Schizophrenia Research最新文献

Psychotic disorders are associated with significant impairment in psychosocial functioning, yet mechanisms associated with this impairment remain poorly understood. Emotional intelligence, a component of social cognition, is associated with psychosocial functioning in this population. However, prior work has used relatively small samples, reported inconsistent relations between functioning domains and emotional intelligence, and inconsistently considered negative symptoms. To address these limitations, we examined the predictive ability of emotional intelligence on functional outcomes using a five-year longitudinal design. We used a large sample of individuals with and without psychotic disorder diagnoses (N = 324), a performance-based measure of emotional intelligence, and three measures of functioning (i.e., social performance, assessor-rated social and occupational functioning, self-rated functioning in independent living). Results revealed individuals diagnosed with a psychotic disorder have lower emotional intelligence than those without a history of psychosis. Emotional intelligence was associated with social performance and social and occupational functioning in both those with and without a history of psychosis. In those diagnosed with a psychotic disorder, emotional intelligence and negative symptoms better predict social performance (β_Emotional = 0.36, R²_delta = 0.09) and social and occupational functioning (β_Emotional = 0.21, R² = 0.03), but not self-rated functioning in independent living (β_Emotional = -0.08, R²_delta = 0.00), as compared to negative symptoms alone. Overall, findings support the use of emotional intelligence as a longitudinal predictor of social and occupational outcomes above and beyond negative symptoms alone. This work highlights potential, specific intervention targets for individuals with psychotic disorders.

Background: Past studies associating personality with psychosis have been limited by small nonclinical samples and a focus on general symptom burden. This study uses a large clinical sample to examine personality's relationship with psychosis-specific features and compare personality dimensions across clinically and neurobiologically defined categories of psychoses.

Methods: A total of 1352 participants with schizophrenia, schizoaffective disorder, and bipolar with psychosis, as well as 623 healthy controls (HC), drawn from the Bipolar-Schizophrenia Network for Intermediate Phenotypes (BSNIP-2) study, were included. Three biomarker-derived biotypes were used to separately categorize the probands. Mean personality factors (openness, conscientiousness, extraversion, agreeableness, and neuroticism) were compared between HC and proband subgroups using a generalized linear model. A robust linear regression was utilized to determine personality differences across biotypes and diagnostic subgroups. Associations between personality factors and cognition were determined through Pearson's correlation. A canonical correlation was run between the personality factors and general functioning, positive symptoms, and negative symptoms to delineate the relationship between personality and clinical outcomes of psychosis.

Results: There were significant personality differences between the proband and HC groups across all five personality factors. Overall, the probands had higher neuroticism and lower extraversion, agreeableness, conscientiousness, and openness. Openness showed the greatest difference across the diagnostic subgroups and biotypes, and greatest correlation with cognition. Openness, agreeableness, and extraversion had the strongest associations with symptom severity.

Conclusions: Individuals with psychotic disorders have different personality traits compared to HC. In particular, openness may be relevant in distinguishing psychosis-specific phenotypes and experiences, and associated with biological underpinnings of psychosis, including cognition. Further studies should identify potential causal factors and mediators of this relationship.

Objective: To investigate the association between ambient coarse particulate matter (PM_2.5-10) pollution and risk of acute schizophrenia episodes.

Methods: A time-stratified case-crossover study with a two-stage analytical approach was conducted to investigate the association between ambient PM_2.5-10 pollution and schizophrenia admissions (an indicator for acute schizophrenia episodes) across 259 Chinese cities of prefecture-level or above during 2013-2017. A conditional logistic regression model was constructed to estimate city-specific changes in hospital admissions for schizophrenia associated with per interquartile range (IQR) increase in ambient PM_2.5-10, and the overall associations were obtained by pooling the city-specific associations using the random-effects model.

Results: A total of 817,296 schizophrenia admissions were included in the analysis. Per IQR increase (28.43 μg/m³) in PM_2.5-10 at lag01 was associated with an increase of 1.66 % (95 % CI: 0.68 %, 2.65 %) in schizophrenia admissions. Compared to concentrations <30 μg/m³, PM_2.5-10 concentrations of 30-49 μg/m³ and ≥50 μg/m³ were associated with increases of 2.25 % (95 % CI: 0.73 %%, 3.79 %) and 4.03 % (95 % CI: 1.92 %, 6.18 %) in schizophrenia admissions, respectively. City-level urbanization has the potential to attenuate the association between ambient PM_2.5-10 and schizophrenia admissions (P = 0.0002).

