Long-acting injectable antipsychotic therapies may offer benefits over oral antipsychotics in patients with schizophrenia. However, there is still a lack of real-world studies assessing the effectiveness of these therapies.

This study aimed to explore the safety, tolerability, and treatment response of aripiprazole monohydrate (AOM) once monthly in non-acute but symptomatic adult patients switched from previous therapy with frequently used oral or injectable atypical antipsychotics.

This was a post hoc analysis of a prospective, interventional, single-arm, open-label, 6-month study.

The patients (N=54) were switched to aripiprazole monohydrate once-monthly (AOM) from daily oral treatment or monthly injectable treatment with either aripiprazole (n=25), olanzapine (n=7), paliperidone extended-release (PP1M) (n=10), quetiapine (n=4), or risperidone (n=8). In all groups, mean Positive and Negative Syndrome Scale total (p=0.0001) and Clinical Global Impression-Severity scores improved significantly (p=0.0001). A reduction of ≥50% reduction of BPRS total-score and a CGI severity-score ≤4 in the Positive and Negative Syndrome Scale total score were observed in 16.7% (aripiprazole), 21.2% (olanzapine), 35.1% (PP1M), 27.3% (quetiapine), and 37.2% (risperidone) of patients. The patients showed significant improvements involving safety features as they experienced significant overall weight loss (p=0.0001) and prolactine decrease (risperidone p=0.0001, paliperidone extended-release p=0.0001). AOM once-monthly was well tolerated, presenting no new safety signals. Patient also reported an overall significant improvement on their quality of life measured with the Quality of Life Rating Scale (QLS) (p=0.0004) as well as in sexual functioning PRSexDQ-SALSEX (p=0.0001). In addition, the all cause treatment discontinuation rate after6-month follow-up was small (n=3; 5,55%)

These data illustrate that stable, non-acute but symptomatic patients either on oral antipsychotic therapy or under monthly antipsychotic treatment may show clinically meaningful improvement of psychotic symptoms, tolerability involving relevant side effects and quality of life perception. The findings are limited by the naturalistic study design; thus, further studies are required to confirm the current findings.

Keywords: Long-acting injectable antipsychotic therapy. Oral antipsychotic. Effectiveness- Tolerability-Quality oflife.

Anxiety, tension, sadness, anger, and other emotions are collectively referred to as negative emotions, which can bring negative emotional experiences, make the body feel uncomfortable, and even affect normal work and life. At present, the proportion of college students suffering from negative emotions is relatively high, which has become a focus of the society. Negative emotions can lead to problems such as memory deterioration and attention impairment. Based on the characteristics of (Electro-EncephaloGram) EEG signals, the study analyzed the improvement effect of music neurofeedback training on college students’ negative emotion and attention state.

This research reaches a cooperation with a well-known university in China, and randomly selects 250 students from the School of Electrical Engineering of the university. Then, the Positive and Negative Affect Scale (PANAS) was used for evaluation, and 60 students with PANAS scores of more than 20 were selected as experimental subjects. Then 50 students were divided into two groups, namely, the test group and the control group, with 40 students in the experimental group and 10 students in the control group. Among them, the experimental group includes 20 people in the music stimulation group and 20 people in the nerve feedback group. The music stimulation group and nerve feedback training group were stimulated for 5 minutes each time, and then took a rest for 2 minutes. After resting twice, EEG signals were collected for 2 minutes. The test period was 2 weeks. The control group did not receive any stimulation or training, and the EEG signal acquisition method and time were consistent with the experimental group. At the end of the test cycle, the PANAS scale is used again for evaluation.

Table 1 shows the change of PANAS (negative) scores of the two groups of college students before and after the test. The results showed that the PANAS scores of students in the experimental group under nerve feedback and music stimulation decreased significantly after the experiment, and the difference before and after the experiment was statistically significant (P < 0.05). The PANAS score of the control group decreased, but the change was not statistically significant (P > 0.05).

On the basis of analyzing the resting EEG signals of nerve feedback training and music stimulation, it is combined with the relative power and continuous coherence analysis method. The intervention effect of music neurofeedback training on college students’ negative emotion and attention state was studied from the aspects of EEG signal and scale evaluation with the help of self-measurement scale. The results showed that the negative emotions of college students under the stimulation of nerve feedback and music were significantly relieved compared with those before the intervention, indicating that this method is an effective tool to regulate negative emotions and cognitive attention, and has certain clinical application value.Table 1.

