Buchanan R W, Kirkpatrick B, Summerfelt A, Hanlon T E, Levine J, Carpenter W T
Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore 21228.
Biol Psychiatry. 1992 Jul 1;32(1):72-8. doi: 10.1016/0006-3223(92)90143-n.
The validity of previously hypothesized predictors of elapse following neuroleptic discontinuation was examined. One hundred sixty-two outpatients, with either Research Diagnostic Criteria schizophrenia or schizoaffective disorder, were discontinued from neuroleptic medication for a 28-day period or until judged to be relapsed. Pre-discontinuation neuroleptic dosage level, the severity of psychotic symptoms, and the presence of dyskinetic movements prior to neuroleptic discontinuation were the predictor variables. Of the 162 patients, 62.7% did not relapse during the study period. There were no differences in the survival rates between the patients withdrawn from oral versus depot neuroleptics. Neuroleptic dosage, but not severity of psychotic symptoms or dyskinetic movements, predicted relapse. These results support the hypothesis that pre-withdrawal neuroleptic dosage level predicts relapse, but fail to validate either severity of psychotic symptoms or presence of dyskinetic movements as predictors of relapse.
对先前假设的抗精神病药物停药后病情复发的预测因素的有效性进行了检验。162名门诊患者，患有研究诊断标准中的精神分裂症或分裂情感性障碍，停用抗精神病药物28天或直至被判定复发。停药前抗精神病药物剂量水平、精神病症状的严重程度以及抗精神病药物停药前是否存在运动障碍是预测变量。在这162名患者中，62.7%在研究期间未复发。从口服与长效抗精神病药物撤药的患者之间的生存率没有差异。抗精神病药物剂量可预测复发，但精神病症状的严重程度或运动障碍不能预测复发。这些结果支持了停药前抗精神病药物剂量水平可预测复发的假设，但未能证实精神病症状的严重程度或运动障碍的存在可作为复发的预测因素。
