Four-Subtest Index-based Short Form of WAIS-IV: Psychometric Properties and Clinical Utility.

Short form of the Wechsler Adult Intelligence Scale is often needed to quickly estimate intelligence for time-saving or screening in clinical practice. The present study aims to examine the psychometric properties of Chinese version of the four-subtest index-based short form (SF4) of WAIS-IV (FS) and to confirm its clinical application. 1,757 adults from the WAIS-IV Chinese version standardization sample and 239 mixed clinical samples including patients with schizophrenia or schizoaffective disorder (SCH), obsessive-compulsive disorder (OCD), and mild or moderate intellectual disability (ID) were used. Demographic data were collected and intelligence was assessed with WAIS-IV. The SF4 split-half reliability, test-retest stability coefficients and corrected SF4-FS correlations were good to excellent. The result of the Bland-Altman plot showed that the difference fell within 2SD was 95% and indicated a random error. The sensitivity, specificity positive predictive value (PPV), and negative predictive value (NPV) of the stepwise screening were good. There was an interaction (p < .001) between the IQ level (≥111) and gender on the accuracy of SF4, SF4 might get underestimated on females with the IQ level (≥111) than on males. In conclusion, SF4 is a valid and reliable instrument for use in the clinic, and its clinical application, stepwise screening and influencing factors in clinical use are discussed herein.

P50 suppression deficits and psychopathology in Han Chinese patients with schizophrenia.

OBJECTIVE: Numerous studies have reported P50 gating deficits in schizophrenia, though with mixed results. Moreover, few studies have explored the association between P50 gating deficits and psychopathology in Chinese patients with schizophrenia. In the present study, we investigated the P50 auditory sensory gating patterns and their correlations with clinical symptoms in a large sample of Han Chinese patients with schizophrenia. METHODS: We assessed P50 sensory gating with a 64-channel electroencephalography system in 133 patients with schizophrenia and 148 healthy controls. The schizophrenia symptomatology was assessed with the Positive and Negative Syndrome Scale (PANSS). RESULTS: Patients with schizophrenia had a significantly higher P50 gating ratio (p<0.001), longer S1 latency (p<0.05), lower S1 amplitude (p<0.01), and lower P50 difference (p<0.001) than did controls. No significant correlations were found between the P50 gating measures and the PANSS total score or subscale scores in patients with schizophrenia. CONCLUSIONS: These findings suggest that the P50 sensory gating deficits identified in Chinese patients with schizophrenia may not be involved in the psychopathology of the illness.

Decreased BDNF in serum of patients with chronic schizophrenia on long-term treatment with antipsychotics.

Accumulating evidence suggests BDNF as a molecule involved in the pathophysiology of schizophrenia. To examine the BDNF levels and the relationship between BDNF levels and psychopathology in patients with schizophrenia, 81 physically healthy patients with schizophrenia were compared with 45 age-, sex- matched normal controls. The psychopathology of patients were assessed by the Positive and Negative Syndrome Scale (PANSS). Serum BDNF levels were measured by sandwich ELISA. The results showed that BDNF-like immunoreactivity were significantly lower in medicated patients with chronic schizophrenia than in healthy control subjects. A significant negative correlation between BDNF-like immunoreactivity and PANSS negative subscore was observed. As compared with normal controls, there was a significant decrease in BDNF-like immunoreactivity in patients treated with both atypical and typical antipsychotics. However, no correlation between standardized drug doses and BDNF-like immunoreactivity was found. These findings suggest that serum BDNF levels in chronic schizophrenia under antipsychotic medication may be decreased. However, long-term effects of antipsychotics remain to be characterized.

[Psychological and physical presentations of severe acute respiratory syndrome].

OBJECTIVE: To study the relation between psychological symptoms and physical parameters in patients with severe acute respiratory syndrome (SARS) at different stages of the disease. METHODS: Physical parameters such as SCL-90, chest CT, T lymphocytes and subset and SaO2 were studied in 29 SARS patients at three different stages (initial stage, serious stage, rehabilitating stage). RESULTS: Patients with SARS showing severe psychological symptoms constituted about 41% (group I) and patients with SARS showing mild psychological symptoms (group II) constituted about 59%. There were no change of the psychological symptoms at the three stages in group I and II (P > 0.05). Statistical differences were found between physical parameters of group I and II in rehabilitating stage. CONCLUSIONS: Severe psychological symptoms such as obsession, depression and anxiety were found in a minority of patients with SARS and the psychological symptoms were not related with the change of physical parameters. The majority of the patients with SARS did not have severe psychological symptoms. Whether or not psychological symptoms were related to their personality needs further study.

Smoking, MATRICS consensus cognitive battery and P50 sensory gating in a Han Chinese population.

