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A clinical control study of modified electroconvulsive therapy and sodium valproate as enhancement strategies for ultra-treatment-resistant schizophrenia 改良电惊厥疗法和丙戊酸钠作为超治疗抵抗性精神分裂症增强策略的临床对照研究
IF 3 Q2 PSYCHIATRY Pub Date : 2025-10-15 DOI: 10.1016/j.scog.2025.100396
Peijuan Wang , Chao Liu , Xueyan Zhu , Qi Yan , Ning Shen , Jiajia Shi , Qinyu Lv , Xiangdong Du

Background

A substantial proportion of patients with schizophrenia show an inadequate response to clozapine, a condition termed ultra-treatment-resistant schizophrenia (UTRS). While modified electroconvulsive therapy (MECT) and sodium valproate are common augmentation strategies, head-to-head trials directly comparing their efficacy and safety are lacking. This study aimed to directly compare the short-term efficacy and safety of MECT versus sodium valproate as augmenting agents to clozapine in patients with UTRS.

Methods

This was an 8-week, single-center, randomized controlled trial. Seventy inpatients meeting diagnostic criteria for UTRS were randomly assigned to receive either MECT augmentation (n = 35) or sodium valproate augmentation (n = 35), both in addition to their ongoing clozapine treatment. The primary outcome was the change in the Positive and Negative Syndrome Scale (PANSS) total score. Secondary outcomes included changes in cognitive function assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and laboratory safety parameters.

Results

At week 8, the MECT group demonstrated a significantly greater reduction in PANSS total score compared to the sodium valproate group (p < 0.01). The response rate, defined as a ≥ 25 % reduction in PANSS total score, was also significantly higher in the MECT group (48.6 %, 17/35) than in the valproate group (14.3 %, 5/35, p < 0.01). Regarding cognitive function, there was no statistically significant difference in the change of the RBANS total score between the two groups from baseline to endpoint (p = 0.24). Both treatments were generally well-tolerated, with no significant differences observed in key laboratory safety parameters, including leukocyte counts, liver function, and glucose levels, either within or between groups (all p > 0.05).

Conclusion

In this cohort of inpatients with UTRS, 8 weeks of MECT augmentation appeared to be more effective than sodium valproate in reducing overall psychotic symptoms. These findings should be considered preliminary, and neither intervention demonstrated short-term benefits for cognitive function. Future studies with longer follow-up periods are warranted to assess the durability of response and should include a clozapine-only control arm to confirm the true value of these augmentation strategies.
相当比例的精神分裂症患者对氯氮平反应不足,这种情况被称为超治疗抵抗性精神分裂症(UTRS)。改良电惊厥治疗(MECT)和丙戊酸钠是常见的强化治疗策略,但缺乏直接比较其疗效和安全性的正面试验。本研究旨在直接比较MECT与丙戊酸钠作为UTRS患者氯氮平增强剂的短期疗效和安全性。方法8周、单中心、随机对照试验。70名符合UTRS诊断标准的住院患者被随机分配接受MECT增强治疗(n = 35)或丙戊酸钠增强治疗(n = 35),两者都是在他们正在进行的氯氮平治疗之外。主要观察指标为阳性和阴性症状量表(PANSS)总分的变化。次要结果包括通过神经心理状态评估可重复电池(rban)和实验室安全参数评估的认知功能变化。结果在第8周,MECT组的PANSS总分较丙戊酸钠组明显降低(p < 0.01)。MECT组的有效率(PANSS总分降低≥25%)(48.6%,17/35)也显著高于丙戊酸组(14.3%,5/35,p < 0.01)。在认知功能方面,两组rban总分从基线到终点的变化差异无统计学意义(p = 0.24)。两种治疗总体上耐受良好,在关键的实验室安全参数,包括白细胞计数、肝功能和血糖水平,在组内或组间均无显著差异(均p >; 0.05)。结论在这组UTRS住院患者中,8周的MECT增强治疗在减轻整体精神病症状方面似乎比丙戊酸钠更有效。这些发现应该被认为是初步的,两种干预措施都没有显示出对认知功能的短期益处。未来有必要进行更长随访期的研究,以评估反应的持久性,并应包括仅氯氮平对照组,以确认这些增强策略的真正价值。
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引用次数: 0
Early versus adult onset of schizophrenia: an examination of premorbid and current IQ 早期与成年精神分裂症发病:发病前和当前智商的检查
IF 3 Q2 PSYCHIATRY Pub Date : 2025-10-14 DOI: 10.1016/j.scog.2025.100397
Tereza Calkova , Anja Vaskinn , Lynn Mørch-Johnsen , Runar Elle Smelror , Kjetil Nordbø Jørgensen , Laura A. Wortinger , Simon Cervenka , Karin Collste , Beathe Haatveit , Christine Mohn , Anne Margrethe Myhre , Erik G. Jönsson , Nils Eiel Steen , Ole A. Andreassen , Ingrid Melle , Ingrid Agartz , Torill Ueland , Dimitrios Andreou

Background

Cognitive deficits are core findings in schizophrenia, but whether the severity of impairments is related to the age of onset remains unclear. We hypothesized that early onset schizophrenia (EOS; onset before age 19) is associated with lower IQ compared to adult-onset schizophrenia (AOS; onset from age 19).

