Pub Date : 2025-11-17DOI: 10.1016/j.schres.2025.11.010
Pedro Henrique Minotto Serafim , Ary Gadelha , Raffael Massuda , Mario Louzã , Clarissa Severino Gama , Luisa de Castro Ostoja Roguski , Pedro Henrique Pereira Alvim , Leticia Sanguinetti Czepielewski
Background and hypothesis
The Positive and Negative Syndrome Scale (PANSS) is a widely used instrument for assessing symptom severity in schizophrenia. Significant concerns remain regarding its structural validity, with no consensus on a definitive model. Although the five-factor model (positive, negative, cognitive, hostility, and affective) is the most widely accepted, studies have demonstrated instability in item distribution across factors and difficulty in achieving adequate fit indices. This exploratory study aims to evaluate the structural validity of the PANSS, addressing these previously identified issues and contributing to the theoretical debate on the limited evidence supporting a robust model fit.
Study design
Data from five independent Brazilian samples (N = 1262) were analyzed. We conducted Exploratory Graph Analysis (EGA) and bootstrap analysis to assess the stability of the PANSS structure. We estimated network loadings and conducted the Loadings Comparison Test (LCT) to evaluate differences between structural frameworks.
Study results
The analysis identified a five-dimensional model consistent with prior literature. However, this model proved unstable, appearing in only 66.3 % of bootstrap samples. Several items exhibited low stability across dimensions, and the LCT algorithm indicated that a network framework provided a better fit for the data.
Conclusions
In line with previous research, this study found that the PANSS exhibits an unstable structure and item distribution. Moreover, the scale presents several validity limitations, and the difficulty in achieving a consolidated model may reflect both methodological gaps in its original construction and the inherently multidimensional nature of certain symptoms.
背景与假设：Positive and Negative Syndrome Scale （PANSS）是一种被广泛使用的评估精神分裂症症状严重程度的工具。对其结构有效性的重大关切仍然存在，对确定的模型没有达成共识。虽然五因素模型（积极，消极，认知，敌意和情感）是最广泛接受的，但研究表明，各因素之间的项目分布不稳定，难以获得足够的拟合指数。本探索性研究旨在评估PANSS的结构有效性，解决这些先前确定的问题，并为支持稳健模型拟合的有限证据的理论辩论做出贡献。研究设计：对来自5个巴西独立样本（N = 1262）的数据进行分析。我们采用探索性图分析（EGA）和自举分析（bootstrap Analysis）来评估PANSS结构的稳定性。我们估计了网络荷载，并进行了荷载比较试验（LCT）来评估结构框架之间的差异。研究结果：分析确定了与文献一致的五维模型。然而，这个模型被证明是不稳定的，只出现在66.3%的bootstrap样本中。有几个项目在维度上表现出较低的稳定性，LCT算法表明网络框架更适合数据。结论：本研究与以往的研究结果一致，发现PANSS的结构和项目分布不稳定。此外，该量表存在若干有效性限制，难以形成一个综合模型，这可能反映了其原始结构在方法上的差距，以及某些症状固有的多维性。
{"title":"The challenges in measuring symptoms of schizophrenia: An exploratory graph analysis of the Positive and Negative Syndrome Scale (PANSS)","authors":"Pedro Henrique Minotto Serafim , Ary Gadelha , Raffael Massuda , Mario Louzã , Clarissa Severino Gama , Luisa de Castro Ostoja Roguski , Pedro Henrique Pereira Alvim , Leticia Sanguinetti Czepielewski","doi":"10.1016/j.schres.2025.11.010","DOIUrl":"10.1016/j.schres.2025.11.010","url":null,"abstract":"<div><h3>Background and hypothesis</h3><div>The Positive and Negative Syndrome Scale (PANSS) is a widely used instrument for assessing symptom severity in schizophrenia. Significant concerns remain regarding its structural validity, with no consensus on a definitive model. Although the five-factor model (positive, negative, cognitive, hostility, and affective) is the most widely accepted, studies have demonstrated instability in item distribution across factors and difficulty in achieving adequate fit indices. This exploratory study aims to evaluate the structural validity of the PANSS, addressing these previously identified issues and contributing to the theoretical debate on the limited evidence supporting a robust model fit.</div></div><div><h3>Study design</h3><div>Data from five independent Brazilian samples (<em>N</em> = 1262) were analyzed. We conducted Exploratory Graph Analysis (EGA) and bootstrap analysis to assess the stability of the PANSS structure. We estimated network loadings and conducted the Loadings Comparison Test (LCT) to evaluate differences between structural frameworks.</div></div><div><h3>Study results</h3><div>The analysis identified a five-dimensional model consistent with prior literature. However, this model proved unstable, appearing in only 66.3 % of bootstrap samples. Several items exhibited low stability across dimensions, and the LCT algorithm indicated that a network framework provided a better fit for the data.</div></div><div><h3>Conclusions</h3><div>In line with previous research, this study found that the PANSS exhibits an unstable structure and item distribution. Moreover, the scale presents several validity limitations, and the difficulty in achieving a consolidated model may reflect both methodological gaps in its original construction and the inherently multidimensional nature of certain symptoms.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"287 ","pages":"Pages 46-53"},"PeriodicalIF":3.5,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145550373","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}
Pub Date : 2025-11-17DOI: 10.1016/j.schres.2025.11.006
Beatriz Rodriguez-Cabo , Ana Catalan , Claudia Aymerich , Gonzalo Salazar de Pablo , Miguel Angel Gonzalez-Torres
Introduction
Catatonia is a neuropsychiatric syndrome observed in psychiatric and physical conditions. Linked to neuroinflammation, schizophrenia spectrum disorders remain its principal diagnostic context. Short-term outcomes are favourable with prompt treatment. Long-term prognosis remains poorly understood. This systematic review aimed to evaluate long-term outcomes and mortality rates in individuals with catatonia.
