Can antidepressants be used to treat the schizophrenia prodrome? Results of a prospective, naturalistic treatment study of adolescents
Can antidepressants be used to treat the schizophrenia prodrome? Results of a prospective, naturalistic treatment study of adolescents
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DOI：
10.4088/jcp.v68n0410
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发表时间：
2007-04-01
影响因子：
5.3
通讯作者：
Correll, Christoph U.
中科院分区：
文献类型：
--
作者：
Cornblatt, Barbara A.;Lencz, Todd;Correll, Christoph U.
目的：本研究报告了一项前瞻性、自然主义治疗研究的结果，该研究对被认为处于前驱期的青少年（即，方法：48名青少年（平均年龄= 15.8岁）参加了识别和预防（RAP）计划（1998-2005年）的初始阶段，包括在本报告中。从总体样本（N = 152）中选择个体，如果他们具有：（1）显示减弱的阳性症状，（2）接受至少8周的治疗，和（3）随访至少6个月结果：两种类型的药物自然处方：抗抑郁药（N = 20）或第二代抗精神病药（N = 28），常见的是多种药物。两个治疗组的基线症状特征没有差异，但思维混乱除外，这种情况在接受第二代抗精神病药物治疗的青少年中更为严重。48名青少年中有12名（25%）发展为精神障碍，所有转换者都被处方了第二代抗精神病药物。在接受抗抑郁药治疗的青少年中没有发生转换（对数秩卡方检验（2）= 7.36，df = 1，p = 0.007）。然而，治疗结果是混淆的，因为12个转换器中的I I是非粘附的。总体而言，青少年更可能不依从第二代抗精神病药物（61%，17/28）而不是抗抑郁药（20%，4/20; chi（2）= 7.86，p =.005）。随着时间的推移，5个阳性症状中有3个有显著改善（p
Objective: This study reports the results of a prospective, naturalistic treatment study of adolescents considered to be in the prodromal (i.e., prepsychotic) phase of schizophrenia.Method: Forty-eight adolescents (mean age = 15.8 years) participating in the initial phase of the Recognition and Prevention (RAP) program (1998-2005) were included in the current report. Individuals were selected from the overall sample (N = 152) if they had: (1) displayed attenuated positive symptoms, (2) been treated pharmacologically for at least 8 weeks, and (3) been followed up for at least 6 months (mean follow-up = 30.5 months).Results: Two types of medication were naturalistically prescribed: antidepressants (N = 20) or second-generation antipsychotics (N = 28), with polypharmacy common. The 2 treatment groups did not differ in baseline symptom profiles, with the exception of disorganized thinking, which was more severe in second-generation antipsychotic-treated adolescents. Twelve of the 48 adolescents (25%) developed a psychotic disorder, with all converters having been prescribed second-generation antipsychotics. There were no conversions among anti depressant-treated adolescents (log-rank chi(2) = 7.36, df = 1, p =.007). Treatment outcome, however, was confounded, since I I of the 12 converters were nonadherent. Adolescents, in general, were more likely to be nonadherent to second-generation antipsychotics (61%, 17/28) than to antidepressants (20%, 4/20; chi(2) = 7.86, p =.005). Improvement in 3 of 5 positive symptoms over time was significant (p