We read the impressive review article“Clozapine resistant schizophrenia:Newer avenues of management”with great enthusiasm and appreciation.The author believes that preventing clozapine resistance from developing may...We read the impressive review article“Clozapine resistant schizophrenia:Newer avenues of management”with great enthusiasm and appreciation.The author believes that preventing clozapine resistance from developing may be the most effective treatment strategy for patients with clozapine-resistant schizophrenia(CRS),and optimizing clozapine treatment is a key component.Disentangling the differences between treatment-resistant schizophrenia and CRS is important for studies addressing treatment strategies for these difficult-to-treat populations.展开更多
BACKGROUND The thalamus plays a key role in filtering information and has extensive interconnectivity with other brain regions.A large body of evidence points to impaired functional connectivity(FC)of the thalamocorti...BACKGROUND The thalamus plays a key role in filtering information and has extensive interconnectivity with other brain regions.A large body of evidence points to impaired functional connectivity(FC)of the thalamocortical pathway in schizophrenia.However,the functional network of the thalamic subregions has not been investigated in patients with treatment-resistant schizophrenia(TRS).AIM To identify the neural mechanisms underlying TRS,we investigated FC of thalamic sub-regions with cortical networks and voxels,and the associations of this FC with clinical symptoms.We hypothesized that the FC of thalamic subregions with cortical networks and voxels would differ between TRS patients and HCs.METHODS In total,50 patients with TRS and 61 healthy controls(HCs)matched for age,sex,and education underwent resting-state functional magnetic resonance imaging(rs-fMRI)and clinical evaluation.Based on the rs-fMRI data,we conducted a FC analysis between thalamic subregions and cortical functional networks and voxels,and within thalamic subregions and cortical functional networks,in the patients with TRS.A functional parcellation atlas was used to segment the thalamus into nine subregions.Correlations between altered FC and TRS symptoms were explored.RESULTS We found differences in FC within thalamic subregions and cortical functional networks between patients with TRS and HCs.In addition,increased FC was observed between thalamic subregions and the sensorimotor cortex,frontal medial cortex,and lingual gyrus.These abnormalities were associated with the pathophysiology of TRS.CONCLUSION Our findings suggest that disrupted FC within thalamic subregions and cortical functional networks,and within the thalamocortical pathway,has potential as a marker for TRS.Our findings also improve our understanding of the relationship between the thalamocortical pathway and TRS symptoms.展开更多
Objective: Clozapine is regarded as the most effective drug for treatment of schizophrenia but has complex adverse effects associated with hyperglycemia and diabetes mellitus. Method: We report that clozapine was very...Objective: Clozapine is regarded as the most effective drug for treatment of schizophrenia but has complex adverse effects associated with hyperglycemia and diabetes mellitus. Method: We report that clozapine was very effective to treat positive, negative, and cognitive symptoms and well tolerated to a treatment-resistant schizophrenia patient with severe type 2 diabetes mellitus (DM) under cautious blood-sugar monitoring. Results: Clozapine itself and discontinuation of other psychotropic and anticholinergic agents after switching may improve cognitive function and adherence to the treatment regimens for schizophrenia and DM. Conclusion: Clozapine can be administered to treatment-resistant schizophrenia patients even with severe DM with caution.展开更多
Treatment-resistant schizophrenia has an extremely negative impact on mental health and social life. If clozapine, the gold standard treatment, fails, there are very few options left. The literature suggests that high...Treatment-resistant schizophrenia has an extremely negative impact on mental health and social life. If clozapine, the gold standard treatment, fails, there are very few options left. The literature suggests that high-dose olanzapine (20 - 60 mg/day) is a possible alternative. We report two cases in which very high doses of olanzapine were administered, with significant clinical improvements above 60 mg/day. Clinical, metabolic and cardiac tolerance was good. This report highlights the usefulness of very-high-dose olanzapine in treatment-resistant schizophrenia. The main hypotheses concerning the psychopharmacological mechanisms of very-high-dose olanzapine are discussed.展开更多
Historically,psychiatric diagnoses have been made based on patient’s reported symptoms applying the criteria from diagnostic and statistical manual of mental disorders.The utilization of neuroimaging or biomarkers to...Historically,psychiatric diagnoses have been made based on patient’s reported symptoms applying the criteria from diagnostic and statistical manual of mental disorders.The utilization of neuroimaging or biomarkers to make the diagnosis and manage psychiatric disorders remains a distant goal.There have been several studies that examine brain imaging in psychiatric disorders,but more work is needed to elucidate the complexities of the human brain.In this editorial,we examine two articles by Xu et al and Stoyanov et al,that show developments in the direction of using neuroimaging to examine the brains of people with schizo-phrenia and depression.Xu et al used magnetic resonance imaging to examine the brain structure of patients with schizophrenia,in addition to examining neurotransmitter levels as biomarkers.Stoyanov et al used functional magnetic resonance imaging to look at modulation of different neural circuits by diagnostic-specific scales in patients with schizophrenia and depression.These two studies provide crucial evidence in advancing our understanding of the brain in prevalent psychiatric disorders.展开更多
BACKGROUND The use of network pharmacology and blood metabolomics to study the patho-genesis of violent aggression in patients with schizophrenia and the related drug mechanisms of action provides new directions for r...BACKGROUND The use of network pharmacology and blood metabolomics to study the patho-genesis of violent aggression in patients with schizophrenia and the related drug mechanisms of action provides new directions for reducing the risk of violent aggression and optimizing treatment plans.AIM To explore the metabolic regulatory mechanism of olanzapine in treating patients with schizophrenia with a moderate to high risk of violent aggression.METHODS Metabolomic technology was used to screen differentially abundant metabolites in patients with schizophrenia with a moderate to high risk of violent aggression before and after olanzapine treatment,and the related metabolic pathways were identified.Network pharmacology was used to establish protein-protein interaction networks of the core targets of olanzapine.Gene Ontology functional analysis and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were subsequently performed.RESULTS Compared with the healthy group,the patients with schizophrenia group presented significant changes in the levels of 24 metabolites related to the disruption of 9 metabolic pathways,among which the key pathways were the alanine,aspartate and glutamate metabolism and arginine biosynthesis pathways.After treatment with olanzapine,the levels of 10 differentially abundant metabolites were significantly reversed in patients with schizophrenia.Olanzapine effectively regulated six metabolic pathways,among which the key pathways were alanine,aspartate and glutamate metabolism and arginine biosynthesis pathways.Ten core targets of olanzapine were involved in several key pathways.CONCLUSION The metabolic pathways of alanine,aspartate,and glutamate metabolism and arginine biosynthesis are the key pathways involved in olanzapine treatment for aggressive schizophrenia.展开更多
