Schizophrenia Research最新文献

Objective

Deficits of dyadic social interaction seem to diminish social functioning in schizophrenia. However, most previous studies are of a limited ecological validity due to decontextualized experimental conditions far off from real-world interaction. In this pilot study, we thus exposed participants to a more real-world-like situation to generate new hypotheses for research and therapeutic interventions.

Methods

Dyads of either participants with schizophrenia (n = 21) or control participants without mental disorder (n = 21) were presented with a 5-min emotionally engaging movie. The subsequent uninstructed dyadic interaction was videotaped and analyzed by means of a semi-quantitative, software-supported behavioral analysis.

Results

The patients with schizophrenia showed significant abnormalities regarding their social interaction, such as more negative verbalizations, a more open display of negative affect and gaze abnormalities. Their interaction behavior was mostly characterized by neutral affect, silence and avoidance of direct eye contact. Neutral affect was associated with poorer psychosocial performance. Verbal intelligence and empathy were associated with positive interaction variables, which were also not impaired by psychotic symptom severity.

Conclusion

In this real-world-like dyadic interaction, participants with schizophrenia show distinct abnormalities that are relevant to psychosocial performance and consistent with a hypothesized lack of attunement to interaffective situations.

Aim - Recent findings suggest that OCS are prevalent in individuals with early psychosis. However, their clinical relevance still needs to be clarified. This research specifically explored OCS in subjects at Clinical High Risk for Psychosis (CHRP), with the aims of determining their baseline prevalence, examining their 2-year stability, and analyzing their association with sociodemographic data, clinical characteristics and outcomes. Methods - Clinical assessments at baseline and during the 2-year follow-up period included: the Comprehensive Assessment of At-Risk Mental states (CAARMS), the Positive And Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF). OCS were identified using the CAARMS item 7.6 subscore. Results - Among 180 CHR-P participants, 66 (36.7 %) had OCS at baseline. CHR-P with OCS had higher PANSS scores and greater antidepressant prescription rates. OCS severity levels improved in the first year, but plateaued over two years, correlating with longitudinal changes in GAF and PANSS total scores. OCS improvement was specifically associated with antidepressant use and intensity of individual psychotherapy sessions. CHR-P subjects with OCS had higher service engagement rates. Conclusions - The presence of OCS could characterize a distinct CHR-P subtype with specific clinical and prognostic characteristics, requiring tailored diagnostic and therapeutic approaches. Recognizing the heterogeneity in CHR-P population is crucial for optimizing care.

Objective

Schizophrenia disorders severely impact social and occupational function and reduce quality of life, furthermore patients often suffer from social withdrawal and isolation.

The aim of this study was to investigate long-term quality of life and social disconnection and determine 10-year changes in quality of life and social disconnection later in life in association with changes in symptom severity, cognition, and global function.

Methods

We used assessments of quality of life and assessor rated social disconnection from the 10- and 20-year follow-up of the OPUS trial to examined 10-year changes in self-rated quality of life and social disconnection in the later stage of illness following a first episode psychosis. Self-rated social disconnection was only assessed in the 174 participants of the 20-year follow-up.

Results

Twenty years after a first episode psychosis only half of the participants reported having face-to-face contact with someone in their network more than once a week, while 90 % reported often or always being able to get emotional support when needed. Quality of life ratings were lower in our study population compared to the general population. On average physical and environmental quality of life worsened from the 10- to the 20-year follow-up while psychological and social quality of life remained stable. All quality-of-life domains were associated with negative symptoms (physical QoL: b = −6.6, p < 0.001, psychological QoL: b = −8, p < 0.001, social QoL: b = −5.7, p < 0.001 and environmental QoL: b = −6.5, p < 0.001) and global function (physical QoL: b = −0. 47, p < 0.001, psychological QoL: b = 0.52, p < 0.001, social QoL: b = 0.31, p < 0.001 and environmental QoL: b = 0.49, p < 0.001).

Conclusion

Social disconnection seems to persist over time. Social disconnection and quality of life were associated with negative symptoms and poor functioning, therefore interventions aimed at improving global and social function might likely also improve quality of life.

Background

mHealth interventions use mobile and wireless technologies to deliver aspects of healthcare, and have been extensively employed in mental health research, showcasing their potential to address the significant treatment gap. While numerous studies underscore the advantages and functionalities of mHealth, challenges persist regarding patient uptake and sustained engagement among individuals with psychosis spectrum disorder. This review aims to explore individual-level barriers and facilitators to engagement with hybrid digital systems, which involves the integration of digital tools alongside in-person care.

Method

Four electronic databases (Medline, Web of Science, CINAHL, and PsychINFO) were systematically searched to identify hybrid digital interventions for psychosis spectrum disorders. Studies that only reported the efficacy of the interventions were excluded. 16 studies were included in the final review.

Results

Six themes were identified in this review, including mHealth as a tool to aid communication, the central role of the therapist, an increased sense of support through the provision of digital support, allowing greater insight into auditory hallucinations, enabling technologies and barriers to engagement.

Conclusions

This review demonstrated the factors impacting engagement in hybrid interventions for psychosis spectrum disorder. By identifying barriers and facilitators, the findings could offer valuable guidance for the design of innovative digital interventions. These findings also underscore the importance of prioritising trustworthiness in digital systems. Future research should focus on establishing and implementing trustworthy digital systems to enhance engagement and effectively integrate mobile health into conventional healthcare practices.

Objective

Previous work suggests that cognitive and environmental risk factors may predict conversion to psychosis in individuals at clinical high risk (CHRs) for the disorder. Less clear, however, is whether these same factors are also associated with the initial emergence of the high risk state in individuals who do not meet current threshold criteria for being considered high risk.

Method

Here, using data from the Adolescent Brain Cognitive Development (ABCD) study, we examined associations between factors previously demonstrated to predict conversion to psychosis in CHRs with transition to a “high risk” state, here defined as having a distress score between 2 and 5 on any unusual thought content question in the Prodromal Questionnaire-Brief Child version. Of a sample of 5237 children (ages 11–12) studied at baseline, 470 transitioned to the high-risk state the following year. A logistic regression model was evaluated using age, cognition, negative and traumatic experiences, decline in school performance, and family history of psychosis as predictors.

Results

The overall model was significant (χ² = 100.89, R² = 0.042, p < .001). Significant predictors included number of negative life events, decline in school performance, number of trauma types, and verbal learning task performance.

Conclusions

These results suggest that factors that predict conversion in CHR teenagers are also associated with initial emergence of a “high-risk” state in preadolescents. Limitations regarding the degree to which model factors and outcome in this study parallel those used in previous work involving psychosis risk in older teenagers are discussed.