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Real-life Affective Forecasting in Young Adults with High Social Anhedonia: An Experience Sampling Study.
Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1093/schizbullopen/sgaf003
Rui-Ting Zhang, Yan Gao, Tian-Xiao Yang, Chao Yan, Ya Wang, Simon S Y Lui, Raymond C K Chan

Background and hypothesis: Affective forecasting (AF), the ability to forecast emotional responses for future events, is critical for optimal decision-making and mental health. Most previous AF studies were conducted using laboratory-based tasks but overlooked the impacts of real-life situations and social interactions. This study used the experience sampling method to examine real-life AF in young healthy adults and individuals with high social anhedonia.

Study design: In Study 1, 109 young healthy adults reported anticipated and experienced emotions of personal events for 30 days on mobile phones. In Study 2, we examined real-life AF in 28 individuals with high social anhedonia (HSA) and 32 individuals with low social anhedonia (LSA).

Study results: In Study 1 (totaling 8031 real-life events), participants anticipated and experienced social events as more positive and more arousing than non-social events, but also with larger AF discrepancy. In Study 2 (totaling 2066 real-life events), compared with the LSA group, the HSA group anticipated less pleasure and displayed a larger valence discrepancy especially for social but not for non-social events. However, the HSA group reported less experienced pleasure for both social and non-social events.

Conclusions: Using an ecological method for assessing real-life AF, we extended the previous laboratory-based findings to real-life situations. These findings demonstrate the effects of sociality on real-life AF and elucidate the deficit in anticipating social pleasure among HSA individuals, which reflects liability to schizophrenia-spectrum disorders. Altered AF may be a potential intervention target in people with schizophrenia spectrum disorder.

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引用次数: 0
The Startle Response and Prepulse Inhibition in Psychosis and Violence: A Combined Electromyography and Electroencephalography Study.
Pub Date : 2024-12-28 eCollection Date: 2025-01-01 DOI: 10.1093/schizbullopen/sgae031
Nina Bang, Johanne H Pettersen, Merete Berg Nesset, Kirsten Rasmussen, Hilde Dahl, Natalia Tesli, Christina Bell, Anja Vaskinn, Thomas Fischer-Vieler, Christine Friestad, Ole A Andreassen, Erik G Jönsson, Torbjørn Elvsåshagen, Unn K Haukvik, Torgeir Moberget

There is a pressing need for biomarkers of violent behavior risk in psychosis. Previous research indicates that electrophysiological measures of automatic defensive reactions may have potential. The purpose of this study was to investigate associations between violent behavior in individuals with and without psychosis and electromyography (EMG) and electroencephalography (EEG) responses to startling auditory stimuli. Electromyography and EEG were recorded during an auditory startle paradigm from healthy controls (HC, n = 211), individuals with psychosis and a history of violent behavior (violent-PSY, n = 18), individuals with psychosis without a history of violence (nonviolent-PSY, n = 32), and individuals with a history of violence without psychosis (violent non-PSY, n = 22). We estimated the auditory startle response (ASR) and prepulse inhibition (PPI) using EMG (ie, EMGASR and EMGPPI) and the auditory-evoked potential (ie, AEPASR and AEPPPI) of the EEG. There were no significant effects of group on the EMGASR (P = .10) or the 30-, 60-, and 120-ms prepulse + pulse EMGPPI amplitudes (P = .11, P = .19, and P = .50, respectively). The N1 amplitude of the AEPASR was reduced in the violent-PSY group (P < .001) and the nonviolent-PSY group (P = .015) compared with HC. The P2 amplitude of the AEPASR was reduced in violent-PSY relative to nonviolent-PSY (P = .003), violent non-PSY (P = .016), and HC (P < .001). Together, these results show that EEG-based neural responses to startling auditory stimuli are promising biomarkers of violence risk in psychosis.

