Schizophrenia Research最新文献_第7页

Does stigma leave its mark? The interplay between negative effects of perceived stigma with positive effect of self-esteem on long-term social functioning in schizophrenia 成见会留下印记吗？认知成见的负面影响与自尊对精神分裂症患者长期社会功能的正面影响之间的相互作用

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2024-10-31 DOI: 10.1016/j.schres.2024.10.011

Mariam P. Ali , Natalia Tiles-Sar , Claudia J.P. Simons , Dominika A. Osicka , GROUP Investigators , Tesfa Dejenie Habtewold , Lisette Van der Meer , Richard Bruggeman , Behrooz Z. Alizadeh

Background

Individuals with schizophrenia commonly experience poor social functioning (SF), influenced by stigmatization and linked to low self-esteem. The intricate role of self-esteem in this context remains insufficiently explored. This study delves into the short and long-term impact of perceived stigma on SF, investigating the mediating or moderating effects of self-esteem and momentary fluctuations in self-esteem.

Methods

Data were derived from a longitudinal cohort of individuals with schizophrenia and related disorders from the 2nd (T₁) and 3rd (T₂) waves. Perceived stigma and self-esteem were measured at T₁ with self-report questionnaires. Self-esteem at T₂ was measured with the experience sampling method. SF was measured at both time points. Multiple regression was applied to analyse the effect of perceived stigma and the role of (fluctuations in) self-esteem on SF.

Results

Perceived stigma significantly correlated with SF in the short-term (β = −4.66, SE = 1.24, p < 0.001) and long-term (β = −3.77, SE = 0.51, p < 0.001). Once we analysed samples with self-esteem (N = 157), stigma was still associated with SF (β = −2.78, SE = 1.36, p = 0.043), but not when self-esteem was controlled for (β = −2.13, SE = 1.34, p < 0.100). Self-esteem significantly mediated stigma-SF relationship in T₁ whereas in T₂ it only significantly predicted SF (β = 2.17, SE = 0.70, p = 0.002). Fluctuations in self-esteem did not show mediating/moderating effects.

Conclusion

Perceived stigma significantly predicts poor SF both concurrently and, to some extent, over the long term. Moreover, self-esteem may serve as a buffer that mitigates the negative impact of perceived stigma. Early interventions aimed at reducing stigma and enhancing self-esteem through anti-stigma initiatives are essential for improving SF.

背景精神分裂症患者通常社会功能低下（SF），这是受污名化的影响，并与自卑有关。在这种情况下，自尊的复杂作用仍未得到充分探讨。本研究深入探讨了感知到的耻辱感对社会功能的短期和长期影响，调查了自尊和自尊的瞬间波动的中介或调节作用。在 T1 阶段，通过自我报告问卷对感知到的耻辱感和自尊进行了测量。T2 阶段的自尊采用经验抽样法进行测量。SF 在两个时间点都进行了测量。结果在短期（β = -4.66，SE = 1.24，p < 0.001）和长期（β = -3.77，SE = 0.51，p < 0.001），感知到的成见与 SF 显著相关。当我们分析具有自尊的样本（N = 157）时，成见仍与 SF 相关（β = -2.78，SE = 1.36，p = 0.043），但当自尊受到控制时，成见与 SF 的相关性就不存在了（β = -2.13，SE = 1.34，p <0.100）。在 T1 中，自尊对成见与 SF 的关系有明显的中介作用，而在 T2 中，自尊仅对 SF 有明显的预测作用（β = 2.17，SE = 0.70，p = 0.002）。自尊的波动没有显示出中介/调节作用。此外，自尊可作为一种缓冲，减轻感知到的成见的负面影响。旨在通过反污名化措施减少污名化和增强自尊的早期干预对于改善自理能力至关重要。

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引用次数: 0

Quality indicators for schizophrenia care: A scoping review 精神分裂症护理质量指标：范围审查

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2024-10-31 DOI: 10.1016/j.schres.2024.10.013

