Background Compromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cogni...Background Compromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cognitive Battery (MCCB), it is not clear about the level and pattern of cognitive impairment among this population. Aim To provide a meta-analysis systematically analysing studies of neurocognitive function using MCCB in Chinese patients with FES. Methods An independent literature search of both Chinese and English databases up to 13 March 2019 was conducted by two reviewers. Standardised mean difference (SMD) was calculated using the random effects model to evaluate the effect size. Results 56 studies (FES=3167, healthy controls (HC)=3017) were included and analysed. No study was rated as 'high quality' according to Strengthening the Reporting of Observational Studies in Epidemiology. Compared with HCs, Chinese patients with FES showed impairment with large effect size in overall cognition (SMD=-1.60,95% Cl -1.82 to -1.38,厂=67%) and all seven cognitive domains, with the SMD ranging from -0.87 to -1.41. In nine MCCB subtests, patients with FES showed significant difference in Symbol Coding (SMD=-1.90), Trail Making Test (TMT)(SMD=-1.36), Continuous Performance Test-Identical Pairs (SMD=-1.33), Hopkins Verbal Learning Test (SMD=-1.24), Brief Visuospatial Memory Test (SMD=-1.18), Mazes (SMD=-1.16), Category Fluency (SMD=-1.01), Spatial Span (SMD=-0.69) and Mayer-Salovey-Caruso Emotional Intelligence Test (SMD=-0.38). Conclusions Our meta-analysis demonstrates that Chinese patients with FES show neurocognitive deficits across all seven MCCB cognitive domains and all nine subtests, particularly in two neurocognitive domains: speed of processing and attention/vigilance, with the least impairment shown in social cognition. Symbol Coding and TMT may be the most sensitive tests to detect cognitive deficit in Chinese patients with FES.展开更多
Objective:Published studies have found prepulse inhibition(PPI)in schizophrenia is impaired,suggesting PPI may be a biomarker of schizophrenia.We aim to examine whether PPI deficits exist in antipsychotic-na-ve,first-...Objective:Published studies have found prepulse inhibition(PPI)in schizophrenia is impaired,suggesting PPI may be a biomarker of schizophrenia.We aim to examine whether PPI deficits exist in antipsychotic-na-ve,first-episode schizophrenia,and evaluate the effect size of PPI deficits between patients and healthy controls.Methods:The effect size of PPI deficits was evaluated for PPI%by calculating standard mean differences(SMDs)between patients with antipsychotic-na-ve,first-episode schizophrenia and healthy controls.Results:Twelve studies met the inclusion criteria,consisting390antipsychotic-na-ve,first-episode schizophrenia and406healthy controls.The effect sizes of76dB PPI in60ms and120ms interstimulus interval(ISI)were-0.19and-0.41respectively,and the76dB PPI overall effect size was-0.30.The effect sizes of85/86dB PPI in30ms,60ms and120ms ISI were-0.25,-0.42and-0.59respectively,and the85/86dB PPI overall effect size was-0.46.One study were excluded due to heterogeneity in the85/86dB,120ms ISI group,the pooled effect size of the PPI differences between patient group and health control dropped to-0.42,and the overall effect size changed to-0.39.There were no statistical differences in startle magnitude(overall effect size=-0.18)and habituation%(overall effect size=-0.17)between patients and healthy controls.Conclusions:Antipsychotic-na-ve,first-episode schizophrenia patients exhibit robust and reliable deficits in PPI,85/86dB PPI deficit was more severe than76dB PPI,and85/86dB,60-ms ISI PPI was more likely to be a biomarker for schizophrenia,it suggested that the parameters of PPI are particularly significant to affect the effect size so that should be interpreted with cautions in the future studies.展开更多