In this editorial,we comment on the recent article by Fei et al exploring the field of near-infrared spectroscopy(NIRS)research in schizophrenia from a bibliometrics perspective.In recent years,NIRS has shown unique a...In this editorial,we comment on the recent article by Fei et al exploring the field of near-infrared spectroscopy(NIRS)research in schizophrenia from a bibliometrics perspective.In recent years,NIRS has shown unique advantages in the auxiliary diagnosis of schizophrenia,and the introduction of bibliometrics has provided a macro perspective for research in this field.Despite the opportunities brought about by these technological developments,remaining challenges require multidi-sciplinary approach to devise a reliable and accurate diagnosis system for schizo-phrenia.Nonetheless,NIRS-assisted technology is expected to contribute to the division of methods for early intervention and treatment of schizophrenia.展开更多
This manuscript explores the recent study by Cui et al which assessed the interplay between inflammatory cytokines and brain-derived neurotrophic factor(BDNF)levels in first-episode schizophrenia patients.The study re...This manuscript explores the recent study by Cui et al which assessed the interplay between inflammatory cytokines and brain-derived neurotrophic factor(BDNF)levels in first-episode schizophrenia patients.The study revealed that higher levels of interleukin-6 and tumor necrosis factor-αcorrelated with reduced BDNF levels and poorer cognitive performance.Schizophrenia is a severe psy-chiatric disorder impacting approximately 1%of the global population,charac-terized by positive symptoms(hallucinations and delusions),negative symptoms(diminished motivation and cognitive impairments)and disorganized thoughts and behaviors.Emerging research highlights the role of BDNF as a potential biomarker for early diagnosis and therapeutic targeting.The findings from Cui et al’s study suggest that targeting neuroinflammation and enhancing BDNF levels may improve cognitive outcomes.Effective treatment approaches involve a com-bination of pharmacological and non-pharmacological interventions tailored to individual patient needs.Hence,monitoring cognitive and neuroinflammatory markers is essential for improving patient outcomes and quality of life.Conse-quently,this manuscript highlights the need for an integrated approach to schizo-phrenia management,considering both clinical symptoms and underlying neuro-biological changes.展开更多
BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid hormones.AIM To study the relationship between triiodothyronine(T3),thyro...BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid hormones.AIM To study the relationship between triiodothyronine(T3),thyroxine(T4),free T3(FT3),free T4(FT4),thyroid stimulating hormone(TSH)and schizophrenia.METHODS In this study,100 schizophrenia patients were selected from our hospital between April 2022 and April 2024.Their clinical data were analyzed retrospectively.Based on the Positive and Negative Syndrome Scale(PANSS)score,patients were divided into mild(1-3 points,n=39),moderate(4 points,n=45),and severe groups(5-7 points,n=16).Additionally,55 healthy individuals served as a control group.Venous blood samples were collected to measure T3,T4,FT3,FT4,TSH,and cortisol concentrations,analyzing their relationship with PANSS scores.RESULTS The serum levels of T3,FT3,FT4,TSH and cortisol in the schizophrenia group were lower than those in the control group(P<0.05).With the increase of the severity of the disease,the concentrations of T3 and T4 decreased,while the con-centrations of TSH and cortisol increased(P<0.05).The concentrations of TSH and cortisol were positively correlated with the PANSS score,while T3 and T4 were negatively correlated with the PANSS score(P<0.05).The receiver ope-rating characteristic curve results showed that T3,T4,TSH,and cortisol had good efficacy in the diagnosis of schizophrenia.Logistic results showed that decreased T3 level,decreased T4 level,decreased TSH level and increased cortisol level may be independent risk factors for schizophrenia.CONCLUSION Thyroid hormone levels are associated with the severity of schizophrenia symptoms,which can provide new solutions for the diagnosis and treatment of schizophrenia.展开更多
Schizophrenia is a severely impacting serious mental illness that presents numerous difficulties to those who suffer from it, their families, and society. While much effort has been invested in understanding successfu...Schizophrenia is a severely impacting serious mental illness that presents numerous difficulties to those who suffer from it, their families, and society. While much effort has been invested in understanding successful treatments, it is still a major issue in public health. This review assesses the advances and issues in the management of schizophrenia in the 21st century, paying special attention to drugs, psychosocial techniques, and connected specialty care. Medications for antipsychotics and psychosocial procedures have shown potential to relieve symptoms and improve functioning, while Recovery-Oriented Care and Psychological Trauma Recovery focus on early diagnosis, combined treatment, and sustained attention. However, many questions remain that need to be answered, including access to care, unmet needs, and discrepancies. Today’s neuroscience research, along with genetic studies and novel therapy options, such as long-acting injectable antipsychotics or telepsychiatry, offers the possibility of further progress being made. Future research exploring fields such as neuroscience, genetics, and implementation science could lead to increasingly effective strategies for people with schizophrenia.展开更多
This article reviews the concept of telemedicine,as well as the current status of its application in patients with schizophrenia,problems,and suggestions for improvement,with the aim of providing a reference for the a...This article reviews the concept of telemedicine,as well as the current status of its application in patients with schizophrenia,problems,and suggestions for improvement,with the aim of providing a reference for the application of telemedicine in patients with schizophrenia.展开更多
BACKGROUND Schizophrenia(SZ),a chronic and widespread brain disorder,presents with complex etiology and pathogenesis that remain inadequately understood.Despite the absence of a universally recognized endophenotype,pe...BACKGROUND Schizophrenia(SZ),a chronic and widespread brain disorder,presents with complex etiology and pathogenesis that remain inadequately understood.Despite the absence of a universally recognized endophenotype,peripheral blood mononuclear cells(PBMCs)serve as a robust model for investigating intracellular alterations linked to SZ.AIM To preliminarily investigate potential pathogenic mechanisms and identify novel biomarkers for SZ.METHODS PBMCs from SZ patients were subjected to integrative transcriptomic and proteomic analyses to uncover differentially expressed genes(DEGs)and differentially expressed proteins while mapping putative disease-associated signaling pathways.Key findings were validated using western blot(WB)and real-time fluorescence quantitative PCR(RT-qPCR).RNAi-lentivirus was employed to transfect rat hippocampal CA1 neurons in vitro,with subsequent verification of target gene expression via RT-qPCR.The levels of neuronal conduction proteins,including calmodulin-dependent protein kinase II(caMKII),CREB,and BDNF,were assessed through WB.Apoptosis was quantified by flow cytometry,while cell proliferation and viability were evaluated using the Cell Counting Kit-8 assay.RESULTS The integration of transcriptomic and proteomic analyses identified 6079 co-expressed genes,among which 25 DEGs were significantly altered between the SZ group and healthy controls.Notably,haptoglobin(HP),lactotransferrin(LTF),and SERPING1 exhibited marked upregulation.KEGG pathway enrichment analysis implicated neuroactive ligand-receptor interaction pathways in disease pathogenesis.Clinical sample validation demonstrated elevated protein and mRNA levels of HP,LTF,and SERPING1 in the SZ group compared to controls.WB analysis of all clinical samples further corroborated the significant upregulation of SERPING1.In hippocampal CA1 neurons transfected with lentivirus,reduced SERPING1 expression was accompanied by increased levels of CaMKII,CREB,and BDNF,enhanced cell viability,and reduced apoptosis.CONCLUSION SERPING1 may suppress neural cell proliferation in SZ patients via modulation of the CaMKII-CREB-BDNF signaling pathway.展开更多