Methods
We conducted a PRISMA–compliant systematic review (PROSPERO: CRD420251027945) searching PubMed, Web of Science, EMBASE, SCOPUS, PsycINFO, and non-peer-reviewed sources from database inception to July 12, 2025. We included studies of adults diagnosed with catatonia with a minimum 6-month follow-up. Catatonia diagnosis was based on criteria, scales, or clinical judgment. One-year mortality was estimated and compared to general population. Methodological quality was assessed using validated tools (NOS, JBI). Findings were synthesized narratively.
Results
Of 6431 records screened, 29 studies met inclusion criteria, encompassing 30,694 patients with catatonia and 11,830 controls. Mean follow-up was 8.1 years. Seventeen studies focused on schizophrenia. Quality of studies was heterogeneous; 58 % showed moderate concerns and 41 % were at high risk of bias. Post-1970s studies reported more episodes, readmissions, and chronicity in catatonic schizophrenia versus other schizophrenia subtypes. Poorer psychiatric outcomes were found when catatonia co-occurred with intellectual disability, depression, or physical illness. Catatonia associated with baseline suicidal ideation (>35 % patients) and follow-up autoimmunity. In 75 % of post-1970s studies, one-year mortality in catatonia cohorts was lower than adjusted population rates.
Conclusion
Catatonia is a marker of poor psychiatric long-term prognosis, without clear link to higher mortality. Early use of effective treatments preventing suicide or psychosis relapses may be considered.
简介：紧张症是在精神和身体状况中观察到的一种神经精神综合征。精神分裂症谱系障碍与神经炎症有关，仍然是其主要的诊断背景。及时治疗，短期效果良好。长期预后仍不清楚。本系统综述旨在评估紧张症患者的长期预后和死亡率。方法：我们进行了一项符合prisma标准的系统评价（PROSPERO: CRD420251027945），检索PubMed， Web of Science， EMBASE， SCOPUS， PsycINFO和非同行评审的来源，从数据库建立到2025年7月12日。我们纳入了诊断为紧张症的成年人的研究，随访时间至少为6个月。紧张症的诊断是基于标准、量表或临床判断。估计一年的死亡率，并与一般人群进行比较。采用经过验证的工具（NOS， JBI）评估方法学质量。研究结果以叙述的方式综合。结果：在筛选的6431条记录中，29项研究符合纳入标准，包括30,694例紧张症患者和11,830例对照。平均随访8.1年。17项研究的重点是精神分裂症。研究质量参差不齐；58%的人表现出中等程度的担忧，41%的人表现出高偏倚风险。20世纪70年代后的研究报告了紧张性精神分裂症的发作、再入院和慢性性高于其他精神分裂症亚型。当紧张症并发智力残疾、抑郁或身体疾病时，精神预后较差。紧张症与基线自杀意念相关（约35%）和随访自身免疫。在70年代后75%的研究中，紧张症队列的一年死亡率低于调整后的人群死亡率。结论：紧张症是精神疾病长期预后不良的标志，与高死亡率无明确联系。可以考虑早期使用有效的治疗方法来预防自杀或精神病复发。
{"title":"Unveiling the prognosis of adult Catatonia: A systematic review","authors":"Beatriz Rodriguez-Cabo , Ana Catalan , Claudia Aymerich , Gonzalo Salazar de Pablo , Miguel Angel Gonzalez-Torres","doi":"10.1016/j.schres.2025.11.006","DOIUrl":"10.1016/j.schres.2025.11.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Catatonia is a neuropsychiatric syndrome observed in psychiatric and physical conditions. Linked to neuroinflammation, schizophrenia spectrum disorders remain its principal diagnostic context. Short-term outcomes are favourable with prompt treatment. Long-term prognosis remains poorly understood. This systematic review aimed to evaluate long-term outcomes and mortality rates in individuals with catatonia.</div></div><div><h3>Methods</h3><div>We conducted a PRISMA–compliant systematic review (PROSPERO: CRD420251027945) searching PubMed, Web of Science, EMBASE, SCOPUS, PsycINFO, and non-peer-reviewed sources from database inception to July 12, 2025. We included studies of adults diagnosed with catatonia with a minimum 6-month follow-up. Catatonia diagnosis was based on criteria, scales, or clinical judgment. One-year mortality was estimated and compared to general population. Methodological quality was assessed using validated tools (NOS, JBI). Findings were synthesized narratively.