BACKGROUND The pathogenesis of cognitive impairment in schizophrenia(SCZ)remains unclear.Accumulating studies showed that inflammatory-immune dysregulation and altered brain derived neurotrophic factor(BDNF)levels pla...BACKGROUND The pathogenesis of cognitive impairment in schizophrenia(SCZ)remains unclear.Accumulating studies showed that inflammatory-immune dysregulation and altered brain derived neurotrophic factor(BDNF)levels play a crucial role in the psychopathology of SCZ.However,their association with cognitive dysfunction in first-episode SCZ patients has not been thoroughly investigated.AIM To explore the interaction effects between cognitive function and inflammatory cytokines and BDNF in first-episode SCZ.METHODS The current study is a cross-sectional case-control investigation that recruited 84 patients with first-episode SCZ(SCZ group)and 80 healthy controls(HCs group)at the Huzhou Third Municipal Hospital between August 2021 and September 2023.ELISA was employed to measure the serum levels of interleukin(IL)-1β,IL-4,IL-6,IL-10,and BDNF.The Chinese brief cognitive test(C-BCT)and the positive and negative syndrome scales were measured the severity of cognitive impairment and psychiatric symptoms.RESULTS Compared to the HC group,the SCZ group exhibited elevated IL-1βand IL-6 levels,decreased BDNF levels,and reduced C-BCT scores(all P<0.001).In SCZ,BDNF was negatively correlated with IL-6(r=-0.324,P<0.05).Information processing speed was negatively correlated with IL-6(r=-0.315,P<0.05)and positively with BDNF(r=0.290,P<0.05);attention,working memory,comprehensive ability,and executive function were negatively correlated with IL-1βand IL-6(all P<0.05)and positively with BDNF(all P<0.05).Multiple regression analysis showed IL-6 influenced C-BCT dimensions(β=-0.218 to-0.327,all P<0.05);attention and executive ability were influenced by IL-1β(β=-0.199 to-0.261,all P<0.05);comprehensive executive ability was influenced by BDNF(β=0.209,P<0.05).CONCLUSION Our findings suggested that interrelationships between immune dysfunction and neurotrophic deficiency might underlie the pathological mechanisms of cognitive impairments in first-episode SCZ patients.展开更多
Background: Approximately 75% of all deaths in people with schizophrenia are caused by physical illness with cardiovascular disease [CVD] being the commonest cause of death. Factors predisposing people with schizophre...Background: Approximately 75% of all deaths in people with schizophrenia are caused by physical illness with cardiovascular disease [CVD] being the commonest cause of death. Factors predisposing people with schizophrenia to CVD include antipsychotic medication. Aim of Work: The aim of this study was to detect metabolic syndrome and its components in de novo paranoid schizophrenics on olanzapine therapy and the metabolic benefits of addition of aripeprazole, clinically and experimentally. Methodology: 1) Clinical study: 200 Outpatients suffered from de novo paranoid schizophrenia according to 10th International Classification of Psychiatric Disorders, Research Criteria [ICD10 RC] were included in the study. None of them had any component of metabolic syndrome. They were maintained on olanzapine [10 - 20 mg]. Patients were assessed clinically, psychometrically using Scale for the Assessment of Negative [SANS] and Positive [SAPS] Symptoms and metabolically at base line and after 6 months. Patients who had metabolic syndrome after 6 month of starting olanzapine therapy, were randomly divided into two groups according to added regime to maintained olanzapine: Group 1: olanzapine [10 mg/day] + placebo [empty hard gelatin capsule]. Group II: olanzapine [10 mg/day] + aripeprazole [10 mg/day]. 2) Experimental study: 40 male albino rats were randomly equally divided into 4 groups: Group 1 [control group]: received a standard diet, Group II [olanzapine treated]: received olanzapine at a dose of 0.5 mg/kg/day, Group III [aripiprazole treatd]: received aripiprazole at a dose of 2 mg/kg/day, Group IV [combined olanzapine and aripiprazole treated]: received olanzapine at a dose of 0.5 mg/kg/day combined with aripiprazole at a dose of 2 mg/kg/day orally. The duration of the study was 16 weeks. All treated rat groups were assessed for metabolic parameters, liver enzymes and histopathology. Results: Clinically, after the 6 months