Methods

We included 99 adult patients with EOS (age of onset: 15.3 ± 2.8 years), 282 adult patients with AOS (age of onset: 26.5 ± 7.4 years), and 863 adult healthy controls (HC). We assessed current IQ with Wechsler Abbreviated Scale of Intelligence (WASI) and estimated premorbid IQ with National Adult Reading Test (NART).

Results

Both patient groups had lower current IQ than HC (p < 0.001). Full-scale (p = 0.004), performance (p = 0.003) and verbal (p = 0.011) current IQ were significantly lower in EOS than in AOS, with 5 IQ units difference for all three measures. EOS and AOS did not differ in premorbid IQ, but EOS showed a steeper IQ decline from premorbid levels than AOS (11.4 vs. 8 IQ units, respectively, p = 0.013).

Conclusion

EOS had lower current IQ than AOS, but did not differ in premorbid IQ, suggesting a larger decline from premorbid IQ levels. This could imply different neurodevelopmental processes underlying cognitive dysfunction related to age of onset in schizophrenia, underscoring the necessity for further inquiry into the mechanisms driving this decline and strategies for its prevention.
认知缺陷是精神分裂症的核心发现,但认知缺陷的严重程度是否与发病年龄有关尚不清楚。我们假设早发性精神分裂症(EOS,发病于19岁之前)与成年性精神分裂症(AOS,发病于19岁)相比,智商较低。方法纳入99例成年EOS患者(发病年龄:15.3±2.8岁)、282例成年AOS患者(发病年龄:26.5±7.4岁)和863例成人健康对照(HC)。我们用韦氏简略智力量表(WASI)评估当前的智商,用国家成人阅读测试(NART)评估病前智商。结果两组患者当前智商均低于HC组(p < 0.001)。全面(p = 0.004)、表现(p = 0.003)和言语(p = 0.011)当前智商在EOS组显著低于AOS组,所有三个测量值相差5个智商单位。EOS和AOS在发病前的智商水平上没有差异,但EOS比AOS表现出更大的智商下降(分别为11.4和8个智商单位,p = 0.013)。结论eos患者的当前智商低于AOS患者,但病前智商差异无统计学意义,较病前智商水平下降幅度较大。这可能意味着与精神分裂症发病年龄相关的认知功能障碍的不同神经发育过程,强调了进一步研究导致这种下降的机制和预防策略的必要性。
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引用次数: 0
Visual suppression deficits as a biomarker of working memory impairment in schizophrenia 视觉抑制缺陷作为精神分裂症工作记忆障碍的生物标志物
IF 3 Q2 PSYCHIATRY Pub Date : 2025-10-11 DOI: 10.1016/j.scog.2025.100395
Cristina Filannino , Elliot Freeman , Andrew Parton , Neelam Laxhman , Corinna Haenschel

Introduction

Although working memory (WM) deficits are well established in schizophrenia (SZ), their underlying source is still unclear. It has been proposed that these WM deficits may depend on an imbalance between cortical excitation and inhibition (E/I), but its importance for SZ remains unclear. A potential biomarker for E/I is visual Surround Suppression (SS), where the apparent contrast of a central grating is typically suppressed by a surround with parallel orientation (versus orthogonal). Here we exploited the SS phenomenon to test whether E/I contributes to WM impairments in schizophrenia.

Methods

Using centre-surround gratings, we measured psychophysical thresholds for contrast matching, detection and orientation discrimination, in 21 SZ patients and 20 matched controls. Using the same stimuli, we also measured WM accuracy and event-related potentials (ERPs) in a delayed-match-to-sample task.

Results

In SZ participants, reduced SS predicted impaired WM performance as well as general cognitive measures (CANTAB). Similar relationships were also observed between other early visual measures (impaired contrast detection and orientation discrimination), WM and general cognition. In response to SS, there was reduced amplitude visual ERPs (P1, N1 and P2) in patients compared with controls. Furthermore, across both groups the P1 amplitude correlated with visual SS.

