Positive And Negative Syndrome Scale Research Articles

Efficacy of continuous theta burst stimulation (cTBS) in the treatment of auditory verbal hallucinations in Schizophrenia: A randomized controlled trial.

Short-term exposure to particulate matter and apparent temperature is associated with schizophrenia severity in Italy.

Inflammation is linked to the pathophysiology of schizophrenia. The neutrophil- to-lymphocyte ratio (NLR), a measure of systemic inflammation, has been reported to be associated with schizophrenia. However, few studies have examined the sex-specific association between neutrophil-to-lymphocyte ratio (NLR) and clinical symptoms in schizophrenia. This study aimed to explore sex differences in NLR and its correlation with symptoms in first-episode schizophrenia (FES) patients. Ninety-seven FES patients and 65 control subjects were recruited. The severity of clinical symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS), and white blood cells were calculated. We performed a cross-sectional analysis comparing NLR in males and females in the patient and control groups. We explored its sex-specific associations with clinical symptoms in the patient group. We found that neutrophil (NEU) counts and NLR were higher in male patients compared to female patients with schizophrenia. There were no significant differences in white blood cell counts and NLR in healthy controls. Linear regression analysis showed that NEU counts were associated with clinical symptoms in male patients, and NLR correlated with symptoms in female patients after controlling for age, onset age, and years of education. Our study suggests that NLR values and NEU counts were higher in male patients compared with female patients with schizophrenia and that the association between NLR or NEU and clinical symptoms was sex-specific.

Determinants of real-world functioning in first-episode psychosis patients receiving 4 weeks of amisulpride treatment: findings from the multinational OPTiMiSE study.

Drug blood levels, influencing factors and their relationship with metabolic parameters in patients with schizophrenia using clozapine.

Obesity and autonomic dysfunction in schizophrenia: Associations with symptom severity and onset subtypes.

Prevalence and predictors of suicidal ideation in patients with chronic schizophrenia: A large-scale study on the mediating roles of depression, insomnia and aggression.

The Catalan Government established in 2017 the creation of Crisis Resolution and Home Treatment teams (CRHT) as an alternative treatment for psychiatric crises in the community. Since then, different programs have been developed with great heterogeneity. The following study evaluates a CRHT program in terms of Patient Reported Outcomes Measures and helps creating a homogeneous model. We conducted a quasi-experimental study of the patients attending the CRHT during 2021. Patients were assessed on admission and at discharge. Demographic, clinical and functional variables were considered as well as satisfaction and family burden. Primary outcome variables were analyzed in 175 patients by intention-to-treat (ITT) as well as per protocol (PP) in 161 patients. The Health of the Nation Outcome Scale (HoNOS) mean decreased 4.2 points whereas The Global Assessment of Functioning scale (GAF) improved 13 points. The mean difference in The EuroQoL-5D-3L Health Questionnaire (EQ-5D-3L) was 0,05. The Positive and Negative Syndrome scale (PANSS) mean was reduced by 16 points in the patients with psychosis. 137 patients reported depressive symptoms. The Zarit Burden Interview (ZBI) scale was assessed in 135 caregivers, of whom 60% had low or any burden. Satisfaction levels were considered in 92 patients and their caregivers, with a total mean of 28,7 in the Encuesta de satisfacción con los servicios de atención domiciliaria (SATISFAD) scale. The program has proved its effectiveness in resolving crisis with an improvement in clinical, functional and social aspects. Changes in the HoNOS, the GAF and the PANSS scale were significant, whereas the increase in quality of life was less relevant. It resulted remarkable the high prevalence of depressive symptoms, even with no diagnostic for depression. The perceived satisfaction of patients and families was notorious, with low levels of burden.

Antipsychotic drugs are the mainstay of schizophrenia treatment; yet, controversy persists regarding their relative efficacy and side effects, and guideline recommendations on efficacy differences are particularly vague. The aim of this trial was to compare seven antipsychotics in acutely ill patients with schizophrenia. The authors performed a multicenter (32 hospitals), industry-independent, parallel, assessor-blinded, flexible-dosage randomized trial (Schizophrenia in Non-Occidental Participants). Eligible inpatients 18-45 years of age with schizophrenia experiencing acute exacerbation were recruited and randomized to 6 weeks of monotherapy with one of seven antipsychotic drugs: olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone, perphenazine, and haloperidol. A total of 3,067 patients were randomized, of whom 82% completed follow-up. The mixed model indicated significant differences in the primary outcome percentage change in Positive and Negative Syndrome Scale (PANSS) score between the antipsychotics. At week 6, olanzapine and risperidone showed a significantly higher percentage change in PANSS score than aripiprazole, ziprasidone, and quetiapine (mean differences: 5.52-7.93) but not haloperidol or perphenazine. Olanzapine was associated with the highest risk of weight gain (relative risk: 1.44-3.22). Aripiprazole was associated with lower risk of hyperprolactinemia than all the other drugs (relative risks: 0.11-0.21). Ziprasidone and aripiprazole were associated with lower risks of weight gain and metabolic side effects. Haloperidol was associated with a higher risk of extrapyramidal symptoms than all other drugs (relative risks: 0.13-0.61). Aripiprazole was least sedating (relative risks: 0.30-0.39). Olanzapine and risperidone showed lower all-cause discontinuation rates than ziprasidone and haloperidol (hazard ratios: 0.61-0.73). This trial fills important knowledge gaps in acute antipsychotic treatment of schizophrenia. It confirms hierarchies in efficacy and side effects of antipsychotics from related evidence.

