Schizophrenia and Bartonella spp. Infection: A Pilot Case-Control Study.

Recently, infections with emerging zoonotic bacteria of the genus Bartonella have been reported in association with a range of central nervous system (CNS) symptoms. Currently, it remains unknown if Bartonella spp. infection is associated with symptoms of schizophrenia/schizoaffective disorder (SCZ/SAD). The objective of this study was to determine if there is an association between Bartonella species infection and SCZ/SAD. A secondary objective was to determine if SCZ/SAD symptoms were more severe among participants with documented Bartonella spp. infection. Using a case-control study design, 17 cases and 13 controls were evaluated with a series of clinical and cognitive assessments. Blood samples were collected and tested for Bartonella spp. infection using serological, microbiological, and molecular techniques. People with SCZ/SAD were more likely than healthy volunteers to have Bartonella spp. DNA in their bloodstream, with 11 of 17 cases (65%) positive by Bartonella spp. droplet digital PCR (ddPCR). In comparison, only one healthy volunteer was Bartonella spp. ddPCR positive (8%, p = 0.0024). Based on serology, Bartonella spp. exposure was common among people with SCZ/SAD (12 of 17) as well as among healthy volunteers (12 of 13), with no significant difference between the groups (p = 0.196). Within the case group of people with SCZ/SAD, there was no significant difference in SCZ/SAD severity scores between people with and without ddPCR evidence of Bartonella spp. infection. This pilot study provides preliminary evidence in support of future investigations that should examine a potential contribution of Bartonella spp. infection to SCZ/SAD.

Predictors of social functioning in patients with higher and lower levels of reduced emotional experience: Social cognition, social competence, and symptom severity.

BACKGROUND: Deficits in social functioning in schizophrenia are primarily predicted by negative symptoms, social cognition deficits, and social skills deficits. Here we examine those predictive variables across variations in the severity of reduced emotional experience. We hypothesized that in patients with high symptom severity, factors such as social cognition would have reduced importance for predicting social outcomes. METHODS: Participants with schizophrenia (n = 312) were tested using five different measures of social cognition. Performance-based assessments and clinical ratings of reduced emotion experience were used to assess social competence. High contact informants rated interpersonal functioning and social acceptability of behavior, while unaware of other patient data. Patients were divided into higher and lower reduced emotional experience using previously validated criteria. RESULTS: 33% of the patients had at least moderate symptoms of reduced emotional experience. Patients with greater severity had more social functioning impairment, but not poorer social competence and social cognition. In the patients with lower severity, social cognition accounted for 9% of the variance in interpersonal functioning, while in patients with higher severity, social cognition did not predict any variance. In the patients with lower severity, social cognition accounted for 4% of the variance in social acceptability of behavior, while in patients with higher severity, social cognition also did not predict any variance. IMPLICATIONS: The influence of social cognition on social outcomes appears greater in patients with less severe symptoms of reduced emotional experience. As there are treatments for both these symptoms and social cognition with demonstrated efficacy, these data suggest differential application of these interventions based on symptom severity.

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

Objective: 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. Methods: 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. Results: There was no significant difference between two groups in changes in weight, BMI, fasting lipids, or cigarette smoking measures (p's > 0.05) Conclusion: 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.