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Paradoxical Sensitivity to Sub-threshold Asynchronies in Schizophrenia: A Behavioral and EEG Approach 精神分裂症对亚阈值异步的矛盾敏感性:一种行为和脑电图方法
Pub Date : 2021-01-01 DOI: 10.1093/SCHIZBULLOPEN/SGAB011
J. E. Marques-Carneiro, Julien Krieg, C. Duval, T. Schwitzer, A. Giersch
The flow of consciousness is disrupted and disorganized in schizophrenia. We explore the hypothesis that this disruption is related to asynchronies not being predicted in advance and standing out instead of being integrated in the flow of events. We recorded EEG continuously during a simultaneity/asynchrony discrimination task, in which subjects decide whether 2 squares are shown simultaneously or with an asynchrony (asynchronies were between 24 and 96 ms). Behavioral data was obtained in 32 patients with schizophrenia and 27 matched controls, and EEG was recorded in a subset of 17 patients vs 15 controls. Two results suggested a lack of asynchrony prediction in patients. Behavioral difficulties at detecting asynchronies increased in patients with schizophrenia relative to controls after a detection of simultaneity, and this effect was correlated with clinical disorganization. Desynchronization of alpha activity observed before the beginning of a trial was larger after asynchronous than simultaneous responses in controls, but not in patients. EEG signals additionally suggested abnormal sensitivity to short asynchronies in patients. The amplitude of early signals around 180 ms after the first square abnormally increased in patients for short asynchronies relative to perfect simultaneity, whereas EEG signals at parietal regions decreased in amplitude in patients relative to controls, in the 400–600 ms interval after the first square. These results reinforce the hypothesis of time prediction and sequencing impairments at the sub-second level and may provide an explanation for the disruption of the patients’ consciousness flow.
精神分裂症患者的意识流被打乱和打乱。我们探索了这样一个假设,即这种中断与未提前预测的异步有关,并且突出而不是集成在事件流中。我们在同时/异步辨别任务中连续记录脑电图,在此任务中,受试者决定两个正方形是同时显示还是异步显示(异步显示在24 - 96 ms之间)。在32例精神分裂症患者和27例匹配的对照组中获得了行为数据,并在17例患者和15例对照组中记录了脑电图。两个结果表明患者缺乏异步预测。在同时性检测后,精神分裂症患者在检测异步性方面的行为困难相对于对照组增加,并且这种影响与临床混乱相关。在试验开始前观察到的α活动的不同步在对照组中异步反应后比同步反应后更大,但在患者中没有。脑电图信号还提示患者对短时间异步异常敏感。相对于完全同时性,短时间非同步性患者在第一个方格后180 ms左右的早期信号幅度异常增加,而在第一个方格后400-600 ms的间隔内,患者顶叶区域的脑电图信号幅度相对于对照组下降。这些结果在亚秒水平上加强了时间预测和排序障碍的假设,并可能为患者意识流动的中断提供解释。
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引用次数: 8
Childhood Trauma and Psychotic Symptomatology in Ethnic Minorities With Schizophrenia 少数民族精神分裂症患者的童年创伤与精神症状
Pub Date : 2021-01-01 DOI: 10.1093/SCHIZBULLOPEN/SGAA068
Jeremy D. Levit, Jorge Valderrama, Penelope Georgakopoulos, Aa-Gpc Brooklyn, Stella Kim Hansen, M. Salisu, A. Fanous, T. Bigdeli, J. Knowles, C. Pato, M. Pato, C. Pato, M. Pato
In response to recent findings implicating trauma in the phenomenology of psychosis, this study explored interactions between adverse childhood experiences (ACEs) and positive symptoms of psychosis in an understudied patient population, comprising individuals of African and Latino ancestry. Endorsement of ACEs was compared between 90 schizophrenia cases and 240 nonpsychotic controls, matched for ethnicity, gender, and age. Relative to controls, cases reported significantly greater exposure to physical abuse, emotional abuse, sexual abuse, neglect, witnessing domestic violence, and household member incarceration. Analyses further evaluated associations between ACEs and subtypes of hallucinations, delusions, and subjective thought disorder. Among female cases, the number of hallucinatory symptoms present increased with increasing ACE score. Hallucinatory symptoms further correlated with individual ACE items. For instance, third-person voices were more common among women exposed to childhood physical and emotional abuse. Interestingly, among women, grandiose delusions were negatively related to sexual abuse, perhaps reflecting the deleterious effects of sexual trauma on the development of a positive self-concept. Among male cases, no positive relationships with hallucinations were observed, but several delusional symptoms were correlated with childhood trauma experiences. The most statistically powerful ACE associations, in both males and females, were observed with experiences of thought broadcasting. This article further advocates for the consideration of ethnicity and gender as factors influencing trauma exposures and their clinical manifestations.
