Two distinct patterns of treatment resistance: clinical predictors of treatment resistance in first-episode schizophrenia spectrum psychoses
Two distinct patterns of treatment resistance: clinical predictors of treatment resistance in first-episode schizophrenia spectrum psychoses
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DOI：
10.1017/s0033291716002014
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发表时间：
2016-11-01
影响因子：
6.9
通讯作者：
Murray, R. M.
中科院分区：
文献类型：
--
作者：
Lally, J.;Ajnakina, O.;Murray, R. M.
背景氯氮平仍然是难治性精神分裂症（TRS）的唯一循证抗精神病药。预测哪些首次发作的精神分裂症患者随后符合治疗抵抗（TR）标准的能力有助于减少严重的功能障碍，如果TR没有被识别和正确治疗，可能会随之而来。这是2005年至2010年在南伦敦进行的NIHR遗传学和精神病（GAP）研究中招募的246例首发精神分裂症谱系患者队列的临床结局的5年纵向评估。我们研究了基线人口统计学和临床指标与TR出现之间的关系。通过审查电子病例记录确定TR状态。我们评估了与早发性、迟发性TR和非TR的相关性，以及接受氯氮平治疗的TR患者与未接受氯氮平治疗的TR患者之间的差异。70%（n = 56）的TR患者和23%的总研究人群（n = 246）从疾病发作起就对治疗耐药。那些在患病的前5年内符合TR标准的人更有可能在较早的年龄首次接触精神病（
Background. Clozapine remains the only evidence-based antipsychotic for treatment-resistant schizophrenia (TRS). The ability to predict which patients with their first onset of schizophrenia would subsequently meet criteria for treatment resistance (TR) could help to diminish the severe functional disability which may ensue if TR is not recognized and correctly treated.Method. This is a 5-year longitudinal assessment of clinical outcomes in a cohort of 246 first-episode schizophrenia spectrum patients recruited as part of the NIHR Genetics and Psychosis (GAP) study conducted in South London from 2005 to 2010. We examined the relationship between baseline demographic and clinical measures and the emergence of TR. TR status was determined from a review of electronic case records. We assessed for associations with early-, and late-onset TR, and non-TR, and differences between those TR patients treated with clozapine and those who were not.Results. Seventy per cent (n = 56) of TR patients, and 23% of the total study population (n = 246) were treatment resistant from illness onset. Those who met criteria for TR during the first 5 years of illness were more likely to have an early age of first contact for psychosis (