Publications by authors named "Xiaoduo Fan"

96 Publications

Racial disparity in mental disorder diagnosis and treatment between non-hispanic White and Asian American patients in a general hospital.

Asian J Psychiatr 2018 Apr 9;34:78-83. Epub 2018 Apr 9.

Department of Psychiatry, UMass Memorial Medical Center/University of Massachusetts Medical School, Worcester, MA, United States. Electronic address:

Purpose: The present study sought to examine the diagnosis and treatment of mental disorders comparing Asian American (AA) and non-Hispanic Whites (WNH) drawn from a population accessing a large general hospital for any reason. Socio-demographic predictors of diagnosis and treatment were also explored.

Methods: Data were obtained from de-identified medical records in the Partner Health Care System's Research Patient Data Registry.

Results: The final sample included 345,070 self-identified WNH and 16,418 self-identified AA's between January 1, 2009 and December 31, 2009. WNH patients were more likely than AA patients to carry a diagnosis of a mental disorder (18.1% vs. 8.6%, p < 0.0001) and were more likely to receive psychotropic medication treatment (15.0% vs 8.5%, p < 0.0001). Logistic regression analyses of the AA cohort identified several risk factors (i.e. language, religion, gender, age) predicting the diagnosis of a mental disorder or use of psychotropic medication.

Conclusions: Our findings on the racial disparity in mental disorder diagnosis and treatment between AA and WNH patients suggest that mental disorders are under-recognized and mental health services are under-utilized in the AA community. There remains a need for health care providers to improve screening services and to gain a better understanding of the cultural barriers that hinder mental health care among AA patients.
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http://dx.doi.org/10.1016/j.ajp.2018.04.019DOI Listing
April 2018

Naltrexone and Bupropion Combination Treatment for Smoking Cessation and Weight Loss in Patients With Schizophrenia.

Front Pharmacol 2018 5;9:181. Epub 2018 Mar 5.

Psychotic Disorders Program, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, United States.

The rates of obesity and cigarette smoking are much higher in patients with schizophrenia compared to the general population. This study was to examine whether naltrexone and bupropion combination treatment can help weight loss and smoking cessation in patients with schizophrenia. Obese male schizophrenia patients with current cigarette smoking were randomized to receive adjunctive naltrexone (25 mg/day) and bupropion (300 mg/day) combination or placebo for 24 weeks. Twenty-two patients were enrolled in the study, and 21 patients completed the study (11 in the treatment group, and 10 in the placebo group). Body weight, body mass index (BMI), fasting lipids, smoking urge, expired carbon monoxide (CO) level and cigarettes smoked per week were measured at baseline and week 24. There was no significant difference between two groups in changes in weight, BMI, fasting lipids, or cigarette smoking measures ('s > 0.05) Naltrexone and bupropion combination treatment didn't show weight loss or smoking cessation effect in patients with schizophrenia in this pilot study.Implications for future studies were discussed. ClinicalTrials.gov identifier: NCT02736474.
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http://dx.doi.org/10.3389/fphar.2018.00181DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850123PMC
March 2018

Changes in plasma levels of nitric oxide metabolites and negative symptoms after 16-week minocycline treatment in patients with schizophrenia.

Schizophr Res 2018 09 9;199:390-394. Epub 2018 Mar 9.

Psychotic Disorders Program, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA, United States. Electronic address:

Objective: This study examined the effect of adjunctive minocycline on psychopathology and possibly relevant biomarkers in patients with schizophrenia.

Method: In a 16-week randomized, double-blind, placebo-controlled study, subjects received either minocycline (200mg per day) or placebo. Psychopathology was assessed using the Scale for the Assessment of Negative Symptoms (SANS) and the Positive and Negative Syndrome Scale (PANSS) at baseline and week 16. Plasma levels of tumor necrosis factor α (TNFα), interleukin-1 β (IL-1β) and nitric oxide metabolites were assessed at both time points.

Results: Fifty-five patients completed the study (27 in the minocycline group, 28 in the placebo group). The minocycline group had significant decreases in the SANS total sore, the PANSS total score and the PANSS negative symptoms score at week 16 compared to the placebo group. In addition, the minocycline group had a significant decrease in plasma levels of nitric oxide metabolites, but no significant difference in changes in plasma levels of IL-1β or TNF-α, compared to the placebo group at week 16. Further, the more decrease in plasma levels of nitric oxide metabolites was associated with less improvement in negative symptoms.

Conclusion: The beneficial effect of adjunctive minocycline treatment on negative symptoms might be through mechanisms other than the nitric oxide pathway. The implications for future studies were discussed.
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http://dx.doi.org/10.1016/j.schres.2018.03.003DOI Listing
September 2018

Association of Hippocampal Atrophy With Duration of Untreated Psychosis and Molecular Biomarkers During Initial Antipsychotic Treatment of First-Episode Psychosis.

JAMA Psychiatry 2018 04;75(4):370-378

Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Importance: Duration of untreated psychosis (DUP) has been associated with poor outcomes in schizophrenia, but the mechanism responsible for this association is not known.

Objectives: To determine whether hippocampal volume loss occurs during the initial 8 weeks of antipsychotic treatment and whether it is associated with DUP, and to examine molecular biomarkers in association with hippocampal volume loss and DUP.

Design, Setting, And Participants: A naturalistic longitudinal study with matched healthy controls was conducted at Shanghai Mental Health Center. Between March 5, 2013, and October 8, 2014, 71 medication-naive individuals with nonaffective first-episode psychosis (FEP) and 73 age- and sex-matched healthy controls were recruited. After approximately 8 weeks, 31 participants with FEP and 32 controls were reassessed.

Exposures: The participants with FEP were treated according to standard clinical practice with second-generation antipsychotics.

Main Outcomes And Measures: Hippocampal volumetric integrity (HVI) (an automated estimate of the parenchymal fraction in a standardized hippocampal volume of interest), DUP, 13 peripheral molecular biomarkers, and 14 single-nucleotide polymorphisms from 12 candidate genes were determined.