</div></div><div><h3>Results</h3><div>Of 6431 records screened, 29 studies met inclusion criteria, encompassing 30,694 patients with catatonia and 11,830 controls. Mean follow-up was 8.1 years. Seventeen studies focused on schizophrenia. Quality of studies was heterogeneous; 58 % showed moderate concerns and 41 % were at high risk of bias. Post-1970s studies reported more episodes, readmissions, and chronicity in catatonic schizophrenia versus other schizophrenia subtypes. Poorer psychiatric outcomes were found when catatonia co-occurred with intellectual disability, depression, or physical illness. Catatonia associated with baseline suicidal ideation (>35 % patients) and follow-up autoimmunity. In 75 % of post-1970s studies, one-year mortality in catatonia cohorts was lower than adjusted population rates.</div></div><div><h3>Conclusion</h3><div>Catatonia is a marker of poor psychiatric long-term prognosis, without clear link to higher mortality. Early use of effective treatments preventing suicide or psychosis relapses may be considered.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"287 ","pages":"Pages 21-36"},"PeriodicalIF":3.5,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145550425","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}
Pub Date : 2025-11-17DOI: 10.1016/j.schres.2025.11.007
Yun-Shuang Fan , Maowei Ye , Yuting Xu , Yong Xu , Jing Guo , Mi Yang , Wei Huang , Huafu Chen
Schizophrenia is a complex neurodevelopmental disorder characterized by widespread functional dysconnectivities across the brain. While disturbed temporal dynamics have been reported in schizophrenia, the information flow involving both temporal and spatial dynamics remains unclear. To capture spatio-temporal transition of brain information and to investigate these processes from a neurodevelopmental perspective, we collected resting-state functional MRI (rs-fMRI) data from 86 early-onset schizophrenia (EOS) patients (onset before age 18) and 91 demographically matched typically developing (TD) controls. We employed a non-homogeneous Markov model (NHMM) on dynamic functional connectivities derived from fMRI data. By means of transition probabilities, we modeled the switching of information flow in brain functional networks over time. Stationary probability vectors were used to describe the information convergence distribution of each network, while optimal reachable steps were used to characterize inter-network transmission efficiency. Compared to controls, EOS patients showed significantly increased stationary transition probabilities in the ventral attention network (VAN) and the dorsal attention network (DAN) but decreased probabilities in the default mode network (DMN). In terms of the dynamic interaction characteristics between networks, patients showed increased optimal reachable steps relative to controls, particularly in the VAN-DMN pathway. By integrating NHMM with neuroimaging data, this study revealed VAN- and DMN-involved information transition abnormalities in the early stage of schizophrenia spatio-temporal dynamics, offering novel insights into the developmental pathophysiology of the disorder. Our approach thus provides a novel analytical framework for quantifying spatio-temporal brain dynamics in neurodevelopmental disorders.
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Pub Date : 2025-11-14DOI: 10.1016/j.schres.2025.11.003
Alexa Ciarolla , Anastasia M. Bobilev , Filip Dybowski , Yan Fang , Carolyn Sacco , Jayme M. Palka , Sina Aslan , Peiying Liu , Hanzhang Lu , Carol A. Tamminga , Elena I. Ivleva
Most of the brain-based biomarker research in schizophrenia (SZ) results from chronic medicated samples. Disambiguating contributions of “primary” disease vs. psychotropic medication effects to the neurobiology of SZ remains challenging. In this study, using 3Tesla pseudo-continuous Arterial Spin Labeling (pCASL), we examined regional cerebral blood flow (CBF) in hippocampus and its cortical projection network in SZ probands [n = 41, including antipsychotic-free (SZ-OFF, n = 14) and treated with antipsychotic(s) (SZ-ON, n = 27)], their first-degree relatives [n = 28, including relatives with lifetime psychosis-spectrum disorders (REL-P, n = 14) and without (REL-NP, n = 14)], and healthy controls (HC, n = 16) [n = 85 total].