Even if dissociation has various facets,it is clear that knowledge of dissociative psychosis and a dissociative schizophrenia-based viewpoint may provide new perspectives on mental disorders.Many researchers screening...Even if dissociation has various facets,it is clear that knowledge of dissociative psychosis and a dissociative schizophrenia-based viewpoint may provide new perspectives on mental disorders.Many researchers screening for comorbid symptoms of“childhood traumatic experiences”and“dissociation”,where specific characteristics are significant to the presence of psychosis and schizophrenia,may lead to an acceptable definition.In recent years,researchers have also reported crucial advances in the understanding of dissociative psychosis and dissociative schizophrenia.Although clinical studies in this area have been ongoing for a long time,research has not demonstrated that a clear and valid relationship exists between dissociation,childhood traumatic experiences,and schizophrenia or psychotic spectrum disorders.However,some results of statistical comparisons have supported the existence of the clinical manifestation known as dissociative psychosis and dissociative schizophrenia.Dissociation,childhood traumatic experiences,and positive psychotic symptoms may be a prominent part of dissociative psychosis and schizophrenia.The intense presence of negative symptoms may indicate classical schizophrenia.In research and clinical practice,researchers and clinicians may use psychometric tests to detect symptoms of dissociative psychosis.Psychotic persons with traumatic experiences likely benefit from treatment focused on trauma symptomatolgy.展开更多
BACKGROUND Schizophrenia is a chronic psychiatric condition with complex symptomatology,including debilitating auditory hallucinations.Transcranial direct current stimulation(tDCS)has been explored as an adjunctive tr...BACKGROUND Schizophrenia is a chronic psychiatric condition with complex symptomatology,including debilitating auditory hallucinations.Transcranial direct current stimulation(tDCS)has been explored as an adjunctive treatment to alleviate such symptoms.AIM To evaluate the therapeutic efficacy of tDCS in schizophrenia.METHODS Adhering to PRISMA guidelines,we systematically searched PubMed,Embase,Web of Science,and the Cochrane Library on September 19,2023,for randomized controlled trials examining the efficacy of tDCS in schizophrenia,with no language or time restrictions.We included studies that compared tDCS with a control condition and reported clinically relevant outcomes.Data extraction and quality assessments were performed by independent evaluators using the Cochrane Collaboration's risk of bias tool.Statistical heterogeneity was evaluated,and a random-effects model was applied due to moderate heterogeneity(I2=41.3%).RESULTS Nine studies comprising 425 participants(tDCS group:219,control group:206)were included.The meta-analysis demonstrated a significant reduction in auditory hallucination scores following tDCS treatment(weighted mean difference:-2.18,95%confidence interval:-4.0 to-0.29,P<0.01).Sensitivity analysis confirmed the robustness of the results,with no significant influence from individual studies.Additionally,publication bias was not detected,supporting the reliability and generalizability of the findings.These results underscore the efficacy of tDCS as a therapeutic intervention for auditory hallucinations in schizophrenia.CONCLUSION tDCS significantly reduces auditory hallucinations in schizophrenia,suggesting its potential as an effective adjunctive treatment for managing this disabling symptom.The findings highlight the practical significance of tDCS in clinical settings,particularly for patients with treatment-resistant auditory hallucinations.展开更多
BACKGROUND Repetitive transcranial magnetic stimulation(rTMS)entered clinical practice in China after 2000,first used in psychiatric surgery,and then in neurology and other disciplines.The First Hospital of Jiaxing in...BACKGROUND Repetitive transcranial magnetic stimulation(rTMS)entered clinical practice in China after 2000,first used in psychiatric surgery,and then in neurology and other disciplines.The First Hospital of Jiaxing introduced TMS in 2015.In practical applications,it has been found that different models of instruments and technical parameters can lead to differences in therapeutic efficacy.Therefore,our hospital selected the Danish TMS instrument,which ranks second in China,to test patients with schizophrenia from March 2021 to July 2021,with a focus on comparing the results at 5 Hz,10 Hz,and 15 Hz.The testing time is concentrated between 8:30 to 10:30 in the morning.A contingency plan was made for the quality after inspection before testing.Two evaluators independently control the quality of the contingency plan.The data is independently saved and proofread by two evaluators.The purpose of this study is to translate the research results into clinical practice and provide reference basis.AIM To investigate the effects of rehabilitation therapy using rTMS on the negative symptoms and event-related potential component of P300 in chronic schizophrenia.METHODS One hundred and five patients with chronic schizophrenia were randomly allocated to three groups based on the frequency of rTMS(5,10,or 15 Hz).The patients underwent five sessions of rTMS per week for 5 weeks.We compared the pre-and post-treatment P300 latency and scores for the Scale for Assessment of Negative Symptoms(SANS).RESULTS A significant decrease in SANS score after rTMS was observed in the 10-Hz group(P<0.05),which was not observed in the 5-Hz and 15-Hz groups.There was a significant increase in P300 amplitude in the 10-Hz group after rTMS treatment(P<0.05),but there was no significant change in P300 latency(P>0.05).The improvement of SANS score in the 10-Hz rTMS group was related to patient age and disease course.CONCLUSION rTMS at 10 Hz improved negative symptoms and cognitive function in chronic schizophrenia;however,further studies on the mechanism of action are required to validate our observations.展开更多
BACKGROUND Very late-onset schizophrenia-like psychosis(VLOSLP)is a subtype of schizophrenia spectrum disorders in which individuals experience psychotic symptoms for the first time after the age of 60.The incidence o...BACKGROUND Very late-onset schizophrenia-like psychosis(VLOSLP)is a subtype of schizophrenia spectrum disorders in which individuals experience psychotic symptoms for the first time after the age of 60.The incidence of VLOSLP shows a linear relationship with increasing age.However,no studies have reported alterations in spontaneous brain activity among VLOSLP patients and their correlation with cognitive function and clinical symptoms.AIM To explore VLOSLP brain activity and correlations with cognitive function and clinical symptoms using resting-state functional magnetic resonance imaging.METHODS This study included 33 VLOSLP patients and 34 healthy controls.The cognitive assessment utilized the Mini Mental State Examination,Montreal Cognitive Assessment,and the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS).Clinical characteristic acquisition was performed via the Positive and Negative Syndrome Scale(PANSS).All participants were scanned via resting-state functional magnetic resonance imaging,and the data were processed using amplitude of low-frequency fluctuations(ALFF),fractional ALFF(fALFF),regional homogeneity,and voxelmirrored homotopic connectivity(VMHC).RESULTS The VLOSLP group presented decreased ALFF values in the left cuneus,right precuneus,right precentral gyrus,and left paracentral lobule;increased fALFF values in the left caudate nucleus;decreased fALFF values in the right calcarine fissure and surrounding cortex(CAL)and right precuneus;increased regional homogeneity values in the right putamen;and decreased VMHC values in the bilateral CAL,bilateral superior temporal gyrus,and bilateral cuneus.In the VLOSLP group,ALFF values in the right precuneus were negatively correlated with Mini Mental State Examination score and PANSS positive subscale score,and VMHC values in the bilateral CAL were negatively correlated with the RBANS total score,RBANS delayed memory score,and PANSS positive subscale score.CONCLUSION The changes of brain activity in VLOSLP are concentrated in the right precuneus and bilateral CAL regions,which may be associated with cognitive impairment and clinically positive symptoms.展开更多
