BACKGROUND:Cardiovascular disease is a leading cause of mortality among patients with schizophrenia. Impaired physical function may contribute to the elevated cardiovascular risk in this population. This study aimed to examine the association between physical function and cardiovascular risk, and to identify optimal functional test cut-offs for detecting high cardiovascular risk in middle-aged and older patients with schizophrenia. METHODS:In this cross-sectional study, physical function was assessed using grip strength, the Timed Up and Go Test (TUGT), the 30-s sit-to-stand test, and the Short Physical Performance Battery (SPPB). The 10-year cardiovascular risk was estimated using the China-PAR model, with high risk defined as ≥10%. Associations were analyzed using binary logistic regression. Receiver Operating Characteristic curve analyses were performed to determine the optimal cut-off values. RESULTS:A total of 202 patients aged ≥45 years with schizophrenia were included (55.45% female). Patients at high cardiovascular risk exhibited significantly poorer physical function (p < 0.05). After full adjustment, grip strength (odds ratio [OR] = 0.86, 95% confidence interval [CI] 0.75-0.97) and SPPB score (OR = 0.71, 95% CI 0.51-0.95) were inversely associated with high cardiovascular risk, while TUGT duration was positively associated (OR = 1.38, 95% CI 1.06-1.84). The SPPB score demonstrated the strongest discriminative ability for identifying high cardiovascular risk (area under the curve = 0.76, 95% CI 0.70-0.82). CONCLUSION:Physical function is significantly associated with cardiovascular risk in middle-aged and older patients with schizophrenia. The SPPB may serve as a practical and effective screening tool for identifying individuals at high cardiovascular risk.

As an evidence-based complementary modality, physical exercise showed significant potential in mitigating sleep disturbances across various populations. The objective of this study was to determine how physical exercise interventions influence the sleep quality among clinical populations diagnosed with psychiatric disorders. A systematic search was conducted across four electronic databases, MEDLINE, Embase, the Cochrane Library, and Web of Science, to identify randomized controlled trials (RCTs) available from inception to March 1, 2026. Studies were included if they focused on exercise interventions in patients with psychiatric disorders, using sleep quality as the outcome. Assessment of risk of bias for the enrolled RCTs was conducted using the revised Cochrane Risk of Bias Tool 2. Data synthesis employed random-effects models to estimate Hedges’ g, with subsequent subgroup analyses conducted according to the FITT (Frequency, Intensity, Time, and Type) framework. A total of 21 RCTs (24 comparisons) with 1628 participants were analyzed and results indicated a moderate overall effect size, indicating that physical exercise contributes to a significant improvement in sleep quality (g = -0.57, 95

BACKGROUND:There are various differences in response to different antipsychotics and antioxidant defense systems (ADS) by sex. Previous studies have shown that several ADS enzymes are closely related to the treatment response of patients with antipsychotics-naïve first-episode (ANFE) schizophrenia.OBJECTIVE:Therefore, the main goal of this study was to assess the sex difference in the relationship between changes in ADS enzyme activities and risperidone response.METHODS:The plasma activities of glutathione peroxidase (GPx), catalase (CAT), superoxide dismutase (SOD), and total antioxidant status (TAS) were measured in 218 patients and 125 healthy controls. Patients were treated with risperidone for 3 months, and we measured PANSS for psychopathological symptoms and ADS biomarkers at baseline and at the end of 3 months of treatment. We compared sex-specific group differences between 50 non-responders and 168 responders at baseline and at the end of the three months of treatment.RESULTS:We found that female patients responded better to risperidone treatment than male patients. At baseline and 3-month follow-up, there were no significant sex differences in TAS levels and three ADS enzyme activities. Interestingly, only in female patients, after 12 weeks of risperidone treatment, the GPx activity of responders was higher than that of non-responders.CONCLUSION:These results indicate that after treatment with risperidone, changes in GPx activity were associated with treatment response, suggesting that changes in GPx may be a predictor of response to risperidone treatment in female patients with ANFE schizophrenia.