Jennifer C. Anderson , Dallas P. Seitz , David Crockford , Donald Addington , Hanji Baek , Diane L. Lorenzetti , Rebecca Barry , James M. Bolton , Valerie H. Taylor , Paul Kurdyak , Julia Kirkham

Measuring quality of care is a critical first step towards improving the healthcare contributing to persistent poor outcomes experienced by many people living with schizophrenia. This scoping review aims to identify and characterize indicators for measuring the quality of care for people living with schizophrenia. We searched 6 academic databases, 4 grey literature databases, and 23 organization websites for documents containing quality indicators developed for or applied in a population with schizophrenia-spectrum disorders. We identified 119 unique documents, yielding 390 distinct quality indicators. Most measures were process indicators (68 %; n = 267) commonly reflecting safety (30 %; n = 118) and effectiveness (35 %; n = 136) domains of quality of care. Quality indicators included measures of primarily mental healthcare (77 %; n = 299), as well as physical healthcare (23 %; n = 91). Indicators reflected aspects of care related to service delivery, pharmacotherapy, assessments, resources and policies, psychological interventions, social and other interventions. Indicator development was notable for a lack of well-described validation and selection processes. Gaps in indicator availability for comorbid substance use, reproductive health, and healthcare equity were also identified. Results reflect a growing recognition of the importance of quality measurement in this population but highlight the need for prioritization of indicators to guide future quality measurement and improvement.

衡量医疗质量是改善医疗服务的关键第一步，而医疗服务质量低下则是造成许多精神分裂症患者治疗效果持续不佳的原因之一。本范围综述旨在确定和描述衡量精神分裂症患者护理质量的指标。我们检索了 6 个学术数据库、4 个灰色文献数据库和 23 个机构网站，以查找包含为精神分裂症谱系障碍患者制定或应用的质量指标的文献。我们发现了 119 篇独特的文献，共产生了 390 个不同的质量指标。大多数指标都是过程指标（68%；n = 267），通常反映了医疗质量的安全性（30%；n = 118）和有效性（35%；n = 136）。质量指标主要包括精神医疗（77%；n = 299）和身体医疗（23%；n = 91）。指标反映了与服务提供、药物治疗、评估、资源和政策、心理干预、社会和其他干预相关的护理方面。指标制定的显著特点是缺乏完善的验证和选择过程。此外，还发现在合并药物使用、生殖健康和医疗保健公平方面的指标可用性存在差距。研究结果表明，人们日益认识到对这一人群进行质量测量的重要性，但同时也强调需要确定指标的优先次序，以指导未来的质量测量和改进工作。

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引用次数: 0

Visual remediation of contrast processing impairments in schizophrenia: A preliminary clinical trial 对精神分裂症患者对比度处理障碍的视觉补救：初步临床试验

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2024-10-30 DOI: 10.1016/j.schres.2024.10.010

Zachary Bergson , Anthony O. Ahmed , Jewel Bell , Pamela D. Butler , James Gordon , Aaron R. Seitz , Steven M. Silverstein , Judy L. Thompson , Vance Zemon

Schizophrenia (SZ) is associated with visual processing impairments, which are related to higher-level functional impairments. This study investigated the impact of a novel visual remediation intervention (VisR) targeting low- and mid-level visual processing impairments in SZ. We hypothesized that VisR would lead to greater improvements in contrast processing when compared to an active control condition and explored potential treatment-related changes in symptom severity. SZ participants (N = 47) were randomized into one of four groups: an active control group (cognitive training; AC); Contrast Sensitivity Training + AC (CST + AC); Contour Integration Training + AC (CIT + AC); and CST + CIT. Participants completed 20–40 training sessions. Clinical symptom severity was assessed using the Positive and Negative Syndrome Scale and contrast processing was assessed using steady-state visual evoked potentials to increasing levels of contrast of isolated-check pattern stimuli. A significant Group × Timepoint × Contrast interaction indicated superiority of CST + CIT over AC for improving contrast processing. Furthermore, a large, significant Group × Timepoint interaction indicated that CST + CIT was associated with a greater reduction in positive symptoms compared to AC. In addition, lower severity of positive symptoms at baseline was associated with a greater improvement in contrast processing over the course of treatment. This initial evaluation of VisR demonstrated that it is well tolerated and may produce greater improvements in contrast processing and positive symptoms compared to an intervention targeting only high-level cognitive functions.