of olanzapine treatment [mean dose 12.75 mg], there was significant increase [p Conclusion and Recommendation: Olanzapine treatment was found to be associated with risk factors of metabolic syndrome clinically and experimentally and its hepatic manifestation of non-alcoholic fatty liver disease in wister rats. Improvements were observed clinically and experimentally in metabolic measures, liver enzymes and liver histopathology by addition of aripeprazole. Patients on olanzapine therapy must be followed regularly regarding metabolic parameters, hepatic, cardiac and cerebrovascular morbidity, with urgent interference with early manifestations. It is recommended to check liver enzymes regularly for those patients kept on atypical antipsychotic drug [olanzapine].展开更多
This paper discusses in detail the concept of “self-awareness” and its main components, and describes the features of self-consciousness and the course of the disease in people with schizophrenia. The specific featu...This paper discusses in detail the concept of “self-awareness” and its main components, and describes the features of self-consciousness and the course of the disease in people with schizophrenia. The specific features inherent in the self-awareness of people who have schizophrenia are revealed. The paper presents the experience of modern researchers who studied the features of self-awareness of patients with schizophrenia by analyzing documentary sources, analyzing the major psychometric scales of the subjects, studying their ideas about their psychological well-being and their own psychological space, and analyzing the self-descriptions of patients.展开更多
Objectives To explore the treatment effect of risperidone on patients with firstepisode schizophrenia at different ages and analyze its influencing factors.Methods fifty cases of adult patients with the first-episode ...Objectives To explore the treatment effect of risperidone on patients with firstepisode schizophrenia at different ages and analyze its influencing factors.Methods fifty cases of adult patients with the first-episode schizophrenia(adult group)and forty cases of juvenile patients with the firstepisode schizophrenia(juvenile group)treated in our hospital from March 2013 to March 2015 were selected for oral administration of risperidone.The clinical efficacy,adverse effect,brief psychiatric rating scale(BPRS)score before and after the therapy,brain-derived neurotrophic factor(BDNF)and blood lipid level were compared between the two groups after eight weeks’treatment with risperidone,and meanwhile,the multivariable linear regression analysis was performed to the related factors possibly influencing the efficacy of risperidone.Results The difference of total effective rate between the adult group(86%)and the juvenile group(82.5%)was not significant(P>0.05).The total score of BPRS,TC,TG,and LDL-C levels in the two groups after the treatment were significantly decreased compared with that before the treatment,while BDNF was significantly increased.The difference of inter-group comparison was significant before and after the treatment(P>0.05).However,the comparison difference between two groups was not significant before and after the treatment(P>0.05).The multivariable linear regression equation was used to analyze the longer duration of untreated psychosis(DUP),BPRS total score before treatment and BDNF levels that influence the efficacy of risperidone on patients with schizophrenia.Conclusion the treatment efficacy of risperidone on adult patients and juvenile patients with first-episode schizophrenia was similar and it was safe and effective.The DUP,BPRS total score before treatment and BDNF levels were associated with the efficacy of risperidone.展开更多
目的采用优化的基于体素的形态学(voxel based morphometry,VBM)方法,比较偏执型精神分裂症、双相情感障碍躁狂患者脑灰质体积的差异。方法运用3.0T磁共振扫描仪对符合美国精神障碍诊断统计手册第4版(DSM-Ⅳ)诊断标准的20例偏执型精神...目的采用优化的基于体素的形态学(voxel based morphometry,VBM)方法,比较偏执型精神分裂症、双相情感障碍躁狂患者脑灰质体积的差异。方法运用3.0T磁共振扫描仪对符合美国精神障碍诊断统计手册第4版(DSM-Ⅳ)诊断标准的20例偏执型精神分裂症住院患者、20例双相情感障碍躁狂相住院患者和20例正常对照进行3D T1像扫描。在SPM2平台上,以优化的VBM方法对高分辨T1加权图像进行处理,比较上述研究对象脑灰质体积的差异。结果与正常对照比较,偏执型精神分裂症患者右侧颞中回、颞下回,左侧颞上回灰质体积减少,而双侧额下回、双侧屏状核灰质体积增加。双相情感障碍躁狂患者与正常对照比较出现灰质体积减少的脑区包括双侧尾状核,右侧颞叶颞上、中、下回,灰质体积增加的脑区包括左侧顶叶中央后回、双侧楔前叶、右侧额上回、左侧扣带回。偏执型精神分裂症患者与双相情感障碍躁狂患者相比左侧颞上回、左侧额下回、右侧尾状核体灰质体积增加。结论偏执型精神分裂症患者与双相情感障碍躁狂患者既存在不同脑区的灰质体积的改变,也存在共同的右侧颞叶灰质体积改变。展开更多