SZ-OFF demonstrated elevated CBF in the left middle cingulate, ventromedial and dorsolateral prefrontal cortex (PFC), compared to SZ-ON (Hedges' g = 0.65–0.91). No difference in hippocampal CBF emerged in SZ-OFF vs. SZ-ON, while SZ-OFF vs. HC showed reduced CBF in the left anterior hippocampus (g = 1.09). Among relatives, REL-P had elevated CBF in the right ventrolateral PFC, compared to REL-NP (g = 0.73) – resembling the “hyperfrontality” effect in SZ-OFF. Conversely, REL-NP vs. HC showed reduced CBF throughout the right PFC (g = 0.52–0.79).
Our findings demonstrate unique regional CBF-based activity signatures potentially capturing primary disease effects (SZ-OFF: elevated CBF in PFC but reduced CBF in the anterior hippocampus) vs. antipsychotic effects (SZ-ON: “normalization” of CBF). The observed PFC “hyperactivity” (evidenced by elevated CBF in both SZ-OFF and REL-P) may constitute a regionally-specific “psychosis maker”. Future research targeted at granular aspects of hippocampal-PFC pathology in medicated and unmedicated samples may inform more precise, novel interventions in SZ.
大多数精神分裂症（SZ）中基于大脑的生物标志物研究都是来自慢性药物样本。消除“原发”疾病与精神药物作用对SZ神经生物学的影响仍然具有挑战性。在这项研究中,使用3特斯拉pseudo-continuous动脉自旋标记(pCASL),我们检查区域脑血流量(CBF)在海马和皮质投影网络深圳渊源者(n = 41个,其中包括antipsychotic-free (SZ-OFF, n = 14)和治疗抗精神病药物(s) (SZ-ON, n = 27)],其一级亲属(n = 28日,包括亲戚一生psychosis-spectrum障碍(REL-P, n = 14)没有(REL-NP, n = 14)],和健康对照组(HC, n = 16) (n = 85)。与SZ-ON相比，SZ-OFF在左扣带中部、腹内侧和背外侧前额叶皮层（PFC）显示CBF升高（Hedges' g = 0.65-0.91）。SZ-OFF组与SZ-ON组海马CBF无差异，而SZ-OFF组与HC组左前海马CBF减少（g = 1.09）。在亲属中，与REL-NP相比，REL-P在右侧腹外侧PFC中具有升高的CBF (g = 0.73)，类似于SZ-OFF的“额叶过度”效应。相反，REL-NP与HC显示右侧PFC的CBF减少（g = 0.52-0.79）。我们的研究结果表明，独特的区域CBF活性特征可能捕获原发疾病效应（SZ-OFF: PFC CBF升高，但海马前部CBF降低）与抗精神病作用（SZ-ON: CBF“正常化”）。观察到的PFC“过度活跃”（由SZ-OFF和REL-P的CBF升高证明）可能构成区域特异性的“精神病制造者”。未来针对用药和未用药样本海马- pfc病理颗粒方面的研究可能会为SZ提供更精确、更新颖的干预措施。
{"title":"The hippocampal-cortical system cerebral blood flow in schizophrenia: Primary disease versus antipsychotic medication effects","authors":"Alexa Ciarolla , Anastasia M. Bobilev , Filip Dybowski , Yan Fang , Carolyn Sacco , Jayme M. Palka , Sina Aslan , Peiying Liu , Hanzhang Lu , Carol A. Tamminga , Elena I. Ivleva","doi":"10.1016/j.schres.2025.11.003","DOIUrl":"10.1016/j.schres.2025.11.003","url":null,"abstract":"<div><div>Most of the brain-based biomarker research in schizophrenia (SZ) results from chronic medicated samples. Disambiguating contributions of “primary” disease vs. psychotropic medication effects to the neurobiology of SZ remains challenging. In this study, using 3Tesla pseudo-continuous Arterial Spin Labeling (pCASL), we examined regional cerebral blood flow (CBF) in hippocampus and its cortical projection network in SZ probands [n = 41, including antipsychotic-free (SZ-OFF, n = 14) and treated with antipsychotic(s) (SZ-ON, n = 27)], their first-degree relatives [n = 28, including relatives with lifetime psychosis-spectrum disorders (REL-P, n = 14) and without (REL-NP, n = 14)], and healthy controls (HC, n = 16) [n = 85 total].</div><div>SZ-OFF demonstrated elevated CBF in the left middle cingulate, ventromedial and dorsolateral prefrontal cortex (PFC), compared to SZ-ON (Hedges' <em>g</em> = 0.65–0.91). No difference in hippocampal CBF emerged in SZ-OFF vs. SZ-ON, while SZ-OFF vs. HC showed reduced CBF in the left anterior hippocampus (<em>g</em> = 1.09). Among relatives, REL-P had elevated CBF in the right ventrolateral PFC, compared to REL-NP (<em>g</em> = 0.73) – resembling the “hyperfrontality” effect in SZ-OFF. Conversely, REL-NP vs. HC showed reduced CBF throughout the right PFC (<em>g</em> = 0.52–0.79).