Depression refers to a series of mental health issues characterized by loss of interest and enjoyment in everyday life,low mood and selected emotional,cognitive,physical and behavioral symptoms.Depression is a common ...Depression refers to a series of mental health issues characterized by loss of interest and enjoyment in everyday life,low mood and selected emotional,cognitive,physical and behavioral symptoms.Depression is a common disorder,affecting 5–15%of the general population.When diagnosed as major depressive disorder（MDD）,patients are currentlytreated with pharmacological agents such as serotonin or noradren- aline uptake inhibitors （SSRI or SNRI） or tricyclics.展开更多
Background Depression,anxiety and schizophrenia among older persons have become global public health challenges.However,the burden of these disorders in ageing and aged countries has not been analysed.Aims To investig...Background Depression,anxiety and schizophrenia among older persons have become global public health challenges.However,the burden of these disorders in ageing and aged countries has not been analysed.Aims To investigate the burden of depression,anxiety and schizophrenia among older adults in ageing and aged countries.Methods Using data from the Global Burden of Disease Study 2019,we calculated the estimated annual percentage change(EAPC)in the age-standardised incidence rates(ASiR)and age-standardised disability-adjusted life years(DALYs)rates(ASDR)for depression,anxiety and schizophrenia of older people in ageing countries(China,India,Indonesia)and aged countries(Japan,Italy,Portugal)between 1990 and 2019.Trends in incidence and DALYs were analysed by gender and age.Results In 2019,the highest incidence of depression,anxiety and schizophrenia in the older population in aged countries was in Japan(927271.3(752552.3-1125796.5),51498.2(37625.7-70487.3)and 126.0(61.0-223.2),respectively),while the highest incidence in ageing countries was in China(5797556.9(4599403.4-7133006.5),330256.1(246448.9-445987.4)and 1067.7(556.2-1775.9),respectively).DALYs for these disorders were similar,with the highest in Japan and China.From 1990 to 2019,the ASIR for depressive disorders decreased in aged countries but increased in ageing countries;the ASIR for anxiety disorders and schizophrenia declined in both ageing and aged countries.The ASDR for depressive disorders was consistent with the ASIR but not for anxiety disorders and schizophrenia.The ASIR for depressive disorders was higher in older women,while the opposite was observed in anxiety disorders and schizophrenia.Notably,the conditions of burden of depressive disorders,anxiety disorders and schizophrenia in the 65-70-year-old age group were the most burdensome.Conclusions The incidence and DALYs of these three mental disorders increased while exhibiting differences between ageing and aged countries.Raising awareness about formulating health policies for preventing and treating mental disorders in the older population is necessary to reduce the future burden posed by the ageing challenge.展开更多
Background:Choosing the appropriate antipsychotic drug(APD)treatment for patients with schizophrenia(SCZ)can be challenging,as the treatment response to APD is highly variable and difficult to predict due to the lack ...Background:Choosing the appropriate antipsychotic drug(APD)treatment for patients with schizophrenia(SCZ)can be challenging,as the treatment response to APD is highly variable and difficult to predict due to the lack of effective biomarkers.Previous studies have indicated the association between treatment response and genetic and epigenetic factors,but no effective biomarkers have been identified.Hence,further research is imperative to enhance precision medicine in SCZ treatment.Methods:Participants with SCZ were recruited from two randomized trials.The discovery cohort was recruited from the CAPOC trial(n=2307)involved 6 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,Quetiapine,Aripiprazole,Ziprasidone,and Haloperidol/Perphenazine(subsequently equally assigned to one or the other)groups.The external validation cohort was recruited from the CAPEC trial(n=1379),which involved 8 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,and Aripiprazole groups.Additionally,healthy controls(n=275)from the local community were utilized as a genetic/epigenetic reference.The genetic and epigenetic(DNA methylation)risks of SCZ were assessed using the polygenic risk score(PRS)and polymethylation score,respectively.The study also examined the genetic-epigenetic interactions with treatment response through differential methylation analysis,methylation quantitative trait loci,colocalization,and promoteranchored chromatin interaction.Machine learning was used to develop a prediction model for treatment response,which was evaluated for accuracy and clinical benefit using the area under curve(AUC)for classification,R^(2) for regression,and decision curve analysis.Results:Six risk genes for SCZ(LINC01795,DDHD2,SBNO1,KCNG2,SEMA7A,and RUFY1)involved in cortical morphology were identified as having a genetic-epigenetic interaction associated with treatment response.The developed and externally validated prediction model,which incorporated clinical information,PRS,genetic risk score(GRS),and proxy methylation level(proxyDNAm),demonstrated positive benefits for a wide range of patients receiving different APDs,regardless of sex[discovery cohort:AUC=0.874(95%CI 0.867-0.881),R^(2)=0.478;external validation cohort:AUC=0.851(95%CI 0.841-0.861),R^(2)=0.507].Conclusions:This study presents a promising precision medicine approach to evaluate treatment response,which has the potential to aid clinicians in making informed decisions about APD treatment for patients with SCZ.Trial registration Chinese Clinical Trial Registry(https://www.chictr.org.cn/),18 Aug 2009 retrospectively registered:CAPOC-ChiCTR-RNC-09000521(https://www.chictr.org.cn/showproj.aspx?proj=9014),CAPEC-ChiCTRRNC-09000522(https://www.chictr.org.cn/showproj.aspx?proj=9013).展开更多
BACKGROUND Compared with current methods used to assess schizophrenia,near-infrared spectroscopy(NIRS)has the advantages of providing noninvasive and real-time monitoring of functional activities of the brain and prov...BACKGROUND Compared with current methods used to assess schizophrenia,near-infrared spectroscopy(NIRS)has the advantages of providing noninvasive and real-time monitoring of functional activities of the brain and providing direct and objective assessment information.AIM To explore the research field of NIRS in schizophrenia from the perspective of bibliometrics.METHODS The Web of Science Core Collection was used as the search tool,and the last search date was April 21,2024.Bibliometric indicators,such as the numbers of publications and citations,were recorded.Bibliometrix and VOS viewer were used for visualization analysis.RESULTS A total of 355 articles from 105 journals were included in the analysis.The overall trend of the number of research publications increased.Schizophrenia Research was identified as an influential journal in the field.Kasai K was one of the most influential and productive authors in this area of research.The University of Tokyo and Japan had the highest scientific output for an institution and a country,respectively.The top ten keywords were“schizophrenia”,“activation”,“near-infrared spectroscopy”,“verbal fluency task”,“cortex”,“brain,performance”,“workingmemory”,“brain activation”,and“prefrontal cortex”.CONCLUSION Our study reveals the evolution of knowledge and emerging trends in the field of NIRS in schizophrenia.the research focus is shifting from underlying disease characteristics to more in-depth studies of brain function and physiological mechanisms.展开更多
文摘We read the impressive review article“Clozapine resistant schizophrenia:Newer avenues of management”with great enthusiasm and appreciation.The author believes that preventing clozapine resistance from developing may be the most effective treatment strategy for patients with clozapine-resistant schizophrenia(CRS),and optimizing clozapine treatment is a key component.Disentangling the differences between treatment-resistant schizophrenia and CRS is important for studies addressing treatment strategies for these difficult-to-treat populations.