The change of PANAS (negative) scores of the two groups of college students before and after the experiment

In the study of colleges and universities, students are under greater pressure to learn English, so the reform of the teaching mode of English in colleges and universities is of great significance to alleviating students’ learning anxiety.

This study chose 150 students with English learning anxiety as its experimental subjects at a particular university in order to investigate the impact of English teaching reform on helping students overcome their learning fear. The experimental employees were split into two groups using the random approach. One group was designated “blank,” and that group was taught using conventional English methods. The experimental group, which uses a multimedia-reformed approach to English instruction, is the other group. The experimental statistical scale uses the Anxiety Disorder Somatic Symptom Assessment Scale, and the experimental period lasts for 3 months.

The panic index scores of the blank group and the experimental group were 78.49 ± 2.32 and 79.50 ± 2.26, respectively, after the evaluation of the Anxiety Disorder Somatic Symptom Assessment Scale, and the tension index scores were 84.65 ± 2.42 and 83.17 ± 1.58, respectively, prior to the start of the experiment. Following the experiment, the scores for stress indicators were 83.79 ± 1.87 and 72.49 ± 4.01, while the scores for panic indicators were 77.76 ± 2.46 and 67.65 ± 1.28, respectively, in the blank group and experimental group. The experimental group’s scores for somatic symptoms of anxiety displayed a considerable decline.

The reform of college English teaching through multimedia can effectively alleviate students’ learning anxiety.

A project of Wuchang Shouyi University (No. 2021Y05).

Car accidents have a serious impact on the physical health and mental state of patients, leading to traumatic stress disorder. A good environment is beneficial for students to cultivate healthy and sound personalities, and has a positive impact on their mental health. Traditional culture and artistic environment can effectively alleviate patients’ anxiety.

The study selected a total of 98 students with traumatic stress disorder caused by car accidents from our hospital from January to December 2022 as the study subjects. The selected research subjects were divided into two groups: the control group and the experimental group. There was no significant difference in age, gender, etc. between the two groups of students (P>0.05). The experimental group received intervention using environmental therapy combined with general treatment, while the control group received routine intervention treatment.

The study used SPSS23.0 statistical software for data analysis, and the results showed that there was no significant difference in the total PCL-L scores between the two groups of patients before the intervention (P>0.05). After the intervention, the scores and scores of both groups decreased, and the experimental group was lower than the control group (P<0.05).

Traditional culture and art environment influence psychological intervention, which starts from various aspects such as psychological and physiological support, active care and encouragement of injured patients to express their feelings, and release and relax treatment, comprehensively improves patients’ understanding of the disease, enhances their treatment compliance, and improves their psychological state.

This study aims to investigate the alleviating effect of Acupuncture combined with Cognitive-Behavioral Therapy (CBT) on anxiety disorders among accounting professionals in the financial sharing services model. Anxiety disorders are prevalent among accounting professionals due to the high-pressure work environment, and effective interventions are essential to mitigate their negative impact.

A total of 120 accounting professionals working in the financial sharing services model were recruited for this study. They were randomly divided into three groups: the Acupuncture combined with CBT group (n=40), the CBT alone group (n=40), and the control group (n=40). The participants’ anxiety levels were measured using the Stanford Acute Stress Response Questionnaire (SASRQ) and the 3-min Confusion Assessment Scale (3D-CAM). The intervention was conducted over a period of six weeks, with regular sessions once a week.

Statistical analysis using SPSS23.0 revealed a significant reduction in anxiety levels in both the Acupuncture combined with CBT group and the CBT alone group compared to the control group (P<0.001). However, the Acupuncture combined with CBT group exhibited a more substantial decrease in anxiety symptoms compared to the CBT alone group (P<0.05), as measured by the SASRQ and 3D-CAM. These results suggest that the combination therapy has a more significant effect on alleviating anxiety disorders among accounting professionals.

This study demonstrates the efficacy of acupuncture combined with CBT in reducing anxiety disorders among accounting professionals in the financial shared service model. These findings highlight the importance of combining complementary therapies, such as acupuncture, with established psychological interventions to achieve more comprehensive treatment outcomes.

