Predictors of treatment response from a first episode of schizophrenia or schizoaffective disorder.
Predictors of treatment response from a first episode of schizophrenia or schizoaffective disorder.
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DOI：
10.1176/ajp.156.4.544
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发表时间：
1999-04
期刊：
影响因子：
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通讯作者：
D. Robinson;M. Woerner;J. Alvir;S. Geisler;A. Koreen;B. Sheitman;M. Chakos;D. Mayerhoff;R. Bilder;R. Goldman;J. Lieberman
中科院分区：
文献类型：
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作者：
D. Robinson;M. Woerner;J. Alvir;S. Geisler;A. Koreen;B. Sheitman;M. Chakos;D. Mayerhoff;R. Bilder;R. Goldman;J. Lieberman
目的：本研究旨在探讨首发精神分裂症和情感性精神障碍患者的治疗反应及其潜在的预测因素。方法对首发患者的精神病理学、认知、社会功能和生物学参数进行评估，并根据标准化算法进行治疗。结果118例患者（52%为男性，平均年龄25.2岁）进入研究。1年内缓解的患者累积百分比为87%;中位缓解时间为9周。以下变量与治疗反应的可能性较低显著相关：男性、产科并发症、更严重的幻觉和妄想、基线时注意力较差以及抗精神病药物治疗期间发生帕金森症。与治疗反应无显著相关的变量为诊断（精神分裂症与情感性精神障碍）、病前功能、进入研究前精神病症状持续时间、基线紊乱、阴性和抑郁症状、基线运动功能、治疗期间静坐不能和肌张力障碍、生长激素和高香草酸测量、哌醋甲酯激活精神病症状和磁共振测量。结论：首发精神分裂症和情感性精神障碍患者对抗精神病药物治疗有较高的反应率;有特异性的临床和病理生物学反应预测因子。
OBJECTIVE This study examined the treatment response of patients with first-episode schizophrenia and schizoaffective disorder and potential predictors of response. METHOD First-episode patients were assessed on measures of psychopathology, cognition, social functioning, and biological parameters and treated according to a standardized algorithm. RESULTS One hundred eighteen patients (52% male, mean age 25.2 years) entered the study. The cumulative percentage of patients responding by 1 year was 87%; the median time to response was 9 weeks. The following variables were significantly associated with less likelihood of response to treatment: male sex, obstetric complications, more severe hallucinations and delusions, poorer attention at baseline, and the development of parkinsonism during antipsychotic treatment. Variables not significantly related to treatment response were diagnosis (schizophrenia versus schizoaffective disorder), premorbid functioning, duration of psychotic symptoms prior to study entry, baseline disorganization, negative and depressive symptoms, baseline motor function, akathisia and dystonia during treatment, growth hormone and homovanillic acid measures, psychotic symptom activation to methylphenidate, and magnetic resonance measures. CONCLUSIONS Patients with first-episode schizophrenia and schizoaffective disorder have high rates of response to antipsychotic treatment; there are specific clinical and pathobiologic predictors of response.