文摘Background Compromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cognitive Battery (MCCB), it is not clear about the level and pattern of cognitive impairment among this population. Aim To provide a meta-analysis systematically analysing studies of neurocognitive function using MCCB in Chinese patients with FES. Methods An independent literature search of both Chinese and English databases up to 13 March 2019 was conducted by two reviewers. Standardised mean difference (SMD) was calculated using the random effects model to evaluate the effect size. Results 56 studies (FES=3167, healthy controls (HC)=3017) were included and analysed. No study was rated as 'high quality' according to Strengthening the Reporting of Observational Studies in Epidemiology. Compared with HCs, Chinese patients with FES showed impairment with large effect size in overall cognition (SMD=-1.60,95% Cl -1.82 to -1.38,厂=67%) and all seven cognitive domains, with the SMD ranging from -0.87 to -1.41. In nine MCCB subtests, patients with FES showed significant difference in Symbol Coding (SMD=-1.90), Trail Making Test (TMT)(SMD=-1.36), Continuous Performance Test-Identical Pairs (SMD=-1.33), Hopkins Verbal Learning Test (SMD=-1.24), Brief Visuospatial Memory Test (SMD=-1.18), Mazes (SMD=-1.16), Category Fluency (SMD=-1.01), Spatial Span (SMD=-0.69) and Mayer-Salovey-Caruso Emotional Intelligence Test (SMD=-0.38). Conclusions Our meta-analysis demonstrates that Chinese patients with FES show neurocognitive deficits across all seven MCCB cognitive domains and all nine subtests, particularly in two neurocognitive domains: speed of processing and attention/vigilance, with the least impairment shown in social cognition. Symbol Coding and TMT may be the most sensitive tests to detect cognitive deficit in Chinese patients with FES.
基金supported by researchgrants from the National Natural Science foundationof China (81471365, 81601169) Major Brain Program of Beijing Science and Technology Plan (Z161100002616017)Beijing Municipal Administration of Hospitals ClinicalMedicine Development of Special Funding Support(ZYLX201807).
文摘Objective:Published studies have found prepulse inhibition(PPI)in schizophrenia is impaired,suggesting PPI may be a biomarker of schizophrenia.We aim to examine whether PPI deficits exist in antipsychotic-na-ve,first-episode schizophrenia,and evaluate the effect size of PPI deficits between patients and healthy controls.Methods:The effect size of PPI deficits was evaluated for PPI%by calculating standard mean differences(SMDs)between patients with antipsychotic-na-ve,first-episode schizophrenia and healthy controls.Results:Twelve studies met the inclusion criteria,consisting390antipsychotic-na-ve,first-episode schizophrenia and406healthy controls.The effect sizes of76dB PPI in60ms and120ms interstimulus interval(ISI)were-0.19and-0.41respectively,and the76dB PPI overall effect size was-0.30.The effect sizes of85/86dB PPI in30ms,60ms and120ms ISI were-0.25,-0.42and-0.59respectively,and the85/86dB PPI overall effect size was-0.46.One study were excluded due to heterogeneity in the85/86dB,120ms ISI group,the pooled effect size of the PPI differences between patient group and health control dropped to-0.42,and the overall effect size changed to-0.39.There were no statistical differences in startle magnitude(overall effect size=-0.18)and habituation%(overall effect size=-0.17)between patients and healthy controls.Conclusions:Antipsychotic-na-ve,first-episode schizophrenia patients exhibit robust and reliable deficits in PPI,85/86dB PPI deficit was more severe than76dB PPI,and85/86dB,60-ms ISI PPI was more likely to be a biomarker for schizophrenia,it suggested that the parameters of PPI are particularly significant to affect the effect size so that should be interpreted with cautions in the future studies.
