Schizophrenia (Heidelberg, Germany)最新文献

Felt presence (FP) - sensing another person without clear sensory evidence - has been described in psychosis for over a century but rarely studied due to challenges in recognition and assessment. Recently FP has been identified as a transdiagnostic phenomenon and highlighted by people with lived experience of psychosis as a clinical priority. Here we describe FP presentation in a first-episode psychosis sample and report preliminary associations with affect, gender, and psychopathology.

Testosterone play an important role in schizophrenia, particularly for impulsive aggressive behaviors. However, there is still unclear how the neurobiological basis and correlates of these risk factors in schizophrenia patients. The schizophrenia patients who visited psychiatric emergency departments (PED) with an acute stage and received an evaluation of aggression and psychotic symptoms by the Positive and Negative Syndrome Scale (PANSS) were included. Blood samples were collected for plasma testosterone measurement. The network analysis and network comparison test were conducted to construct and evaluate whether network characteristics differed by gender. The prevalence of level Ⅱ aggression was 41.4%, level Ⅲ aggression was 33.3%, and level Ⅳ aggression was 8.8% in the SCZ patients visited in PED, respectively. The total score of PANSS, the average level of testosterone, and the proportion of males in the aggressive group were higher than those in the non-aggressive group, respectively. Network analysis identified "Guilt feelings", "Poor impulse control" and "Difficulty in abstract thinking" as the most influential symptoms. "Poor impulse control" appeared to be the bridge symptom linking psychotic symptoms to aggressive behavior. Concurrently, "Poor impulse control" stand as critical bridge symptoms between psychotic symptoms to aggressive behaviors. Moreover, "Blunted affect" exhibited the strongest positive correlation with testosterone levels among SCZ patients in the acute stage. The findings highlight the complex interplay between testosterone and psychotic symptoms of schizophrenia patients, emphasizing the importance of targeting influential symptoms in psychiatric emergency care. The identification of central and bridge symptoms suggests potential pathways for individual interventions for SCZ patients.

Identification of cell type-specific and temporally dynamic regulatory features of schizophrenia (SCZ) risk genes is essential for advancing mechanistic neurobiological studies. This study systematically dissected the genetic architecture and neurodevelopmental mechanisms of SCZ by integrating genome-wide association study (GWAS) data from European (N = 130,644) and East Asian (N = 30,761) population, alongside multi-omics and single-cell sequencing analyses. Cross-method validation identified seven core genes (e.g., MDK, RERE, ERBB4), with RERE exhibiting a notably high eQTL-SCZ colocalization probability of 92.8-93.9%. Single-cell and epigenetic analyses reveal that the spatiotemporal dynamics of RERE may lead to differences in its mediated SCZ disease risk at the levels of genetic variation and transcriptional regulation. Cleavage Under Targets and Tagmentation (CUT&Tag) confirmed that RERE directly regulates synaptic genes such as PPP4R3B and RPS27L, and its co-expression network was found to be strongly linked to SCZ risk. This study unveils a RERE-mediated epigenetic-neurodevelopmental axis and suggests that GABAergic neurons may be a potential new target for the treatment of SCZ. Future validation using organoid models and exploration of clinical translation are warranted.

Understanding neurobiological similarities among individuals with psychosis risk symptoms can improve early identification and intervention strategies. We aimed to (i) identify neurobiologically similar psychosis risk subgroups by integrating resting-state functional connectivity and psychosis risk symptom data and (ii) discern discriminating symptom profiles and brain connectivity patterns in the identified sub-groups. Our sample (N = 922) was extracted from the Philadelphia Neurodevelopmental Cohort, a community group of individuals aged 12-21 years, with fMRI and self-reported psychopathology data. Analyses were conducted separately for youth and early adults. We constructed a two-layer network using pair-wise similarity distances between participants based on resting-state fMRI and psychosis risk symptoms measured with the PRIME screen. We then performed community detection via a multiplex stochastic block model to identify subject clusters. We identified 2 blocks or communities for both the youth (n = 458 and 179) and early adult (n = 173 and 112) groups. Connection parameter estimates of the neuroimaging layer were nearly identical between blocks for both age groups whereas there was significant variation for the symptom layer. Psychopathology symptom and brain system segregation profiles were consistent across age groups. The youth block (n = 458) with higher salience network segregation values had higher mean psychosis risk symptom scores while the early adult block (n = 173) with lower salience network segregation had higher mean psychosis risk symptom scores. By integrating global similarities in brain connectivity and psychosis risk symptoms, we identified distinct subgroups. These groups exhibit different symptom profiles and network segregation in youth and early adults, suggesting variations in developmental paths for psychosis spectrum.