为了回应最近发现的精神现象学中的创伤,本研究在一个未充分研究的患者群体中探讨了不良童年经历(ace)和精神病阳性症状之间的相互作用,包括非洲和拉丁裔个体。我们比较了90例精神分裂症患者和240例非精神病对照者对ace的支持,这些对照者的种族、性别和年龄相匹配。与对照组相比,这些病例报告的遭受身体虐待、精神虐待、性虐待、忽视、目睹家庭暴力和家庭成员监禁的情况明显更多。分析进一步评估了ace与幻觉、妄想和主观思维障碍亚型之间的关系。在女性病例中,出现幻觉症状的次数随着ACE评分的增加而增加。幻觉症状与个别ACE项目进一步相关。例如,在童年遭受身体和精神虐待的女性中,第三人称声音更为常见。有趣的是,在女性中,浮夸妄想与性虐待呈负相关,这也许反映了性创伤对积极自我概念发展的有害影响。在男性病例中,没有观察到与幻觉呈正相关,但一些妄想症状与童年创伤经历相关。从统计上看,在男性和女性中,最强大的ACE关联是在思想传播的经历中观察到的。本文进一步提倡考虑种族和性别作为影响创伤暴露及其临床表现的因素。
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引用次数: 2
Inpatient Treatment of People With Schizophrenia: Quantifying Clinical Change Using the Health of the Nation Outcome Scales 精神分裂症患者的住院治疗:使用国家健康结果量表量化临床变化
Pub Date : 2021-01-01 DOI: 10.1093/schizbullopen/sgab030
B. Lay, P. Roser, W. Kawohl
Schizophrenia can require hospital inpatient care in crisis periods or times of severe symptoms, although the length of hospital stays has been considerably reduced in the last few decades. Evidence on individual outcomes under routine psychiatric practice conditions is sparse. This study aims to evaluate the outcomes of inpatient treatment in patients with schizophrenia using the reliable and clinically significant change approach. We used routinely collected Health of the Nation Outcome Scales (HoNOS) data to assess the extent to which and the areas where symptomatic and functional improvement was achieved. Data from 1783 schizophrenia patients admitted to a large psychiatric centre in Switzerland were examined. Mean HoNOS total score dropped from 17.9 to 11.7 (effect size 0.8) during treatment; the greatest improvements were achieved regarding symptomatic problems and aggressive, agitated behavior. According to the reliable change index formula, 24.5% of patients were to be considered improved, 73.3% unchanged and 2.2% deteriorated. In total, 56.6% were discharged from the hospital in a subclinical or mild functional state. The degree of individual improvement and time to achieve maximum symptom reduction varied considerably, depending on the patients’ functional state at admission, as did the length of hospital stay (median 28 days). Rates of readmission within 28 days (17.8%) were significantly lower in patients with clinically significant improvement, discharged in better clinical condition. These findings support reconsidering (length of) inpatient treatment within the overall framework of meaningful clinical change and subsequent treatment needs in patients with schizophrenia.
