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Background: Schizophrenia (SCZ) is a severe mental illness, Cognitive deficits and negative symptoms (NS) are prevalent in individuals with SCZ and are crucial indicators of functional recovery. It is well known that cognitive symptoms and negative symptoms are interrelated and that negative symptoms can affect the ability to take cognitive tests. However, the specific relationship between attention, working memory (WM), and NS in stable SCZ remains unclear. This study aims to explore these associations and provide valuable insights for the subsequent treatment of SCZ. Methods: We conducted a comprehensive assessment of 145 patients with stable SCZ using the Chinese Brief Neurocognitive Suite of Tests (C-BCT) and the Positive and Negative Symptom Scale (PANSS). Results: Patients with abnormal cognition exhibited significantly higher PANSS total scores, cognitive symptom scores, and NS than those with normal cognition (P<0.05). Pearson's correlation analysis revealed significant positive correlations between digital breadth(DB) and continuous operation(CO) (r=0.389, P<0.001), as well as a significant negative correlation between DB and NS (r=-0.291, P<0.001). Moreover, CO showed a negative correlation with NS (r=-0.173, P<0.05). However, no significant correlations were found between the digital breadth-anterograde score and CO or NS (r=0.148, P>0.05; r=-0.068, P>0.05). Notably, NS were identified as a mediator in the relationship between attention and WM (effect size=0.024). Conclusion: Our findings highlight significant associations between WM, attention, and NS in individuals with stable SCZ. Moreover, attention not only directly impacts WM but also indirectly influences it through NS. Addressing cognitive deficits and NS in the treatment of SCZ may lead to improved overall outcomes for affected individuals.
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BACKGROUND: Although diagnostic instability in first-episode psychosis (FEP) is of major concern, little is known about its determinants. This very long-term follow-up study aimed to examine the diagnostic stability of FEP diagnoses, the baseline predictors of diagnostic change and the timing of diagnostic change. METHODS: This was a longitudinal and naturalistic study of 243 subjects with FEP who were assessed at baseline and reassessed after a mean follow-up of 21 years. The diagnostic stability of DSM-5 psychotic disorders was examined using prospective and retrospective consistencies, logistic regression was used to establish the predictors of diagnostic change, and survival analysis was used to compare time to diagnostic change across diagnostic categories. RESULTS: The overall diagnostic stability was 47.7%. Schizophrenia and bipolar disorder were the most stable diagnoses, with other categories having low stability. Predictors of diagnostic change to schizophrenia included a family history of schizophrenia, obstetric complications, developmental delay, poor premorbid functioning in several domains, long duration of untreated continuous psychosis, spontaneous dyskinesia, lack of psychosocial stressors, longer duration of index admission, and poor early treatment response. Most of these variables also predicted diagnostic change to bipolar disorder but in the opposite direction and with lesser effect sizes. There were no significant differences between specific diagnoses regarding time to diagnostic change. At 10-year follow-up, around 80% of the diagnoses had changed. CONCLUSIONS: FEP diagnoses other than schizophrenia or bipolar disorder should be considered as provisional. Considering baseline predictors of diagnostic change may help to enhance diagnostic accuracy and guide therapeutic interventions.
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Trastornos Psicóticos , Esquizofrenia , Humanos , Estudios de Seguimiento , Estudios Retrospectivos , Estudios Prospectivos , Trastornos Psicóticos/psicología , Esquizofrenia/diagnósticoRESUMEN
Objective@#To explore the relationship between plasma cytokine level and cognitive function in patients with stable schizophrenia and explore the possible role of cytokine in the occurrence mechanism of cognitive impairment in them.@*Methods@#A total of 75 stable patients who met the mental disorder diagnostic criteria of DSM-IV (patient group) and 40 healthy people (control group) were included in the essay.The method of enzymelinked immunosorbent assay (ELISA) were used to detected the concentrations of plasma proinflammatory cytokines IL-1β, IL-8, TNF-α and IFN-γ as well as the anti-inflammatory cytokines IL-10 in all research objects.The MATRICS Consensus Cognitive Battery (MCCB) was used to assess the cognitive function of patients.The relationship between plasma cytokines and cognitive function of patients were analyzed when the differences of the plasma cytokines concentrations were compared between the patient group and the control group.@*Results@#(1)Compared with the control group, plasma IL-8 (2.80(2.13)pg/ml vs 0.23 (0.80)pg/ml), TNF-α (1.16(0.47)pg/ml vs 0.67(0.15)pg/ml) in the patient group showed statistically significant difference (P<0.01). (2)In the partial correlation analysis of plasma cytokines and cognitive functions in patients, TNF-α was negatively correlated with the attention/vigilance dimensions(r=-0.29, P=0.03).@*Conclusion@#Stable schizophrenia patients have some problems with cytokine level.There is a correlation between TNF-α level and attention/vigilance dimensions.What's more, cytokine level immunological abnormalities may play some role in the development of cognitive impairment occurrence in patients.
