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Objective: To evaluate the neglect of left-behind children (LBC) in China. Method: Participants: Children separated from one or both parents for at least 6 months. Intervention: Trauma of separation. Comparison: Non-left-behind children (NLBC). Outcomes: Neglect rates and severity. Only case–control studies were included. Results: Thirteen studies were included; there were 18,688 LBC in a large sample (N = 42,003) of children aged 0–18 years in China. The overall neglect rate was significantly higher in LBC compared to NLBC (odds ratio [OR] = 1.58, 95% confidence interval [CI] = [1.50, 1.67], p < .01) based on the Chinese Rural Child Neglected Evaluation Model (CRCNEM) and the Parents–Child Conflict Tactics Scales (OR = 1.44, 95% CI [1.35, 1.54], p < .01). The overall neglect severity in LBC was also significantly higher than NLBC (SMD = 0.31, 95% CI [0.28, 0.33], p < .01). The same trends were observed in sex subgroups. With regard to subtypes, LBC were significantly more likely to have emotional neglect (OR = 2.29, 95% CI [1.88, 2.78], p < .01), medical neglect (OR = 1.79, 95% CI [1.62, 1.98], p < .01), physical neglect (OR = 1.75, 95% CI [1.60, 1.91], p < .01), security neglect (OR = 1.52, 95% CI [1.32, 1.75], p < .01), educational neglect (OR = 1.50, 95% CI [1.31, 1.72], p < .01), and social neglect (OR = 1.33, 95% CI [1.18, 1.51], p < .01). Furthermore, LBC had significantly higher severity in medical neglect (SMD = 0.31, 95% CI [0.27, 0.35], p < .01), emotional neglect (SMD = 0.28, 95% CI [0.24, 0.32], p < .01), physical neglect (SMD = 0.24, 95% CI [0.18, 0.29], p < .01), security neglect (SMD = 0.26, 95% CI [0.23, 0.29], p < .01), educational neglect (SMD = 0.25, 95% CI [0.20, 0.31], p < .01), and social neglect (SMD = 0.25, 95% CI [0.10, 0.40], p < .01). Conclusion: The neglect rates and severity in LBC in China were both significantly higher than those in NLBC. There was a strong association between neglect and LBC. Public policy changes are urgently needed to improve the dire situation and the well-being of the LBC.

Background Recurrent observations have indicated the presence of deficits in mismatch negativity (MMN) among schizophrenia. There is evidence suggesting a correlation between increased dopaminergic activity and reduced MMN amplitude, but there is no consensus on whether antipsychotic medications can improve MMN deficit in schizophrenia. Methods We conducted clinical assessments, cognitive function tests, and EEG data collection and analysis on 31 drug-naïve patients with schizophrenia. Comprehensive evaluation tools such as PANSS and MCCB. MMN amplitude was analyzed by event-related potential (ERP) approaches, evoked theta power was analyzed by event-related spectral perturbation (ERSP) approaches. Results Our findings indicate that antipsychotic treatment significantly improved clinical symptoms, as evidenced by reductions in PANSS positive, negative, general symptoms, and total scores (all p  < 0.001). Cognitive function improvements were observed in language learning, working memory, and overall MCCB scores ( p  < 0.05), although other cognitive domains showed no significant changes. However, no significant improvements were noted in MMN amplitude and evoke theta power after four weeks of antipsychotic treatment ( p  > 0.05). Conclusion These results suggest that while antipsychotic medications effectively alleviate clinical symptoms, their impact on MMN amplitude and evoke theta power deficit is limited in the short term. Moreover, the amelioration of cognitive impairment in individuals with schizophrenia is not readily discernible, and it cannot be discounted that the enhancement observed in language acquisition and working memory may be attributed to a learning effect. These findings underscore the complexity of the neurobiological mechanisms involved and highlight the need for further research to optimize individualized treatment strategies for schizophrenia. Trial Registration ChiCTR2000038961, October 10, 2020.

