Psychosis Early Detection and Intervention Centre (PEDIC), Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf.
Pharmacopsychiatry. 2009 Nov;42(6):277-83. doi: 10.1055/s-0029-1234105. Epub 2009 Nov 18.
'Early-onset' studies have shown that symptomatic response often occurs early and that early symptomatic response is predictive for later outcome. Limiting factors of these studies include the restriction on symptomatic outcome, the inclusion of mostly moderately ill patients, and the use of various antipsychotics.
Response and remission rates were assessed in 528 severely ill patients with schizophrenia at baseline, week 2, 4 and 12 using PANSS, SWN-K, CGI-S, and SOFAS. The clinical measures were combined to one outcome criterion (CombOut). Predicitive validity was analyzed for CombOut using linear regression models.
Rate and time to response differed markedly between outcome measures. 32% reached positive symptom response at week 2, 58% at week 4 and 85% at week 12. Non-response at week 4, but not at week 2 was predictive for later non-response. The combined outcome criterion was best predicted by early response in subjective wellbeing (T=-7.88, p<0.001) and social functioning (T=-7.43, p<0.001).
Rate and time to response might depend on sample characteristics and outcome measure. In severely ill patients early antipsychotic response is possibly delayed from the first 2 to the first 4 weeks. Early response in subjective wellbeing and social functioning are strong predictors for overall outcome, which make them a useful supplementation to the assessment of symptomatic response.
“早期发病”的研究表明，症状缓解通常发生得较早，且早期症状缓解可预测后期结果。这些研究的限制因素包括对症状缓解的限制，主要纳入中度病情患者，以及使用各种抗精神病药物。
使用 PANSS、SWN-K、CGI-S 和 SOFAS 在基线、第 2、4 和 12 周评估 528 名严重精神分裂症患者的缓解率和缓解率。将临床测量值组合为一个结果标准（CombOut）。使用线性回归模型分析 CombOut 的预测有效性。
不同的结果测量标准中，缓解率和缓解时间差异明显。2 周时有 32%的患者达到阳性症状缓解，4 周时有 58%，12 周时有 85%。4 周时无缓解，但 2 周时无缓解预测后期无缓解。早期的主观幸福感（T=-7.88，p<0.001）和社会功能（T=-7.43，p<0.001）反应是综合结果标准的最佳预测指标。
缓解率和缓解时间可能取决于样本特征和结果测量。在严重的患者中，早期抗精神病药物的反应可能从第 2 周延迟到第 4 周。主观幸福感和社会功能的早期反应是整体结果的有力预测指标，这使其成为症状缓解评估的有用补充。
