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Childhood trauma influences the clinical features of schizophrenia. In this study, we examined how childhood trauma and perceived stress are associated with clinical manifestations and subcortical gray matter volumes (GMVs) in patients with schizophrenia.
We recruited 127 patients with schizophrenia and 83 healthy controls for assessment of early childhood trauma, perceived stress, and clinical symptoms. With structural brain imaging, we identified the GMVs of subcortical structures and examined the relationships between childhood trauma, perceived stress, clinical symptoms, and subcortical GMVs.
Compared to controls, patients with schizophrenia showed higher levels of childhood trauma and perceived stress. Patients with schizophrenia showed significantly smaller amygdala and hippocampus GMVs as well as total cortical GMVs than age-matched controls. Childhood trauma score was significantly correlated with the severity of clinical symptoms, depression, perceived stress, and amygdala GMVs. Perceived stress was significantly correlated with clinical symptoms, depression, and hippocampus and amygdala GMVs. Further, the association between childhood trauma (emotional neglect) and stress coping ability was mediated by right amygdala GMV in patients with schizophrenia.
Patients with schizophrenia had more exposure to early-life trauma and poorer stress coping. Both childhood trauma and perceived stress were associated with smaller amygdala volumes. The relationship between early-life trauma and perceived stress was mediated by right amygdala GMV in patients with schizophrenia. These findings together suggest the long-term effects of childhood trauma on perceived stress and the subcortical volumetric correlates of the effects in schizophrenia.
Understanding the patterns of treatment response is critical for the treatment of patients with schizophrenia; one way to achieve this is through using a longitudinal dynamic process study design.
This study aims to explore the response trajectory of antipsychotics and compare the treatment responses of seven different antipsychotics over 6 weeks in patients with schizoprenia (trial registration: Chinese Clinical Trials Registry Identifier: ChiCTR-TRC-10000934).
Data were collected from a multicentre, randomised open-label clinical trial. Patients were evaluated with the Positive and Negative Syndrome Scale (PANSS) at baseline and follow-up at weeks 2, 4 and 6. Trajectory groups were classified by the method of k-means cluster modelling for longitudinal data. Trajectory analyses were also employed for the seven antipsychotic groups.
The early treatment response trajectories were classified into a high-trajectory group of better responders and a low-trajectory group of worse responders. The results of trajectory analysis showed differences compared with the classification method characterised by a 50% reduction in PANSS scores at week 6. A total of 349 patients were inconsistently grouped by the two methods, with a significant difference in the composition ratio of treatment response groups using these two methods (χ2 = 43.37, P < 0.001). There was no differential contribution of high- and low trajectories to different drugs (χ2 = 12.52, P = 0.051); olanzapine and risperidone, which had a larger proportion in the >50% reduction at week 6, performed better than aripiprazole, quetiapine, ziprasidone and perphenazine.
The trajectory analysis of treatment response to schizophrenia revealed two distinct trajectories. Comparing the treatment responses to different antipsychotics through longitudinal analysis may offer a new perspective for evaluating antipsychotics.
Computerized cognitive remediation therapy (CCRT) is generally effective for the cognitive deficits of schizophrenia. However, there is much uncertainty about what factors mediate or moderate effectiveness and are therefore important to personalize treatment and boost its effects.
In total, 311 Chinese inpatients with Diagnostic and Statistical Manual of Mental Disorders-IV schizophrenia were randomized to receive CCRT or Active control for 12 weeks with four to five sessions per week. All participants were assessed at baseline, post-treatment and 3-month follow-up. The outcomes were cognition, clinical symptoms and functional outcomes.
There was a significant benefit in the MATRICS Consensus Cognitive Battery (MCCB) total score for CCRT (F1,258 = 5.62; p = 0.02; effect size was 0.27, 95% confidence interval 0.04–0.49). There were no specific moderators of CCRT improvements. However, across both groups, Wisconsin Card Sort Test improvement mediated a positive effect on functional capacity and Digit Span benefit mediated decreases in positive symptoms. In exploratory analyses younger and older participants showed cognitive improvements but on different tests (younger on Symbol Coding Test, while older on the Spatial Span Test). Only the older age group showed MSCEIT benefits at post-treatment. In addition, cognition at baseline negatively correlated with cognitive improvement and those whose MCCB baseline total score was around 31 seem to derive the most benefit.
