BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with an...BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with and without prominent nega-tive symptoms(PNS).AIM To evaluate the effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia in real-world clinical settings and to explore the efficacy and safety of different doses of blonanserin for patients with PNS and without PNS.METHODS A 12-week,multicenter,prospective post-marketing surveillance was conducted.In this study,we included patients with first-episode schizophrenia who received blonanserin monotherapy.Patients were divided into those with PNS and without PNS,based on the Brief Psychiatric Rating Scale(BPRS)negative symptoms subscale scores.Additionally,patients were labeled as high-dose and low-dose was evaluated through the incidence of adverse drug reactions(ADRs).RESULTS A total of 653 patients were included in the analysis,with 613 completing the study.The BPRS total score decreased significantly from 47.94±16.31 at baseline to 26.88±9.47 at 12 weeks(P<0.001).A significant interaction of PNS×dose×time was observed for BPRS total scores(F=3.47,P=0.040)and negative symptom subscale scores(F=6.76,P=0.002).In the PNS group,the high-dose group showed greater reductions in BPRS total scores(P=0.001)and negative symptom subscale scores(P=0.003)than the low-dose group in week 12.In the without PNS group,no significant difference was observed between the high-dose and low-dose groups at any visit.Most adverse reactions were mild or moderate,with extrapyramidal symptoms(9.3%)being most common;1.5%of patients gained≥7%body weight at 12 weeks.CONCLUSION Blonanserin effectively alleviated the clinical symptoms of first-episode schizophrenia with an acceptable safety profile.High-dose blonanserin is particularly beneficial for patients with PNS in the acute phase of first-episode schizophrenia.However,due to the limitation of ADR reporting the real world,the ADR incidence observed in this study may be underestimated.展开更多
BACKGROUND Patients with schizophrenia may lack awareness of the importance of posttracheotomy care due to the impact of their condition,often showing resistance or misunderstanding of care measures.When coupled with ...BACKGROUND Patients with schizophrenia may lack awareness of the importance of posttracheotomy care due to the impact of their condition,often showing resistance or misunderstanding of care measures.When coupled with the impact of negative symptoms and the risk of complications after tracheotomy,patients may experience emotional fluctuations,restlessness,anxiety,and hostile behaviors,which pose significant challenges to nursing work.CASE SUMMARY We have reported the case of an 87-year-old male patient who was admitted to the hospital because of negative symptoms of schizophrenia and who underwent tracheotomy for severe pneumonia.In this study,we have summarized the nursing experience of a patient with negative symptoms of schizophrenia who underwent tracheotomy.The key nursing strategies included proper tracheotomy care,the management of psychiatric symptoms,a thorough assessment and implementation of enteral and parenteral nutrition,effective skincare,infection prevention,and comprehensive mental care.Individualized nursing skills helped stabilize the patient’s condition,followed by isolation and observation in a psychiatric hospital.CONCLUSION Effective postoperative tracheostomy care in patients with schizophrenia necessitates a tailored,multidisciplinary approach that addresses their psychiatric,physical,and emotional needs to achieve optimal clinical outcomes.展开更多
The causal mechanisms and treatment for the negative symptoms and cognitive dysfunction in schizophrenia are the main issues attracting the attention of psychiatrists over the last decade.The first part of this review...The causal mechanisms and treatment for the negative symptoms and cognitive dysfunction in schizophrenia are the main issues attracting the attention of psychiatrists over the last decade.The first part of this review summarizes the pathogenesis of schizophrenia,especially the negative symptoms and cognitive dysfunction from the perspectives of genetics and epigenetics.The second part describes the novel medications and several advanced physical therapies(e.g.,transcranial magnetic stimulation and transcranial direct current stimulation)for the negative symptoms and cognitive dysfunction that will optimize the therapeutic strategy for patients with schizophrenia in future.展开更多