基金Supported by the Korean Mental Health Technology R&D Project,Ministry of Health&Welfare,Republic of Korea,No.HL19C0015the Korea Health Technology R&D Project through the Korea Health Industry Development Institutefunded by the Ministry of Health&Welfare,Republic of Korea,No.HR18C0016.
文摘BACKGROUND The thalamus plays a key role in filtering information and has extensive interconnectivity with other brain regions.A large body of evidence points to impaired functional connectivity(FC)of the thalamocortical pathway in schizophrenia.However,the functional network of the thalamic subregions has not been investigated in patients with treatment-resistant schizophrenia(TRS).AIM To identify the neural mechanisms underlying TRS,we investigated FC of thalamic sub-regions with cortical networks and voxels,and the associations of this FC with clinical symptoms.We hypothesized that the FC of thalamic subregions with cortical networks and voxels would differ between TRS patients and HCs.METHODS In total,50 patients with TRS and 61 healthy controls(HCs)matched for age,sex,and education underwent resting-state functional magnetic resonance imaging(rs-fMRI)and clinical evaluation.Based on the rs-fMRI data,we conducted a FC analysis between thalamic subregions and cortical functional networks and voxels,and within thalamic subregions and cortical functional networks,in the patients with TRS.A functional parcellation atlas was used to segment the thalamus into nine subregions.Correlations between altered FC and TRS symptoms were explored.RESULTS We found differences in FC within thalamic subregions and cortical functional networks between patients with TRS and HCs.In addition,increased FC was observed between thalamic subregions and the sensorimotor cortex,frontal medial cortex,and lingual gyrus.These abnormalities were associated with the pathophysiology of TRS.CONCLUSION Our findings suggest that disrupted FC within thalamic subregions and cortical functional networks,and within the thalamocortical pathway,has potential as a marker for TRS.Our findings also improve our understanding of the relationship between the thalamocortical pathway and TRS symptoms.
文摘Objective: Clozapine is regarded as the most effective drug for treatment of schizophrenia but has complex adverse effects associated with hyperglycemia and diabetes mellitus. Method: We report that clozapine was very effective to treat positive, negative, and cognitive symptoms and well tolerated to a treatment-resistant schizophrenia patient with severe type 2 diabetes mellitus (DM) under cautious blood-sugar monitoring. Results: Clozapine itself and discontinuation of other psychotropic and anticholinergic agents after switching may improve cognitive function and adherence to the treatment regimens for schizophrenia and DM. Conclusion: Clozapine can be administered to treatment-resistant schizophrenia patients even with severe DM with caution.
文摘Treatment-resistant schizophrenia has an extremely negative impact on mental health and social life. If clozapine, the gold standard treatment, fails, there are very few options left. The literature suggests that high-dose olanzapine (20 - 60 mg/day) is a possible alternative. We report two cases in which very high doses of olanzapine were administered, with significant clinical improvements above 60 mg/day. Clinical, metabolic and cardiac tolerance was good. This report highlights the usefulness of very-high-dose olanzapine in treatment-resistant schizophrenia. The main hypotheses concerning the psychopharmacological mechanisms of very-high-dose olanzapine are discussed.
文摘Historically,psychiatric diagnoses have been made based on patient’s reported symptoms applying the criteria from diagnostic and statistical manual of mental disorders.The utilization of neuroimaging or biomarkers to make the diagnosis and manage psychiatric disorders remains a distant goal.There have been several studies that examine brain imaging in psychiatric disorders,but more work is needed to elucidate the complexities of the human brain.In this editorial,we examine two articles by Xu et al and Stoyanov et al,that show developments in the direction of using neuroimaging to examine the brains of people with schizo-phrenia and depression.Xu et al used magnetic resonance imaging to examine the brain structure of patients with schizophrenia,in addition to examining neurotransmitter levels as biomarkers.Stoyanov et al used functional magnetic resonance imaging to look at modulation of different neural circuits by diagnostic-specific scales in patients with schizophrenia and depression.These two studies provide crucial evidence in advancing our understanding of the brain in prevalent psychiatric disorders.
基金Supported by Henan Provincial Science and Technology Research Project,No.242102310203.
文摘BACKGROUND The use of network pharmacology and blood metabolomics to study the patho-genesis of violent aggression in patients with schizophrenia and the related drug mechanisms of action provides new directions for reducing the risk of violent aggression and optimizing treatment plans.AIM To explore the metabolic regulatory mechanism of olanzapine in treating patients with schizophrenia with a moderate to high risk of violent aggression.METHODS Metabolomic technology was used to screen differentially abundant metabolites in patients with schizophrenia with a moderate to high risk of violent aggression before and after olanzapine treatment,and the related metabolic pathways were identified.Network pharmacology was used to establish protein-protein interaction networks of the core targets of olanzapine.Gene Ontology functional analysis and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were subsequently performed.RESULTS Compared with the healthy group,the patients with schizophrenia group presented significant changes in the levels of 24 metabolites related to the disruption of 9 metabolic pathways,among which the key pathways were the alanine,aspartate and glutamate metabolism and arginine biosynthesis pathways.After treatment with olanzapine,the levels of 10 differentially abundant metabolites were significantly reversed in patients with schizophrenia.Olanzapine effectively regulated six metabolic pathways,among which the key pathways were alanine,aspartate and glutamate metabolism and arginine biosynthesis pathways.Ten core targets of olanzapine were involved in several key pathways.CONCLUSION The metabolic pathways of alanine,aspartate,and glutamate metabolism and arginine biosynthesis are the key pathways involved in olanzapine treatment for aggressive schizophrenia.