PurposeThis study aims to investigate the efficacy of metacognitive training (MCT) as an adjunctive treatment strategy for schizophrenia, particularly its impact on negative symptoms and potential mechanisms.Patients and MethodsThis study included a total of 73 inpatients with schizophrenia. 36 patients were in the MCT group and 37 patients were in the control group. Both groups of patients were receiving a single second-generation antipsychotic drug treatment. The MCT group underwent a 4-week MCT program consisting of 8 modules, while the control group received non-cognitive psychological support for the same duration and frequency. The Positive and Negative Syndrome Scale (PANSS) five-factor model and negative symptom two-factor model were used to assess psychiatric symptoms, and the Snyder’s Self-Monitoring Scale (SSMS) and the Personal and Social Performance Scale (PSP) were used as functional evaluation indicators.ResultsAfter treatment, compared to the control group, the MCT group had significantly lower scores in the PANSS total score (p<0.001), negative factor (p=0.002), and hostility factor (p=0.046). Further, the PSP score (p<0.001) and SSMS score (p=0.042) were significantly improved. In the two-factor analysis of negative symptoms, the MCT group showed significant improvements in both diminished expression (DE) symptoms (p<0.001) and social amotivation (SA) symptoms (p=0.010) after treatment. Multivariate linear regression analysis revealed that changes in the reduction rates of P2 (Conceptual disorganization), N7 (stereotyped thinking), and SA scores had a significant impact on the reduction in DE scores; changes in the reduction rates of P6 (Suspiciousness/persecution) and DE scores had a significant impact on the reduction rate of SA scores (p<0.05).ConclusionMCT can improve the clinical symptoms and functions of patients with schizophrenia, especially in the DE factor characterized by conceptual disorganization and stereotyped thinking, and the SA factor prominent in suspiciousness/persecution symptom. This provides insights for the precise treatment of negative symptoms.

Objectives: The current study embarked on an Arabic translation of the BNSS and an examination of its psychometric properties in a Tunisian sample of inpatients and outpatients with schizophrenia. Method: Care recipients with schizophrenia (N=178) completed administrations of the A-BNSS, the Scale for the Assessment of Negative Symptoms (SANS), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and the St. Hans Rating Scale (SHRS). Results: The A-BNSS produced strong evidence for the reliability of the scale with Cronbach’s alpha and interrater ICC estimates for the full measure and its subscales falling in the good to excellent range. The A-BNSS showed excellent convergent validity with large correlations of its full scale and subscale scores with the SANS and PANSS negative symptom scores. The A-BNSS showed minimal correlations with PANSS positive and emotional distress scores, CDSS depression, and SHRS extrapyramidal symptoms, suggesting strong discriminant validity. CFA favored a five-factor model consistent with the NIMH consensus domains. Conclusion: The study supports the robust psychometric properties of the Arabic translation of the BNSS rendering it promising for the assessment of negative symptoms in Arabic speaking individuals with schizophrenia. Along with pre-existing translations, this extension of the language repertoire of the BNSS would support cross-cultural deconstruction of the phenomenology of negative symptoms and outcome evaluation in global clinical trials. The A-BNSS is a promising tool for the assessment of negative symptoms in Arabic-speaking individuals with schizophrenia.

ObjectiveCognitive impairment is a core feature of schizophrenia spectrum disorders. Our previous study on a first-episode psychosis cohort showed that symptoms related to impoverished/disorganized communication and motor impoverishment predicted verbal and working memory scores, respectively. This study aimed to explore those predictors in people across the range of illness chronicity.MethodsWe employed iterative Constrained Principal Component Analysis (iCPCA) to investigate the relationship between 15 cognitive measures from the MATRICS battery, including processing speed, attention, working, verbal and nonverbal memory, reasoning, and problem-solving, and 27 Positive and Negative Syndrome Scale (PANSS) items in 198 outpatients from two sites in Australia and one in Canada. The iCPCA method was used to determine symptoms that reliably predict specific combinations of cognitive measures while controlling Type I errors.ResultsWe found that a verbal memory and learning component was predicted by the PANSS item Lack of Spontaneity and Flow of Conversation, and a visual attention/working memory component was linked to the PANSS item Motor Retardation.ConclusionsThese accord with our previous findings in an early psychosis sample, that is, negative symptoms of diminished expression are key predictors of cognitive abilities in schizophrenia. Namely, communication and motor impoverishments predicted lower scores on tests of verbal memory, learning, visual attention, and working memory. These findings may inform personalized treatment approaches targeting cognitive deficits and negative symptoms in schizophrenia.