Accumulating evidence suggests that a disruption of early brain development,in which insulin-like growth factor-2(IGF-2)has a crucial role,may underlie the pathophysiology of schizophrenia.Our previous study has shown...Accumulating evidence suggests that a disruption of early brain development,in which insulin-like growth factor-2(IGF-2)has a crucial role,may underlie the pathophysiology of schizophrenia.Our previous study has shown that decreased serum IGF-2 was correlated with the severity of psychopathology in patients with schizophrenia.Here we conducted a prospective observation trial to investigate the effects of atypical antipsychotics on serum IGF-2 level and its relationship with clinical improvements in schizophrenia patients.Thirty-one schizophrenia patients with acute exacerbation and 30 healthy individuals were recruited in this study.Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale(PANSS)and serum IGF-2 levels were determined using ELISA.We found that schizophrenia patients with acute exacerbation had lower serum IGF-2 levels than control individuals at baseline(P<0.05).After 2 months of atypical antipsychotic treatment,a significant improvement in each PANSS subscore and total score was observed in patients(all P<0.01),and the serum IGF-2 levels of patients were significantly increased compared with those at baseline(203.13±64.62 vs.426.99±124.26 ng/mL;t=−5.044,P<0.001).Correlation analysis revealed that the changes of serum IGF-2 levels in patients were significantly correlated with the improvements of negative symptoms(r=−0.522,P=0.006).Collectively,our findings demonstrated changes of serum IGF-2 response to improvements of negative symptoms in schizophrenia patients treated with atypical antipsychotics,suggesting that serum IGF-2 might be a treatment biomarker for schizophrenia.展开更多
BACKGROUND Accumulating evidence suggests that the inflammatory cytokine interleukin-6(IL-6)contributes to the pathophysiology of psychiatric disorders.However,there was no study concerning the relationship between IL...BACKGROUND Accumulating evidence suggests that the inflammatory cytokine interleukin-6(IL-6)contributes to the pathophysiology of psychiatric disorders.However,there was no study concerning the relationship between IL-6 concentrations and clinical features in the chronic phase of early-onset schizophrenia(EOS).AIM To investigate the relationship between serum IL-6 concentration and the clinical features of EOS.METHODS We measured serum IL-6 Levels from 74 patients with chronic schizophrenia,including 33 with age at onset<21 years(EOS group)and 41 with onset≥21 years in[adult-onset schizophrenia(AOS)group],and from 41 healthy controls.Symptom severities were evaluated using the Positive and Negative Syndrome Scale(PANSS).RESULTS Serum IL-6 concentrations were higher in both EOS and AOS groups than healthy controls(F=22.32,P<0.01),but did not differ significantly between EOS and AOS groups(P>0.05)after controlling for age,body mass index,and other covariates.Negative symptom scores were higher in the EOS group than the AOS group(F=6.199,P=0.015).Serum IL-6 concentrations in the EOS group were negatively correlated with both total PANSS-negative symptom score(r=-0.389,P=0.032)and avolition/asociality subscore(r=-0.387,P=0.026).CONCLUSION Patients with EOS may have more severe negative symptoms than those with adult-onset schizophrenia during the chronic phase of the illness.IL-6 signaling may regulate negative symptoms and its avolition/asociality subsymptoms among the early-onset chronic schizophrenic patients.展开更多
BACKGROUND Cognitive reserve(CR)and the catechol-O-methyltransferase(COMT)Val/Met polymorphism are reportedly linked to negative symptoms in schizophrenia.However,the regulatory effect of the COMT genotype on the rela...BACKGROUND Cognitive reserve(CR)and the catechol-O-methyltransferase(COMT)Val/Met polymorphism are reportedly linked to negative symptoms in schizophrenia.However,the regulatory effect of the COMT genotype on the relationship between CR and negative symptoms is still unexamined.AIM To investigate whether the relationship between CR and negative symptoms could be regulated by the COMT Val/Met polymorphism.METHODS In a cross-sectional study,54 clinically stable patients with schizophrenia underwent assessments for the COMT genotype,CR,and negative symptoms.CR was estimated using scores in the information and similarities subtests of a short form of the Chinese version of the Wechsler Adult Intelligence Scale.RESULTS