Conclusion

Together, these findings provide evidence that imbalances in cortical excitation and inhibition may contribute to visual and some cognitive deficits in schizophrenia, and that SS may provide a behavioural and electrophysiological biomarker.
虽然工作记忆(WM)缺陷在精神分裂症(SZ)中得到了很好的确立,但其潜在的来源仍不清楚。有人提出,这些WM缺陷可能取决于皮层兴奋和抑制(E/I)之间的不平衡,但其对SZ的重要性尚不清楚。E/I的潜在生物标志物是视觉环绕抑制(SS),其中中心光栅的明显对比度通常被平行方向的环绕抑制(相对于正交方向)。在这里,我们利用SS现象来检验精神分裂症中E/I是否会导致WM损伤。方法采用中心-环绕光栅测量21例SZ患者和20例对照组的对比匹配、检测和取向辨别的心理物理阈值。使用相同的刺激,我们还测量了延迟匹配-样本任务中WM的准确性和事件相关电位(erp)。结果在SZ参与者中,SS降低预示着WM表现和一般认知测量(CANTAB)的受损。在其他早期视觉测量(对比度检测和方向辨别受损)、WM和一般认知之间也观察到类似的关系。与对照组相比,SS治疗组患者的视觉erp (P1、N1和P2)振幅降低。此外,在两组中,P1振幅与视觉SS相关。结论:这些发现提供了证据,表明皮层兴奋和抑制的不平衡可能导致精神分裂症患者的视觉和某些认知缺陷,并且SS可能提供了一种行为和电生理生物标志物。
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引用次数: 0
Neurocognitive function in schizophrenia spectrum disorders: A 20-year prospective study of a community sample 精神分裂症谱系障碍的神经认知功能:社区样本的20年前瞻性研究
IF 3 Q2 PSYCHIATRY Pub Date : 2025-09-30 DOI: 10.1016/j.scog.2025.100393
Christine Mohn , Anna-Karin Olsson , Maivor Olsson-Tall , Fredrik Hjärthag , Iris van Dijk Härd , Lars Helldin
Longitudinal studies of neurocognition in schizophrenia spectrum disorders (SSD) usually follow relatively young first-episode patients across several years. Comparatively little is known about the neurocognitive trajectory of samples also consisting of older patients. This is a 20-year follow-up study of participants who performed the baseline assessment at different ages and utilizes data from the Swedish Clinical Long-Term Psychosis Study (CLIPS). At baseline, 61 SSD patients were included and available for clinical assessment after 20 years. Of these, 28 performed neurocognitive assessment at both baseline and 20 years later. The test results from this group were used for this study. After 20 years, the participants exhibited significantly worsening cognitive flexibility, verbal learning, verbal retention memory, and verbal intellectual function compared to baseline. All the statistically significant differences from baseline to follow-up had large effect sizes. The other cognitive domains showed no statistically significant changes from baseline for either group. We conclude that although the overall picture was one of neurocognitive stability across 20 years, our participants showed signs of accelerated ageing in the verbal domain specifically.
精神分裂症谱系障碍(SSD)神经认知的纵向研究通常对相对年轻的首发患者进行数年随访。相对而言,我们对老年患者的神经认知轨迹知之甚少。这是一项20年的随访研究,参与者在不同年龄进行基线评估,并利用瑞典临床长期精神病研究(CLIPS)的数据。在基线时,61例SSD患者在20年后可用于临床评估。其中28人在基线和20年后都进行了神经认知评估。本研究采用了该组的测试结果。20年后,与基线相比,参与者表现出显著恶化的认知灵活性、言语学习、言语保留记忆和言语智力功能。从基线到随访的所有统计学显著差异均具有较大的效应量。两组的其他认知领域与基线相比没有统计学上的显著变化。我们得出的结论是,尽管20年来的总体情况是神经认知稳定的,但我们的参与者在语言领域表现出加速衰老的迹象。
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引用次数: 0
Premorbid functioning trajectories and the one-year course of cognitive performance in first-episode psychosis: a cluster analysis in PSYSCAN 首发精神病的发病前功能轨迹和一年的认知表现过程:PSYSCAN的聚类分析
IF 3 Q2 PSYCHIATRY Pub Date : 2025-09-26 DOI: 10.1016/j.scog.2025.100391
Margot I.E. Slot , Hendrika H. van Hell , Inge Winter-van Rossum , George Gifford , Paola Dazzan , Arija Maat , Lieuwe De Haan , Benedicto Crespo-Facorro , Birte Y. Glenthøj , Colm McDonald , Thérèse van Amelsvoort , Celso Arango , Irina Falkenberg , Barnaby Nelson , Silvana Galderisi , Mark Weiser , Gabriele Sachs , Anke Maatz , Jun Soo Kwon , the PSYSCAN Consortium , René S. Kahn

Background

We examined the course of cognitive performance in first-episode psychosis (FEP) compared to healthy controls (HC), and whether this varied across subgroups of patients defined by premorbid functioning (PMF) trajectories, using a clustering approach.

Methods

Data were collected in 302 FEP and 136 HC subjects participating in PSYSCAN (HEALTH.2013.2.2.1-2-FEP). K-means clustering (Euclidean distance) was used to cluster longitudinal trajectories of different PMF domains simultaneously. Since PMF was assessed retrospectively using the Premorbid Adjustment Scale (PAS), findings should be interpreted with caution, although PAS ratings have shown reasonable validity against prospective data.

Results

As expected, FEP showed impaired performance across all cognitive domains compared to HC. We identified four trajectories of PMF: a normal premorbid developmental trajectory (globally-normal, 21 %), stable intermediate PMF across domains (stable-intermediate, 29 %), stable poor or deteriorating PMF in the academic domain (normal-social/poor-academic, 29 %), and a globally impaired group with poor/deteriorating PMF across domains (globally-poor, 21 %). These clusters showed distinct levels of post-onset impairments in sustained visual attention, visual working memory and emotion recognition.