Aim of the study The main aim of the study was to examine how patients’ initial levels of psychopathology and general functioning affected their recovery during treatment in a day rehabilitation psychiatric ward. Subject or material and methods Demographic and clinical data were collected during patients’ hospitalization in a day rehabilitation psychiatric ward. Sixty patients were included. The variables were measured at baseline (Pretest) and at the end (Posttest). The study included the following tools: the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning Scale (GAF) and the Illness and the Recovery Management Scale (IMRS). Results The results showed a significant improvement in patients’ subjective experiences of illness management and recovery between the Pretest and Posttest. In addition, an initial lower level of psychopathology and better general functioning, as assessed by clinicians, improved treatment outcomes. Treatment led to a reduction of psychopathological symptoms and improved daily functioning in the day rehabilitation unit. Discussion: The findings of this study support the importance of multidimensional rehabilitation approaches for schizophrenia treatment, thus emphasizing the need for thorough diagnostic assessment before treatment to ensure a more personalized approach. Discussion The findings of this study support the importance of multidimensional rehabilitation approaches for schizophrenia treatment, thus emphasizing the need for thorough diagnostic assessment before treatment to ensure a more personalized approach. Conclusions This study provides preliminary conclusions on the legitimacy of implementing the assumptions of programs focused on recovery in psychiatric care and proves that the therapeutic effects provided within them are effective.

BACKGROUNDSchizophrenia, a complex group of mental disorders, is primarily managed with antipsychotic medications. The safety and efficacy of different initial doses of lurasidone for acute schizophrenia remain uncertain, particularly concerning discontinuation rates due to adverse events (AEs).AIMTo compare the safety of two initial doses of lurasidone for the treatment of acute schizophrenia in Chinese patients.METHODSThis 6-week, randomized, open-label, multicenter trial allocated participants to receive either 40 mg/day or 80 mg/day lurasidone initially, with dose adjustment allowed after a one-week fixed-dose period. Safety assessments included the primary endpoint of discontinuation due to AEs, as well as evaluations of AEs, weight changes, and laboratory parameters. Efficacy assessments included responder rates and changes in scores on the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity scale, and Calgary Depression Scale for Schizophrenia.RESULTSAmong 197 participants, no significant difference was found in discontinuation rate due to AEs between groups (3.03% vs 5.10%, P = 0.707). Treatment-emergent AEs were reported in 64.6% and 71.4% of participants in the 40 mg/day and 80 mg/day initiation groups, respectively. Response rates at weeks 1 and 2 showed no statistically significant differences. Both groups demonstrated significant improvements in PANSS total, Clinical Global Impression-Severity, and Calgary Depression Scale for Schizophrenia scores from baseline (all P < 0.01). Notably, the 80 mg/day initiation group showed greater improvement in the PANSS positive subscale score at visits 1 and 2 compared to the 40 mg/day initiation group (P < 0.05).CONCLUSIONInitial doses of 40 mg/day and 80 mg/day lurasidone are safe and effective for acute schizophrenia, with no significant increase in AEs-related discontinuation rate at the higher dose.

BACKGROUNDFirst-generation antipsychotics demonstrate certain therapeutic benefits in schizophrenia; however, they often fail to significantly address negative symptoms. Thus, continued exploration is essential to refine these treatments.AIMTo examine lurasidone plus sulpiride influence on treatment efficacy, psychiatric symptoms, and quality of life in patients with schizophrenia.METHODSA total of 110 patients with schizophrenia, admitted between October 2021 and October 2024, were recruited for this study. The control group (n = 50) received sulpiride alone. Conversely, the observation group (n = 60) was treated with a combination of lurasidone and sulpiride. A series of assessments were conducted to compare the two groups. These included evaluating treatment efficacy; recording the incidence of adverse events such as fatigue, xerostomia, insomnia, anorexia, and headache; assessing psychiatric symptoms using the positive and negative syndrome scale (PANSS); evaluating cognitive and social functions using the repeatable battery for the assessment of neuropsychological status (RBANS), and the personal and social performance scale (PSP); measuring quality of life using the schizophrenia quality of life scale (SQLS); and analyzing serum markers including interleukin 6 (IL-6), IL-17, and prolactin (PRL).RESULTSOverall treatment efficacy was significantly higher in the observation group than in the control group. The total incidence of adverse events was comparable between the two groups. After treatment, the scores for positive symptoms, negative symptoms, and general psychopathological symptoms on the PANSS in the observation group were significantly reduced compared to pretreatment levels, and were also lower than those in the control group. Additionally, RBANS and PSP scores in the observation group significantly increased post-treatment and were notably higher than in the control group. Regarding the quality of life, SQLS scores in the psychosocial, symptoms, and side effects and motivation and energy dimensions in the observation group were significantly lower after treatment than both baseline levels and those in the control group. Furthermore, post-treatment levels of IL-6 and IL-17 in the observation group were significantly reduced and lower than those in the control group, whereas the PRL level was significantly elevated.CONCLUSIONThe combination of lurasidone and sulpiride can effectively enhance treatment efficacy, alleviate psychiatric symptoms, and improve quality of life in patients with schizophrenia, supporting its broader clinical use.

