European Archives of Psychiatry and Clinical Neuroscience最新文献

This study aims to identify the factors influencing the age of first hospitalization in patients with chronic schizophrenia, focusing on clinical features and blood parameters. A total of 1271 patients diagnosed with chronic schizophrenia were recruited from 17 psychiatric hospitals across China. Demographic and clinical data, including age of first hospitalization, were collected. The study also included assessments of psychiatric symptoms, duration of untreated psychosis (DUP), and various blood parameters. Statistical analyses were conducted to examine the relationships between these factors and the age of first hospitalization. The average age of first hospitalization was 28.07 ± 9.993 years. Single patients and those with a family history of mental illness were hospitalized at a younger age. Patients with suicidal ideation or behavior also had an earlier hospitalization age compared to those without such history. Regression analysis revealed that marital status (single), family history of mental illness, and suicide ideation or behavior were significant risk factors for earlier hospitalization age. Conversely, DUP, total protein (TP), and low-density lipoprotein (LDL) levels were positively correlated with the age of first hospitalization, while antipsychotic medication dosage and albumin (ALB) levels were negatively correlated. The study identifies significant demographic, clinical, and biochemical factors associated with the age of first hospitalization in chronic schizophrenia patients in China. These findings underscore the importance of early intervention and targeted support for high-risk groups to improve treatment outcomes.

Auditory verbal hallucinations (AVHs) in schizophrenia are hypothesized to involve alterations in hemispheric lateralization, but the specific neural mechanisms remain unclear. This study investigated functional intra- and inter-hemispheric connectivity to identify lateralization patterns unique to AVHs. Resting-state fMRI data were collected from 60 schizophrenia patients with persistent AVHs (p-AVH group), 39 patients without AVHs (n-AVH group), and 59 healthy controls (HC group). Using a homotopic atlas, we quantified lateralization indices of functional segregation and integration across 200 homotopic ROI pairs. Segregation was defined as the degree of preferential intra-hemispheric communication within each hemisphere versus inter-hemispheric communication. Integration was used to assess the extent of inter-hemispheric communication between the two hemispheres. Our findings revealed a significant rightward lateralization of segregation in two lateral prefrontal cortex homotopic pairs in the p-AVH group. Additionally, we observed a leftward lateralization of integration in an inferior parietal lobule homotopic pair within the temporoparietal junction region, specifically in the p-AVH group. Importantly, the lateralization index of segregation in the prefrontal cortex was negatively correlated with AVH severity, indicating that greater rightward lateralization is associated with more severe AVHs. These lateralization changes were absent when comparing the n-AVH group to HC group, suggesting they are unique to AVHs in schizophrenia. Our results underscore the pivotal role of altered hemispheric lateralization of functional segregation and integration in the etiology of AVHs, providing new insights into the neural mechanisms underlying these symptoms.

Recent studies suggested that structural changes in the cerebellum are implicated in the pathophysiology of bipolar disorder (BD). Here, we aimed to characterize the structural alterations of cerebellar lobules in BD, evaluating their possible relation with those occurring in the rest of the brain. One-hundred-fifty-five type I BD patients were recruited and compared with one-hundred-nineteen controls subjects. Cerebral cortical thickness (CT) was evaluated vertex-wise, while cerebellar CT at the level of its twelve lobules. A widespread pattern of cortical thinning was found in several clusters of BD patients. In the cerebellum, we found an anterior thinning (lobule I_II, III, X) and a posterior thickening (crus I, crus II, lobule VI and lobule IX) of its lobules in BD. Exploring the relation between cerebral and cerebellar CT changes in BD patients, after correcting for age and disease duration, the CT of a large subset of cerebral regions, found thinned in BD, were also inversely correlated with the thickening of cerebellar lobule IX. We speculate that this lobule may undergo adaptive changes to compensate the widespread cortical thinning which characterizes BD syndrome. Such a compensatory adaptation of the cerebellum would be similar to that found in other neurological and psychiatric disorders.

Psychological resilience is a key factor for societal and military stability when faced with terror attacks and/or war. The research presents physiological findings-obtained with the electrodermal activity (EDA) and Auditory Sustained Attention Test (ASAT)-on stress responses, attentional and emotion regulation abilities in 57 Israel Defense Force male and female combat soldiers during the ongoing Israel-Hamas war. In addition, it shows self-reported resilience scores and post traumatic symptomatology measured by questionnaires and explores the relationship between the subjective and objective data. Compared to male soldiers, female soldiers showed significantly higher hyperarousal symptoms yet showed a tendency to a significantly lower specific skin conductance response (on the EDA) to the first startle sound. Furthermore, the self-reported acute stress symptoms positively and significantly correlated with the physiological emotion regulation measured by startle responses, and negatively correlated with attentional regulation measured by the ASAT. The lack of gender differences in stress level, resilience and self-regulation abilities emphasizes the high capabilities of women combat soldiers, especially due to gender-related risks in combat. Relatively high scores of acute stress symptomology in the population of combat soldiers invite later screening and assessment for the prevention of post traumatic disorders in vulnerable individuals. The combination of physiological measures and questionnaires highlights possible report biases, and thus underscores the importance of combining these objective/subjective measures for adequate assessment of resilience and post traumatic symptomology.

The β-site amyloid precursor protein-cleaving enzyme 1 (BACE1) gene polymorphism (rs638405) has been widely reported to be associated with Alzheimer's disease (AD) risk. However, studies on the relationship between BACE1 gene polymorphism (rs638405), brain volume, and cognition in AD patients remain scarce. To investigate the effect of genetic polymorphism in BACE1 on gray matter volume (GMV) and cognition in AD, this study recruited 111 cognitively unimpaired (CU) controls and 144 AD patients. The effect of BACE1 rs638405 polymorphism on cognition was explored in CU and AD groups. Then the interaction effect of the diagnosis and BACE1 rs638405 polymorphism on GMV was performed, following the post-hoc analysis of regions of interest (ROIs) in interaction analysis. Mediation analysis was used to elucidate the relationship among genotypes, ROIs and cognition. BACE1 rs638405 G carriers (BACE1 G+) showed significantly lower scores in global cognition and memory function than noncarriers (BACE1 G-) in AD group. Genotypes (G+/G-) and diagnosis (CU/AD) have interaction on GMV of medial temporal lobe (MTL) including the left parahippocampus and right hippocampus. Post-hoc analysis revealed that BACE1 G+ exhibited significantly lower GMV in ROIs compared to BACE1 G- in AD. Finally, mediation analysis further demonstrated that the GMV of ROIs mediated the effect of BACE1 rs638405 polymorphism on cognition in AD. Our results emphasize the BACE1 rs638405 gene polymorphisms may affect the GMV of MTL and cognition in AD, deepening the understanding of AD pathogenesis.