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引用次数: 0
Associations Between Klotho Levels, KL-VS Heterozygosity and Cognition in Schizophrenia. 精神分裂症患者的 Klotho 水平、KL-VS 杂合度与认知之间的关系
Pub Date : 2024-12-25 eCollection Date: 2025-01-01 DOI: 10.1093/schizbullopen/sgae030
Vijaya Majumdar, Prosenjeet Chakroborty, Rashmi Arasappa, K Murugesh, Shanthala Hegde, Amrutha Jose, N K Manjunath, Arpitha Dharmappa

Background and hypothesis: The relationship between Klotho and cognitive dysfunction in schizophrenia has been scarcely explored, with a few paradoxical findings. Hence, we aimed to enhance our understanding by testing associations between the functional KL-VS gene variant and circulating protein levels.

Research design: This case-control study included 239 healthy controls and 241 patients with schizophrenia, who were comprehensively characterized by neurocognitive tests and further subtyped into cognitive clusters; cognitively deficient (CD) and cognitively spared (CS), using K-means cluster analysis. Linear regression models were run to assess the main and iinteraction effects of the KL-VS heterozygosity (KL-VSHet+)/KL levels with confounding variables (disease status and age) on cognitive scores.

Results: There was no main effect of KL-VSHet+ on the cognitive domains, but the CD cluster exhibited strong negative interactions between disease status and Klotho for executive function at the gene level, KL-VSHet+ × disease status, β = -.61, P = .043, with comparatively higher effect observed for KL levels, KL levels × disease status, β = -.91, P = .028. There was an opposing positive interaction for response inhibition, KL-VSHet+ × disease status, limited again to the CD cluster, β = .35, P = .046, with a higher effect at protein levels, KL levels × disease status, β = .72, <.004, though without CD cluster effect.

Conclusions: Overall, these dissociable patterns of association across cognitive domains indicate the need to exert caution over accepting any generalised direction of effect of Klotho at gene or protein level on cognition in schizophrenia.

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引用次数: 0
Utilizing Technology to Enhance the Ecological Validity of Cognitive and Functional Assessments in Schizophrenia: An Overview of the State-of-the-Art. 利用技术提高精神分裂症认知和功能评估的生态有效性:技术现状概述》。
Pub Date : 2024-11-28 eCollection Date: 2024-01-01 DOI: 10.1093/schizbullopen/sgae025
William P Horan, Raeanne C Moore, Heather G Belanger, Philip D Harvey

Cognitive impairment is a core feature of schizophrenia and a key determinant of functional outcome. Although conventional paper-and-pencil based cognitive assessments used in schizophrenia remained relatively static during most of the 20th century, this century has witnessed the emergence of innovative digital technologies that aim to enhance the ecological validity of performance-based assessments. This narrative review provides an overview of new technologies that show promise for enhancing the ecological validity of cognitive and functional assessments. We focus on 2 approaches that are particularly relevant for schizophrenia research: (1) digital functional capacity tasks, which use simulations to measure performance of important daily life activities (e.g., virtual shopping tasks), delivered both in-person and remotely, and (2) remote device-based assessments, which include self-administered cognitive tasks (e.g., processing speed test) or functionally-focused surveys regarding momentary activities and experiences (e.g., location, social context), as well as passive sensor-based metrics (e.g., actigraphy measures of activity), during daily life. For each approach, we describe the potential for enhancing ecological validity, provide examples of select measures that have been used in schizophrenia research, summarize available data on their feasibility and validity, and consider remaining challenges. Rapidly growing evidence indicates that digital technologies have the potential to enhance the ecological validity of cognitive and functional outcome assessments, and thereby advance research into the causes of, and treatments for, functional disability in schizophrenia.