精神分裂症（SZ）与视觉处理障碍有关，而视觉处理障碍又与高级功能障碍相关。本研究调查了一种新型视觉矫正干预（VisR）对精神分裂症中低级视觉处理障碍的影响。我们假设，与积极的对照组相比，VisR 将在对比度处理方面带来更大的改善，并探讨了与治疗相关的症状严重程度的潜在变化。SZ 参与者（N = 47）被随机分为四组：积极对照组（认知训练；AC）；对比敏感度训练 + AC（CST + AC）；轮廓整合训练 + AC（CIT + AC）；以及 CST + CIT。参与者完成 20-40 次训练。临床症状严重程度采用正负综合征量表进行评估，对比度处理采用稳态视觉诱发电位对对比度不断增加的孤立检查模式刺激进行评估。组别 × 时间点 × 对比度的交互作用非常明显，表明 CST + CIT 在改善对比度处理方面优于 AC。此外，"组别 × 时间点 "的交互作用也非常明显，表明与 AC 相比，CST + CIT 能更有效地减少阳性症状。此外，在治疗过程中，基线阳性症状的严重程度越低，对比度处理的改善程度就越大。对 VisR 的初步评估表明，与只针对高级认知功能的干预相比，VisR 的耐受性良好，并能在对比处理和阳性症状方面产生更大的改善。

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引用次数: 0

Mortality among older people with late-onset and non-late-onset schizophrenia: A 5-year prospective multicenter study 晚期和非晚期精神分裂症老年人的死亡率：一项为期 5 年的前瞻性多中心研究。

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2024-10-30 DOI: 10.1016/j.schres.2024.10.014

Katayoun Rezaei , Marina Sánchez-Rico , María Sofia Garcés-González , Pierre Vandel , Jean-Pierre Schuster , Carlos Blanco , Frédéric Limosin , Nicolas Hoertel , CSA Study Group

引用次数: 0

Assessment of patient life engagement in schizophrenia using items from the Positive and Negative Syndrome Scale 使用积极与消极综合征量表中的项目评估精神分裂症患者的生活参与度。

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2024-10-29 DOI: 10.1016/j.schres.2024.10.008

Zahinoor Ismail , Stine R. Meehan , Anja Farovik , Maia Miguelez , Shivani Kapadia , Stephane Alexandre Regnier , Zhen Zhang , T. Michelle Brown , Mirline Milien , Roger S. McIntyre

Background

Improved patient life engagement is a meaningful treatment goal in schizophrenia that cannot be satisfactorily measured using existing tools. This research aimed to determine whether certain items from the Positive and Negative Syndrome Scale (PANSS) can assess patient life engagement in schizophrenia.

Methods

Three approaches were used to identify PANSS items that reflect patient life engagement: (1) a panel discussion with expert psychiatrists (n = 4); (2) interviews with patients with schizophrenia (n = 20); and (3) a principal component analysis to explore clustering of items (n = 954 from three randomized controlled trials). Internal consistency was assessed by Cronbach's alpha and item–total correlations. A minimal clinically important difference (MCID) was determined by anchor- and distribution-based methods.

Results

Expert psychiatrists identified 11 relevant items, and patients rated 13 items as “very relevant” to patient life engagement, most of which clustered in the principal component analysis. Considering all results, a composite set of 14 PANSS items that may be relevant to patient life engagement in schizophrenia was devised: P2, N1, N2, N3, N4, N5, N6, N7, G6, G7, G11, G13, G15, G16 (Cronbach's alpha, 0.84; item–total correlations, 0.35–0.56, indicating acceptable correlation with the underlying concept; exception: G6 [depression], 0.19). An MCID of 5 points (small/moderate improvement) or 10 points (large improvement) may be appropriate.