COMT Met-carriers exhibited fewer negative symptoms than Val homozygotes.In the total sample,significant negative correlations were found between negative symptoms and information,similarities.Associations between information,similarities and negative symptoms were observed in Val homozygotes only,with information and similarities showing interaction effects with the COMT genotype in relation to negative symptoms(information,β=-0.282,95%CI:-0.552 to-0.011,P=0.042;similarities,β=-0.250,95%CI:-0.495 to-0.004,P=0.046).CONCLUSION This study provides initial evidence that the association between negative symptoms and CR is under the regulation of the COMT genotype in schizophrenia.展开更多
Objective To study the association of DTNBP1 gene with some symptom factors of schizophrenia.Methods A total of 285 unrelated schizophrenic individuals were recruited from December 2004 to January 2009 for genetic ana...Objective To study the association of DTNBP1 gene with some symptom factors of schizophrenia.Methods A total of 285 unrelated schizophrenic individuals were recruited from December 2004 to January 2009 for genetic analysis,and their symptom factors were assessed based on the Positive and Negative Syndrome Scale(PANSS).The quantitative trait test was performed by the UNPHASED program(version 3.0.12) to investigate the association between scored positive and negative symptoms and the single nucleotide polymorphisms(SNPs) in DTNBP1 gene.Results The quantitative trait test showed allelic association of rs909706 with the excitement symptom of schizophrenia(P<0.05,adjusted by 10 000 permutations),while the genotype C/G of rs2619539 with a negative symptom,lack of spontaneity and flow of conversation(P<0.05,adjusted by 10 000 permutations).Conclusion DTNBP1 variations are possibly associated with some symptoms of schizophrenia,which could partly explain the relationship between the susceptibility gene DTNBP1 and that disease.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 In patients with schizophrenia,the brain structure and neurotransmitter levels change,which may be related to the occurrence and progression of this disease.AIM To explore the relationships between changes ...BACKGROUND In patients with schizophrenia,the brain structure and neurotransmitter levels change,which may be related to the occurrence and progression of this disease.AIM To explore the relationships between changes in neurotransmitters,brain structural characteristics,and the scores of the Positive and Negative Symptom Scale(PANSS)in patients with first-episode schizophrenia.METHODS The case group comprised 97 patients with schizophrenia,who were evaluated using the Canadian Neurological Scale and confirmed by laboratory tests at Ningbo Mental Hospital from January 2020 to July 2022.The control group comprised 100 healthy participants.For all participants,brain structural characteristics were explored by measuring brain dopamine(DA),glutamic acid(Glu),and gamma-aminobutyric acid(GABA)levels,with magnetic resonance imaging.The case group was divided into negative and positive symptom subgroups using PANSS scores for hierarchical analysis.Linear correlation analysis was used to analyze the correlations between neurotransmitters,brain structural character istics,and PANSS scores.RESULTS Patients in the case group had higher levels of DA and lower levels of Glu and GABA,greater vertical and horizontal distances between the corpus callosum and the inferior part of the fornix and larger ventricle area than patients in the control group(P<0.05).Patients with positive schizophrenia symptoms had significantly higher levels of DA,Glu,and GABA than those with negative symptoms(P<0.05).In patients with positive schizophrenia symptoms,PANSS score was significantly positively correlated with DA,vertical and horizontal distances between the corpus callosum and the infrafornix,and ventricular area,and was significantly negatively correlated with Glu and GABA(P<0.05).In patients with negative schizophrenia symptoms,PANSS score was significantly positively correlated with DA,vertical distance between the corpus callosum and the infrafornix,horizontal distance between the corpus callosum and the infrafornix,and ventricular area,and was significantly negatively correlated with Glu and GABA(P<0.05).CONCLUSION In patients with first-episode schizophrenia,DA levels increased,Glu and GABA levels decreased,the thickness of the corpus callosum increased,and these variables were correlated with PANSS scores.展开更多