精神分裂症患者在危急时期或出现严重症状时可能需要住院治疗,尽管在过去几十年中住院时间已大大缩短。在常规精神病学实践条件下的个体结果的证据很少。本研究旨在评估精神分裂症患者住院治疗的结果,采用可靠和临床显著的改变方法。我们使用常规收集的国家健康结果量表(HoNOS)数据来评估症状和功能改善的程度和领域。对瑞士一家大型精神病中心收治的1783名精神分裂症患者的数据进行了研究。治疗期间平均HoNOS总分从17.9降至11.7(效应值0.8);在症状问题和攻击性、激动行为方面取得了最大的改善。根据可靠变化指数公式,24.5%的患者认为改善,73.3%的患者认为不变,2.2%的患者认为恶化。总共56.6%的患者出院时处于亚临床或轻度功能状态。个体改善的程度和达到最大症状减轻的时间差异很大,这取决于患者入院时的功能状态,住院时间也不同(中位28天)。临床有明显改善的患者28天内再入院率(17.8%)明显降低,出院时临床状况较好。这些发现支持在精神分裂症患者有意义的临床改变和后续治疗需求的总体框架内重新考虑住院治疗(长度)。
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引用次数: 2
Polygenic Risk for Schizophrenia, Brain Structure and Environmental Risk in UK Biobank 英国生物库中精神分裂症、大脑结构和环境风险的多基因风险
Pub Date : 2021-01-01 DOI: 10.1101/2021.04.15.21255587
Xingxing Zhu, J. Ward, B. Cullen, D. Lyall, R. Strawbridge, L. Lyall, Danny J. Smith
Schizophrenia is a heritable neurodevelopmental disorder characterized by neuroanatomical changes in the brain but exactly how increased genetic burden for schizophrenia influences brain structure is unknown. Similarly, the impact of environmental risk factors for schizophrenia on brain structure is not fully understood. We investigated how genetic burden for schizophrenia (indexed by a polygenic risk score, PRS-SCZ) was associated with cortical thickness (CT), cortical surface area (SA), cortical volume (CV) and multiple subcortical structures within 18,147 White British ancestry participants from UK Biobank. We also explored whether environmental risk factors for schizophrenia (cannabis use, childhood trauma, low birth weight and Townsend social deprivation index) exacerbated the impact of PRS-SCZ on brain structure. We found that PRS-SCZ was significantly associated with lower CT in the frontal lobe, insula lobe, lateral orbitofrontal cortex, medial orbitofrontal cortex, posterior cingulate cortex and inferior frontal cortex, as well as reduced SA and CV in the supramarginal cortex and superior temporal cortex, but not with differences in subcortical volumes. When models included environmental risk factors as covariates, PRS-SCZ was only associated with lower SA/CV within the supramarginal cortex, superior temporal cortex and inferior frontal cortex. Moreover, no interactions were observed between PRS-SCZ and each of the environmental risk factors on brain structure. Overall, we identified brain structural correlates of PRS-SCZ predominantly within frontal and temporal regions. Some of these associations were independent of environmental risk factors, suggesting that they may represent biomarkers of genetic risk for schizophrenia.
精神分裂症是一种以大脑神经解剖改变为特征的遗传性神经发育障碍,但精神分裂症的遗传负担增加究竟如何影响大脑结构尚不清楚。同样,精神分裂症的环境风险因素对大脑结构的影响也不完全清楚。我们调查了来自UK Biobank的18147名白人英国血统参与者的精神分裂症遗传负担(由多基因风险评分,PRS-SCZ索引)如何与皮质厚度(CT)、皮质表面积(SA)、皮质体积(CV)和多个皮质下结构相关。我们还探讨了精神分裂症的环境危险因素(大麻使用、童年创伤、低出生体重和Townsend社会剥夺指数)是否加剧了PRS-SCZ对脑结构的影响。我们发现,PRS-SCZ与额叶、岛叶、外侧眶额皮质、内侧眶额皮质、后扣带皮质和额下皮质的CT降低以及边缘上皮质和颞上皮质的SA和CV降低显著相关,但与皮质下体积差异不显著。当模型将环境风险因素作为协变量时,PRS-SCZ仅与边缘上皮层、颞上皮层和额下皮层内较低的SA/CV相关。此外,PRS-SCZ与各环境危险因素对脑结构的影响没有相互作用。总的来说,我们确定了PRS-SCZ的大脑结构相关性主要在额叶和颞叶区域。其中一些关联独立于环境风险因素,表明它们可能代表精神分裂症遗传风险的生物标志物。
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引用次数: 9
Does the Phenomenology of Auditory Hallucinations Differ Across Patients Having Severe Mental Illness With and Without Hearing Impairment? 有听力障碍和无听力障碍的严重精神疾病患者的幻听现象不同吗?