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Objective To explore the relationship between plasma cytokine level and cognitive function in patients with stable schizophrenia and explore the possible role of cytokine in the occurrence mechanism of cognitive impairment in them.Methods A total of 75 stable patients who met the mental disorder diagnostic criteria of DSM-ⅣV (patient group) and 40 healthy people (control group) were included in the essay.The method of enzymelinked immunosorbent assay (ELISA) were used to detected the concentrations of plasma proinflammatory cytokines IL-1β,IL-8,TNF-α and IFN-γas well as the anti-inflammatory cytokines IL-10 in all research objects.The MATRICS Consensus Cognitive Battery (MCCB) was used to assess the cognitive function of patients.The relationship between plasma cytokines and cognitive function of patients were analyzed when the differences of the plasma cytokines concentrations were compared between the patient group and the control group.Results (1) Compared with the control group,plasma IL-8 (2.80 (2.13) pg/ml vs 0.23 (0.80) pg/ml),TNF-α (1.16 (0.47) pg/ml vs 0.67 (0.15) pg/ml) in the patient group showed statistically significant difference (P＜0.01).(2)In the partial correlation analysis of plasma cytokines and cognitive functions in patients,TNF-α was negatively correlated with the attention/vigilance dimensions(r=-0.29,P=0.03).Conclusion Stable schizophrenia patients have some problems with cytokine level.There is a correlation between TNF-α level and attention/vigilance dimensions.What's more,cytokine level immunological abnormalities may play some role in the development of cognitive impairment occurrence in patients.
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OBJECTIVES: To assess daytime cognitive performance, sedation and treatment satisfaction in patients with schizophrenia receiving quetiapine extended release (XR) versus quetiapine immediate release (IR). METHODS: Phase IV prospective, double-blind, crossover study (NCT01213836). Patients (N=66) with stable schizophrenia, treated with XR or IR before study start, were randomised (1:1) to treatment with XR followed by IR, or IR followed by XR, at the dose received before enrolment (400-750mg). After 10-16days on formulation 1, patients switched to formulation 2. Assessments from three post-dose visits (≥5days following treatment on each formulation) were analysed. Cognitive performance was measured by CogState Cognition testing. Sedation, treatment satisfaction and safety were also assessed. RESULTS: 65 patients received treatment (69.2% male; mean age 37.8years). Daytime cognitive functioning was similar for both groups; adjusted mean difference in Attentional Composite Score in XR and IR patients was 0.005 (p=0.907). Patients receiving XR were less sedated than those receiving IR, (Bond-Lader visual analogue scale score, mean [SD]: 23.5 [19.0] vs 28.6 [21.4]); estimated overall treatment difference: 5.2 (95% CI: 2.3, 8.2; p<0.0009). Patients receiving XR reported feeling less sedated than those on IR (Stanford Sleepiness Scale, mean [SD]: 2.4 [0.9] vs 2.6 [1.0]); estimated overall treatment difference: 0.28 (95% CI: 0.12, 0.43; p<0.0008). Patients reported improved overall treatment satisfaction (p=0.0417) and milder side effects (p=0.0035) with XR. Safety profile was similar in both groups. CONCLUSION: Daytime cognitive performance was similar for both groups. XR was associated with less daytime sedation and improved patient satisfaction than IR.