Psychopathology Scale Research Articles

Formal Thought Disorders and Neurocognition in Treatment-Resistant Schizophrenia: Trouble du cours de la pensée et neurocognition dans la schizophrénie réfractaire.

Formal thought disorders (FTDs), a core feature of schizophrenia, have been subdivided into positive and negative types, and are clinically assessed by examining speech (objective) or patient introspection (subjective). Despite being associated with poorer treatment response and worse outcomes, FTDs have been understudied in patients with schizophrenia, in particular treatment-resistant schizophrenia (TRS) or schizoaffective disorder. We aimed to explore the relationship between the severity of positive and negative FTDs and neurocognition as well as social/occupational functioning in this clinical subgroup. This was a retrospective chart review conducted at the Clozapine Clinic at the Centre for Addiction and Mental Health, Toronto, Canada. We reviewed charted standardized assessment of FTDs using the Thought and Language Disorder (TALD) scale, neurocognition using the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS), and functioning using the Social and Occupational Functioning Assessment Scale (SOFAS) between October 2022 and June 2023. Following the original factor structure of the TALD, we computed 4- factor scores that combined positive or negative and objective or subjective FTDs. We then explored the correlation between the scores from each TALD factor and the neurocognition and functioning scores. We analysed data for 23 outpatients on clozapine. After the Bonferroni adjustment, total TALD scores, indicating overall severity of FTDs, were strongly and inversely correlated with SOFAS scores (p < 0.001). A strong inverse correlation was found between the objective positive TALD factor and Letter-Number Span verbal working memory scores, r(21) = -0.63, p < 0.001. Our results demonstrate the strong relationship between FTDs, neurocognition, and social/occupational functioning in a sample of TRS outpatients. Within the cognitive domains assessed, verbal working memory impairment had the strongest correlation with positive FTDs, such as derailment or tangentiality. These findings highlight the value of employing standardized psychopathological scales for FTDs in clinical practice.

Multisensory temporal processing in schizophrenia and bipolar disorder: implications for psychosis

Structuring sensory events in time is essential for interacting with the environment and producing adaptive behaviors. Over the past years, the microstructure of temporality received increasing attention, recognized as a fundamental factor influencing cognitive, affective, and social abilities, whose alteration can underlie the etiopathogeneses of some clinical symptoms in psychiatric disorders. The present research investigated multisensory temporal processing in individuals with schizophrenia (N = 21), bipolar disorder (N = 20) and healthy controls (N = 21) in order to explore a plausible link between multisensory alterations in the temporal order of events and the psychopathological dimensions underlying psychosis. We asked participants to temporally order audio-tactile, visual-tactile, and audio-visual stimuli, and we administered different psychopathological scales to explore depressive, manic and psychotic symptoms. Results demonstrated that both subjects with schizophrenia and bipolar disorder are less precise in temporal order judgment independently of the sensory modalities involved. Interestingly, reduced precision in temporal processing of patients is positively associated with the presence and severity of positive symptoms. Our findings support the hypothesis that low-level sensory alterations in temporal structure may contribute to the emergence of clinical symptoms such as delusions, hallucinations, and disorganized behaviors.

An Equine-Assisted Intervention Versus Non-Manualized Psychotherapy for Youth in a Residential Childcare Facility

AbstractCharacteristics of individuals with disruptive behavior disorders often include elevated externalizing behaviors such as impulsivity, defiance of authority and antagonism of social norms. Evidence shows that adolescents diagnosed with these types of disorders are particularly challenging to treat; however, therapies incorporating horses have shown some success. We examined the impact of an equine-assisted intervention compared to a non-manualized cognitive behavioral therapy in youth between 12- and 18-years old living in a residential childcare facility. Upon admittance, youth were administered three assessments: the Youth Self-Report, Adolescent Psychopathology Scale, and Basic Empathy Scale. Youth scoring in the clinical range for at least one externalizing subscale of the Youth Self-Report were assigned to equine-assisted intervention (EQI; N = 23) or non-manualized cognitive behavioral therapy (NM-CBT; N = 20) groups. Each group received a total of 7 h of treatment per week (three 2-hr group sessions and one 1-hr individual session) for 24 weeks. After 24 weeks of treatment, the same three assessments were administered a second time. There were no significant differences between the NM-CBT and EQI groups in the amount of change between assessments. A significant time effect was found for total externalizing behaviors in the Adolescent Psychopathology Scale and Youth Self-Report such that these measures were within the normal range after 24 weeks of treatment for participants in both groups.

