Search

Background Diagnostic criteria for mental disorders are subject to change. This is particularly true for schizophrenia, whose diagnostic criteria in the current DSM-5 bear little resemblance to what Kraepelin once named "dementia praecox" and Bleuler termed "the schizophrenias." The present study reports results from a survey of experts on two core topics of schizophrenia: (a) whether subsequent editions of the DSM should once again give the Schneiderian first-rank symptoms (FRS; eg, thought broadcasting) the prominent role they had in the DSM-IV and (b) whether the currently quite narrow definition of hallucinations in the DSM-5 requiring them to be vivid and clear and have the full force and impact of normal perceptions should be broadened to incorporate perceptual-like phenomena that the individual can differentiate from proper perceptions but still perceives as real and externally generated. Hypothesis The aim of the survey was to learn about experts' opinions with no clear hypotheses. Study Design International experts on schizophrenia were recruited via various sources and invited to participate in a short online survey. The final sample comprised 136 experts with a subgroup of 53 experts with verified identity and at least 6 years of clinical and/or research experience. Study Results Slightly more experts voted in favor (49.3%) of returning FRS to the prominent role they had in earlier versions of the DSM than against (34.6%). Approximately four out of five experts agreed that the definition of hallucinations in the DSM should be expanded. According to the results, alongside internal symptoms that are phenomenologically indistinguishable from true perceptions, sensory intrusions that the holder is convinced were inserted from another source (ie, not self-generated) should be included in the definition. Conclusions While a large majority of experts recommend a change in the definition of hallucinations, the experts' opinions on FRS are more mixed. We hope that this article will stimulate future studies targeting the diagnostic relevance of these symptoms and encourage discussion about the definition of core psychotic symptoms and the diagnostic criteria for the upcoming edition of the DSM. [ABSTRACT FROM AUTHOR]

Suicidal ideation is common among individuals with first episode psychosis (FEP), with prevalence estimates up to 56.5 %. Despite its high prevalence, relatively little is known about how sociodemographic, clinical and/or developmental characteristics contribute to the experience of suicidal ideation in individuals with FEP. In this cross-sectional study (FEP n = 551 and controls n = 857), univariate logistic regression analyses were performed to study the associations of sociodemographic, clinical, and developmental factors with suicidal ideation in individuals with FEP as well as controls. Suicidal ideation was assessed using the Community Assessment of Psychic Experiences (CAPE). In addition, multivariate logistic regression analyses were conducted based on a stepwise approach. In FEP, only depressive symptoms remained significantly associated with suicidal ideation when all correlates were integrated into one model. In the multivariate model in controls, depressive symptoms, positive symptoms, and traumatic childhood experiences were significantly associated with suicidal ideation. This study showed that depressive symptoms are an important factor relating to suicidal ideation in individuals with FEP, over and above other clinical, sociodemographic, and developmental factors. This underscores the relevance of screening for suicidal ideation in individuals with FEP, and highlights the need for a better understanding of the diagnostic uncertainty and course of mood symptoms in early psychosis. Cross-sectional study design, self-reported questionnaires. [ABSTRACT FROM AUTHOR]

The onset of psychotic symptoms occurs prior to age 19 in 39% of the patients with schizophrenia. There are limited approved treatment options for adolescents with schizophrenia. Brexpiprazole was approved by the United States Food and Drug Administration (FDA) for treatment of schizophrenia in adolescents in 2022. Extrapolation of adult data to youth and use of pharmacologic modeling coupled with open long-term safety data were used by the FDA to approve brexpiprazole for adolescent schizophrenia. They were all reviewed herein. D2 receptor partial agonist antipsychotic agents are preferred in the early phase of treatment of psychotic disorders. Approval of brexpiprazole in adolescent schizophrenia provides an additional option. Brexpiprazole was approved by the FDA on the basis of extrapolation of adult data without controlled trials in adolescents. This reduces placebo exposure in young people. Two previous agents (asenapine and ziprasidone) approved for adult schizophrenia failed to separate from placebo in adolescent schizophrenia studies; this partially undermines the process of extrapolation. For brexpiprazole, the paucity of data in adolescents relegates it to a second-line agent. More research on brexpiprazole is needed to delineate its relative role in the management of adolescent schizophrenia. [ABSTRACT FROM AUTHOR]

• Negative symptoms impact quality of life and functioning. • Complement regulators and coagulation regulators are prognostic factors of negative symptoms. • Their prognostic value is independent of clinical and demographic prognostic factors. • These results may aid early intervention for negative symptoms of psychosis. Negative symptoms impact the quality of life of individuals with psychosis and current treatment options for negative symptoms have limited effectiveness. Previous studies have demonstrated that complement and coagulation pathway protein levels are related to later psychotic experiences, psychotic disorder, and functioning. However, the prognostic relationship between complement and coagulation proteins and negative symptoms is poorly characterised. In the North American Prodrome Longitudinal Studies 2 and 3, negative symptoms in 431 individuals at clinical high-risk for psychosis (mean age: 18.2, SD 3.6; 42.5 % female) were measured at multiple visits over 2 years using the Scale of Psychosis-Risk Symptoms. Plasma proteins were quantified at baseline using mass spectrometry. Four factors were derived to represent levels of proteins involved in the activation or regulation of the complement or coagulation systems. The relationships between standardised protein group factors and serial measurements of negative symptoms over time were modelled using generalised least squares regression. Analyses were adjusted for baseline candidate prognostic factors: negative symptoms, positive symptoms, functioning, depressive symptoms, suicidal ideation, cannabis use, tobacco use, antipsychotic use, antidepressant use, age, and sex. Clinical and demographic prognostic factors of follow-up negative symptoms included negative, positive, and depressive symptoms, functioning, and age. Adjusting for all candidate prognostic factors, the complement regulators group and the coagulation regulators group were identified as prognostic factors of follow-up negative symptoms (β: 0.501, 95 % CI: 0.160, 0.842; β: 0.430, 95 % CI: 0.080, 0.780 respectively. The relationship between complement regulator levels and negative symptoms was also observed in NAPLS2 alone (β: 0.501, 95 % CI: −0.037, 1.039) and NAPLS3 alone, additionally adjusting for BMI (β: 0.442, 95 % CI: 0.127, 0.757). The results indicate that plasma complement and coagulation regulator levels are prognostic factors of negative symptoms, independent of clinical and demographic prognostic factors. These results suggest complement and coagulation regulator levels could have potential utility in informing treatment decisions for negative symptoms in individuals at risk. [ABSTRACT FROM AUTHOR]

It is unclear what types of stigma youth at clinical high risk for psychosis (CHR) experience, and the relationship between them and symptomatology. 94 CHR youth, and a control group of 45 youth with no psychosis spectrum symptoms (NP) were rated for perceived devaluation (i.e. negative views from others) and internalized mental health stigma (i.e. the extent to which they would agree with said views) as well as positive and mood symptomatology. CHR youth reported stigma more frequently than the NP group (χ2(1) = 53.55, p <.001) and at higher levels (perceived devaluation: t (137) = 8.54, p <.001; internalized stigma: t (137) = 7.48, p <.001). Surprisingly, in the CHR group, positive symptoms held no significant relationship to stigma measures. However, ratings of perceived devaluation stigma were associated with depressive symptomatology (β = 0.27, t = 2.68, p =.0087) and depression scores were conversely associated with perceived devaluation stigma (β = 0.30, t = 2.05, p =.043). These findings speak to the relationship between depressive symptomatology and perceived devaluation stigma in CHR youth. Perceived devaluation stigma showed greater clinical significance and could have different mechanisms than internalized stigma in CHR youth. It is also noteworthy that while positive symptoms play a central role in defining the CHR syndrome, they seem less relevant to the experience of stigma than mood symptoms. These findings highlight the importance of interventions aimed at ameliorating youth's exposure to negative views about mental health as those managing depressive symptomatology. [ABSTRACT FROM AUTHOR]