The 2017 Shaanxi Provincial Department of Education project (No. 17JK0942); The 2021 Xi’an Social Science Planning Fund project (No. JX163); The 2022 Shaanxi International Business School Science and Technology Innovation Team Construction Project (No. 2022KYTD05).

Many schools have readjusted their teaching management strategies in order to implement the principle of “Sanquan education”, that is, whole-process education and all-round education. The purpose of this study is to understand the influence of Sanquan teaching concept on the identification of students with functional cognitive impairment.

Patients with cognitive impairment in a school were selected as research objects and randomly divided into a control group and an experimental group. The control group received the traditional teaching management mode, while the experimental group implemented the new teaching management mode that fully implemented the three-in-one education policy. The Montreal Cognitive Assessment Scale was used for assessment and SPSS22.0 was used for statistical analysis.

After 6 months of experiment, the control group’s cognitive rating scale score changed from 11 to 13 points, while the experimental group’s cognitive rating scale score changed from 12 to 26 points. In the experimental group, the symptoms of patients with functional cognitive impairment were significantly alleviated (P<0.05). The experimental results show that the introduction of the concept of Sanquan education into teaching management has a significant impact on students’ recognition of functional cognitive impairment.

The introduction of the “ Sanquan education” policy in school teaching management can have a positive impact on the identification of students with functional cognitive impairment, reduce the symptoms of patients, and provide a potential therapeutic method with research significance. The results of this study provide a reference for school management and treatment of mental illness.

Evening-dosed DR/ER-MPH (formerly HLD200), a delayed-release and extended-release methylphenidate, was designed to provide efficacy upon awakening and through the evening. The objective was to evaluate whether treatment with DR/ER-MPH in children with attention-deficit/hyperactivity disorder (ADHD): (1) improves caregiver-rated ADHD symptoms, and (2) reduces caregiver strain, versus placebo.

Caregiver-rated ADHD symptoms (Conners’ Global Index–Parent [CGI-P]) and caregiver strain (Caregiver Strain Questionnaire [CGSQ]) were assessed as secondary endpoints following 3 weeks of treatment in a randomized, double-blind, multicenter, placebo-controlled, parallel-group, phase 3 trial of DR/ER-MPH in children (6-12 years) with ADHD (NCT02520388). Using the 10-item CGI-P, parents rated their child’s ADHD symptoms on a 4-point scale (0=never/seldom; 3=very often/frequently). Caregivers also rated the impact of caring for a child with emotional and behavioral challenges on the 21-item CGSQ (5-point scale: 1=not at all; 5=very much). A reduction on individual item and total scores for both measures indicated an improvement.

Of 163 children enrolled across 22 sites, 161 were included in the intent-to-treat population (DR/ER-MPH, n=81; placebo, n=80) and 138 completed the study. The mean DR/ER-MPH dose after 3 weeks of treatment was 68.1 mg. Mean CGI-P scores at baseline and CGSQ scores at screening (ie, before washout of prior ADHD therapy) were comparable for both DR/ER-MPH (CGI-P: 22.8, CGSQ: 54.5) and placebo (CGI-P: 21.8; CGSQ: 54.9) groups. After 3 weeks of treatment, caregivers of children onDR/ER-MPH reported significant reductions in CGI-P scores versus those on placebo (least-squares [LS] mean: 12.3 vs 17.4; P<0.001). Additionally, there was a significant reduction in CGSQ scores after 3 weeks of treatment with DR/ER-MPH versus placebo (LS mean: 41.2 vs 49.1; P<0.001). Post hoc analyses on the effect of DR/ER-MPHversus placebo on individual items of CGI-P and CGSQ, and the two subscales of CGI-P will be presented. No serious TEAEs were reported and all TEAEs were consistent with those of MPH.

Caregivers reported significant improvements in their child’s ADHD symptoms and these improvements coincided with reductions in caregiver strain after 3 weeks of treatment on evening-dosed DR/ER-MPH versus placebo.

Ironshore Pharmaceuticals & Development, Inc.

Disease prevalence, comorbid conditions, and pharmacological treatments were examined in a large population of US commercial- or Medicaid-insured individuals with schizophrenia.

