Predictors of acute treatment response in patients with a first episode of non-affective psychosis:: Sociodemographics, premorbid and clinical variables
Predictors of acute treatment response in patients with a first episode of non-affective psychosis:: Sociodemographics, premorbid and clinical variables
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DOI：
10.1016/j.jpsychires.2006.05.002
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发表时间：
2007-10-01
影响因子：
4.8
通讯作者：
Vazquez-Barquero, Jose Luis
中科院分区：
文献类型：
--
作者：
Crespo-Facorro, Benedicto;Pelayo-Teran, Jose Maria;Vazquez-Barquero, Jose Luis
大约60%的首次精神病发作患者使用抗精神病药物会显著降低阳性症状的严重程度。本研究的目的是调查非情感性精神病首次发作时抗精神病药物治疗反应的预测因素。172名患者（107名男性）被诊断为单型精神分裂症、精神分裂症、情感性精神分裂、短暂反应性精神病、分裂型人格障碍或非其他特定精神病。评估基线时的社会人口学、发病前和临床数据。分别采用连续的非配对t检验和分类数据的chi(2)来比较反应者和非反应者选择的变量。采用多元logistic回归建立预测模型。57.6%的研究对象（172人中的99人）对抗精神病药物治疗有反应。以下变量与较低的反应可能性显著相关：-一般精神病理、阳性症状和紊乱症状的严重程度较低；2. -发病年龄较早；3. -精神分裂症诊断；4. -更长的DUP；5. 5 .青春期的病前适应能力较差；——住院治疗。多因素logistic回归显示，有反应者和无反应者之间的差异主要由BPRS总分、发病年龄、青春期早期的发病前调整和诊断来解释。精神分裂症发病年龄较早、发病前青少年功能较差、入院时精神病理严重程度较低的患者对抗精神病药物治疗的反应可能性较低。帮助临床医生识别无反应者是优化治疗工作的第一步，以使这一弱势群体的个体受益。(c) 2006 Elsevier Ltd.版权所有。
Approximately 60% of patients with a first episode of psychosis will significantly reduce the severity of their positive symptomatology with antipsychotic drugs. The aim of this study was to investigate predictors of response to antipsychotic treatment during the first episode of non-affective psychosis. 172 patients (107 male) with a diagnosis of schizophreniform, schizophrenia, schizo affective, brief reactive psychosis, schizotypal personality disorder or psychosis non-otherwise specified entered the study. Sociodemographic, premorbid and clinical data at baseline were evaluated. Unpaired t-test for continuous and chi(2) for categorical data, respectively, were used to compare responders and non-responders selected variables. Multivariate logistic regression was used to establish a prediction model. 57.6% of study subjects (99 of 172) responded to antipsychotic treatment. The following variables were significantly associated with less likelihood of response: 1. - lower severity of general psychopathology, positive symptoms and disorganized symptoms at baseline; 2. - earlier age of onset; 3. - diagnosis of schizophrenia; 4. - longer DUP; 5. - poorer premorbid adjustment during adolescence, and 6. - hospitalization. Multivariate logistic regression demonstrated that differences between responders and non-responders were largely accounted for by BPRS total score, age of onset, premorbid adjustment at early adolescence, and diagnosis. Patients with an early age of onset of schizophrenia, a poor premorbid adolescent functioning, and with a lower severity of psychopathology at intake seem to have a decrease likelihood of responding to antipsychotic treatment. Helping clinicians to identify non-responders is meant as a first step to optimise therapeutic effort to benefit individuals in this vulnerable group. (c) 2006 Elsevier Ltd. All rights reserved.