Objective:The efficacy and occurrence of adverse reactions of prescriptions containing phlegm-resolving Chinese medicine combined with risperidone in the treatment of schizophrenia were retrospectively studied by mean...Objective:The efficacy and occurrence of adverse reactions of prescriptions containing phlegm-resolving Chinese medicine combined with risperidone in the treatment of schizophrenia were retrospectively studied by means of meta-analysis.Methods:A variety of different Chinese and English databases were searched from January 1,2000 to May 1,2020.Review Manager 5.3 software was used to evaluate the methodological quality of the included studies.The positive and negative symptom scale(PANSS)was used as the evaluation standard to analyze the total scores,positive scores,negative scores and general psychopathological scores,clinical efficacy and safety of prescriptions containing phlegmresolving Chinese medicine combined with risperidone of schizophrenia.The heterogeneity test and sensitivity analysis were also carried out by Review Manager 5.3,and the potential publication bias was analyzed by"funnel plot".Results:A total of 1515 patients were included in 15 studies.Compared with control group of risperidone alone,the total PANSS scale score,positive symptom score,negative symptom score and general psychopathological score of the treatment group of phlegm-resolving Chinese medicine combined with risperidone were all lower than those of the control group(P=0.01,MD=-6.35,95%CI[-11.29,-1.40]),(P=0.04,MD=-1.42,95%CI[-2.74,-0.09]),(P<0.01,MD=-2.16,95%CI[-3.41,-0.91]),and(P<0.01,MD=-3.80,95%CI[-6.37,-1.24]),the clinical efficacy of phlegm-resolving Chinese medicine combined with risperidone treatment group on schizophrenia was better than that of the control group[P<0.01,RR=1.09,95%CI(1.05-1.13)].The incidence of adverse reactions was reduced(P=0.02,RR=0.56,95%CI[0.34-0.93]).Conclusion:The combination of prescriptions containing phlegm-resolving Chinese medicine and risperidone can effectively improve the efficacy of patients with schizophrenia and reduce the occurrence of adverse drug reactions compared with risperidone alone.展开更多
Schizophrenia includes positive,negative,and cognitive symptoms.Negative and cognitive symptoms do not benefit from current treatments and currently are the main determinants of functional outcome.In the European Unio...Schizophrenia includes positive,negative,and cognitive symptoms.Negative and cognitive symptoms do not benefit from current treatments and currently are the main determinants of functional outcome.In the European Union,where healthcare is widely accessible,80%-90%of patients with schizophrenia are unemployed,while 10%of them die by suicide.Currently,it is believed that psychosis and schizophrenia's positive symptoms stem from excessive dopamine D2 activity in the striatum,leading to'hyper-salience'followed by delusions,and in the sensory cortex leading to'self-generated sensory activity'followed by hallucinations.The reviewed evidence in this article suggests open potassium and hyperpolarization-activated cyclic nucleotide-gated(HCN)channels leading to prefrontal cortex(PFC)dysfunction followed by'cognitive impairment'/loss of insight'/lack of deliberate reasoning'/lack of reality monitoring'to also be a contributing factor in psychosis and schizophrenia.This could explain how kappa-opioid agonists and potassium channel openers induce psychosis while lowering dopamine but opening potassium channels;how nicotine improves certain schizophrenia symptoms while increasing dopamine but closing potassium/HCN channels;how insightfulness is maintained with 5HT2A psychedelics which increase dopamine but close potassium channels;why guanfacine which closes potassium/HCN channels is the best treatment in delirium psychosis which is characterized by prominent cognitive dysfunction;and why clozapine which closes potassium/HCN channels is superior to other antipsychotics.This article concludes that having a cognitive deficit in the first place may make someone more susceptible to developing all schizophrenia symptoms and that potassium/HCN channel blockers would improve that.They would especially ameliorate the neglected cognitive and negative symptoms.This article also notes the importance of norepinephrine and NMDA.Lastly,it proposes treatment perspectives,summarizes the reviewed findings in Table 1,and presents theorized pathways behind schizophrenia and psychosis in Figure 1.展开更多
