout rate of 44.2%), with no significant difference in dropout rates between the two groups. The PANSS score reduction rate in the PGx intervention group significantly exceeded that of the standard care group during weeks 3, 6, and 12 of follow-up (P < 0.05). At the 12th week, the PGx intervention group achieved a treatment response rate of 81.7%, significantly surpassing the 48.8% of the standard care group (odds ratio of 4.67, 95% confidence interval of 1.96–11.41; P = 0.001). Furthermore, the PGx intervention was significantly more effective than standard care regardless of whether the patient had a first episode or a relapse (P < 0.05). Furthermore, the Global Assessment of Functioning (GAF) scores and the Personal and Social Performance Scale (PSP) score changes in the PGx intervention group were both significantly different from those in the standard care group (P < 0.05). It is noteworthy that the PGx intervention similarly improves the prognostic outcomes for patients with and without a family history of mental disorders.In conclusion, the application of a PGx intervention treatment model based on PGx testing can significantly improve medication efficacy and shorten the time to achieve the effects of medication in schizophrenia.

Correlation of Serum High-Sensitivity C-Reactive Protein, Homocysteine, and Macrophage Migration Inhibitory Factor Levels With Symptom Severity and Cognitive Function in Patients With Schizophrenia.

This trial analyzed high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), and macrophage migration inhibitory factor (MIF) level in serum and their correlation with symptom severity and cognitive function in patients with schizophrenia (SP). Sixty-eight SP patients were enrolled in the SP group, and 68 healthy volunteers were in the control (CN) group. Serum hs-CRP, Hcy, and MIF were measured, and symptom severity was assessed with the Positive and Negative Symptom Scale (PANSS). Cognitive function was determined with the MATRICS Consensus Cognitive Battery (MCCB). The SP group was divided into high PANSS score (PANSS ≥70 points) and low PANSS score (PANSS <70 points), or the mild cognitive dysfunction group and severe cognitive dysfunction group according to the median MCCB score. The correlation between serum hs-CRP, Hcy, and MIF levels and PANSS and MCCB scores in SP patients was examined by Pearson correlation analysis. SP patients had higher serum hs-CRP, Hcy, and MIF levels and showed higher PANSS scores and lower MCCB total score. Serum hs-CRP, Hcy, and MIF levels in the high PANSS group were higher than those in the low PANSS group and in the severe cognitive dysfunction group than in the mild cognitive dysfunction group. Serum hs-CRP, Hcy, and MIF levels in SP patients were positively correlated with PANSS total score and negatively correlated with MCCB total score. High serum hs-CRP, Hcy, and MIF levels in SP patients are correlated with symptom severity and cognitive dysfunction.

Efficacy and feasibility of aerobic exercise interventions as an adjunctive treatment for patients with schizophrenia: a meta-Analysis

Schizophrenia is a chronic mental disorder primarily treated with antipsychotics, which have limited efficacy for negative symptoms. This study aims to evaluate the effectiveness and feasibility of exercise interventions as adjuncts to pharmacotherapy through a meta-analysis, providing valuable insights for rational intervention design. Four databases were searched, and randomized controlled trials with no language restrictions published up to March 27, 2023, were included. The primary outcome indicator was the Positive and Negative Symptom Scale (PANSS) total score along with its three sub-scales. Secondary outcomes included the Scale for Assessment of Negative Symptoms (SANS) and Body Mass Index (BMI), which were used to assess the efficacy of aerobic exercise interventions in patients with schizophrenia. Subgroup analyses were conducted to explore the impact of intervention duration and total weekly exercise time, while treatment feasibility was assessed through adherence rates. A total of 17 publications involving 973 patients with schizophrenia were deemed eligible and included in the analysis. Compared to other forms of adjunctive interventions, the network meta-analysis of 12 PANSS-based studies revealed that adjunctive aerobic exercise interventions were the most effective in reducing overall PANSS scores in patients with schizophrenia, with statistically significant pooled results (MD = −4.84, 95% CI: −5.72, −3.96). Both the PANSS negative symptom subscale (MD = −2.11, 95% CI: −3.26, −0.95) and SANS (MD = −9.11, 95% CI: −11.94, −6.27) indicated that adjunctive aerobic exercise interventions effectively alleviate negative symptoms. Subgroup meta-analysis indicated that 2-3 month interventions involving 100–220 min of exercise per week were the most effective. Additionally, adherence to the adjunctive aerobic exercise regimen was found to be comparable to that of conventional treatment alone. Aerobic exercise interventions, as adjunctive therapy, are an effective measure for reducing PANSS scores in patients with schizophrenia, contributing to the alleviation of both the positive and negative symptoms, and patients demonstrated strong adherence to aerobic exercise.

