Schizoaffective Disorder

This research aims to evaluate whether taking antipsychotic medication every other day is as effective as the usual daily dosing for people with schizophrenia or related disorders. The study also explores if the alternate day dosing reduces side effects compared to daily treatment. It is a randomized, double-blind trial designed to compare these two dosing schedules over one year. Participants will be randomly assigned to either continue their current daily antipsychotic medication (risperidone, olanzapine, or paliperidone) or switch to an alternate day dosing schedule. To maintain blinding, active medication and placebo capsules are provided in matching blister packs so participants and staff cannot tell which regimen is assigned. Doses range from 1 mg to 16 mg for risperidone, 5 mg to 20 mg for olanzapine, and 3 mg to 12 mg for paliperidone. Treatment is individualized, and other psychotropic medications can continue if stable. Participants will attend 22 visits over 52 weeks, with visits every two weeks for the first six months and monthly visits for the final six months. Researchers will assess symptom severity and side effects using several scales, including the Brief Psychiatric Rating Scale and multiple symptom and wellbeing questionnaires. The main outcome focuses on clinical deterioration at the start and end of the study. Safety and medication adherence will be closely monitored throughout the trial.

Researchers are investigating the use of 40 Hz visual stimulation as an add-on method to help improve negative symptoms, including cognitive difficulties, in people with schizophrenia or schizoaffective disorder. The study is a pilot trial comparing a group receiving visual stimulation with a group receiving their usual treatment. The goal is to assess whether this non-invasive brain stimulation method can influence brain activity patterns linked to symptoms and improve mood and cognition. Participants in the experimental group will undergo one hour of 40 Hz visual stimulation each day for five consecutive days using a customized sleep mask with red LEDs flickering at 40 Hz. They will lie down with their eyes closed and be encouraged to fall asleep during the stimulation. The control group will continue their usual treatment without additional intervention. The study includes pre- and post-assessments conducted before the first and after the last stimulation session. EEG brain activity will be recorded during the first and last stimulation sessions. Throughout the study, participants will complete mood and cognitive tests, and trained physicians will assess psychiatric symptoms. The visual stimulation sessions will be monitored for any side effects by asking participants about undesired effects after each session. EEG data will be analyzed to measure brain responses to the stimulation. The total study duration includes multiple assessment sessions before and after the stimulation week, providing detailed information on brain and symptom changes related to the intervention.

Cognitive impairment related to dementia is often missed in primary care, especially among older adults from minority and socio-economically disadvantaged populations. Researchers are evaluating the 5-Cog brief cognitive assessment, a quick, simple, and standardized tool that takes less than 5 minutes and addresses cultural and logistical barriers. This pragmatic cluster-randomized trial aims to test whether the 5-Cog paradigm improves detection of new cases of cognitive impairment and dementia care in older adults with cognitive concerns. The study involves 22 primary care clinics in Bronx and Indiana, enrolling about 6,600 patients aged 65 and older who report cognitive concerns. Participants receive either the 5-Cog battery combined with a clinical decision-making tool or enhanced usual care, which includes cognitive concern screening. The 5-Cog battery includes tests like Picture Memory Impairment Screen, Motoric Cognitive Risk Syndrome diagnosis, and Symbol Match. Primary care physicians receive results and decision support but use their clinical judgment in care decisions. Participants undergo cognitive concern screening before their appointments. Researchers will review new cognitive impairment diagnoses and improvements in dementia care within 90 days after the primary care visit using electronic medical records. Additional evaluations include tests for reversible causes, medication changes, specialist referrals, and social support. The study also examines the 5-Cog paradigm's implementation and cost-effectiveness, focusing on populations facing health disparities. Total participation duration varies by patient and clinic schedule.