Conclusions: Our study provides novel evidence for the acute adverse effects of ambient PM_2.5-10 on schizophrenia and calls for special attention on the control of high PM_2.5-10 pollution in disease prevention.

Background: Promoting positive mental health is crucial for maintaining a healthy balance of mental well-being, both for individuals with and without mental health conditions, including schizophrenia.

Objective: To map interventions that promote positive mental health in individuals with schizophrenia.

Methods: We conducted a scoping review following Joanna Briggs Institute recommendations. Searches were performed on Scopus, MEDLINE and CINAHL Complete (via EBSCOhost), and RCAAP for grey literature. Papers that met the following criteria were included: published from September 1999 to May 2023; involving only individuals diagnosed with schizophrenia; focused on interventions that promote positive mental health; presenting interventions with defined objectives and duration; designed for individuals or groups.

Results: We identified 1111 potentially relevant records, which were screened by 2 independent researchers. 26 studies, published between 2004 and 2023 were found eligible. Most of the identified interventions were implemented in community-based settings (n = 22), in group formats (n = 20), with a total duration between 4 and 12 weeks (n = 20), session duration about 45-60 min (n = 13) and without follow up (n = 17). A significant number of interventions focused on improving interpersonal relationship capacity (n = 15) and personal satisfaction (n = 13). 9 interventions focused on enhancing autonomy, 3 on promoting self-control, 2 on problem-solving/self-actualization and 1 on promoting pro-social attitude.

Conclusions: This scoping review can contribute to improving the quality of care provided and optimizing health outcomes, enhancing the promotion of community health through increased knowledge in the field of positive mental health.

Background: Previous reviews have indicated that family interventions in early psychosis are beneficial for patients and family caregivers. Given recent developments in research and service provision an updated review is warranted.

Methods: We conducted a systematic review and meta-analysis of family intervention trials in the first 5 years after psychosis onset. We identified randomized controlled trials that reported outcomes for family members and extracted available outcomes in relation to identified patients.

Results: We screened 8737 abstracts and 177 full text papers, resulting in 36 for extraction. We found significant pooled treatment effects for family interventions for carer psychological distress (Hedges g = 0.35), carer burden (Hedges g = -0.68), positive and negative carer appraisals (Hedges g = 0.20, g = -0.21), and components of expressed emotion (critical comments and emotional overinvolement) compared with care as usual (Hedges g = -0.81, -0.92). For patients we found a moderate pooled effect for reduced rates of hospitalization compared with care as usual (Hedges g = -0.52). The effects for carer burden were maintained for studies in China, but not in other settings combined. The effects for hospitalization were maintained for multicomponent interventions but not when psychoeducation was the sole component. There was evidence of significant study heterogeneity. Risk of bias assessment indicated that deviations from intended treatment were most frequently rated as the weakest domain.

Conclusions: Family interventions for early psychosis benefit both family carers and their relatives diagnosed with psychosis when compared with usual care. Future research should further clarify the effective components and investigate innovations in cultural sensitivity, peer support and digital modes.

Background: Obsessive-compulsive symptoms (OCS) frequently co-occur in patients with Schizophrenia Spectrum Disorders (SSD). Patients with SSD and OCS experience increased clinical and social challenges, including diminished quality of life and subjective well-being. However, it is unknown whether co-morbid OCS are associated with personal recovery.

Aim: To investigate whether the presence and severity of OCS in patients with SSD is associated with lower self-reported personal recovery.

Methods: A cross-sectional design was employed, examining 527 patients with SSD. Group comparisons between patients with and without OCS for self-reported personal recovery (assessed with the Recovery Assessment Scale (RAS-24)) were conducted using analysis of covariance, adjusting for positive, negative and general symptoms. Multiple regression analyses were performed in 133 patients with co-occurring OCS to assess the additional explained variance in personal recovery by OCS severity after adjusting for the same covariates in the first block of the model.