Brain texture as a marker of transdiagnostic clinical profiles in patients with recent-onset psychosis and depression

The inter-relationships of voxels can be captured by the radiomics texture features across multiple spatial scales. Prediction models of brain texture changes captured by the contrast texture feature in recent-onset psychosis (ROP) and recent-onset depression (ROD) have recently been proposed, although the validation of these models transdiagnostically at the individual level and the investigation of the variability in clinical profiles are lacking. Established prevention and treatment approaches focus on specific diagnoses and do not address the heterogeneity and manifold potential outcomes of patients. Here we aimed to investigate the cross-sectional utility of brain texture changes for (1) identification of the psychopathological state (ROP and ROD) and (2) the association of individualized brain texture maps with clinical symptom severity and outcome profiles. We developed transdiagnostic models based on structural magnetic resonance imaging data for 116 patients with ROD, 122 patients with ROP and 197 healthy control participants from the PRONIA (Personalized pROgNostic tools for early psychosIs mAnagement) study by applying a set of tools and frameworks to explain the classification decisions of the deep-learning algorithm (named explainable artificial intelligence) and clustering analysis. We investigated the contrast texture feature as the key feature for the identification of a general psychopathological state. The discrimination power of the trained prediction model was >72% and was validated in a second independent age- and sex-matched sample of 137 ROP, 94 ROD and 159 healthy control participants. Clustering analysis was implemented to map the changes in texture brain produced from an explainable artificial intelligence algorithm, in a group fashion. The explained individualized brain contrast map grouped into eight homogeneous clusters. In the clinical group, we investigated the association between the explained brain contrast texture map and clinical symptom severity as well as outcome profiles. Different patterns in the explained brain contrast texture map showed unique associations of brain alterations with clinical symptom severity and clinical outcomes, that is, age, positive, negative and depressive symptoms, and functionality. In some clusters, the mean explained brain contrast texture map values and/or brain contrast texture voxels that contributed significantly to the classification decision predicted accurately the PANSS (positive and negative symptom scale) scores, functionality and change in functionality over time. In conclusion, we created homogeneous clusters which predict the clinical severity and outcome profile in ROP and ROD patients.

Multigenetic Pharmacogenomics–Guided Treatment vs Treatment As Usual Among Hospitalized Men With Schizophrenia

Limited evidence supports multigenetic pharmacogenomics-guided treatment (MPGT) in schizophrenia. To evaluate the clinical effectiveness of MPGT in schizophrenia in a randomized clinical trial (RCT). This RCT was conducted from March 2020 to March 2022. Male Chinese Han inpatients aged 18 to 60 years diagnosed with schizophrenia with a Positive and Negative Symptom Scale (PANSS) score of 60 or more from 2 selected study hospitals were included. Patients and raters were masked to MPGT or treatment as usual (TAU) randomization. Participants were randomly assigned in a 1:1 ratio to receive either MPGT or TAU for 12 weeks. The primary efficacy outcome was the percentage change in PANSS total scores (range, 30 to 210) from baseline to week 6 analyzed by a modified intention-to-treat mixed model for repeated measures. The secondary outcome included response and symptomatic remission rates. A total of 210 participants (mean [SD] age, 29.2 [8.8] years) were enrolled and analyzed, with 113 assigned to MPGT and 97 to TAU. Compared with those randomized to TAU, participants randomized to MPGT demonstrated a significantly higher percentage change in PANSS score (74.2% vs 64.9%; adjusted mean difference, 9.2 percentage points; 95% CI, 4.4-14.1 percentage points; P < .001) and a higher response rate (93 of 113 [82.3%] vs 63 of 97 [64.9%]; adjusted odds ratio, 2.48; 95% CI, 1.28-4.80; P = .01) at the end of week 6. In this RCT of MPGT, MPGT was more effective than TAU in treating patients with schizophrenia. These findings suggest that multigenetic pharmacogenomic testing could serve as an effective tool to guide the treatment of schizophrenia. Chinese Clinical Trial Registry Identifier: ChiCTR2000029671.