Abstrac Objectives This study aimed to preliminarily and exploratorily examine the associations between childhood trauma (CT), its subtypes, and personality traits among unaffected first-degree relatives (FDR, children, or siblings) of patients with major depressive disorder (MDD). Methods The study sample included three subgroups: MDD patients ( N  = 85), Patients’ FDRs ( N  = 35), and healthy control individuals (HC, N  = 89). The Childhood Trauma Questionnaire (CTQ) was used to assess childhood trauma and the Eysenck Personality Questionnaire was used to assess personality traits. Results Significant differences were found in a few personality traits ( p  < 0.05 for extraversion, neuroticism, and psychoticism) among MDD patients, FDR, and HC, and there were no significant differences between HC and FDR. In the FDR group, compared with those without CT, participants with CT scored significantly higher for neuroticism (N) ( F  = 3.246, p  = 0.046). CT was significantly associated with N, psychoticism (P) and Lie (L), and the strongest association was between CT total score and N. Significantly positive correlations were found between N and sexual abuse (SA) ( r  = 0.344, p  = 0.043), emotional neglect (EN) ( r  = 0.394, p  = 0.019), physical neglect (PN) ( r  = 0.393, p  = 0.019), and CTQ total score ( r  = 0.452, p  = 0.006); between P and CTQ total score ( r  = 0.336, p  = 0.049); and significant negative correlations were found between L and EN ( r  = -0.446, p  = 0.007), CTQ total score ( r  = -0.375, p  = 0.027). Conclusion In unaffected FDRs, there were significant associations between childhood trauma and a few personality traits, including neuroticism, psychoticism, and lie, and emotional neglect was significantly associated with neuroticism.

Background Prepulse inhibition (PPI) and attention were impaired, which may cause psychotic symptoms and (or) hinder the cognitive functions in schizophrenia. However, due to the measurement methods of PPI, findings about the relationship between PPI and clinical symptoms, cognitive performances have been equivocal. Methods Seventy-five schizophrenia patients (SZ) and 50 healthy controls (HC) were assessed in a modified acoustic PPI paradigm, named perceived spatial separation-induced PPI (PSS-PPI), compared to perceived spatial co-location PPI (PSC-PPI) with inter-stimulus interval (ISI) of 120 ms. Repeatable Battery for the Assessment of Neuropsychological Status and the Stroop Color-Word Test were administered to all subjects. Results Significant decrease in the modified PPI was found in the patients as compared to the controls, and effect sizes (Cohen’ d ) for patients vs. HCs % PPI levels achieved a significant level (PSC-PPI d  = 0.84, PSS-PPI d  = 1.27). A logistic regression model based on PSS-PPI significantly represented the diagnostic grouping (χ 2 = 29.3; p  < 0 .001), with 85.2% area under ROC curve in predicting group membership. In addition, patients exhibited deficits in neurocognition. Among patients of “non-remission”, after controlling for gender, age, education, duration, recurrence times, onset age, cigarettes per day and chlorpromazine equivalent dosage, PSS-PPI levels were associated with positive and negative symptoms, PANSS total and thought disorder (P1, P6, P7, N5, N7, G9). In multiple linear regression analyses, male and higher attention scores contributed to better PSC-PPI and PSS-PPI in controls group, while larger amount of smoke and longer word-color interfere time contributed to poor PSS-PPI. In patients’ group, higher education and attention scores contributed to better PSS-PPI, while repeated relapse contributed to poor PSS-PPI. Conclusions The acoustic perceived spatial separation-induced PPIs may bring to light the psychopathological symptoms, especially for thought disorder, and the mechanism(s) of the novel PPI paradigm was associated with attention function.