BackgroundMotivational impairment associated with deficits in processing the anticipation of future reward is hypothesized to be a cardinal feature of schizophrenia spectrum disorders (SZ). Evidence from short-term follow-up (6-week post-treatment) studies suggests that these deficits may improve or be reversed with treatment, although longer-term outcomes are unknown. Here we examined the one-year trajectory of functional activation in brain circuitry associated with reward anticipation in people with recent onset SZ who participated in coordinated specialty care (CSC) treatment, hypothesizing normalization of brain response mirroring previous short-term findings in first-episode individuals.MethodBlood oxygen level-dependent (BOLD) response in the dorsal anterior cingulate cortex, anterior insula, and ventral striatum (VS) associated with reward anticipation during the Incentivized Control Engagement Task (ICE-T) was analyzed in a baseline sample of 49 healthy controls (HCs) and 52 demographically matched people with SZ, with follow-up data available for 35 HCs and 17 people with SZ.ResultsIn agreement with our hypothesis, significant time × diagnosis interactions were observed across all regions, in which reward anticipation-associated BOLD response increased in SZ to above baseline HC levels at follow-up. Increased VS activation was associated with decreased reality distortion symptoms over the follow-up period. Baseline reward anticipation-associated BOLD response in the right anterior insula was associated with improvement in reality distortion symptoms.ConclusionsThese findings suggest that functional deficits in reward anticipation may be reversed after one year of CSC in recent onset participants with SZ, and that this improvement is associated with reduced positive symptoms in the illness.

BackgroundRehabilitation for schizophrenia typically relies on pharmacological interventions， yet their efficacy in improving social function and quality of life remains limited. In recent years， non-pharmacological approaches have shown promise in enhancing rehabilitation outcomes. However， research on the effectiveness of psychomotor therapy specifically for young and middle-aged schizophrenic inpatients is limited.ObjectiveTo explore the effects of psychomotor therapy on the rehabilitation of young and middle-aged schizophrenic inpatients， and to provide a reference for treatment strategies.MethodsA total of 104 young and middle-aged schizophrenic inpatients who met the International Classification of Diseases，tenth edition （ICD-10） diagnostic criteria and hospitalized in the Fourth People's Hospital of Wuhu from June 2021 to June 2022 were selected. Patients were randomly divided into two groups of 52 each using random number table method. Both groups received treatment with risperidone tablets （2~4 mg/d） ， along with routine nursing care. Additionally， the research group received an extra 45~55 minutes of psychomotor therapy 2~3 times per week for 12 weeks. The control group received the same psychomotor therapy after the study. Positive and Negative Symptom Scale （PANSS）， Scales of Social-skills for Psychiatric Inpatient （SSPI） and Insight and Treatment Attitude Questionnaire （ITAQ） were used to assess the patients before the intervention and at 4th， 8th and 12th week after the intervention.ResultsThe main effects of intervention at different time points for PANSS positive symptoms， negative symptoms and general psychopathology subscale scores， PANSS total score， SSPI score and ITAQ score were all statistically significant （F=33.989， 204.245， 82.817， 279.596， 26.144， 7.463， P

Schizophrenia is a severe mental disorder that leads to impaired social adaptation, interpersonal interaction, and disability. Negative symptoms are an integral part of schizophrenia. In the world psychiatric science and practice, there are still many questions about the typology of schizophrenia, the description of its clinical manifestations, first of all, the features of negative symptoms in schizophrenia. Psychiatrists of different countries draw attention to the fact that these descriptions do not always coincide. Socio-demographic factors can be considered as factors affecting the prognosis of the course and outcome of schizophrenia. In this regard, a comprehensive approach to the study of socio-demographic characteristics of patients with schizophrenia involves the study of the influence of social factors on the formation and course of schizophrenia and determines the relevance of this study. The purpose of the study was to determine the features of socio-demographic characteristics of patients with schizophrenia in order to improve diagnosis and create psycho-corrective measures. 252 patients with negative symptoms of schizophrenia and 79 patients with positive symptoms of schizophrenia were examined. During the research, a comprehensive approach was used, consisting in the use of clinical-psychopathological, clinical-anamnestic and statistical research methods. Socio-demographic features of patients with negative symptoms in schizophrenia were established, consisting in the predominance of women; patients aged 20-29 years; persons with special secondary education; divorced and single persons; patients busy with physical labor; average level of material wealth; very poor and poor living conditions. Socio-demographic characteristics of patients with positive symptoms in schizophrenia were outlined by the predominance of men; patients aged 30-49 years; persons with incomplete higher education and with higher education; divorced and single persons; patients with disabilities; with extremely low and low levels of material well-being and a satisfactory level of living conditions. The conducted research made it possible to draw conclusions that socio-demographic features of patients with negative and positive symptoms have their own specificity, which should be taken into account when diagnosing patients with schizophrenia.

Objectives: Music therapy has been recognized as an effective treatment for various conditions, including psychiatric disorders like schizophrenia. Given the limited number of studies on music therapy and its effects on schizophrenia in Iran, and the importance of incorporating multi-modal treatment approaches for this disorder, this study aimed to evaluate the impact of music therapy on the positive and negative symptoms and overall functioning of chronically schizophrenic patients. Methods: A pre-post clinical trial was conducted in 2021 at the Parham Care Center in Kashan, involving 43 patients with chronic schizophrenia diagnosed based on DSM-V criteria. Patients underwent three sessions of music therapy per week for six months. Assessment tools included the Positive and Negative Symptoms Scale (PANSS), Brief Psychiatric Rating Scale (BPRS), and Global Assessment Function (GAF) scale administered before and after the intervention. Results: Following music therapy, there was a significant decrease in overall scores and subscales as measured by PANSS and BPRS (P