Researchers are conducting the GENESIS clinical study to map the HLA genomic region in the Greek population and explore its possible links with various underlying diseases. This non-interventional, multicenter study aims to provide a pilot map of genetic variation in HLA that may be useful in medical research and clinical applications related to selected diseases. The study plans to include 12,000 participants over a total duration of 36 months. Each participant will attend one visit at a participating site during which they will provide demographic data, lifestyle information such as smoking and alcohol use, blood pressure measurements, details on diagnosed diseases and treatments, and recent laboratory test results if available. Buccal swab samples will be collected from each participant to extract DNA for HLA genotyping analysis. Selected samples will undergo further whole genome sequencing to investigate associations with autoimmune diseases. Participants will receive a personalized ancestry report after analysis completion. During the study visit, data collection includes demographic and health information, as well as laboratory and clinical test results from the past year. The genetic material from buccal swabs will be stored and processed for genetic analysis. Researchers will measure allele frequency of HLA alleles in the Greek population and assess the prevalence and risk associations of selected HLA-related diseases. The study's total duration is 36 months with results available at the end of this period.

Researchers are exploring how a digital life story application can support person-centred care for older adults with dementia. The study focuses on healthcare professionals' perspectives and aims to see if the digital application can replace traditional written life story documents used in care. The life story tool is intended to help create security and improve communication between healthcare professionals and people with dementia by sharing important personal information and experiences. The study involves healthcare professionals who currently use a written life story in their daily care routines. They will participate in focus group interviews to share their experiences, then transfer information from the written life story to the digital application called Min Memoria. This digital tool will be tested in daily care settings, and researchers will observe how it is used during interactions and communication with older adults with dementia. Participants will be involved over several periods: from October 2023 to August 2024, researchers will collect experiences of using the written life story; from September 2024 to August 2025, usage data of the digital tool will be gathered; and from September 2025 to December 2026, observations will be made on how the digital life story is used in care situations. The study will monitor these experiences and interactions to evaluate the potential benefits and application of the digital life story tool.

Researchers are investigating how transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, affects working memory in older adults with mild cognitive impairment (MCI) compared to cognitively healthy older adults. This mechanistic study aims to understand the brain and cognitive function changes caused by a single session of tDCS. The study uses advanced brain imaging and machine learning to analyze the effects of stimulation on brain structure and working memory performance during specific tasks. Participants will receive either active or sham tDCS using a neuroConn MR-safe device that delivers 2.0 mA current through electrodes placed on the scalp over frontal brain regions. Active stimulation lasts 12 minutes with gradual ramp-up and ramp-down, while sham stimulation mimics the sensation but only delivers current for 30 seconds. Each participant completes three runs of an N-back working memory task before, during, and after stimulation. The study uses a randomized, double-blind, crossover design with at least two weeks between sessions. Throughout the study, participants undergo cognitive testing and brain MRI scans to measure working memory accuracy and brain connectivity changes. The main outcome is working memory performance on the 2-back task comparing active versus sham stimulation. Researchers will also monitor safety and participant ability to perform the tasks and tolerate stimulation. The total participation period includes multiple sessions spaced to allow for washout and evaluation of stimulation effects, with the study concluding by late 2029.

Researchers are investigating the effects of a multidomain lifestyle intervention to slow cognitive decline and dementia risk in elderly residents aged 60 to 80 in Zhejiang Province, China. The study builds on findings from Finland, where a similar approach combining physical activity, nutrition, cognitive training, social activities, and vascular risk management showed promise in healthy older adults at risk of cognitive decline. This trial aims to explore how such an intervention may change brain structure and function as well as cognitive abilities in an Asian population. Participants are randomly assigned to either a structured multidomain intervention group or a self-guided control group. The intervention group receives tailored nutritional guidance, cognitive training, physical exercises, and vascular risk monitoring, all adapted to Chinese cultural norms. The control group receives regular health education campaigns and basic health monitoring every 6 to 12 months. This trial runs for two years with ongoing assessments to evaluate the impact of these lifestyle changes. During the study, participants undergo various evaluations including cognitive tests measuring global and domain-specific cognition, neuroimaging scans like MRI and fMRI, laboratory blood tests, and physical performance measures such as grip strength and gait speed. Questionnaires assess quality of life, depression, sleep quality, and daily activities. Researchers also monitor cardiovascular health, dementia onset, and falls. This comprehensive monitoring will help determine the intervention's effects on brain health and daily functioning over the 24-month period.