Results: The full sample consisted of 71 individuals with FEP (39 women and 32 men; mean [SD] age, 25.2 [7.7] years) and 73 healthy controls (40 women and 33 men; mean [SD] age, 23.9 [6.4] years). Baseline median left HVI was lower in the FEP group (n = 57) compared with the controls (n = 54) (0.9275 vs 0.9512; difference in point estimate, -0.020 [95% CI, -0.029 to -0.010]; P = .001). During approximately 8 weeks of antipsychotic treatment, left HVI decreased in 24 participants with FEP at a median annualized rate of -.03791 (-4.1% annualized change from baseline) compared with an increase of 0.00115 (0.13% annualized change from baseline) in 31 controls (difference in point estimate, -0.0424 [95% CI, -0.0707 to -0.0164]; P = .001). The change in left HVI was inversely associated with DUP (r = -0.61; P = .002). Similar results were found for right HVI, although the association between change in right HVI and DUP did not achieve statistical significance (r = -0.35; P = .10). Exploratory analyses restricted to the left HVI revealed an association between left HVI and markers of inflammation, oxidative stress, brain-derived neurotrophic factor, glial injury, and markers reflecting dopaminergic and glutamatergic transmission.

Conclusions And Relevance: An association between longer DUP and accelerated hippocampal atrophy during initial treatment suggests that psychosis may have persistent, possibly deleterious, effects on brain structure. Additional studies are needed to replicate these exploratory findings of molecular mechanisms by which untreated psychosis may affect hippocampal volume and to determine whether these effects account for the known association between longer DUP and poor outcome.
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http://dx.doi.org/10.1001/jamapsychiatry.2017.4595DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875378PMC
April 2018

No Effect of Adjunctive Minocycline Treatment on Body Metabolism in Patients With Schizophrenia.

J Clin Psychopharmacol 2018 Apr;38(2):125-128

Purpose/background: This study examined the effect of adjunctive minocycline on body metabolism in risperidone-treated patients with schizophrenia.

Methods/procedures: Each subject had a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of schizophrenia and had been on stable dose of risperidone for at least 4 weeks. In a 16-week randomized, double-blind, placebo-controlled study, subjects received either minocycline (200 mg/d) or placebo. Various metabolic parameters, including weight, waist circumference, fasting insulin, glucose, and lipids, were measured at baseline and week 16.

Findings/results: A total of 63 subjects with schizophrenia were enrolled in the study. Fifty-five patients completed week-16 assessments (27 in the minocycline group, 28 in the placebo group). There were no significant differences between the 2 groups in week 16 changes for body weight, body mass index, waist circumference, fasting insulin, glucose, and lipids (P's > 0.300).

Implications/conclusions: In the present study, adjunctive treatment of minocycline did not seem to improve body metabolism in patients with schizophrenia receiving risperidone. The implications for future studies were discussed.
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http://dx.doi.org/10.1097/JCP.0000000000000841DOI Listing
April 2018

Salsalate as an adjunctive treatment for psychopathology and cognition in patients with schizophrenia: a pilot study.

Int Clin Psychopharmacol 2018 03;33(2):88-91

Psychotic Disorders Program, UMass Memorial Medical Center.

This pilot study examined the effect of adjunctive salsalate on psychopathology and cognition in patients with schizophrenia. This was a 12-week, open-label trial of salsalate (1.5 g, twice per day) in patients with schizophrenia. Psychopathology, cognition, and daily function were assessed at baseline and week 12 using various rating scales. Blood levels of inflammatory markers including white blood cell count, high-sensitivity C-reactive protein, and interleukin-6 levels were also measured. Eight patients completed the study. There was no significant change in any of the rating scales at week 12. However, there was a trend decrease in the Positive and Negative Syndrome Scale total score, and a trend improvement in the Brief University of California San Diego Performance-based Skills Assessment total score (58.3±11.4 vs. 53.5±11.9, P=0.072; 69.7±18.2 vs. 79.1±15.9, P=0.084, respectively). There was a trend improvement in quality of life as measured by the Quality of Life Scale total score (74.0±20.8 vs. 76.9±22.7, P=0.080). There was a significant decrease in white blood cell count (6.8±1.3 vs. 6.0±1.2 k/mm, P=0.022). There was no change in the levels of high-sensitivity C-reactive protein or interleukin-6 over 12 weeks (P's>0.1). Salsalate may have positive therapeutic effect in patients with schizophrenia. Future studies to examine potential benefits of salsalate as an adjunctive treatment to improve clinical symptoms and daily function in patients with schizophrenia are warranted.
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http://dx.doi.org/10.1097/YIC.0000000000000204DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794614PMC
March 2018

Gray matter volume showed dynamic alterations in methamphetamine users at 6 and 12months abstinence: A longitudinal voxel-based morphometry study.

Prog Neuropsychopharmacol Biol Psychiatry 2018 Feb 5;81:350-355. Epub 2017 Sep 5.

Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China. Electronic address:

Background: Previous studies have demonstrated brain gray matter reduction in methamphetamine (MA) users; however, little is known about longitudinal brain structural alternations during abstinence.

Method: Brain volumes were compared among 30 MA-dependent patients (average 6.3years of drug use) at 6months' abstinence and 27 drug-naïve controls by voxel-based morphometry. A longitudinal analysis of MA subjects was performed from 6 to 12months' abstinence, and multiple regression analyses were performed between drug use patterns and gray matter volumes (GMV) at 6months' abstinence.

Results: Compared with drug-naïve subjects, subjects with 6months' abstinent of MA showed significantly lower GMV in the precentral gyrus, caudate head, fusiform gyrus, and cerebellum. Compared to 6months' abstinence, GMV was greater in the cerebellum and lower in the cingulate gyrus at 12months' abstinence. Accumulated years of MA use negatively correlated with GMV in the right superior frontal gyrus, the right superior temporal cortex, and the right caudate nucleus (significant at the whole brain level, p<0.001; FWE cluster-corrected p<0.05).

Conclusion: The present study suggested that heavy MA users' GMV could show dynamic alterations in different brain regions at different time lengths of abstinence.
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http://dx.doi.org/10.1016/j.pnpbp.2017.09.004DOI Listing
February 2018

The Clinical Value, Principle, and Basic Practical Technique of Mindfulness Intervention.

Shanghai Arch Psychiatry 2016 Jun;28(3):121-130

UMass Memorial Medical Center/ UMass Medical School, Worcester, MA, USA.