Conclusions

This study confirms a positive association between PMF and cognitive performance in the early years following psychosis onset. It aligns with findings that individuals later diagnosed with schizophrenia already show developmental deficits/lags from childhood to early adolescence compared to normally developing children. As PMF can be considered a proxy for cognitive reserve, our results suggest that higher reserve acts as a buffer against cognitive decline and supports better performance on sustained visual attention, complex visual working memory, and aspects of emotion recognition.
背景:我们使用聚类方法研究了首发精神病患者(FEP)与健康对照组(HC)的认知表现过程,以及这是否在由病前功能(PMF)轨迹定义的患者亚组中有所不同。方法收集参加心理扫描(HEALTH.2013.2.2.1-2-FEP)的302例FEP和136例HC受试者的数据。采用k均值聚类(欧几里得距离)对不同PMF域的纵向轨迹同时聚类。由于PMF是使用病前调整量表(PAS)进行回顾性评估的,因此研究结果应谨慎解释,尽管PAS评分相对于前瞻性数据显示出合理的有效性。结果正如预期的那样,与HC相比,FEP在所有认知领域都表现出受损的表现。我们确定了PMF的四种轨迹:正常的病前发展轨迹(全球正常,21%),跨领域稳定的中度PMF(稳定-中级,29%),学术领域稳定的差或恶化的PMF(正常-社会/差-学术,29%),以及跨领域差/恶化的PMF的全球受损群体(全球差,21%)。这些群体在持续视觉注意、视觉工作记忆和情绪识别方面表现出不同程度的发病后损伤。结论:本研究证实了精神病发病早期PMF与认知表现之间的正相关。这与后来被诊断为精神分裂症的个体与正常发育的儿童相比,从童年到青春期早期已经表现出发育缺陷/滞后的发现相一致。由于PMF可以被认为是认知储备的代表,我们的研究结果表明,较高的储备可以缓冲认知衰退,并支持在持续视觉注意,复杂视觉工作记忆和情绪识别方面的更好表现。
{"title":"Premorbid functioning trajectories and the one-year course of cognitive performance in first-episode psychosis: a cluster analysis in PSYSCAN","authors":"Margot I.E. Slot ,&nbsp;Hendrika H. van Hell ,&nbsp;Inge Winter-van Rossum ,&nbsp;George Gifford ,&nbsp;Paola Dazzan ,&nbsp;Arija Maat ,&nbsp;Lieuwe De Haan ,&nbsp;Benedicto Crespo-Facorro ,&nbsp;Birte Y. Glenthøj ,&nbsp;Colm McDonald ,&nbsp;Thérèse van Amelsvoort ,&nbsp;Celso Arango ,&nbsp;Irina Falkenberg ,&nbsp;Barnaby Nelson ,&nbsp;Silvana Galderisi ,&nbsp;Mark Weiser ,&nbsp;Gabriele Sachs ,&nbsp;Anke Maatz ,&nbsp;Jun Soo Kwon ,&nbsp;the PSYSCAN Consortium ,&nbsp;René S. Kahn","doi":"10.1016/j.scog.2025.100391","DOIUrl":"10.1016/j.scog.2025.100391","url":null,"abstract":"<div><h3>Background</h3><div>We examined the course of cognitive performance in first-episode psychosis (FEP) compared to healthy controls (HC), and whether this varied across subgroups of patients defined by premorbid functioning (PMF) trajectories, using a clustering approach.</div></div><div><h3>Methods</h3><div>Data were collected in 302 FEP and 136 HC subjects participating in PSYSCAN (HEALTH.2013.2.2.1-2-FEP). K-means clustering (Euclidean distance) was used to cluster longitudinal trajectories of different PMF domains simultaneously. Since PMF was assessed retrospectively using the Premorbid Adjustment Scale (PAS), findings should be interpreted with caution, although PAS ratings have shown reasonable validity against prospective data.</div></div><div><h3>Results</h3><div>As expected, FEP showed impaired performance across all cognitive domains compared to HC. We identified four trajectories of PMF: a normal premorbid developmental trajectory (globally-normal, 21 %), stable intermediate PMF across domains (stable-intermediate, 29 %), stable poor or deteriorating PMF in the academic domain (normal-social/poor-academic, 29 %), and a globally impaired group with poor/deteriorating PMF across domains (globally-poor, 21 %). These clusters showed distinct levels of post-onset impairments in sustained visual attention, visual working memory and emotion recognition.</div></div><div><h3>Conclusions</h3><div>This study confirms a positive association between PMF and cognitive performance in the early years following psychosis onset. It aligns with findings that individuals later diagnosed with schizophrenia already show developmental deficits/lags from childhood to early adolescence compared to normally developing children. As PMF can be considered a proxy for cognitive reserve, our results suggest that higher reserve acts as a buffer against cognitive decline and supports better performance on sustained visual attention, complex visual working memory, and aspects of emotion recognition.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"43 ","pages":"Article 100391"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical psychopathology-based early relapse prediction model using speech and language in psychosis 基于临床精神病理学的精神病患者言语语言早期复发预测模型
IF 3 Q2 PSYCHIATRY Pub Date : 2025-09-23 DOI: 10.1016/j.scog.2025.100392
Tyler C. Dalal , Min Tae M. Park , Angelica M. Silva , Svetlana Iskhakova , Alban Voppel , Noah J. Brierley , Michael MacKinley , Emmanuel Olarewaju , Lena Palaniyappan

Introduction

Prediction of psychotic relapse using speech-derived markers promises targeted early intervention. However, the sheer number of speech markers and the ‘black box’ nature of predictive models challenges clinical translation.