Pub Date : 2021-01-01 DOI: 10.1093/SCHIZBULLOPEN/SGAB001
K. Sadh, U. Mehta, K. Muralidharan, N. Shivashankar, S. Jain
We compared the experience of auditory hallucinations, in persons who have normal (HN; N = 20), or impaired hearing (HI; N = 20), while experiencing psychoses. We assessed this experience across 42 domains and observed that irrespective of the hearing status, patients most often heard voices mainly in the language that they had learnt first (χ2 = 5.584; P = .018). However, a few experienced hallucinations in languages they “did not know” (3/20; 15%). The voices were most often attributed to both males and females (35/40; 87.5%). Those with hearing impairment heard voices closer to their ears, a hubbub of voices of crowds talking to them, and “as if” stuck or repetitive; often in the hearing-impaired ear. The hearing-impaired subjects also reported hearing nonverbal auditory hallucinations more frequently (χ2 = 17.625; P = .001), and the voices lacked emotional salience (χ2 = 4.055; P = .044). In contrast, the hallucinations were experienced in elaborate detail by the HN (20/20), while those with HI often heard only simple sentences (14/20, P = 0.05). The intensity of the hallucinatory voices remained the same on closing the affected ear or both of the ears in the HI group as compared to the HN group. Interestingly, the use of hearing aids attenuated the intensity of the hallucinations (6/7; 85%) in those with HI.
我们比较了患有正常(HN;N = 20),或听力受损(HI;N = 20),同时出现精神病。我们评估了42个领域的这种体验,并观察到,无论听力状况如何,患者最常听到的声音主要是他们首先学习的语言(χ2 = 5.584;P = .018)。然而,少数人在他们“不知道”的语言中出现幻觉(3/20;15%)。这些声音通常被认为是男性和女性发出的(35/40;87.5%)。那些有听力障碍的人听到的声音离他们的耳朵更近,是人群对他们说话的嘈杂声,“好像”是固定的或重复的;常在听力受损的耳朵里。听力受损者报告非言语幻听的频率也更高(χ2 = 17.625;P = .001),声音缺乏情绪显著性(χ2 = 4.055;P = .044)。相比之下,HN患者的幻觉经历非常详细(20/20),而HI患者通常只听到简单的句子(14/20,P = 0.05)。与HN组相比,HI组在关闭受影响的耳朵或双耳时,幻觉声音的强度保持不变。有趣的是,助听器的使用减轻了幻觉的强度(6/7;85%)。
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引用次数: 1
My Addiction and Breaking Free From My Addiction 我的瘾与戒瘾
Pub Date : 2021-01-01 DOI: 10.1093/schizbullopen/sgab029
Rudy Tian
{"title":"My Addiction and Breaking Free From My Addiction","authors":"Rudy Tian","doi":"10.1093/schizbullopen/sgab029","DOIUrl":"https://doi.org/10.1093/schizbullopen/sgab029","url":null,"abstract":"","PeriodicalId":21348,"journal":{"name":"Schizophrenia Bulletin Open","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86779173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hyper-Coordinated DNA Methylation is Altered in Schizophrenia and Associated with Brain Function 精神分裂症患者超协调DNA甲基化改变与脑功能相关
Pub Date : 2021-01-01 DOI: 10.1093/schizbullopen/sgab036
Junfang Chen, Kristina Schwarz, Z. Zang, U. Braun, A. Harneit, T. Kremer, Ren Ma, J. Schweiger, C. Moessnang, Lena S. Geiger, Han Cao, F. Degenhardt, M. Nöthen, H. Tost, A. Meyer-Lindenberg, E. Schwarz
DNA methylation is an epigenetic biological process that is emerging as an important mediator of environmental risk effects on the susceptibility of severe illness, such as schizophrenia. DNA methylation shows coordination across biologically-related genes, but it is not known whether the resulting network structure has a mediating effect on illness risk. Here we identified a large gene network with hyper-coordinated DNA methylation in several biological processes that are changed in the brain of patients with schizophrenia, and that are associated with schizophrenia-relevant brain function as well as genetic illness susceptibility. We found that DNA methylation was physiologically coordinated in a reproducible network that comprised 6399 genes and showed a similar architecture in blood and brain. The network was hyper-coordinated in biological processes of core importance for schizophrenia, including synaptic processes that are associated with the strongest common genetic risk variants for schizophrenia. Coordinated methylation in these processes was decreased in brain samples from donors with schizophrenia, and showed an age-dependent association with schizophrenia-relevant brain function. These results support the coordination of DNA methylation as a regulatory principle relevant to schizophrenia that may be sensitive to environmental risk exposure during specific developmental periods and compound genetic illness predisposition.