Due to its impairment in patients with schizophrenia, mismatch negativity (MMN) generation has been identified as a potential biomarker for identifying primary impairments in auditory sensory processing. This study aimed to investigate the dysfunctional differences in different MMN deviants and evoked theta power in patients with first-episode schizophrenia (FES) and chronic schizophrenia (CS). We measured frequency and duration MMN from 40 FES, 40 CS, and 40 healthy controls (HC). Evoked theta power was analyzed by event-related spectral perturbation (ERSP) approaches. Deficits in duration MMN were observed in both FES ( = 0.048, Bonferroni-adjusted) and CS ( < 0.001, Bonferroni-adjusted). However, deficits in frequency MMN were restricted to the CS ( < 0.001, Bonferroni-adjusted). Evoked theta power deficits were observed in both patient groups when compared with the HC ( = 0.001, < 0.001, Bonferroni-adjusted), yet no significant differences were found between FES and CS. Frequency MMN was correlated with the MATRICS consensus cognitive battery (MCCB) combined score ( = -0.327, < 0.05) and MCCB verbal learning ( = -0.328, < 0.05) in FES. Evoked theta power was correlated with MCCB working memory in both FES ( = 0.347, < 0.05) and CS ( = 0.408, < 0.01). These findings suggest that duration MMN and evoked theta power deficits may be more sensitive for detection of schizophrenia during its early stages. Moreover, frequency MMN and theta power could potentially linked to poor cognitive functioning in schizophrenic patients. The findings mentioned above indicated that the neural mechanisms of the three indexes may vary between people.

In this study, we aimed to determine the influence of various types of childhood trauma (CT) on cognitive functions in Chinese patients presented with schizophrenia. One hundred sixty-two patients were assessed with the Childhood Trauma Questionnaire-Short Form (CTQ-SF) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). We investigated the correlations between various types of CT, demographic characteristics, and cognitive functions. Significant negative correlations were observed in physical abuse (PA) and sexual abuse (SA) with the language score (r=−0.190, −0.216, respectively, p<0.05). Similarly, physical neglect (PN) and the total score of CTQ were negatively correlated with the attention score (r=−0.17, −0.206, p<0.05, respectively) as well as the total RBANS score (r=−0.199, −0.223, respectively P<0.05). PN was also negatively correlated with delayed memory (r=−0.167, p<0.05). Regressions analysis indicated significant negative correlations between PN and attention, as well as the cognitive total score (p<0.001). Furthermore, demographic variables (years of education, family income) and clinical characteristics (type of anti-psychotics, duration of illness and times of recurrence) were correlated with cognitive functions. The current study showed that different types of CT could impact specific cognitive functions in Chinese schizophrenia patients. Therefore, we recommend that trauma-focused mental interventions for schizophrenia patients should be developed and routinely offered to patients.

Background Childhood trauma (CT) has been found to contribute to the onset of schizophrenia and auditory sensory gating deficit is a leading endophenotype for schizophrenia. However, the association between the CT and sensory gating in first-episode schizophrenia remains elusive. Methods Fifty-six patients and 49 age and sex-matched healthy controls were assessed using the Childhood Trauma Questionnaire-Short Form (CTQ-SF) for CT and Positive and Negative Syndrome Scale (PANSS) for symptoms severity. Sensory gating was tested using the modified paradigm, perceived spatial separation-induced prepulse inhibition (PSS-PPI), and the perceived spatial co-location PPI (PSC-PPI or classical PPI). Results Comparing with healthy controls, the patients had significantly higher score on sexual abuse ( t  = 2.729, p  < 0.05), lower PSS- PPI, % (ISI = 120 ms and ISI = 60 ms) ( t  = − 3.089, − 4.196, p  < 0.05). Univariate analysis revealed the absence of a significant correlation among CT, PPI paradigms and symptoms. However, multiple linear regression analyses demonstrated the CTQ-SF total was negatively associated with PSS PPI (ISI = 120 ms) ( p  = 0.018). Conclusion The current study illustrates that the impact of CT on sensory gating in patients with first-episode schizophrenia, and thus we conclude that CT may be a risk factor to the occurrence of schizophrenia through its impact on sensory gating.

