European Archives of Psychiatry and Clinical Neuroscience最新文献

Cannabis use is highly prevalent in individuals with psychosis, raising concerns about its influence on brain function. Electroencephalography (EEG) studies have identified alterations in brain activity in psychosis, including changes in spectral entropy (SE) modulation and connectivity strength (CS). However, the degree to which cannabis use contributes to these alterations remains unclear. This study investigated the effects of recent cannabis use on specific EEG measures previously found to be altered in psychosis: (i) SE modulation, (ii) pre-stimulus theta and broadband CS, and (iii) baseline CS in the gamma band. We focused specifically on the immediate effects of recent cannabis use, without considering factors like tetrahydrocannabinol content, frequency of use, or age of onset. We included 93 patients with psychosis (32 recent cannabis users, 61 non-users) and 86 age- and sex-matched healthy controls (HC; all non-users). Recent cannabis use was defined as any consumption within the past week, assessed through a clinical interview and confirmed by urinalysis. Patients had diagnosis of schizophrenia or bipolar disorder. EEG data were recorded during a P300 task, and SE modulation and baseline CS were calculated. Both patient groups (cannabis users and non-users) exhibited significantly impaired SE modulation and elevated gamma and broadband CS, compared to HC. Crucially, no significant differences were found between the two patient groups in any of the EEG measures. Recent cannabis use does not appear to be the primary driver of the observed electrophysiological alterations in psychosis. Impaired SE modulation and increased CS are likely core features of psychosis itself, independent of recent cannabis exposure. This suggests that these EEG abnormalities may represent underlying vulnerability markers for psychosis. However, further research is needed to explore the potential long-term and early-onset effects of cannabis use on brain function in individuals with psychosis.

Obsessive-compulsive symptoms (OCS) frequently manifest in individuals with schizophrenia, affecting their prognosis and quality of life. The etiology of OCS in schizophrenia is complex, with theories ranging from subtype-specific manifestations to pharmacological influences. Notably, clozapine has been associated with a higher prevalence of OCS. However, the clinical factors influencing clozapine-induced OCS remain unclear. This cross-sectional study recruited individuals diagnosed with schizophrenia who were using clozapine, as well as a comparison group of individuals diagnosed with schizophrenia who were using other second-generation antipsychotics (SGA). Clinical assessments included OCS which were quantified using the Obsessive-Compulsive Inventory-Revised (OCI-R). 189 Participants were recruited, of whom 129 were taking clozapine and 60 other atypical antipsychotics. Statistical analyses, including moderated regression modeling, identified clinical factors influencing OCS occurrence. Clozapine users exhibited significantly higher OCI-R scores compared to non-clozapine users (p = 0.001). Moderated regression analysis revealed a moderating effect of negative symptom severity, indicating that when negative symptoms increased, the difference in OCI-R scores between clozapine and non-clozapine groups decreased. Other factors like duration of illness, medication duration, and psychopathology severity did not significantly moderate the group differences in OCI-R scores. As negative symptoms worsened, the impact of clozapine on OCS lessened, a pattern not seen with other antipsychotics. This suggests that clozapine's effect on OCS is specific and influenced by different mechanisms. The study recommends screening for OCS in patients with mild negative symptoms and further research into biological markers to better understand clozapine-induced OCS.

This study utilized network analysis to explore the intricate relationships between anxiety, depression, and quality of life in a cohort of hospitalized schizophrenia patients. Through a cross-sectional design, the investigation aimed to identify key symptoms and bridge connections to inform tailored clinical interventions and improve patient well-being. Symptom severity was measured using the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Schizophrenia Quality of Life Scale, with network analysis elucidating central nodes and bridging symptoms within the patient sample of 1328 individuals. Findings revealed psychic anxiety, insomnia, and depressed mood as pivotal within the network, significantly impacting overall symptomatology and quality of life. Furthermore, symptoms such as tension and fears were identified as essential connectors among different symptom domains, highlighting potential intervention targets. The study underscores the complex dynamics between anxiety, depression, and quality of life in schizophrenia, advocating for an integrated treatment approach that focuses on critical symptoms to enhance overall well-being. This approach suggests a paradigm shift towards personalized care in schizophrenia management, aiming to optimize outcomes by addressing the root of symptom networks.

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.

Schizophrenia has been linked to an elevated cardiovascular risk profile and premature onset of cardiovascular disease. Quantifying epicardial adipose tissue (EAT) volume provides insight into its correlation with coronary artery disease (CAD) severity and associated risk factors. Previous research indicates higher pericardial adipose tissue in individuals with schizophrenia compared to non-schizophrenic counterparts. RBP4, FABP3, and FABP4 have been implicated in CAD pathogenesis. In this study, we examined the potential increase in EAT volume in individuals with chronic schizophrenia and aimed to elucidate the relationship between circulating levels of RBP4, FABP3, and FABP4 with EAT volume and coronary artery calcium score within this cohort. We recruited 186 consecutive patients with chronic schizophrenia and utilized enzyme-linked immunosorbent assay to assess plasma concentrations of RBP4, FABP3, and FABP4. Cardiac multislice computed tomography measured EAT volume and coronary artery calcium scores. Significantly higher EAT volume in patients with chronic schizophrenia compared to controls. RBP4 associated positively with metabolic factors and EAT volumes, while FABP3 associated positively with creatinine and coronary atherosclerosis markers. FABP4 showed positive associations with metabolic factors, hypertension, and EAT volumes, but negative associations with HDL-C and eGFR. Logistic regression identified RBP4 and FABP4 as independent factors associated with increased EAT volumes, even after adjusting for known biomarkers. Both RBP4 and FABP4 were significantly associated with metabolic syndrome components and EAT volume. This study elucidates the association between chronic schizophrenia and augmented EAT volume, suggesting plausible correlations with CAD-related health complications through RBP4 and FABP4 pathways.

Background: Personality traits influence symptoms, functioning, and illness trajectory in chronic psychosis. However, their role in early-stage psychosis remains poorly defined, particularly regarding potential differences from healthy controls and their association with clinical outcomes.

Methods: We conducted a systematic review and meta-analysis of studies assessing personality domains in early-stage psychosis using validated dimensional instruments. Searches were performed in PubMed/MEDLINE, CINAHL, and Web of Science until March 2025. The meta-analysis included studies using the NEO Five-Factor Inventory (NEO-FFI), with patient scores compared to published normative data. Studies reporting T-scores and those reporting raw scores were analyzed separately. Associations between personality domains and clinical features were narratively synthesized.

Results: Eighteen studies met the inclusion criteria; eight were included in the meta-analysis (n = 1109). Considering studies reporting T-scores, individuals with early-stage psychosis showed higher neuroticism (MD = 27.4, 95% CI [25.0 to 29.9]) and lower extraversion (MD = -6.0, 95% CI [-8.6 to -3.5]) and conscientiousness (MD = -5.5, 95% CI [-7.9 to -3.2]), relative to normative data. Analyses of studies reporting raw scores showed similar effects, though not statistically significant. The same personality domains were consistently associated with symptom severity, treatment adherence, functioning, and service use.

Conclusions: Early-stage psychosis may be characterized by a specific personality profile that modulates clinical presentation. Early personality assessment may guide tailored treatment strategies. Longitudinal studies are needed to clarify their prognostic relevance and potential role in the personalization of treatment.

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.