Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
Eur Neuropsychopharmacol. 2011 May;21(5):370-8. doi: 10.1016/j.euroneuro.2010.10.003. Epub 2011 Jan 20.
To evaluate the predictive validity of early response compared to other well-known predictor variables in acutely ill first-episode patients.
112 patients were treated with a mean dosage of 4.14 mg (±1.70) haloperidol and 112 patients with a mean dosage of 4.17 mg (±1.55) risperidone for a mean inpatient treatment duration of 42.92 days (±16.85) within a double-blind, randomized controlled trial. Early response was defined as a ≥ 30% improvement in the PANSS total score by week 2, response as a ≥ 50% reduction in the PANSS total score from admission to discharge and remission according to the consensus criteria. Univariate tests and logistic regression models were applied to identify significant predictors of response and remission.
52% of the patients were responders and 59% remitters at discharge. Non-remitters at discharge were hindered from becoming remitters mainly by the presence of negative symptoms. Univariate tests revealed several significant differences between responders/non-responders and remitters/non-remitters such as age, severity of baseline psychopathology as well as the frequency of early response. Both early response (p<0.0001) and a higher PANSS positive subscore at admission (p=0.0002) were identified as significant predictors of response at discharge, whereas a shorter duration of untreated psychosis (p=0.0167), a lower PANSS general psychopathology subscore (p<0.0001), and early treatment response (p=0.0002) were identified as significant predictors of remission.
Together with the finding that early response is a significant predictor of response and remission, the relevance and predictive validity of negative and depressive symptoms for outcome is also highlighted.
评估急性期首发患者中早期反应与其他知名预测变量相比的预测有效性。
在一项双盲、随机对照试验中，112 名患者接受了平均剂量为 4.14 毫克（±1.70）的氟哌啶醇治疗，112 名患者接受了平均剂量为 4.17 毫克（±1.55）的利培酮治疗，平均住院治疗时间为 42.92 天（±16.85）。早期反应定义为第 2 周时 PANSS 总分改善≥30%，反应定义为入院至出院时 PANSS 总分降低≥50%，缓解根据共识标准。应用单变量检验和逻辑回归模型来确定反应和缓解的显著预测因素。
出院时，52%的患者为反应者，59%的患者为缓解者。未缓解的患者主要因存在阴性症状而无法成为缓解者。单变量检验显示，反应者/无反应者和缓解者/无缓解者之间存在几个显著差异，如年龄、基线精神病理学严重程度以及早期反应的频率。早期反应（p<0.0001）和入院时更高的 PANSS 阳性亚评分（p=0.0002）均被确定为出院时反应的显著预测因素，而未治疗精神病的持续时间较短（p=0.0167）、PANSS 一般精神病理学亚评分较低（p<0.0001）和早期治疗反应（p=0.0002）被确定为缓解的显著预测因素。
早期反应是反应和缓解的显著预测因素，同时也突出了阴性和抑郁症状对结局的相关性和预测有效性。