CCRT can improve the cognitive function of patients with schizophrenia. Changes in cognitive outcomes also contributed to improvements in functional outcomes either directly or solely in the context of CCRT. Age and the basic cognitive level of the participants seem to affect the cognitive benefits from CCRT.
Whether there are distinct subtypes of schizophrenia is an important issue to advance understanding and treatment of schizophrenia.
To understand and treat individuals with schizophrenia, the aim was to advance understanding of differences between individuals, whether there are discrete subtypes, and how fist-episode patients (FEP) may differ from multiple episode patients (MEP).
These issues were analysed in 687 FEP and 1880 MEP with schizophrenia using the Positive and Negative Syndrome Scale for (PANSS) schizophrenia before and after antipsychotic medication for 6 weeks.
The seven Negative Symptoms were correlated with each other and with P2 (conceptual disorganisation), G13 (disturbance of volition), and G7 (motor retardation). The main difference between individuals was in the cluster of seven negative symptoms, which had a continuous unimodal distribution. Medication decreased the PANSS scores for all the symptoms, which were similar in the FEP and MEP groups.
The negative symptoms are a major source of individual differences, and there are potential implications for treatment.
This paper examines the dispersal–germination strategy of seeds of 66 native tree species from a seasonal evergreen monsoon rainforest on Hainan Island, China, and assesses correlations among seed germination and phylogeny, dispersal mode and dispersal season. Seeds of 15, 7, 25 and 19 species were dispersed during the warm dry (March–May), rainy (June–September), late rainy (October–November) and cool dry (December–February) seasons, respectively. Berries (16 species), drupes (14 species) and capsules (12 species) were common and represented about 64% of the species. Zoochory was the most common dispersal mode (69.7%) followed by anemochory (16.7%) and autochory (13.6%). More than 65% of species had dormant seeds. Based on germination speed and synchrony, six patterns were recognized: rapid and synchronous germination (13 species), intermediate and synchronous germination (3 species), intermediate and intermediately synchronous germination (24 species), intermediate and asynchronous germination (2 species), slow and intermediately synchronous germination (5 species), and slow and asynchronous germination (19 species). One-way ANOVAs revealed that the variance in germination percentages among species was largely dependent upon phylogeny. The mean and median length of germination (MLG) were largely dependent upon phylogeny, dispersal mode and dispersal season. Anemochorous seeds germinated faster than autochorous and zoochorous seeds. Seeds dispersed in the late dry or early rainy season (March–May) tended to germinate quickly, whereas those dispersed towards the end of the rainy season and into the cool dry season are likely to have a much longer length of dormancy. Correlation analyses indicated that larger seeds germinated faster and had higher germination percentages.
We performed a pot experiment in which 540 seedlings of nine non-pioneer light-demanding tree species were grown for 12 months in shade houses at three light levels, 46% daylight, 13% daylight and 2% daylight, to examine the mechanisms contributing to the coexistence of seedlings of non-pioneer light-demanding tree species in secondary successional tropical rain forest in Hainan, China. Growth and survival of tree seedlings were compared at different light levels, and the morphological and physiological correlates of high-light seedling growth and low-light survival across species were determined. For all species, mortality was very low in the 46% daylight and 13% daylight treatment but increased significantly in the 2% daylight treatment. Seedling survival in 2% daylight treatment was positively related to seed mass. Trade-off between high-light growth and low-light survival was more evident in the relationship with 2% daylight treatment as compared with 13% daylight treatment. Relative growth rate in the 2% daylight treatment was not significantly related to relative growth rate in the 13% daylight or 46% daylight treatment; although a slight negative correlation was apparent. Interspecific variation in RGRm was only closely correlated with net assimilation rate (NAR). The results provide some support for the niche-partitioning hypothesis.
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