认知障碍是精神分裂症的核心特征,也是决定功能结果的关键因素。尽管在 20 世纪的大部分时间里,精神分裂症患者使用的基于纸笔的传统认知评估仍相对固定,但本世纪却出现了旨在提高基于表现的评估的生态效度的创新数字技术。本综述概述了有望提高认知和功能评估生态有效性的新技术。我们将重点关注与精神分裂症研究尤为相关的两种方法:(1) 数字功能能力任务,利用模拟来测量重要日常生活活动的表现(如虚拟购物任务),可亲自或远程进行;(2) 基于远程设备的评估,包括自我管理的认知任务(如处理速度测试)或以功能为重点的评估、(2) 基于远程设备的评估,包括日常生活中的自我认知任务(如处理速度测试)或以功能为重点的瞬间活动和体验调查(如位置、社会环境),以及基于被动传感器的度量(如活动量动图)。对于每种方法,我们都会描述其提高生态有效性的潜力,提供已用于精神分裂症研究的精选测量实例,总结有关其可行性和有效性的可用数据,并考虑剩余的挑战。快速增长的证据表明,数字技术有可能提高认知和功能结果评估的生态效度,从而推动精神分裂症功能障碍的原因和治疗方法的研究。
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引用次数: 0
Clinical and Functional Outcomes of Community-Recruited Individuals at Clinical High-Risk for Psychosis: Results From the Youth Mental Health Risk and Resilience Study (YouR-Study). 社区招募的精神病临床高危个体的临床和功能结局:来自青少年心理健康风险和恢复力研究(YouR-Study)的结果
Pub Date : 2024-11-12 eCollection Date: 2024-01-01 DOI: 10.1093/schizbullopen/sgae029
Kate Haining, Ruchika Gajwani, Joachim Gross, Andrew I Gumley, Stephen M Lawrie, Frauke Schultze-Lutter, Matthias Schwannauer, Peter J Uhlhaas

Clinical high-risk for psychosis (CHR-P) individuals are typically recruited from clinical services but the clinical and functional outcomes of community-recruited CHR-P individuals remain largely unclear. The Youth Mental Health Risk and Resilience Study (YouR-Study) obtained a community sample of CHR-P individuals through an online-screening approach and followed-up these individuals for a period of up to 3 years to determine transition rates, persistence of attenuated psychotic symptoms (APS) and functional outcomes. Baseline data were obtained from n = 144 CHR-P participants, n = 51 participants who met online cutoff criteria but not CHR-P criteria (CHR-Ns), and n = 58 healthy controls. Baseline assessments included clinical measures for assessing CHR-P status, including the Comprehensive Assessment of At-Risk Mental States (CAARMS) and the Schizophrenia Proneness Instrument, Adult version (SPI-A), as well as functioning and cognitive measures. CHR-P and CHR-N groups were followed-up. Results show that 12.1% of CHR-P individuals transitioned to psychosis over 3 years, with no transitions in the CHR-N group. Nearly 60% of CHR-P individuals experienced poor functional outcome (PFO) and over 40% experienced persistent APS. A combination of CAARMS/SPI-A criteria was associated with a higher likelihood of PFO, but not with transition to psychosis nor APS persistence. However, transition risk was generally higher among those meeting both CAARMS/SPI-A criteria (64.3%) vs CAARMS (28.6%) or SPI-A (7.1%) alone. In summary, community-recruited CHR-P individuals are characterized by similar clinical characteristics and longitudinal outcomes to those recruited from clinical services, emphasizing the need to widen the scope of early detection and intervention strategies.

临床精神病高危人群(chrp)通常是从临床服务中招募的,但社区招募的chrp个体的临床和功能结局在很大程度上仍不清楚。青少年心理健康风险和恢复力研究(YouR-Study)通过在线筛查方法获得了chrp个体的社区样本,并对这些个体进行了长达3年的随访,以确定转换率、减轻精神病症状(APS)的持久性和功能结局。基线数据来自n = 144名chrp参与者,n = 51名符合在线截止标准但未达到chrp标准(chrn - ns)的参与者,n = 58名健康对照。基线评估包括评估chrp状态的临床措施,包括高危精神状态综合评估(CAARMS)和精神分裂症倾向量表,成人版(SPI-A),以及功能和认知测量。随访hr - p组和hr - n组。结果显示12.1%的chrp - p个体在3年内转变为精神病,而chrn组没有转变。近60%的chrp患者出现功能预后不良(PFO),超过40%的患者出现持续性APS。CAARMS/SPI-A标准的组合与PFO的可能性较高相关,但与向精神病的过渡或APS的持续性无关。然而,与单独满足CAARMS(28.6%)或SPI-A(7.1%)标准的患者相比,同时满足CAARMS/SPI-A标准的患者的转移风险普遍更高(64.3%)。总之,社区招募的chrp个体与从临床服务中招募的个体具有相似的临床特征和纵向结果,强调需要扩大早期发现和干预策略的范围。
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引用次数: 0
Attention Deficit Hyperactivity Disorder Among Youth at Clinical High Risk of Psychosis. 精神病临床高危青少年中的注意缺陷多动障碍。
Pub Date : 2024-11-06 eCollection Date: 2024-01-01 DOI: 10.1093/schizbullopen/sgae028
Amy Braun, Lu Liu, Carrie E Bearden, Kristin S Cadenhead, Barbara A Cornblatt, Matcheri Keshavan, Daniel H Mathalon, Diana O Perkins, William S Stone, Ming T Tsuang, Elaine F Walker, Scott W Woods, Tyrone D Cannon, Jean Addington