Impact of flexible assertive community treatment model (FACT) on community rehabilitation of schizophrenia in Southern China.

Schizophrenia is a group of severe mental illnesses of unknown etiology, most of which are slow or subacute in young adults. 160 adult schizophrenic patients were randomly divided into an intervention group given FACT and a control group given routine mental health follow-up. The scale includes the Positive and Negative Syndrome Scale (PANSS), Social Disability Screening Schedule Scale (SDSS), and the World Health Organization's multicultural quality of life instrument in its brief form Scale(WHOQOL-BREF) were recorded. The average scores of positive scale, negative scale, general psychopathology scale and total score in PANSS scale before intervention(baseline) of the patients in the intervention group were 24.90 ± 5.43, 17.53 ± 3.84, 38.31 ± 4.09 and 80.54 ± 6.75. After 6 months and 12 months of intervention, positive scale, negative scale, general psychopathology scale and total score of the PANSS scale in the intervention group and the total score of SDSS all decreased significantly. The WHOQOL-BREF total score was significantly improved, and the differences were statistically significant (P < 0.05). The FACT intervention model has a significant effect on the rehabilitation of patients with schizophrenia in the community, improves their social function, and improves their quality of life.

Dysfunction of thalamocortical circuits in early-onset schizophrenia.

Previous studies have demonstrated that the thalamus is involved in multiple functional circuits in participants with schizophrenia. However, less is known about the thalamocortical circuit in the rare subtype of early-onset schizophrenia. A total of 110 participants with early-onset schizophrenia (47 antipsychotic-naive patients) and 70 matched healthy controls were recruited and underwent resting-state functional and diffusion-weighted magnetic resonance imaging scans. A data-driven parcellation method that combined the high spatial resolution of diffusion magnetic resonance imaging and the high sensitivity of functional magnetic resonance imaging was used to divide the thalamus. Next, the functional connectivity between each thalamic subdivision and the cortex/cerebellum was investigated. Compared to healthy controls, individuals with early-onset schizophrenia exhibited hypoconnectivity between subdivisions of the thalamus and the frontoparietal network, visual network, ventral attention network, somatomotor network and cerebellum, and hyperconnectivity between subdivisions of thalamus and the parahippocampal and temporal gyrus, which were included in limbic network. The functional connectivity between the right posterior cingulate cortex and 1 subdivision of the thalamus (region of interest 1) was positively correlated with the general psychopathology scale score. This study showed that the specific thalamocortical dysconnection in individuals with early-onset schizophrenia involves the prefrontal, auditory and visual cortices, and cerebellum. This study identified thalamocortical connectivity as a potential biomarker and treatment target for early-onset schizophrenia.

Widespread cortical and subcortical gray matter loss and an increase of globus pallidus volume in treatment-resistant schizophrenia

