Back to top Open menu arrow
The Journal of Clinical Psychiatry The Journal of Clinical Psychiatry

The Journal of
Clinical Psychiatry
Access icon

This article is available to members only. Please enjoy the abstract for free. Subscribe for instant access to the full article.

This content is restricted to subscribers

Continue Reading...

Did you know members enjoy unlimited free PDF downloads as part of their subscription? Subscribe today for instant access to this article and our entire library in your preferred format. Alternatively, you can purchase the PDF of this article individually.

Subscribe Now

Already a member? Login

  1. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  2. Drs Zhang, Xiao, and H. Wu contributed equally to this work.
  3. Corresponding Authors: TianHong Zhang, MD, PhD, and JiJun Wang, MD, PhD, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders (No.13dz2260500), Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wanping Nan Road, Shanghai 200030, China (Zhang: [email protected]; Wang: [email protected]).
  4. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  5. Drs Zhang, Xiao, and H. Wu contributed equally to this work.
  6. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  7. Drs Zhang, Xiao, and H. Wu contributed equally to this work.
  8. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  9. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  10. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  11. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  12. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  13. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  14. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  15. Department of Automation, Shanghai Jiao Tong University, China (H. Liu);
  16. ); Big Data Research Laboratory, University of Waterloo, Ontario, Canada (Chen);
  17. Labor and Worklife Program, Harvard University, Cambridge, Massachusetts (Chen);
  18. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  19. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  20. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  21. Nantong Fourth People’s Hospital & Nantong Brain Hospital, Jiangsu, China (X. Wu);
  22. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, PR China (Zhang, Xiao, H. Wu, Zeng, Ye, Gao, Hu, Xu, Wei, Tang, X. Liu, Li, Zhou, Wang);
  23. Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, PR China (Wang);
  1. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789–1858. PubMed CrossRef
  2. Solis M. Prevention: before the break. Nature. 2014;508(7494):S12–S13. PubMed CrossRef
  3. Zhang T, Li H, Woodberry KA, et al. Interaction of social role functioning and coping in people with recent-onset attenuated psychotic symptoms: a case study of three Chinese women at clinical high risk for psychosis. Neuropsychiatr Dis Treat. 2015;11:1647–1654. PubMed CrossRef
  4. Cui H, Giuliano AJ, Zhang T, et al. Cognitive dysfunction in a psychotropic medication-naïve, clinical high-risk sample from the ShangHai-At-Risk-for-Psychosis (SHARP) study: associations with clinical outcomes. Schizophr Res. 2020;226:138–146. PubMed CrossRef
  5. Zhang T, Cui H, Wei Y, et al. Neurocognitive assessments are more important among adolescents than adults for predicting psychosis in clinical high risk. Biol Psychiatry Cogn Neurosci Neuroimaging. 2022;7(1):56–65. PubMed CrossRef
  6. Zhang T, Xu L, Tang Y, et al. Relationship between duration of untreated prodromal symptoms and symptomatic and functional recovery. Eur Arch Psychiatry Clin Neurosci. 2019;269(8):871–877. PubMed CrossRef
