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Systematic review and meta-analysis

Brainnetome of schizophrenia: focus on impaired cognitive function

Tianzi JIANG, Yuan ZHOU

Abstract: Impaired cognitive function, along with positive and negative symptoms, is a core clinical feature of schizophrenia. Earlier studies suggest that impaired cognitive functioning should be assessed from the perspective of brain networks. The recently developed brainnetome approach to evaluating brain networks—an approach that was initially developed by Chinese scientists—provides a new methodology for studying this issue. In this paper we first introduce the concept of brainnetome. We then review recent progress in developing a brainnetome of impaired cognitive function in people with schizophrenia. The models of the relevant brain networks considered were created using data obtained from functional and anatomical brain imaging technologies at different levels of analysis: networks centered on regions of interest, networks related to specific cognitive functions, whole brain networks, and the attributes of brain networks. Finally, we discuss the current challenges and potential new directions for research about brainnetome. 

Key words: Brainnetome; Magnetic resonance imaging; Schizophrenia; Cognitive function

Original research article
Predictors of re-hospitalization over a two-year follow-up period among patients with schizophrenia enrolled in a community management program in Chengdu, China
Yinbo ZHANG, Guangzhi DAI

Background: China has recently introduced a community-based service network for managing individuals with schizophrenia but there has been relatively little formal evaluation of the effectiveness of this approach. 

Objective: Assess the retention rate and the two-year re-hospitalization rate of patients who are enrolled in the community management network in Chengdu, China.
Methods: Patients with a confirmed diagnosis of schizophrenia who had at least one prior hospitalization and who were enrolled in the service network at the community health clinics in 14 communities in the Jinniu District of Chengdu and 10 communities in the Qingyang District of Chengdu participated in the two-year prospective follow-up assessment. Detailed demographic and clinical information was obtained at the time of intake into the follow-up program and their hospitalization status was recorded during monthly evaluations over the subsequent two years.
Results: Of the 1 027 participating patients, 963 (93.8%) remained in the program for the entire two-year period. Patients with a lower level of education and those who did not live with family members were more likely to drop-out of the network. Among the 963 patients who completed the follow-up 174 (18.1%) were re-hospitalized over the two-year period. Multivariate logistic regression identified factors related to re-hospitalization: not married or not living with family members, having more prominent positive and negative symptoms at the time of intake, and using medication less in the six months prior to intake.
Conclusion: The 94% two-year retention of patients in this urban community management network for individuals with schizophrenia was excellent and the two-year re-hospitalization rate of 18% is better than that reported in most similar programs in other countries. Patients not living with family members were at higher risk for dropping out of the network and for re-hospitalization so this is a high-risk group that deserves special attention. Standardization of the community interventions and longer follow-up studies with control communities that consider the full range of factors relevant to the well-being of patients with schizophrenia (i.e., social integration, quality of life and re-hospitalization) are needed to definitively demonstrate the effectiveness of this community service network.
Keywords: Community; Schizophrenia; Re-hospitalization; Factor analysis; Prospective study


Where is the path to recovery when psychiatric

Biostatistics in psychiatry

Heterogeneity of treatment effects
Naihua DUAN, Yuanjia WANG