Background: Attention Deficit Hyperactivity Disorder (ADHD) affects a significant proportion of the population and is associated with numerous adverse outcomes including lower educational attainment, occupational challenges, increased substance use, and various mental health issues including psychosis. This study examined the demographic, clinical, cognitive, social cognitive, and functional differences between youth at clinical high-risk (CHR) for psychosis with and without comorbid ADHD.

Method: Data were drawn from the North American Prodrome Longitudinal Studies (NAPLS2 and NAPLS3), which included 764 and 710 CHR individuals, respectively. After applying exclusion criteria, the sample consisted of 271 CHR participants with ADHD and 1118 without ADHD. All data were examined cross-sectionally.

Results: Compared with the non-ADHD group, the ADHD group was younger, had more difficulties with role functioning, premorbid functioning, and social cognition, were more likely to have a comorbid learning disorder, and reported less depression symptoms. There were no significant differences between the groups on positive or negative psychotic symptoms, transition rates, adverse events, or other comorbid disorders including substance use and depression.

Discussion: Comorbid ADHD is likely not a significant predictor of transition to psychosis among CHR youth; however, those CHR with ADHD may experience symptoms at a younger age than those without and present with a distinct clinical profile.

背景:注意力缺陷多动障碍(ADHD)影响着很大一部分人口,并与许多不良后果相关,包括教育程度降低、职业挑战、药物使用增加以及包括精神病在内的各种心理健康问题。本研究调查了患有和未患有多动症的精神病临床高危(CHR)青少年在人口统计学、临床、认知、社会认知和功能方面的差异:数据来自北美前驱期纵向研究(NAPLS2 和 NAPLS3),其中分别包括 764 名和 710 名临床高危精神病患者。在应用排除标准后,样本包括271名患有多动症的CHR参与者和1118名不患有多动症的CHR参与者。所有数据均为横截面数据:与非多动症组相比,多动症组更年轻,在角色功能、病前功能和社会认知方面有更多困难,更有可能合并学习障碍,并且报告的抑郁症状较少。在阳性或阴性精神病症状、转归率、不良事件或其他合并症(包括药物使用和抑郁症)方面,两组之间没有明显差异:讨论:合并多动症可能并不是预测青少年精神病患者向精神病过渡的重要因素;但是,与不合并多动症的青少年精神病患者相比,合并多动症的青少年精神病患者可能会在更小的年龄出现症状,并表现出独特的临床特征。
{"title":"Attention Deficit Hyperactivity Disorder Among Youth at Clinical High Risk of Psychosis.","authors":"Amy Braun, Lu Liu, Carrie E Bearden, Kristin S Cadenhead, Barbara A Cornblatt, Matcheri Keshavan, Daniel H Mathalon, Diana O Perkins, William S Stone, Ming T Tsuang, Elaine F Walker, Scott W Woods, Tyrone D Cannon, Jean Addington","doi":"10.1093/schizbullopen/sgae028","DOIUrl":"10.1093/schizbullopen/sgae028","url":null,"abstract":"<p><strong>Background: </strong>Attention Deficit Hyperactivity Disorder (ADHD) affects a significant proportion of the population and is associated with numerous adverse outcomes including lower educational attainment, occupational challenges, increased substance use, and various mental health issues including psychosis. This study examined the demographic, clinical, cognitive, social cognitive, and functional differences between youth at clinical high-risk (CHR) for psychosis with and without comorbid ADHD.</p><p><strong>Method: </strong>Data were drawn from the North American Prodrome Longitudinal Studies (NAPLS2 and NAPLS3), which included 764 and 710 CHR individuals, respectively. After applying exclusion criteria, the sample consisted of 271 CHR participants with ADHD and 1118 without ADHD. All data were examined cross-sectionally.</p><p><strong>Results: </strong>Compared with the non-ADHD group, the ADHD group was younger, had more difficulties with role functioning, premorbid functioning, and social cognition, were more likely to have a comorbid learning disorder, and reported less depression symptoms. There were no significant differences between the groups on positive or negative psychotic symptoms, transition rates, adverse events, or other comorbid disorders including substance use and depression.</p><p><strong>Discussion: </strong>Comorbid ADHD is likely not a significant predictor of transition to psychosis among CHR youth; however, those CHR with ADHD may experience symptoms at a younger age than those without and present with a distinct clinical profile.</p>","PeriodicalId":94380,"journal":{"name":"Schizophrenia bulletin open","volume":"5 1","pages":"sgae028"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Integrated Analysis of Gut Microbiome, Inflammation, and Neuroimaging Features Supports the Role of Microbiome-Gut-Brain Crosstalk in Schizophrenia. 肠道微生物组、炎症和神经影像学特征的综合分析支持微生物组-肠-脑串扰在精神分裂症中的作用。
Pub Date : 2024-10-28 eCollection Date: 2024-01-01 DOI: 10.1093/schizbullopen/sgae026
Hui Wu, Yaxi Liu, Yunwu Han, Bingdong Liu, Shengyun Chen, Zhiye Ye, Jianbo Li, Liwei Xie, Xiaoli Wu