Conclusions

A subset of 14 PANSS items may be used to reflect patient life engagement in clinical practice/trials in schizophrenia, complementing the results of traditional psychiatric symptom scales with a patient-centered outcome that is relevant to real-world treatment goals.

背景：提高患者的生活参与度是精神分裂症患者一个有意义的治疗目标，但现有工具无法对其进行满意的测量。本研究旨在确定积极与消极综合征量表（PANSS）中的某些项目能否评估精神分裂症患者的生活参与度：我们采用了三种方法来确定能够反映患者生活参与度的 PANSS 项目：（1）与精神科专家进行小组讨论（n = 4）；（2）对精神分裂症患者进行访谈（n = 20）；（3）采用主成分分析法对项目进行聚类分析（n = 954，来自三项随机对照试验）。内部一致性通过克朗巴赫α和项目-总相关性进行评估。通过基于锚和分布的方法确定了最小临床重要差异（MCID）：结果：精神科专家确定了 11 个相关项目，患者将 13 个项目评为与患者生活参与度 "非常相关"，其中大部分项目在主成分分析中进行了聚类。考虑到所有结果，我们设计出了一套由 14 个 PANSS 项目组成的综合集，这些项目可能与精神分裂症患者的生活参与度相关：P2、N1、N2、N3、N4、N5、N6、N7、G6、G7、G11、G13、G15、G16（Cronbach's alpha，0.84；项目-总相关性，0.35-0.56，表明与基本概念的相关性可以接受；例外情况除外：例外情况：G6 [抑郁]，0.19）。MCID 为 5 分（小幅/中度改善）或 10 分（大幅改善）可能比较合适：14个PANSS项目的子集可用于反映精神分裂症患者在临床实践/试验中的生活参与度，以患者为中心的结果补充了传统精神症状量表的结果，与现实世界的治疗目标相关。

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引用次数: 0

Understanding the potential mechanisms of disease modifying effects of physical activity and exercise in people with schizophrenia 了解体育锻炼和运动对精神分裂症患者的疾病调节作用的潜在机制

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2024-10-28 DOI: 10.1016/j.schres.2024.10.004

Auwal Abdullahi PhD, Thomson WL Wong, Shamay SM Ng

Schizophrenia is a serious chronic mental health problem that usually starts during adolescence and early childhood. It is characterized by positive symptoms (delusions, hallucinations and grossly disorganized speech and behaviour), negative symptoms (apathy, isolation and diminished affect), and cognitive impairment that negatively affect quality of life. Its treatments include the use of pharmacological interventions, exercise, non-invasive brain stimulation and cognitive remediation training. Exercise is a very simple and cost-effective intervention. However, it is important the mechanisms of its effects are understood so that it can be trusted in clinical practice. In addition, understanding the mechanisms is important for its modification and safe use. Similarly, it may help provide the basis for invention of safe and cost-effective pharmacological or alternative therapies. From the literature, the mechanisms of diseases modifying effects of exercise seem to include increased cardiorespiratory fitness, biochemical changes (increased level of BDNF, increased N-acetylaspartate (NAA)/cr (creatine) ratio, decreased level of triglycerides, increased high density lipoprotein (HDL) and decreased salivary cortisol), structural changes (increase in cerebral volume, increased white matter integrity and increased cortical thickness) and anthropometric changes (reduced body weight and body mass index (BMI), increased muscular strength and decreased waist-hip ratio or waist circumference or hip circumference).

