The correlation between lipid level and cognitive function in first-episode schizophrenia patients with positive and negative symptoms / 中华行为医学与脑科学杂志

Objective To explore the characteristics of blood lipid level and cognitive impairment in first-episode schizophrenic patients with positive and negative symptoms, and their correlation. Meth-ods Seventy inpatients with first-episode schizophrenia were enrolled in the hospital. Their psychiatric symptoms were assessed by positive and negative syndrome scale ( PANSS). They were divided into two groups: positive symptoms group with 42 patients and negative symptoms group with 28 patients. All patients were assessed with the Chinese version of the measurement and treatment research to improve cognition in schizophrenia consensus cognitive battery (MCCB). The differences and characteristics of cognitive function between the two groups were compared. Body mass index (BMI),serum triglyceride,total cholesterol,low density lipoprotein and high density lipoprotein were recorded at admission,and the results were compared between the two groups. The correlation between cognitive assessment scores and metabolic indicators intra groups were analyzed using pearson correlation analysis. Results The scores of trail making test( TMT), brief assessment of cognition in schizophrenia-symbol encoding(BACS),Hopkins verbal learning test,maze and continuous performance test-identical pairs ( CPT-IP) in positive group (( 27. 13 ± 6. 89), ( 32. 97 ± 13. 69),(35. 70 ± 7. 52),(32. 63 ± 4. 59),( 33. 35 ± 11. 10)) were higher than those in negative group ((12. 90±14. 72),(19. 90±11. 98),(25. 80±5. 44),( 27. 50±5. 20),( 19. 89±11. 29),all P<0. 05). In terms of BMI and lipid metabolism indicators,the total cholesterol and low-density lipoprotein levels in the negative group ((5. 03± 1. 42),( 3. 04 ± 1. 18)) were higher than those in the positive group ((4. 18± 0. 78),(2. 45±0. 64)),and the difference was statistically significant (P<0. 05). In negative group,total cholesterol and low density lipoprotein were negatively correlated with the scores of TMT ( r=-0. 469,-0. 751),BACS( r=-0. 517,-0. 538) and CPT-IP ( r=-0. 495,-0. 542) in cognitive function(all P<0. 05). Conclusion First-episode schizophrenia patients with positive and negative symptoms have similar lesion dimensions in cognitive function, but patients with negative symptoms are more severely impaired. There are differences in lipid metabolism between first-episode schizophrenia patients with positive dominant symptoms and negative dominant symptoms,and the lipid metabolism of first-episode schizophrenia patients with negative dominant symptoms is related to cognitive function.

The correlation between lipid level and cognitive function in first-episode schizophrenia patients with positive and negative symptoms / 中华行为医学与脑科学杂志

Objective@#To explore the characteristics of blood lipid level and cognitive impairment in first-episode schizophrenic patients with positive and negative symptoms, and their correlation.@*Methods@#Seventy inpatients with first-episode schizophrenia were enrolled in the hospital.Their psychiatric symptoms were assessed by positive and negative syndrome scale (PANSS). They were divided into two groups: positive symptoms group with 42 patients and negative symptoms group with 28 patients.All patients were assessed with the Chinese version of the measurement and treatment research to improve cognition in schizophrenia consensus cognitive battery (MCCB). The differences and characteristics of cognitive function between the two groups were compared.Body mass index (BMI), serum triglyceride, total cholesterol, low density lipoprotein and high density lipoprotein were recorded at admission, and the results were compared between the two groups.The correlation between cognitive assessment scores and metabolic indicators intra groups were analyzed using pearson correlation analysis.@*Results@#The scores of trail making test(TMT), brief assessment of cognition in schizophrenia-symbol encoding(BACS), Hopkins verbal learning test, maze and continuous performance test-identical pairs(CPT-IP) in positive group((27.13±6.89), (32.97±13.69), (35.70±7.52), (32.63±4.59), (33.35±11.10)) were higher than those in negative group ((12.90±14.72), (19.90±11.98), (25.80±5.44), (27.50±5.20), (19.89±11.29), all P<0.05). In terms of BMI and lipid metabolism indicators, the total cholesterol and low-density lipoprotein levels in the negative group ((5.03±1.42), (3.04±1.18)) were higher than those in the positive group ((4.18±0.78), (2.45±0.64)), and the difference was statistically significant (P<0.05). In negative group, total cholesterol and low density lipoprotein were negatively correlated with the scores of TMT(r=-0.469, -0.751), BACS(r=-0.517, -0.538) and CPT-IP(r=-0.495, -0.542) in cognitive function(all P<0.05).@*Conclusion@#First-episode schizophrenia patients with positive and negative symptoms have similar lesion dimensions in cognitive function, but patients with negative symptoms are more severely impaired.There are differences in lipid metabolism between first-episode schizophrenia patients with positive dominant symptoms and negative dominant symptoms, and the lipid metabolism of first-episode schizophrenia patients with negative dominant symptoms is related to cognitive function.