Background and hypothesis: Gut microbiota has been implicated in the pathogenesis of schizophrenia (SZ) and relevant changes in the brain, but the underlying mechanism remains elusive. This study aims to investigate the microbiota-gut-brain crosstalk centered on peripheral inflammation in SZ patients.

Study design: We recruited a cohort of 182 SZ patients and 120 healthy controls (HC). Multi-omics data, including fecal 16S rRNA, cytokine data, and neuroimaging data, were collected and synthesized for analysis. Multi-omics correlations and mediation analyses were utilized to determine the associations of gut microbiome with inflammatory cytokines and neuroimaging characteristics. Additionally, machine learning models for effective SZ diagnosis were separately generated based on gut microbial and neuroimaging data.

Study results: Gut microbial dysbiosis, characterized by a decrease in butyrate-producing bacteria and an increase in proinflammatory bacteria, has been identified in SZ patients. These key microbial taxa were associated with increased inflammatory cytokines, potentially through mediating lipid metabolic pathways such as steroid biosynthesis and linoleic acid metabolism. Further analysis revealed altered microbial genera to be correlated with disrupted gray matter volume and regional homogeneity in SZ patients. Importantly, certain inflammatory cytokines mediated the relationship between the SZ-enriched genus Succinivibrio and aberrant activity of anterior cingulate cortex and left inferior temporal gyrus in the SZ group. Moreover, the classification model based on gut microbial data showed comparable efficacy to the model based on brain functional signatures in SZ diagnosis.

Conclusions: This study presents evidence for the dysregulated microbiota-gut-brain axis in SZ and emphasizes the central role of peripheral inflammation.