Researchers are evaluating a combined sleep promotion and cognitive training intervention to help improve cognitive function in older survivors of intensive care units (ICU). This study focuses on adults aged 60 and older who are at high risk for delirium and cognitive decline similar to mild Alzheimer's disease after ICU discharge. The study aims to assess whether these interventions can reduce the risk of developing Alzheimer's disease and related dementias by addressing sleep deficiency, inactivity, and circadian rhythm disturbances common in ICU survivors. Participants will be randomly assigned to one of four groups: a combination of nighttime sleep promotion using earplugs and eye masks plus daily 30-minute computerized cognitive training sessions; cognitive training alone; sleep promotion alone; or an active control group receiving educational modules on brain health. The interventions last up to seven days following ICU discharge, with cognitive training sessions scheduled based on individual circadian rhythms measured by a wearable sensor. During the study, participants will be monitored using body temperature sensors to optimize the timing of cognitive training. Researchers will assess cognitive function, including executive function and working memory, at several time points: within seven days after hospital discharge, and at one, six, and twelve months follow-up. The study also examines how sleep and activity may influence cognitive outcomes, with safety and ongoing care monitored throughout the study period, which concludes in May 2027.

Researchers are evaluating a peer-delivered recovery program called SUPPORT designed for Veterans with serious mental illness (such as psychotic and bipolar disorders) who are at increased risk of suicide. The study aims to improve functional and social recovery and reduce suicide risk by tailoring recovery planning to each Veteran's suicidal experiences. This intervention is an adaptation of the Wellness Recovery Action Plan (WRAP) and uses cognitive learning strategies to help Veterans recall their safety plans and improve functioning. The 5-year study has two phases: Phase 1 focuses on refining SUPPORT using input from Veterans and experts and training Peer Specialists. Phase 2 is a pilot randomized controlled trial comparing SUPPORT to enhanced standard care (ESC), which includes usual suicide prevention measures plus additional research contacts. SUPPORT is delivered weekly in 50-minute sessions by Peer Specialists who work closely with each Veteran to create a personalized recovery plan. The ESC group receives standard suicide risk assessments, safety planning, mental health referrals, and follow-up contacts. Participants are assessed quantitatively at baseline, mid-treatment, post-treatment, and 3 months post-treatment, with additional qualitative interviews after treatment. Peer Specialists are also interviewed after delivering the intervention. Researchers measure the feasibility of recruitment and retention, participant satisfaction, and changes in suicidal thoughts and recovery. The study is sponsored by the VA Office of Research and Development and involves ongoing monitoring over about four years.

Researchers are evaluating whether a cognitive training program can improve processing speed in individuals who have recently experienced an acute traumatic spinal cord injury (SCI). This pilot randomized controlled trial aims to address cognitive difficulties such as attention, memory, and information processing speed, which can significantly impact rehabilitation outcomes and quality of life. The study focuses on early intervention to potentially enhance overall health and well-being for people with acute SCI. Participants are randomly assigned to one of two groups: an experimental group or a placebo control group. Both groups complete pre-specified game-like computerized tasks using an internet-based cognitive training portal. These sessions occur three times per week, lasting 60 minutes each, over a total of 12 weeks. The study uses a quadruple masking design to reduce bias. During the study, participants undergo assessments at baseline, immediately after treatment (week 13), and at long-term follow-up (week 25). Researchers measure processing speed using tests such as the Useful Field of View (UFOV), Letter & Pattern Comparison (LPC), and Symbol Digit Modalities Test (SDMT). Quality of life related to spinal cord injury is also evaluated. The total participation period spans approximately six months, including treatment and follow-up evaluations.