BACKGROUND: The effects of smoking on cognitive performance have long been studied, with mixed results. P50 sensory gating has been used as endophenotype for studying nicotinic systems genetics, and P50 gating deficits have been reported to be a sensitive biomarker for cognitive impairment in schizophrenia. This study examined the inter-relationship between P50 suppression, cognitive function, and smoking in a healthy Han Chinese population, which has not been reported before. METHODS: We recruited 82 healthy male subjects, including 48 smokers and 34 non-smokers who were matched for age and education. The authors measured P50 sensory gating and administered the Chinese-language version of the MATRICS consensus cognitive battery (MCCB) and Stroop tests. RESULTS: The results showed that the smokers scored lower than nonsmokers on the MCCB brief visuospatial memory test (BVMT) index and the STROOP test. Furthermore, the MCCB total score was negatively associated with number of cigarettes smoked per day in the smoker group. However, P50 sensory gating was not associated with either smoking status or any cognitive performance. CONCLUSIONS: Our results show that smoking is associated with cognitive impairment, but not with P50 sensory gating.

Impaired prepulse inhibition of acoustic startle in Chinese patients with first-episode, medication-naïve schizophrenia.

BACKGROUND: Patients with schizophrenia have prominent abnormality in information processing that can be observed by measures of prepulse inhibition (PPI) of acoustic startle reflex and PPI deficits have been considered as a candidate endophenotypic marker of schizophrenia. However, there has been little information on PPI and related measures in Chinese patients with schizophrenia. The research was to explore the deficits of acoustic startle reflex that might exist in Chinese patients with schizophrenia. METHODS: Startle response to acoustic stimuli, habituation, and PPI were examined in 31 Chinese patients with first-episode, medication-naïve schizophrenia and 30 age- and sex-matched healthy Chinese controls. At the same day of startle testing, psychopathological symptoms of the patients were assessed with the Positive and Negative Syndrome Scale (PANSS). RESULTS: Compared with healthy controls, patients exhibited the significant reduction in startle response and PPI deficits at 60 milliseconds (ms) intervals (PPI60, P < 0.05) but not at 30 or 120 ms intervals. Furthermore, there was a relatively strong correlation between PPI60 (P < 0.05) and scores of positive scale of PANSS in patients with schizophrenia. CONCLUSION: Our findings confirmed impaired PPI in Chinese patients with schizophrenia and suggested that a relationship between sensorimotor gating deficits and clinical symptoms of patients with schizophrenia might exist.

Ventral medial prefrontal functional connectivity and emotion regulation in chronic schizophrenia: a pilot study.

People with schizophrenia exhibit impaired social cognitive functions, particularly emotion regulation. Abnormal activations of the ventral medial prefrontal cortex (vMPFC) during emotional tasks have been demonstrated in schizophrenia, suggesting its important role in emotion processing in patients. We used the resting-state functional connectivity approach, setting a functionally relevant region, the vMPFC, as a seed region to examine the intrinsic functional interactions and communication between the vMPFC and other brain regions in schizophrenic patients. We found hypo-connectivity between the vMPFC and the medial frontal cortex, right middle temporal lobe (MTL), right hippocampus, parahippocampal cortex (PHC) and amygdala. Further, there was a decreased strength of the negative connectivity (or anticorrelation) between the vMPFC and the bilateral dorsal lateral prefrontal cortex (DLPFC) and pre-supplementary motor areas. Among these connectivity alterations, reduced vMPFC-DLPFC connectivity was positively correlated with positive symptoms on the Positive and Negative Syndrome Scale, while vMPFC-right MTL/PHC/amygdala functional connectivity was positively correlated with the performance of emotional regulation in patients. These findings imply that communication and coordination throughout the brain networks are disrupted in schizophrenia. The emotional correlates of vMPFC connectivity suggest a role of the hypo-connectivity between these regions in the neuropathology of abnormal social cognition in chronic schizophrenia.

Visual scanning of emotional faces in schizophrenia.

This study investigated eye movement differences during facial emotion recognition between 101 patients with chronic schizophrenia and 101 controls. Independent of facial emotion, patients with schizophrenia processed facial information inefficiently; they showed significantly more direct fixations that lasted longer to interest areas (IAs), such as the eyes, nose, mouth, and nasion. The total fixation number, mean fixation duration, and total fixation duration were significantly increased in schizophrenia. Additionally, the number of fixations per second to IAs (IA fixation number/s) was significantly lower in schizophrenia. However, no differences were found between the two groups in the proportion of number of fixations to IAs or total fixation number (IA fixation number %). Interestingly, the negative symptoms of patients with schizophrenia negatively correlated with IA fixation number %. Both groups showed significantly greater attention to positive faces. Compared to controls, patients with schizophrenia exhibited significantly more fixations directed to IAs, a higher total fixation number, and lower IA fixation number/s for negative faces. These results indicate that facial processing efficiency is significantly decreased in schizophrenia, but no difference was observed in processing strategy. Patients with schizophrenia may have special deficits in processing negative faces, and negative symptoms may affect visual scanning parameters.

