Acute-phase treatment in general hospitals: clinical psychopharmacologic evaluation in first-episode schizophrenia patients

Abstract 

A case-control study was conducted to investigate possible predictors of response to antipsychotic treatment in acute schizophrenic patients. During a 14-month period, 13 female first-episode schizophrenic patients were included. According to their antipsychotic treatment response 8 weeks after admission, they were placed in either a good-response group (n = 8) or poor-response group (n = 5). Scores of the two groups differed on several items of the Positive and Negative Syndrome Scale (PANSS) at baseline and during the following 8 weeks. At baseline, the maximum scores for Conceptual disorganization, Poor rapport, Passive/apathetic social withdrawal, and Stereotyped thinking in the good-response group were lower than the corresponding minimum scores in the poor-response group. Furthermore, minimum improvements after 1 week in scores for excitement in the good-response group were higher than the maximum improvements in the corresponding scores of the poor-response group. These PANSS items might serve as simple and rapid predictors of treatment resistance. In addition, Lack of judgment and insight significantly improved by 1 week, and further improved by 5 weeks in the good-response group. This suggests that treatment in the good-response group will be optimal if provided during a hospital stay of appropriate length.

Keywords:  Time course, Positive and Negative Syndrome Scale, Treatment-resistance, Risperidone, Insight