</div><div>Our findings demonstrate unique regional CBF-based activity signatures potentially capturing <em>primary disease effects</em> (SZ-OFF: elevated CBF in PFC but reduced CBF in the anterior hippocampus) vs. <em>antipsychotic effects</em> (SZ-ON: “normalization” of CBF). The observed PFC “hyperactivity” (evidenced by elevated CBF in both SZ-OFF and REL-P) may constitute a regionally-specific “psychosis maker”. Future research targeted at granular aspects of hippocampal-PFC pathology in medicated and unmedicated samples may inform more precise, novel interventions in SZ.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"287 ","pages":"Pages 3-15"},"PeriodicalIF":3.5,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519349","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}
Pub Date : 2025-11-14DOI: 10.1016/j.schres.2025.11.002
Muhammad Abdullah , Shih-Hsien Lin , Li-Chung Huang , Yen Kuang Yang
Background
The role of peripheral glutamate as an accessible biomarker for schizophrenia remains unclear. Its potential to reflect illness progression or differentiate treatment-resistant (TRS) from non-resistant (non-TRS) patients, and its relationship with central glutamate, require further investigation. This exploratory study assessed plasma glutamate levels and their associations with anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC) glutamate in both TRS and non-TRS patients. Additionally, we examined associations between plasma glutamate and clinical characteristics, including psychiatric and cognitive measures.
Methods
We examined 71 patients (33 non-TRS, 38 TRS). Plasma glutamate was measured using colorimetry, and ACC and mPFC glutamate were assessed via Magnetic Resonance Spectroscopy (MRS).
Results
Plasma glutamate levels were significantly higher in non-TRS compared to TRS patients. However, there was no significant correlation between plasma glutamate and ACC or mPFC glutamate in either group. Furthermore, plasma glutamate was not associated with clinical measures, including Positive and Negative Syndrome Scale (PANSS) scores, aggression scores, general scores, or the working memory index.
Conclusion
There is preliminary evidence that peripheral glutamate levels are lower in TRS compared to non-TRS patients; however, peripheral glutamate does not appear to reliably reflect brain glutamate levels or symptom severity in schizophrenia.
{"title":"Assessing plasma and brain glutamate in treatment resistant and non-resistant schizophrenia: a peripheral-central disconnect","authors":"Muhammad Abdullah , Shih-Hsien Lin , Li-Chung Huang , Yen Kuang Yang","doi":"10.1016/j.schres.2025.11.002","DOIUrl":"10.1016/j.schres.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>The role of peripheral glutamate as an accessible biomarker for schizophrenia remains unclear. Its potential to reflect illness progression or differentiate treatment-resistant (TRS) from non-resistant (non-TRS) patients, and its relationship with central glutamate, require further investigation. This exploratory study assessed plasma glutamate levels and their associations with anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC) glutamate in both TRS and non-TRS patients. Additionally, we examined associations between plasma glutamate and clinical characteristics, including psychiatric and cognitive measures.</div></div><div><h3>Methods</h3><div>We examined 71 patients (33 non-TRS, 38 TRS). Plasma glutamate was measured using colorimetry, and ACC and mPFC glutamate were assessed via Magnetic Resonance Spectroscopy (MRS).</div></div><div><h3>Results</h3><div>Plasma glutamate levels were significantly higher in non-TRS compared to TRS patients. However, there was no significant correlation between plasma glutamate and ACC or mPFC glutamate in either group. Furthermore, plasma glutamate was not associated with clinical measures, including Positive and Negative Syndrome Scale (PANSS) scores, aggression scores, general scores, or the working memory index.</div></div><div><h3>Conclusion</h3><div>There is preliminary evidence that peripheral glutamate levels are lower in TRS compared to non-TRS patients; however, peripheral glutamate does not appear to reliably reflect brain glutamate levels or symptom severity in schizophrenia.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"287 ","pages":"Pages 16-20"},"PeriodicalIF":3.5,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519344","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}
