Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
World J Biol Psychiatry. 2012 Jan;13(1):30-8. doi: 10.3109/15622975.2011.552633. Epub 2011 May 13.
To evaluate depressive symptoms regarding their association with the acute outcome in first-episode schizophrenia comparing risperidone and haloperidol.
A total of 274 patients were analysed within a double-blind randomized controlled trial and treated with risperidone or haloperidol. The patients were grouped according to their baseline HAMD-21 total score in a "depressed" (HAMD-21 ≥16) or "non-depressed" (HAMD-21 <16) patient subgroup. PANSS, HAMD-21, GAF, SOFAS and AIMS ratings were performed. Early response was defined as an initial 20% reduction of the PANSS total score from admission to week 2, response as an at least 50% reduction of the PANSS total score from admission to discharge and remission according to the consensus criteria.
A total of 124 patients were classified as depressive at baseline with 22 patients still being depressive at discharge. The depressed and non-depressed patients did not significantly differ regarding the treatment with risperidone and haloperidol (P = 0.2270). The depressive patients suffered from significantly more suicidal tendencies (P = 0.0165), had significantly less insight into their illness (P = 0.0152) and featured significantly worse functioning (P = 0.0066). Patients with depressive symptoms achieved remission significantly less often than non-depressed patients.
The importance of a specific and adequate treatment of depressive symptoms is highlighted.
评估首发精神分裂症患者抑郁症状与急性期结局的相关性，比较利培酮和氟哌啶醇的疗效。
对 274 名患者进行了一项双盲随机对照试验分析，给予利培酮或氟哌啶醇治疗。根据基线 HAMD-21 总分将患者分为“抑郁”（HAMD-21≥16）或“非抑郁”（HAMD-21<16）亚组。进行 PANSS、HAMD-21、GAF、SOFAS 和 AIMS 评分。早期反应定义为入院至第 2 周时 PANSS 总分降低 20%，反应定义为入院至出院时 PANSS 总分降低 50%以上，缓解根据共识标准定义。
共有 124 名患者在基线时被分类为抑郁，其中 22 名患者在出院时仍为抑郁。抑郁和非抑郁患者在接受利培酮和氟哌啶醇治疗方面无显著差异（P=0.2270）。抑郁患者自杀倾向明显更严重（P=0.0165），对疾病的洞察力明显更差（P=0.0152），功能明显更差（P=0.0066）。有抑郁症状的患者缓解的比例明显低于无抑郁症状的患者。
强调了对抑郁症状进行特定和充分治疗的重要性。
