Effects of adjunctive intranasal oxytocin on olfactory identification and clinical symptoms in schizophrenia: results from a randomized double blind placebo controlled pilot study.
Effects of adjunctive intranasal oxytocin on olfactory identification and clinical symptoms in schizophrenia: results from a randomized double blind placebo controlled pilot study.
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DOI：
10.1016/j.schres.2013.01.001
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发表时间：
2013-04
影响因子：
4.5
通讯作者：
Kelly DL
中科院分区：
文献类型：
--
作者：
Lee MR;Wehring HJ;McMahon RP;Linthicum J;Cascella N;Liu F;Bellack A;Buchanan RW;Strauss GP;Contoreggi C;Kelly DL
嗅觉识别缺陷在精神分裂症(SZ)患者中被广泛报道，并与阴性症状学有关。经鼻腔给药的催产素可以改善精神分裂症患者的社会认知能力，改善阳性症状和阴性症状。鉴于催产素的鼻内传递途径是嗅觉通路，嗅觉异常是SZ的一个潜在的内表型，我们研究了鼻内催产素对精神分裂症患者嗅觉识别以及阳性和阴性症状的影响。精神分裂症或分裂情感性精神障碍患者(n=28；16例门诊患者，12例住院患者)被随机分为两组，分别接受鼻腔内催产素20IU，2次/d或安慰剂治疗3周。所有28名参与者都完成了临床试验。在宾夕法尼亚大学气味识别测试(UPSIT)的气味识别总分和宜人气味分分数上，气味识别性能显着提高。将接受催产素治疗的患者的UPSIT评分(F=5.2，df=1，23，p=0.032)和气味评分(F=4.56，df=1，23，p=0.044)从基线到终点与安慰剂进行比较。鼻内注射催产素不能改善全身症状以及阳性和阴性症状。事实上，在安慰剂组中，改善的是整体症状，而不是阳性或阴性症状。二次分析表明，鼻腔内注射催产素改善了一小部分住院患者的阴性症状。在三周的试验中，鼻腔内注射催产素的耐受性良好。辅助性鼻内催产素可提高嗅觉辨别能力，尤其是在正价项上。需要更大规模的研究来确定催产素对深圳阴性症状的影响。
Deficits in olfactory identification have been widely reported in patients with schizophrenia (SZ) and are associated with negative symptomatology. Adjunctive oxytocin delivered intranasally has been shown to improve some aspects of social cognition as well as positive and negative symptoms in patients with schizophrenia. Given the intranasal delivery route of oxytocin to olfactory pathways and that olfactory abnormalities are a potential endophenotype in SZ, we investigated the effect of intranasal oxytocin on olfactory identification as well as positive and negative symptoms in people with schizophrenia. Individuals with schizophrenia or schizoaffective disorder (n=28; 16 outpatients, 12 inpatients) were randomized to receive adjunctive intranasal oxytocin 20 IU BID or placebo for 3 weeks. All 28 participants completed the clinical trial. Odor identification performance significantly improved on the University of Pennsylvania Smell Identification Test (UPSIT) total score and subscore for pleasant smells. UPSIT score (F=5.20, df=1,23, p=0.032) and subscore for pleasant smells (F=4.56, df=1,23, p=0.044), in patients treated with oxytocin were compared to placebo from baseline to endpoint. Global symptomatology as well as positive and negative symptoms were not improved by intranasal oxytocin. In fact, global symptoms, not positive or negative symptoms, improved in the placebo group. Secondary analysis shows that intranasal oxytocin improved negative symptoms in the small group of inpatients. Intranasal oxytocin was well tolerated during the three week trial. Adjunctive intranasal oxytocin may improve olfactory identification, particularly in items of positive valence. Larger studies are needed to determine the effects of oxytocin on negative symptoms in SZ.
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通讯作者：
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