精神分裂症是一种严重的慢性精神健康问题，通常在青春期和儿童早期发病。其特征是阳性症状（妄想、幻觉和言行严重紊乱）、阴性症状（冷漠、孤僻和情感减退）和认知障碍，对生活质量产生负面影响。治疗方法包括药物干预、运动、非侵入性脑部刺激和认知矫正训练。运动是一种非常简单且具有成本效益的干预措施。然而，重要的是要了解其作用机制，以便在临床实践中值得信赖。此外，了解其作用机制对于调整和安全使用非常重要。同样，这也有助于为发明安全且具有成本效益的药物疗法或替代疗法提供依据。从文献来看，运动对疾病的调节作用机制似乎包括心肺功能增强、生化变化（BDNF 水平上升、N-乙酰天冬氨酸（NAA）/cr（肌酸）比率上升、甘油三酯水平下降、高密度脂蛋白（HDL）上升和唾液皮质醇下降）、结构变化（脑容量增加、白质完整性增强、皮质厚度增加）和人体测量变化（体重和体重指数（BMI）降低、肌肉力量增强、腰臀比或腰围或臀围降低）。

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引用次数: 0

Efficacy and tolerability of blonanserin in schizophrenia: A systematic review and meta-analysis of randomized controlled trials 布洛南色林治疗精神分裂症的疗效和耐受性：随机对照试验的系统回顾和荟萃分析

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2024-10-28 DOI: 10.1016/j.schres.2024.10.016

Jing Tian , Shimeng Dong , Nobuyuki Nomura , Spyridon Siafis , Xiao Lin , Hui Wu , Mengchang Qin , Hiroko Yanagimoto , Johannes Schneider-Thoma , Stefan Leucht

Background

Blonanserin is approved for treating schizophrenia in Japan, South Korea, India, and China. We aimed to synthesize the efficacy and tolerability of blonanserin compared to other antipsychotics.

Methods

A systematic review and pairwise meta-analysis were conducted using the Cochrane Schizophrenia Group's study-based trial register until January 24, 2024. We included open and blinded randomized controlled trials (RCTs) involving schizophrenia patients, with studies lasting at least 3 weeks. Primary outcomes focused on overall schizophrenia symptoms using rating scales and relapse rates. Secondary outcomes included symptom subtypes, treatment response, dropout rates, quality of life, and side effects, analyzed using standardized mean difference (SMD), mean difference (MD), and risk ratio (RR) with 95 % confidence intervals (CIs). The review protocol was published in Open Science Framework (https://osf.io/e7jfa/).

Results

Fourteen acute-phase studies with 2697 participants compared blonanserin to olanzapine, haloperidol, risperidone, paliperidone, aripiprazole, amisulpride, and placebo. Blonanserin showed greater efficacy than placebo (SMD = −0.47, 95 % CI: −0.66 to −0.27) and similar efficacy to other antipsychotics in reducing schizophrenia overall symptoms. No data on the number of participants who experienced relapse with blonanserin was available in the single maintenance-phase study. There were also no clear differences between antipsychotics in most secondary efficacy outcomes, but blonanserin produced less prolactin and weight increase but more akathisia and tremor than risperidone, and less prolactin increase, anticholinergic and extrapyramidal side-effects than haloperidol.

Conclusion

Our study suggests that differences in efficacy between blonanserin and other antipsychotics are small and that blonanserin has a different tolerability profile than haloperidol and risperidone.

背景布南色林在日本、韩国、印度和中国被批准用于治疗精神分裂症。我们的目的是综合分析布洛南色林与其他抗精神病药物相比的疗效和耐受性。方法我们利用科克伦精神分裂症小组的研究型试验注册表进行了系统综述和配对荟萃分析，该注册表的有效期截至 2024 年 1 月 24 日。我们纳入了涉及精神分裂症患者的开放性和盲法随机对照试验（RCT），研究持续时间至少为 3 周。主要研究结果侧重于使用评分量表的总体精神分裂症症状和复发率。次要结果包括症状亚型、治疗反应、辍药率、生活质量和副作用，采用标准化平均差（SMD）、平均差（MD）和风险比（RR）以及 95% 置信区间（CI）进行分析。综述方案发表在《开放科学框架》（https://osf.io/e7jfa/）上。结果14项急性期研究共2697名参与者将布洛南色林与奥氮平、氟哌啶醇、利培酮、帕利哌酮、阿立哌唑、阿米舒必利和安慰剂进行了比较。在减少精神分裂症总体症状方面，布洛南色林的疗效高于安慰剂（SMD = -0.47，95 % CI：-0.66 至 -0.27），与其他抗精神病药物的疗效相似。在单项维持阶段研究中，没有关于布洛南色林复发人数的数据。在大多数次要疗效结果中，抗精神病药物之间也没有明显的差异，但与利培酮相比，布洛南色林产生的泌乳素和体重增加较少，但产生的无运动和震颤较多，与氟哌啶醇相比，产生的泌乳素增加、抗胆碱能和锥体外系副作用较少。