Dysfunction in different phases of working memory in schizophrenia: evidence from ERP recordings.

The present study combined a time-locked paradigm and high-time-resolution event-related potential (ERP) recordings to examine different phases of working memory, including early visual processing and late memory-related processes of encoding, maintenance, and retrieval, in 67 adults with schizophrenia and 46 healthy controls. Alterations in ERP components were correlated with task performance. Patients performed significantly worse in the working memory task than healthy subjects, although all subjects' accuracy exceeded 80%. During encoding, the N1 and P2 component amplitudes were lower while the P300 amplitude was higher in schizophrenic patients compared to healthy controls. There were no differences between groups with respect to the mean amplitudes of the negative slow waves in the early stage (the first 400 ms) of the maintenance phase. However, in the next 500-ms time window, the patients exhibited a more negative deflection in the middle fronto-central region than the control group. Likewise, a similar pattern was observed in the second 500-ms period in the middle fronto-central region, although the effect was marginally significant. There were no differences between groups in the remaining 1000 ms. During retrieval, the P1, N1 and P2 amplitudes were lower while the P300 amplitude and latency were higher in schizophrenic patients. The present results indicate early visual deficits in the working memory task in adults with schizophrenia. Impairments in the maintenance phase were confined to the late rehearsal stage. The increased P300 amplitude at the fronto-central electrode sites along with the poorer behavioral performance suggests that schizophrenic patients have an inefficient working memory system.

Chinese psychiatrists views on global features of CCMD-III, ICD-10 and DSM-IV.

OBJECTIVE: To survey psychiatrists' opinions about psychiatric classification in China, and provide information and suggestions for developing a new version of classificatory system. METHOD: The questionnaire about psychiatry classification written by Professor Graham Mellsop, New Zealand, was translated and modified into Chinese. An anonymous field survey of 380 psychiatry professionals was undertaken in Beijing. RESULTS: A total of 181 questionnaires were eligible for analysis. The Chinese Classification of Mental Disorders version 3 (CCMD-III) is the most commonly used in China (63.8%), then ICD-10 (28.5%) and DSM-IV (7.7%). Half of the respondents (53.0%) agreed that the most important diagnostic classification is for communication among physicians, and then for communication between physician and patient (21.0%). Most professionals (90.0%) agree that classification should include less than 100 diagnostic options. Disagreement presents on cross-culture application of the ICD-10 and DSM-III: 75.1% professionals agreed that they are "useful and reliable regardless of patient ethnicity and culture", while 46.8% found "sometimes difficult to apply across cultures", and 35.8% thought classification is "over-embedded in European cultural concepts and values". CONCLUSION: There is a strong trend of convergence and unification of China's diagnostic standards with international standards inevitable. A classification that is less complicated and confused, easy-to-communicate and understand and cross-cultural/nation applicable is expected by most Chinese psychiatrists. Such classification should also be reflective of the advances in understanding of aetiology of disorders and helpful in clinical management.

REMOVED: Association between the BDNF C270T polymorphism and negative symptoms of schizophrenia.

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[Psychiatric and central nervous system involvement in Sjogren's syndrome].

OBJECTIVE: To study psychiatric features and the manifestations of central nervous system involvement in Chinese patients with primary Sjogren's syndrome (PSS). METHODS: The Minnesota Multiphasic Personality Inventory (MMPI) was used to study 27 PSS female patients and 57 healthy women. The results from two groups were compared. Ten SS patients were evaluated by electroencephalography (EEG), transcranial doppler ultrasound (TCD) and magnetic resonance imaging (MRI). RESULTS: Of 27 patients tested, the three highest clinical mean scales included Hypochondriasis (Hs), Hysteria (Hy), Psychasthenia (Pt) were found. When PSS group was compared with normal control, T scores of SS patients were significantly higher than the healthy women in Hs, Hy. Abnormal EEG was found in 3 of 9 PSS patients. TCD was abnormal in 5 of 9 patients. MRI in 1 patient showed abnormality. CONCLUSIONS: This study shows that the personality of PSS patients is abnormal, the features are neuroticism. Central nervous system was markedly involved in Chinese patients with PSS, including abnormal EEG and TCD. The changes of central nervous system may be related to abnormalities of psychiatric changes.