Mindfulness intervention is a psychotherapy based on the Buddhist practice of meditation, combining the theories and methodology of contemporary psychology. The empirical research in recent years has indicated that mindfulness intervention yields favorable results including reduction of depression relapse, alleviation of the symptoms of depression and anxiety, reduction of substance abuse, relief of pain, blood pressure management, enhancement of immunity, and improvement of sleep. Currently, mindfulness therapy has become the mainstream of psychotherapy in the realm of European and American psychotherapy. The fields of psychology and psychotherapy in China have also begun to introduce mindfulness intervention in recent years. However, there is a lack of relevant practice and research in the field of clinical mental health. This article will briefly introduce the concept of mindfulness, the basic mechanism of the intervention, and the basic skills and guidelines in clinical practice.
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http://dx.doi.org/10.11919/j.issn.1002-0829.216060DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434297PMC
June 2016

Abnormal regional homogeneity as a potential imaging biomarker for adolescent-onset schizophrenia: A resting-state fMRI study and support vector machine analysis.

Schizophr Res 2018 02 3;192:179-184. Epub 2017 Jun 3.

Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center on Mental Disorders, Changsha, China; National Technology Institute on Mental Disorders, Changsha, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China. Electronic address:

Objective: Structural and functional abnormalities have been reported in the brain of patients with adolescent-onset schizophrenia (AOS). The brain regional functional synchronization in patients with AOS remains unclear.

Methods: We analyzed resting-state functional magnetic resonance scans in 48 drug-naive patients with AOS and 31 healthy controls by using regional homogeneity (ReHo), a measurement that reflects brain local functional connectivity or synchronization and indicates regional integration of information processing. Then, receiver operating characteristic curves and support vector machines were used to evaluate the effect of abnormal regional homogeneity in differentiating patients from controls.

Results: Patients with AOS showed significantly increased ReHo values in the bilateral superior medial prefrontal cortex (MPFC) and significantly decreased ReHo values in the left superior temporal gyrus (STG), right precentral lobule, right inferior parietal lobule (IPL), and left paracentral lobule when compared with controls. A combination of the ReHo values in bilateral superior MPFC, left STG, and right IPL was able to discriminate patients from controls with the sensitivity of 88.24%, specificity of 91.89%, and accuracy of 90.14%.

Conclusion: The brain regional functional synchronization abnormalities exist in drug-naive patients with AOS. A combination of ReHo values in these abnormal regions might serve as potential imaging biomarker to identify patients with AOS.
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http://dx.doi.org/10.1016/j.schres.2017.05.038DOI Listing
February 2018

Antioxidant and anti-inflammatory nutrient status, supplementation, and mechanisms in patients with schizophrenia.

Prog Neuropsychopharmacol Biol Psychiatry 2017 08 9;78:1-11. Epub 2017 May 9.

Department of Psychiatry, UMass Memorial Medical Center/University of Massachusetts Medical School, One Biotech, 365 Plantation Street, Worcester, MA 01605, USA. Electronic address:

Over 50 million people around the world suffer from schizophrenia, a severe mental illness characterized by misinterpretation of reality. Although the exact causes of schizophrenia are still unknown, studies have indicated that inflammation and oxidative stress may play an important role in the etiology of the disease. Pro-inflammatory cytokines are crucial for normal central nervous development and proper functioning of neural networks and neurotransmitters. Patients with schizophrenia tend to have abnormal immune activation resulting in elevated pro-inflammatory cytokine levels, ultimately leading to functional brain impairments. Patients with schizophrenia have also been found to suffer from oxidative stress, a result of an imbalance between the production of free radicals and the ability to detoxify their harmful effects. Furthermore, inflammation and oxidative stress are implicated to be related to the severity of psychotic symptoms. Several nutrients are known to have anti-inflammatory and antioxidant functions through various mechanisms in our body. The present review evaluates studies and literature that address the status and supplementation of omega-3 polyunsaturated fatty acids, vitamin D, B vitamins (B6, folate, B12), vitamin E, and carotenoids in different stages of schizophrenia. The possible anti-inflammatory and antioxidant mechanisms of action of each nutrient are discussed.
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http://dx.doi.org/10.1016/j.pnpbp.2017.05.005DOI Listing
August 2017

Altered resting-state intra- and inter- network functional connectivity in patients with persistent somatoform pain disorder.

PLoS One 2017 28;12(4):e0176494. Epub 2017 Apr 28.

Department of Psychological Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

Patients with persistent somatoform pain disorder (PSPD) usually experience various functional impairments in pain, emotion, and cognition, which cannot be fully explained by a physiological process or a physical disorder. However, it is still not clear for the mechanism underlying the pathogenesis of PSPD. The present study aimed to explore the intra- and inter-network functional connectivity (FC) differences between PSPD patients and healthy controls (HCs). Functional magnetic resonance imaging (fMRI) was performed in 13 PSPD patients and 23 age- and gender-matched HCs. We used independent component analysis on resting-state fMRI data to calculate intra- and inter-network FCs, and we used the two-sample t-test to detect the FC differences between groups. Spearman correlation analysis was employed to evaluate the correlations between FCs and clinical assessments. As compared to HCs, PSPD patients showed decreased coactivations in the right superior temporal gyrus within the anterior default-mode network and the anterior cingulate cortex within the salience network, and increased coactivations in the bilateral supplementary motor areas within the sensorimotor network and both the left posterior cingulate cortex and the medial prefrontal cortex within the anterior default-mode network. In addition, we found that the PSPD patients showed decreased FNCs between sensorimotor network and audio network as well as visual network, between default-mode network and executive control network as well as audio network and between salience network and executive control network as well as right frontoparietal network, and increased FNCs between sensorimotor network and left frontoparietal network, salience network as well as cerebellum network, which were negatively correlated with the clinical assessments in PSPD patients. Our findings suggest that PSPD patients experience large-scale reorganization at the level of the functional networks, which suggests a possible mechanism underlying the pathogenesis of PSPD.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0176494PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5409184PMC
September 2017

Resting-state functional connectivity changes within the default mode network and the salience network after antipsychotic treatment in early-phase schizophrenia.

Neuropsychiatr Dis Treat 2017 7;13:397-406. Epub 2017 Feb 7.

First-Episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine.

Objective: Abnormal resting-state functional connectivity (FC), particularly in the default mode network (DMN) and the salience network (SN), has been reported in schizophrenia, but little is known about the effects of antipsychotics on these networks. The purpose of this study was to examine the effects of atypical antipsychotics on DMN and SN and the relationship between these effects and symptom improvement in patients with schizophrenia.