文摘BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with and without prominent nega-tive symptoms(PNS).AIM To evaluate the effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia in real-world clinical settings and to explore the efficacy and safety of different doses of blonanserin for patients with PNS and without PNS.METHODS A 12-week,multicenter,prospective post-marketing surveillance was conducted.In this study,we included patients with first-episode schizophrenia who received blonanserin monotherapy.Patients were divided into those with PNS and without PNS,based on the Brief Psychiatric Rating Scale(BPRS)negative symptoms subscale scores.Additionally,patients were labeled as high-dose and low-dose was evaluated through the incidence of adverse drug reactions(ADRs).RESULTS A total of 653 patients were included in the analysis,with 613 completing the study.The BPRS total score decreased significantly from 47.94±16.31 at baseline to 26.88±9.47 at 12 weeks(P<0.001).A significant interaction of PNS×dose×time was observed for BPRS total scores(F=3.47,P=0.040)and negative symptom subscale scores(F=6.76,P=0.002).In the PNS group,the high-dose group showed greater reductions in BPRS total scores(P=0.001)and negative symptom subscale scores(P=0.003)than the low-dose group in week 12.In the without PNS group,no significant difference was observed between the high-dose and low-dose groups at any visit.Most adverse reactions were mild or moderate,with extrapyramidal symptoms(9.3%)being most common;1.5%of patients gained≥7%body weight at 12 weeks.CONCLUSION Blonanserin effectively alleviated the clinical symptoms of first-episode schizophrenia with an acceptable safety profile.High-dose blonanserin is particularly beneficial for patients with PNS in the acute phase of first-episode schizophrenia.However,due to the limitation of ADR reporting the real world,the ADR incidence observed in this study may be underestimated.
基金Supported by Tianjin Key Medical Discipline(Specialty)Construction Project,No.TJYXZDXK-033A。
文摘BACKGROUND Patients with schizophrenia may lack awareness of the importance of posttracheotomy care due to the impact of their condition,often showing resistance or misunderstanding of care measures.When coupled with the impact of negative symptoms and the risk of complications after tracheotomy,patients may experience emotional fluctuations,restlessness,anxiety,and hostile behaviors,which pose significant challenges to nursing work.CASE SUMMARY We have reported the case of an 87-year-old male patient who was admitted to the hospital because of negative symptoms of schizophrenia and who underwent tracheotomy for severe pneumonia.In this study,we have summarized the nursing experience of a patient with negative symptoms of schizophrenia who underwent tracheotomy.The key nursing strategies included proper tracheotomy care,the management of psychiatric symptoms,a thorough assessment and implementation of enteral and parenteral nutrition,effective skincare,infection prevention,and comprehensive mental care.Individualized nursing skills helped stabilize the patient’s condition,followed by isolation and observation in a psychiatric hospital.CONCLUSION Effective postoperative tracheostomy care in patients with schizophrenia necessitates a tailored,multidisciplinary approach that addresses their psychiatric,physical,and emotional needs to achieve optimal clinical outcomes.
基金This review was supported by the National Key R&D Program of China(2016YFC1306900)the National Natural Science Foundation of China(81622018)an Innovation Driven Project of Central South University(2020CX018).
文摘The causal mechanisms and treatment for the negative symptoms and cognitive dysfunction in schizophrenia are the main issues attracting the attention of psychiatrists over the last decade.The first part of this review summarizes the pathogenesis of schizophrenia,especially the negative symptoms and cognitive dysfunction from the perspectives of genetics and epigenetics.The second part describes the novel medications and several advanced physical therapies(e.g.,transcranial magnetic stimulation and transcranial direct current stimulation)for the negative symptoms and cognitive dysfunction that will optimize the therapeutic strategy for patients with schizophrenia in future.
基金This work was supported by grants from the National Natural Science Foundation of China(No.81760254)the Natural Science Foundation of Fujian Province of China(No.2019J01164)the Scientific Foundation of Quanzhou City for High Level Talents(No.2019C075R).