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引用次数: 0

Distinct trajectories of psychotic-like experiences and their associations with violent behavior among 3539 young adults: A 3-year prospective cohort study 3539 名青少年中类似精神病经历的不同轨迹及其与暴力行为的关联：为期 3 年的前瞻性队列研究

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2024-10-28 DOI: 10.1016/j.schres.2024.10.012

Shaoling Zhong, Hongling Zhou, Xin Yu, Yue Li, Xinhu Yang, Jiawen Zhang, Liang Zhou, Meng Sun

Background

Violence perpetration may be linked to psychotic-like experiences (PLEs), but relevant research is limited, especially in general population. Therefore, we aimed to identify trajectories of PLEs and examine whether specific trajectories were related to violent behavior in a 3-year cohort study.

Methods

We developed a prospective cohort study and collected data in 2020 (T0), 2021 (T1), and 2022 (T2) in Guangzhou, China. A total of 3539 university students from two universities were included and completed self-report questionnaires to assess PLEs, violent ideation, violent threats, and violent acts. Socio-demographic and clinical factors were assessed and considered as confounding factors. We used growth mixture modeling to identify trajectories of PLEs. Associations between PLEs trajectories and violent behavior were examined using binary logistic regression.

Results

At T2, 162 (5.3 %) participants had violent behavior. We identified three distinct trajectories: low stable trajectory, low increasing trajectory, and high decreasing trajectory. The binary logistic regression models revealed that the high decreasing (OR: 2.46, 95%CI:1.60–3.72) group and the low increasing (OR: 11.7, 95%CI: 7.62–17.9) were associated with higher violent risk compared to the low stable group after controlling for baseline socio-demographic and clinical factors.

Conclusion

Our study delineated three distinct trajectories and indicated that PLEs trajectories are related to subsequent violent ideation and violent acts. The results provide crucial clarifications regarding the nature of the associations between PLEs trajectories and violence over time.

背景暴力行为可能与精神病样经历（PLEs）有关，但相关研究有限，尤其是在普通人群中。因此，我们旨在通过一项为期 3 年的队列研究，识别类精神病体验的轨迹，并考察特定轨迹是否与暴力行为有关。方法我们开展了一项前瞻性队列研究，并在中国广州收集了 2020 年（T0）、2021 年（T1）和 2022 年（T2）的数据。研究共纳入了两所大学的 3539 名大学生，他们填写了自我报告问卷，以评估 PLEs、暴力意念、暴力威胁和暴力行为。我们对社会人口学和临床因素进行了评估，并将其视为混杂因素。我们使用生长混合模型来确定 PLEs 的轨迹。结果在第二阶段，162 名参与者（5.3%）有暴力行为。我们发现了三种不同的轨迹：低稳定轨迹、低增长轨迹和高下降轨迹。二元逻辑回归模型显示，在控制了基线社会人口学和临床因素后，高递减组（OR：2.46，95%CI：1.60-3.72）和低递增组（OR：11.7，95%CI：7.62-17.9）与低稳定组相比具有更高的暴力风险。这些结果为阐明 PLEs 轨迹与暴力行为之间随时间变化的关联性质提供了重要依据。

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引用次数: 0

Reply to Dyadic interaction in schizophrenia – A promising new avenue of investigation? 答复精神分裂症中的二元交互作用--一条有前途的新研究途径？

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2024-10-28 DOI: 10.1016/j.schres.2024.09.031

Georg Juckel

引用次数: 0

Association between auditory P300 event-related potential and suicidal thoughts and behaviors in first-episode antipsychotic-naïve patients with schizophrenia 听觉 P300 事件相关电位与首发抗精神病药物无效的精神分裂症患者的自杀想法和行为之间的关系