Methods: This was a prospective study of 33 patients diagnosed with schizophrenia and treated with antipsychotics at Shanghai Mental Health Center. Thirty-three healthy controls matched for age and gender were recruited. All subjects underwent functional magnetic resonance imaging (fMRI). Healthy controls were scanned only once; patients were scanned before and after 6-8 weeks of treatment.

Results: In the DMN, the patients exhibited increased FC after treatment in the right superior temporal gyrus, right medial frontal gyrus, and left superior frontal gyrus and decreased FC in the right posterior cingulate/precuneus (<0.005). In the SN, the patients exhibited decreased FC in the right cerebellum anterior lobe and left insula (<0.005). The FC in the right posterior cingulate/precuneus in the DMN negatively correlated with the difference between the Clinical Global Impression (CGI) score pre/post-treatment (=-0.564, =0.023) and negative trends with the difference in the Positive and Negative Syndrome Scale (PANSS) total score pre/post-treatment (=-0.475, =0.063) and the difference in PANSS-positive symptom scores (=-0.481, =0.060).

Conclusion: These findings suggest that atypical antipsychotics could regulate the FC of certain key brain regions within the DMN in early-phase schizophrenia, which might be related to symptom improvement. However, the effects of atypical antipsychotics on SN are less clear.
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http://dx.doi.org/10.2147/NDT.S123598DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308583PMC
February 2017

Decreased Functional Connectivity of Insular Cortex in Drug Naïve First Episode Schizophrenia: In Relation to Symptom Severity.

PLoS One 2017 20;12(1):e0167242. Epub 2017 Jan 20.

The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Background: This study was to examine the insular cortical functional connectivity in drug naïve patients with first episode schizophrenia and to explore the relationship between the connectivity and the severity of clinical symptoms.

Methods: Thirty-seven drug naïve patients with schizophrenia and 25 healthy controls were enrolled in this study. A seed-based approach was used to analyze the resting-state functional imaging data. Insular cortical connectivity maps were bilaterally extracted for group comparison and validated by voxel-based morphometry (VBM) analysis. Clinical symptoms were measured using the Positive and Negative Syndrome Scale (PANSS).

Results: There were significant reductions in the right insular cortical connectivity with the Heschl's gyrus, anterior cingulate cortex (ACC), and caudate (p's<0.001) in the patient group compared with the healthy control (HC) group. Reduced right insular cortical connectivity with the Heschl's gyrus was further confirmed in the VBM analysis (FDR corrected p<0.05). Within the patient group, there was a significant positive relationship between the right insula-Heschl's connectivity and PANSS general psychopathology scores (r = 0.384, p = 0.019).

Conclusion: Reduced insula-Heschl's functional connectivity is present in drug naïve patients with first episode schizophrenia, which might be related to the manifestation of clinical symptoms.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0167242PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5249106PMC
August 2017

Altered Neural Correlates of Emotion Associated Pain Processing in Persistent Somatoform Pain Disorder: An fMRI Study.

Pain Pract 2016 Nov 19;16(8):969-979. Epub 2016 Sep 19.

Department of Psychiatry, University of Massachusetts Medical School, Massachusetts, USA.

Patients with persistent somatoform pain disorder (PSPD) suffer from long-term pain and emotional conflicts. Recently, accumulating evidence indicated that emotion has a significant role in pain perception of somatoform pain disorder. To further understand the association between emotion and pain-related brain activities, functional activities of patients with PSPD fulfilling ICD-10 criteria and healthy controls were assessed using functional magnetic resonance imaging technology, while participants viewed a series of positive, neutral, or negative pictures with or without pinprick pain stimulation. Results showed that patients with PSPD had altered brain activities in the parietal gyrus, temporal gyrus, posterior cingulate cortex, prefrontal cortex, and parahippocampus in response to pinprick pain stimuli during different emotions compared with the healthy control group. Moreover, patients with PSPD consistently showed hyperactivities in the prefrontal, the fusiform gyrus and the insula in response to negative stimuli under pinprick pain vs. non-pain condition. The current findings provide some insights into the underlying relationship between emotion and pain-related brain activity in patients with PSPD, which is of both theoretical and clinical importance.
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http://dx.doi.org/10.1111/papr.12358DOI Listing
November 2016

Impaired cue identification and intention retrieval underlie prospective memory deficits in patients with first-episode schizophrenia.

Aust N Z J Psychiatry 2017 Mar 11;51(3):270-277. Epub 2016 Jul 11.

1 First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Objective: Schizophrenia is associated with impairment in prospective memory, the ability to remember to carry out an intended action in the future. It has been established that cue identification (detection of the cue event signaling that an intended action should be performed) and intention retrieval (retrieval of an intention from long-term memory following the recognition of a prospective cue) are two important processes underlying prospective memory. The purpose of this study was to examine prospective memory deficit and underlying cognitive processes in patients with first-episode schizophrenia.

Methods: This study examined cue identification and intention retrieval components of event-based prospective memory using a dual-task paradigm in 30 patients with first-episode schizophrenia and 30 healthy controls. All participants were also administered a set of tests assessing working memory and retrospective memory.

Results: Both cue identification and intention retrieval were impaired in patients with first-episode schizophrenia compared with healthy controls ( ps < 0.05), with a large effect size for cue identification (Cohen's d = 0.98) and a medium effect size for intention retrieval (Cohen's d = 0.62). After controlling for working memory and retrospective memory, the difference in cue identification between patients and healthy controls remained significant. However, the difference in intention retrieval between the two groups was no longer significant. In addition, there was a significant inverse relationship between cue identification and negative symptoms ( r = -0.446, p = 0.013) in the patient group.

Conclusion: These findings suggest that both cue identification and intention retrieval in event-based prospective memory are impaired in patients with first-episode schizophrenia. Cue identification and intention retrieval could be potentially used as biomarkers for early detection and treatment prognosis of schizophrenia. In addition, addressing cue identification deficit through cognitive enhancement training may potentially improve negative symptoms as well.
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http://dx.doi.org/10.1177/0004867416640097DOI Listing
March 2017

Abnormal white matter microstructure in drug-naive first episode schizophrenia patients before and after eight weeks of antipsychotic treatment.

Schizophr Res 2016 Apr 3;172(1-3):1-8. Epub 2016 Feb 3.

