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BackgroundInter-hemispheric disconnection is a primary pathological finding in schizophrenia. However, given the inherent complexity of this disease and its development, it remains unclear as to whether associated inter-hemispheric changes play an important role in auditory verbal hallucination (AVH) development. As such, this study was developed to explore inter-hemispheric connectivity in the context of schizophrenia with AVH while excluding positive symptoms and other factors with the potential to confound these results.MethodIn total, resting-state functional magnetic resonance imaging (fMRI) was used to assess 42 patients with AVH (APG), 26 without AVH (NPG), and 82 normal control (NC) individuals. Inter-hemispheric connectivity in these subjects was then assessed through the use of voxel-mirrored homotopic connectivity (VMHC) and Pearson correlation analyses.ResultRelative to HC and NPG subjects, APG individuals exhibited a decrease in VMHC in the superior temporal gyrus (STG) extending into Heschl's gyrus, the insula, and the Rolandic operculum as well as in the fusiform gyrus extending into the para-hippocampus (Corrected p < 0.005, cluster size = 52). Among APG individuals, these observed impairments of inter-hemispheric connectivity were negatively correlated with Hoffman auditory hallucination scores.ConclusionThese results support the schizophrenia hemitropic disconnection hypothesis, and provide novel evidence suggesting that there may be a relationship between reductions in inter-hemispheric connectivity in auditory and memory-related networks and the pathogenesis of AVH in patients with schizophrenia following the exclusion of confounding factors from other positive symptoms.

IntroductionCommunity-acquired pneumonia (CAP) is an important cause of hospitalization and death in patients with mental disorders. It is critical to understand the risk factors of CAP and determine prevention strategies to reduce CAP. The aim of this study is to explore the characteristics of inpatients with mental disorders who have CAP and analyze the risk factors.MethodsThis retrospective study included 16,934 inpatients with mental disorders who were admitted for the first time to a tertiary general hospital between January 2017 and July 2021 (excluding January 2020–May 2020). Risk factors for CAP were identified by logistic regression analysis after propensity score matching (PSM, 1:4) for age, gender, and BMI.ResultsThe CAP rate of inpatients with mental disorders was 1.78%. Inpatients who had CAP had a significantly prolonged hospital stay, and were more often admitted to a closed ward or the ICU. After PSM, the multivariable analysis revealed that clozapine use (OR = 3.212, 95% CI = 1.744–5.915, P < 0.001), schizophrenia spectrum disorder (OR = 2.785, 95% CI = 1.684–4.607, P < 0.001), alcohol consumption (OR = 2.549, 95% CI = 1.586–4.096, P < 0.001), cardiovascular disease (OR = 2.299, 95% CI = 1.362–3.879, P = 0.002), Charlson comorbidity index (CCI) ≥ 3 (OR = 2.092, 95% CI = 1.342–3.260, P = 0.001), organic mental disorder (OR = 1.941, 95% CI = 1.194–3.156, P = 0.007), antipsychotic drug use (OR = 1.886, 95% CI = 1.312–2.711, P = 0.001), unmarried status (OR = 1.720, 95% CI = 1.164–2.541, P = 0.006) and junior high school education (OR = 1.591, 95%CI = 1.010–2.508, P = 0.045) were independent risk factors for CAP in inpatients with mental disorders.ConclusionCAP was common in inpatients with mental disorders. Patients with mental disorders have unique risk factors for CAP. Further research is required to explore the relationship and mechanism between different mental disorders, antipsychotic drugs and CAP.