背景与假设:肠道微生物群与精神分裂症(SZ)的发病机制和大脑的相关变化有关,但其潜在机制尚不清楚。本研究旨在探讨SZ患者以外周炎症为中心的微生物-肠-脑串扰。研究设计:我们招募了182名SZ患者和120名健康对照(HC)。收集并合成多组学数据,包括粪便16S rRNA、细胞因子数据和神经影像学数据进行分析。利用多组学相关性和中介分析来确定肠道微生物组与炎症细胞因子和神经影像学特征的关联。此外,基于肠道微生物和神经影像学数据,分别生成了有效诊断SZ的机器学习模型。研究结果:在SZ患者中发现了肠道微生物生态失调,其特征是产生丁酸盐的细菌减少,促炎细菌增加。这些关键的微生物类群与炎症细胞因子的增加有关,可能通过介导脂质代谢途径,如类固醇生物合成和亚油酸代谢。进一步分析显示,SZ患者的微生物属的改变与灰质体积的破坏和区域均匀性相关。重要的是,某些炎症因子介导了SZ组富含SZ的琥珀弧菌属与前扣带皮层和左颞下回异常活动之间的关系。此外,基于肠道微生物数据的分类模型与基于脑功能特征的模型在SZ诊断中的疗效相当。结论:本研究提供了SZ中微生物-肠-脑轴失调的证据,并强调了外周炎症的核心作用。
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引用次数: 0
Intranasal Oxytocin Combined With Social Skills Training for Schizophrenia: An Add-on Randomized Controlled Trial. 鼻内催产素结合社交技能训练治疗精神分裂症:附加随机对照试验》。
Pub Date : 2024-10-21 eCollection Date: 2024-01-01 DOI: 10.1093/schizbullopen/sgae022
Liron Saporta-Wiesel, Ruth Feldman, Linda Levi, Michael Davidson, Shimon Burshtein, Ruben Gur, Orna Zagoory-Sharon, Revital Amiaz, Jinyoung Park, John M Davis, Mark Weiser

Some but not other studies on oxytocin for schizophrenia, particularly those using a higher dose, indicate that oxytocin improves negative symptoms of schizophrenia. We performed an add-on randomized controlled trial to examine the effect of high-dose oxytocin, social skills training, and their combination in the treatment of negative symptoms and social dysfunction in schizophrenia. Fifty-one subjects with schizophrenia were randomized, employing a two-by-two design: intranasal oxytocin (24 IU X3/day) or placebo, and social skills training or supportive psychotherapy, for 3 weeks. The primary outcome was the difference in the total score from baseline to end-of-study of a semi-structured interview which assessed patients' social interactions in 3 scenarios: sharing a positive experience, sharing a conflict, and giving support when the experimenter shared a conflict. The interactions were scored using the Coding Interactive Behavior Manual (CIB), clinical symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). No significant difference was found between groups in the total CIB or PANSS scores. The majority of comparisons in the different social interactions between oxytocin and placebo, and between social skills training vs supportive psychotherapy, were also nonsignificant. Social skills training reduced blunted affect and gaze. In post-hoc analyses of the support interaction, oxytocin improved synchrony and decreased tension, while in the positive interaction it improved positive affect and avoidance. None of these findings remained significant when controlling for multiple comparisons. In conclusion, oxytocin did not influence participants' social behavior, and was not effective in improving the symptoms of schizophrenia. Clinicaltrials.gov Identifier: NCT01598623.

关于催产素治疗精神分裂症的一些研究(尤其是使用较大剂量的研究)表明,催产素可改善精神分裂症的阴性症状,但其他研究并未表明催产素可改善精神分裂症的阴性症状。我们进行了一项附加随机对照试验,以研究大剂量催产素、社交技能训练及其组合在治疗精神分裂症阴性症状和社交功能障碍方面的效果。51 名精神分裂症受试者被随机分配,采用两两对照设计:鼻内注射催产素(24 IU X3/天)或安慰剂,以及社交技能训练或支持性心理疗法,为期 3 周。主要结果是半结构化访谈总分从基线到研究结束的差异,该访谈评估了患者在三种情况下的社交互动:分享积极经历、分享冲突以及在实验者分享冲突时给予支持。互动采用《互动行为编码手册》(CIB)进行评分,临床症状采用《阳性和阴性综合征量表》(PANSS)进行评估。在 CIB 或 PANSS 总分上,各组之间没有发现明显差异。催产素与安慰剂之间以及社交技能训练与支持性心理疗法之间在不同社交互动方面的大多数比较结果也不显著。社交技能训练减少了情感迟钝和凝视。在支持性互动的事后分析中,催产素改善了同步性并降低了紧张度,而在积极互动中,催产素改善了积极情绪和回避。在控制多重比较后,这些结果均不显著。总之,催产素不会影响参与者的社交行为,也不能有效改善精神分裂症的症状。Clinicaltrials.gov Identifier:NCT01598623。
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引用次数: 0
Rationale and Challenges for a New Instrument for Remote Measurement of Negative Symptoms. 新的消极症状远程测量工具的原理和挑战。
Pub Date : 2024-10-18 eCollection Date: 2024-01-01 DOI: 10.1093/schizbullopen/sgae027
David Gordon Daniel, Alex S Cohen, Philip D Harvey, Dawn I Velligan, William Z Potter, William P Horan, Raeanne C Moore, Stephen R Marder

