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Schizophrenia (SZ) and intellectual disability (ID) are both included in the continuum of neurodevelopmental disorders (NDDs). DNA methylation is known to be important in the occurrence of NDDs. The family study is conducive to eliminate the effects of relative epigenetic backgrounds, and to screen for differentially methylated positions (DMPs) and regions (DMRs) that are truly associated with NDDs. Four monozygotic twin families were recruited, and both twin individuals suffered from NDDs (either SZ, ID, or SZ plus ID). Genome-wide methylation analysis was performed in all samples and each family. DMPs and DMRs between NDD patients and unaffected individuals were identified. Functional and pathway enrichment analyses were performed on the annotated genes. Two significant DMPs annotated to CYP2E1 were found in all samples. In Family One, 1476 DMPs mapped to 880 genes, and 162 DMRs overlapping with 153 unique genes were recognised. Our results suggested that the altered methylation levels of FYN, STAT3, RAC1, and NR4A2 were associated with the development of SZ and ID. Neurodevelopment and the immune system may participate in the occurrence of SZ and ID. Our findings suggested that DNA methylation participated in the development of NDDs by affecting neurodevelopment and the immune system. [ABSTRACT FROM AUTHOR]

Evidence of comparative benefits of long-acting injectable (LAI) antipsychotics in Asian patients with schizophrenia has been inconsistent. This scoping review aimed to synthesize the current evidence in the past ten years and provide an overview of efficacy, safety, treatment adherence, patient attitudes, and healthcare resource utilization of LAI in this population. A systematic search was conducted with a pre-defined search strategy in six electronic databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang, PubMed, Embase, CINAHL, and PsycArticles. A total of 46 studies were included, including 15 cohort studies, 13 single-arm trials, 10 randomized controlled trials, four mirror-image studies, three cross-sectional studies, and one controlled clinical trial. Paliperidone palmitate once-monthly injection (27/46) and risperidone LAI (14/46) were the most frequently investigated LAIs. Compared with oral antipsychotic medications (OAMs), LAIs demonstrated a lower rate of relapse/hospitalization and comparable improvement in efficacy. Adverse events (AEs) were similar between LAIs and OAMs, although types and incidence varied. Significant reduction in the length of hospitalization and number of outpatient visits/inpatient admission was observed after initiation of LAIs. These findings suggest that LAI demonstrated comparable efficacy and safety among Asian populations with schizophrenia in comparison to OAMs. Better adherence and lower relapse were observed in patients receiving LAIs from published evidence. Future research is warranted to better understand the comprehensive performance of LAI in specific population or context.Plain Language Summary: LAI antipsychotic drugs for the maintenance treatment of schizophrenia have been considered the therapy of choice in case of poor adherence to treatment and frequent relapses. Few review studies focused on the benefits of LAI antipsychotics for schizophrenia in the Asian population have been conducted to date. Therefore, we conducted this scoping review to comprehensively summarize the current published evidence in terms of LAI efficacy, safety, treatment adherence, patient attitudes, and healthcare resource utilization in Asia. [ABSTRACT FROM AUTHOR]

Objective: Nonadherence to antipsychotic medication is a major health concern. Identification of risk factors associated with nonadherence is a useful initial step toward designing an effective intervention. This study compared the characteristics of medication-adherent and -nonadherent outpatients with schizophrenia in a Chinese community setting.Methods: In a naturalistic, multicenter, and cross-sectional design, 601 outpatients with schizophrenia served by the National Continuing Management and Intervention Program for Psychoses (the "686 program") were surveyed from June 2013 to January 2014 in four Chinese cities. On the basis of self-reported behavior, the patients were divided into medication-adherent and -nonadherent groups. Logistic regression analyses were performed to identify potential risk factors associated with nonadherence.Results: The analyses included 554 patients, 20% of whom were considered to be nonadherent. Compared with the adherent group, the nonadherent group had a longer period of untreated psychosis (odds ratio [OR]=1.09), lower body mass index (OR=.94), higher rate of rural residency (OR=2.01), and lower monthly household income per capita (OR=.94/100 renminbi) (p<.05 by hierarchical analysis). Other characteristics (age, gender, occupation, education, marital status, living with family, age at initial presentation of symptoms, duration of illness, and type of antipsychotic medication) did not differ significantly between the groups.Conclusions: Medication-adherent and -nonadherent groups differed significantly in some social and treatment characteristics. These findings may be useful in informing the development of strategies for reducing medication nonadherence. [ABSTRACT FROM AUTHOR]

Abstract: Mounting evidence suggest that astrocytes might be involved in the pathogenesis of schizophrenia. Of particular interest is S100B, a protein produced primarily by astrocytes that plays a critical role in the maintenance of functional neuronal and astroglial activation. Abnormalities in S100B levels have been associated with schizophrenia. In this study, we examined serum S100B protein levels and the relationship between S100B levels and psychopathological symptoms in first-episode, drug-naïve patients with schizophrenia (SCZ). Sixty-four patients with schizophrenia were compared with 66 age- and sex-matched healthy controls (HCs). Psychopathology in the SCZ group was assessed by the Positive and Negative Syndrome Scale (PANSS). Serum S100B protein levels were measured by sandwich enzyme-linked immunosorbent assay (ELISA). The results showed that S100B protein-like immunoreactivity was significantly higher in the SCZ group than the HC group. S100B-like immunoreactivity was correlated with age, duration of illness, and PANSS subscale scores for negative and general psychopathology and total scores. In the SCZ group, serum S100B levels in residual subtypes were significantly higher than in the paranoid and disorganized subtypes. Our findings suggest an upregulation of a marker for astrocyte activity, i.e., S100B, in first-episode medication-free patients with schizophrenia, and thus support the involvement of astrocytes in the pathogenesis of schizophrenia. [Copyright &y& Elsevier]