Introduction: Our object is to examine the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on the symptoms, cognitive functions and subjective experiences in patients with chronic schizophrenia and to enhance the overall understanding of the TMS method. Methods: Thirty three patients who had chronic schizophrenia were included in the study. Seventeen patients received rTMS and 16 received sham. The Positive and Negative Syndrome Scale, Repeatable Battery for the Assessment of Neuropsychological Status Scale, Insight and Treatment Attitudes Questionnaire and a self-experience checklist developed by the researchers to evaluate post-TMS experiences were applied to all patients. Results: There were no statistical differences between the groups with regard to symptoms, cognitive functions and insight. However rTMS group reported overall better treatment experience and more positive subjective experiences. Conclusion: rTMS treatment did not cause any improvement in symptoms, cognitive functions and insight but provided a better selfexperience, which might improve treatment compliance. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion Mental disorders and HIV are the main contributors to the increase in years lived with disability rates per person in sub‐Saharan Africa. A complex inter‐relationship exists between HIV and mental illness, especially in a region with a high HIV prevalence. We examined the duration of untreated psychosis (DUP), and the nature of psychotic and cognitive symptoms in people with first episode psychosis (FEP) living with and without HIV.Adults aged between 18 and 45 years were assessed using a clinical interview, physical examination and several psychiatric tools. These included the Mini International Neuro‐psychiatric Interview to confirm psychosis, Positive and Negative Syndrome Scale, International HIV Dementia Scale and other scales to measure symptom variables. HIV ELISA was used for HIV serology testing, with measures being carried out within 6 weeks of the first presentation.Of the 172 people presenting with FEP, 36 (21%) had comorbid HIV, those with both being older and more likely to be female (p < .001). Clinically, participants with FEP and HIV scored lower on the positive subscale (p = .008). There were no statistically significant differences for DUP or cognitive screening. Of those living with HIV and FEP (n = 36) comorbidity, nine were newly diagnosed with HIV at the time of the study.Individuals presenting with FEP and comorbid HIV were older, female and reported more mood symptoms. The identification of nine new HIV infections also reflects the ongoing need to test for HIV in people presenting with severe mental illness. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic and the lockdown experience may have not only precipitated or exacerbated mental illness but also influenced access to care and the nature and content of the psychotic symptomatology of people with psychosis. Aim: This study aimed to evaluate the association of the COVID‐19 pandemic and lockdown experience on clinical presentation and quality of life of people (QOL) with first episode psychosis (FEP). Method: Two first episode psychosis cohorts from the same epidemiological area collected prior to, and during the COVID‐19 pandemic and lockdown were compared in terms of clinical symptomatology, substance use and QOL. All adult in‐ and outpatients with FEP at five clinical units in KwaZulu‐Natal, South Africa, aged between 18 and 45 years, were assessed with the MINI interview for psychosis, Positive and Negative Symptoms Scale, WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the WHO QOL scales. Results: Eighty‐eight FEP participants were recruited between 2019 and 2020 (cohort 1) before the pandemic. Study recruitment was suspended in March 2020 due to the pandemic. On study resumption from November 2020 to November 2022, 95 new participants (cohort 2) were recruited. There were no sociodemographic differences between the two cohorts, except unemployment status (57% vs. 65%) and household income. The cohort presenting post‐COVID‐19 pandemic onset had significantly more positive psychotic symptoms (21.9 vs. 23.7), lower PANSS domain depressive score, more lifetime use of tobacco, cannabis and alcohol. However, they reported improved QOL (196 vs. 239). Conclusion: Following the pandemic and lockdown experience participants presented with more severe psychotic symptoms and concomitant substance use but improved perceived QOL. This suggests the need to explore individual and social factors that may influence the clinical presentation. [ABSTRACT FROM AUTHOR]

The clinical profiles of methamphetamine-induced psychosis (MIP) and schizophrenia are largely overlapping making differentiation challenging. In this systematic review and meta-analysis, we aim to compare the positive and negative symptoms of MIP and schizophrenia to better understand the differences between them. In accordance with our pre-registered protocol (CRD42021286619), we conducted a search of English-language studies up to December 16th, 2022, in PubMed, EMBASE, and PsycINFO, including stable outpatients with MIP and schizophrenia. We used the Newcastle-Ottawa Scale to measure the quality of cross-sectional, case-control, and cohort studies. Of the 2052 articles retrieved, we included 12 studies (6 cross-sectional, 3 case-control, and 2 cohort studies) in our meta-analysis, involving 624 individuals with MIP and 524 individuals with schizophrenia. Our analysis found no significant difference in positive symptoms between the two groups (SMD, −0.01; 95%CI, −0.13 to +0.11; p = 1). However, individuals with MIP showed significantly less negative symptoms compared to those with schizophrenia (SMD, −0.35; 95CI%, −0.54 to −0.16; p = 0.01; I2 = 54 %). Our sensitivity analysis, which included only studies with a low risk of bias, did not change the results. However, our meta-analysis is limited by its cross-sectional approach, which limits the interpretation of causal associations. Furthermore, differences in population, inclusion criteria, methodology, and drug exposure impact our findings. Negative symptoms are less prominent in individuals with MIP. While both groups do not differ regarding positive symptoms, raises the possibility of shared and partly different underlying neurobiological mechanisms related to MIP and schizophrenia. [ABSTRACT FROM AUTHOR]

Objectives: Music therapy has been recognized as an effective treatment for various conditions, including psychiatric disorders like schizophrenia. Given the limited number of studies on music therapy and its effects on schizophrenia in Iran, and the importance of incorporating multi-modal treatment approaches for this disorder, this study aimed to evaluate the impact of music therapy on the positive and negative symptoms and overall functioning of chronically schizophrenic patients. Methods: A pre-post clinical trial was conducted in 2021 at the Parham Care Center in Kashan, involving 43 patients with chronic schizophrenia diagnosed based on DSM-V criteria. Patients underwent three sessions of music therapy per week for six months. Assessment tools included the Positive and Negative Symptoms Scale (PANSS), Brief Psychiatric Rating Scale (BPRS), and Global Assessment Function (GAF) scale administered before and after the intervention. Results: Following music therapy, there was a significant decrease in overall scores and subscales as measured by PANSS and BPRS (P<0.001), accompanied by a significant improvement in patients' functioning based on the GAF scale (P<0.001). Conclusions: The study findings suggest that integrating music therapy, both active and passive, alongside standard pharmacotherapy for chronic schizophrenia can lead to a significant reduction in positive and negative symptoms while enhancing overall functioning. [ABSTRACT FROM AUTHOR]

Background and hypothesis: Schizophrenia is often associated with severe difficulties in social functioning, resulting in increased isolation and subsequent loneliness. Interpersonal distance – the amount of space around an individual's body during social interaction – can signal such difficulties. However, little is known about how individuals with schizophrenia regulate their interpersonal distance during social encounters. Summarizing the current empirical findings of interpersonal distance regulation in schizophrenia can bring novel perspectives for understanding interpersonal difficulties observed in this clinical population. This systematic review examined empirical studies indexed in Web of Science and PubMed based on a-priori-defined criteria. 1164 studies were screened with the final review consisting of 14 studies. They together included 1145 adult participants, of whom 668 were diagnosed with schizophrenia or psychotic disorder. The studies clearly showed that patients maintain greater interpersonal distances than do controls. Furthermore, a larger distance was linked to more severe positive and negative symptoms. More specifically, the link to symptoms was more pronounced when patients were being approached by someone else during interactions. On a neurobiological level, the increased activity and functional connectivity of the dorsal inferior parietal sulcus and increased subjective state-dependent stress are further indicated as being potentially related to increase interpersonal distancing in schizophrenia. We provided information about the aberrant modulation of interpersonal distance in schizophrenia. Studies showed substantial heterogeneity in tasks used to measure interpersonal distance. Future studies should look at links to social functioning, underlying neurobiology, and neuroendocrinal regulation of interpersonal space in schizophrenia. [ABSTRACT FROM AUTHOR]

Autism Spectrum Disorder (ASD), characterized by socio-communicative abnormalities and restricted, repetitive, and stereotyped behaviors, is part of Neurodevelopmental Disorders (NDDs), a diagnostic category distinctly in accordance with the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, (DSM-5), clearly separated from Schizophrenia Spectrum Disorder (SSD) (schizophrenia, schizophreniform disorder, schizoaffective disorder, schizotypal personality disorder). Over the last four decades, this clear distinction is gradually being replaced, describing ASD and SSD as two heterogeneous conditions but with neurodevelopmental origins and overlaps. Referring to the proposal of a neurodevelopmental continuum model, the current research's aim is to provide an update of the knowledge to date on the course of clinical symptoms and their overlaps among ASD and SSD. A narrative review of the literature published between January 2010 and June 2023 was conducted. Five studies were included. All studies show a global impairment in both conditions. Two studies show a focus on neurodevelopmental perspective in ASD and SSD. Only one study of these adopts a longitudinal prospective in terms of prognostic markers among ASD and SSD. Three studies underline the overlap between ASD and SSD in terms of negative, disorganized and positive symptomatology. To date, there is a gap in the current scientific literature focused on ASD-SSD course of clinical symptoms and their overlaps from a neurodevelopmental perspective. Future longitudinal studies to identify risk markers and tailored treatments are needed. [ABSTRACT FROM AUTHOR]

