Schizophrenia Research最新文献_第4页

Issue Highlights 问题突出

IF 3.5 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2026-01-17 DOI: 10.1016/S0920-9964(26)00018-6

引用次数: 0

Perceptual organization and its visual subcomponents in schizophrenia and schizotypy: A systematic review 精神分裂症和精神分裂型患者的知觉组织及其视觉成分：系统综述

IF 3.5 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2026-01-16 DOI: 10.1016/j.schres.2026.01.004

Roberta Cessa , Andrea Ghiani , Ezgi Cenk , Marco Bertamini

Perceptual organization (PO) deficits have long been considered a hallmark of schizophrenia (SZ), reflecting disruptions in the integration of visual information. This systematic review critically evaluates the behavioral evidence for PO impairments in SZ and individuals with high schizotypal traits, focusing on three key mid-level processes: contour integration, perceptual grouping, and figure-ground segmentation. Forty-four studies were included, identified through a systematic search and evaluated for bias using the QUADAS-2 tool.

Findings reveal robust and replicable deficits in contour integration among individuals with SZ, especially in those with disorganization symptoms, suggesting impaired lateral interactions in early visual areas. Perceptual grouping deficits were also prominent but appeared more sensitive to cognitive load and stimulus complexity, consistent with top-down integration failures. Figure-ground segmentation impairments were less consistently reported and often dependent on task demands, emerging more clearly under challenging conditions.

In schizotypy, evidence of PO deficits was more variable. Some studies identified subtle impairments in contour integration and grouping, particularly under high attentional load or in individuals with disorganized traits, while others reported intact performance. The heterogeneity of methods across studies, particularly differences in stimulus type, complexity, and grouping cues, was a major limiting factor for cross-study comparisons.

Findings from this review support a dimensional view of PO deficits, where specific symptom clusters, rather than diagnosis alone, predict perceptual dysfunction. PO impairments, particularly in contour integration, may serve as sensitive cognitive markers for early detection and targeted intervention in SZ-spectrum disorders.

知觉组织（PO）缺陷一直被认为是精神分裂症（SZ）的标志，反映了视觉信息整合的中断。本系统综述批判性地评估了SZ和具有高度分裂型特征的个体的PO损伤的行为证据，重点关注三个关键的中间水平过程：轮廓整合、知觉分组和图像-背景分割。纳入了44项研究，通过系统搜索确定并使用QUADAS-2工具评估偏倚。研究结果显示，SZ患者在轮廓整合方面存在明显且可复制的缺陷，特别是在那些有组织紊乱症状的患者中，这表明早期视觉区域的横向相互作用受损。知觉分组缺陷也很突出，但对认知负荷和刺激复杂性更为敏感，与自上而下的整合失败一致。图像-背景分割障碍的报道不太一致，通常取决于任务需求，在具有挑战性的条件下表现得更明显。在精神分裂型中，PO缺陷的证据更加多变。一些研究发现了轮廓整合和分组的细微损伤，特别是在高注意力负荷或具有无组织特征的个体中，而其他研究则报告了完整的表现。跨研究方法的异质性，特别是刺激类型、复杂性和分组线索的差异，是交叉研究比较的主要限制因素。这篇综述的发现支持对PO缺陷的维度观点，其中特定的症状群，而不是单独的诊断，预测知觉功能障碍。PO障碍，特别是轮廓整合障碍，可以作为sz谱系障碍早期发现和有针对性干预的敏感认知标志物。

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引用次数: 0

A multimodal fusion analysis of structural and functional abnormalities in acute onset treatment-resistant schizophrenia 急性发作的难治性精神分裂症的结构和功能异常的多模式融合分析

IF 3.5 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2026-01-15 DOI: 10.1016/j.schres.2026.01.008

Peiyu Cao , Yanlin Han , Lulu Zou , Shuzhan Gao , Qing Xu , Chaoyong Xiao , Xijia Xu

Background

Patients with treatment-resistant schizophrenia (TRS) experience more severe clinical symptoms, which may derive from greater structural and functional brain abnormalities compared to non-TRS. However, the neural underpinnings of TRS remain poorly understood, and conventional unimodal neuroimaging approaches are limited in capturing cross-modal interactions. Therefore, we used multimodal fusion via multiset canonical correlation and joint independent component analysis (mCCA+jICA) to integrate MRI data to examine shared and modality-specific features in TRS.