DNA甲基化是一种表观遗传生物学过程,是环境风险对严重疾病(如精神分裂症)易感性影响的重要中介。DNA甲基化显示了生物相关基因之间的协调,但目前尚不清楚由此产生的网络结构是否对疾病风险有中介作用。在这里,我们发现了一个大型基因网络,在精神分裂症患者的大脑中改变了几个生物过程,这些过程与精神分裂症相关的大脑功能以及遗传疾病易感性相关。我们发现DNA甲基化在一个包含6399个基因的可重复网络中具有生理协调,并且在血液和大脑中显示出相似的结构。该网络在精神分裂症的核心重要生物学过程中高度协调,包括与精神分裂症最常见的遗传风险变异相关的突触过程。在精神分裂症供体的脑样本中,这些过程中的协同甲基化减少,并显示出与精神分裂症相关的脑功能存在年龄依赖性关联。这些结果支持DNA甲基化作为一种与精神分裂症相关的调节原则的协调,这种精神分裂症可能对特定发育时期的环境风险暴露和复合遗传疾病易感性敏感。
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引用次数: 0
Reducing Stigma Among College Students Toward People With Schizophrenia: A Randomized Controlled Trial Grounded on Intergroup Contact Theory 减少大学生对精神分裂症患者的耻辱感:基于群体间接触理论的随机对照试验
Pub Date : 2021-01-01 DOI: 10.1093/SCHIZBULLOPEN/SGAB008
Siyu Gao, S. Ng
Public stigma has been shown to have multidimensional negative impacts on people with schizophrenia (PWS). A new 1-day intervention grounded on the intergroup contact theory was developed and implemented in the current study to reduce college students’ stigma toward PWS. We hypothesized that intergroup contact could better alleviate the stigmatizing situation compared with absence of direct contact and different levels of contact may have different functions on stigma reduction. To examine the effectiveness of the intervention, a randomized controlled trial was conducted in Hong Kong with 37 college students participating the intervention. Different levels of contact (zero, moderate, and intimate) with PWS were organized in the intervention group while no direct contact with PWS was introduced in the control group. Participants’ knowledge of schizophrenia, stigmatizing attitudes and social distance toward PWS were measured at pre-, post, 1-month and 3-month after the intervention. Repeated-measures ANOVA revealed significant changes in all outcome variables in the intervention group with moderate-to-high effect sizes. The results indicated that different levels of contact with PWS had different functions in stigma reduction. Knowledge session without direct contact contributed most to participants’ knowledge improvement, and moderate and intimate level of contact led to an obvious improvement in participants’ stigmatizing attitudes and social distance changes. Also, psychoeducation and direct contact should be combined to tackle with the 3 components of stigma. The current study provided evidence supporting the efficacy of the new intervention based on intergroup contact theory and practical experience for future research design regarding stigma reduction.