Item Response Theory (IRT) describes a set of statistical models describing how individual items in a test or questionnaire relate to the underlying characteristic or trait that the test claims to measure. Until now IRT models have not been applied to the Positive and Negative Syndrome Scale (PANSS) in forensic and general psychiatric samples to establish its psychometric properties and explore the link between psychotic symptom severity and violent behavior in schizophrenia. This study investigated patients with schizophrenia spectrum disorders and a history of violence from forensic institutions and non-violent patients from general psychiatric settings in five European countries. A total of 398 participants were assessed using the PANSS. IRT analysis revealed a poor model fit for the Partial Credit Model (PCM) with considerably disordered thresholds for most items. Differential item functioning (DIF) revealed significant differences between the two groups, notably for items hypothetically linked to violence risk, such as delusions and hostility. These findings reveal potential limitations when trying to compare PANSS scores across these two clinical populations.

Stigma associated with schizophrenia has been well-documented in both society and healthcare settings. However, the use of stigmatizing language in research papers remains largely unexplored. This study examined how researchers refer to schizophrenia in peer-reviewed articles, aiming to characterize the descriptive terms used to refer to individuals with schizophrenia and assess the adoption of person-first language. We conducted an electronic search on PubMed using the MeSH term "schizophrenia" and randomly selected 500 articles. Descriptive terminology was categorized as neutral (e.g., "schizophrenia patients"), person-first (e.g., "person with schizophrenia"), or identity-first (e.g., "schizophrenic patient"). Reference terms were assessed based on their alignment with a person-first perspective. Of the 500 studies, 475 (95%) included at least one term referring to people affected by schizophrenia. Among them, 238 (50.1%) used identity-first terms, 228 (48%) used person-first terms, and 91 (18.2%) employed both. Over time, the use of identity-first terms decreased. The decline in identity-first terms over time suggests a positive impact of the person-first movement. Despite these encouraging findings, our data also indicate that there is still room for improvement in reducing the use of identity-first terms. We propose recommendations for researchers to promote less stigmatizing language.

The "dopamine hypothesis" of schizophrenia suggests the imbalance of the brain dopamine system plays a crucial role in the development of this disorder. Although this hypothesis has been partly supported by early studies, the brain region-specific abnormalities of different dopamine subsystems, and the influential factors on the heterogeneity of dopamine dysfunction of schizophrenia are still unknown. To address these issues, we carried out random-effect meta-analyses by collecting 49 in vivo PET studies (692 patients and 730 controls). Patients exhibited significant regional and population heterogeneity in D_2/3 receptor availability, primarily manifesting as a moderate increased in the striatum of only drug-off patients (Cohen's d = 0.56, 95%CI [0.16; 0.97]), whereas only drug-on patients showed a large decrease in D_2/3 receptor availability in the thalamus, limbic lobe, substantia nigra, and temporal lobe (Cohen's d < -1.40). Drug-off patients also had a small increase in dopamine synthesis in the striatum (Cohen's d = 0.38, 95%CI[0.06; 0.69]), with no replicable dysfunctions in drug-on patients or other brain regions. D₁ receptor availability and DAT showed high heterogeneity but no consistent significances. Finally, Meta-regression indicated that elevated striatal D_2/3 levels correlated with a higher proportion of males, older patients, longer duration and worse symptoms predicted more severe D₁ deficits in the striatum and prefrontal cortex. This study suggests that different dopamine subsystems in schizophrenia are selectively involved across brain regions; moreover, medication status, sex, age, illness duration and symptom diversity have significant impacts on the dysfunctions of dopamine subsystems in schizophrenia.