Shanghai Key Laboratory of Psychotic Disorders (No.13dz2260500), Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, PR China; Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiaotong University, Shanghai, 200030, PR China. Electronic address:

Background: Abnormal white matter integrity has been reported among first episode schizophrenia patients. However, findings on whether it can be reversed by short-term antipsychotic medications are inconsistent.

Method: Diffusion tensor imaging (DTI) was obtained from 55 drug-naive first episode schizophrenia patients and 61 healthy controls, and was repeated among 25 patients and 31 controls after 8 weeks during which patients were medicated with antipsychotics. White matter integrity is measured using fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). These measures showing a group difference by Tract-based spatial statistics (TBSS) at baseline were extracted for longitudinal comparisons.

Results: At baseline, patients exhibited lower FA, higher MD and higher RD versus controls in forceps, left superior longitudinal fasciculus, inferior fronto-occipital fasciculus, left corticospinal tract, left uncinate fasciculus, left anterior thalamic radiation, and bilateral inferior longitudinal fasciculi. FA values of schizophrenia patients correlated with their negative symptoms (r=-0.412, P=0.002), working memory (r=0.377, P=0.005) and visual learning (r=0.281, P=0.038). The longitudinal changes in DTI indices in these tracts did not differ between patients and controls. However, among the patients the longitudinal changes in FA values in left superior longitudinal fasciculus correlated with the change of positive symptoms (r=-0.560, p=0.004), and the change of processing speed (r=0.469, p=0.018).

Conclusions: White matter deficits were validated in the present study by a relatively large sample of medication naïve and first episode schizophrenia patients. They could be associated with negative symptoms and cognitive impairment, whereas improvement in white matter integrity of left superior longitudinal fasciculus correlated with improvement in psychosis and processing speed. Further examination of treatment-related changes in white matter integrity may provide clues to the mechanism of antipsychotic response and provide a biomarker for clinical studies.
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http://dx.doi.org/10.1016/j.schres.2016.01.051DOI Listing
April 2016

Vitamin D in schizophrenia: a clinical review.

Evid Based Ment Health 2016 Feb 14;19(1):6-9. Epub 2016 Jan 14.

Psychotic Disorders Program, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA Henan Province Mental Hospital, The Second Affiliated Hospital/Xinxiang Medical University, Xinxiang, China.

Vitamin D (vitD) is known for its essential role in calcium homeostasis and bone health. VitD is made endogenously in the skin from UVB radiation from sunlight. VitD is now considered as a potent neurosteroid hormone, critical to brain development and normal brain function, and is known for its anti-inflammatory property affecting various aspects of human health. VitD ligand-receptor, a receptor that mediates much of vitD's biological actions, has been found throughout the body including the central nervous system. VitD deficiency is common in patients with severe mental illness such as schizophrenia. Schizophrenia is a debilitating chronic mental illness characterised by positive symptoms, such as hallucinations and delusions, and negative symptoms including flat affect and lack of motivation. Several environmental risk factors for schizophrenia, such as season of birth, latitude and migration, have been linked to vitD deficiency. Recent studies have suggested a potential role of vitD in the development of schizophrenia. For example, neonatal vitD status is associated with the risk of developing schizophrenia in later life obesity, insulin resistance, diabetes, hyperlipidaemia and cardiovascular disease, which are commonly seen in patients with schizophrenia. It has been well established that vitD deficiency is related to these metabolic problems. The biological mechanism is most likely related to vitD's action on the regulation of inflammatory and immunological processes, consequently affecting the manifestation of clinical symptoms and treatment response of schizophrenia. Potential benefits of vitD supplementation to improve schizophrenia symptoms as well as physical health in patients with schizophrenia should be further explored in future studies.
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http://dx.doi.org/10.1136/eb-2015-102117DOI Listing
February 2016

Relationship between serum uric acid level and cardiometabolic risks in nondiabetic patients with schizophrenia.

Int Clin Psychopharmacol 2016 Jan;31(1):51-6

aPsychotic Disorders Program, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA bThe First Affiliated Hospital, Zhengzhou University, Zhengzhou cHenan Province Mental Hospital, the Second Affiliated Hospital, Xinxiang Medical University, Xinxiang, China.

This study examined the relationship between serum levels of uric acid and insulin resistance and metabolic syndrome in nondiabetic patients with schizophrenia. Outpatients diagnosed with schizophrenia or schizoaffective disorder participated in a multicenter, cross-sectional study. Fasting blood samples were obtained to determine serum levels of metabolic measures. A total of 135 patients were recruited for the study. A significant positive relationship was found between serum levels of uric acid and the homeostasis model of assessing insulin resistance (log transformed, r=0.394, P<0.001), and a significant negative relationship was found between serum levels of uric acid and low-density lipoprotein particle size (log transformed, r=-0.306, P=0.001) after controlling for potential confounding variables. Hierarchical multiple regression suggested that serum uric acid level is a significant predictor of insulin resistance (P=0.001) and of low-density lipoprotein particle size (P<0.015). Further, logistic regression showed that serum uric acid levels strongly predicted the condition of metabolic syndrome (odds ratio 0.630, 95% confidence interval 0.463-0.856, P=0.003). This study suggested that uric acid may be a clinically useful biomarker to indicate cardiometabolic risks in nondiabetic patients with schizophrenia.
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http://dx.doi.org/10.1097/YIC.0000000000000107DOI Listing
January 2016

Dysfunctional resting-state connectivities of brain regions with structural deficits in drug-naive first-episode schizophrenia adolescents.

Schizophr Res 2015 Oct 15;168(1-2):353-9. Epub 2015 Aug 15.

Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China. Electronic address:

Objective: Individuals with adolescent-onset schizophrenia (AOS) are a subgroup of patients who present clinical symptoms between 13 and 18years of age. Little is known about neurodevelopmental abnormalities in this patient population. The present study was to examine possible resting-state dysfunctional connectivity of brain regions with altered gray matter volume in AOS.

Methods: Gray matter volume was investigated by voxel-based morphometry (VBM) analysis. Resting-state functional connectivity analysis was used to examine the correlations between regions with structural deficits and the remaining regions.