Correlation of circRNAs' differential expression to negative-positive symptoms of patients with schizophrenia / 解放军医学杂志

Objective To explore the correlation of circRNAs' expression level to the negative-and positive symptoms of patients with schizophrenia (SZ).Methods Gene chip screening was performed with the peripheral blood samples from each five of SZ patients and normal controls.Nine circRNAs showing differentiate expression were confirmed,and further verification was done by real-time fluorescence quantitative PCR in 102 SZ patients and 103 normal controls.All the SZ patients were assessed with Positive and Negative Symptom Scale (PANSS).Results It was revealed that the expression levels of circRNA_102101,circRNA_102315,circRNA_104597,circRNA_101835 and circRNA_101836 were significantly down-regulated (P＜0.01 or P＜0.05),and circRNA_103102 and circRNA_103704 were up-regulated in SZ group (P＜0.01).The ACT value of circRNA_102101 and circRNA_103102 was positively correlated to the positive symptoms (P＜0.01 or P＜0.05),and the ACT value of circRNA_103704 also showed positive correlation with positive symptoms and general psychopathological symptoms (P＜0.01 or P＜0.05).The ACT values of circRNA_102101,circRNA_103102,circRNA_102315,circRNA_103704 and circRNA_102802 were correlated with thinking disorder (P＜0.01 or P＜0.05),and the ACT values of circRNA_102101,circRNA_103102,circRNA_104597,circRNA_103704 and circRNA_102802 were correlated with the activation (P＜0.01 or P＜0.05).The ACT values of circRNA_102101,circRNA_103102,circRNA_103704 and circRNA_102802 were positively correlated with paranoid (P＜0.01 or P＜0.05),and of circRNA_102101,circRNA_103102,circRNA_103704 and circRNA_102802 were markedly correlated with assault (P＜0.01 or P＜0.05).Therefore,circRNA_103704 was chosen into regressive equation of positive symptoms (P＜0.01),and circRNA_103704 and circRNA_102315 were chosen into regressive equation of general pathological findings (P＜0.01 or P＜0.05).Conclusion The expression levels of circRNA_103704 and circRNA_103102 are obviously up-regulated in SZ patients than in normal controls,and markedly correlated with the negative and positive SZ symptoms,so might be the dominant regulatory factors in the pathological process of schizophrenia.

Research progress of antipsychotics / 药学学报

Epidemiology indicates that schizophrenia affects approximately 8‰ of the world's population. The atypical (second and third generation) antipsychotics generally endowed with D2/5-HTHT2 receptors antagonism properties are commonly used as first-line drugs for the treatment of schizophrenia presently. They have been proven effective in the treatment of positive and negative symptoms of schizophrenia, but they are largely ineffective in the treatment of cognitive deficit. Moreover, the atypical antipsychotics are usually associated with cardiovascular and metabolic side effects such as QT prolongation and weight gain. To develop more potent antipsychotics with fewer side effects, more targets have been identified such as D3, glutamate, H3 receptors and PDE10A in recent years. Herein, the research progress of antipsychotics is reviewed.

Multivariate Analysis of Relationship between Childhood Trauma and Psychotic Symptoms in Patients with Schizophrenia

The aim of this study was to examine the relationship between childhood trauma and psychotic symptoms in schizophrenic patients after controlling for the possible confounding factors, such as depression and dissociative symptoms. Ninety-eight schizophrenic inpatients participated. Childhood trauma was examined using the Childhood Trauma Questionnaires (CTQ), which consists of physical abuse (PA), sexual abuse (SA), emotional abuse (EA), physical neglect (PN), and emotional neglect (EN). Positive and Negative Syndrome Scale (PANSS), Dissociative Experience Scale (DES), and Beck's Depression Inventory (BDI) were also administered. Data were analyzed by partial correlation and general linear model. The total score of CTQ was positively correlated with positive, general, and total scores of PANSS. All five types of childhood trauma were associated with dissociative symptoms. EA and EN were positively correlated with depressive symptoms. Only SA significantly predicted positive symptoms of schizophrenia after controlling for age, sex, BDI, and DES scores, with a dose-response relationship between SA and positive symptoms.