文摘Accumulating evidence suggests that a disruption of early brain development,in which insulin-like growth factor-2(IGF-2)has a crucial role,may underlie the pathophysiology of schizophrenia.Our previous study has shown that decreased serum IGF-2 was correlated with the severity of psychopathology in patients with schizophrenia.Here we conducted a prospective observation trial to investigate the effects of atypical antipsychotics on serum IGF-2 level and its relationship with clinical improvements in schizophrenia patients.Thirty-one schizophrenia patients with acute exacerbation and 30 healthy individuals were recruited in this study.Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale(PANSS)and serum IGF-2 levels were determined using ELISA.We found that schizophrenia patients with acute exacerbation had lower serum IGF-2 levels than control individuals at baseline(P<0.05).After 2 months of atypical antipsychotic treatment,a significant improvement in each PANSS subscore and total score was observed in patients(all P<0.01),and the serum IGF-2 levels of patients were significantly increased compared with those at baseline(203.13±64.62 vs.426.99±124.26 ng/mL;t=−5.044,P<0.001).Correlation analysis revealed that the changes of serum IGF-2 levels in patients were significantly correlated with the improvements of negative symptoms(r=−0.522,P=0.006).Collectively,our findings demonstrated changes of serum IGF-2 response to improvements of negative symptoms in schizophrenia patients treated with atypical antipsychotics,suggesting that serum IGF-2 might be a treatment biomarker for schizophrenia.
基金Supported by National Natural Science Foundation of China,No.82371508 and No.81771439Jiangsu Provincial Key Research and Development Program,No.BE2020661+6 种基金Suzhou Municipal Health Commission Science Research Program,No.GSWS2020095National Mentorship Training Programme for Young Health Professionals,No.Qngg2022027Suzhou Clinical Key disciplines for Geriatric Psychiatry,No.SZXK202116Suzhou Clinical Medical Center for Mood Disorders,No.Szlcyxzx202109Suzhou Key Technologies Program,No.SKY2021063Suzhou Municipal Science and Technology Bureau Program,No.SKJY2021142,No.SKJY2021143,No.SKY2023227,No.SKY2022064 and No.SKYD2023159Suzhou Key Disease Diagnosis and Treatment Program,No.LCZX202218.
文摘BACKGROUND Accumulating evidence suggests that the inflammatory cytokine interleukin-6(IL-6)contributes to the pathophysiology of psychiatric disorders.However,there was no study concerning the relationship between IL-6 concentrations and clinical features in the chronic phase of early-onset schizophrenia(EOS).AIM To investigate the relationship between serum IL-6 concentration and the clinical features of EOS.METHODS We measured serum IL-6 Levels from 74 patients with chronic schizophrenia,including 33 with age at onset<21 years(EOS group)and 41 with onset≥21 years in[adult-onset schizophrenia(AOS)group],and from 41 healthy controls.Symptom severities were evaluated using the Positive and Negative Syndrome Scale(PANSS).RESULTS Serum IL-6 concentrations were higher in both EOS and AOS groups than healthy controls(F=22.32,P<0.01),but did not differ significantly between EOS and AOS groups(P>0.05)after controlling for age,body mass index,and other covariates.Negative symptom scores were higher in the EOS group than the AOS group(F=6.199,P=0.015).Serum IL-6 concentrations in the EOS group were negatively correlated with both total PANSS-negative symptom score(r=-0.389,P=0.032)and avolition/asociality subscore(r=-0.387,P=0.026).CONCLUSION Patients with EOS may have more severe negative symptoms than those with adult-onset schizophrenia during the chronic phase of the illness.IL-6 signaling may regulate negative symptoms and its avolition/asociality subsymptoms among the early-onset chronic schizophrenic patients.
基金Supported by the National Natural Science Foundation of China,No.81971250 and No.82171501Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support,No.ZLRK202335Early Psychosis Cohort Program of Beijing Anding Hospital,No.ADDL-03.