Schizophrenia with hypozincemia: Clinical features and symptom severity.

ABSTRACTIntroductionMitochondrial dysfunction and disrupted cerebral energy metabolism have been increasingly linked to the pathophysiology of schizophrenia. Preclinical studies suggest that certain atypical antipsychotics may exacerbate mitochondrial dysfunction by inhibiting respiratory complex I, contributing to adverse effects. Risperidone, a dopamine D2/serotonin 5-HT2 antagonist, and aripiprazole, a partial dopamine D2 agonist, were selected because of their contrasting pharmacological profiles and reported differential effects on mitochondrial complex I activity. Despite these findings, the clinical implications remain poorly understood. This randomised controlled trial aims to evaluate and compare the biochemical and clinical effects of risperidone and aripiprazole on mitochondrial dysfunction in patients with schizophrenia.Methods and analysisIn this randomised, open-label, parallel-arm clinical trial, 60 patients with schizophrenia who were drug-naïve or had not taken any antipsychotic drugs for at least 4 weeks before recruitment were randomly assigned to risperidone or aripiprazole treatment for 12 weeks, with inclusion of an additional group of 30 healthy individuals for baseline comparisons. The primary outcome is the change in mitochondrial respiratory chain complex I concentration in platelets, and secondary outcomes include serum lactate, pyruvate, creatine kinase levels and Newcastle Mitochondrial Disease Adult Scale (NMDAS) scores. Clinical efficacy and safety are evaluated using the Positive and Negative Syndrome Scale (PANSS) and monitoring treatment-emergent adverse events. Intention-to-treat analysis will be done for all parameters using suitable statistical tools.Ethics and disseminationEthical approval was obtained from the Institutional Ethics Committee and the study conformed to the provisions of the Declaration of Helsinki and ICMR’s national ethical guidelines for biomedical and health research involving human participants (2017). Written informed consent will be obtained from the legally authorised representative of the patients. Results will be disseminated through peer-reviewed publications and conferences to inform safer treatment strategies for schizophrenia.Trial registration numberNCT06236451.

A clinical control study of modified electroconvulsive therapy and sodium valproate as enhancement strategies for ultra-treatment-resistant schizophrenia

Decreased serum VEGF, NRG1, and Neuropilin-1 levels in male patients with treatment-resistant schizophrenia: implications for VEGF as a protective factor.

ObjectiveThe high metabolic risk and inherent brain structural changes in patients with schizophrenia are associated with cognitive impairment; however, the underlying mechanism remains unclear. This study investigated whether cortical surface area (CSA) and cortical thickness (CT) mediate obesity-related cognitive impairment in patients with first-episode schizophrenia (FEPS).MethodsWe included 160 patients with FEPS and 150 healthy controls (HCs). Cognitive function and psychiatric symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS) and the Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB). The CSA and CT of 34 grey matter regions in each hemisphere were measured using 3.0-T magnetic resonance imaging. Obesity metrics included waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body mass index (BMI).ResultsHCs had significantly higher CSA and CT in several brain regions than FEPS after adjusting for covariates (p < 0.05). WHR significantly correlated with Verbal Learning, Working Memory, and MCCB composite scores, while WHtR was linked to Social Cognition and MCCB composite scores (p < 0.05). Bilateral CSA mediated the associations between WHR, WHtR, and MCCB scores (p < 0.05), with stronger mediation observed for WHtR. Right inferior parietal gyrus CSA specifically mediated WHR and WHtR links to cognitive outcomes.ConclusionsCSA, particularly in the right inferior parietal gyrus, mediates the relationship between obesity metrics and cognitive function. WHtR may be a more reliable marker than BMI or WHR for assessing abdominal obesity’s impact on cognition, offering insights into the mechanisms of cognitive deficits in schizophrenia.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12888-025-07458-z.