Evidence mapPaperPMID 41449373Full record

ArticleBMC psychiatry2025

Elevated prolactin and association with treatment resistance indicators in first-hospitalized schizophrenia spectrum disorders: a real-world cohort study.

Dan Qi, Wenjie Sun, Meijuan Li, Tongxin Li, Jing Ma, Di Liu, Minghui Li, Chenghao Lu, Xinxu Wang, Yeqing Dong and 5 more

Abstract read
In one paragraph

Article in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Dan QiInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
Wenjie SunInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
Meijuan LiInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
Tongxin LiInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
Jing MaDepartment of Information Technology, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China.
Di LiuDepartment of Information Technology, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China.
Minghui LiInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
Chenghao LuInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
Xinxu WangInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
Yeqing DongInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
Shaobing LiInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
Yanzhe LiInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
Jie LiInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China. jieli@tmu.edu.cn.
Shen LiInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China. lishen@tmu.edu.cn.
Nannan LiuInstitute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China. liunn1204@tmu.edu.cn.

Funding

Foundation of Tianjin Health Commission for Young Scholars TJWJ2021QN064the National Natural Science Foundation of China 62027812the National Natural Science Foundation of China 82371512
6 · The paper itself

Abstract

backgroundHyperprolactinemia frequently occurs during antipsychotic treatment but is also observed in antipsychotic-naïve schizophrenia patients. The relationship between prolactin (PRL) and treatment resistance remains underexplored in real-world populations.

objectiveTo characterize age-/sex-stratified PRL distribution in first-hospitalized schizophrenia spectrum disorder (SSD) patients and examine associations with treatment resistance proxies (clozapine use/rehospitalization).

methodsWe analyzed 4,103 first-hospitalized SSD patients using real-world data. PRL levels were stratified by age/sex. Binary logistic regression evaluated PRL-clozapine/rehospitalization associations with confounder adjustment. ROC analysis assessed PRL's discriminative capacity for clozapine use.

resultsElevated PRL prevalence was highest in females aged 18-45 (71.5%). PRL negatively correlated with clozapine use in males (P < 0.001), with lower median levels in users vs. non-users (374.40 vs. 529.10 mIU/L, P < 0.001). This persisted in males aged 18-45 (434.90 vs. 558.60 mIU/L) and ≥ 55 years (308.60 vs. 583.30 mIU/L) (both P < 0.01). In males ≥ 55, each 1 mIU/L PRL increase reduced clozapine use probability by 0.2% (aOR = 0.998, 95%CI:0.997-1.000). ROC analysis showed moderate discriminative capacity (AUC = 0.72, sensitivity 78.6%, specificity 39.4%). No significant associations occurred in females or for rehospitalization.

conclusionThe PRL demonstrates inverse, age-specific associations with clozapine use in male SSD patients, suggesting potential as a stratification biomarker for treatment resistance.

Indexed as

Antipsychotic AgentsClozapineHyperprolactinemiaProlactinSchizophreniaAdolescentAdultAge FactorsCohort StudiesFemaleHospitalizationHumansMaleMiddle AgedPatient ReadmissionSex FactorsAntipsychotic AgentsClozapineProlactinClozapineFirst-hospitalized patientsReal-world dataSchizophrenia spectrum disordersSerum prolactinSex differences

Identifiers

PMID41449373
PMCPMC12849556

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.