This retrospective, cross-sectional claims analysis sourced data from the IBM MarketScan Commercial and Medicare Supplemental Databases and the Multi-state Medicaid Database (01Jan2009 to 30Jun2016). Cases were defined by =1 diagnostic claim (ICD-9-CM/ICD-10-CM) for schizophrenia during the study period. Comorbidities (=1 ICD-9-CM/ICD-10-CM diagnosis code) were grouped according to Clinical Classifications Software (CCS) level 2 categories. For the per-database analysis of comorbidities, schizophrenia cases were matched with controls by demographic characteristics. Case-control comorbidity comparisons were performed using prevalence rate ratios (PRRs) and 95% CIs. Per-database medication exposure (=1 National Drug Code in outpatients grouped by Redbook classification) was also assessed.

Schizophrenia prevalence was 0.11% and 0.99% in commercially and Medicaid-insured patients, respectively. In both databases, comorbidity prevalence was higher among schizophrenia cases versus controls in approximately =80% of the CCS level 2 categories assessed. Common top categories of comorbidities for schizophrenia cases were mood disorders, anxiety disorders, other connective tissue disease, and diseases of the heart. Comorbidities with the highest case-control PRRs included personality disorders, suicide and intentional self-inflicted injury, and impulse control disorders. Across databases, the most commonly prescribed medications in cases were antipsychotics, antidepressants, and analgesics/antipyretics opiate agonists; the most highly prescribed antipsychotics were risperidone, quetiapine, aripiprazole, and olanzapine.

This large-scale analysis quantifies the high prevalence of medical and psychiatric comorbidity burden in patients with schizophrenia, highlighting the importance of integrated medical and psychiatric care.

Alkermes, Inc.

Current treatments for schizophrenia are often associated with increased rates of metabolic syndrome (MetSy). MetSy is defined as meeting 3 of the following 5 criteria: waist circumference >40in (men) or >35in (women), triglycerides =150mg/dL, high density lipoprotein cholesterol (HDL) <40mg/dL (men) or <50mg/dL (women), systolic blood pressure (BP) =130mmHg or diastolic BP =85mmHg, fasting glucose =100mg/dL. Patients with MetSy have an elevated risk of developing type II diabetes and increased mortality due to cardiovascular disease. Lumateperone (lumateperone tosylate, ITI−007), a mechanistically novel antipsychotic that simultaneously modulates serotonin, dopamine, and glutamate neurotransmission, is FDA approved for the treatment of schizophrenia. This distinct pharmacological profile has been associated with favorable tolerability and a low risk of adverse metabolic effects in clinical trials. This post hoc analysis of 2 randomized, double-blind, placebo-controlled studies of patients with an acute exacerbation of schizophrenia compared rates of MetSy with lumateperone and risperidone. Data from an open-label long-term trial of lumateperone were also evaluated.

The incidence and shift in MetSy were analyzed in data pooled from 2 short-term (4 or 6 week) placebo- and active-controlled (risperidone 4mg) studies of lumateperone 42mg (Studies 005 and 302). The pooled lumateperone data were compared with data for risperidone. Data from an open-label 1-year trial (Study 303) evaluated MetSy in patients with stable schizophrenia switched from prior antipsychotic (PA) treatment to lumateperone 42mg.

In the acute studies (n=256 lumateperone 42mg, n=255 risperidone 4mg), rates of MetSy were similar between groups at baseline (16% lumateperone, 19% risperidone). At the end of treatment (EOT), MetSy was less common with lumateperone than with risperidone (13% vs 25%). More lumateperone patients (46%) compared with risperidone (25%) patients improved from having MetSy at baseline to no longer meeting MetSy criteria at EOT. Conversely, more patients on risperidone than on lumateperone developed MetSy during treatment (13% vs 5%). Differences in MetSy conversion rates were driven by changes in triglycerides and glucose. In the long-term study (n=602 lumateperone 42mg), 33% of patients had MetSy at PA baseline. Thirty-six percent of patients (36%) with MetSy at PA baseline improved to no longer meeting criteria at EOT. Fewer than half that percentage shifted from not meeting MetSy criteria to having MetSy (15%).

In this post hoc analysis, lumateperone 42mg patients had reduced rates of MetSy compared with risperidone patients. In the long-term study, patients with MetSy on PA switched to lumateperone 42mg had a reduction in the risk of MetSy. These results suggest that lumateperone 42mg is a promising new treatment for schizophrenia with a favorable metabolic profile.

Intra-Cellular Therapies, Inc.