Introduction It is still being discussed whether treatment-resistant schizophrenia (TRS) is a biological subtype which differs from non-treatment-resistant schizophrenia or is it a more severe condition that affects brain worse than non-treatment-resistant schizophrenia. However, there are few and heterogeneous studies and the etiology of TRS remains quite unclear.ObjectivesThis study aimed to explore cortical and subcortical morphometric characteristics in TRS patients and its associations with the clinical features. The pilot stage comprises the comparison to the mentally healthy subjects.Methods 21 right-handed male patients (mean age 28.99 ± 8.08 years) fulfilling TRS criteria and 21 matched healthy controls (mean age 29.35 ± 7.41 years) underwent T1-weighted structural MRI at 3T Philips scanner and clinical examination. Images were processed using FreeSurfer 7.1.1. Cortical thickness and area, volumes of subcortical structures and separately volumes of the amygdala nuclei and hippocampal subregions were compared between groups. The morphometry data, PANSS (Positive and Negative Syndrome Scale), CDSS (Calgary Depression Scale for Schizophrenia) and daily chlorpromazine equivalent doses of antipsychotics were included in correlational analysis. Results were considered significant if they retained significance after correction for multiple comparisons.Results Compared to healthy controls, TRS patients showed decreased gray matter thickness in frontal, temporal, parietal, occipital, cingulate and insular regions (Figure 1). The temporal lobe showed the most prominent thinning of the cortex. The volumes of the amygdala, hippocampus (Figure 2) and nucleus accumbens, a number of amygdala nuclei and hippocampal subregions bilaterally were also decreased in TRS patients. The volume of the right globus pallidus, on the contrary, was increased (Figure 2). No correlations between altered cortical thickness, PANSS (positive, negative, general psychopathology scales and total score), CDSS and chlorpromazine equivalent doses of antipsychotics were found.Image:Image 2:Conclusions The widespread gray matter cortical and subcortical loss in TRS finds confirmation in the literature. The increased globus pallidus volume is an unexpected and intriguing result. Other studies demonstrated conflicting results on that point. Some studies reported possible therapy influence, others suggested possible associations with symptoms. We did not find any correlations with psychometric or therapy characteristics. It is possible that there are non-linear relationships or relationships that exist only at a certain stage of the disease. As for therapy, patients took individual medication, consisting of various antipsychotics and drugs from other pharmacological groups, and such heterogeneity could affect the results of the study. Further research is going to be carried out.Disclosure of InterestNone Declared

Sleep Matters: Unpacking the Link between Sleep Disorders and Clinical Characteristics in Schizophrenia.

IntroductionSleep disorders are a significant concern for patients with schizophrenia, and they can have a profound impact on their quality of life. Studies have shown that sleep disturbances are prevalent in patients with schizophrenia, and they may be linked to the clinical characteristics of the disorder. Despite this, the exact nature of the relationship between sleep disorders and schizophrenia remains unclear. Understanding this relationship is critical as it may lead to better diagnosis and treatment of both conditions, ultimately improving the overall health and wellbeing of patients.ObjectivesTo establish the link between sleep disorders and clinical characteristics in a clinical population being treated for schizophrenia.MethodsWe conducted a cross-sectional, descriptive, and analytical study that took place over a period of one month (from 1st to 31nd March 2023) among patients consulting the post-care service of Psychiatry Department D at Razi Hospital, Tunisia. We included patients aged between 18 and 65 years, diagnosed with schizophrenia according to DSM-5, and stabilized on psychiatric treatment. We used the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality over a period of one month. The evaluation of the clinical characteristics of schizophrenia was carried out using the Positive and Negative Syndrome Scale (PANSS).The interview was conducted by a single researcher, and when the questionnaire was distributed to the participants, we explained the framework and the principle of this study as well as the implications of participating in it and explained that the participant could stop participating at any time if he or she wished.Results We collected data from 30 male patients with a mean age of 42.5 ± 14.02. The mean overall PSQI score was 9.23 ± 4.58. The subscales evaluating the subjective quality of sleep obtained an average score of 1.42 ± 0.72, sleep latency was 1.61 ± 1.33, sleep duration was 1.01 ± 0.98, habitual sleep efficiency was 0.67 ± 0.75, sleep disturbances were 0.91 ± 0.52, sleep medication use was 1.36 ± 1.68, and daytime dysfunction was 1.12 ± 0.96. The mean scores of PANSS were: positive scale (28.26 ± 5.93), negative scale (18 ± 6.15), and general psychopathology scale (90.03 ± 16.21). We found a statistically significant association between the positive PANSS scale and sleep latency (p=0.002) and sleep medication use (p&lt;10-3).ConclusionsThe findings highlight the importance of evaluating and addressing sleep disturbances in the overall management of patients with schizophrenia, as they may have an impact on the severity of clinical symptoms.Disclosure of InterestNone Declared

Deriving the Transdiagnostic Scales From the Personality Assessment Inventory and SPECTRA: Indices of Psychopathology: A Demonstration.