Abstract Aims To investigate effects of repetitive transcranial magnetic stimulation (rTMS) on the prospective memory (PM) in patients with schizophrenia (SCZ). Methods Fifty of 71 patients completed this double‐blind placebo‐controlled randomized trial and compared with 18 healthy controls' (HCs) PM outcomes. Bilateral 20 Hz rTMS to the dorsolateral prefrontal cortex at 90% RMT administered 5 weekdays for 4 weeks for a total of 20 treatments. The Positive and Negative Symptom Scale (PANSS), the Scale for the Assessment of Negative Symptoms (SANS), and PM test were assessed before and after treatment. Results Both Event‐based PM (EBPM) and Time‐based PM (TBPM) scores at baseline were significantly lower in patients with SCZ than that in HCs. After rTMS treatments, the scores of EBPM in patients with SCZ was significantly improved and had no differences from that in HCs, while the scores of TBPM did not improved. The negative symptom scores on PANSS and the scores of almost all subscales and total scores of SANS were significantly improved in both groups. Conclusions Our findings indicated that bilateral high‐frequency rTMS treatment can alleviate EBPM but not TBPM in patients with SCZ, as well as improve the negative symptoms. Significance: Our results provide one therapeutic option for PM in patients with SCZ.

BackgroundWomen may develop severe symptoms of stress disorder following childbirth， which may be exposed to a risk of developing mental health problems， and even lead to the recurrence of the illness in female patients with schizophrenia， while comparatively limited research has been undertaken concerning the clinical characteristics and treatment of puerperal schizophrenia in China.ObjectiveTo explore the clinical characteristics of puerperal schizophrenia， so as to provide references for the clinical treatment.MethodsA total of 24 patients with puerperal schizophrenia who were hospitalized in the female ward of adult psychiatry department of the Affiliated Brain Hospital of Guangzhou Medical University from 2012 to 2020 and met the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） diagnostic criteria for schizophrenia were included as puerperal group. Another 48 non-puerperal women with schizophrenia were concurrently enrolled as control group. Then the basic data， scores on Positive and Negative Symptom Scale （PANSS） and the discharge medication were recorded.ResultsThe percentages of newly onset and positive family history of psychosis in puerperal group were larger than those in control group， with statistical significance （χ2=9.321， 5.240， P

Abstract Background This study examined the association between social support and the severity of positive symptoms in rural community-dwelling schizophrenia patients during the COVID-19 pandemic. Method The cross-sectional study included 665 rural community-dwelling schizophrenia patients investigated during the COVID-19 pandemic. Social support was measured using the Social Support Rating Scale, and positive symptoms were assessed using the Positive Scale extracted from the Positive and Negative Syndrome Scale. Multiple linear regression was adopted to examine the association of social support with positive symptoms. Result The scores for total social support, subjective support, objective support and the use of social support were 28.3 ± 5.9, 16.4 ± 5.2, 6.5 ± 1.4 and 5.4 ± 2.8, respectively. Total social support (β = −0.08, 95%CI: −0.13 to −0.02, P

Background Rehabilitation for schizophrenia typically relies on pharmacological interventions, yet their efficacy in improving social function and quality of life remains limited. In recent years, non-pharmacological approaches have shown promise in enhancing rehabilitation outcomes. However, research on the effectiveness of psychomotor therapy specifically for young and middle-aged schizophrenic inpatients is limited. Objective To explore the effects of psychomotor therapy on the rehabilitation of young and middle-aged schizophrenic inpatients, and to provide a reference for treatment strategies. Methods A total of 104 young and middle-aged schizophrenic inpatients who met the International Classification of Diseases, tenth edition (ICD-10) diagnostic criteria and hospitalized in the Fourth People's Hospital of Wuhu from June 2021 to June 2022 were selected. Patients were randomly divided into two groups of 52 each using random number table method. Both groups received treatment with risperidone tablets (2~4 mg/d), along with routine nursing care. Additionally, the research group received an extra 45~55 minutes of psychomotor therapy 2~3 times per week for 12 weeks. The control group received the same psychomotor therapy after the study. Positive and Negative Symptom Scale (PANSS), Scales of Social-skills for Psychiatric Inpatient (SSPI) and Insight and Treatment Attitude Questionnaire (ITAQ) were used to assess the patients before the intervention and at 4th, 8th and 12th week after the intervention. Results The main effects of intervention at different time points for PANSS positive symptoms, negative symptoms and general psychopathology subscale scores, PANSS total score, SSPI score and ITAQ score were all statistically significant (F=33. 989, 204. 245, 82. 817, 279. 596, 26. 144, 7. 463, P<0. 01). Furthermore, statistically significant between-group differences were observed in PANSS negative symptoms and general psychopathology subscale scores, PANSS total score, SSPI score and ITAQ score (F=30. 053, 5. 306, 33. 417, 33. 013, 18. 608, P<0. 05 or 0. 01). Moreover, the interaction effect of time and group were statistically significant for PANSS positive symptoms, negative symptoms and general psychopathology subscale score, PANSS total score and SSPI score (F=3. 472, 9. 798, 3. 843, 14. 390, 20. 661, P<0. 05 or 0. 01). After 12 weeks of intervention, the research group exhibited statistically significantly lower PANSS total score and subscale scores compared with baseline (P<0. 01), while their SSPI total score was significantly higher than that of control group (P<0. 01). Additionally, compared with the control group, the research group had statistically significantly lower PANSS total score and subscale scores, while their SSPI score was statistically significantly higher than those of control group (P<0. 01). Conclusion Psychomotor therapy may contribute to the improvement of the psychiatric symptoms and social function in young and middle-aged inpatients with schizophrenia, enhancing their rehabilitation outcomes. [ABSTRACT FROM AUTHOR]

Schizophrenia is a debilitating and long-lasting psychiatric condition characterized by its severity. The main causes of this disorder are still complex and not fully understood. Schizophrenia is a serious and lifelong psychiatric condition, is estimated to affect around 1% of the population throughout their lifetime. This study aims to determine the contribution of serum Brain-derived neurotrophic (BDNF) levels in schizophrenia patients during antipsychotic treatment at Reksodiwiryo Army Hospital and Siti Rahmah Islamic Hospital, Padang, Indonesia. Duration of antipsychotic treament range 1 year to 10 years. The method used in this research was a random perspective approach and consecutive sampling for patients undergoing outpatient treatment at the Reksodiwiryo Army Hospital and Siti Rahmah Islamic Hospital, Padang City, Indonesia. The sample consisted of 43 patients diagnosed with schizophrenia through structured clinical interviews (mini ICD 10). The results obtained in this study were that of the 43 total patients observed, sociodemographics were found with women (51.2%) being more numerous than men (48.8%), the age of most patients encountered was in the age range of 36-25 years (28%) and duration of illness <5 years (34.9%) is smaller than >5 years (65%), for various treatments ranging from FGAs, SGAs and combination of FGAs and SGAs where the highest results were found in patients with SGAs treatment (37.2%). From the statistical analysis, the correlation between serum BDNF levels was insignificant with negative and positive symptoms. [ABSTRACT FROM AUTHOR]

The ability to remember our past and to imagine the future are critical to our sense of self. Previous research has indicated that they are disrupted in schizophrenia. However, it is unclear (i) whether this is found when examining experimenter-scored indices of content and/or participants' self-report of phenomenological characteristics, and (ii) how these abilities might be related to symptoms. This study sought to address these questions by taking a dimensional approach and measuring positive and negative schizotypal experiences in healthy people (n = 90). Participants were given cue words. For some, they remembered an event from the past and for others they generated an event in the future. No significant relationships were found with any aspect of schizotypy when participants' descriptions were scored by the experimenter according to a standardised episodic content measure. In contrast, several significant positive correlations were observed for past memory and future thinking when examining the positive dimension of schizotypy and participants' ratings, particularly to sensory characteristics of the experience and mental pre- or reliving. These results indicate enhanced subjective experiences of autobiographical memory and future thinking in those who report delusional and hallucinatory-like occurrences, which might be linked to mental imagery or metacognitive alterations. [ABSTRACT FROM AUTHOR]

