The impairment of cognitive function is one of the core symptoms in schizophrenia, and the degree of recovery is closely related to whether patients are able to rejoin society successfully. This study was to clarify the correlation between cognitive function and cerebral grey matter volume in schizophrenia. The neuro-cognitive functions of thirty-seven patients with first-episode schizophrenia (the patient group) and thirty healthy controls (the control group) was evaluated with the Clock Drawing Test, Trail Marking Test, Digit Span Test, Auditory Verbal Learning Test, Wisconsin Card Sorting Test, Verbal Fluency Test, Semantic Similarity Test and Stroop Color-Word Test. The facial emotion cognitive task was employed to assess the facial emotion cognitive functions of thirty-two patients with first-episode schizophrenia (the patient group) and 29 healthy controls (the control group). The psychotic symptoms of patients with first-episode schizophrenia were evaluated using the Positive and Negative Syndrome Scale (PANSS). The brain imaging data of the patient group and control group were collected using the magnetic resonance imagine (MRI). The difference between the patient group and the control group in the results of Clock Drawing Test, Trail Marking Test, Digit Span Test, Auditory Verbal Learning Test, Wisconsin Card Sorting Test, Verbal Fluency Test, Semantic Similarity Test and Stroop Color-Word Test's reaction time were significant. These two groups' Slopes in the facial emotion cognitive task were also significantly different from each other. According to the comparison of cerebral grey matter volume between the patient group and the control group, it was found that the grey matter volume of the patient group increased in the left superior frontal gyrus, and decreased in the left occipital gyrus, lingual gyrus and upper cerebellum. Based on the analyses of neuro-cognitive data and brain imaging data of the patient group, the scores of the number of correct responses in Stroop Color-Word Test's Card C were negatively correlated with grey matter volumes of the left upper frontal gyrus, right upper frontal gyrus and middle frontal gyrus. The analyses on the facial emotion cognitive task and brain imaging data of the patient group showed that the slope data were positively correlated with grey matter volumes of the right superior temporal gyrus, middle temporal gyrus, left middle temporal gyrus, inferior temporal gyrus and fusiform gyrus. There are general impairments in the neuro-cognitive functions and facial emotion cognitive functions of patients with first-episode schizophrenia, and the results suggest that brain areas with abnormal grey matter volumes are likely to be the brain structure and functional basis of the cognitive impairments.

Background: There is limited evidence on the efficacy of electroconvulsive therapy (ECT) in adolescents with mental illness. The present study reported outcomes of adolescents with mental illness treated with ECT aimed at providing evidence for large-scale feasibility.Objectives: The primary objective of this trial was to examine the differences in demographic and clinical data between responders and non-responders. The secondary objective was to determine whether ECT produced differential readmission rates, the burden of oral medication, and social function in responders and non-responders in the long term.Methods: Patients aged 14–18 years diagnosed with schizophrenia (SCZ), major depressive disorder (MDD), or bipolar disorder (BD) who received ECT between 2015 and 2020 were included in the study. Demographic and clinical data were compared, and both short-term and long-term outcomes were assessed: response on the Clinical Global Impressions-Improvement scale and readmission at follow-up. The independent-sample t–test was used to compare the continuous variables and the X² test was used to compare the dichotomous variables with statistical significance at P ≤ 0.05.Results: Four hundred ten adolescents (aged 14–18 years, 53.90% female) received ECT for SCZ, MDD, and BD. The response rate for SCZ, MDD, and BD were 65.61, 78.57, and 69.95%, respectively. Both SCZ (P = 0.008) and BD (P = 0.008) groups had a significant elder age in responders than in non-responders. Besides that MDD responders had a significantly larger number of ECT sessions than non-responders (P = 0.046), the study failed to find a significant difference in other ECT parameters. A significantly higher proportion of readmission was found in BD non-responders than in responders (P = 0.029), there was no difference in the rate of readmission in other diagnostic groups.Conclusions: These data suggested that ECT is an effective treatment for adolescents with severe mental illness, and the rate of readmission was low in the long term. The present study supports that large-scale systematic studies are warranted for further investigation of the response rate of ECT for treating adolescents with mental illness.

The basal ganglia are important structures for the release of dopamine in the limbic circuits of the midbrain, and the striatum and globus pallidus are the major nuclei of the basal ganglia, and the dysfunction of these regions has been the basis of many models that have attempted to explain the underlying mechanisms of schizophrenia symptoms. The purpose of this study was to investigate the changes in the volume of the striatum subregion and globus pallidus in three different stages of schizophrenia, and to analyze whether these volume changes were related to antipsychotic drugs and schizophrenia symptoms. In this study, we investigated the volume of the striatum and globus pallidus in patients with schizophrenia at three different stages. The study included 57 patients with first-episode schizophrenia (FSZ), 51 patients with early-stage schizophrenia (ESZ), 86 patients with chronic schizophrenia (CSZ), and 191 healthy controls (HC), all of whom underwent structured magnetic resonance imaging (MRI) scans. Covariance analysis was performed using SPSS 26.0 was used for covariance analysis to determine whether there were significant differences in striatal subregion and globus pallidus volume between groups, and stratified analysis was used to further eliminate the effect of age on brain volume. Finally, the correlation analysis between the region of interest and the cumulative dose of antipsychotic drugs and psychotic symptoms was performed. The comparison between the different stages of the illness showed significant volume differences in the left caudate nucleus (lCAU) (F = 2.665, adjusted p = 0.048), left putamen (lPUT) (F = 12.749, adjusted p < 0.001), left pallidum (lPAL) (F = 41.111, adjusted p < 0.001), and right pallidum (rPAL) (F = 14.479, adjusted p < 0.001). Post-hoc analysis with corrections showed that the volume differences in the lCAU subregion disappeared. Further stratified analysis controlling for age showed that compared with the HC, the lPAL (t = 4.347, p < 0.001) was initially significantly enlarged in the FSZ group, the lPUT (t = 4.493, p < 0.001), rPUT (t = 2.190, p = 0.031), lPAL (t = 7.894, p < 0.001), and rPAL (t = 4.983, p < 0.001) volumes were all significantly increased in the ESZ group, and the lPUT (t = 3.314, p = 0.002), lPAL (t = 6.334, p < 0.001), and rPAL (t = 3.604, p < 0.001) subregion volumes were also significantly increased in the CSZ group. Correlation analysis showed that lPUT and bilateral globus pallidus were associated with cumulative dose of antipsychotics, but were not associated with clinical symptoms in each subregion. The findings suggest that different subregions of the striatum and globus pallidus show significant volume differences at different stages of schizophrenia compared to HC. These volume differences may be strong radiographic evidence for schizophrenia. In addition, the lPAL was the only significantly different brain region observed in the FSZ group, suggesting that it may be a sensitive indicator of early brain structural changes in schizophrenia. Finally, our findings support the hypothesis that antipsychotic drugs have an effect on the volume of brain structures.