Methods65 TRS patients, 65 non-TRS patients, and 54 healthy controls (HCs) underwent 3 T MRI. Structural MRI and resting-state functional MRI data were preprocessed using DPARSFA, and grey matter volume (GMV), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo) maps were extracted. The mCCA+jICA was performed to derive joint independent components (ICs) and subject-specific mixing coefficients. Group differences in mixing coefficients were assessed via MANCOVA, and clinical correlations were evaluated using partial correlations.

Results

Patients showed significant differences in mixing coefficients for one modality-specific group-discriminative IC (GMV-IC3) and two joint group-discriminative ICs (ReHo-IC6, and GMV-IC6) compared to HCs. These components also differentiated TRS from non-TRS, with abnormalities concentrated in the precuneus in both ReHo and GMV. Partial correlation analysis revealed significant positive associations between the mixing coefficients of GMV-IC3, GMV-IC6, and total PANSS scores and CPZ equivalents specifically in the TRS group.

Conclusions

This study demonstrates that co-existing structural and functional brain alterations are associated with the pathophysiology of TRS, highlighting their potential as novel multimodal biomarkers.

背景：难治性精神分裂症（TRS）患者的临床症状更为严重，与非TRS相比，这可能源于更大的大脑结构和功能异常。然而，TRS的神经基础仍然知之甚少，传统的单峰神经成像方法在捕获跨模态相互作用方面受到限制。因此，我们使用多模态融合，通过多集典型相关和联合独立成分分析（mCCA+jICA）来整合MRI数据，以检查TRS的共享和模态特异性特征。方法对65例TRS患者、65例非TRS患者和54例健康对照（hc）进行3t MRI检查。使用DPARSFA对结构MRI和静息状态功能MRI数据进行预处理，提取灰质体积（GMV）、低频波动分数幅值（fALFF）和区域均匀性（ReHo）图。mCCA+jICA得到了联合独立分量（ICs）和特定主体的混合系数。混合系数的组间差异通过MANCOVA评估，临床相关性通过偏相关性评估。结果与hc相比，患者对一种模式特异性组鉴别IC （GMV-IC3）和两种联合组鉴别IC （ReHo-IC6和GMV-IC6）的混合系数存在显著差异。这些成分也可以区分TRS和非TRS，异常集中在ReHo和GMV的楔前叶。偏相关分析显示GMV-IC3、GMV-IC6的混合系数与PANSS总分和CPZ当量之间存在显著正相关，特别是在TRS组。本研究表明，TRS的病理生理机制与共存的脑结构和功能改变有关，这凸显了TRS作为新型多模态生物标志物的潜力。

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引用次数: 0

Randomized double-blind inpatient study of a gluten-free diet for negative symptoms in people with schizophrenia 无麸质饮食治疗精神分裂症患者阴性症状的随机双盲住院研究

IF 3.5 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2026-01-15 DOI: 10.1016/j.schres.2026.01.006

Deanna L. Kelly , Christopher M. Lee , Gopal Vyas , Robert W. Buchanan , Daniel J. Roche , Valerie Harrington , Laura M. Rowland , S. Andrea Wijtenburg , Bhim M. Adhikari , Korrapati V. Sathyasaikumar , Peter Kochunov , Monica V. Talor , James Waltz , Fang Liu , Stephanie Hare , Heather A. Adams , Robert Schwarcz , Deepak Salem , James M. Gold , Sarah M. Clark , William W. Eaton

Background

There are no FDA-approved treatments for negative symptoms in schizophrenia and related disorders (SRD). In an SRD subgroup with systemic and central inflammation and elevated anti-gliadin immunoglobulin G antibodies (AGA IgG+), previous findings suggested that a gluten-free diet (GFD) improved negative symptoms.

Methods

We conducted a five-week double-blind randomized placebo-controlled inpatient trial comparing a GFD versus a gluten-containing diet (GCD) in people with SRD and elevated AGA IgG+ (N = 39; n = 21 GFD and n = 18 GCD). The Clinical Assessment Interview for Negative Symptoms Motivation and Pleasure (CAINS MAP) scale measured the primary outcome of negative symptoms. Secondary outcomes evaluated other symptom domains and kynurenine pathway metabolites. Also, we explored inflammatory markers and, in n = 20 participants, measured cerebral blood flow (CBF) using Arterial Spin Labeling, and neurochemistry using magnetic resonance spectroscopy.

Outcomes

Relative to a GCD, a GFD was associated with a modest decrease in CAINS MAP scores (df = 31.2.1, F = 2.96, p = 0.035); decrease in kynurenic acid (KYNA; df = 32, F = 9.51, p = 0.0042) and kynurenine (df = 32, F = 11.45, p = 0.0019); and increase in CBF and total creatine in frontal brain regions. KYNA and CAINS MAP change scores were correlated (r = 0.350, p = 0.039) while cognition was not impacted.