Aims: To investigate effects of repetitive transcranial magnetic stimulation (rTMS) on the prospective memory (PM) in patients with schizophrenia (SCZ). Methods: Fifty of 71 patients completed this double‐blind placebo‐controlled randomized trial and compared with 18 healthy controls' (HCs) PM outcomes. Bilateral 20 Hz rTMS to the dorsolateral prefrontal cortex at 90% RMT administered 5 weekdays for 4 weeks for a total of 20 treatments. The Positive and Negative Symptom Scale (PANSS), the Scale for the Assessment of Negative Symptoms (SANS), and PM test were assessed before and after treatment. Results: Both Event‐based PM (EBPM) and Time‐based PM (TBPM) scores at baseline were significantly lower in patients with SCZ than that in HCs. After rTMS treatments, the scores of EBPM in patients with SCZ was significantly improved and had no differences from that in HCs, while the scores of TBPM did not improved. The negative symptom scores on PANSS and the scores of almost all subscales and total scores of SANS were significantly improved in both groups. Conclusions: Our findings indicated that bilateral high‐frequency rTMS treatment can alleviate EBPM but not TBPM in patients with SCZ, as well as improve the negative symptoms. Significance: Our results provide one therapeutic option for PM in patients with SCZ. [ABSTRACT FROM AUTHOR]

Background: This study examined the association between social support and the severity of positive symptoms in rural community-dwelling schizophrenia patients during the COVID-19 pandemic. Method: The cross-sectional study included 665 rural community-dwelling schizophrenia patients investigated during the COVID-19 pandemic. Social support was measured using the Social Support Rating Scale, and positive symptoms were assessed using the Positive Scale extracted from the Positive and Negative Syndrome Scale. Multiple linear regression was adopted to examine the association of social support with positive symptoms. Result: The scores for total social support, subjective support, objective support and the use of social support were 28.3 ± 5.9, 16.4 ± 5.2, 6.5 ± 1.4 and 5.4 ± 2.8, respectively. Total social support (β = −0.08, 95%CI: −0.13 to −0.02, P < 0.01) and subjective social support (β = −0.10, 95%CI: −0.16 to −0.04, P < 0.01) were significantly and negatively associated with the Positive Scale score after adjustment for confounders. Objective social support (β = 0.11, 95%CI: −0.10 to 0.32, P = 0.31) and the use of social support (β = −0.03, 95%CI: −0.14 to 0.07, P = 0.53) were not significantly associated with the Positive Scale score. Conclusion: The study confirmed the importance of social support, especially subjective support, provided to rural community-dwelling schizophrenia patients during the COVID-19 pandemic. This support should be addressed and strengthened for such patients in emergent events. [ABSTRACT FROM AUTHOR]

Objectives: Evidence suggests that emotional awareness--the ability to identify and label emotions--may be impaired in schizophrenia and related to positive symptom severity. Exposure to childhood maltreatment is a risk factor for both low emotional awareness and positive symptoms. Methods: The current investigation examines associations between a performance-based measure of emotional awareness, positive symptom severity, and childhood maltreatment exposure in 44 individuals with a schizophrenia-spectrum disorder and 48 healthy comparison participants using the electronic Levels of Emotional Awareness Scale (eLEAS), Positive and Negative Syndrome Scale (PANSS) and Childhood Trauma Questionnaire (CTQ). Results: Patients demonstrated significant deficits in emotional awareness overall, which was true for both self and others. In patients, lower emotional awareness was significantly associated with more severe positive symptoms. Emotional awareness was significantly impaired in patients with schizophrenia with self-reported maltreatment exposure, relative to other groups. Severity of maltreatment was not significantly associated with emotional awareness or positive symptoms when looking continuously, and there was no significant indirect effect. Conclusion: These data suggest that emotional awareness impairments observed in schizophrenia may be exacerbated by exposure to childhood maltreatment, possibly putting individuals at greater risk for experiencing positive symptoms of psychosis. [ABSTRACT FROM AUTHOR]

The aim of our study was to evaluate the efficacy of cariprazine augmentation of clozapine in treatment-resistant schizophrenia in a retrospective chart review. Among 916 medical records of schizophrenia patients, we identified 12 individuals treated with a combination of those drugs for a duration of 3–60 weeks [median 32 (10–40)]. Clinical Global Impression–Improvement (CGI-I) scores were used to measure the treatment response between the introduction of cariprazine augmentation of clozapine and the last point of observation. The majority of the patients presented treatment response (9/12 patients, 75%) after 4–16 weeks of therapy [median 6 (4–12)]. Treatment was associated with the decrease in positive, negative, affective, and anxiety symptom severity, as well as improvement of patient global functioning. One patient discontinued the treatment due to side effects (akathisia), and two patients halted the therapy due to the exacerbation of psychotic symptoms. Our study presents a thorough clinical description of the largest number of treatment-resistant schizophrenia patients medicated using cariprazine augmentation of clozapine in a “real-world” setting. Our results suggest that the use of this combination may lead to the improvement in a broad range of symptoms of patients with this condition. [ABSTRACT FROM AUTHOR]

Background Women may develop severe symptoms of stress disorder following childbirth, which may be exposed to a risk of developing mental health problems, and even lead to the recurrence of the illness in female patients with schizophrenia, while comparatively limited research has been undertaken concerning the clinical characteristics and treatment of puerperal schizophrenia in China. Objective To explore the clinical characteristics of puerperal schizophrenia, so as to provide references for the clinical treatment. Methods A total of 24 patients with puerperal schizophrenia who were hospitalized in the female ward of adult psychiatry department of the Affiliated Brain Hospital of Guangzhou Medical University from 2012 to 2020 and met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) diagnostic criteria for schizophrenia were included as puerperal group. Another 48 non-puerperal women with schizophrenia were concurrently enrolled as control group. Then the basic data, scores on Positive and Negative Symptom Scale (PANSS) and the discharge medication were recorded. Results The percentages of newly onset and positive family history of psychosis in puerperal group were larger than those in control group, with statistical significance (χ2 =9. 321,5. 240,P<0. 05 or 0. 01). Puerperal group scored higher on PANSS excitement factor (t=-2. 220, P<0. 05) and lower on negative factor (t=3. 377,P<0. 01) compared with control group. In terms of discharge medication, puerperal group reported a higher dosage of antipsychotic drugs (t=-2. 095,P<0. 05), and a larger proportion of combined use of benzodiazepines or antidepressants (χ²=21. 316,5. 114,P<0. 05 or 0. 01) compared with control group, with statistical significance. Conclusion Patients with puerperal schizophrenia display increased ratings of excitement symptoms and decreased ratings of negative symptoms, which necessitates the use of high doses of antipsychotic drugs, and combined use of benzodiazepines and antidepressants. [ABSTRACT FROM AUTHOR]