Pub Date : 2025-11-13DOI: 10.1016/j.schres.2025.11.004
Louise Birkedal Glenthøj , Lise Sandvig Mariegaard , Lisa Charlotte Smith , Mads Juul Christensen , Sara Nørgård Jensen , Mar Rus-Calafell , Neil Thomas , Merete Nordentoft , Ditte Lammers Vernal
{"title":"Impact of avatar features and presence on treatment outcomes in virtual reality-assisted therapy for auditory hallucinations","authors":"Louise Birkedal Glenthøj , Lise Sandvig Mariegaard , Lisa Charlotte Smith , Mads Juul Christensen , Sara Nørgård Jensen , Mar Rus-Calafell , Neil Thomas , Merete Nordentoft , Ditte Lammers Vernal","doi":"10.1016/j.schres.2025.11.004","DOIUrl":"10.1016/j.schres.2025.11.004","url":null,"abstract":"","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"287 ","pages":"Pages 1-2"},"PeriodicalIF":3.5,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145499849","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}
Pub Date : 2025-11-11DOI: 10.1016/j.schres.2025.10.025
Vinod H. Srihari , Matcheri S. Keshavan
{"title":"Learning health systems for first-episode psychosis: Insights from North America","authors":"Vinod H. Srihari , Matcheri S. Keshavan","doi":"10.1016/j.schres.2025.10.025","DOIUrl":"10.1016/j.schres.2025.10.025","url":null,"abstract":"","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"286 ","pages":"Pages A1-A5"},"PeriodicalIF":3.5,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506709","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}
Pub Date : 2025-11-10DOI: 10.1016/j.schres.2025.10.021
Benjamin Buck , Erica Whiting , Kevin Hallgren , Maria Monroe-DeVita , Dror Ben-Zeev
Caregiver involvement is critical to outcomes for young people with early psychosis. Caregiver-focused interventions reduce caregiver distress, improve family communication, and increase likelihood of recovery, but many caregivers face barriers to access. Because mHealth interventions can be accessed remotely and require minimal staffing, they could address some of these challenges. Our team conducted a pilot trial of Bolster, an mHealth intervention for early psychosis caregivers, with sixty (N = 60) caregivers to young adults with early psychosis to determine the acceptability and preliminary efficacy of Bolster as well as the feasibility of this approach. Participants were randomized to receive (1) a list of extant online resources (control arm), or (2) these resources alongside the Bolster mobile app (intervention arm). Caregivers used Bolster frequently (30.2 % of days during the intervention period and 10.4 min per use day) and reported finding it usable and helpful in supporting their caregiving activities. Outcome analyses demonstrated improvements in multiple outcomes, including family communication (Cohen's d = 0.86) and caregiver psychological morbidity (d = 0.98). Improvements in the Bolster arm were larger than control for caregiver psychological morbidity (d = 0.61) and distress related to the loved one's illness (d = 0.72), and caregivers in the Bolster arm were more likely to report that their loved one accessed psychotherapy or counseling (aRR = 2.53 [95 % CI: 1.07 to 6.01]) and met with a medication provider (aRR = 2.91 [95 % CI: 1.10 to 7.65]). Results suggest that Bolster is acceptable to caregivers and has promising preliminary efficacy.