Rural tourism combined with psychological intervention on functional cognitive disorders

BackgroundFunctional cognitive impairment, also known as cognitive impairment, can lead to severe loss of daily or social communication abilities and diagnosis of dementia. The treatment methods for functional cognitive impairment include medication, psychological training, and so on.Subjects and MethodsThe study conducted an experiment on 88 patients with functional cognitive impairment, dividing them into a control group, a psychological group, and an experimental group. The control group only received prescription medication provided by the doctor, the psychological group received social psychological intervention treatment on the basis of the control group, and the experimental group received comprehensive treatment of rural tourism projects on the basis of the psychological group. The study used the MATRICS Consensus Cognitive Battery (MCCB) and Positive and Negative Symptom Scale (PANSS) to evaluate the condition of three groups of patients after treatment, in order to analyze the therapeutic effects of different treatment plans on the patient’s condition.ResultsAs the treatment duration increases, the patient’s MCCB score gradually increases and the PANSS score gradually decreases, indicating that all three treatment regimens can improve the patient’s cognitive impairment. The MCCB and PANSS scores of the experimental group were better than those of the control group and the psychological group.ConclusionsThe effect of simple drug therapy is unclear and the treatment course is long. Combining medication with social psychology intervention training can improve the treatment effect of patients. Rural tourism projects combined with social psychological intervention present the best treatment effect.AcknowledgementThe Year of 2021 Vocational Education Teaching Reform Research Project of Shandong Province (No.2021120).

Clinical intervention effect of computer-aided therapy based on software engineering on patients with schizophrenia

BackgroundSchizophrenia (SCH) is a serious mental disorder of unknown aetiology, with clinical symptoms involving sensory perception, thinking, emotions, behavior, and other aspects. When symptoms occur repeatedly and the condition persists, the patient’s life and learning abilities are significantly impaired and gradually exhibiting cognitive impairment. The treatment effectiveness and rehabilitation process for SCH are often complex and diverse. This study developed a computer-aided treatment system using software engineering methods to evaluate its impact on the clinical intervention effectiveness of schizophrenia patients.Subjects and MethodsA total of 300 patients with schizophrenia were selected for the experiment and divided into an experimental group and a control group, with 150 patients in each group. The experimental group received a 6-month intervention using a computer-aided treatment system, while the control group received traditional treatment methods. Evaluate using the Positive and Negative Symptom Scale (PANSS) and record the changes in scores before and after the intervention in both groups. The process data was analyzed using SPSS.ResultsAfter 6 months of treatment, the PANSS score of the experimental group significantly improved, with a statistical difference compared to the control group (P&lt;0.05). The treatment compliance of the experimental group was also significantly improved, with higher patient satisfaction.ConclusionsComputer-assisted therapy based on software engineering has shown positive effects in clinical interventions for schizophrenia and can serve as a beneficial supplement to traditional treatment methods. Future research needs to further improve the usability of the system and explore its applicability in different types of mental disorders and treatment stages.AcknowledgementScience Research Fund Project of Yunnan Education Department in 2019 (No. 2019J0999).

Changes in neurotransmitter levels, brain structural characteristics, and their correlation with PANSS scores in patients with first-episode schizophrenia.

In patients with schizophrenia, the brain structure and neurotransmitter levels change, which may be related to the occurrence and progression of this disease. To explore the relationships between changes in neurotransmitters, brain structural characteristics, and the scores of the Positive and Negative Symptom Scale (PANSS) in patients with first-episode schizophrenia. The case group comprised 97 patients with schizophrenia, who were evaluated using the Canadian Neurological Scale and confirmed by laboratory tests at Ningbo Mental Hospital from January 2020 to July 2022. The control group comprised 100 healthy participants. For all participants, brain structural characteristics were explored by measuring brain dopamine (DA), glutamic acid (Glu), and gamma-aminobutyric acid (GABA) levels, with magnetic resonance imaging. The case group was divided into negative and positive symptom subgroups using PANSS scores for hierarchical analysis. Linear correlation analysis was used to analyze the correlations between neurotransmitters, brain structural characteristics, and PANSS scores. Patients in the case group had higher levels of DA and lower levels of Glu and GABA, greater vertical and horizontal distances between the corpus callosum and the inferior part of the fornix and larger ventricle area than patients in the control group (P < 0.05). Patients with positive schizophrenia symptoms had significantly higher levels of DA, Glu, and GABA than those with negative symptoms (P < 0.05). In patients with positive schizophrenia symptoms, PANSS score was significantly positively correlated with DA, vertical and horizontal distances between the corpus callosum and the infrafornix, and ventricular area, and was significantly negatively correlated with Glu and GABA (P < 0.05). In patients with negative schizophrenia symptoms, PANSS score was significantly positively correlated with DA, vertical distance between the corpus callosum and the infrafornix, horizontal distance between the corpus callosum and the infrafornix, and ventricular area, and was significantly negatively correlated with Glu and GABA (P < 0.05). In patients with first-episode schizophrenia, DA levels increased, Glu and GABA levels decreased, the thickness of the corpus callosum increased, and these variables were correlated with PANSS scores.