Discussion

Our preliminary data suggests that a GFD may be associated with modest improvements on experiential negative symptoms within an SRD subgroup. A GFD may be associated with reductions in kynurenine pathway metabolites and increased CBF. Larger and longer studies are needed to confirm negative symptom efficacy in this AGA IgG+ SRD subgroup.

背景：目前还没有fda批准的治疗精神分裂症及相关疾病（SRD）阴性症状的药物。在系统性和中枢性炎症和抗麦胶蛋白免疫球蛋白G抗体（AGA IgG+）升高的SRD亚组中，先前的研究结果表明，无麸质饮食（GFD）可改善阴性症状。方法我们进行了一项为期五周的双盲随机安慰剂对照住院试验，比较SRD和AGA IgG+升高的患者（N = 39; N = 21 GFD和N = 18 GCD）的GFD和含麸质饮食（GCD）。消极症状临床评估访谈动机和愉悦（CAINS MAP）量表测量消极症状的主要结局。次要结果评估其他症状域和犬尿氨酸途径代谢物。此外，我们探索了炎症标志物，并在n = 20参与者中，使用动脉自旋标记测量了脑血流量（CBF），使用磁共振波谱测量了神经化学。结果：相对于GCD， GFD与CAINS MAP评分适度下降相关（df = 31.2.1, F = 2.96, p = 0.035）；犬尿酸（KYNA, df = 32, F = 9.51, p = 0.0042）和犬尿氨酸（df = 32, F = 11.45, p = 0.0019）降低；脑额叶区CBF和总肌酸增加。KYNA评分与CAINS MAP评分相关（r = 0.350, p = 0.039），认知能力不受影响。我们的初步数据表明，在SRD亚组中，GFD可能与经验阴性症状的适度改善有关。GFD可能与犬尿氨酸途径代谢物减少和CBF增加有关。需要更大规模和更长期的研究来证实AGA IgG+ SRD亚组的阴性症状疗效。

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引用次数: 0

Frailty and fall risk in schizophrenia: Which components drive the risk of falls? 精神分裂症患者的虚弱和跌倒风险：哪些因素导致了跌倒的风险？

IF 3.5 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2026-01-13 DOI: 10.1016/j.schres.2026.01.005

Tomomi Sugisaki , Norio Sugawara , Masataka Shinozaki , Narifumi Yokoyama , Ryota Yoshida , Yasushi Kawamata , Norio Yasui-Furukori

Objectives

Frailty is increasingly recognized in schizophrenia and is linked to adverse outcomes such as fall. However, mechanisms connecting body composition to frailty and fall risk in psychiatric inpatients remain insufficiently understood. This study aimed to examine (1) the association between fat-free mass and frailty; (2) the relationship between frailty and fall in the past 12 months; and (3) which frailty components most strongly relate to fall among inpatients with schizophrenia.

Methods

In this cross-sectional study, 195 hospitalized adults (≥40 years; mean age 65.9 years) with schizophrenia or schizoaffective disorder were assessed. Frailty was defined using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria. Body composition was measured by bioelectrical impedance analysis to compute fat-free mass index (FFMI) and fat mass index (FMI).

Results

Frailty prevalence was 32.8% (prefrail 54.9%; robust 12.3%). Higher FFMI was independently associated with lower odds of being frail. Frailty was strongly associated with fall history (OR = 9.85 vs. prefrail/robust). Across individual frailty components, slowness (reduced gait speed) showed the strongest relationship with fall.

Conclusions

Frailty is highly prevalent among inpatients with schizophrenia and strongly predicts fall risk. Among the individual frailty components, slowness was the key driver of fall, pointing to gait impairment as a critical focus for intervention. Routine gait assessment, combined with physiotherapy, nutritional support, and careful medication review, may help reduce frailty and prevent fall in this population. Prospective studies are needed to confirm these associations and to establish effective strategies for fall prevention in schizophrenia.