Results: Thirty-seven first-episode schizophrenia adolescents and 30 healthy controls were enrolled. Compared to the controls, the patients showed significantly decreased gray matter volumes in the right superior temporal gyrus (STG) and middle temporal gyrus (MTG) (ps<0.05). With the right STG as seed, significantly reduced connectivities were found within the frontal-temporal networks in the patient group (ps<0.05). With the right MTG as seed, the patient group showed significantly reduced connectivities in the default-mode networks and visual networks (ps<0.05). Compared to significant correlations in the controls (p=0.02), the patients had no observed correlations between functional connectivity of the right STG and gray matter volume of this region. Significant positive correlations were found between functional connectivity of the right STG with the left middle frontal gyrus and the Positive and Negative Syndrome Scale total scores (p=0.048) after controlling the confounding variables.

Conclusions: These findings show dysfunctional resting-state connectivities of the right STG and MTG with decreased gray matter volume in adolescents with AOS, suggesting that neurodevelopmental abnormalities may be present in AOS.
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http://dx.doi.org/10.1016/j.schres.2015.07.031DOI Listing
October 2015

Hippocampal volume reduction in female but not male recent abstinent methamphetamine users.

Behav Brain Res 2015 Aug 25;289:78-83. Epub 2015 Apr 25.

Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. Electronic address:

Growing evidence suggests abnormalities in brain morphology including hippocampal structure in patients with methamphetamine (MA) dependence. This study was performed to examine hippocampal volume in abstinent MA users, and to further explore its relationship with cognitive function. 30 abstinent MA users (20 males and 10 females) with average 5.52 months of duration of abstinence and 29 healthy controls (19 males and 10 females) age 18-45 years old were recruited for clinical assessment and imaging scan. FreeSurfer was used to segment the hippocampus bilaterally, and hippocampal volumes were extracted for group and gender comparisons. Cognitive function was measured using the CogState Battery Chinese language version (CSB-C). Analysis of covariance (ANCOVA) controlling for education showed a significant group by gender interaction for the right hippocampal relative volume adjusted for total brain size (p = 0.020); there was a significant difference between male controls and female controls (p < 0.001), but such a difference did not exist between male patients and female patients (p = 0.203). No significant correlations were found between hippocampal volume and cognitive measures. There seems to be a gender difference in how MA affects hippocampal volume in abstinent MA users. Hippocampus might be an important treatment target for cognitive improvement and functional recovery in this patient population, especially in females.
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http://dx.doi.org/10.1016/j.bbr.2015.04.033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441589PMC
August 2015

Neural correlates of the preserved inhibition of return in schizophrenia.

PLoS One 2015 13;10(4):e0119521. Epub 2015 Apr 13.

First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Inhibition of return (IOR) is an attentional mechanism that previously has been reported to be either intact or blunted in subjects with schizophrenia (SCZ). In the present study, we explored the neural mechanism of IOR in SCZ by comparing the target-locked N1 and P1 activity evoked by valid-cued trials with that evoked by invalid-cued trials. Twenty-seven schizophrenia patients and nineteen healthy controls participated in a task involving covert orienting of attention with two stimulus onset asynchronies (SOAs: 700 ms and 1200 ms) during which 64-channel EEG data were recorded. Behavioral reaction times (RTs) were longer in response to valid-cued trials than to invalid-cued ones, suggesting an intact IOR in SCZ. However, reduced N1 amplitude elicited by valid-cued trials suggested a stronger inhibition of attention from being oriented to a previously cued location, and therefore a relative inhibition of perceptual processing at that location in SCZ. These results indicate that altered N1 activity is associated with the preservation of IOR in SCZ and could be a sensitive marker to track the IOR effect.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0119521PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395298PMC
April 2016

Decreased cortical thickness in drug naïve first episode schizophrenia: in relation to serum levels of BDNF.

J Psychiatr Res 2015 Jan 19;60:22-8. Epub 2014 Sep 19.

UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address:

This study was to examine cortical thickness in drug naïve, first episode schizophrenia patients, and to explore its relationship with serum levels of brain-derived neurotrophic factor (BDNF). Forty-five drug naive schizophrenia patients and 28 healthy controls were enrolled in the study. Freesurfer was used to parcellate cortical regions, and vertex-wise group analysis was used for whole brain cortical thickness. The clusters for the brain regions that demonstrated group differences were extracted, and the mean values of thickness were calculated. Serum levels of BDNF were measured using enzyme-linked immunosorbent assay (ELISA). After controlling for age and gender, significantly thinner cortical thickness was found in left insula and superior temporal gyrus in the patient group compared with the healthy control group (HC group) (p's < 0.001). Lower serum levels of BDNF were also found in the patient group compared with the HC group (p = 0.001). Correlation analysis showed a significant positive relationship between thickness of left insula and serum levels of BDNF within the HC group (r = 0.396, p = 0.037) but there was no such relationship within the patient group (r = 0.035, p = 0.819). Cortical thinning is present in drug naïve, first episode schizophrenia patients, indicating neurodevelopmental abnormalities at the onset of schizophrenia. Left insula might be an imaging biomarker in detecting the impaired protective role of neurotrophic factor for the brain development in schizophrenia.
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http://dx.doi.org/10.1016/j.jpsychires.2014.09.009DOI Listing
January 2015

Fat-mass and obesity-associated gene polymorphisms and weight gain after risperidone treatment in first episode schizophrenia.

Behav Brain Funct 2014 Oct 2;10(1):35. Epub 2014 Oct 2.

The first Affiliated Hospital/Zhengzhou University, Zhengzhou, China.

Background: Obesity induced by antipsychotics severely increases the risk of many diseases and significantly reduces quality of life. Genome Wide Association Studies has identified fat-mass and obesity-associated (FTO) gene associated with obesity. The relationship between the FTO gene and drug-induced obesity is unclear.

Method: Two hundred and fifty drug naïve, Chinese Han patients with first-episode schizophrenia were enrolled in the study, and genotyped for four single nucleotide polymorphisms (SNPs rs9939609, rs8050136, rs1421085 and rs9930506) by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and direct sequencing. Body weight and body mass index (BMI) were measured at baseline and six months after risperidone treatment.

Results: At baseline, body weight and BMI of TT homozygotes were lower than those of A allele carriers in rs9939609; body weight of AA homozygotes was higher than those of G allele carriers in rs9930506 (p's < 0.05). After 6 months of risperidone treatment, body weight and BMI of TT homozygotes were lower than those of A allele carriers in rs9939609 (p's <0.01); body weight and BMI of CC homozygotes were lower than those of A allele carriers in rs8050136 (p's < 0.05); body weight of AA homozygotes was higher than those of G allele carriers in rs9930506 (p's < 0.05). After controlling for age, gender, age of illness onset, disease duration, weight at baseline and education, weight gain of TT homozygotes at 6 months remained to be lower than those of A allele carriers in rs9939609 (p < 0.01); weight gain of CC homozygotes at 6 months was lower than those of A allele carriers in rs8050136 (p = 0.01). Stepwise multiple regression analysis suggested that, among 4 SNPs, rs9939609 was the strongest predictor of weight gain after 6 months of risperidone treatment (p = 0.001).