Methods

We propose a psychopathology-based systematic approach to identify likely relapse. We draw on the notion that the predictors of relapse should mark (1) the presence of schizophrenia in its untreated early stages and (2) track disorganization in psychosis. By leveraging Natural Language Processing, we derive 3 lexical, syntactic and narrative markers -semantic similarity, clause complexity, and analytic thinking index from speech samples of people with acute psychosis (n = 68) followed up for subsequent relapses over a year (12 out of 68).

Results

Speech-based model predicted relapse status with strong evidence (Bayes Factor BF10 = 79.5) against the clinical intuition model.

Conclusion

Using a Bayesian approach, this preliminary study demonstrates the utility of psychopathology-guided variable selection for speech-based relapse prediction complementing clinical intuition in practice.
使用言语衍生标志物预测精神病复发有望有针对性的早期干预。然而,大量的语音标记和预测模型的“黑箱”性质对临床翻译提出了挑战。方法我们提出了一种基于精神病理学的系统方法来识别可能的复发。我们借鉴的概念,复发的预测因素应该标志(1)精神分裂症的存在,在其未经治疗的早期阶段和(2)跟踪精神错乱。通过利用自然语言处理,我们从急性精神病患者(n = 68)的语音样本(68人中有12人)中获得了3个词汇、句法和叙事标记——语义相似性、句子复杂性和分析性思维指数。结果基于语音的预测模型与临床直觉模型相比具有较强的证据(Bayes Factor BF10 = 79.5)。结论采用贝叶斯方法,本初步研究证明了精神病理学指导的变量选择在基于语言的复发预测中补充临床直觉的实用性。
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引用次数: 0
Divergent age-related cognitive impairments in first-episode psychosis 首发精神病中不同年龄相关认知障碍
IF 3 Q2 PSYCHIATRY Pub Date : 2025-09-22 DOI: 10.1016/j.scog.2025.100394
ChengFei Duan , ChunHua Cao , MingLiang Ju , YanYan Wei , XiaoChen Tang , LiHua Xu , HuiRu Cui , YingYing Tang , ZhengHui Yi , Xin Wei , JiJun Wang , TianHong Zhang

Background

Cognitive impairment is a core feature of first-episode psychosis (FEP), but its age-associated cognitive patterns remain unclear. Prior studies suggest FEP is associated with baseline cognitive deficits and accelerated decline, yet inconsistencies exist regarding whether cognitive aging in FEP mirrors or diverges from healthy aging.

Methods

We compared 378 drug-naive FEP patients and 477 healthy controls (HC) using the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB). Clinical symptoms were evaluated via the Positive and Negative Syndrome Scale (PANSS). Age-correlations with cognitive domains were analyzed via Pearson's coefficients and Fisher's z-transformation.

Results

FEP patients showed significant deficits across all cognitive domains (all p < 0.001) and disrupted age-associated cognitive patterns. In HC, age was associated with gradual declines in memory (e.g., HVLT-R r = −0.304, p < 0.001), working memory (r = −0.168, p < 0.001), and learning functions, aligning with normative aging. FEP patients showed a complex pattern: while some executive functions (e.g., Trail Making A) mirrored HC's negative age correlations, social cognition (r = 0.174, p < 0.001), attention (r = 0.125, p = 0.015), and specific learning domains exhibited positive age associations. Group comparisons revealed significant differences in age-cognition relationships for verbal memory, working memory, and overall cognitive composites (all p < 0.0028 after Bonferroni correction), indicating disrupted cognitive aging in FEP.