目的精神分裂症患者越来越多地认识到虚弱，并与跌倒等不良后果有关。然而，在精神科住院病人中，身体组成与虚弱和跌倒风险之间的联系机制仍然没有得到充分的了解。本研究旨在检验(1)无脂肪量与虚弱之间的关系；(2)近12个月内身体虚弱与跌倒的关系；(3)住院精神分裂症患者哪些虚弱因素与跌倒关系最密切。方法在这项横断面研究中，对195名患有精神分裂症或分裂情感性障碍的住院成人（≥40岁，平均年龄65.9岁）进行评估。虚弱的定义采用日本版的心血管健康研究（J-CHS）标准。采用生物电阻抗法测定体成分，计算无脂质量指数（FFMI）和脂肪质量指数（FMI）。结果体弱多病患病率为32.8%（体弱多病54.9%，健全病12.3%）。较高的FFMI与较低的虚弱几率独立相关。虚弱与跌倒史密切相关（OR = 9.85 vs.虚弱/健壮）。在个体虚弱因素中，缓慢（步态速度降低）与跌倒的关系最强。结论精神分裂症住院患者虚弱程度高，与跌倒风险有密切关系。在个体虚弱因素中，缓慢是跌倒的关键驱动因素，这表明步态障碍是干预的关键焦点。常规步态评估，结合物理治疗、营养支持和仔细的药物审查，可能有助于减少这一人群的虚弱和预防跌倒。需要前瞻性研究来证实这些关联，并建立有效的策略来预防精神分裂症患者跌倒。

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引用次数: 0

Magnetic seizure therapy preserves delayed memory and 40-Hz auditory steady-state responses compared with electroconvulsive therapy in schizophrenia 与电休克治疗相比，磁发作治疗保留了精神分裂症患者的延迟记忆和40赫兹的听觉稳态反应

IF 3.5 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2026-01-13 DOI: 10.1016/j.schres.2026.01.001

Yawen Hong , Jiangling Jiang , Jin Li , Xiaochen Tang , Xiong Jiao , Zhenying Qian , Yingying Tang , Tianhong Zhang , Chunbo Li , Jijun Wang

Background

Electroconvulsive therapy (ECT) is effective for schizophrenia but often impairs delayed memory, whereas magnetic seizure therapy (MST) typically spares cognition. We investigated whether these modalities differentially affect 40-Hz auditory steady-state responses (ASSR)—a marker of gamma synchrony critical for memory—and if these changes predict cognitive outcomes.

Methods

This study is a secondary analysis of a randomized clinical trial for schizophrenia comparing ECT (n = 16) and MST (n = 17). Clinical symptoms and cognition were assessed using Positive and Negative Syndrome Scale (PANSS) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) at baseline and after 10 treatment sessions. 40-Hz ASSR were recorded via EEG at baseline and after the first treatment session.

Results

Both treatments improved psychotic symptoms. However, ECT induced cognitive deficits (particularly delayed memory) and significant reductions in acute ASSR power and phase-locking. In contrast, MST preserved both cognitive function and ASSR integrity. Notably, within the ECT group, greater acute suppression of ASSR power predicted better preservation of delayed memory.

Conclusion

MST demonstrates a superior safety profile compared to ECT, preserving both gamma synchrony and memory. The association between acute gamma suppression and better memory retention in ECT suggests this reduction may be an adaptive physiological response. Thus, early ASSR changes may serve as a predictive biomarker for cognitive tolerability.

电痉挛疗法（ECT）对精神分裂症有效，但通常会损害延迟记忆，而磁发作疗法（MST）通常不会损害认知。我们研究了这些模式是否会对40赫兹的听觉稳态反应（ASSR）产生不同的影响——这是记忆中至关重要的伽马同步的标志——以及这些变化是否能预测认知结果。方法本研究是对一项精神分裂症的随机临床试验进行二次分析，比较ECT （n = 16）和MST （n = 17）。采用阳性和阴性症状量表（PANSS）和神经心理状态评估可重复电池（rban）在基线和10个疗程后评估临床症状和认知。在基线和第一次治疗后通过脑电图记录40 hz ASSR。结果两种治疗均能改善精神病症状。然而，ECT引起认知缺陷（特别是延迟记忆）和急性ASSR功率和锁相显著降低。相比之下，MST保留了认知功能和ASSR的完整性。值得注意的是，在ECT组中，ASSR功率的更大的急性抑制预示着延迟记忆的更好保存。结论：与ECT相比，mst具有更高的安全性，可以同时保持伽马同步和记忆。在ECT中，急性伽马抑制和更好的记忆保留之间的联系表明这种减少可能是一种适应性生理反应。因此，早期ASSR变化可以作为认知耐受性的预测性生物标志物。

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引用次数: 0

Antipsychotic use and associating factors among persons with substance-induced psychosis and first-episode psychotic disorder- A nationwide register-linkage study 药物性精神病和首发精神病患者的抗精神病药物使用及相关因素——一项全国性的登记关联研究

IF 3.5 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2026-01-12 DOI: 10.1016/j.schres.2026.01.003

Jeyaniroshan Jeyapalan , Heidi Taipale , Antti Tanskanen , Jari Tiihonen , Ellenor Mittendorfer-Rutz , Solja Niemelä

Background

Antipsychotic use after first-episode psychotic disorder (FEPD) has been widely studied, but data on substance-induced psychosis (SIP) are lacking.

