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Abstract There is significant heterogeneity in individual responses to antipsychotic drugs, but there is no reliable predictor of antipsychotics response in first-episode psychosis. This study aimed to investigate whether psychotic symptom-related alterations in fractional anisotropy (FA) and mean diffusivity (MD) of white matter (WM) at the early stage of the disorder may aid in the individualized prediction of drug response. Sixty-eight first-episode patients underwent baseline structural MRI scans and were subsequently randomized to receive a single atypical antipsychotic throughout the first 12 weeks. Clinical symptoms were evaluated using the eight “core symptoms” selected from the Positive and Negative Syndrome Scale (PANSS-8). Follow-up assessments were conducted at the 4th, 8th, and 12th weeks by trained psychiatrists. LASSO regression model and cross-validation were conducted to examine the performance of baseline symptom-related alterations FA and MD of WM in the prediction of individualized treatment outcome. Fifty patients completed both clinical follow-up assessments by the 8th and 12th weeks. 30 patients were classified as responders, and 20 patients were classified as nonresponders. At baseline, the altered diffusion properties of fiber tracts in the anterior thalamic radiation, corticospinal tract, callosum forceps minor, longitudinal fasciculi (ILF), inferior frontal-occipital fasciculi (IFOF) and superior longitudinal fasciculus (SLF) were related to the severity of symptoms. These abnormal fiber tracts, especially the ILF, IFOF, and SLF, significantly predicted the response to antipsychotic treatment at the individual level (AUC = 0.828, P

ObjectiveThe disclosure of mental illness is a first and crucial step in alleviating stigma and promoting mental recovery. However, at present, there is a lack of research on this subject in the Chinese context. Therefore, we conducted this survey among patients with mental illness and their family members and analyzed the influencing factors.MethodsQuestionnaires were distributed to qualified patients with mental illness and their family members, who were enrolled from the inpatient departments of two major mental health centers in China. Hierarchical linear regression analysis was used to evaluate the factors affecting the disclosure of disease information by patients with mental illness and their family members.ResultsA total of 153 patients and 159 family members were included. The percentages of patients and family members who intended to disclose disease information were 34.6 and 18.2%, respectively. Regarding the benefits of being out (BBO), marital status and the number of hospitalizations explained 13.1% of the variance, and stigma explained 4.3% of the variance. Regarding the reasons for staying in (RSI), marital status and family history of mental illness explained 14.4% of the variance, and stigma explained 14.8% of the variance. In the model predicting the influencing factors of family member disclosure, stigma was a predictor of both BBO and RSI, explaining 8.1 and 8.7% of the variance, respectively.ConclusionBoth patients and their families were more reluctant than willing to disclose. Marital status, number of hospitalizations and family history of mental illness were all influencing factors of patients’ intentions to disclose disease information. Stigma is closely related to disclosure intention and plays an important role in the disclosure intentions of patients and their families. This suggests that the disclosure of disease information is complex, and many factors need to be considered. Disclosure guidelines should be tailored to individuals.

Background: Schizophrenia is a chronic condition that leads to high rates of disability and high levels of family burden but the interactive relationship between these variables remains unclear, particularly in low- and middle-income countries where the vast majority of patients live with their families. Aim: Assess the symptom severity, level of disability, and family burden among clinically stable outpatients with schizophrenia in Sichuan, China. Methods: A total of 101 clinically stable outpatients with schizophrenia who had a median duration of illness of five years were assessed using the World Health Organization Disability Assessment Scale 2.0 (WHODAS II), the Positive and Negative Syndrome Scale (PANSS) and the Family Adaptation, Partnership, Growth, Affection and Resolve Index scale (APGAR); and their caregivers were surveyed using the Family Burden Interview Schedule (FBIS). Results: Among the 101 patients, 92 lived with their immediate family members, 74 had clinically significant disability, and 73 were unemployed. The level of disability was associated with the severity of symptoms (r=0.50, p<0.001), duration of illnesses (r=0.22, p=0.028), age of onset (r=-0.22, p=0.024) and patients' level of satisfaction with family support (r=-0.30, p=0.020). Disability was also associated with the overall level of family burden (r=0.40, p<0.001), and with several subtypes of family burden: financial burden (r=0.21, p=0.040), the degree of disruption in family routines (r=0.33, p=0.001), the effect on family leisure activities (r=0.31, p=0.001) and the quality of family interactions (r=0.43, p<0.001). Four variables remained significantly associated with the level of disability in the stepwise multivariate linear regression: duration of illness, severity of symptoms, patient satisfaction with family support, and the overall burden of the illness on the family. Conclusions: Even after adjusting for the severity of patients' symptoms, patient disability is independently associated with family burden. This highlights the importance of targeting both symptoms and disability in treatment strategies for this severe, often lifelong, condition. In countries like China where most individuals with schizophrenia live with their families, family burden is an important component of the impact of the illness on the community that should be included in measures of the relative social and economic importance of the condition. [ABSTRACT FROM AUTHOR]