SYMPTOM SEVERITY IN SCHIZOPHRENIA PATIENTS WITH NPAS3, DYSBINDIN-1 AND/OR TRIOBP PROTEIN PATHOLOGY IN THEIR BLOOD SERUM: A PANSS-BASED FOLLOW UP STUDY.

It has been proposed that aggregation of specific proteins in the brain may be a pathological element in schizophrenia and other chronic disorders. Multiple such aggregating proteins have now been implicated through post mortem investigation, including NPAS3 (Neuronal PAS domain protein 3), dysbindin-1 (encoded by the DTNBP1, Dystrobrevin Binding Protein 1, gene) and TRIOBP (Trio-Binding Protein, multiple isoforms). While the presence of protein aggregates in the brain is interesting in terms of understanding pathology, it is impractical as a biomarker. These proteins were therefore investigated recently in blood serum of schizophrenia patients and controls, showing patients to have higher levels of NPAS3 in their serum generally. TRIOBP-1 and dysbindin-1 were also found in an insoluble state, implying aggregation, but did not clearly corresponding to disease state. We revisit 47 of the originally recruited 50 patients with schizophrenia, all of whom are Croatian and aged between 18 and 72. We assessed their symptom specificity and severity using PANSS (the Positive and Negative Symptoms Scale), comparing those with NPAS3, insoluble dysbindin-1 and/or insoluble TRIOBP-1 in their blood serum to those lacking any such protein dysregulation. The frequency of each individual potential protein pathology among these patients was too low for meaningful statistical analysis, however the 11 patients that displayed one or more of these pathologies (NPAS3, dysbindin-1, TRIOBP-1 and/or TRIOBP-5/6) showed a subtle but significant increase in total PANSS scores compared to the 36 patients displaying none of the pathologies (p = 0.031), seemingly driven principally by increased scores on the general psychopathology scale. While the numbers of patients involved do not allow firm conclusions to be drawn at this time, this provides the first indication that disturbed proteostasis in blood serum, of proteins that aggregate in the brains of schizophrenia patients, may correlate with the severity of schizophrenia symptoms.

Gender differences in prevalence and associated factors of metabolic syndrome in first-treatment and drug-naïve schizophrenia patients

BackgroundMetabolic syndromes (MetS) are clinical syndromes involving multiple pathological states with distinct gender-specific clinical patterns. As a serious disorder associated with psychiatric conditions, the prevalence of MetS is significantly higher in the population with schizophrenia (Sch). The aim of this paper is to report gender differences in the prevalence, associated factors and severity-related factors of MetS in first-treatment and drug-naïve (FTDN) patients with Sch.MethodsA total of 668 patients with FTDN Sch were included in this study. We collected socio-demographic and general clinical information on the target population, measured and evaluated common metabolic parameters and routine biochemical indicators, and assessed the severity of psychiatric symptoms using Positive and Negative Symptom Scale (PANSS).ResultsIn the target group, the prevalence of MetS was significantly higher in women (13.44%, 57/424) than in men (6.56%, 16/244). In the males, waist circumference (WC), fasting blood glucose (FBG), diastolic blood pressure (DBP), and triglycerides (TG) were risk factors for MetS, while systolic blood pressure (SBP), TG, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and platelet (PLT) were risk factors for the females. More importantly, for the females, we found that age, LDL-C, PANSS scores and blood creatinine (CRE) were risk factors for higher MetS scores, while onset age and hemoglobin (HGB) were protective factors.ConclusionThere are significant gender differences in the prevalence of MetS and its factors among patients with FTDN Sch. The prevalence of MetS is higher and the factors that influence MetS are more numerous and extensive in females. The mechanisms of this difference need further research and clinical intervention strategies should be formulated with gender differences.