{"title":"Pilot randomized controlled trial of Bolster, an mHealth intervention for caregivers to young people with early psychosis","authors":"Benjamin Buck , Erica Whiting , Kevin Hallgren , Maria Monroe-DeVita , Dror Ben-Zeev","doi":"10.1016/j.schres.2025.10.021","DOIUrl":"10.1016/j.schres.2025.10.021","url":null,"abstract":"<div><div>Caregiver involvement is critical to outcomes for young people with early psychosis. Caregiver-focused interventions reduce caregiver distress, improve family communication, and increase likelihood of recovery, but many caregivers face barriers to access. Because mHealth interventions can be accessed remotely and require minimal staffing, they could address some of these challenges. Our team conducted a pilot trial of Bolster, an mHealth intervention for early psychosis caregivers, with sixty (<em>N</em> = 60) caregivers to young adults with early psychosis to determine the acceptability and preliminary efficacy of Bolster as well as the feasibility of this approach. Participants were randomized to receive (1) a list of extant online resources (control arm), or (2) these resources alongside the Bolster mobile app (intervention arm). Caregivers used Bolster frequently (30.2 % of days during the intervention period and 10.4 min per use day) and reported finding it usable and helpful in supporting their caregiving activities. Outcome analyses demonstrated improvements in multiple outcomes, including family communication (<em>Cohen's d</em> = 0.86) and caregiver psychological morbidity (<em>d</em> = 0.98). Improvements in the Bolster arm were larger than control for caregiver psychological morbidity (<em>d</em> = 0.61) and distress related to the loved one's illness (<em>d</em> = 0.72), and caregivers in the Bolster arm were more likely to report that their loved one accessed psychotherapy or counseling (aRR = 2.53 [95 % CI: 1.07 to 6.01]) and met with a medication provider (aRR = 2.91 [95 % CI: 1.10 to 7.65]). Results suggest that Bolster is acceptable to caregivers and has promising preliminary efficacy.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"286 ","pages":"Pages 132-141"},"PeriodicalIF":3.5,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496586","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}
Pub Date : 2025-11-06DOI: 10.1016/j.schres.2025.10.026
Thomas A. Bart , Megan M. Hricovec , Shealen Taylor , Wesley Amlong , David C. Cicero
Paranoid ideation relates to a mistrust or suspicion of other people and their motives and may be especially influenced by environmental and psychosocial factors. Historically marginalized populations consistently endorse higher levels of paranoid ideation than Non-Hispanic White individuals, but it is unclear whether these differences can be attributed to measurement bias or if they represent genuine between-group differences in the latent construct. The current study aimed to examine the measurement invariance of five common paranoia measures. Participants included Non-Hispanic White (n = 308), Black American (n = 299), and Hispanic (n = 281) groups recruited from the general population. Scales included the Revised-Green Paranoid Thoughts Scale (R-GPTS), Paranoia Scale (PS), Persecution and Deservedness Scale (PaDS), Paranoia/Suspiciousness Questionnaire (PSQ), and the Personality Inventory for the DSM-5 (PID-5) Suspiciousness facet scale. Measurement invariance analyses indicated the R-GPTS, PS, PaDS, PID-5 Suspiciousness facet, and PSQ Negative Mood/Withdrawal and Perceived Hardship/Resentment subscales showed configural, metric, and scalar invariance, while the Interpersonal Suspiciousness/Hostility and Mistrust/Wariness subscales lacked scalar invariance. Black American participants had higher mean scores on all invariant measures, followed by Hispanic and Non-Hispanic White participants. For the scales that displayed scalar invariance, these results are unlikely to be attributable to measurement bias, and instead likely reflect cultural and potentially adaptive responses to the complex relationships between cultural, social, and economic factors. To better understand how demographic variables and social determinants of health may influence paranoid ideation in diverse populations, future research should incorporate these variables into measurement invariance and group difference analyses.
{"title":"Assessing measurement invariance of paranoia scales across racial and ethnic groups in the U.S.","authors":"Thomas A. Bart , Megan M. Hricovec , Shealen Taylor , Wesley Amlong , David C. Cicero","doi":"10.1016/j.schres.2025.10.026","DOIUrl":"10.1016/j.schres.2025.10.026","url":null,"abstract":"<div><div>Paranoid ideation relates to a mistrust or suspicion of other people and their motives and may be especially influenced by environmental and psychosocial factors. Historically marginalized populations consistently endorse higher levels of paranoid ideation than Non-Hispanic White individuals, but it is unclear whether these differences can be attributed to measurement bias or if they represent genuine between-group differences in the latent construct. The current study aimed to examine the measurement invariance of five common paranoia measures. Participants included Non-Hispanic White (<em>n</em> = 308), Black American (<em>n</em> = 299), and Hispanic (<em>n</em> = 281) groups recruited from the general population. Scales included the Revised-Green Paranoid Thoughts Scale (R-GPTS), Paranoia Scale (PS), Persecution and Deservedness Scale (PaDS), Paranoia/Suspiciousness Questionnaire (PSQ), and the Personality Inventory for the DSM-5 (PID-5) Suspiciousness facet scale. Measurement invariance analyses indicated the R-GPTS, PS, PaDS, PID-5 Suspiciousness facet, and PSQ Negative Mood/Withdrawal and Perceived Hardship/Resentment subscales showed configural, metric, and scalar invariance, while the Interpersonal Suspiciousness/Hostility and Mistrust/Wariness subscales lacked scalar invariance. Black American participants had higher mean scores on all invariant measures, followed by Hispanic and Non-Hispanic White participants. For the scales that displayed scalar invariance, these results are unlikely to be attributable to measurement bias, and instead likely reflect cultural and potentially adaptive responses to the complex relationships between cultural, social, and economic factors. To better understand how demographic variables and social determinants of health may influence paranoid ideation in diverse populations, future research should incorporate these variables into measurement invariance and group difference analyses.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"286 ","pages":"Pages 125-131"},"PeriodicalIF":3.5,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467585","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}
Pub Date : 2025-11-05DOI: 10.1016/j.schres.2025.10.019
Yu-Cheng Wang , Hui-Ying Fan , Qian-Hua Huang , Xuan-Chen Liu , Yi-Ran Huang , Zhaohui Su , Teris Cheung , Gabor S. Ungvari , Yuan Feng , Gang Wang , Chee H. Ng , Yu-Tao Xiang
Background
Although numerous studies have examined the impact of schizophrenia on quality of life (QoL), the results have been mixed. This meta-analysis compared QoL across various domains between schizophrenia patients and healthy controls and identified the moderators of group differences.