Conclusions

FEP disrupts normative cognitive aging patterns, characterized by atypical decline and compensatory improvements. These findings highlight the need for longitudinal studies to clarify mechanisms and inform age-adapted interventions.
背景认知障碍是首发精神病(FEP)的核心特征,但其与年龄相关的认知模式尚不清楚。先前的研究表明,FEP与基线认知缺陷和加速衰退有关,但关于FEP的认知衰老是否反映或偏离健康衰老存在不一致。方法采用“改善精神分裂症认知的测量与治疗研究”(metrics)共识认知电池(MCCB)对378例初治FEP患者和477例健康对照(HC)进行比较。采用阳性和阴性症状量表(PANSS)评估临床症状。通过Pearson’s系数和Fisher’s z变换分析年龄与认知域的相关性。结果fep患者在所有认知领域均表现出显著的缺陷(均p <; 0.001),并破坏了与年龄相关的认知模式。在HC中,年龄与记忆力(例如,HVLT-R r = - 0.304, p < 0.001)、工作记忆(r = - 0.168, p < 0.001)和学习功能的逐渐下降有关,与正常衰老一致。FEP患者表现出复杂的模式:虽然某些执行功能(如Trail Making a)反映了HC的负年龄相关性,但社会认知(r = 0.174, p < 0.001)、注意力(r = 0.125, p = 0.015)和特定学习领域表现出正的年龄相关性。组间比较显示,言语记忆、工作记忆和整体认知复合材料的年龄认知关系存在显著差异(经Bonferroni校正后p均为0.0028),表明FEP的认知衰老受到干扰。结论fep破坏了正常的认知衰老模式,表现为非典型衰退和代偿性改善。这些发现强调了纵向研究的必要性,以阐明机制并为年龄适应的干预措施提供信息。
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引用次数: 0
Development of a cognitive function assessment tool based on psychomotor function tests in patients with schizophrenia 基于精神分裂症患者精神运动功能测试的认知功能评估工具的开发
IF 3 Q2 PSYCHIATRY Pub Date : 2025-09-08 DOI: 10.1016/j.scog.2025.100390
Yuma Shimizu , Ippei Takeuchi , Masakazu Hatano , Manako Hanya , Kiyoshi Fujita , Nakao Iwata , Hiroyuki Kamei

Background

Cognitive dysfunction has a significant impact on social functioning, such as employment, in patients with schizophrenia. However, existing cognitive assessments are time-consuming, impose a significant burden on patients, and require specialized training for evaluators, making them impractical for routine clinical use. Therefore, the present study investigated whether a simple and novel assessment tool, called Psychomotor Function Tests (PFT), correlates with existing Neuropsychological Tests (NT) and assessments with the Life Assessment Scale for the Mentally Ill (LASMI), which evaluates social functioning, including employment.

Methods

Cognitive function was examined in 24 patients with schizophrenia using NT (the Japanese Adult Reading Test, Trail Making Test (TMT), and word fluency test) and tablet-based PFT, while social functioning was evaluated using LASMI. Twenty-four healthy controls (HCs) underwent the same cognitive assessments.

Results

Psychomotor function, as evaluated by the choice reaction time, compensatory tracking test, and rapid visual information processing, was significantly worse in patients with schizophrenia than in HCs (p < 0.001). Furthermore, the composite score of PFT correlated with the time required for TMT (r = −0.707, −0.637) and LASMI subscales related to work, endurance & stability, self-recognition, required skills, and retention skills (r = −0.640, −0.689, −0.634, −0.420, −0.548).

Conclusion

PFT correlated with existing NT, which are widely used in cognitive function assessments. Cognitive function examined by PFT was closely associated with social functioning. These results suggest the potential of PFT for evaluating cognitive function in routine clinical settings for patients with schizophrenia.
精神分裂症患者的认知功能障碍对社会功能(如就业)有显著影响。然而,现有的认知评估费时,给患者带来沉重的负担,并且需要对评估人员进行专门培训,使其无法用于常规临床应用。因此,本研究调查了一种简单而新颖的评估工具,称为精神运动功能测试(PFT),是否与现有的神经心理测试(NT)和评估精神病患者生活评估量表(LASMI)相关,后者评估社会功能,包括就业。方法对24例精神分裂症患者采用NT(日本成人阅读测验、TMT、单词流畅性测验)和平板电脑PFT检测认知功能,采用LASMI评估社会功能。24名健康对照(hc)接受了相同的认知评估。结果通过选择反应时间、代偿跟踪试验和快速视觉信息加工来评估精神分裂症患者的心理运动功能,其表现明显差于正常人(p < 0.001)。此外,PFT的综合得分与TMT所需的时间相关(r = - 0.707, - 0.637),与LASMI工作、耐力和稳定性、自我认知、所需技能和保留技能相关的子量表相关(r = - 0.640, - 0.689, - 0.634, - 0.420, - 0.548)。结论pft与现有NT相关,可广泛用于认知功能评估。PFT检测的认知功能与社会功能密切相关。这些结果表明PFT在精神分裂症患者的常规临床环境中评估认知功能的潜力。
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引用次数: 0
Equivalence verification of the electronic version of the Chinese Brief Cognitive Test (C-BCT): Focus on Chinese schizophrenia populations 中文简短认知测验(C-BCT)电子版本的等效性验证:以中国精神分裂症人群为研究对象
IF 3 Q2 PSYCHIATRY Pub Date : 2025-08-31 DOI: 10.1016/j.scog.2025.100386
Han Han , Shuling Ye , Mengjuan Xie , Xin Yu , Renrong Wu , Dengtang Liu , Shaohua Hu , Yong Xu , Huanzhong Liu , Xijin Wang , Gang Zhu , Huaning Wang , Shaohong Zou , Tao Li , Wanjun Guo , Xiufeng Xu , Yuqi Cheng , Yi Li , Juan Yang , Min Peng , Chuan Shi

Objective

To complete the preparation of the electronic version of C-BCT, verifying the criterion validity of the electronic version of C-BCT.