文摘In this editorial,we comment on the recent article by Fei et al exploring the field of near-infrared spectroscopy(NIRS)research in schizophrenia from a bibliometrics perspective.In recent years,NIRS has shown unique advantages in the auxiliary diagnosis of schizophrenia,and the introduction of bibliometrics has provided a macro perspective for research in this field.Despite the opportunities brought about by these technological developments,remaining challenges require multidi-sciplinary approach to devise a reliable and accurate diagnosis system for schizo-phrenia.Nonetheless,NIRS-assisted technology is expected to contribute to the division of methods for early intervention and treatment of schizophrenia.
基金Supported by Basic Science Research Program Through the National Research Foundation of Korea(NRF)Funded By the Ministry of Education,No.NRF-RS-2023-00237287.
文摘This manuscript explores the recent study by Cui et al which assessed the interplay between inflammatory cytokines and brain-derived neurotrophic factor(BDNF)levels in first-episode schizophrenia patients.The study revealed that higher levels of interleukin-6 and tumor necrosis factor-αcorrelated with reduced BDNF levels and poorer cognitive performance.Schizophrenia is a severe psy-chiatric disorder impacting approximately 1%of the global population,charac-terized by positive symptoms(hallucinations and delusions),negative symptoms(diminished motivation and cognitive impairments)and disorganized thoughts and behaviors.Emerging research highlights the role of BDNF as a potential biomarker for early diagnosis and therapeutic targeting.The findings from Cui et al’s study suggest that targeting neuroinflammation and enhancing BDNF levels may improve cognitive outcomes.Effective treatment approaches involve a com-bination of pharmacological and non-pharmacological interventions tailored to individual patient needs.Hence,monitoring cognitive and neuroinflammatory markers is essential for improving patient outcomes and quality of life.Conse-quently,this manuscript highlights the need for an integrated approach to schizo-phrenia management,considering both clinical symptoms and underlying neuro-biological changes.
文摘BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid hormones.AIM To study the relationship between triiodothyronine(T3),thyroxine(T4),free T3(FT3),free T4(FT4),thyroid stimulating hormone(TSH)and schizophrenia.METHODS In this study,100 schizophrenia patients were selected from our hospital between April 2022 and April 2024.Their clinical data were analyzed retrospectively.Based on the Positive and Negative Syndrome Scale(PANSS)score,patients were divided into mild(1-3 points,n=39),moderate(4 points,n=45),and severe groups(5-7 points,n=16).Additionally,55 healthy individuals served as a control group.Venous blood samples were collected to measure T3,T4,FT3,FT4,TSH,and cortisol concentrations,analyzing their relationship with PANSS scores.RESULTS The serum levels of T3,FT3,FT4,TSH and cortisol in the schizophrenia group were lower than those in the control group(P<0.05).With the increase of the severity of the disease,the concentrations of T3 and T4 decreased,while the con-centrations of TSH and cortisol increased(P<0.05).The concentrations of TSH and cortisol were positively correlated with the PANSS score,while T3 and T4 were negatively correlated with the PANSS score(P<0.05).The receiver ope-rating characteristic curve results showed that T3,T4,TSH,and cortisol had good efficacy in the diagnosis of schizophrenia.Logistic results showed that decreased T3 level,decreased T4 level,decreased TSH level and increased cortisol level may be independent risk factors for schizophrenia.CONCLUSION Thyroid hormone levels are associated with the severity of schizophrenia symptoms,which can provide new solutions for the diagnosis and treatment of schizophrenia.
文摘Schizophrenia is a severely impacting serious mental illness that presents numerous difficulties to those who suffer from it, their families, and society. While much effort has been invested in understanding successful treatments, it is still a major issue in public health. This review assesses the advances and issues in the management of schizophrenia in the 21st century, paying special attention to drugs, psychosocial techniques, and connected specialty care. Medications for antipsychotics and psychosocial procedures have shown potential to relieve symptoms and improve functioning, while Recovery-Oriented Care and Psychological Trauma Recovery focus on early diagnosis, combined treatment, and sustained attention. However, many questions remain that need to be answered, including access to care, unmet needs, and discrepancies. Today’s neuroscience research, along with genetic studies and novel therapy options, such as long-acting injectable antipsychotics or telepsychiatry, offers the possibility of further progress being made. Future research exploring fields such as neuroscience, genetics, and implementation science could lead to increasingly effective strategies for people with schizophrenia.
文摘This article reviews the concept of telemedicine,as well as the current status of its application in patients with schizophrenia,problems,and suggestions for improvement,with the aim of providing a reference for the application of telemedicine in patients with schizophrenia.
基金Supported by the Key R&D Projects of Hainan Province,No.ZDYF2022SHFZ295.
文摘BACKGROUND Schizophrenia(SZ),a chronic and widespread brain disorder,presents with complex etiology and pathogenesis that remain inadequately understood.Despite the absence of a universally recognized endophenotype,peripheral blood mononuclear cells(PBMCs)serve as a robust model for investigating intracellular alterations linked to SZ.AIM To preliminarily investigate potential pathogenic mechanisms and identify novel biomarkers for SZ.METHODS PBMCs from SZ patients were subjected to integrative transcriptomic and proteomic analyses to uncover differentially expressed genes(DEGs)and differentially expressed proteins while mapping putative disease-associated signaling pathways.Key findings were validated using western blot(WB)and real-time fluorescence quantitative PCR(RT-qPCR).RNAi-lentivirus was employed to transfect rat hippocampal CA1 neurons in vitro,with subsequent verification of target gene expression via RT-qPCR.The levels of neuronal conduction proteins,including calmodulin-dependent protein kinase II(caMKII),CREB,and BDNF,were assessed through WB.Apoptosis was quantified by flow cytometry,while cell proliferation and viability were evaluated using the Cell Counting Kit-8 assay.RESULTS The integration of transcriptomic and proteomic analyses identified 6079 co-expressed genes,among which 25 DEGs were significantly altered between the SZ group and healthy controls.Notably,haptoglobin(HP),lactotransferrin(LTF),and SERPING1 exhibited marked upregulation.KEGG pathway enrichment analysis implicated neuroactive ligand-receptor interaction pathways in disease pathogenesis.Clinical sample validation demonstrated elevated protein and mRNA levels of HP,LTF,and SERPING1 in the SZ group compared to controls.WB analysis of all clinical samples further corroborated the significant upregulation of SERPING1.In hippocampal CA1 neurons transfected with lentivirus,reduced SERPING1 expression was accompanied by increased levels of CaMKII,CREB,and BDNF,enhanced cell viability,and reduced apoptosis.CONCLUSION SERPING1 may suppress neural cell proliferation in SZ patients via modulation of the CaMKII-CREB-BDNF signaling pathway.