Abnormal changes of static and dynamic functional connectivity of dopaminergic midbrain in patients with first-episode schizophrenia and their correlations with clinical symptoms

Objective: To investigate the abnormal changes of static functional connectivity (sFC) and dynamic functional connectivity (dFC) in the dopaminergic midbrain (ventral dorsal tegmental area and bilateral substantia nigra compacta, VTA/SNc) in patients with first-episode schizophrenia(SCH), and their correlation with the Positive and Negative Symptom Scale (PANSS). Methods: The data of 198 first-episode untreated schizophrenia patients and 199 healthy controls (HC) matched by age, sex and years of education who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2019 to May 2022 were prospectively collected. All subjects underwent high resolution structural MRI and resting state functional magnetic resonance imaging (rs-fMRI) scanning. The dopaminergic midbrain (VTA/SNc) was defined as three regions of interest (ROI). The sFC and dFC analyses with VTA/SNc as seeds were performed to produce a whole-brain diagram initially, which subsequently were compared between schizophrenia group and HC group. Finally, the correlation analysis of sFC and dFC values with the PANSS scores were performed, including the positive scale score, negative scale score, general psychopathology scale score, total score and symptom scores. Results: There were 86 males and 112 females in SCH group, and aged (23±9) years. Meanwhile, there were 95 males and 104 females in HC group, and aged (22±5) years. In the SCH group, the positive (P), the negative (N) and the general psychopathology (G) scale scores and the total score (T) of the PANSS scale was 20±7, 21±7, 41±11 and 82±22, respectively. Compared with the HC group, the VTA showed decreased sFC with four clusters including cerebellar vermis 7/9, left putamen, right thalamus and left middle cingulate gyrus in the schizophrenia group (peak center, t=-4.35, -4.81, -4.35 and -4.65; voxel P<0.005; cluster P<0.05), the right SNc showed decreased sFC with four clusters including left cerebellar hemisphere 4/5/8, right putamen, right medial orbitofrontal gyrus and the left putamen in the schizophrenia group (peak center, t=-4.91, -5.15, -4.77 and -5.21; voxel P<0.005; cluster P<0.05), and the left SNc showed decreased sFC with four clusters including the left putamen, right putamen, right medial orbitofrontal gyrus and left middle cingulate gyrus in the schizophrenia group (peak center, t=-5.82, -4.83 and -4.65; voxel P<0.005; cluster P<0.05). Compared with the HC group, the VTA showed decreased dFC with the right inferior parietal gyrus, right angular gyrus and right superior parietal gyrus in schizophrenia group (t=-4.17). In the schizophrenia group, the sFC value of cluster 2 (left putamen) with VTA as seed and cluster 4 (left putamen) with right SNc as seed were positively correlated with the positive scale scores in PANSS (r=0.141, 0.169, both P<0.05). The sFC and dFC values of significant regions were also correlated with hallucination, delusion, suspicion, hostility, communication disorder, passivity/indifference, lack of communication, stereotyped thinking, depression, non-cooperation, lack of judgment and insight, impulse control disorder, active social avoidance (all P<0.05). Conclusion: The static and dynamic functional connectivity (stability) of VTA/SNc to cerebellum, thalamus, striatum, prefrontal lobe and cingulate gyrus in first-episode schizophrenia patients were decreased, which were closely related to the positive and negative symptoms of schizophrenia.

Incidence and factors associated of early non-response in first-treatment and drug-naïve patients with schizophrenia: a real-world study.

Schizophrenia is a severe and persistent mental condition that causes disability. For subsequent clinical care, it is extremely practical to effectively differentiate between patients who respond to therapy quickly and those who do not. This study set out to document the prevalence and risk factors for patient early non-response. The current study included 143 individuals with first-treatment and drug-naïve (FTDN) schizophrenia. Patients were classified as early non-responders based on a Positive and Negative Symptom Scale (PANSS) score reduction of less than 20% after 2 weeks of treatment, otherwise as early responders. Clinical subgroups' differences in demographic data and general clinical data were compared, and variables related to early non-response to therapy were examined. Two weeks later, a total of 73 patients were described as early non-responders, with an incidence of 51.05%. The early non-response subgroup had significantly higher PANSS scores, Positive symptom subscale (PSS) scores, General psychopathology subscale (GPS) scores, Clinical global impression scale - severity of illness (CGI-SI) and Fasting blood glucose (FBG) levels compared to the early-response subgroup. CGI-SI and FBG were risk factors for early non-response. High rates of early non-response have been seen in FTDN schizophrenia patients, and risk variables for predicting early non-response include CGI-SI scores and FBG levels. However, we need more in-depth studies to confirm the generalizable range of these two parameters.