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research

Pub Date : 2024-10-28 DOI: 10.1016/j.schres.2024.10.015

Shaobing Li , Chenghao Lu , Nannan Liu , Yanzhe Li , Xinxu Wang , Shen Li , Jie Li , Xiang Yang Zhang

Objective

Suicidal thoughts and behaviors (STBs) are critical concern in schizophrenia (SZ). Concurrent changes in event-related potential (ERP), particularly the P300 (P3) components, have been observed in SZ patients, but the association between these changes and STBs remains unclear. This study aims to explore the relationships between P3 components and STBs in first-episode antipsychotic-naïve SZ (FEAN-SZ) patients.

Methods

The study included 321 FEAN-SZ patients and 146 healthy controls (HC). Sociodemographic data, clinical assessments, and ERP P3 components (N1, P3a, and P3b) were collected. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), while depressive symptoms were evaluated with the Hamilton Depression Scale (HAMD).

Results

Compared to HC, FEAN-SZ patients exhibited lower N1 and P3 amplitudes and longer latencies (all p_s < 0.001). Patients with STBs exhibited higher scores on negative, general psychopathology, PANSS total and HAMD, decreased N1 and P3a amplitudes, as well as prolonged P3a and P3b latencies compared to those without STBs (all p_s < 0.001). The P3a latency predicted the general psychopathology scores (β = 0.103, p < 0.001), and the N1 amplitude predicted the HAMD scores (β = −1.057, p = 0.001), both exclusively within the STBs group. Logistic regression analysis identified that N1 amplitude (Beta = −0.132, p = 0.018, OR = 1.02, 95%CI = 1.01–1.04) and HAMD scores (Beta = 0.068, p = 0.001, OR = 1.07, 95%CI = 1.03–1.11) as independent predictors of STBs in FEAN-SZ patients. Combining these variables yielded an area under the receiver operating characteristic (AUCROC) curve of 0.840 for distinguishing between patients with and without STBs.

Conclusions

FEAN-SZ patients with STBs have lower P3 amplitude and longer latency. The N1 amplitude and depressive levels are associated with STBs in FEAN-SZ patients. The N1 amplitude may serve as an early biological marker for STBs in SZ patients.

目的自杀念头和行为（STBs）是精神分裂症（SZ）的一个重要问题。在 SZ 患者中已观察到事件相关电位（ERP），尤其是 P300（P3）成分的并发变化，但这些变化与 STB 之间的关系仍不清楚。本研究旨在探讨首次发病的抗精神病药物无效的 SZ（FEAN-SZ）患者的 P3 成分与 STB 之间的关系。研究收集了社会人口学数据、临床评估和 ERP P3 成分（N1、P3a 和 P3b）。结果与健康对照组相比，FEAN-SZ 患者的 N1 和 P3 波幅较低，潜伏期较长（所有 ps 均为 0.001）。与无 STB 患者相比，STB 患者在负性、一般精神病理学、PANSS 总分和 HAMD 方面得分更高，N1 和 P3a 振幅降低，P3a 和 P3b 潜伏期延长（所有 ps 均为 0.001）。P3a潜伏期可预测一般精神病理学评分（β = 0.103，p < 0.001），N1振幅可预测HAMD评分（β = -1.057, p = 0.001），这两项指标仅在STBs组中存在。逻辑回归分析发现，N1 振幅（β = -0.132，p = 0.018，OR = 1.02，95%CI = 1.01-1.04）和 HAMD 评分（β = 0.068，p = 0.001，OR = 1.07，95%CI = 1.03-1.11）是 FEAN-SZ 患者 STBs 的独立预测因素。结论FEAN-SZ STB 患者的 P3 波幅较低，潜伏期较长。N1振幅和抑郁水平与FEAN-SZ患者的STBs有关。N1 振幅可作为 SZ 患者 STB 的早期生物学标记。

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引用次数: 0