文摘BACKGROUND Cognitive reserve(CR)and the catechol-O-methyltransferase(COMT)Val/Met polymorphism are reportedly linked to negative symptoms in schizophrenia.However,the regulatory effect of the COMT genotype on the relationship between CR and negative symptoms is still unexamined.AIM To investigate whether the relationship between CR and negative symptoms could be regulated by the COMT Val/Met polymorphism.METHODS In a cross-sectional study,54 clinically stable patients with schizophrenia underwent assessments for the COMT genotype,CR,and negative symptoms.CR was estimated using scores in the information and similarities subtests of a short form of the Chinese version of the Wechsler Adult Intelligence Scale.RESULTS COMT Met-carriers exhibited fewer negative symptoms than Val homozygotes.In the total sample,significant negative correlations were found between negative symptoms and information,similarities.Associations between information,similarities and negative symptoms were observed in Val homozygotes only,with information and similarities showing interaction effects with the COMT genotype in relation to negative symptoms(information,β=-0.282,95%CI:-0.552 to-0.011,P=0.042;similarities,β=-0.250,95%CI:-0.495 to-0.004,P=0.046).CONCLUSION This study provides initial evidence that the association between negative symptoms and CR is under the regulation of the COMT genotype in schizophrenia.
基金Supported by National High Technology Research and Development Program of China (863 Program) (2006AA02A407)National Basic Research Program (973 Program) (2010CB529603)Beijing Natural Science Foundation (7102109)
文摘Objective To study the association of DTNBP1 gene with some symptom factors of schizophrenia.Methods A total of 285 unrelated schizophrenic individuals were recruited from December 2004 to January 2009 for genetic analysis,and their symptom factors were assessed based on the Positive and Negative Syndrome Scale(PANSS).The quantitative trait test was performed by the UNPHASED program(version 3.0.12) to investigate the association between scored positive and negative symptoms and the single nucleotide polymorphisms(SNPs) in DTNBP1 gene.Results The quantitative trait test showed allelic association of rs909706 with the excitement symptom of schizophrenia(P<0.05,adjusted by 10 000 permutations),while the genotype C/G of rs2619539 with a negative symptom,lack of spontaneity and flow of conversation(P<0.05,adjusted by 10 000 permutations).Conclusion DTNBP1 variations are possibly associated with some symptoms of schizophrenia,which could partly explain the relationship between the susceptibility gene DTNBP1 and that disease.
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.
文摘BACKGROUND In patients with schizophrenia,the brain structure and neurotransmitter levels change,which may be related to the occurrence and progression of this disease.AIM To explore the relationships between changes in neurotransmitters,brain structural characteristics,and the scores of the Positive and Negative Symptom Scale(PANSS)in patients with first-episode schizophrenia.METHODS The case group comprised 97 patients with schizophrenia,who were evaluated using the Canadian Neurological Scale and confirmed by laboratory tests at Ningbo Mental Hospital from January 2020 to July 2022.The control group comprised 100 healthy participants.For all participants,brain structural characteristics were explored by measuring brain dopamine(DA),glutamic acid(Glu),and gamma-aminobutyric acid(GABA)levels,with magnetic resonance imaging.The case group was divided into negative and positive symptom subgroups using PANSS scores for hierarchical analysis.Linear correlation analysis was used to analyze the correlations between neurotransmitters,brain structural character istics,and PANSS scores.RESULTS Patients in the case group had higher levels of DA and lower levels of Glu and GABA,greater vertical and horizontal distances between the corpus callosum and the inferior part of the fornix and larger ventricle area than patients in the control group(P<0.05).Patients with positive schizophrenia symptoms had significantly higher levels of DA,Glu,and GABA than those with negative symptoms(P<0.05).In patients with positive schizophrenia symptoms,PANSS score was significantly positively correlated with DA,vertical and horizontal distances between the corpus callosum and the infrafornix,and ventricular area,and was significantly negatively correlated with Glu and GABA(P<0.05).In patients with negative schizophrenia symptoms,PANSS score was significantly positively correlated with DA,vertical distance between the corpus callosum and the infrafornix,horizontal distance between the corpus callosum and the infrafornix,and ventricular area,and was significantly negatively correlated with Glu and GABA(P<0.05).CONCLUSION In patients with first-episode schizophrenia,DA levels increased,Glu and GABA levels decreased,the thickness of the corpus callosum increased,and these variables were correlated with PANSS scores.
