175. Emotional recognition deficits and the impact of pattern-based traditional chinese medicine intervention on diabetic comorbidity in early-stage schizophrenia

Abstract Background Clinical outcomes in early schizophrenia with type 2 diabetes mellitus (T2DM) are heterogeneous, and current treatments usually address psychosis and metabolic risk separately. Facial emotion recognition (FER) deficits and alexithymia, core features of social-cognitive impairment, may further hinder diabetes self-management and functional recovery, yet few interventions target these processes and metabolic control together. Emerging evidence suggests that pattern-based traditional Chinese medicine (TCM) can improve antipsychotic-related metabolic abnormalities, but its impact on FER remains unknown. To evaluate whether TCM syndrome differentiation intervention can simultaneously improve FER and glycemic control in individuals with early-stage schizophrenia and T2DM, this study assessed the effects of adding a 24-week TCM syndrome differentiation intervention to standard treatment on FER performance and metabolic indicators in this high-risk population. Methods This 24-week rater-blinded randomized controlled trial enrolled 120 patients aged 18-45 years with early-stage schizophrenia (illness duration ≤5 years) who also met the diagnostic criteria for T2DM, recruited from two psychiatric specialty centers. Participants were randomly assigned in a 1:1 ratio to either a control group or a TCM group. Both groups received standard antipsychotic pharmacotherapy and guideline-based diabetes management, while the TCM group additionally received pattern-based TCM treatment. Statistical analyses followed the intention-to-treat principle, and mixed-effects models were used to evaluate time-by-group interaction effects. Results The intervention effects on the primary outcomes are summarized in Table 1. As shown in Table 1, FER accuracy increased by 11.80% in the TCM group, whereas the control group exhibited an increase of only 4.20%, yielding a between-group difference of 7.60%, which was statistically significant (p