Results: Group comparisons demonstrated that the presence of co-morbid OCS was associated with lower scores in personal recovery. Multiple hierarchical regression analyses showed that OCS severity was significantly associated with personal recovery by explaining an additional 3.0 % of variance in personal recovery.

Conclusion: Our findings suggest that co-occurring OCS in patients with SSD are relevant for personal recovery and that treatment should also address OCS.

Background: Loneliness, distress from having fewer social contacts than desired, has been recognized as a significant public health crisis. Although a substantial body of research has established connections between loneliness and various forms of psychopathology, our understanding of the neural underpinnings of loneliness in schizophrenia spectrum disorders (SSD) and major depressive disorder (MDD) remains limited.

Methods: In this study, structural magnetic resonance imaging (sMRI) data were collected from 57 SSD and 45 MDD patients as well as 41 healthy controls (HC). Loneliness was measured with the German version of the University of California, Los Angeles Loneliness Scale (UCLA-LS). We used FreeSurfer v7.2 for automated parcellation of cortical regions.

Results: SSD patients showed reduced cortical volume and thickness in fronto-parietal and temporal regions when compared to HC (p < 0.05, Benjamini-Hochberg (BH) corr.). In SSD, volume of the right superior temporal gyrus was associated with UCLA-LS total score (p = 0.030; BH corr.). MDD patients showed reduced cortical volume and thickness in fronto-parietal regions (p < 0.05, BH corr.). In MDD, cortical thickness of the right superior parietal cortex was associated with UCLA-LS total score (p = 0.038; BH corr.).

Conclusion: Our study suggests a different neural signature of loneliness in patients with SSD and MDD, comprising temporal and parietal regions responsible for social and attentive processing. Identifying neurobiological mechanisms underlying loneliness is critical for understanding its role in severe mental illnesses and identifying potential therapeutic targets.

Background: The immune system may play an important role in the aetiology of psychotic disorders and there is increasing interest in the relationship between immune markers and clinical outcomes in psychosis. The present study investigated whether subclinical systemic inflammation was associated with length of stay in individuals with psychosis admitted to a psychiatric hospital. We tested the hypothesis that a higher level of subclinical systemic inflammation, as measured by the neutrophil-to-lymphocyte ratio (NLR) would be associated with a longer period in hospital.

Method: Retrospective cohort study based on electronic health records. We included patients with a psychosis spectrum disorder (ICD10: F20-F29) who had a routine blood test upon being admitted to a psychiatric hospital within the South London and Maudsley NHS Foundation Mental Health Trust, London, UK between 2013 and 2019. Multiple linear regression was used to determine the association between the NLR at the time of admission and the duration of the corresponding hospital stay, adjusting for covariables.

Results: Data from 1683 individuals with psychosis were analyzed. The median admission duration was 31 days (interquartile range = 48 days). Higher neutrophil-to-lymphocyte ratio (NLR) was significantly associated with longer admission (B = 0.07, p < 0.003) after adjusting for covariates.

Conclusion: An association between a NLR and a longer admission, whilst controlling for relevant covariables, was observed highlighting the potential utility of inflammatory markers as prognostic marker in clinical settings.

Learning Health Systems (LHSs) promise meaningful health care improvement through the ongoing use of data, including the lived experience of diverse constituents, such as people participating in and providing services. Most LHSs operate within a specific healthcare system, typically hospital-based, under a common electronic health record (EHR) and management structure. The Early Psychosis Intervention Network in Texas (EPINET-TX) is a novel case study of a developing LHS across 16 independent community mental health clinics operating state-funded coordinated specialty care (CSC) programs for early psychosis. EPINET-TX is a partnership among a multidisciplinary research hub and state and local entities. Grounded in participatory research frameworks, multiple strategies were utilized to align partners around learning goals, build data use competencies, enhance researchers' understanding of program context, and cultivate a continuous performance improvement mindset. Key strategies for developing a LHS culture included a) intentionally building collaborative relationships, b) establishing shared values and governance, c) collaborating in research and change-focused workgroups, and d) sharing learning and growth experiences. For CSC programs operating within the public mental health system, the LHS framework provides a promising model to foster quality improvement, innovation, and action-oriented participatory research.