Prediction of acute clinical response following a first episode of non affective psychosis: Results of a cohort of 375 patients from the Spanish PAFIP study

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• 作者：Benedicto Crespo-Facorro^a ; ^b ; ^{bcfacorro@humv.es} ; Victor Ortiz-Garcia de la Foz^a ; ^b ; Rosa Ayesa-Arriola^a ; ^b ; Rocí ; o Pé ; rez-Iglesias^b ; ^c ; Ignacio Mata^a ; ^b ; Paula Suarez-Pinilla^a ; Rafael Tabares-Seisdedos^d ; José ; Luis Vá ; zquez-Barquero^a ; ^b
• 关键词：CGI ; Clinical Global Impression ; DSM ; Diagnostic and Statistical Manual of Mental Disorders ; DUI ; Duration of untreated illness ; DUP ; Duration of untreated psychosis ; OR ; Odds Ratio ; PAS ; Premorbid Adjustment Scale ; PAFID ; Epidemiological and three-year l
• 刊名：Progress in Neuro-Psychopharmacology and Biological Psychiatry
• 出版年：2013
• 出版时间：1 July, 2013
• 年：2013
• 卷：44
• 期：Complete
• 页码：162-167
• 全文大小：211 K

文摘

Objective

Predicting response to antipsychotic treatment might optimize treatment strategies in early phases of schizophrenia. We aimed to investigate sociodemographic, premorbid and clinical predictors of response to antipsychotic treatment after a first episode of non-affective psychosis.

Method

375 (216 males) patients with a diagnosis of non affective psychosis entered the study. The main outcome measure was clinical response at 6 weeks and variables at baseline were evaluated as predictors of response. ANOVA for continuous and chi-square for categorical data were used to compare responders and non-responders. Multivariate logistic regression was used to establish a prediction model.

Results

53.3 % of study subjects responded to antipsychotic treatment. The following variables were associated with an unfavorable response:1. ¡ª lower severity of symptoms at baseline;2. ¡ª diagnosis of schizophrenia;3. ¡ª longer DUI and DUP;4. ¡ª poorer premorbid adjustment during adolescence and adulthood;5. ¡ª family history of psychosis, and 6. ¡ª hospitalization. Patients with a family history of psychosis, longer DUP, poor premorbid functioning and lower severity of psychotic symptoms at intake have a reduced likelihood of responding to antipsychotic treatment.

Conclusion

Helping clinicians to identify those first episode patients with a lower probability of having a favorable clinical response is meant as a first step to achieve a successful initial treatment.