Jäger Markus, Riedel Michael, Schmauss Max, Pfeiffer Herbert, Laux Gerd, Naber Dieter, Gaebel Wolfgang, Huff Wolfgang, Schmidt Lutz G, Heuser Isabella, Buchkremer Gerhard, Kühn Kai-Uwe, Rüther Eckart, Hoff Paul, Gastpar Markus, Bottlender Ronald, Strauss Anton, Möller Hans-Jürgen
Department of Psychiatry, Ludwig-Maximilians University, Munich, Germany.
Psychiatry Res. 2008 Apr 15;158(3):297-305. doi: 10.1016/j.psychres.2007.01.002. Epub 2008 Feb 15.
The aim of the present study was to examine the relevance of depressive symptoms during an acute schizophrenic episode for the prediction of treatment response. Two hundred inpatients who fulfilled DSM-IV criteria for schizophrenia or schizophreniform disorders were assessed at hospital admission and after 6 weeks of inpatient treatment using the Positive and Negative Syndrome Scale (PANSS) and the Hamilton Rating Scale for Depression (HAM-D). Depressive symptoms showed positive correlations with both positive and negative symptoms at admission and after 6 weeks, and decreased during 6 weeks of treatment. Pronounced depressive symptoms (HAM-D score> or =16) were found in 28% of the sample at admission and in 9% after 6 weeks of treatment. Depressive symptoms at admission predicted a greater improvement of positive and negative symptoms over 6 weeks of treatment, but also more, rather than fewer remaining symptoms after 6 weeks. Both results, however, lost statistical significance when analyses were controlled for the influence of positive and negative symptoms at admission. Therefore, the hypothesis that depressive symptoms are predictive of a favorable treatment response was not supported by the present study.
本研究的目的是检验急性精神分裂症发作期间的抑郁症状与治疗反应预测之间的相关性。对200名符合精神分裂症或精神分裂症样障碍DSM-IV标准的住院患者在入院时以及住院治疗6周后,使用阳性和阴性症状量表(PANSS)和汉密尔顿抑郁量表(HAM-D)进行评估。抑郁症状在入院时和6周后与阳性和阴性症状均呈正相关,且在6周的治疗期间有所减轻。入院时,28%的样本存在明显的抑郁症状(HAM-D评分≥16),治疗6周后这一比例为9%。入院时的抑郁症状预测了6周治疗期间阳性和阴性症状有更大改善,但也预测了6周后残留症状更多而非更少。然而,当分析控制了入院时阳性和阴性症状的影响后,这两个结果均失去了统计学意义。因此,本研究不支持抑郁症状可预测良好治疗反应这一假设。