Tag: Schizophrenia spectrum

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The ECHO study: compassion-focused therapy for young voice hearers and their caregivers. A pilot study

BackgroundVoice hearing can occur in healthy people without a trigger, be caused by a traumatic event, or occur as part of a psychiatric disorder. There are still many gaps in our understanding of voice hearing, and research in this field can be challenging, maybe because it is associated with shame and stigma. Those who experience distress by voice hearing could benefit from a treatment, aimed directly at that. The ECHO manualized treatment is based on the principles of compassion-focused therapy (CFT).MethodsTreatment will take place on several different psychiatric hospitals in the Region of Southern Denmark. Treatment consists of a 10-session, manualized CFT for voice hearing. Caregivers participate in half of the sessions, and a recording of the voice content is made, which the caregivers are encouraged to listen to. The study is designed as a prospective single-arm pre–post intervention study using a mirror-image approach, in which participants serve as their own controls over time. The intervention group consists of (N = 60) voice-hearing adolescents aged 13–18 years. Additionally, a clinical comparison group (who also receive the intervention) of (N = 20) individuals aged 18–20 years with first-episode schizophrenia and voice hearing is included for descriptive and exploratory analyses. Data are collected 3 months prior to CFT treatment, immediately before the start of treatment, immediately after treatment is completed, and at 1 month follow-up. Data will be centered around social cognition, perceived social safeness, social connectedness, general well being, auditory hallucinations and compassion.DiscussionThe ECHO study addresses the wellbeing and thriving of an overlooked group of young people. The results of this study will provide information about who the voice hearers are, what challenges they face, and how they perceive them. The results will also provide information about the feasibility and efficacy of the treatment manual and, thus, its potential further implementability. Caregivers participate in half of the sessions, to facilitate a common language about mental states and voice hearing. To support their understanding, a recording of the voice content is made and the caregivers are encouraged to listen to it. We suggest that when caregivers understand the young voice hearers’ experiences, they can adjust their expectations and approach accordingly. We also suggest that by sharing the voice content, the young voice hearer will feel less isolated.Study protocol registrationhttps://clinicaltrials.gov/study/NCT07314515, identifier NCT07314515.
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A novel mutation in SETD1A is associated with early-onset epilepsy—a rare case report

SET Domain Containing 1A (SETD1A) is a histone H3K4 methyltransferase implicated in neurodevelopmental disorders. Pathogenic variants in this gene are associated with schizophrenia, intellectual disability, and epilepsy. Here, whole-exome sequencing and Sanger sequencing were performed on a 4-year-old Chinese girl with early-onset epilepsy and her unaffected parents. A novel de novo heterozygous variant in SETD1A (NM_014712.3: c.1067C > T/p.Ser356Phe) was identified in a patient presenting with focal-to-bilateral tonic–clonic seizures, beginning at 3 months of age. Neuroimaging revealed a normal brain MRI, and comprehensive neuropsychological assessment indicated preserved cognitive function. The variant was absent in 200 local controls and classified as likely pathogenic per ACMG criteria. This study may expand the mutation and phenotypic spectrum of SETD1A-related disorders, establishing the relationship between SETD1A variants and isolated early-onset epilepsy without accompanying severe neurodevelopmental deficits, highlighting the value of genetic testing in infants with unexplained epilepsy.
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The Effect of Comorbid Alcohol/Substance Use

Conditions: Alcohol Abuse; Alcohol Use Disorder; Substance Use Disorders; Severe Mental Disorder; Schizophrenia; Bipolar Disorder; Ostracism

Interventions: Other: scale

Sponsors: Abant Izzet Baysal University

Recruiting
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<![CDATA[In the final episode, “Take-Home Messages: Clinical Confidence in Transitioning Patients to Cobenfy,” David Walling, PhD, explored how these findings add to the evolving evidence base for Cobenfy in schizophrenia, and what questions remain for future research.]]>
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Evaluating Wearable Devices for Remote Monitoring in Psychosis: Pilot Study Nested Within the CONNECT Cohort Study