Objectives

To examine the prevalence and associated factors of antipsychotic use in individuals with incident SIP compared to a matched FEPD cohort.

Methods

From Swedish healthcare registers, 7320 incident SIP cases (2006–2016) were identified and matched 1:1 by age, sex, and year with FEPD cases. The point prevalence of antipsychotic use was assessed biannually from three years before to three years after the incident diagnosis. Associations between any antipsychotic use during one year post-diagnosis and sociodemographic, clinical, and work-related factors were estimated using modified Poisson regression to obtain unadjusted and age- and sex-adjusted risk ratios (RRs) with 95% CIs. This register-based analysis followed RECORD reporting standards.

Results

The point prevalence of antipsychotic use peaked six months after the first psychotic episode (23% in SIP vs 54% in FEPD) and remained approximately stable thereafter (20% vs 50% at three years). During the first year, the cumulative prevalence of any antipsychotic use was 43% in SIP and 73% in FEPD. Among SIP patients, younger age, female sex, non-European origin, and prior psychiatric comorbidity particularly anxiety, depression, ADHD, and personality disorders were the strongest correlates of antipsychotic use. Functional impairment indicators such as long-term sickness absence and disability pension were also associated with increased use. In FEPD, age, depression, autism-spectrum diagnosis, and short-term sickness absence showed similar but weaker patterns. Olanzapine was the most commonly used antipsychotic in both cohorts.

Conclusions

Despite diagnostic definitions describing SIP as transient, a substantial proportion of patients continued antipsychotic treatment beyond the acute phase. These findings emphasise that younger age, psychiatric comorbidity, and psychosocial vulnerability strongly influence prescribing decisions in SIP and highlight the need for evidence-based, subtype-specific treatment guidelines.

背景：首次发作精神障碍（FEPD）后抗精神病药物的使用已被广泛研究，但缺乏物质诱导精神病（SIP）的数据。目的：与匹配的FEPD队列相比，研究SIP患者抗精神病药物使用的患病率和相关因素。方法从瑞典医疗保健登记册中确定7320例SIP事件（2006-2016），并按年龄、性别和年份与FEPD病例进行1:1匹配。从事件诊断前3年到事件诊断后3年，每半年评估一次抗精神病药物使用的点患病率。诊断后一年内任何抗精神病药物使用与社会人口学、临床和工作相关因素之间的关联使用修正泊松回归进行估计，以获得未调整的、年龄和性别调整的风险比（RRs）， 95% ci。这种基于记录的分析遵循RECORD报告标准。结果抗精神病药物的点患病率在首次精神病发作后6个月达到高峰（SIP组23% vs FEPD组54%），此后保持稳定（三年后20% vs 50%）。在第一年，任何抗精神病药物使用的累积患病率在SIP中为43%，在FEPD中为73%。在SIP患者中，年龄较小、女性、非欧洲血统和既往精神共病，特别是焦虑、抑郁、ADHD和人格障碍是抗精神病药物使用的最强相关性。功能损害指标，如长期病假和残疾养恤金，也与使用增加有关。在FEPD中，年龄、抑郁、自闭症谱系诊断和短期病假表现出相似但较弱的模式。奥氮平是两个队列中最常用的抗精神病药物。尽管诊断定义将SIP描述为短暂的，但相当比例的患者在急性期后继续接受抗精神病药物治疗。这些发现强调，年龄更小、精神合并症和心理社会脆弱性强烈影响SIP的处方决定，并强调需要循证的、针对亚型的治疗指南。

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引用次数: 0

Association between negative symptoms and health-related quality of life and functional outcomes in persons with schizophrenia: A systematic review 精神分裂症患者阴性症状与健康相关生活质量和功能结局之间的关系：一项系统综述

IF 3.5 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2026-01-08 DOI: 10.1016/j.schres.2025.12.019

Allyssa Chan , Andy Lu , Trisha Menon , Sabrina Wong , Kyle Valentino , Gia Han Le , Christine E. Dri , Roger S. McIntyre

Background

Negative symptoms in schizophrenia (SCZ) are core phenomenological characteristics known to affect health-related quality of life (HRQoL) and functioning. This systematic review aims to synthesize extant literature to evaluate/elucidate the effect of negative symptoms on HRQoL and functional outcomes in persons with SCZ, as well as to better understand the association between HRQoL and functional outcomes.