Conclusions: The FTO gene polymorphisms, especially rs9939609, seem to be related to weight gain after risperidone treatment in Chinese Han patients with first episode schizophrenia.
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http://dx.doi.org/10.1186/1744-9081-10-35DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4282200PMC
October 2014

A randomized placebo-controlled pilot study of pravastatin as an adjunctive therapy in schizophrenia patients: effect on inflammation, psychopathology, cognition and lipid metabolism.

Schizophr Res 2014 Nov 26;159(2-3):395-403. Epub 2014 Sep 26.

Schizophrenia Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, 25 Staniford Street, Boston, MA 02114, United States. Electronic address:

Objective: The aim of this study was to investigate the role of pravastatin, as an adjunctive therapy, on inflammatory markers, lipid and glucose metabolism, psychopathology, and cognition in subjects with schizophrenia and schizoaffective disorder.

Methods: Schizophrenia or schizoaffective subjects (N=60) were randomized to receive either a 12-week supply of pravastatin 40 mg/day or placebo treatment. Anthropometric measures, lipids and glucose metabolism, inflammatory markers, psychopathology and cognitive performance were assessed at baseline, 6 weeks and 12 weeks.

Results: Pravastatin use was associated with a significant decrease in total cholesterol, low density lipoprotein (LDL) cholesterol and LDL particle number levels, but was not associated with any significant changes in cognition or psychopathology in the participants, except a significant decrease in the Positive and Negative Syndrome Scale (PANSS) positive symptom score from baseline to week 6. However, this decrease failed to remain significant at 12 weeks. Interestingly, triglycerides, LDL-cholesterol, total cholesterol, LDL particle number, small LDL particle number, large very low density lipoprotein (VLDL) particle number and C-reactive protein (CRP) followed a similar pattern at 6 and 12 weeks as psychopathology.

Conclusions: These results suggest that a randomized trial with a larger sample size and a higher dosage of pravastatin would be helpful in further evaluating the anti-inflammatory properties of pravastatin, its association with improvements in cognitive symptoms, and its potential to reduce positive and negative symptoms associated with schizophrenia or schizoaffective disorders.
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http://dx.doi.org/10.1016/j.schres.2014.08.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311769PMC
November 2014

Schizophrenia and the gut-brain axis.

Prog Neuropsychopharmacol Biol Psychiatry 2015 Jan 19;56:155-60. Epub 2014 Sep 19.

University of Massachusetts Medical School, Worcester, MA, United States.

Several risk factors for the development of schizophrenia can be linked through a common pathway in the intestinal tract. It is now increasingly recognized that bidirectional communication exists between the brain and the gut that uses neural, hormonal, and immunological routes. An increased incidence of gastrointestinal (GI) barrier dysfunction, food antigen sensitivity, inflammation, and the metabolic syndrome is seen in schizophrenia. These findings may be influenced by the composition of the gut microbiota. A significant subgroup of patients may benefit from the initiation of a gluten and casein-free diet. Antimicrobials and probiotics have therapeutic potential for reducing the metabolic dysfunction and immune dysregulation seen in patients with schizophrenia.
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http://dx.doi.org/10.1016/j.pnpbp.2014.08.018DOI Listing
January 2015

Decreased gray matter volume in the left middle temporal gyrus as a candidate biomarker for schizophrenia: a study of drug naive, first-episode schizophrenia patients and unaffected siblings.

Schizophr Res 2014 Oct 23;159(1):43-50. Epub 2014 Aug 23.

Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan 410011, China; The Second Affiliated Hospital of Xinxiang Medical University, Henan Province Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, Henan 453002, China. Electronic address:

Background: Studies have shown that patients with schizophrenia and their siblings share decreased gray matter (GM) volumes in certain brain regions, which may represent candidate endophenotypes of schizophrenia. However, the specificity and utility of these possible endophenotypes in relation to schizophrenia remain unclear.

Methods: Twenty drug-naive, first-episode schizophrenia patients and 20 first-degree unaffected siblings from the same families as the patients (USS group), a separate group of 25 first-degree unaffected siblings of schizophrenia patients from other families (USO group), and 43 healthy controls were recruited. Voxel-based morphometry (VBM) was used to analyze structural imaging data.

Results: The VBM analysis showed a significant difference in GM volume between the combined sibling group and the control group in the left middle temporal gyrus (MTG). Group comparison showed that the patients, the USS, and the USO had significantly decreased GM volume of the left MTG compared with the controls; such a difference did not exist among the patients and the two sibling groups. A receiver operating characteristic curve (ROC curve) analysis showed good predictive value of the mean cluster volume in the left MTG to distinguish patients, USS, and USO from healthy controls. There were no significant correlations between the mean cluster volume in the left MTG and clinical variables in the patients.

Conclusions: The GM volume decrease of the left MTG may be utilized as a candidate biomarker for schizophrenia. The novel design of including a USO group in our study enhances both the specificity and the heritability of the biomarker identified.
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http://dx.doi.org/10.1016/j.schres.2014.07.051DOI Listing
October 2014

Serum levels of BDNF, folate and homocysteine: in relation to hippocampal volume and psychopathology in drug naïve, first episode schizophrenia.

Schizophr Res 2014 Oct 12;159(1):51-5. Epub 2014 Aug 12.

Henan Province Biological Psychiatry Key Laboratory, Xinxiang Medical University, Xinxiang, China; Henan Province Mental Hospital, The Second Affiliated Hospital/Xinxiang Medical University, Xinxiang, China. Electronic address:

Objective: The present study was to examine serum levels of brain-derived neurotrophic factor (BDNF), folate, homocysteine (Hcy), and their relationships with hippocampal volume and psychopathology in drug naïve, first episode schizophrenia.

