Background Antipsychotic medications may prolong the corrected QT interval (QTc), posing a potential cardiovascular safety concern. This pilot study evaluated QTc evolution during the first two weeks of hospitalization and examined factors associated with QTc change, with the aim of generating preliminary data to inform future larger-scale investigations. Methods A prospective observational pilot study was conducted at the Psychiatric Hospital of the Cross, Lebanon. Forty-eight newly admitted patients initiated on antipsychotic therapy were enrolled. Standard 12-lead electrocardiograms were obtained at baseline (T1) and at two weeks (T2). The QTc interval was calculated using Fridericia's correction formula (QTcFri = QT/RR1/3). Results The mean QTc at admission was 377.13 ± 32.55 ms, increasing marginally to 380.25 ± 28.97 ms at two weeks, corresponding to a mean ΔQTc of 3.11 ± 35.07 ms (p = 0.568). Only one patient (2.4%) developed clinically significant QTc prolongation. Approximately 47.6% of patients experienced a net decrease in QTc, while 21.4% showed an increase exceeding 30ms. In the multivariable model, which included age, gender, chlorpromazine-equivalent dose, and first psychiatric hospitalization, first psychiatric hospitalization showed a positive but non-significant association with ΔQTc (B = 19.596, 95% CI −3.615 to 42.807, p = 0.096). Given the small pilot sample, this finding should be considered preliminary and hypothesis-generating. Conclusion Short-term inpatient antipsychotic treatment was not associated with clinically meaningful QTc prolongation. The positive association between first psychiatric hospitalization and QTc change was not statistically significant after adjustment. These preliminary findings support routine ECG monitoring, particularly in first-episode patient.
Although social cognition impairments are common in 22q11.2 deletion syndrome and are linked to psychosis risk, research on this association has yielded contradictory results. The present study aims to investigate emotion perception processes in 22q11.2 deletion syndrome as a function of the presence of psychotic symptoms in children under the age of 13. Forty-six children with 22q11.2 deletion syndrome and fifty-four healthy controls completed one task of facial expression recognition, one task of attribution of facial expressions to faceless characters involved in visually presented social interactions, and one task of attribution of facial expressions to characters involved in orally presented dialogues. Children with 22q11.2 deletion syndrome were subdivided in groups with or without psychotic symptoms based on a structured clinical interview. 22q11.2 deletion patients didn't perform as well as controls on all three tasks, performing particularly poorly on the second and third tasks. This pattern of performance was independent of the presence of psychotic symptoms. The debate over the complex relationships between social cognition and psychosis remains open, but our data indicate that deficits in social cognition may not be a marker of early psychosis.
Schizophrenia's cognitive symptoms are a key therapeutic target because these are important predictors of the patient's ability to function in the community. Recently, an Integrative Cognitive Remediation (ICR) program has been developed for patients with early psychosis, that combines both a restorative approach and a compensatory approach, as well as social cognition training. We aimed to evaluate the feasibility and acceptability of implementing this program in a Global South setting for patients with chronic schizophrenia, and to explore its preliminary impact on cognitive symptoms and social functioning. In this pilot study, we recruited a sample of 16 patients, implemented a 12-week ICR program following previously published guidelines, and assessed feasibility, acceptability, as well as changes in cognition and functioning. The implementation of this ICR program was feasible and well appreciated by our patients with chronic schizophrenia. Their favorable subjective reported experiences were matched by significant changes in Global cognition (+2.6 points in MCCB Global Cognition T Score, p < 0.05, +2.5 points in MoCA, p < 0.0469) and social functioning (+3.6 points in SFS, p < 0.049). However, these findings need to be confirmed by a larger ICR study in chronic schizophrenia patients, in a controlled randomized trial that includes a control group.
Probiotics are increasingly discussed by families as accessible adjuncts for attention deficit hyperactivity disorder (ADHD), encouraged by expanding interest in the microbiota gut brain axis. However, the clinical meaning of the available evidence remains uncertain. A recent meta-analysis found no clear benefit for core ADHD outcomes but identified a small signal in one parent reported behavioral measure that was not reproduced across other instruments. This discrepancy matters because parent ratings, clinician assessments, computerized attention tests, emotional behavioral scales, and gastrointestinal symptoms measure different outcomes. Improvement in one domain should not automatically be interpreted as improvement in ADHD. Current evidence does not support probiotics as treatment for core symptoms or ADHD related emotional dysregulation. A more plausible future role may lie in selected patients with coexisting gastrointestinal symptoms, although this remains unproven. Clinicians should ask what changed, who observed the change, and whether it translated into better daily functioning. Future trials should recruit clinically defined phenotypes and separate core symptoms, emotional regulation, gastrointestinal burden, and functional outcomes.
Cognitive impairment is a core feature in schizophrenia spectrum disorders, strongly associated with daily functioning, and remains difficult to treat. This study aimed to investigate changes in cognitive function following an exercise intervention in individuals with schizophrenia spectrum disorders. Data were derived from a single-arm intervention study conducted across 16 outpatient units in Sweden. The intervention consisted of one circuit training session per week, incorporating both aerobic and muscle-strengthening exercises. Cognitive function was assessed before and after the six-month-long intervention using the Cogstate Schizophrenia Battery (n = 90) and the Trail Making Test (n = 125). Analyses included within-person change summaries, t-tests, effect sizes and regression models. In the Cogstate Schizophrenia Battery, the most prominent changes were an improvement in executive function and declines in psychomotor function and the psychomotor/attention composite. Improvements were observed in both Trail Making Test domains: processing speed/attention and executive function. Greater improvement in VO2max was associated with greater improvement in processing speed/attention in the Trail Making Test. These findings suggest that physical exercise may be associated with modest improvements in some aspects of cognitive performance in individuals with SSD, particularly in executive function.