  7. Fusar-Poli P, Cappucciati M, Borgwardt S, et al. Heterogeneity of psychosis risk within individuals at clinical high risk: a meta-analytical stratification. JAMA Psychiatry. 2016;73(2):113–120. PubMed CrossRef
  8. McGorry PD. Early clinical phenotypes, clinical staging, and strategic biomarker research: building blocks for personalized psychiatry. Biol Psychiatry. 2013;74(6):394–395. PubMed CrossRef
  9. Hu Y, Xu L, Gan R, et al. A potential objective marker in first-episode schizophrenia based on abnormal niacin response. Schizophr Res. 2022;243:405–412. PubMed CrossRef
  10. Gan R, Zhao Y, Wu G, et al. Replication of the abnormal niacin response in first episode psychosis measured using laser Doppler flowmeter. Asia-Pac Psychiatry. 2022;14(4):e12516. PubMed CrossRef
  11. Gan R, Wei Y, Wu G, et al. Attenuated niacin-induced skin flush response in individuals with clinical high risk for psychosis. Gen Psychiatr. 2022;35(2):e100748. PubMed CrossRef
  12. Messamore E. The niacin response biomarker as a schizophrenia endophenotype: a status update. Prostaglandins Leukot Essent Fatty Acids. 2018;136:95–97. PubMed CrossRef
  13. Sun L, Yang X, Jiang J, et al. Identification of the niacin-blunted subgroup of schizophrenia patients from mood disorders and healthy individuals in Chinese population. Schizophr Bull. 2018;44(4):896–907. PubMed CrossRef
  14. Hudson CJ, Lin A, Cogan S, et al. The niacin challenge test: clinical manifestation of altered transmembrane signal transduction in schizophrenia? Biol Psychiatry. 1997;41(5):507–513. PubMed CrossRef
  15. Bouwer C, Stein DJ. Hyperresponsivity to nicotinic acid challenge in generalized social phobia: a pilot study. Eur Neuropsychopharmacol. 1998;8(4):311–313. PubMed CrossRef
  16. Pike NB. Flushing out the role of GPR109A (HM74A) in the clinical efficacy of nicotinic acid. J Clin Invest. 2005;115(12):3400–3403. PubMed CrossRef
  17. Tang Y, Zhou L, Gunnet JW, et al. Enhancement of arachidonic acid signaling pathway by nicotinic acid receptor HM74A. Biochem Biophys Res Commun. 2006;345(1):29–37. PubMed CrossRef
  18. Murakami M, Kudo I. Recent advances in molecular biology and physiology of the prostaglandin E2-biosynthetic pathway. Prog Lipid Res. 2004;43(1):3–35. PubMed CrossRef
  19. Misiak B, Bartoli F, Carrà G, et al. Immune-inflammatory markers and psychosis risk: a systematic review and meta-analysis. Psychoneuroendocrinology. 2021;127:105200. PubMed CrossRef
  20. Monji A, Kato T, Kanba S. Cytokines and schizophrenia: microglia hypothesis of schizophrenia. Psychiatry Clin Neurosci. 2009;63(3):257–265. PubMed CrossRef
  21. Morris G, Walder K, Puri BK, et al. The deleterious effects of oxidative and nitrosative stress on palmitoylation, membrane lipid rafts and lipid-based cellular signalling: new drug targets in neuroimmune disorders. Mol Neurobiol. 2016;53(7):4638–4658. PubMed CrossRef
  22. Ansarey SH. Inflammation and JNK’s role in niacin-GPR109A diminished flushed effect in microglial and neuronal cells with relevance to schizophrenia. Front Psychiatry. 2021;12:771144. PubMed CrossRef
  23. Miller TJ, McGlashan TH, Rosen JL, et al. Prodromal assessment with the Structured Interview for Prodromal Syndromes and the Scale of Prodromal Symptoms: predictive validity, interrater reliability, and training to reliability. Schizophr Bull. 2003;29(4):703–715. PubMed CrossRef
  24. Miller TJ, McGlashan TH, Rosen JL, et al. Prospective diagnosis of the initial prodrome for schizophrenia based on the Structured Interview for Prodromal Syndromes: preliminary evidence of interrater reliability and predictive validity. Am J Psychiatry. 2002;159(5):863–865. PubMed CrossRef