公众耻辱感已被证明对精神分裂症患者具有多方面的负面影响。本研究以群体间接触理论为基础,提出并实施了一种新的为期1天的干预措施,以减少大学生对PWS的污名化。我们假设群体间接触比没有直接接触更能缓解被污名化的情况,并且不同程度的接触对污名化的减少可能有不同的作用。为了检验干预的有效性,我们在香港进行了一项随机对照试验,有37名大学生参与了干预。干预组组织不同程度的PWS接触(零接触、中度接触和亲密接触),对照组不直接接触PWS。分别于干预前、干预后、干预后1个月和干预后3个月测量被试对精神分裂症的认知、对PWS的污名化态度和社会距离。重复测量方差分析显示,干预组的所有结果变量都发生了显著变化,具有中高效应量。结果表明,不同程度的PWS接触对柱头还原有不同的作用。无直接接触的知识会话对被试的知识提升贡献最大,适度和亲密的接触对被试的污名化态度和社会距离变化有明显的改善。此外,心理教育和直接接触应该结合起来,以解决耻辱的三个组成部分。本研究为支持基于群体间接触理论的新干预措施的有效性提供了证据,并为未来减少耻辱感的研究设计提供了实践经验。
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引用次数: 4
The First Episode Psychosis Services Fidelity Scale 1.0: Review and Update 首发精神病服务忠实度量表1.0:回顾与更新
Pub Date : 2021-01-01 DOI: 10.1093/SCHIZBULLOPEN/SGAB007
D. Addington
The First Episode Psychosis Fidelity Scale, first published in 2016, is based on a list of essential components identified by systematic reviews and an international consensus process. The purpose of this paper was to present the FEPS-FS 1.0 version of the scale, review the results of studies that have examined the scale and provide an up-to-date review of evidence for each component and its rating. The First Episode Psychosis Services Fidelity Scale 1.0 has 35 components, which rate access and quality of health care delivered by early psychosis teams. Twenty-five components rate service components, and 15 components rate team functioning. Each component is rated on a 1–5 scale, and a rating of 4 is satisfactory. The service components describe services received by patients rather than staff activity. The fidelity rater completes ratings based on administrative data, health record review, and interviews. Fidelity raters from two multicenter studies provided feedback on the clarity and precision of component definitions and ratings. When administered by trained raters, the scale demonstrated good to excellent interrater reliability. The selection of components can be adjusted to rate programs serving patients with bipolar disorder or an attenuated psychosis syndrome. The scale can be used to assess and improve the quality of individual programs, compare programs and program networks. Researchers can use the scale as an outcome measure for implementation studies and as a process measure for outcome studies. Future research should focus on demonstrating predictive validity.
首次发布于2016年的《首发精神病保真度量表》基于系统审查和国际共识过程确定的基本组成部分清单。本文的目的是介绍该量表的FEPS-FS 1.0版本,回顾检查该量表的研究结果,并为每个组成部分及其评级提供最新的证据。首发精神病服务保真度量表1.0有35个组成部分,对早期精神病治疗团队提供的医疗服务的获取和质量进行评估。25个组件评估服务组件,15个组件评估团队功能。每个组件的评分为1-5分,4分是满意的。服务组成部分描述的是患者获得的服务,而不是工作人员的活动。保真度评级员根据管理数据、健康记录审查和访谈完成评级。来自两个多中心研究的保真度评分者提供了对成分定义和评分的清晰度和准确性的反馈。当由训练有素的评价者管理时,量表显示出良好到优异的评价者之间的信度。成分的选择可以调整,以评估服务于双相情感障碍或轻度精神病综合征患者的项目。该量表可用于评估和提高个别节目的质量,比较节目和节目网络。研究人员可以使用量表作为实施研究的结果测量,作为结果研究的过程测量。未来的研究应侧重于证明预测效度。
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引用次数: 7
My Road to Recovery from Schizophrenia 我的精神分裂症康复之路
Pub Date : 2021-01-01 DOI: 10.1093/SCHIZBULLOPEN/SGAB020
Rudy Tian
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引用次数: 1
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Schizophrenia Bulletin Open
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