Method

A systematic search was conducted from inception to July 24, 2025, using Pubmed, MedLine, Embase, AMED, PsychInfo, and Scopus. All studies were independently screened by three reviewers (A.C., A.L., T.M.). Primary studies reporting on the association between negative symptoms, HRQoL, and/or functional outcomes in persons with SCZ were included.

Results

We included 68 relevant studies. Most studies were observational and cross-sectional, while others employed case-control, before–after without control, or randomized controlled trial designs. A consistent, small, negative correlation was observed between the presence and severity of negative symptoms and HRQoL (r = −0.67 to 0.69), as well as functional outcomes (r = −0.85 to 0.63. A slight positive association was found between functional outcomes and HRQoL (r = −0.63 to 0.58).

Conclusion

Our findings underscore the significant impact of negative symptoms on critical patient-reported outcomes, including HRQoL and functional outcomes. Notwithstanding their clinical importance, there is limited research on negative symptoms, and more research is needed on treatments that address negative symptoms directly, emphasizing the urgent need for targeted therapeutic development.

精神分裂症（SCZ）的阴性症状是影响健康相关生活质量（HRQoL）和功能的核心现象学特征。本系统综述旨在综合现有文献，评估/阐明阴性症状对SCZ患者HRQoL和功能结局的影响，并更好地了解HRQoL和功能结局之间的关系。方法采用Pubmed、MedLine、Embase、AMED、PsychInfo、Scopus，系统检索自成立至2025年7月24日。所有的研究都由三位评论者（A.C， A.L， T.M.）独立筛选。纳入了报告SCZ患者阴性症状、HRQoL和/或功能结局之间关联的初步研究。结果纳入68项相关研究。大多数研究是观察性和横断面的，而其他研究采用病例对照、前后无对照或随机对照试验设计。在阴性症状的存在和严重程度与HRQoL （r = - 0.67至0.69）以及功能结局（r = - 0.85至0.63）之间观察到一致的、小的负相关。功能结局与HRQoL之间存在轻微的正相关（r = - 0.63 ~ 0.58）。结论：我们的研究结果强调了阴性症状对患者报告的关键结局（包括HRQoL和功能结局）的显著影响。尽管阴性症状具有重要的临床意义，但对阴性症状的研究有限，需要更多的研究直接针对阴性症状的治疗方法，强调迫切需要有针对性的治疗开发。

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引用次数: 0

Long-term efficacy, safety, and tolerability of xanomeline and trospium chloride in schizophrenia: A 52-week, open-label trial (EMERGENT-5) xanomeline和trospium chloride治疗精神分裂症的长期疗效、安全性和耐受性：一项52周的开放标签试验（急诊-5）

IF 3.5 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2026-01-07 DOI: 10.1016/j.schres.2025.12.015

Inder Kaul , Amy Claxton , Soumya Chaturvedi , Tejendra Patel , Hsiuanlin Wu , Sharon Sawchak , Colin Sauder

Background

The M₁/M₄ muscarinic receptor agonist xanomeline combined with the peripherally restricted pan-muscarinic receptor antagonist trospium chloride is the first approved treatment for adults with schizophrenia with no direct D₂ dopamine receptor blockade. Xanomeline and trospium chloride (KarXT) reduced symptoms and was generally well tolerated in adults with schizophrenia in three, 5-week, randomized, double-blind, placebo-controlled trials and a 52-week, open-label extension trial.

Methods

EMERGENT-5 (NCT04820309) was a 52-week, open-label trial evaluating the long-term safety, tolerability, and efficacy of twice daily KarXT (maximum dose 125/30 mg) in psychiatrically stable adults with schizophrenia. Safety measures included treatment-emergent adverse events (TEAEs), vital signs, and laboratory parameters. Efficacy measures included change in Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity (CGIS).

Results

Between June 2021–May 2024, 566 participants at 54 US sites received ≥1 dose of KarXT. Overall, 277/566 (48.9 %) participants completed the trial. A total of 466/566 (82.3 %) experienced ≥1 TEAE, the majority of which were mild or moderate in intensity; severe TEAEs were reported in 33/566 (5.8 %) participants. The most common TEAEs occurring in ≥5 % of participants were nausea (23.1 %), vomiting (20.3 %), constipation (18.0 %), hypertension (10.4 %), diarrhea and dry mouth (9.4 % each), dizziness (8.8 %), headache (8.1 %), dyspepsia (7.2 %), somnolence (6.2 %), weight decreased (5.7 %), and hyperhidrosis (5.1 %). KarXT improved PANSS total, PANSS positive and negative subscale, and CGI-S scores over the trial duration.