Methods

747 healthy subjects and 139 schizophrenics completed the electronic version of C-BCT and MCCB. To measure psychotic symptoms and severity, patients with schizophrenia completed the PANSS scale. Mean, standard deviation, percentage, etc. were used to describe demographic variables. One-way analysis of variance and independent sample t-test were used to compare differences between groups. MCCB as a calibration tool, criterion validity was examined using Pearson product moment correlations.

Results

In the equivalence analysis of the healthy group, all tests have good calibration validity (p < 0.01). SC and TMT-A showed moderate correlation (r- value ranged from 0.572 to 0.651, p < 0.01), DS showed a weak correlation(r = 0.373, p < 0.01), CPT showed a weak correlation (r- value ranged from 0.219 to 0.444, p < 0.01), the comprehensive scores of the two sets of cognitive tools showed a strong correlation (r = 0.739, p < 0.01). In the equivalence analysis of the patient group, TMT-A and SC showed strong correlation (r- value ranged from 0.754 to 0.803, p < 0.01), DS showed a weak correlation (r = 0.381, p < 0.01), the cognitive tools comprehensive score was significantly strong correlation (r = 0.755, p < 0.01), there was no correlation between CPT(p > 0.05). In the healthy group, there was a correlation between the scores of each subtest of the electronic version of C-BCT and the comprehensive scores of the two cognition tools, (r- value ranged from 0.261 to 0.824, p < 0.01). In the patient group, there was a correlation between the scores of each subtest and the comprehensive scores of the two tools,(r- value ranged from 0.266 to 0.778, p < 0.01).

Conclusion

The electronic version of C-BCT has been compiled. The electronic version of the C-BCT performs well in overall calibration validity and could be used to assess the cognitive function of schizophrenia.
目的完成C-BCT电子版的编制,验证C-BCT电子版的标准效度。方法对747名健康受试者和139名精神分裂症患者进行C-BCT和MCCB电子版测试。为了测量精神分裂症的症状和严重程度,精神分裂症患者完成了PANSS量表。用均值、标准差、百分比等来描述人口统计变量。组间差异比较采用单因素方差分析和独立样本t检验。MCCB作为校准工具,使用Pearson积矩相关检验标准效度。结果在健康组的等效性分析中,各试验的标度均较好(p < 0.01)。SC与TMT-A呈中度相关(r值为0.572 ~ 0.651,p < 0.01), DS呈弱相关(r值为0.373,p < 0.01), CPT呈弱相关(r值为0.219 ~ 0.444,p < 0.01),两组认知工具综合得分呈强相关(r = 0.739, p < 0.01)。在患者组的等效性分析中,TMT-A与SC呈强相关(r值范围为0.754 ~ 0.803,p < 0.01), DS呈弱相关(r = 0.381, p < 0.01),认知工具综合评分呈显著强相关(r = 0.755, p < 0.01), CPT与CPT无相关性(p < 0.05)。健康组C-BCT电子版各单项测试得分与两种认知工具综合得分均存在相关性(r值为0.261 ~ 0.824,p < 0.01)。在患者组中,各亚测试得分与两种工具的综合得分存在相关性(r值为0.266 ~ 0.778,p < 0.01)。结论C-BCT电子版已编制完成。电子版C-BCT在整体校正效度上表现良好,可用于评估精神分裂症的认知功能。
{"title":"Equivalence verification of the electronic version of the Chinese Brief Cognitive Test (C-BCT): Focus on Chinese schizophrenia populations","authors":"Han Han ,&nbsp;Shuling Ye ,&nbsp;Mengjuan Xie ,&nbsp;Xin Yu ,&nbsp;Renrong Wu ,&nbsp;Dengtang Liu ,&nbsp;Shaohua Hu ,&nbsp;Yong Xu ,&nbsp;Huanzhong Liu ,&nbsp;Xijin Wang ,&nbsp;Gang Zhu ,&nbsp;Huaning Wang ,&nbsp;Shaohong Zou ,&nbsp;Tao Li ,&nbsp;Wanjun Guo ,&nbsp;Xiufeng Xu ,&nbsp;Yuqi Cheng ,&nbsp;Yi Li ,&nbsp;Juan Yang ,&nbsp;Min Peng ,&nbsp;Chuan Shi","doi":"10.1016/j.scog.2025.100386","DOIUrl":"10.1016/j.scog.2025.100386","url":null,"abstract":"<div><h3>Objective</h3><div>To complete the preparation of the electronic version of C-BCT, verifying the criterion validity of the electronic version of C-BCT.</div></div><div><h3>Methods</h3><div>747 healthy subjects and 139 schizophrenics completed the electronic version of C-BCT and MCCB. To measure psychotic symptoms and severity, patients with schizophrenia completed the PANSS scale. Mean, standard deviation, percentage, etc. were used to describe demographic variables. One-way analysis of variance and independent sample <em>t-</em>test were used to compare differences between groups. MCCB as a calibration tool, criterion validity was examined using Pearson product moment correlations.</div></div><div><h3>Results</h3><div>In the equivalence analysis of the healthy group, all tests have good calibration validity (<em>p</em> &lt; 0.01). SC and TMT-A showed moderate correlation (r- value ranged from 0.572 to 0.651, <em>p</em> &lt; 0.01), DS showed a weak correlation(<em>r</em> = 0.373, <em>p</em> &lt; 0.01), CPT showed a weak correlation (r- value ranged from 0.219 to 0.444, <em>p</em> &lt; 0.01), the comprehensive scores of the two sets of cognitive tools showed a strong correlation (<em>r</em> = 0.739, p &lt; 0.01). In the equivalence analysis of the patient group, TMT-A and SC showed strong correlation (r- value ranged from 0.754 to 0.803, p &lt; 0.01), DS showed a weak correlation (<em>r</em> = 0.381, <em>p</em> &lt; 0.01), the cognitive tools comprehensive score was significantly strong correlation (<em>r</em> = 0.755, p &lt; 0.01), there was no correlation between CPT(<em>p</em> &gt; 0.05). In the healthy group, there was a correlation between the scores of each subtest of the electronic version of C-BCT and the comprehensive scores of the two cognition tools, (r- value ranged from 0.261 to 0.824, <em>p</em> &lt; 0.01). In the patient group, there was a correlation between the scores of each subtest and the comprehensive scores of the two tools,(r- value ranged from 0.266 to 0.778, p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>The electronic version of C-BCT has been compiled. The electronic version of the C-BCT performs well in overall calibration validity and could be used to assess the cognitive function of schizophrenia.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100386"},"PeriodicalIF":3.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anomalous self-experience in schizophrenia spectrum disorders: Phenomenological and psychopathological correlates 精神分裂症谱系障碍的异常自我体验:现象学和精神病理学相关性
IF 3 Q2 PSYCHIATRY Pub Date : 2025-08-30 DOI: 10.1016/j.scog.2025.100389
Alessio Mosca , Stefania Chiappini , Arianna Pasino , Andrea Miuli , Carlotta Marrangone , Mauro Pettorruso , Giovanni Martinotti