基金Supported by Huzhou Public Welfare Research Project Social Development Category,No.2021GYB09,No.2021GY38,No.2019GY26 and No.2019GZB02.
文摘BACKGROUND The pathogenesis of cognitive impairment in schizophrenia(SCZ)remains unclear.Accumulating studies showed that inflammatory-immune dysregulation and altered brain derived neurotrophic factor(BDNF)levels play a crucial role in the psychopathology of SCZ.However,their association with cognitive dysfunction in first-episode SCZ patients has not been thoroughly investigated.AIM To explore the interaction effects between cognitive function and inflammatory cytokines and BDNF in first-episode SCZ.METHODS The current study is a cross-sectional case-control investigation that recruited 84 patients with first-episode SCZ(SCZ group)and 80 healthy controls(HCs group)at the Huzhou Third Municipal Hospital between August 2021 and September 2023.ELISA was employed to measure the serum levels of interleukin(IL)-1β,IL-4,IL-6,IL-10,and BDNF.The Chinese brief cognitive test(C-BCT)and the positive and negative syndrome scales were measured the severity of cognitive impairment and psychiatric symptoms.RESULTS Compared to the HC group,the SCZ group exhibited elevated IL-1βand IL-6 levels,decreased BDNF levels,and reduced C-BCT scores(all P<0.001).In SCZ,BDNF was negatively correlated with IL-6(r=-0.324,P<0.05).Information processing speed was negatively correlated with IL-6(r=-0.315,P<0.05)and positively with BDNF(r=0.290,P<0.05);attention,working memory,comprehensive ability,and executive function were negatively correlated with IL-1βand IL-6(all P<0.05)and positively with BDNF(all P<0.05).Multiple regression analysis showed IL-6 influenced C-BCT dimensions(β=-0.218 to-0.327,all P<0.05);attention and executive ability were influenced by IL-1β(β=-0.199 to-0.261,all P<0.05);comprehensive executive ability was influenced by BDNF(β=0.209,P<0.05).CONCLUSION Our findings suggested that interrelationships between immune dysfunction and neurotrophic deficiency might underlie the pathological mechanisms of cognitive impairments in first-episode SCZ patients.
文摘Background: Approximately 75% of all deaths in people with schizophrenia are caused by physical illness with cardiovascular disease [CVD] being the commonest cause of death. Factors predisposing people with schizophrenia to CVD include antipsychotic medication. Aim of Work: The aim of this study was to detect metabolic syndrome and its components in de novo paranoid schizophrenics on olanzapine therapy and the metabolic benefits of addition of aripeprazole, clinically and experimentally. Methodology: 1) Clinical study: 200 Outpatients suffered from de novo paranoid schizophrenia according to 10th International Classification of Psychiatric Disorders, Research Criteria [ICD10 RC] were included in the study. None of them had any component of metabolic syndrome. They were maintained on olanzapine [10 - 20 mg]. Patients were assessed clinically, psychometrically using Scale for the Assessment of Negative [SANS] and Positive [SAPS] Symptoms and metabolically at base line and after 6 months. Patients who had metabolic syndrome after 6 month of starting olanzapine therapy, were randomly divided into two groups according to added regime to maintained olanzapine: Group 1: olanzapine [10 mg/day] + placebo [empty hard gelatin capsule]. Group II: olanzapine [10 mg/day] + aripeprazole [10 mg/day]. 2) Experimental study: 40 male albino rats were randomly equally divided into 4 groups: Group 1 [control group]: received a standard diet, Group II [olanzapine treated]: received olanzapine at a dose of 0.5 mg/kg/day, Group III [aripiprazole treatd]: received aripiprazole at a dose of 2 mg/kg/day, Group IV [combined olanzapine and aripiprazole treated]: received olanzapine at a dose of 0.5 mg/kg/day combined with aripiprazole at a dose of 2 mg/kg/day orally. The duration of the study was 16 weeks. All treated rat groups were assessed for metabolic parameters, liver enzymes and histopathology. Results: Clinically, after the 6 months of olanzapine treatment [mean dose 12.75 mg], there was significant increase [p Conclusion and Recommendation: Olanzapine treatment was found to be associated with risk factors of metabolic syndrome clinically and experimentally and its hepatic manifestation of non-alcoholic fatty liver disease in wister rats. Improvements were observed clinically and experimentally in metabolic measures, liver enzymes and liver histopathology by addition of aripeprazole. Patients on olanzapine therapy must be followed regularly regarding metabolic parameters, hepatic, cardiac and cerebrovascular morbidity, with urgent interference with early manifestations. It is recommended to check liver enzymes regularly for those patients kept on atypical antipsychotic drug [olanzapine].
