Efficacy of identifying Treatment-Resistant and non-Treatment-Resistant Schizophrenia using niacin skin flushing response combined with clinical feature

Abstract Treatment-resistant schizophrenia (TRS) is a serious mental disease and early identification of this disease is necessary for timely initiation of treatment strategies and management measures. This study aimed to investigate the potential of niacin skin flushing response (NSFR) combined wit...

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Main Authors: Jizhi Wang, Jinfeng Wang, Siyuan Wang, Yu Gu, Kai Liang, Yingxu Li, Zheng Zhang, Yan Li, Xiaoping Wang, Huijuan Guo, Jiansong Zhou
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Schizophrenia
Online Access:https://doi.org/10.1038/s41537-025-00567-4
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author Jizhi Wang
Jinfeng Wang
Siyuan Wang
Yu Gu
Kai Liang
Yingxu Li
Zheng Zhang
Yan Li
Xiaoping Wang
Huijuan Guo
Jiansong Zhou
author_facet Jizhi Wang
Jinfeng Wang
Siyuan Wang
Yu Gu
Kai Liang
Yingxu Li
Zheng Zhang
Yan Li
Xiaoping Wang
Huijuan Guo
Jiansong Zhou
author_sort Jizhi Wang
collection DOAJ
description Abstract Treatment-resistant schizophrenia (TRS) is a serious mental disease and early identification of this disease is necessary for timely initiation of treatment strategies and management measures. This study aimed to investigate the potential of niacin skin flushing response (NSFR) combined with clinical features in recognizing TRS and non-TRS (NTRS). A total of 269 patients with schizophrenia (99 TRS and 170 NTRS) were included in this study. We conducted NSFR test on 269 participants. Positive and negative syndrome scale (PANSS), repeatable battery for the assessment of neuropsychological status (RBANS) and insight and treatment attitudes questionnaires (ITAQ) were used to assess the patients’ psychiatric symptoms, cognitive function, and attitude towards illness and treatment, respectively. Differences in NSFR and clinical features between TRS and NTRS were assessed and the relation was evaluated using Spearman correlation. The efficacy of NSFR and clinical features in identifying TRS was assessed using the receiver operating characteristic (ROC) curve. Patients with TRS have enhanced NSFR compared to patients with NTRS, and NSFR was positively correlated with the course of the disease. PANSS total score was negatively correlated with the age of first onset, RBANS total score, and ITAQ score and positively correlated with the course of disease. Age of first onset, course of disease, RBANS total score, and NSFR were poor indicators for identifying TRS and NTRS. The ITAQ score has better diagnostic validity for TRS compared to the above indicators. Among the clinical features, the ITAQ has an important role in recognizing TRS. The NSFR has poor efficacy in recognizing TRS.
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spelling doaj-art-b12fc961916848ad92c69926417d572f2025-02-09T12:42:03ZengNature PortfolioSchizophrenia2754-69932025-02-011111710.1038/s41537-025-00567-4Efficacy of identifying Treatment-Resistant and non-Treatment-Resistant Schizophrenia using niacin skin flushing response combined with clinical featureJizhi Wang0Jinfeng Wang1Siyuan Wang2Yu Gu3Kai Liang4Yingxu Li5Zheng Zhang6Yan Li7Xiaoping Wang8Huijuan Guo9Jiansong Zhou10Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityBio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong UniversityPingtang Compulsory Isolation Detoxification Institute in Hunan ProvinceDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityHunan Forensic Psychiatric HospitalHunan Forensic Psychiatric HospitalDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityAbstract Treatment-resistant schizophrenia (TRS) is a serious mental disease and early identification of this disease is necessary for timely initiation of treatment strategies and management measures. This study aimed to investigate the potential of niacin skin flushing response (NSFR) combined with clinical features in recognizing TRS and non-TRS (NTRS). A total of 269 patients with schizophrenia (99 TRS and 170 NTRS) were included in this study. We conducted NSFR test on 269 participants. Positive and negative syndrome scale (PANSS), repeatable battery for the assessment of neuropsychological status (RBANS) and insight and treatment attitudes questionnaires (ITAQ) were used to assess the patients’ psychiatric symptoms, cognitive function, and attitude towards illness and treatment, respectively. Differences in NSFR and clinical features between TRS and NTRS were assessed and the relation was evaluated using Spearman correlation. The efficacy of NSFR and clinical features in identifying TRS was assessed using the receiver operating characteristic (ROC) curve. Patients with TRS have enhanced NSFR compared to patients with NTRS, and NSFR was positively correlated with the course of the disease. PANSS total score was negatively correlated with the age of first onset, RBANS total score, and ITAQ score and positively correlated with the course of disease. Age of first onset, course of disease, RBANS total score, and NSFR were poor indicators for identifying TRS and NTRS. The ITAQ score has better diagnostic validity for TRS compared to the above indicators. Among the clinical features, the ITAQ has an important role in recognizing TRS. The NSFR has poor efficacy in recognizing TRS.https://doi.org/10.1038/s41537-025-00567-4
spellingShingle Jizhi Wang
Jinfeng Wang
Siyuan Wang
Yu Gu
Kai Liang
Yingxu Li
Zheng Zhang
Yan Li
Xiaoping Wang
Huijuan Guo
Jiansong Zhou
Efficacy of identifying Treatment-Resistant and non-Treatment-Resistant Schizophrenia using niacin skin flushing response combined with clinical feature
Schizophrenia
title Efficacy of identifying Treatment-Resistant and non-Treatment-Resistant Schizophrenia using niacin skin flushing response combined with clinical feature
title_full Efficacy of identifying Treatment-Resistant and non-Treatment-Resistant Schizophrenia using niacin skin flushing response combined with clinical feature
title_fullStr Efficacy of identifying Treatment-Resistant and non-Treatment-Resistant Schizophrenia using niacin skin flushing response combined with clinical feature
title_full_unstemmed Efficacy of identifying Treatment-Resistant and non-Treatment-Resistant Schizophrenia using niacin skin flushing response combined with clinical feature
title_short Efficacy of identifying Treatment-Resistant and non-Treatment-Resistant Schizophrenia using niacin skin flushing response combined with clinical feature
title_sort efficacy of identifying treatment resistant and non treatment resistant schizophrenia using niacin skin flushing response combined with clinical feature
url https://doi.org/10.1038/s41537-025-00567-4
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