Transdiagnostic models of psychopathology address many of the shortcomings common to categorical diagnostic systems. These empirically derived models conceptualize psychopathology as a few broad interrelated and hierarchically arranged dimensions, with an overarching general psychopathology dimension, the p-factor, at the apex. While transdiagnostic models are gaining prominence in mental health research, the lack of available tools has limited their clinical translation. The present study explored the potential of creating transdiagnostic scales from the joint factor structure of the Personality Assessment Inventory, Alternative Model of Personality Disorder trait scales (AMPD), and the clinical scales of the SPECTRA: Indices of Psychopathology (SPECTRA). Exploratory factor analysis in a clinical sample (n = 212) identified five factors corresponding to the Negative Affect/Internalizing, Detachment, Antagonism/Externalizing, Disinhibition/Externalizing, and Thought Disorder transdiagnostic dimensions. Goldberg's "Bass-Ackward" method supported a hierarchical structure. Five composite transdiagnostic scales were created by summing each factor's highest loading PAI and SPECTRA scales. A global psychopathology scale was created by summing the five composite scales. All the composite scales demonstrated adequate internal consistency. Correlations between the composite scales and the NEO Five-Factor Inventory-3 provide initial validity evidence for four composite and global scales. The composite thought disorder scale had no conceptually corresponding NEO domain. Clinical implications and study limitations are discussed.

Aberrant salience in cannabis-induced psychosis: a comparative study.

Natural Cannabis (NC) and Synthetic Cannabinoids (SCs) use can increase the risk and exacerbate the course of psychotic disorders. These could be influenced by the Aberrant Salience (AS) construct. It refers to an excess of attribution of meaning to stimuli that are otherwise regarded as neutral, thereby transform them into adverse, dangerous, or mysterious entities. This leads the patient to engage in aberrant and consequently incorrect interpretative efforts concerning the normal perception of reality and its relationship with our analytical abilities. AS appears to play a significant role in the onset and perpetuation of psychotic disorders. The internal conflict arising from aberrant attributions of significance leads to delusional thoughts, ultimately culminating in the establishment of a self-sustaining psychosis. To examine the differences between psychoses course not associated with cannabis use and those associated with NC-use and SCs-use, in terms of psychotic and dissociative symptoms, AS, global functioning and suicidal ideation. A sample of 62 patients with First Episode Psychosis (FEP) was divided into 3 groups: non cannabis users (non-users, N = 20); NC-users or rather Delta-9-tetrahydrocannabinol (THC) users (THC-users, N = 21); SCs-users, commonly referred to as SPICE-users (SPICE-users, N = 20). Each group underwent assessments at the onset of psychotic symptoms, as well as at the 3 months and 6 months marks, utilizing a range of psychopathological scales. These included the Positive and Negative Syndrome Scale (PANSS) for investigating psychotic symptoms, the Global Assessment of Functioning (GAF) scale for assessing overall functioning, the Dissociative Experiences Scale (DES-II) for measuring dissociative symptoms, the Scale for Suicide Ideation (SSI) for evaluating suicidal ideation and the Aberrant Salience Inventory (ASI) scale for gauging AS. SPICE-users showed more severe and persistent positive symptoms, while negative symptoms were mostly represented among non-users. Non-users showed better recovery than SPICE-users in global functioning. All groups showed a decrease in both ASI scores and subscale scores. SPICE-users exhibited higher global AS scores and less improvement in this aspect compared to other groups. This study may help understanding the role of AS in both non-substance-related and substance-induced psychosis. This knowledge may lead clinician to a better diagnosis and identify patient-tailored psychopharmacological treatment.

Adolescent Well Being: Positive Vs Autocratic School Culture

Reinforcing positive characteristics and minimizing individual weaknesses is what practice of Positive Psychology should be aimed at. In this study, an investigator has analyzed the effect of Indian Values Based-Positive-Encouraging Vs Highly Disciplined-Autocratic School Culture on Adolescent Psychopathology. Randomly selected 220 adolescent (Boys &amp; Girls) students (Mean Age = 14.2 years) from two Day-Boarding Schools of Nagpur, Maharashtra were assigned to Between Group Design. They were administered Adolescent Psychopathology Scale (short form) by Dr. William Rynolds which consist of 12 clinical scales focused on DSM-IV symptomatology. Data collected was analyzed to find out the major areas of psychopathology in adolescents belonging to different type of school cultures. It has been found that adolescent students from Highly Disciplined-Autocratic School Culture are significantly higher on Conduct Disorder, Generalized Anxiety Disorder, Eating Disorder, Depression, Interpersonal Problems and Oppositional Defiant Disorder. These results indicate towards the need of cultivating positive culture at Institutional level and inculcating Human Strengths and Virtues in upcoming generation for better prospects. Investigator believes that this study suggests insightful ways of developing and practicing competent avenues to fulfill the basic endeavor of Education.