Methods
A meta-analysis of case-control studies was conducted following PRISMA guidelines. Major international databases (PubMed, Web of Science, EMBASE and PsycINFO) and Chinese databases (CNKI and Wanfang) were searched from their inception to December 2024. Studies comparing QoL between patients with schizophrenia and healthy controls using standardized validated instruments (e.g., WHOQOL, SF-36) were included. Standardized mean differences (SMDs) were calculated using a random-effects model. Subgroup and meta-regression analyses were performed to explore the moderators of group differences.
Results
Thirty-six studies (5664 patients; 5042 controls) met the inclusion criteria, revealing significant QoL impairment in patients across all domains. Deficits were most pronounced in the physical domain (WHOQOL: SMD = −1.52; SF-36: SMD = −1.16; GQOLI: SMD = −2.38) and social domain (WHOQOL: SMD = −1.33; SF-36: SMD = −1.24; GQOLI: SMD = −2.56), with notable impairment also in psychological (WHOQOL: SMD = −1.11) and environmental (WHOQOL: SMD = −0.87) domains. Meta-regression demonstrated that more severe negative symptoms score (β = −0.051, p = 0.043) and greater general psychopathology (β = −0.038, p = 0.049) were significantly associated with poorer environmental QoL.
Conclusion
This meta-analysis demonstrated that patients with schizophrenia have significant QoL impairment across multiple domains, particularly in the physical and social functioning domains. These findings highlight the need to address clinical moderators to develop patient-centered interventions.
{"title":"Quality of life in patients with schizophrenia: A systematic review and meta-analysis of case-control studies","authors":"Yu-Cheng Wang , Hui-Ying Fan , Qian-Hua Huang , Xuan-Chen Liu , Yi-Ran Huang , Zhaohui Su , Teris Cheung , Gabor S. Ungvari , Yuan Feng , Gang Wang , Chee H. Ng , Yu-Tao Xiang","doi":"10.1016/j.schres.2025.10.019","DOIUrl":"10.1016/j.schres.2025.10.019","url":null,"abstract":"<div><h3>Background</h3><div>Although numerous studies have examined the impact of schizophrenia on quality of life (QoL), the results have been mixed. This meta-analysis compared QoL across various domains between schizophrenia patients and healthy controls and identified the moderators of group differences.</div></div><div><h3>Methods</h3><div>A meta-analysis of case-control studies was conducted following PRISMA guidelines. Major international databases (PubMed, Web of Science, EMBASE and PsycINFO) and Chinese databases (CNKI and Wanfang) were searched from their inception to December 2024. Studies comparing QoL between patients with schizophrenia and healthy controls using standardized validated instruments (e.g., WHOQOL, SF-36) were included. Standardized mean differences (SMDs) were calculated using a random-effects model. Subgroup and meta-regression analyses were performed to explore the moderators of group differences.</div></div><div><h3>Results</h3><div>Thirty-six studies (5664 patients; 5042 controls) met the inclusion criteria, revealing significant QoL impairment in patients across all domains. Deficits were most pronounced in the physical domain (WHOQOL: SMD = −1.52; SF-36: SMD = −1.16; GQOLI: SMD = −2.38) and social domain (WHOQOL: SMD = −1.33; SF-36: SMD = −1.24; GQOLI: SMD = −2.56), with notable impairment also in psychological (WHOQOL: SMD = −1.11) and environmental (WHOQOL: SMD = −0.87) domains. Meta-regression demonstrated that more severe negative symptoms score (β = −0.051, <em>p</em> = 0.043) and greater general psychopathology (β = −0.038, <em>p</em> = 0.049) were significantly associated with poorer environmental QoL.</div></div><div><h3>Conclusion</h3><div>This meta-analysis demonstrated that patients with schizophrenia have significant QoL impairment across multiple domains, particularly in the physical and social functioning domains. These findings highlight the need to address clinical moderators to develop patient-centered interventions.</div></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":"286 ","pages":"Pages 112-124"},"PeriodicalIF":3.5,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459730","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}
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