Background

Anomalous self-experiences (ASEs) are increasingly recognized as core features of schizophrenia spectrum disorders, reflecting disruptions of the pre-reflective self or ipseity. While ASEs have been conceptualized as foundational to psychotic vulnerability, their empirical associations with broader clinical and psychological dimensions remain underexplored.

Objective

This study aimed to investigate the relationship between ASEs, schizotypal traits, general psychopathology, personality dimensions, and intolerance of uncertainty in individuals diagnosed with schizophrenia-spectrum disorders.

Methods

A cross-sectional sample of clinically stable patients (n = 30) with schizophrenia-spectrum disorders was assessed using the Examination of Anomalous Self-Experience (EASE), Positive and Negative Syndrome Scale (PANSS), Schizotypal Personality Questionnaire (SPQ), Big Five Questionnaire (BFQ), and the Intolerance of Uncertainty Scale. Pearson correlations and multiple linear regression analyses were performed to examine associations and predictive factors of self-disturbance severity.

Results

EASE scores were significantly correlated with SPQ total and cognitive-perceptual dimensions, general psychopathology (PANSS), and intolerance of uncertainty. Regression analysis identified SPQ total positive percentage, PANSS general psychopathology scores, and prospective intolerance of uncertainty as significantly associated with ASEs, explaining 42 % of the total variance. BFQ personality traits showed no significant predictive value.

Conclusion

These findings support the conceptualization of ASEs as a core, trait-like feature of schizophrenia-spectrum psychopathology. The study highlights the interconnection between self-disturbance and schizotypy, affective dysregulation, and experiential disorganization. Incorporating phenomenological assessment into routine clinical practice may enhance early detection and inform targeted therapeutic approaches.
异常自我体验(ASEs)越来越被认为是精神分裂症谱系障碍的核心特征,反映了前反思自我或迟钝的破坏。虽然asa已经被定义为精神病易感性的基础,但它们与更广泛的临床和心理维度的经验关联仍未得到充分探讨。目的探讨精神分裂症谱系障碍与分裂型特征、一般精神病理、人格维度和不确定性耐受之间的关系。方法采用异常自我体验(EASE)、正阴性综合征量表(PANSS)、分裂型人格问卷(SPQ)、大五人格问卷(BFQ)和不确定性耐受度量表对30例临床稳定型精神分裂症谱系障碍患者进行横断面评估。采用Pearson相关和多元线性回归分析来检验自我困扰严重程度的相关性和预测因素。结果ase得分与SPQ总分、认知知觉维度、一般精神病理(PANSS)、不确定性耐受度显著相关。回归分析发现SPQ总阳性百分比、PANSS一般精神病理评分和对不确定性的预期不耐受与asa显著相关,解释了总方差的42%。BFQ人格特征无显著预测价值。结论:这些发现支持了as作为精神分裂症谱系精神病理的核心特征的概念。该研究强调了自我困扰与精神分裂、情感失调和经验紊乱之间的联系。将现象学评估纳入常规临床实践可以提高早期发现和有针对性的治疗方法。
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引用次数: 0
期刊
Schizophrenia Research-Cognition
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