Conclusions

Psychiatrically stable adults with schizophrenia were safely switched from prior antipsychotics to KarXT with a trend toward symptom improvement over 1 year. The safety and tolerability profile of KarXT was consistent with observations in prior clinical trials; no new safety issues emerged.

M1/M4毒蕈碱受体激动剂xanomeline联合外周限制性泛毒蕈碱受体拮抗剂trospium chloride是首个被批准用于无D2多巴胺受体直接阻断的成人精神分裂症的治疗方法。在3周、5周、随机、双盲、安慰剂对照试验和52周的开放标签扩展试验中，Xanomeline和trospium chloride （KarXT）减轻了精神分裂症成人患者的症状，并且通常耐受性良好。semergent -5 （NCT04820309）是一项为期52周的开放标签试验，评估每日两次KarXT（最大剂量125/30 mg）对精神稳定的精神分裂症成人患者的长期安全性、耐受性和有效性。安全措施包括治疗中出现的不良事件（teae）、生命体征和实验室参数。疗效测量包括阳性和阴性症状量表（PANSS）和临床总体印象严重程度（CGIS）的变化。结果在2021年6月至2024年5月期间，54个美国站点的566名参与者接受了≥1剂量的KarXT。总体而言，277/566（48.9 %）参与者完成了试验。共有466/566（82.3 %）发生≥1次TEAE，其中大多数为轻度或中度；566名参与者中有33人（5.8 %）报告了严重teae。最常见的流泪发生≥5 %的参与者恶心(23.1 %),呕吐(20.3 %)、便秘(18.0 %)、高血压(10.4 %),腹泻和口干(9.4 %)、头晕(8.8 %),头痛(8.1 %)、消化不良(7.2 %),嗜睡(6.2 %),体重下降(5.7 %),和多汗(5.1 %)。在整个试验期间，KarXT改善了PANSS总分、PANSS阳性和阴性分量表以及CGI-S评分。结论精神稳定的成人精神分裂症患者可以安全地从先前的抗精神病药物切换到KarXT，并且在1 年以上有症状改善的趋势。KarXT的安全性和耐受性与先前临床试验的观察结果一致；没有出现新的安全问题。

{"title":"Long-term efficacy, safety, and tolerability of xanomeline and trospium chloride in schizophrenia: A 52-week, open-label trial (EMERGENT-5)","authors":"Inder Kaul , Amy Claxton , Soumya Chaturvedi , Tejendra Patel , Hsiuanlin Wu , Sharon Sawchak , Colin Sauder","doi":"10.1016/j.schres.2025.12.015","DOIUrl":"10.1016/j.schres.2025.12.015","url":null,"abstract":"<div><h3>Background</h3><div>The M<sub>1</sub>/M<sub>4</sub> muscarinic receptor agonist xanomeline combined with the peripherally restricted pan-muscarinic receptor antagonist trospium chloride is the first approved treatment for adults with schizophrenia with no direct D<sub>2</sub> dopamine receptor blockade. Xanomeline and trospium chloride (KarXT) reduced symptoms and was generally well tolerated in adults with schizophrenia in three, 5-week, randomized, double-blind, placebo-controlled trials and a 52-week, open-label extension trial.</div></div><div><h3>Methods</h3><div>EMERGENT-5 (<span><span>NCT04820309</span><svg><path></path></svg></span>) was a 52-week, open-label trial evaluating the long-term safety, tolerability, and efficacy of twice daily KarXT (maximum dose 125/30 mg) in psychiatrically stable adults with schizophrenia. Safety measures included treatment-emergent adverse events (TEAEs), vital signs, and laboratory parameters. Efficacy measures included change in Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity (CGI<img>S).</div></div><div><h3>Results</h3><div>Between June 2021–May 2024, 566 participants at 54 US sites received ≥1 dose of KarXT. Overall, 277/566 (48.9 %) participants completed the trial. A total of 466/566 (82.3 %) experienced ≥1 TEAE, the majority of which were mild or moderate in intensity; severe TEAEs were reported in 33/566 (5.8 %) participants. The most common TEAEs occurring in ≥5 % of participants were nausea (23.1 %), vomiting (20.3 %), constipation (18.0 %), hypertension (10.4 %), diarrhea and dry mouth (9.4 % each), dizziness (8.8 %), headache (8.1 %), dyspepsia (7.2 %), somnolence (6.2 %), weight decreased (5.7 %), and hyperhidrosis (5.1 %). KarXT improved PANSS total, PANSS positive and negative subscale, and CGI-S scores over the trial duration.</div></div><div><h3>Conclusions</h3><div>Psychiatrically stable adults with schizophrenia were safely switched from prior antipsychotics to KarXT with a trend toward symptom improvement over 1 year. The safety and tolerability profile of KarXT was consistent with observations in prior clinical trials; no new safety issues emerged.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"288 ","pages":"Pages 86-94"},"PeriodicalIF":3.5,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Schizotypal traits and daily social functioning: Insights from ecological momentary assessment 精神分裂型特征和日常社会功能：来自生态瞬时评估的见解