文摘This paper discusses in detail the concept of “self-awareness” and its main components, and describes the features of self-consciousness and the course of the disease in people with schizophrenia. The specific features inherent in the self-awareness of people who have schizophrenia are revealed. The paper presents the experience of modern researchers who studied the features of self-awareness of patients with schizophrenia by analyzing documentary sources, analyzing the major psychometric scales of the subjects, studying their ideas about their psychological well-being and their own psychological space, and analyzing the self-descriptions of patients.
基金Public Health Research Program of Wuhan Municipal Health Burea(WG13A02)--A Analysis of the Death Distribution and Life Lost of Cerebrovascular Disease among Wuhan Urban and Rural Residents in 2013
文摘Objectives To explore the treatment effect of risperidone on patients with firstepisode schizophrenia at different ages and analyze its influencing factors.Methods fifty cases of adult patients with the first-episode schizophrenia(adult group)and forty cases of juvenile patients with the firstepisode schizophrenia(juvenile group)treated in our hospital from March 2013 to March 2015 were selected for oral administration of risperidone.The clinical efficacy,adverse effect,brief psychiatric rating scale(BPRS)score before and after the therapy,brain-derived neurotrophic factor(BDNF)and blood lipid level were compared between the two groups after eight weeks’treatment with risperidone,and meanwhile,the multivariable linear regression analysis was performed to the related factors possibly influencing the efficacy of risperidone.Results The difference of total effective rate between the adult group(86%)and the juvenile group(82.5%)was not significant(P>0.05).The total score of BPRS,TC,TG,and LDL-C levels in the two groups after the treatment were significantly decreased compared with that before the treatment,while BDNF was significantly increased.The difference of inter-group comparison was significant before and after the treatment(P>0.05).However,the comparison difference between two groups was not significant before and after the treatment(P>0.05).The multivariable linear regression equation was used to analyze the longer duration of untreated psychosis(DUP),BPRS total score before treatment and BDNF levels that influence the efficacy of risperidone on patients with schizophrenia.Conclusion the treatment efficacy of risperidone on adult patients and juvenile patients with first-episode schizophrenia was similar and it was safe and effective.The DUP,BPRS total score before treatment and BDNF levels were associated with the efficacy of risperidone.
文摘目的采用优化的基于体素的形态学(voxel based morphometry,VBM)方法,比较偏执型精神分裂症、双相情感障碍躁狂患者脑灰质体积的差异。方法运用3.0T磁共振扫描仪对符合美国精神障碍诊断统计手册第4版(DSM-Ⅳ)诊断标准的20例偏执型精神分裂症住院患者、20例双相情感障碍躁狂相住院患者和20例正常对照进行3D T1像扫描。在SPM2平台上,以优化的VBM方法对高分辨T1加权图像进行处理,比较上述研究对象脑灰质体积的差异。结果与正常对照比较,偏执型精神分裂症患者右侧颞中回、颞下回,左侧颞上回灰质体积减少,而双侧额下回、双侧屏状核灰质体积增加。双相情感障碍躁狂患者与正常对照比较出现灰质体积减少的脑区包括双侧尾状核,右侧颞叶颞上、中、下回,灰质体积增加的脑区包括左侧顶叶中央后回、双侧楔前叶、右侧额上回、左侧扣带回。偏执型精神分裂症患者与双相情感障碍躁狂患者相比左侧颞上回、左侧额下回、右侧尾状核体灰质体积增加。结论偏执型精神分裂症患者与双相情感障碍躁狂患者既存在不同脑区的灰质体积的改变,也存在共同的右侧颞叶灰质体积改变。