文摘Even if dissociation has various facets,it is clear that knowledge of dissociative psychosis and a dissociative schizophrenia-based viewpoint may provide new perspectives on mental disorders.Many researchers screening for comorbid symptoms of“childhood traumatic experiences”and“dissociation”,where specific characteristics are significant to the presence of psychosis and schizophrenia,may lead to an acceptable definition.In recent years,researchers have also reported crucial advances in the understanding of dissociative psychosis and dissociative schizophrenia.Although clinical studies in this area have been ongoing for a long time,research has not demonstrated that a clear and valid relationship exists between dissociation,childhood traumatic experiences,and schizophrenia or psychotic spectrum disorders.However,some results of statistical comparisons have supported the existence of the clinical manifestation known as dissociative psychosis and dissociative schizophrenia.Dissociation,childhood traumatic experiences,and positive psychotic symptoms may be a prominent part of dissociative psychosis and schizophrenia.The intense presence of negative symptoms may indicate classical schizophrenia.In research and clinical practice,researchers and clinicians may use psychometric tests to detect symptoms of dissociative psychosis.Psychotic persons with traumatic experiences likely benefit from treatment focused on trauma symptomatolgy.
文摘BACKGROUND Schizophrenia is a chronic psychiatric condition with complex symptomatology,including debilitating auditory hallucinations.Transcranial direct current stimulation(tDCS)has been explored as an adjunctive treatment to alleviate such symptoms.AIM To evaluate the therapeutic efficacy of tDCS in schizophrenia.METHODS Adhering to PRISMA guidelines,we systematically searched PubMed,Embase,Web of Science,and the Cochrane Library on September 19,2023,for randomized controlled trials examining the efficacy of tDCS in schizophrenia,with no language or time restrictions.We included studies that compared tDCS with a control condition and reported clinically relevant outcomes.Data extraction and quality assessments were performed by independent evaluators using the Cochrane Collaboration's risk of bias tool.Statistical heterogeneity was evaluated,and a random-effects model was applied due to moderate heterogeneity(I2=41.3%).RESULTS Nine studies comprising 425 participants(tDCS group:219,control group:206)were included.The meta-analysis demonstrated a significant reduction in auditory hallucination scores following tDCS treatment(weighted mean difference:-2.18,95%confidence interval:-4.0 to-0.29,P<0.01).Sensitivity analysis confirmed the robustness of the results,with no significant influence from individual studies.Additionally,publication bias was not detected,supporting the reliability and generalizability of the findings.These results underscore the efficacy of tDCS as a therapeutic intervention for auditory hallucinations in schizophrenia.CONCLUSION tDCS significantly reduces auditory hallucinations in schizophrenia,suggesting its potential as an effective adjunctive treatment for managing this disabling symptom.The findings highlight the practical significance of tDCS in clinical settings,particularly for patients with treatment-resistant auditory hallucinations.
基金Supported by Key Discipline Construction Project of Neurology of Jiaxing City in Zhejiang Province of China,No.2023-ZC-006.
文摘BACKGROUND Repetitive transcranial magnetic stimulation(rTMS)entered clinical practice in China after 2000,first used in psychiatric surgery,and then in neurology and other disciplines.The First Hospital of Jiaxing introduced TMS in 2015.In practical applications,it has been found that different models of instruments and technical parameters can lead to differences in therapeutic efficacy.Therefore,our hospital selected the Danish TMS instrument,which ranks second in China,to test patients with schizophrenia from March 2021 to July 2021,with a focus on comparing the results at 5 Hz,10 Hz,and 15 Hz.The testing time is concentrated between 8:30 to 10:30 in the morning.A contingency plan was made for the quality after inspection before testing.Two evaluators independently control the quality of the contingency plan.The data is independently saved and proofread by two evaluators.The purpose of this study is to translate the research results into clinical practice and provide reference basis.AIM To investigate the effects of rehabilitation therapy using rTMS on the negative symptoms and event-related potential component of P300 in chronic schizophrenia.METHODS One hundred and five patients with chronic schizophrenia were randomly allocated to three groups based on the frequency of rTMS(5,10,or 15 Hz).The patients underwent five sessions of rTMS per week for 5 weeks.We compared the pre-and post-treatment P300 latency and scores for the Scale for Assessment of Negative Symptoms(SANS).RESULTS A significant decrease in SANS score after rTMS was observed in the 10-Hz group(P<0.05),which was not observed in the 5-Hz and 15-Hz groups.There was a significant increase in P300 amplitude in the 10-Hz group after rTMS treatment(P<0.05),but there was no significant change in P300 latency(P>0.05).The improvement of SANS score in the 10-Hz rTMS group was related to patient age and disease course.CONCLUSION rTMS at 10 Hz improved negative symptoms and cognitive function in chronic schizophrenia;however,further studies on the mechanism of action are required to validate our observations.
基金Supported by Wuxi Municipal Health Commission Major Project,No.202107and Wuxi Taihu Talent Project,No.WXTTP 2021.
文摘BACKGROUND Very late-onset schizophrenia-like psychosis(VLOSLP)is a subtype of schizophrenia spectrum disorders in which individuals experience psychotic symptoms for the first time after the age of 60.The incidence of VLOSLP shows a linear relationship with increasing age.However,no studies have reported alterations in spontaneous brain activity among VLOSLP patients and their correlation with cognitive function and clinical symptoms.AIM To explore VLOSLP brain activity and correlations with cognitive function and clinical symptoms using resting-state functional magnetic resonance imaging.METHODS This study included 33 VLOSLP patients and 34 healthy controls.The cognitive assessment utilized the Mini Mental State Examination,Montreal Cognitive Assessment,and the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS).Clinical characteristic acquisition was performed via the Positive and Negative Syndrome Scale(PANSS).All participants were scanned via resting-state functional magnetic resonance imaging,and the data were processed using amplitude of low-frequency fluctuations(ALFF),fractional ALFF(fALFF),regional homogeneity,and voxelmirrored homotopic connectivity(VMHC).RESULTS The VLOSLP group presented decreased ALFF values in the left cuneus,right precuneus,right precentral gyrus,and left paracentral lobule;increased fALFF values in the left caudate nucleus;decreased fALFF values in the right calcarine fissure and surrounding cortex(CAL)and right precuneus;increased regional homogeneity values in the right putamen;and decreased VMHC values in the bilateral CAL,bilateral superior temporal gyrus,and bilateral cuneus.In the VLOSLP group,ALFF values in the right precuneus were negatively correlated with Mini Mental State Examination score and PANSS positive subscale score,and VMHC values in the bilateral CAL were negatively correlated with the RBANS total score,RBANS delayed memory score,and PANSS positive subscale score.CONCLUSION The changes of brain activity in VLOSLP are concentrated in the right precuneus and bilateral CAL regions,which may be associated with cognitive impairment and clinically positive symptoms.