Aberrant topological organization of whole-brain networks has been inconsistently reported in studies of patients with major depressive disorder (MDD), reflecting limited sample sizes. To address this issue, we utilized a big data sample of MDD patients from the REST-meta-MDD Project, including 821 MDD patients and 765 normal controls (NCs) from 16 sites. Using the Dosenbach 160 node atlas, we examined whole-brain functional networks and extracted topological features (e.g., global and local efficiency, nodal efficiency, and degree) using graph theory-based methods. Linear mixed-effect models were used for group comparisons to control for site variability; robustness of results was confirmed (e.g., multiple topological parameters, different node definitions, and several head motion control strategies were applied). We found decreased global and local efficiency in patients with MDD compared to NCs. At the nodal level, patients with MDD were characterized by decreased nodal degrees in the somatomotor network (SMN), dorsal attention network (DAN) and visual network (VN) and decreased nodal efficiency in the default mode network (DMN), SMN, DAN, and VN. These topological differences were mostly driven by recurrent MDD patients, rather than first-episode drug naive (FEDN) patients with MDD. In this highly powered multisite study, we observed disrupted topological architecture of functional brain networks in MDD, suggesting both locally and globally decreased efficiency in brain networks.

The aim of this study is to compare ecologically-valid measure (the Cambridge Prospective Memory Test, CAMPROMPT) and laboratory measure (eye-tracking paradigm) in assessing prospective memory (PM) in individuals with schizophrenia spectrum disorders (SSDs). In addition, eye-tracking indices are used to examine the relationship between PM and other cognitive domains in SSDs patients. Initially, the study sample was formed by 32 SSDs patients and 32 healthy control subjects (HCs) who were matched in sociodemographic profile and the performance on CAMPROMPT. An eye-tracking paradigm was employed to examine the differences in PM accuracy and key cognitive processes (e.g., cue monitoring) between the two groups. Additional 31 patients were then recruited to investigate the relationship between PM cue monitoring, other cognitive functions, and the severity of clinical symptoms within the SSDs group. The monitoring of PM cue was reflected in total fixation time and total fixation counts for distractor words. Cognitive functions were assessed using the Chinese version of the MATRICS Consensus Cognitive Battery (MCCB). The Positive and Negative Syndrome Scale (PANSS) was applied to assess psychopathology. SSDs patients exhibited fewer total fixation counts for distractor words and lower PM accuracy compared to HCs, even though they were priori matched on CAMPROMPT. Correlation analysis within the SSDs group (63 cases) indicated a negative correlation between PM accuracy and PANSS total score, and a positive correlation with working memory and attention/vigilance. Regression analysis within the SSDs group revealed that higher visual learning and lower PANSS total scores independently predicted more total fixation counts on distractor words. Impairment in cue monitoring is a critical factor in the PM deficits in SSDs. The eye-tracking laboratory paradigm has advantages over the ecologically-valid measurement in identifying the failure of cue detection, making it a more sensitive tool for PM deficits in patients with SSDs.

Objective Relapse prevention is the main goal of maintenance treatment in schizophrenia. This study aimed to determine the rate and the socio-demographic and clinical predictors of relapse in Chinese schizophrenia patients following treatment of the acute phase of the illness. Methods In a multi-center, randomized, controlled, longitudinal study, 404 patients with schizophrenia who were clinically stabilized following an acute episode were randomly assigned to either the maintenance (i.e., initial optimal therapeutic doses continued throughout the study) or the dose-reduction group (i.e., initial optimal therapeutic doses continued for 4 or 26 weeks followed by a 50% dose reduction that was maintained until the end of the study). Participants were interviewed at entry using standardized assessment instruments, and followed up for 12–26 months. Results In univariate analyses, relapse was significantly associated with the membership of the dose-reduction group, poor medication adherence, and having a diagnosis of the paranoid type of schizophrenia. In Cox proportional-hazards regression analysis the membership of the dose-reduction group, poorer medication adherence, more severe drug-induced side effects and prominent paranoid symptoms independently predicted a higher risk of relapse. Conclusion The study confirmed the importance of maintenance medication in preventing relapse in Chinese schizophrenia patients underscoring the risk of relapse associated with lack of treatment adherence, severe side effects and the patients’ paranoid attitude. Socio-demographic characteristics were not associated with relapse in Chinese schizophrenia patients. Potential residual confounding caused by unmeasured variables should be fully considered in future studies.