Levinson D F, Singh H, Simpson G M
Department of Psychiatry, Medical College of Pennsylvania, Eastern Pennsylvania Psychiatric Institute, Philadelphia 19129.
Br J Psychiatry. 1992 Mar;160:365-71. doi: 10.1192/bjp.160.3.365.
The time course of clinical improvement was studied in 41 schizophrenic and schizoaffective acute in-patients treated for 28 days with 10, 20 or 30 mg/day of oral fluphenazine hydrochloride in a double-blind, randomised study. Significant improvement was seen in the four BPRS factors: thinking disturbance, hostile-suspiciousness, withdrawal-retardation and anxious depression. The first two of these factors were improved by day 5. Significant improvement was seen up to day 22 for three of the four factors, but without significant improvement during the last week (although scores continued to drop). The half of the sample showing greater overall improvement did not improve faster than the sample as a whole. These more improved subjects did not differ significantly from the less improved subjects in the thinking disturbance factor until day 15, suggesting that at least a two-week neuroleptic trial would be necessary to begin to differentiate more and less responsive patients. The longer-term course of improvement cannot be determined from these data. The withdrawal-retardation and anxious depression factors showed their greatest improvement later than the 'positive' symptom factors, suggesting that the former may improve as a result of change in the latter.
在一项双盲、随机研究中，对41例精神分裂症和分裂情感性急性住院患者进行了为期28天的研究，这些患者每天口服10、20或30毫克盐酸氟奋乃静。在简明精神病评定量表（BPRS）的四个因子中观察到显著改善：思维紊乱、敌对-猜疑、退缩-迟缓及焦虑抑郁。其中前两个因子在第5天就有改善。四个因子中有三个因子在第22天前均有显著改善，但在最后一周无显著改善（尽管评分持续下降）。总体改善程度较大的那一半样本并不比整个样本改善得更快。直到第15天，这些改善程度较大的受试者在思维紊乱因子上与改善程度较小的受试者并无显著差异，这表明至少需要进行为期两周的抗精神病药物试验，才开始区分反应性较高和较低的患者。无法从这些数据中确定改善的长期过程。退缩-迟缓及焦虑抑郁因子的改善比“阳性”症状因子出现得更晚，这表明前者可能是后者变化的结果。