Method: Drug naïve, first episode schizophrenia patients and healthy controls were enrolled in the study. Serum levels of BDNF, folate and Hcy were measured using enzyme-linked immunosorbent assay (ELISA), electrochemiluminescence immunoassay (ECLIA), and enzymatic cycling method respectively. Hippocampus was parcellated and bilateral hippocampal volumes were measured using FreeSurfer.

Results: Forty-six patients with drug naïve, first episode schizophrenia (SZ group) and 30 healthy controls (control group) were enrolled. The SZ group had significantly lower serum levels of BDNF and folate, and significantly higher serum levels of Hcy compared with the control group (p=0.013, p<0.001, p=0.003 respectively). There were no significant differences in hippocampal volumes between the two groups (ps>0.2). Within the SZ group, there were significant positive relationships between serum levels of BDNF and both left and right hippocampal volumes (r=0.327, p=0.026; r=0.338, p=0.022 respectively). In contrast, such relationships did not exist in the control group. Within the SZ group, there were significant negative relationships between serum levels of folate and PANSS-total scores and PANSS-negative symptom scores (r=0.319, p=0.031; r=0.321, p=0.030 respectively); and there was a positive relationship between serum levels of Hcy and PANSS-total scores (r=0.312, p=0.035). Controlling for potential confounding variables resulted in similar findings.

Conclusions: Drug naïve, first episode schizophrenia presents decreased serum levels of BDNF, folate and increased serum levels of Hcy, which may play an important role in the neurodevelopmental process and clinical manifestation of schizophrenia.
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http://dx.doi.org/10.1016/j.schres.2014.07.033DOI Listing
October 2014

Phenotypic characteristics in metabolically healthy but obese patients with schizophrenia.

Psychiatry Res 2014 Dec 16;220(1-2):71-5. Epub 2014 Jul 16.

Psychotic Disorders Program, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address:

The purpose of this study was to characterize phenotypic characteristics of metabolically healthy but obese individuals with schizophrenia. Participants were non-diabetic outpatients 19 to 75 years old diagnosed with schizophrenia or schizoaffective disorder. Obese patients (body mass index (BMI)>30 kg/m(2)) were included in the present analysis. Patients were further defined as metabolically healthy but obese or obese individuals with metabolic abnormalities based on a cut-off value of 2.5 using the homeostasis model assessment of insulin resistance (HOMA-IR). Fasting blood samples were collected to determine levels of various metabolic parameters. Lipoprotein subclass concentrations and sizes were analyzed using nuclear magnetic resonance (NMR) spectroscopy. Fourteen metabolically healthy but obese patients and 62 obese patients with metabolic abnormalities were identified from 206 patients with schizophrenia. After controlling for age, there were no significant differences between the two groups on anthropometric measures. However, the metabolically healthy but obese group had significantly lower levels of large VLDL particle, significantly higher levels of intermediate VLDL particle, and significantly smaller mean particle size in VLDL compared with the obese group with metabolic abnormalities (metabolically obese). A metabolically healthy but obese phenotype characterized by high levels of intermediate VLDL particle and low levels of large VLDL particle exists in obese, non-diabetic patients with schizophrenia.
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http://dx.doi.org/10.1016/j.psychres.2014.07.015DOI Listing
December 2014

What can the medical education do for eliminating stigma and discrimination associated with mental illness among future doctors? effect of clerkship training on chinese students' attitudes.

Int J Psychiatry Med 2014 ;47(3):241-54

Institute of Mental Health, the Second Xiangya Hospital, Central South University, Changsha, China.

Objective: The study was to examine the changes in attitudes towards psychiatry and mental illness among Chinese medical students during their psychiatry clerkship training.

Methods: The Attitudes Towards Mental Illness (AMI) and the Attitudes Towards Psychiatry-30 (ATP-30) questionnaires were administered to 325 fourth-year Chinese medical students before and after they completed an 8-week psychiatry clerkship training.

Results: After the clerkship training, there was a significant improvement in attitudes towards psychiatry and mental health as reflected by the total scores on ATP-30 (103.4 ± 8.6 versus 111.8 ± 9.6, p < 0.001) and AMI (58.9 ± 6.3 versus 64.1 ± 6.6, p < 0.001). The proportions of students who showed positive attitudes to psychiatry and mental illness were significantly increased on most of the items on ATP-30 and AMI after rotation (p's = 0.027). Although there was a significant change after training, the percentage of the students who would consider psychiatry as their future medical specialty was still on a low level (6.5% versus 11.4%, before versus after rotation, p = 0.028).

Conclusions: The results of our study suggested that psychiatry clerkship training may improve medical students' attitudes towards psychiatry and mental illness, but its influence on medical students' consideration to choose psychiatry as a future medical career is limited. The students who did not consider psychiatry as a future career held less positive attitudes to psychiatrists, psychiatric patients and the treatment.
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http://dx.doi.org/10.2190/PM.47.3.eDOI Listing
October 2014

Prolactin serum levels correlate with inflammatory status in drug-naïve first-episode schizophrenia.

World J Biol Psychiatry 2014 Sep 24;15(7):546-52. Epub 2014 Jun 24.

The First Affiliated Hospital/Zhengzhou University , Zhengzhou , China.

Objectives: The present study was to examine the relationship between serum levels of prolactin and the inflammatory status in drug-naïve, first-episode schizophrenia patients with normal weight.

Methods: Patients with normal weight, drug-naïve, first-episode schizophrenia and healthy controls were enrolled in the study. Serum levels of prolactin (PRL) were measured using electrical chemiluminescence immunoassay. Serum levels of interleukin-1β (IL-1β), tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were examined using enzyme-linked immunosorbent assay (ELISA).

Results: Sixty patients with normal weight, drug-naïve, first-episode schizophrenia and 60 healthy controls were enrolled. The schizophrenia group had higher serum levels of PRL, IL-1β, IL-6 and TNF-α compared with the control group. There was a gender difference of hyperprolactinemia in schizophrenia group. There were positive relationships between serum levels of PRL and serum levels of IL-1β, IL-6 and TNF-α within the schizophrenia group. Within the schizophrenia group, TNF-α was the strongest predictor among the three cytokines for serum levels of prolactin after controlling for gender, age, education, smoking status and disease duration.

Conclusions: Patients with normal weight, drug-naïve, first-episode schizophrenia present elevated serum levels of PRL, which might be related to the up-regulated inflammatory status in this patient population.
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http://dx.doi.org/10.3109/15622975.2014.922699DOI Listing
September 2014