An Examination of the MMPI-2 and MMPI-2-RF Validity Scales in Detecting Malingering and Dissimulation of Psychopathology

This article examined the responsiveness of the MMPI-2 and MMPI-2-RF validity scales to simulation and dissimulation of psychopathology. Two experiments were performed. The simulation study included 66 participants (33 in the control group and 33 in the experimental group, age M = 36.76, SD = 15.24) and the dissimulation study included 60 patients diagnosed with a mental disorder (30 in the control group and 30 in the experimental group, M = 40.32, SD = 15.79). In both experiments, all participants completed the MMPI-2 questionnaire. Participants in the control group were given standard instructions, while participants in the experimental groups received instructions to either simulate symptoms of mental disorders or present themselves as completely healthy. Differences in the expected direction of the MMPI-2 psychopathology scales between the experimental and control groups indicated that the study instruction had an effect on the responses of the study participants. The results of the comparison of the validity scales showed that the majority of the MMPI-2 and MMPI-2-RF scales respond to an attempt to provide false information about oneself. Estimates of validity scales were statistically significantly different between control and experimental groups in both simulation and dissimulation studies, and the difference effect was mostly large. The obtained results show that the MMPI-2 and MMPI-2-RF are able to successfully recognize the simulation and dissimulation of psychopathology, which can be of practical value to specialists who seek to differentiate subjects who answer honestly from those who are feigning during psychological assessment.

Efficacy and acceptability of adjunctive n-acetylcysteine for psychotic disorders: Systematic review and meta-analysis.

N-acetylcysteine (NAC) augmentation of antipsychotic medication has been studied in psychotic disorders but the results are inconsistent. This meta-analysis aimed to evaluate the efficacy and acceptability of NAC as an augmentation strategy for psychotic disorders. PubMed, Web of Science, EMBASE, PsycINFO, Cochrane Library, and ClinicalTrials.gov were searched until the date of November 28, 2022. The inclusion criteria were randomized controlled trials (RCTs) comparing NAC and placebo in patients with psychotic disorders. The outcomes were the psychotic symptoms measured by the Positive and Negative Syndrome Scale (PANSS) and drop-out rates. A total of 594 patients from eight trials were included. The results showed that no difference was found in score changes of PANSS total, positive, negative, or general psychopathology scale scores between the NAC group and placebo group in both time points (≤24weeks and >24weeks). There was also no statistical difference in drop-out rates between the two groups. For the moment, it is not appropriate to recommend NAC as an augmentation of antipsychotic medication to treat psychotic disorders in routine clinical practice.

Longitudinal and transcultural assessment of the relationship between hallucinogens, well-being, and post-traumatic growth during the COVID-19 pandemic

The COVID-19 pandemic has had a devastating impact on the health and wellbeing of the global population. This paper presents the results of a longitudinal transcultural study that was begun at the peak of the pandemic (in April, 2020). An online survey was used to collect data from English-, Spanish-, and Portuguese-speaking participants. The survey collected information about sociodemographics, lifestyle activities, COVID-19-related circumstances, and drug use (with an emphasis on hallucinogenic drugs), as well as involving psychometric questionnaires. Users of hallucinogenic drugs had higher psychological well-being and lower scores on psychopathology scales, both at baseline and during follow-ups. This difference was larger when users were distinguished by frequency of use, as regular users scored higher on psychological well-being and lower on psychopathology scales. Subjects with more psychological distress had lower scores for all scales of post-traumatic growth, but if they were regular hallucinogens users, they had higher scores for post-traumatic growth. When comparing the results between cultural contexts, heterogeneous results were obtained. There were more English-speaking regular users of hallucinogenic drugs. Further research should analyse the potential role of hallucinogens in large-scale catastrophes, with a special focus on post-traumatic growth.