Evaluating the Effect of Melatonin on Positive and Negative Symptoms of Schizophrenic Patients: A Randomized Placebo-Controlled Study.

Objective: Schizophrenia is known as a severe psychiatric disorder with a broad range of clinical indications and symptoms such as positive and negative symptoms. This study was conducted with the aim of investigating the effect of melatonin on positive and negative symptoms of inpatients with schizophrenia. Method : This study was conducted as a randomized placebo-controlled trial (double-blind) in the population of patients with schizophrenia. Study samples were selected from inpatients with schizophrenia, according to the DSM-5 criteria, who had not been diagnosed with a depressive episode of schizophrenia based on the Calgary questionnaire and who also met the inclusion criteria. 46 patients with schizophrenia were randomly assigned to the intervention (6 mg melatonin per day as two 3 mg pills for six weeks) and placebo groups. The positive and negative symptom scale (PANSS) was used to assess the effect of treatment at T1 (before intervention), T2 (three weeks after beginning the intervention) and T3 (six weeks after beginning the intervention). To check the research hypotheses, multiple comparison statistics were used by the SPSS 22 software. Results: The placebo and melatonin groups had no significant difference in terms of PANSS scores (negative, positive, general and total symptom scores) at T1. Also, there was no difference in PANSS scores between the two groups at T2. However, at T3, there was a significant difference between the two groups only in the score of negative symptoms of PANSS (P = 0.036), so that negative symptoms of schizophrenia were significantly reduced in the intervention group compared to the placebo group. Furthermore, based on within-group analyzes, all PANSS scores were significantly reduced in the two groups at T2 and T3 (P < 0.05). Conclusion: Long-term use (at least six weeks) of melatonin can improve the negative symptoms of schizophrenia. Since antipsychotics can better affect the positive symptoms, the use of melatonin in combination with these drugs may perhaps further improve the patients' symptoms.

The Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE): an easy tool for investigating Self-Disorders, subjective experiences and global functioning

IntroductionSelf Disorders (SDs) are regarded as the subjective phenotype of Schizophrenia vulnerability. The EASE (Examination of Anomalous Self-Experiences) scale is the most detailed and widely used instrument to investigate SDs, but it requires long administration times and specific training. The IPASE (Inventory of Psychotic-like Anomalous Self-Experiences) scale might be a self-administered instrument of widespread use for an easier SDs investigation.ObjectivesThe present study was aimed at validating the Italian version of IPASE, testing its internal consistency and usability for a first level SDs survey. A secondary objective was to confirm the correlations between IPASE, EASE, main symptom dimensions, subjective bodily experiences, symptoms of schizophrenic autism as well as levels of global functioning.MethodsFifty patients with Schizophrenia were administered the IPASE scale in its Italian version, the Examination of Anomalous Self-Experiences scale (EASE), the Positive And Negative Symptoms Scale (PANSS), the Social and Occupational Functioning Assessment Scale (SOFAS) to assess global functioning, the Autism Rating Scale (ARS) and the Abnormal Bodily Phenomena questionnaire (ABPq). The internal consistency of IPASE in its Italian version was investigated and the correlations between IPASE, EASE, ABP, ARS, PANSS and SOFAS were explored.ResultsThe internal consistency of the Italian version of IPASE was high (α 0.97). The IPASE and EASE total scores were positively correlated with each other, as were many of the conceptually related subdomains of both scales. The IPASE score was negatively correlated with global functioning (SOFAS) and positively correlated with total PANSS scores and with PANSS negative domain. Moreover, the IPASE total score was positively correlated with autism dimension (ARS), while anomalies in subjective experience of the lived body were coherently correlated with higher scores in IPASE “somatization” subdomain.Conclusions The IPASE may be an easy instrument with high internal consistency for an initial investigation of SDs. IPASE domains appear to be correlated with the SDs investigated through EASE and with the main symptomatologic dimensions of Schizophrenia, in particular with negative symptoms. IPASE might also be a useful instrument for a first level investigation of subjective experiences concerning intersubjectivity and bodily dimensions.SDs are confirmed to be a core feature of the schizophrenia psychopathology, with a adverse impact on global functioning.Disclosure of InterestNone Declared