  25. Aas IH. Global Assessment of Functioning (GAF): properties and frontier of current knowledge. Ann Gen Psychiatry. 2010;9(1):20. PubMed CrossRef
  26. McGlashan T, Walsh B, Woods S. The Psychosis-Risk Syndrome: Handbook for Diagnosis and Follow-up. Oxford University Press; 2010.
  27. Shi C, He Y, Cheung EF, et al. An ecologically valid performance-based social functioning assessment battery for schizophrenia. Psychiatry Res. 2013;210(3):787–793. PubMed CrossRef
  28. Messamore E, Hoffman WF, Janowsky A. The niacin skin flush abnormality in schizophrenia: a quantitative dose-response study. Schizophr Res. 2003;62(3):251–258. PubMed CrossRef
  29. Messamore E, Hoffman WF, Yao JK. Niacin sensitivity and the arachidonic acid pathway in schizophrenia. Schizophr Res. 2010;122(1-3):248–256. PubMed CrossRef
  30. Kumar R, Indrayan A. Receiver operating characteristic (ROC) curve for medical researchers. Indian Pediatr. 2011;48(4):277–287. PubMed CrossRef
  31. Yao JK, Dougherty GG Jr, Gautier CH, et al. Prevalence and specificity of the abnormal niacin response: a potential endophenotype marker in schizophrenia. Schizophr Bull. 2016;42(2):369–376. PubMed CrossRef
  32. Wang DD, Hu XW, Jiang J, et al. Attenuated and delayed niacin skin flushing in schizophrenia and affective disorders: a potential clinical auxiliary diagnostic marker. Schizophr Res. 2021;230:53–60. PubMed CrossRef
  33. Smesny S, Berger G, Rosburg T, et al. Potential use of the topical niacin skin test in early psychosis: aa combined approach using optical reflection spectroscopy and a descriptive rating scale. J Psychiatr Res. 2003;37(3):237–247. PubMed CrossRef
  34. Berger GE, Smesny S, Schäfer MR, et al. Niacin skin sensitivity is increased in adolescents at ultra-high risk for psychosis. PLoS One. 2016;11(2):e0148429. PubMed CrossRef
  35. Langbein K, Schmidt U, Schack S, et al. State marker properties of niacin skin sensitivity in ultra-high risk groups for psychosis: an optical reflection spectroscopy study. Schizophr Res. 2018;192:377–384. PubMed CrossRef
  36. Khoury R, Nasrallah HA. Inflammatory biomarkers in individuals at clinical high risk for psychosis (CHR-P): state or trait? Schizophr Res. 2018;199:31–38. PubMed CrossRef
  37. Delaney S, Fallon B, Alaedini A, et al. Inflammatory biomarkers in psychosis and clinical high risk populations. Schizophr Res. 2019;206:440–443. PubMed CrossRef
  38. Karanikas E, Manganaris S, Ntouros E, et al. Cytokines, cortisol and IGF-1 in first episode psychosis and ultra high risk males. Evidence for TNF-α, IFN-γ, ΤNF-β, IL-4 deviation. Asian J Psychiatr. 2017;26:99–103. PubMed CrossRef
  39. Karanikas E, Griveas I, Ntouros E, et al. Evidence for increased immune mobilization in First Episode Psychosis compared with the prodromal stage in males. Psychiatry Res. 2016;244:333–338. PubMed CrossRef
  40. Zhang T, Tang X, Li H, et al. Clinical subtypes that predict conversion to psychosis: canonical correlation analysis study from the ShangHai At Risk for Psychosis (SHARP) program. Aust N Z J Psychiatry. 2020;45(suppl 2):S329–S330. PubMed CrossRef
  41. Penninx BW, Kritchevsky SB, Yaffe K, et al. Inflammatory markers and depressed mood in older persons: results from the Health, Aging and Body Composition study. Biol Psychiatry. 2003;54(5):566–572. PubMed CrossRef
  42. Kim YK, Na KS, Shin KH, et al. Cytokine imbalance in the pathophysiology of major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2007;31(5):1044–1053. PubMed CrossRef