Effectiveness of Adjuvant Treatment of N-Acetylcysteine on Negative Symptoms and Neutrophil-Lymphocyte Ratio (NLR) in Schizophrenic Patients

Highlights:1. The essence of schizophrenia is the negative symptoms.2. Adding meloxicam can improve the negative symptoms and changes in the NLR in schizophrenic patients. AbstractIntroduction: Schizophrenia is a mental disorder that has a negative symptom domain. Negative symptoms are commonly referred to as the essence of schizophrenia. Treatment of negative symptoms is still considered less than optimal. The ratio of neutrophils and lymphocytes is one of the markers of inflammation. This study aimed to analyze the effectiveness of N-acetylcysteine as adjuvant therapy for improving negative symptoms and changes in the neutrophil-lymphocyte ratio (NLR) in schizophrenic patients. Methods: This was a quasi-experimental study using a single-blind, pretest–post-test design. The subjects were 34 schizophrenic patients who were inpatients at Dr. Arif Zainuddin Regional Mental Hospital (RSJD), Surakarta, from May to July 2020. The subjects were assigned using a purposive sampling technique based on inclusion criteria and received adjuvant N-acetylcysteine therapy at 400 mg/day for 4 weeks. Data collection was obtained from medical records, interviews, field notes, positive scale, negative scale, and general psychopathology scale (PANSS) assessment sheets, and blood NLR examinations. Data analysis used SPSS 25.0.Results: There was a significant difference between the treatment and control groups in reducing negative PANSS subscale measurement after adjuvant N-acetylcysteine treatment. However, there was no significant difference between the control and treatment groups after N-acetylcysteine administration for NLR.Conclusion: The dose of adjuvant therapy N-acetylcysteine given to patients in this study had an effect on decreasing the negative subscale PANSS score.

The Effectiveness of Meloxicam Adjuvant Therapy against Negative Symptoms and Neutrophil Lymphocyte Ratio (NLR) in Schizophrenic Patients

Highlights:1. The NLR value can show the role of neuroinflammation in schizophrenic patients.2. Meloxicam as adjuvant therapy can improve negative symptoms and changes in the NLR in schizophrenic patients. AbstractIntroduction: Neutrophil-lymphocyte ratio is a simple and affordable marker of inflammation that has recently been widely used to assess systemic inflammation in psychiatric patients. This study aimed to determine and analyze the effectiveness of meloxicam as adjuvant therapy to improve negative symptoms and changes in the neutrophil-lymphocyte ratio (NLR) in schizophrenic patients. Methods: This was a quasi-experimental study using a single-blind, pretest–post-test design. Subjects were determined using a purposive sampling technique based on inclusion criteria. This study examined 34 samples and divided them into two groups. The treatment group consisted of 17 subjects who received adjuvant therapy with meloxicam 15 mg/day for 4 weeks and 17 subjects in the control group. Data collection was obtained from medical records, interviews, field notes, positive scale, negative scale, and general psychopathology scale (PANSS) assessment sheets, and blood NLR examinations. Data analysis used SPSS 25.0.Results: The negative subscale PANSS score in the treatment group decreased lower than in the control group, with p-value = 0.640. However, the decrease in NLR values was more significant in the treatment group than in the control group, with p-value = 0.094. There was a decrease in the negative subscale PANSS scores and clinical NLR scores, but it was not statistically significant.Conclusion: Adjuvant therapy with Meloxicam, given once a day for four weeks, had an effect on decreasing the negative subscale PANSS score and NLR scores for schizophrenic patients at Dr. Arif Zainudin Regional Mental Hospital (RSJD), Surakarta, clinically, but it was not statistically significant.

The Differences in Adjuvant Therapy Effectiveness Meloxicam and N-Acetylcysteine against Negative Symptoms of Schizophrenia