• Canakinumab is a monoclonal antibody to the proinflammatory cytokine Interleukin-1β. • People with schizophrenia and elevated peripheral inflammation enrolled in a trial. • Canakinumab reduced peripheral c-reactive protein and positive symptom severity. • C-reactive protein level change was related to change in positive symptom severity. • Blocking Interleukin-1β reduces symptoms in patients with elevated inflammation. Clinical trials of anti-inflammatories in schizophrenia do not show clear and replicable benefits, possibly because patients were not recruited based on elevated inflammation status. Interleukin 1-beta (IL-1β) mRNA and protein levels are increased in serum, plasma, cerebrospinal fluid, and brain of some chronically ill patients with schizophrenia, first episode psychosis, and clinical high-risk individuals. Canakinumab, an approved anti-IL-1β monoclonal antibody, interferes with the bioactivity of IL-1β and interrupts downstream signaling. However, the extent to which canakinumab reduces peripheral inflammation markers, such as, high sensitivity C-reactive protein (hsCRP) and symptom severity in schizophrenia patients with inflammation is unknown. We conducted a randomized, placebo-controlled, double-blind, parallel groups, 8-week trial of canakinumab in chronically ill patients with schizophrenia who had elevated peripheral inflammation. Twenty-seven patients with schizophrenia or schizoaffective disorder and elevated peripheral inflammation markers (IL-1β, IL-6, hsCRP and/or neutrophil to lymphocyte ratio: NLR) were randomized to a one-time, subcutaneous injection of canakinumab (150 mg) or placebo (normal saline) as an adjunctive antipsychotic treatment. Peripheral blood hsCRP, NLR, IL-1β, IL-6, IL-8 levels were measured at baseline (pre injection) and at 1-, 4- and 8-weeks post injection. Symptom severity was assessed at baseline and 4- and 8-weeks post injection. Canakinumab significantly reduced peripheral hsCRP over time, F(3, 75) = 5.16, p = 0.003. Significant hsCRP reductions relative to baseline were detected only in the canakinumab group at weeks 1, 4 and 8 (p's = 0.0003, 0.000002, and 0.004, respectively). There were no significant hsCRP changes in the placebo group. Positive symptom severity scores were significantly reduced at week 8 (p = 0.02) in the canakinumab group and week 4 (p = 0.02) in the placebo group. The change in CRP between week 8 and baseline (b = 1.9, p = 0.0002) and between week 4 and baseline (b = 6.0, p = 0.001) were highly significant predictors of week 8 change in PANSS Positive Symptom severity scores. There were no significant changes in negative symptoms, general psychopathology or cognition in either group. Canakinumab was well tolerated and only 7 % discontinued. Canakinumab quickly reduces peripheral hsCRP serum levels in patients with schizophrenia and inflammation; after 8 weeks of canakinumab treatment, the reductions in hsCRP are related to reduced positive symptom severity. Future studies should consider increased doses or longer-term treatment to confirm the potential benefits of adjunctive canakinumab in schizophrenia. Australian and New Zealand Clinical Trials Registry number: ACTRN12615000635561. [ABSTRACT FROM AUTHOR]

Schizophrenia is a severe mental disorder that leads to impaired social adaptation, interpersonal interaction, and disability. Negative symptoms are an integral part of schizophrenia. In the world psychiatric science and practice, there are still many questions about the typology of schizophrenia, the description of its clinical manifestations, first of all, the features of negative symptoms in schizophrenia. Psychiatrists of different countries draw attention to the fact that these descriptions do not always coincide. Socio-demographic factors can be considered as factors affecting the prognosis of the course and outcome of schizophrenia. In this regard, a comprehensive approach to the study of sociodemographic characteristics of patients with schizophrenia involves the study of the influence of social factors on the formation and course of schizophrenia and determines the relevance of this study. The purpose of the study was to determine the features of socio-demographic characteristics of patients with schizophrenia in order to improve diagnosis and create psycho-corrective measures. 252 patients with negative symptoms of schizophrenia and 79 patients with positive symptoms of schizophrenia were examined. During the research, a comprehensive approach was used, consisting in the use of clinical-psychopathological, clinical-anamnestic and statistical research methods. Socio-demographic features of patients with negative symptoms in schizophrenia were established, consisting in the predominance of women; patients aged 20-29 years; persons with special secondary education; divorced and single persons; patients busy with physical labor; average level of material wealth; very poor and poor living conditions. Sociodemographic characteristics of patients with positive symptoms in schizophrenia were outlined by the predominance of men; patients aged 30-49 years; persons with incomplete higher education and with higher education; divorced and single persons; patients with disabilities; with extremely low and low levels of material well-being and a satisfactory level of living conditions. The conducted research made it possible to draw conclusions that socio-demographic features of patients with negative and positive symptoms have their own specificity, which should be taken into account when diagnosing patients with schizophrenia. [ABSTRACT FROM AUTHOR]

Kurt Schneider has played a leading role in shaping our current view of schizophrenia, placing certain manifestations of delusions and hallucinations at the center of the disorder, especially ideas of persecution and voice-hearing. The first part of this review summarizes Schneider's original ideas and then traces how the different editions of the DSM merged aspects of Kraepelin's, Bleuler's, and Schneider's historical concepts. Special attention is given to the transition from the DSM-IV to the DSM-5, which eliminated much of Schneider's original concept. In the second part of the article, we contrast the current definition of hallucination in the DSM-5 with that of Schneider. We present empirically derived arguments that favor a redefinition of hallucinations, much in accordance with Schneider's original ideas. We plea for a two-dimensional model of hallucinations that represents the degree of insight and perceptuality, ranging from thoughts with full "mineness" via perception-laden thoughts and intrusions (including "as if" experiences") to hallucinations. While we concur with the DSM-5 that cognitions that are indistinguishable from perceptions should be labeled as hallucinations, we suggest expanding the definition to internally generated sensory phenomena, including those with only partial resemblance to external perceptions, that the individual considers real and that may lie at the heart of a subsequent delusional superstructure. [ABSTRACT FROM AUTHOR]

Background: To assess the mediator effect of dispositional mindfulness on the relationship between psychotic symptoms and psychological quality of life of people experiencing psychosis. Method: One hundred thirty-eight participants with psychosis were recruited. Psychotic symptoms were assessed through the PANSS scale, dispositional mindfulness was assessed using the MAAS questionnaire, and psychological quality of life was tapped with the WHOQOL-BREF questionnaire. Mediational analysis was performed setting PANSS factors as independent variables, MAAS scores as mediator, and WHOQOL-BREF Psychological as dependent variable. Results: MAAS scores mediated the relationship between WHOQOL-BREF Psychological scores and PANSS Positive (b = -.246, BCa CI [-.345, -.153]), PANSS Negative (b = -.173, BCa CI [-.251, -.096]), and PANSS Depressed scores (b = -.227, BCa CI [-.31, -.148]). Conclusions: Dispositional mindfulness can ameliorate the negative impact of hallucinations, delusions, negative symptoms, and depression feelings on psychological quality of life of people experiencing psychosis.

The aim: to determine the features of the clinical-psychopathological structure and severity of negative and positive symptoms in patients with schizophrenia to improve diagnosis and treatment of schizophrenia. Materials and methods. 252 patients with negative symptoms (NS) in schizophrenia and 79 patients with positive symptoms (PS) in schizophrenia were examined. The research used a comprehensive approach, which consisted in the use of clinical-psychopathological, psychometric (PANSS scale) and statistical research methods. Results. Manifestations of positive symptoms in patients with NS in schizophrenia were mainly delineated by delusions of a minimal and weak level; minimal manifestations of delirium, unusual behavior and thought disorders; the predominance of patients with no disorders, minimal disorders and a weak level of disorders of hallucinatory behavior, excitement, ideas of grandeur, suspiciousness, and hostility. Manifestations of negative symptoms in patients with NS in schizophrenia were characterized by a predominance of medium and severe levels of blunted affect; moderate and average levels of emotional alienation; violation of abstract thinking of a weak and moderate level; average level of impaired fluency and spontaneity of speech; moderate communication impairment; passive-apathetic social detachment of the average level. Among patients with PS in schizophrenia, the manifestations of positive symptoms were mainly delineated by delusions of medium and strong levels of severity; moderate and pronounced manifestations of delirium; a moderate level of severity of thinking disorders and unusual behavior; predominance of moderate, medium and strong levels of expression of hallucinatory behavior, excitement, ideas of grandeur, suspicion and hostility. Manifestations of negative symptoms in patients with PS in schizophrenia were characterized by a predominance of a minimal level of expression of dulled affect, social exclusion and impaired fluency and spontaneity of speech; minimal and weak levels of emotional alienation; average level of communication disorders and abstract thinking. Conclusions. Features of the clinical-psychopathological structure and severity of negative and positive symptoms in patients with schizophrenia were established. The obtained data can serve as diagnostic criteria for conducting differential diagnosis and choosing treatment strategies for patients with schizophrenia.