Tardive dyskinesia (TD) is a persistent and potentially disabling movement disorder associated with exposure to antipsychotics and other dopamine receptor blocking agents. Effective and comprehensive treatment of TD requires reducing patients’ abnormal involuntary movements without disrupting their psychiatric stability. This can be especially challenging when patients have complex psychiatric conditions (e.g., >1 psychiatric diagnosis) and are taking multiple medications. Valbenazine, a highly potent and selective vesicular monoamine transporter 2 (VMAT2) inhibitor, is approved for the once-daily treatment of TD. This post hoc analysis of two long-term studies (KINECT 3, KINECT 4) was conducted to evaluate changes in psychiatric status and clinician- and patient-reported treatment success in study participants who received valbenazine (40 or 80 mg) for 48 weeks.

Data from KINECT 3 and KINECT 4 were pooled and analyzed in participants categorized by their primary psychiatric diagnosis: schizophrenia/schizoaffective disorder (“SCHZ”) or mood disorder (“MD”). Concomitant medications needed for managing these and other psychiatric or medical conditions were allowed. Treatment success was defined as achieving a rating of “much improved” or “very much improved” at Week 48, as assessed using the Clinical Global Impression of Change-Tardive Dyskinesia (CGI-TD) and Patient Global Impression of Change (PGIC). Psychiatric stability was monitored using the following scales: Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) in the SCHZ subgroup; Young Mania Rating Scale (YMRS) and Montgomery-Åsberg Depression Rating Scale (MADRS) in the MD subgroup. Suicidal ideation/behavior was monitored using the Columbia-Suicide Severity Rating Scale.

More than 75% of study participants in the SCHZ subgroup achieved treatment success with valbenazine, based on clinician assessment (CGI-TD, 79.7%) and patient self-report (PGIC, 78.0%). Mean changes from baseline to Week 48 for PANSS scores (positive symptoms [-0.7], negative symptoms [‑0.6], general psychopathology [-1.9], total [-3.2]) and CDSS total score (-0.5) indicated maintenance of psychiatric stability in the SCHZ subgroup. Similar treatment success rates were found in the MD subgroup for both CGI-TD (77.6%) and PGIC (84.5%), with mean changes from baseline in YMRS total score (-1.0) and MADRS total score (+0.3) indicating psychiatric stability was maintained. No emergence of suicidal ideation/behavior was observed during the studies.

Pooled analyses from two 48-week studies indicate that long-term treatment of TD with once-daily valbenazine resulted in substantial clinician- and patient-reported global improvements in TD, while psychiatric stability was maintained regardless of primary psychiatric condition.

Neurocrine Biosciences, Inc.

The 12-week ARM-TD and AIM-TD studies in tardive dyskinesia (TD) patients showed statistically significant improvements in TD symptoms with deutetrabenazine. The completed open-label extension (OLE) study (SD-809-C−20) evaluated long-term efficacy and safety of deutetrabenazine in TD.

Patients who completed ARM-TD or AIM-TD enrolled in the OLE study, with deutetrabenazine dose titrated based on dyskinesia control and tolerability. Change from baseline in Abnormal Involuntary Movement Scale (AIMS) score was assessed by local site raters. Treatment success was evaluated locally as patients being “much improved” or “very much improved” on Clinical Global Impression of Change (CGIC).

343 patients enrolled in the OLE study; 6 patients were excluded from analyses. At Week 54 (n=249; dose [mean±SE]: 38.7±0.66mg/day), mean change from baseline in AIMS score was –4.8±0.28; 66% of patients experienced treatment success. At Week 106 (n=194; dose: 39.3±0.75mg/day), mean change from baseline in AIMS score was –5.4±0.33; 65% of patients experienced treatment success. At Week 145 (n=160; dose: 39.4±0.83mg/day), mean change from baseline in AIMS score was –6.6±0.37; 73% of patients experienced treatment success. Treatment was generally well tolerated across 723 patient-years of exposure through Week 158, and exposure-adjusted incidence rates (incidence/patient-years) for akathisia/restlessness were 0.01, somnolence/sedation were 0.07, and symptoms which may represent parkinsonism or depression were 0.08 each.

Patients who received long-term treatment with deutetrabenazine achieved sustained improvement in AIMS scores. Findings from this open-label trial with response-driven dosing suggest the possibility of increasing benefit over time.

Teva Pharmaceutical Industries Ltd., Petach Tikva, Israel