Background: Digital remote monitoring technologies, including smartphones and wearables, offer promising avenues for early detection of psychosis relapse. However, selecting devices that are acceptable to participants and produce high-quality data remains challenging. Objective: The aim of this nested pilot study was to assess the acceptability and data quality of 3 commercially available wearable devices in people with psychosis recruited to the CONNECT cohort study. Methods: Participants recruited to the CONNECT study before July 31, 2024, were included in the pilot study and selected 1 of 3 wearable devices: a Fitbit Charge 5, Samsung Galaxy Watch 5, or Apple Watch SE. Baseline demographics were compared between device groups. Acceptability of devices to participants was assessed through a Wearable Device Satisfaction Questionnaire after 3 months of use, with the proportion of positive responses to each question calculated and compared. Data completeness was also assessed by calculating the number (and percentage) of valid days of step count, heart rate, and sleep data, and comparing between groups. Data quality was assessed through summarizing the amount of troubleshooting required, additional metrics available from the wearables, and continuity of data completeness by calculating the proportion of participants with at least 3 days of heart rate data per week for the first 20 weeks of follow-up. Predefined criteria were used to determine the next steps for the wider CONNECT study: if one device was superior, this would be selected; if none were found to be superior and the Fitbit was found to be noninferior, then Fitbit would be retained. Results: Of the first 107 participants recruited to CONNECT, 105 were included in the pilot study evaluation. The Samsung Galaxy Watch was selected most frequently by participants (46/105, 43.8%), followed by the Apple Watch (27/105, 25.7%), and Fitbit Charge (23/105, 21.9%). Differences in participant demographics were observed across device groups. Self-reported acceptability after use did not differ substantially between devices. However, in terms of data completeness, the median proportion of valid heart rate data days was significantly lower for Samsung Galaxy (median 31.2%, IQR 8.5%-46.0%) compared to Fitbit (median 80.1%, IQR 26.7%-95.0%; =.003) and Apple Watch (median 49.3%, IQR 21.5%-86.0%; =.02). There was no significant difference between Fitbit and Apple Watch. Similar patterns were observed for step count and sleep data. The Samsung Galaxy Watch required more frequent troubleshooting for data flow issues and lacked additional physiological metrics, available from the other devices. Conclusions: Due to comparatively lower data quality and technical performance, the Samsung Galaxy Watch was discontinued for use in the subsequent phase of the CONNECT study. The study highlights the importance of incorporating nested evaluations of devices in long-term research.
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<![CDATA[Open-label phase 2 trial tests IV Briumvi alongside antipsychotics for treatment-resistant schizophrenia, targeting B-cell depletion to improve symptoms and assess safety.]]>
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Disrupted self-referential processing and empathy-based interventions in mental disorders: neural mechanisms, cognitive biases, and therapeutic integration

Self-referential processing (SRP), the mental activity of linking experiences and stimuli to the self, is fundamental to shaping identity, regulating affect, and navigating complex social environments. Disruptions in SRP are increasingly recognized as a transdiagnostic hallmark across psychiatric disorders, including schizophrenia spectrum disorders, major depressive disorder, and anxiety disorders. Such disruptions often manifest as distorted self-perception, negative cognitive-affective biases, and dysfunctional connectivity within key neural networks, particularly the default mode network (DMN) and the medial prefrontal cortex (mPFC). Emerging evidence reveals a dynamic bidirectional relationship between SRP and empathy. Impairments in self-processing may hinder the capacity to accurately infer others’ emotional and cognitive states, while deficits in empathic attunement may reinforce maladaptive self-focus. This interplay contributes to social withdrawal, interpersonal dysfunction, and emotional dysregulation across diagnostic boundaries. Recent therapeutic advances suggest that interventions targeting the interface between SRP and empathy may effectively modulate shared neurocognitive mechanisms. Such interventions include metacognitive therapy, mindfulness-based interventions, and psychedelic-assisted psychotherapy. These therapeutic approaches show preliminary but promising evidence for reducing maladaptive self-focused attention, enhancing emotion regulation, and improving social functioning. This review synthesizes empirical evidence regarding the neural underpinnings of SRP, delineates disorder-specific alterations in self-referential processing, and examines the bidirectional interplay between SRP and empathic functioning. We further outline a conceptual framework for empathy-based interventions targeting SRP dysfunction and propose future directions for precision psychiatry research. Emphasis is placed on developing personalized, mechanism-driven therapeutic strategies informed by computational modeling, transdiagnostic biomarker identification, and digital therapeutic platforms.