基金funded by Ministry of Education,University and Research(MIUR)ex-60% research fund University of Brescia,Italy
文摘Depression refers to a series of mental health issues characterized by loss of interest and enjoyment in everyday life,low mood and selected emotional,cognitive,physical and behavioral symptoms.Depression is a common disorder,affecting 5–15%of the general population.When diagnosed as major depressive disorder（MDD）,patients are currentlytreated with pharmacological agents such as serotonin or noradren- aline uptake inhibitors （SSRI or SNRI） or tricyclics.
基金Shanghai'Science and Technology Innovation Action Plan'medical innovation research(21Y11905600)Shanghai'Science and Technology Innovation Action Plan'Natural Science Foundation of Shanghai(21ZR1455100)+1 种基金the National Natural Science Foundation of China(81701344)the Shanghai Mental Health Center General Projects(2021-YJ-02).
文摘Background Depression,anxiety and schizophrenia among older persons have become global public health challenges.However,the burden of these disorders in ageing and aged countries has not been analysed.Aims To investigate the burden of depression,anxiety and schizophrenia among older adults in ageing and aged countries.Methods Using data from the Global Burden of Disease Study 2019,we calculated the estimated annual percentage change(EAPC)in the age-standardised incidence rates(ASiR)and age-standardised disability-adjusted life years(DALYs)rates(ASDR)for depression,anxiety and schizophrenia of older people in ageing countries(China,India,Indonesia)and aged countries(Japan,Italy,Portugal)between 1990 and 2019.Trends in incidence and DALYs were analysed by gender and age.Results In 2019,the highest incidence of depression,anxiety and schizophrenia in the older population in aged countries was in Japan(927271.3(752552.3-1125796.5),51498.2(37625.7-70487.3)and 126.0(61.0-223.2),respectively),while the highest incidence in ageing countries was in China(5797556.9(4599403.4-7133006.5),330256.1(246448.9-445987.4)and 1067.7(556.2-1775.9),respectively).DALYs for these disorders were similar,with the highest in Japan and China.From 1990 to 2019,the ASIR for depressive disorders decreased in aged countries but increased in ageing countries;the ASIR for anxiety disorders and schizophrenia declined in both ageing and aged countries.The ASDR for depressive disorders was consistent with the ASIR but not for anxiety disorders and schizophrenia.The ASIR for depressive disorders was higher in older women,while the opposite was observed in anxiety disorders and schizophrenia.Notably,the conditions of burden of depressive disorders,anxiety disorders and schizophrenia in the 65-70-year-old age group were the most burdensome.Conclusions The incidence and DALYs of these three mental disorders increased while exhibiting differences between ageing and aged countries.Raising awareness about formulating health policies for preventing and treating mental disorders in the older population is necessary to reduce the future burden posed by the ageing challenge.
基金supported by the National Natural Science Foundation of China(81825009,82071505,81901358)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2MC&T-B-099,2019-I2M-5–006)+2 种基金the Program of Chinese Institute for Brain Research Beijing(2020-NKX-XM-12)the King’s College London-Peking University Health Science Center Joint Institute for Medical Research(BMU2020KCL001,BMU2019LCKXJ012)the National Key R&D Program of China(2021YFF1201103,2016YFC1307000).
文摘Background:Choosing the appropriate antipsychotic drug(APD)treatment for patients with schizophrenia(SCZ)can be challenging,as the treatment response to APD is highly variable and difficult to predict due to the lack of effective biomarkers.Previous studies have indicated the association between treatment response and genetic and epigenetic factors,but no effective biomarkers have been identified.Hence,further research is imperative to enhance precision medicine in SCZ treatment.Methods:Participants with SCZ were recruited from two randomized trials.The discovery cohort was recruited from the CAPOC trial(n=2307)involved 6 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,Quetiapine,Aripiprazole,Ziprasidone,and Haloperidol/Perphenazine(subsequently equally assigned to one or the other)groups.The external validation cohort was recruited from the CAPEC trial(n=1379),which involved 8 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,and Aripiprazole groups.Additionally,healthy controls(n=275)from the local community were utilized as a genetic/epigenetic reference.The genetic and epigenetic(DNA methylation)risks of SCZ were assessed using the polygenic risk score(PRS)and polymethylation score,respectively.The study also examined the genetic-epigenetic interactions with treatment response through differential methylation analysis,methylation quantitative trait loci,colocalization,and promoteranchored chromatin interaction.Machine learning was used to develop a prediction model for treatment response,which was evaluated for accuracy and clinical benefit using the area under curve(AUC)for classification,R^(2) for regression,and decision curve analysis.Results:Six risk genes for SCZ(LINC01795,DDHD2,SBNO1,KCNG2,SEMA7A,and RUFY1)involved in cortical morphology were identified as having a genetic-epigenetic interaction associated with treatment response.The developed and externally validated prediction model,which incorporated clinical information,PRS,genetic risk score(GRS),and proxy methylation level(proxyDNAm),demonstrated positive benefits for a wide range of patients receiving different APDs,regardless of sex[discovery cohort:AUC=0.874(95%CI 0.867-0.881),R^(2)=0.478;external validation cohort:AUC=0.851(95%CI 0.841-0.861),R^(2)=0.507].Conclusions:This study presents a promising precision medicine approach to evaluate treatment response,which has the potential to aid clinicians in making informed decisions about APD treatment for patients with SCZ.Trial registration Chinese Clinical Trial Registry(https://www.chictr.org.cn/),18 Aug 2009 retrospectively registered:CAPOC-ChiCTR-RNC-09000521(https://www.chictr.org.cn/showproj.aspx?proj=9014),CAPEC-ChiCTRRNC-09000522(https://www.chictr.org.cn/showproj.aspx?proj=9013).
基金Supported by The Southwest Medical University Student Innovation and Entrepreneurship Project Fund,No.202310632045 and No.202310632059。
文摘BACKGROUND Compared with current methods used to assess schizophrenia,near-infrared spectroscopy(NIRS)has the advantages of providing noninvasive and real-time monitoring of functional activities of the brain and providing direct and objective assessment information.AIM To explore the research field of NIRS in schizophrenia from the perspective of bibliometrics.METHODS The Web of Science Core Collection was used as the search tool,and the last search date was April 21,2024.Bibliometric indicators,such as the numbers of publications and citations,were recorded.Bibliometrix and VOS viewer were used for visualization analysis.RESULTS A total of 355 articles from 105 journals were included in the analysis.The overall trend of the number of research publications increased.Schizophrenia Research was identified as an influential journal in the field.Kasai K was one of the most influential and productive authors in this area of research.The University of Tokyo and Japan had the highest scientific output for an institution and a country,respectively.The top ten keywords were“schizophrenia”,“activation”,“near-infrared spectroscopy”,“verbal fluency task”,“cortex”,“brain,performance”,“workingmemory”,“brain activation”,and“prefrontal cortex”.CONCLUSION Our study reveals the evolution of knowledge and emerging trends in the field of NIRS in schizophrenia.the research focus is shifting from underlying disease characteristics to more in-depth studies of brain function and physiological mechanisms.