Schizophrenia is ranked among the top 25 leading causes of disability worldwide in 2013 which resulting in social and economic burden. By observing patients with schizophrenia one year before and after switching from oral antipsychotics (OAPs) to once-monthly paliperidone palmitate (PP1M), we can better understand the change of total costs in schizophrenic patients, including direct costs and indirect costs, after switching treatment patterns. A total of 100 schizophrenic (ICD-10) patients from Shandong Mental Health Center were collected from December 2016 to June 2019. Treatment modalities, health care resource utilization and costs were compared before and after switching directly from oral antipsychotics to PP1M. Of the 82 patients included in the main analyses, treatment with PP1M resulted in an increase in direct costs of 31.92% (P < 0.01), an increase in medicine costs of approximately 142% (P < 0.01), and a reduction in hospital costs of 68.15% (P > 0.05). There was no significant increase in total costs (P = 0.25), while 31.92% increase in direct costs (P < 0.01), and 35.62% decrease in indirect costs (P < 0.01) after conversion to PP1M. Compared with before administration of PP1M, patients with ≥ 1 inpatient stay in 1 year Pre-PP1M treatment with OAPs (n = 32) had a 20.16% decrease in direct costs (P < 0.01), a 144% increase in medicine costs (P < 0.01), and a significant 72.02% decrease in hospital costs (P < 0.01). The observed reduction in the number of hospitalizations (t = 2.56, P ≤ 0.01) and inpatient stays (t = 1.73, P < 0.05) and after transition to PP1M resulted in a reduction in hospitalization costs (P < 0.01). Switching from OAPs to PP1M decreased the household workforce burden without increasing clinical healthcare costs. Direct costs were significantly reduced in patients with ≥ 1 inpatient stay in 1 year pre-PP1M treatment with OAPs after the switch, which decreased by improving adherence to therapy and reducing the number and length of hospital stays, suggesting that those patients may benefit after switching to PP1M.

Abstract Background: Schizophrenia is ranked among the top 25 leading causes of disability worldwide in 2013 which resulting in social and economic burden. By observing patients with schizophrenia one year before and after switching from oral antipsychotics (OAPs) to once-monthly paliperidone palmitate (PP1M), we can better understand the change of total costs in schizophrenic patients, including direct costs and indirect costs, after switching treatment patterns. Methods: A total of 100 schizophrenic (ICD-10) outpatient and inpatient patients from Shandong Mental Health Center were collected from December 2016 to June 2019. Treatment modalities, health care resource utilization and costs were compared before and after switching directly from oral antipsychotics to PP1M.Results: Of the 82 patients included in the main analyses, hospitalization costs decreased was partly offset by the increase of medical costs, which causing direct costs slightly increased (t=-1.81, P＞0.05). The reduction of productivity costs (t=2.06, P＜0.05) and caregiver care costs (t=1.99, P≤0.05) was seen at post-PP1M switch, therefore the indirect costs also obviously reduced (t=2.31, P＜0.05). Total costs slightly increased (t=-0.05, P＞0.05）compared to pre-PP1M period. For patients with ≥ 1 all-cause inpatient stay in the baseline period (n=32), compared with pre-PP1M, a fewer number of inpatient stays (t=1.73, P＜0.05) and hospitalizations (t=2.56, P≤0.01) were observed and a significant reduction in direct costs (t=2.20, P＜0.01) was observed post-transition to PP1M. Conclusions: Switching to PP1M from OAPs can improve adherence to therapy and not increase the costs of health care in the clinical. Patients with ≥1 recent all-cause inpatient stay had a significant reduction in direct costs after switching from oral antipsychotics to PP1M, suggesting that patients with ≥1 all-cause inpatient stay may benefit after switching to PP1M. Indirect costs decrease from OAPs to PP1M, suggesting that reduce the burden of the family labor after switch to PP1M.