Abstract Background Schizophrenia patients have a high risk of suicide, and their cognition function is impaired with increasing age. The association between neurocognitive and suicidality in schizophrenia patients are heterogeneous. We aimed to explore the relationship between neurocognitive function and suicidal ideation in schizophrenia patients across age groups. Methods A total of 587 patients with schizophrenia were enrolled in this study. The schizophrenia patients were divided into young group (aged 18–44) and middle-aged and elderly group (aged 45–70). The schizophrenia patients were divided into suicidal ideation group and non-suicidal ideation group according to the evaluation results of the Beck Scale for Suicide Ideation. Insomnia symptoms were measured by the Insomnia Severity Index (ISI). Psychotic symptoms were measured by the Positive and Negative Syndrome Scale (PANSS), and cognitive function was measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Results There was a negative correlation between the age and attention scores of RBANS (P = 0.018). The young schizophrenia patients had higher risk of suicidality than middle-aged and elderly schizophrenia patients (P = 0.001). In the logistic regression analysis, the scores of ISI and positive symptoms scores of PANSS were associated with suicidal ideation among young schizophrenia patients (All P

Copyright of Turk Psikiyatri Dergisi is the property of Turk Psikiyatri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Hypotheses Auditory verbal hallucinations (AVH) are central features of schizophrenia (SZ). However, AVH also occur in a small percentage of the general population who do not have a need for care, termed nonclinical voice hearers (NCVH). We sought to determine the degree to which the experience of AVH was similar in NCVH and in people with schizophrenia (PSZ) and evaluate the degree to which NCVH shared other features of SZ such as delusional beliefs, cognitive impairment, and negative symptoms. Study Design We recruited 76 people with a DSM-V diagnosis of SZ/schizoaffective disorder (PSZ; 49 with current AVH, 27 without), 48 NCVH, and 51 healthy controls. Participants received a broad battery of clinician-administered and self-report symptom assessments and a focused cognitive assessment. Study Results The AVH of NCVH and PSZ shared very similar sensory features. NCVH experienced less distress, had greater control over their AVH, and, unlike PSZ, rarely heard 2 voices speaking to each other. NCVH demonstrated a wide range of deeply held unusual beliefs, but reported less paranoia, and fewer first-rank symptoms such as passivity and alterations in self-experience. NCVH showed no evidence of cognitive deficits or negative symptoms. Conclusions The AVH in NCVH and PSZ demonstrate important similarities as well as clear differences. Specific features, rather than the presence, of AVH appear to determine the need for care. NCVH do not share the cognitive and motivational deficits seen in PSZ. These results suggest that AVH and unusual beliefs can be separated from the broader phenotype of SZ. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia patients have a high risk of suicide, and their cognition function is impaired with increasing age. The association between neurocognitive and suicidality in schizophrenia patients are heterogeneous. We aimed to explore the relationship between neurocognitive function and suicidal ideation in schizophrenia patients across age groups. Methods: A total of 587 patients with schizophrenia were enrolled in this study. The schizophrenia patients were divided into young group (aged 18–44) and middle-aged and elderly group (aged 45–70). The schizophrenia patients were divided into suicidal ideation group and non-suicidal ideation group according to the evaluation results of the Beck Scale for Suicide Ideation. Insomnia symptoms were measured by the Insomnia Severity Index (ISI). Psychotic symptoms were measured by the Positive and Negative Syndrome Scale (PANSS), and cognitive function was measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Results: There was a negative correlation between the age and attention scores of RBANS (P = 0.018). The young schizophrenia patients had higher risk of suicidality than middle-aged and elderly schizophrenia patients (P = 0.001). In the logistic regression analysis, the scores of ISI and positive symptoms scores of PANSS were associated with suicidal ideation among young schizophrenia patients (All P < 0.05). Age, BMI, the scores of ISI, general symptoms scores of PANSS, visuospatial scores of RBANS and attention scores of RBANS were associated with suicidal ideation in middle-aged and elderly schizophrenia patients (All P < 0.05). Conclusions: High visuospatial scores of RBANS and attention scores of RBANS were risk factors for suicidal ideation in middle-aged and elderly schizophrenia patients. [ABSTRACT FROM AUTHOR]

The purpose of the study was to examine specific learning functions among people coping with schizophrenia and the possibility of a relationship between the different aspects of learning function (e.g., reading or writing) and the severity of the mental illness. We hypothesized that (a) the basic learning functions of people with schizophrenia after the first episode of the disease would be low compared with the general population, but (b) there would be broad intra-individual variance in the degree of damage to the different functions, and (c) this intra-individual variance would be associated with the severity of the illness. The sample comprised 38 schizophrenia patients, ages 20–37, who were hospitalized in two psychiatric hospitals in northern Israel. The learning functions were examined using MATAL, a computerized set of standardized tests and questionnaires developed for the diagnosis of learning disabilities among higher education students in Israel. The results supported the first two hypotheses; the learning functions of the participants were significantly lower than the norm in the general population on all tasks and there was variance among individuals regarding the different functions. However, inconsistent with our third hypothesis, no correlation was found between this variance and the severity of the illness. The findings provide initial support for the presence of learning disabilities among patients with schizophrenia. Further research is recommended to better understand this subject and evaluate the need for diagnosis and intervention. [ABSTRACT FROM AUTHOR]

Autism Spectrum Disorder (ASD), characterized by socio-communicative abnormalities and restricted, repetitive, and stereotyped behaviors, is part of Neurodevelopmental Disorders (NDDs), a diagnostic category distinctly in accordance with the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, (DSM-5), clearly separated from Schizophrenia Spectrum Disorder (SSD) (schizophrenia, schizophreniform disorder, schizoaffective disorder, schizotypal personality disorder). Over the last four decades, this clear distinction is gradually being replaced, describing ASD and SSD as two heterogeneous conditions but with neurodevelopmental origins and overlaps. Referring to the proposal of a neurodevelopmental continuum model, the current research’s aim is to provide an update of the knowledge to date on the course of clinical symptoms and their overlaps among ASD and SSD. A narrative review of the literature published between January 2010 and June 2023 was conducted. Five studies were included. All studies show a global impairment in both conditions. Two studies show a focus on neurodevelopmental perspective in ASD and SSD. Only one study of these adopts a longitudinal prospective in terms of prognostic markers among ASD and SSD. Three studies underline the overlap between ASD and SSD in terms of negative, disorganized and positive symptomatology. To date, there is a gap in the current scientific literature focused on ASD-SSD course of clinical symptoms and their overlaps from a neurodevelopmental perspective. Future longitudinal studies to identify risk markers and tailored treatments are needed.