  43. Whetzel CA, Corwin EJ, Klein LC. Disruption in Th1/Th2 immune response in young adult smokers. Addict Behav. 2007;32(1):1–8. PubMed CrossRef
  44. Miller BJ, Buckley P, Seabolt W, et al. Meta-analysis of cytokine alterations in schizophrenia: clinical status and antipsychotic effects. Biol Psychiatry. 2011;70(7):663–671. PubMed CrossRef
  45. Chang SS, Liu CM, Lin SH, et al. Impaired flush response to niacin skin patch among schizophrenia patients and their nonpsychotic relatives: the effect of genetic loading. Schizophr Bull. 2009;35(1):213–221. PubMed CrossRef
  46. Schwartz TL, Sachdeva S, Stahl SM. Genetic data supporting the NMDA glutamate receptor hypothesis for schizophrenia. Curr Pharm Des. 2012;18(12):1580–1592. PubMed CrossRef
  47. Schwarz MJ, Müller N, Riedel M, et al. The Th2-hypothesis of schizophrenia: a strategy to identify a subgroup of schizophrenia caused by immune mechanisms. Med Hypotheses. 2001;56(4):483–486. PubMed CrossRef
  48. Zhang T, Gan R, Zeng J, et al. Attenuated niacin response is associated with a subtype of first-episode drug-naïve psychosis characterized as serious negative symptoms. Eur Arch Psychiatry Clin Neurosci. 2023. PubMed CrossRef
  49. Zhang T, Xu L, Tang Y, et al; SHARP (ShangHai At Risk for Psychosis) Study Group. Prediction of psychosis in prodrome: development and validation of a simple, personalized risk calculator. Psychol Med. 2019;49(12):1990–1998. PubMed CrossRef
  50. Zhang TH, Li HJ, Woodberry KA, et al. Two-year follow-up of a Chinese sample at clinical high risk for psychosis: timeline of symptoms, help-seeking and conversion. Epidemiol Psychiatr Sci. 2017;26(3):287–298. PubMed CrossRef
  51. Müller N, Riedel M, Scheppach C, et al. Beneficial antipsychotic effects of celecoxib add-on therapy compared to risperidone alone in schizophrenia. Am J Psychiatry. 2002;159(6):1029–1034. PubMed CrossRef
  52. Müller N, Krause D, Dehning S, et al. Celecoxib treatment in an early stage of schizophrenia: results of a randomized, double-blind, placebo-controlled trial of celecoxib augmentation of amisulpride treatment. Schizophr Res. 2010;121(1–3):118–124. PubMed CrossRef
  53. Schmidt SJ, Hurlemann R, Schultz J, et al; ESPRIT-B1 Group. Multimodal prevention of first psychotic episode through N-acetyl-l-cysteine and integrated preventive psychological intervention in individuals clinically at high risk for psychosis: protocol of a randomized, placebo-controlled, parallel-group trial. Early Interv Psychiatry. 2019;13(6):1404–1415. PubMed CrossRef
  54. Dwir D, Cabungcal JH, Xin L, et al. Timely N-acetyl-cysteine and environmental enrichment rescue oxidative stress-induced parvalbumin interneuron impairments via MMP9/RAGE pathway: a translational approach for early intervention in psychosis. Schizophr Bull. 2021;47(6):1782–1794. PubMed CrossRef
  55. Li Z, Zhang T, Xu L, et al. Decreasing risk of psychosis by sulforaphane study protocol for a randomized, double-blind, placebo-controlled, clinical multi-centre trial. Early Interv Psychiatry. 2021;15(3):585–594. PubMed CrossRef

Save Save

Share Share

Cite Cite

Read the Current Issue

Vol 85, 2024 3

Can Our Collective Experiences As Clinicians Improve Mental Health Care?

SSRI Discontinuation and AUD Relapse

Reproductive Pharmacovigilance and Best Practices

Olanzapine and Mirtazapine for Cancer-Related Anorexia

Economic Impact of Cognitive Impairment and Negative Symptoms in Schizophrenia

Functional Unblinding in Pivotal Studies and the Future of Psychedelic Medicine
View current Issue

Celebrating
85 Years

Read the Journal of Clinical Psychiatry

Subscribe to read
more articles

Subscribe