Background: Few studies have examined whether social support contributes to better consequences among chronic patients with severe mental illnesses (SMI) in their community recovery stage and whether self-stigma would be a mechanism through which social support impacts psychiatric symptoms and personal and social functioning., Aims: This study aimed to examine prospective associations of social support with long-term self-stigma, psychiatric symptoms, and personal and social functioning, and to investigate whether self-stigma would mediate the associations of social support with psychiatric symptoms and personal and social functioning among patients with SMI., Methods: A total of 312 persons with SMI (schizophrenia and bipolar disorder) in their community recovery stage participated in the study. Social support, self-stigma, psychiatric symptoms, and personal and social functioning were evaluated at baseline. The follow-up assessment was conducted at 6 months with the baseline measures except for social support. Hierarchical linear regression and mediation analysis were performed., Results: The results showed that baseline social support predicted decreases in stigma (β = -.115, p  = .029) and psychiatric symptoms (β = -.193, p  < .001), and increases in personal and social functioning (β = .134, p  = .008) over 6 months, after adjusting for relevant covariates. Stigma at 6 months partially mediated the association between baseline social support and 6-month psychiatric symptoms (indirect effect: β = -.043, CI [-0.074, -0.018]). Stigma and psychiatric symptoms at 6 months together mediated the association between baseline social support and 6-month personal and social functioning (indirect effect: β = .084, 95% CI [0.029, 0.143])., Conclusion: It is necessary to provide comprehensive social support services and stigma reduction interventions at the community level to improve the prognosis of SMI.

Background: Community-based peer support service is widely and effectively deployed for persons suffering severe mental illness (SMI) in countries with well-developed outpatient mental health systems. The objective of this study is to evaluate the effectiveness of a 1-year peer service project among persons with SMI implemented in China., Methods: A total of 101 consumers (service recipients) and 66 family caregivers were recruited at baseline from communities located in Beijing and Chengdu. Severity of psychiatric symptoms, personal and social functioning, self-esteem, life satisfaction, and medication adherence were evaluated among consumers. Self-esteem, life satisfaction, anxiety, and depressive symptoms were assessed among family caregivers. Participants were reevaluated at 1 year with the same measures. Changes in outcomes from baseline to 1-year follow-up were examined using paired sample t tests or Stuart-Maxwell tests., Results: Consumers' psychiatric symptoms were decreased at 1 year ( p  < 0.001). Their personal and social functioning ( p  = 0.003) and life satisfaction ( p  < 0.001) were increased. There were no improvements in self-esteem ( p  = 0.108) and medication adherence ( ps  ≥ 0.827) among consumers. For caregivers, no increases were presented in outcomes at the 1-year assessment ( ps  ≥ 0.164)., Conclusions: The findings suggest that peer support services could be sustainably implemented across China, with positive impacts on the psychiatric symptoms, social functioning, and life satisfaction of participants suffering SMI., Competing Interests: The authors declare there are no competing interests., (©2022 Fan et al.)

Competing Interests: Conflicts of interest: No conflicts of interest were reported.

The National Continuing Management and Intervention Programme for Psychoses, also known as the 686 Programme, was launched in China in 2004, marking a shift to a hospital-and-community collaborative model of care for patients with psychoses. An updated programme, the National Comprehensive Management Pilot Project for Mental Health, was launched in 2015 with the cooperation of six government ministries and bodies, including the China Disabled Persons Federation. Mechanisms for multi-sector cooperation in mental health services are being put in place in China.

Objective: Nonadherence to antipsychotic medication is a major health concern. Identification of risk factors associated with nonadherence is a useful initial step toward designing an effective intervention. This study compared the characteristics of medication-adherent and -nonadherent outpatients with schizophrenia in a Chinese community setting., Methods: In a naturalistic, multicenter, and cross-sectional design, 601 outpatients with schizophrenia served by the National Continuing Management and Intervention Program for Psychoses (the "686 program") were surveyed from June 2013 to January 2014 in four Chinese cities. On the basis of self-reported behavior, the patients were divided into medication-adherent and -nonadherent groups. Logistic regression analyses were performed to identify potential risk factors associated with nonadherence., Results: The analyses included 554 patients, 20% of whom were considered to be nonadherent. Compared with the adherent group, the nonadherent group had a longer period of untreated psychosis (odds ratio [OR]=1.09), lower body mass index (OR=.94), higher rate of rural residency (OR=2.01), and lower monthly household income per capita (OR=.94/100 renminbi) (p<.05 by hierarchical analysis). Other characteristics (age, gender, occupation, education, marital status, living with family, age at initial presentation of symptoms, duration of illness, and type of antipsychotic medication) did not differ significantly between the groups., Conclusions: Medication-adherent and -nonadherent groups differed significantly in some social and treatment characteristics. These findings may be useful in informing the development of strategies for reducing medication nonadherence.