Factor Structure of the Targeted Inventory on Problems in Schizophrenia

OBJECTIVE: The aim of this study was to explore the factor structure of a novel, 10-item rating scale, the Targeted Inventory on Problems in Schizophrenia (TIP-Sz). Determining the factor structure will be useful in the brief evaluation of medication and non-medication treatment of the disease. METHODS: An exploratory factor analysis was performed on TIP-Sz scores obtained from 100 patients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for schizophrenia. RESULTS: The factor analysis extracted four factors that were deemed clinically pertinent, which we labeled: disorganization, social cooperativeness, functional capacity, and emotional state. The items exhibited cross-loadings on the first three factors (i.e., some items loaded on more than one factor). In particular, the 'behavioral dyscontrol and disorganization,' 'insight and reality testing,' and 'overall prognostic impression' items had comparable cross-loadings on all of the first three factors. The emotional state factor was distinct from the other factors in that the items loading on it did not cross-load on other factors. CONCLUSION: The TIP-Sz scale comprises factors that are associated with the psychosocial functioning and emotional state of patients, which are important outcome parameters for successful treatment of the disease.

Relationships between Psychotic Symptoms and Cognitive Functions in Schizophrenic Patients

OBJECTIVES: The aim of this study was to investigate relationships between psychotic symptoms and cognitive functions in schizophrenia. METHODS: The study group was composed of 36 schizophrenic patients. Positive, negative, and disorganization symptoms were assessed using the PANSS. Verbal, visuospatial, attention, memory, and executive functions were assessed using a battery of cognitive tests. RESULTS: Correlation analysis between symptom vs. cognitive measures showed that (a) positive symptoms were significantly correlated with no cognitive measures, (b) negative symptoms were significantly correlated with all cognitive measures, and (c) disorganization symptoms were significantly correlated with executive and memory measures. Correlation analyses between symptom vs. cognitive factors showed that negative-disorganization factor is significantly correlated with executive-memory factor. CONCLUSION: Significant relationships were confined mostly to frontal symptoms vs. frontal cognitive functions. Thus, the relationships may be mediated mainly by variations in severity of frontal pathology among patients.

Correlations between Anxious, Depressive Mood and Positive, Negative Symptoms in Chronic Schizophrenics: a Differential Relationship with the Presence of Akathisia / 신경정신의학

OBJECTIVES: In previous studies, the significant correlations between depression-anxiety symptoms and positive symptoms had been reported in schizophrenia. However, it is suggested that these correlations reflect the common influence of third variable, and akathisia-associated dysphoria may be the strong mediator of these relationships. The aim of this study is to investigate the correlations between depression-anxiety symptoms and the schizophrenic symptoms including direct measures of drug-induced akathisia. METHODS: The subjects were 57 patients with chronic schizophrenia. All patients were functioning cognitively at a level to understand and complete the several self-report inventories. Akathisia was rated using Barnes akathisia rating scale (BARS), and depression-anxiety symptoms were assessed by two self-report measures, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). The symptoms of schizophrenia were assessed using Manchester Scale. RESULTS: In the whole group of subjects, the scores on BDI and dysphoria composite index were significantly correlated with total positive symptom scores and all subscale scores of positive symptoms. In akathisia group, the scores on BDI and dysphoria composite index were still significantly correlated with total positive symptom scores and the subscale scores of delusion. In non-akathisia group, however, there were no significant correlations between self-report depression, anxiety symptoms and total positive symptom scores. CONCLUSION: These results suggest that the akathisia is the important factor in correlations between dysphoric symptoms and positive symptoms. Therefore, the caution is necessary in the interpretation of previous studies which report the direct correlations between depression and positive symptoms. Future research is needed to investigate the associations in akathisia, depression, and the schizophrenic symptom complexes.

Relationship between Regional Cerebral Blood Flow in 99m-Tc-ECD SPECT and Symptom Profiles in Unmedicated Patients with Schizophrenia / 신경정신의학

Symptom profiles in schizophrenia consists of positive and negative symptom dimensions which are considered to be related to different underlying pathophysiologies and neural substrates. The purpose of the study was to identify the possible relationship between relative regional cerebral perfusion and positive and negative symptom dimension in unmedicated patients with schizophrenia. Twenty-seven unmedicated patients with schizophrenia(13 patients who were antipsychotic drug-naive and 14 patients who had been drug-free for at least 1 week) were included in the study. Regional cerebral perfusion was studied with the single-photon emission computed tomography(SFECT). Symptom dimensions were assessed with positive and negative syndrome scale(PANSS). The scores of each symptom dimension were correlated with regional cerebral perfusion. The results were 1) positive symptom dimension score was significantly related to decreased perfusion in the medial temporal lobe and increased perfusion in the frontal lobe, 2) negative symptom dimension score was significantly related to decreased perfusion in the basal ganglia, thalamus and increased perfusion in the frontal lobe. These results suggest that positive symptom dimension is associated with the dysfunction of the link between the frontal lobe and the medial temporal lobe and that negative symptom dimension is related with the impairment of frontal-basal ganglia circuit.