基金National Natural Scicnce Foundation of China(No.81973747,81873299)。
文摘Objective:The efficacy and occurrence of adverse reactions of prescriptions containing phlegm-resolving Chinese medicine combined with risperidone in the treatment of schizophrenia were retrospectively studied by means of meta-analysis.Methods:A variety of different Chinese and English databases were searched from January 1,2000 to May 1,2020.Review Manager 5.3 software was used to evaluate the methodological quality of the included studies.The positive and negative symptom scale(PANSS)was used as the evaluation standard to analyze the total scores,positive scores,negative scores and general psychopathological scores,clinical efficacy and safety of prescriptions containing phlegmresolving Chinese medicine combined with risperidone of schizophrenia.The heterogeneity test and sensitivity analysis were also carried out by Review Manager 5.3,and the potential publication bias was analyzed by"funnel plot".Results:A total of 1515 patients were included in 15 studies.Compared with control group of risperidone alone,the total PANSS scale score,positive symptom score,negative symptom score and general psychopathological score of the treatment group of phlegm-resolving Chinese medicine combined with risperidone were all lower than those of the control group(P=0.01,MD=-6.35,95%CI[-11.29,-1.40]),(P=0.04,MD=-1.42,95%CI[-2.74,-0.09]),(P<0.01,MD=-2.16,95%CI[-3.41,-0.91]),and(P<0.01,MD=-3.80,95%CI[-6.37,-1.24]),the clinical efficacy of phlegm-resolving Chinese medicine combined with risperidone treatment group on schizophrenia was better than that of the control group[P<0.01,RR=1.09,95%CI(1.05-1.13)].The incidence of adverse reactions was reduced(P=0.02,RR=0.56,95%CI[0.34-0.93]).Conclusion:The combination of prescriptions containing phlegm-resolving Chinese medicine and risperidone can effectively improve the efficacy of patients with schizophrenia and reduce the occurrence of adverse drug reactions compared with risperidone alone.
文摘Schizophrenia includes positive,negative,and cognitive symptoms.Negative and cognitive symptoms do not benefit from current treatments and currently are the main determinants of functional outcome.In the European Union,where healthcare is widely accessible,80%-90%of patients with schizophrenia are unemployed,while 10%of them die by suicide.Currently,it is believed that psychosis and schizophrenia's positive symptoms stem from excessive dopamine D2 activity in the striatum,leading to'hyper-salience'followed by delusions,and in the sensory cortex leading to'self-generated sensory activity'followed by hallucinations.The reviewed evidence in this article suggests open potassium and hyperpolarization-activated cyclic nucleotide-gated(HCN)channels leading to prefrontal cortex(PFC)dysfunction followed by'cognitive impairment'/loss of insight'/lack of deliberate reasoning'/lack of reality monitoring'to also be a contributing factor in psychosis and schizophrenia.This could explain how kappa-opioid agonists and potassium channel openers induce psychosis while lowering dopamine but opening potassium channels;how nicotine improves certain schizophrenia symptoms while increasing dopamine but closing potassium/HCN channels;how insightfulness is maintained with 5HT2A psychedelics which increase dopamine but close potassium channels;why guanfacine which closes potassium/HCN channels is the best treatment in delirium psychosis which is characterized by prominent cognitive dysfunction;and why clozapine which closes potassium/HCN channels is superior to other antipsychotics.This article concludes that having a cognitive deficit in the first place may make someone more susceptible to developing all schizophrenia symptoms and that potassium/HCN channel blockers would improve that.They would especially ameliorate the neglected cognitive and negative symptoms.This article also notes the importance of norepinephrine and NMDA.Lastly,it proposes treatment perspectives,summarizes the reviewed findings in Table 1,and presents theorized pathways behind schizophrenia and psychosis in Figure 1.