ObjectivesEvidence suggests that emotional awareness—the ability to identify and label emotions—may be impaired in schizophrenia and related to positive symptom severity. Exposure to childhood maltreatment is a risk factor for both low emotional awareness and positive symptoms.MethodsThe current investigation examines associations between a performance-based measure of emotional awareness, positive symptom severity, and childhood maltreatment exposure in 44 individuals with a schizophrenia-spectrum disorder and 48 healthy comparison participants using the electronic Levels of Emotional Awareness Scale (eLEAS), Positive and Negative Syndrome Scale (PANSS) and Childhood Trauma Questionnaire (CTQ).ResultsPatients demonstrated significant deficits in emotional awareness overall, which was true for both self and others. In patients, lower emotional awareness was significantly associated with more severe positive symptoms. Emotional awareness was significantly impaired in patients with schizophrenia with self-reported maltreatment exposure, relative to other groups. Severity of maltreatment was not significantly associated with emotional awareness or positive symptoms when looking continuously, and there was no significant indirect effect.ConclusionThese data suggest that emotional awareness impairments observed in schizophrenia may be exacerbated by exposure to childhood maltreatment, possibly putting individuals at greater risk for experiencing positive symptoms of psychosis.

The aim of our study was to evaluate the efficacy of cariprazine augmentation of clozapine in treatment-resistant schizophrenia in a retrospective chart review. Among 916 medical records of schizophrenia patients, we identified 12 individuals treated with a combination of those drugs for a duration of 3–60 weeks [median 32 (10–40)]. Clinical Global Impression–Improvement (CGI-I) scores were used to measure the treatment response between the introduction of cariprazine augmentation of clozapine and the last point of observation. The majority of the patients presented treatment response (9/12 patients, 75%) after 4–16 weeks of therapy [median 6 (4–12)]. Treatment was associated with the decrease in positive, negative, affective, and anxiety symptom severity, as well as improvement of patient global functioning. One patient discontinued the treatment due to side effects (akathisia), and two patients halted the therapy due to the exacerbation of psychotic symptoms. Our study presents a thorough clinical description of the largest number of treatment-resistant schizophrenia patients medicated using cariprazine augmentation of clozapine in a “real-world” setting. Our results suggest that the use of this combination may lead to the improvement in a broad range of symptoms of patients with this condition.

Abstract Aims Schizophrenia is a psychiatric disorder presenting a lack of insight. Although insight changes over time, longitudinal studies of insight in schizophrenia are scarce. Furthermore, most previous studies on insight and intelligence have not measured full‐scale IQ and have not been able to examine the relationship between detailed dimensions of cognitive function and insight. In this study, we assessed insight at two time points and assessed dimensions of cognitive function. Methods A total of 163 patients with schizophrenia participated in the study. We evaluated insight at two time points to understand the patterns of change and examined the association between insight and clinical variables. Additionally, we examined the relationship between the dimensions of cognitive function and insight. Results The patients were divided into three groups based on their change in insight over time: stable at a low level of insight (poor insight), stable at a high level of insight (good insight), and changed in insight over time (unstable insight). Those in the poor insight group had lower general intelligence scores than those in the good insight and unstable insight groups. Regarding cognitive function, verbal comprehension was associated with the level of insight at baseline and follow‐up. Regarding psychiatric symptoms, the poor insight group exhibited more severe symptoms than the other two groups, especially regarding positive symptoms. Conclusions Our classification of patients based on changes in insight revealed that poor insight patients had impaired cognitive function, especially verbal comprehension, and more severe positive symptoms than good insight or unstable insight patients.

Introduction: Schizophrenia is a mental disorder in which the facts surrounding a person are interpreted as abnormal. The treatment aims to reduce symptoms and the possibility of disease recurrence. Aim: This study aimed to investigate the effectiveness of spironolactone on schizophrenia symptoms. Method: In this double-blind analytical and clinical study, 44 patients were randomly divided into two groups. The study was carried out in Quds Hospital and centers for psychiatric patients in Sanandaj city in 2019 and 2020. The number of patients decreased to 32 due to drug side effects and unwillingness to continue treatment. The instrument used was the scale test of positive and negative symptoms of schizophrenia. Datum were analyzed using chi-square and ANOVA with repeated measurements and independent t-tests by SPSS-23 software. Results: The results showed that out of 44 patients studied, 37 (84.1%) were men and 7 (15.9%) were women. The imbalance was due to the small sample size. There was no significant difference between the two groups in terms of sex distribution, literacy level, marital status, employment history, and background medication use (P>0.05). In addition, there was no significant difference between the two groups in terms of reducing negative symptoms (P=0.666), positive symptoms (P=0.748) and general symptoms (P=0.342). Conclusion: According to the finding, spironolactone has no significant effect on reducing negative, positive, and general symptoms. Therefore, it is suggested to carry out more studies using this drug (by removing the limitations of this study) and other drugs.

Background: To assess the mediator effect of dispositional mindfulness on the relationship between psychotic symptoms and psychological quality of life of people experiencing psychosis. Method: One hundred thirty-eight participants with psychosis were recruited. Psychotic symptoms were assessed through the PANSS scale, dispositional mindfulness was assessed using the MAAS questionnaire, and psychological quality of life was tapped with the WHOQOL-BREF questionnaire. Mediational analysis was performed setting PANSS factors as independent variables, MAAS scores as mediator, and WHOQOL-BREF Psychological as dependent variable. Results: MAAS scores mediated the relationship between WHOQOL-BREF Psychological scores and PANSS Positive (b = -.246, BCa CI [-.345, -.153]), PANSS Negative (b = -.173, BCa CI [-.251, -.096]), and PANSS Depressed scores (b = -.227, BCa CI [-.31, -.148]). Conclusions: Dispositional mindfulness can ameliorate the negative impact of hallucinations, delusions, negative symptoms, and depression feelings on psychological quality of life of people experiencing psychosis. [ABSTRACT FROM AUTHOR]

Abstract Background Even though there is an increasing amount of evidence from behavioral and neuroimaging studies to suggest that pathological inner speech plays a role in the emergence of auditory verbal hallucinations (AVH), studies investigating the mechanisms underlying this relationship are rather scarce. Examining moderators might inform the development of new treatment options for AVH. We sought to extend the existing knowledge by testing the moderating role of cognitive impairment in the association between inner speech and hallucinations in a sample of Lebanese patients with schizophrenia. Methods A cross-sectional study was conducted from May till August 2022, enrolling 189 chronic patients. Results Moderation analysis revealed that, after controlling for delusions, the interaction of experiencing voices of other people in inner speech by cognitive performance was significantly associated with AVH. In people having low (Beta = 0.69; t = 5.048; p

The severity of positive symptoms in schizophrenia is associated with poor prognosis. About one-third of schizophrenia patients partially respond to treatment with available antipsychotics. The purpose of the present manuscript is to provide an updated overview of novel pharmacotherapy targeting positive symptoms in schizophrenia. A comprehensive research on the main database sources (PubMed, PsychINFO, Isi Web of Knowledge, MEDLINE, and EMBASE) was performed to obtain original articles published till 31st January 2023 about new pharmacological strategies for the treatment of positive symptoms in schizophrenia. The most promising compounds include: lamotrigine, pro-cognitive-compounds (donepezil – in the short term, idazoxan and piracetam) and drugs acting partially or totally outside the Central Nervous System (CNS) (anti-inflammatory drugs: celecoxib, methotrexate; cardiovascular compounds: L-theanine, mononitrate isosorbide, propentofylline, sodium nitroprusside; metabolic regulators: diazoxide, allopurinol; others: bexarotene, raloxifene [in women]). The effectiveness of the latter compounds indicates that other biological systems, such as immunity or metabolism can be object of future research to identify pharmacological targets for positive symptoms of schizophrenia. Mirtazapine could be useful for treating negative symptoms without increasing the risk of a worsening of delusions/hallucinations. Nevertheless, the lack of replication of studies prevents to draw definitive conclusions and future studies are needed to confirm the findings presented in this overview. [ABSTRACT FROM AUTHOR]