Uçok Alp, Polat Asliotahan, Genç Aysun, Cakir Sibel, Turan Nurten
Department of Psychiatry, Istanbul University Istanbul Medical Faculty, Millet Street, Capa 34390, Istanbul, Turkey.
J Psychiatr Res. 2004 Mar-Apr;38(2):163-8. doi: 10.1016/s0022-3956(03)00104-3.
There is growing evidence for a relationship between the duration of untreated psychosis (DUP) and the prognosis in schizophrenia. The objective of this study is to evaluate whether DUP and premorbid level of social functioning are related to treatment response in acute treatment of first-episode schizophrenia. Seventy-nine first-episode schizophrenia patients were assessed with BPRS, SAPS, and SANS on admission and discharge during their first hospitalisation. Percentage of the difference between admission and discharge in total scores of all scales were taken as measures of absolute symptom reduction. The median DUP was 6 months (mean=8.6). DUP was correlated with reduction in BPRS and SAPS scores but not SANS scores. Patients with a short DUP (n=41) also showed a higher reduction in BPRS, and SAPS scores than those with a long DUP. Premorbid Adjustment Scale (PAS) scores were inversely correlated with age at onset and positively correlated with BPRS scores at admission. We did not find any relationship between PAS scores and response to treatment. Our findings suggest that DUP may be an important predictor of response in acute treatment of first-episode schizophrenia and thus, attempts for early diagnosis may also have a positive effect on acute treatment response.
未治疗精神病持续时间(DUP)与精神分裂症预后之间的关系,证据日益增多。本研究的目的是评估DUP和病前社会功能水平是否与首发精神分裂症急性治疗中的治疗反应相关。79例首发精神分裂症患者在首次住院期间入院和出院时接受了简明精神病评定量表(BPRS)、阳性与阴性症状量表(SAPS)和阴性症状评定量表(SANS)评估。所有量表总分入院与出院差异的百分比作为绝对症状减轻的指标。DUP的中位数为6个月(平均=8.6)。DUP与BPRS和SAPS评分的降低相关,但与SANS评分无关。DUP短的患者(n=41)在BPRS和SAPS评分上的降低也高于DUP长的患者。病前适应量表(PAS)评分与发病年龄呈负相关,与入院时BPRS评分呈正相关。我们未发现PAS评分与治疗反应之间存在任何关系。我们的研究结果表明,DUP可能是首发精神分裂症急性治疗中反应的重要预测指标,因此,早期诊断的尝试也可能对急性治疗反应产生积极影响。