Highlights:1. Schizophrenic patients can have negative symptoms.2. Adjuvant therapy is needed to assist antipsychotics in reducing the negative symptoms of schizophrenic patients. AbstractIntroduction: Meloxicam and N-Acetylcysteine are examples of drugs with anti-inflammatory effects that have been widely studied, and are considered to reduce negative symptoms of schizophrenia. Both of these drugs are also widely available in Indonesia and can be obtained at an affordable price. This study aimed to analyze the differences in the effectiveness of adjuvant therapy meloxicam and N-Acetylcysteine on negative symptoms of schizophrenic patients. Methods: This was a quasi-experimental study using a single-blind, pretest–post-test design. Determination of the subject used a purposive sampling technique according to the inclusion criteria. This study examined 34 samples and divided them into two groups. In group A, 17 subjects received adjuvant meloxicam therapy of 15 mg/day for 4 weeks; in group B, 17 subjects received adjuvant therapy of N-Acetylcysteine 400 mg/day for 4 weeks. Score assessment was performed using the positive scale, negative scale, and general psychopathology scale (PANSS) negative subscale pre- and post-therapy, then compared the effectiveness. Data analysis used SPSS 25.0.Results: The mean score of the PANSS post-test subscale was negative in the meloxicam adjuvant therapy group 15.58, while for the N-Acetylcysteine adjuvant therapy group was 17.64 with a p-value of 0.009. The mean decrease in the negative subscale PANSS score in the meloxicam adjuvant therapy group was 11.00, while the N-Acetylcysteine adjuvant therapy group was 19.70 with a p-value of 0.000.Conclusion: There was no difference in the effectiveness of adjuvant therapy meloxicam and N-Acetylcysteine in improving negative symptoms of schizophrenic patients.

Sleep Disturbances in Panic Disorder with Comorbid Complex PTSD: A Possible Relationship and Different Psychopathology?

Several studies have shown the possible link between trauma and sleep disturbances, particularly in anxiety disorders. This issue could be because sympathetic hyperarousal is central to both disorders, probably caused by a dysregulation of the noradrenergic system. This study aimed to establish if the comorbidity with complex post-traumatic stress disorder (cPTSD) is associated with sleep disturbances in panic disorder (PD) and if the presence of poor sleep quality is associated with a higher psychopathological burden. Participants (N = 211) with PD completed the International Trauma Questionnaire concerning their most troubling experience, the Hamilton Anxiety Rating Scale (HAM-A), and the Pittsburgh Sleep Quality Index (PSQI) to assess anxiety symptoms and sleep disturbances, respectively. The sample was divided into two subgroups based on the presence of cPTSD. No significant differences emerged in the bivariate analyses for what concerns sociodemographic features. As for the scores of the psychopathological scales, the analysis highlighted statistically significant differences between the subgroups. Subjects with cPTSD reported significantly higher HAM-A total scores. As for the disturbances in self-organization (DSO) and PSQI scores, these were all significantly higher in the cPTSD subsample. At the logistic regression, the presence of cPTSD was inserted as the dependent variable, while the PSQI scores of the subscales evaluating subjective sleep quality, sleep duration, sleep efficacy, and the use of hypnotics were used as independent variables. The presence of cPTSD was significantly associated with the PSQI subscores for subjective sleep quality and use of hypnotics. Patients with PD exhibit more severe sleep disturbances and a higher anxiety burden when experiencing prolonged trauma. Therapeutic advances are needed in this field to target these symptomatologic domains.

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.

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.

Inflammatory Markers and Brain Volume in Patients with Post-traumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is characterized by increased inflammatory processing and altered brain volume. In this study, we investigated the relationship between inflammatory markers and brain volume in patients with PTSD. Forty-five patients with PTSD, and 70 healthy controls (HC) completed clinical assessments and self-reported psychopathology scales. Factors associated with inflammatory responses including brain-derived neurotrophic factor and four inflammatory biomarkers (C-reactive protein, cortisol, Interleukin-6, and homocysteine) and T1-magnetic resonance imaging of the brain were measured. In the PTSD group, cortisol level was significantly lower (t = 2.438, p = 0.046) than that of the HC. Cortisol level was significantly negatively correlated with the left thalamus proper (r = -0.369, p = 0.035), right thalamus proper (r = -0.394, p = 0.014), right frontal pole (r = -0.348, p = 0.039), left occipital pole (r = -0.338, p = 0.044), and right superior occipital gyrus (r = -0.397, p = 0.008) in patients with PTSD. However, these significant correlations were not observed in HC. Our results indicate that increased cortisol level, even though its average level was lower than that of HC, is associated with smaller volumes of the thalamus, right frontal pole, left occipital pole, and right superior occipital gyrus in patients with PTSD. Cortisol, a major stress hormone, might be a reliable biomarker to brain volumes and pathophysiological pathways in patients with PTSD.