IF 3.5 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2026-01-02 DOI: 10.1016/j.schres.2025.12.011

Madisen T. Russell , Wei Wu , Michelle P. Salyers , Tess F. Filip , Sarah Akhras , Heather Busanet , Amanda McCleery , Katharine N. Thakkar , Kyle S. Minor

Elevated schizotypal traits are a risk factor for developing schizophrenia and other forms of psychopathology. Because schizophrenia is marked by social functioning difficulties, examining how schizotypal traits shape everyday interactions can clarify early risk processes. Although ecological momentary assessment (EMA) has been used to examine social interaction likelihood (how often people interact), depth (complexity of content in interactions), and enjoyment (pleasure derived from interactions) in people with schizophrenia, few have explored differences in social interactions across schizotypal traits (positive, negative, and disorganized). This study used EMA to evaluate how positive, negative, and disorganized schizotypal traits in college students (n = 185) relate to social interaction likelihood, depth, and enjoyment in daily life. Given their established role in social functioning and their complex relationships with schizotypal traits, we also investigated whether affect and stress predict individuals' concurrent likelihood, depth, and enjoyment of social interactions. Results revealed that negative traits more strongly predicted reduced social interaction likelihood (B = −0.02, p = .04) and enjoyment (B = -0.06, p < .01) compared to positive (likelihood: B = 0.01, p = .37; enjoyment: B = 0.03, p = .02) and disorganized (likelihood: B = 0.00, p = .85; enjoyment: B = -0.04, p = .04) traits. Contrary to hypotheses, positive affect emerged as the strongest predictor of social interaction outcomes, surpassing negative affect and stress. Additionally, we observed a significant interaction between positive schizotypal traits and negative affect (B = -0.01, p = .03), such that individuals higher in positive traits showed a stronger reduction in enjoyment when experiencing negative affect. These findings enhance our understanding of how schizotypal traits and affect impact daily social interactions and may inform future personalized interventions designed to improve social functioning deficits in at-risk individuals.

升高的分裂型特征是发展为精神分裂症和其他形式的精神病理的危险因素。因为精神分裂症的特点是社会功能障碍，研究精神分裂症的特征是如何影响日常互动的，可以澄清早期的风险过程。虽然生态瞬间评估（EMA）已被用于检查精神分裂症患者的社会互动可能性（人们互动的频率）、深度（互动内容的复杂性）和享受（互动带来的快乐），但很少有人探索精神分裂症特征（积极、消极和无组织）在社会互动方面的差异。本研究使用EMA来评估大学生（n = 185）的积极、消极和无组织分裂型特征与日常生活中社会互动的可能性、深度和享受之间的关系。考虑到它们在社会功能中的既定作用及其与分裂型特征的复杂关系，我们还研究了影响和压力是否能预测个体同时进行社会互动的可能性、深度和乐趣。结果表明，与积极特质（likelihood: B = 0.01, p = 0.37; enjoy: B = 0.03, p = 0.02）和无序特质（likelihood: B = 0.00, p = 0.85; enjoy: B = -0.04, p = 0.04）相比，消极特质更能预测社会交往可能性（B = - 0.02, p = 0.04）和享受（B = -0.06, p = 0.01）的降低。与假设相反，积极影响成为社会互动结果的最强预测因子，超过了消极影响和压力。此外，我们观察到积极的分裂型特征与消极情绪之间存在显著的相互作用（B = -0.01, p = .03），因此，积极特征越高的个体在经历消极情绪时，享受程度越低。这些发现增强了我们对分裂型特征和影响如何影响日常社会互动的理解，并可能为未来个性化干预提供信息，旨在改善高危个体的社会功能缺陷。

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引用次数: 0