There is a broad consensus that the commonly used clinician-administered rating scales for assessment of negative symptoms share significant limitations, including (1) reliance upon accurate self-report and recall from the patient and caregiver; (2) potential for sampling bias and thus being unrepresentative of daily-life experiences; (3) subjectivity of the symptom scoring process and limited sensitivity to change. These limitations led a work group from the International Society of CNS Clinical Trials and Methodology (ISCTM) to initiate the development of a multimodal negative symptom instrument. Experts from academia and industry reviewed the current methods of assessing the domains of negative symptoms including diminished (1) affect; (2) sociality; (3) verbal communication; (4) goal-directed behavior; and (5) Hedonic drives. For each domain, they documented the limitations of the current methods and recommended new approaches that could potentially be included in a multimodal instrument. The recommended methods for assessing negative symptoms included ecological momentary assessment (EMA), in which the patient self-reports their condition upon receipt of periodic prompts from a smartphone or other device during their daily routine; and direct inference of negative symptoms through detection and analysis of the patient's voice, appearance or activity from audio/visual or sensor-based (eg, global positioning systems, actigraphy) recordings captured by the patient's smartphone or other device. The process for developing an instrument could resemble the NIMH MATRICS process that was used to develop a battery for measuring cognition in schizophrenia. Although the EMA and other digital measures for negative symptoms are at relatively early stages of development/maturity and development of such an instrument faces substantial challenges, none of them are insurmountable.

人们普遍认为,常用的由临床医生操作的阴性症状评估评分量表都有很大的局限性,包括:(1)依赖于患者和护理人员的准确自我报告和回忆;(2)可能存在抽样偏差,因此不能代表日常生活经验;(3)症状评分过程主观,对变化的敏感性有限。这些局限性促使国际中枢神经系统临床试验和方法学学会(ISCTM)的一个工作小组着手开发一种多模式阴性症状工具。来自学术界和工业界的专家回顾了目前评估消极症状领域的方法,这些领域包括:(1) 情感减退;(2) 社交能力减退;(3) 语言交流能力减退;(4) 目标导向行为减退;以及 (5) 享乐驱动力减退。对于每个领域,他们都记录了当前方法的局限性,并推荐了有可能纳入多模态工具的新方法。推荐的负面症状评估方法包括生态瞬间评估(EMA),即患者在日常生活中收到智能手机或其他设备的周期性提示后,自我报告其状况;以及通过检测和分析患者智能手机或其他设备捕获的音频/视频或传感器(如全球定位系统、行为记录仪)记录中患者的声音、外表或活动,直接推断负面症状。仪器的开发过程可以类似于 NIMH MATRICS 流程,该流程曾用于开发测量精神分裂症认知能力的电池。尽管 EMA 和其他针对阴性症状的数字测量方法还处于相对较早的开发/成熟阶段,开发这样一种工具也面临着巨大的挑战,但这些挑战都不是不可克服的。
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引用次数: 0
Cognitive Impairment Associated With Schizophrenia: New Research Agenda. 与精神分裂症有关的认知障碍:新的研究议程。
Pub Date : 2024-09-19 eCollection Date: 2024-01-01 DOI: 10.1093/schizbullopen/sgae023
Silvana Galderisi, Stephen R Marder
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引用次数: 0
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Schizophrenia bulletin open
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