Reducing rural-urban disparities in health and health care has been a key policy goal for the Chinese government. With mental health becoming an increasingly significant public health issue in China, empirical evidence of disparities in the use of mental health services can guide steps to reduce them. We conducted this study to inform China's on-going health-care reform through examining how health insurance might reduce rural-urban disparities in the utilization of mental health inpatient services in China. This retrospective study used 10 years (2005-2014) of hospital electronic health records from the Shandong Center for Mental Health and the DaiZhuang Psychiatric Hospital, two major psychiatric hospitals in Shandong Province. Health insurance was measured using types of health insurance and the actual reimbursement ratio (RR). Utilization of mental health inpatient services was measured by hospitalization cost, length of stay (LOS), and frequency of hospitalization. We examined rural-urban disparities in the use of mental health services, as well as the role of health insurance in reducing such disparities. Hospitalization costs, LOS, and frequency of hospitalization were all found to be lower among rural than among urban inpatients. Having health insurance and benefiting from a relatively high RR were found to be significantly associated with a greater utilization of inpatient services, among both urban and rural residents. In addition, an increase in the RR was found to be significantly associated with an increase in the use of mental health services among rural patients. Consistent with the existing literature, our study suggests that increasing insurance schemes' reimbursement levels could lead to substantial increases in the use of mental health inpatient services among rural patients, and a reduction in rural-urban disparities in service utilization. In order to promote mental health care and reduce rural-urban disparities in its utilization in China, improving rural health insurance coverage (e.g., reducing the coinsurance rate) would be a powerful policy instrument.

This study evaluated the effectiveness and safety of amisulpride in Chinese schizophrenia patients.

Background: Mental health is increasingly becoming a huge public health issue in China. Yet for various cultural, healthcare system, and social economic reasons, people with mental health need have long been under-served in China. In order to inform the current ongoing health care reform, empirical evidences on the economic burden of mental illnesses in China are urgently needed to contribute to health policy makers' understanding of the potential benefits to society from allocating more resources to preventing and treating mental illness. However, the cost of mental illnesses and particularly its trend in China remains largely unknown.Aims of the Study: To investigate the trend of health care resource utilization among inpatients with mental illnesses in China, and to analyze what are the factors influencing the inpatient costs.Method: Our study sample included 15,721 patients, both adults and children, who were hospitalized over an eight-year period (2005-2012) in Shandong Center for Mental Health (SCMH), the only provincial psychiatric hospital in Shandong province, China. Data were extracted from the Health Information System (HIS) at SCMH, with detailed and itemized cost data on all inpatient expenses incurred during hospitalization. The identification of the patients was based on the ICD-10 diagnoses recorded in the HIS. Descriptive analysis was done to analyze the trend of hospitalization cost and length of stay during the study period. Multivariate stepwise regression analysis was conducted to assess the factors that influence hospitalization cost.Results: Among the inpatients in our sample, the most common mental disorders were schizophrenia, schizotypal and delusional disorders. The disease which had the highest per capita hospital expense was behavioral and emotional disorders with onset usually occurring in childhood and adolescence (RMB 8,828.4; US$ 1,419.4, as compared to the average reported household annual income of US$ 2,095.3 in China). The average annual growth rate of per capita hospitalization cost was 23.6%, with the inpatient cost reaching RMB 11,949 (US$ 1921.1) in 2012. The hospitalization cost was found to be strongly associated with hospital length of stay, level of care, age, employment status, admission diagnoses, and frequency of hospitalization.Discussion: Our study found that mental health inpatient resources use, particularly hospitalization cost, has been growing at an increasing rate. In our sample, hospitalization cost nearly tripled from 2005 to 2012. Mental illnesses and the related economic burden on the population will continue to grow, making mental health a major public health issue in China. Hospital length of stay was found to be increasing in our sample, and positively correlated with hospitalization cost. Childhood and adolescence behavioral and emotional disorders were found to be significantly associated with higher inpatient cost.Implications for Health Policies and Future Research: The policy implications generated from the results of this study are twofold: first of all, in order to meet the growing need of mental health care in China, the government needs to significantly increase its spending in preventing and treating mental illnesses. Second, cost containment in inpatient care would become a major challenge for mental health policy makers in China. Government support, clinical practices and guideline development, as well as research are urgently needed to promote mental health prevention and improve the efficiency of mental health system in China. The current mental health system, like the overall healthcare system in China, relies heavily on hospital inpatient care. In order to build a sustainable mental health care system to meet increasing population need in China, it is crucial to integrate mental health care reform with the ongoing primary health care reform. Future mental health policy reform and research in China should put more focus on how to strengthen primary care system as well as community support, establish effective two-tier referring mechanism between hospital and primary care system, and to ensure continuity of care.