Misiak Błażej, Frydecka Dorota, Beszłej Jan A, Moustafa Ahmed A, Tybura Piotr, Kucharska-Mazur Jolanta, Samochowiec Agnieszka, Bieńkowski Przemysław, Samochowiec Jerzy
Departments of aPsychiatry bGenetics, Wroclaw Medical University, Wroclaw cDepartment of Psychiatry, Pomeranian Medical University dDepartment of Clinical Psychology, Institute of Psychology, University of Szczecin, Szczecin eDepartment of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland fSchool of Social Sciences and Psychology, Marcs Institute of Brain and Behaviour, University of Western Sydney, Penrith, New South Wales, Australia.
Int Clin Psychopharmacol. 2016 Jul;31(4):185-91. doi: 10.1097/YIC.0000000000000120.
We aimed to investigate whether antipsychotics differentially impact insight and whether these effects appear because of improvement in psychopathological manifestation in 132 first-episode schizophrenia patients and 201 acutely relapsed schizophrenic patients, who were followed up for 12 weeks. Olanzapine and risperidone were administered to first-episode schizophrenia patients, whereas acutely relapsed schizophrenic patients were treated with olanzapine, perazine and ziprasidone. The Positive And Negative Syndrome Scale (PANSS) was used to assess psychopathology. Insight was assessed using the G12 item of PANSS. Unadjusted mixed-model regression analysis indicated a significant improvement in the PANSS G12 item score in both groups. There were no significant differences between distinct treatment subgroups of patients in terms of improvement in the PANSS G12 item score. After adjustment for the trajectories of changes in symptom dimensions, a decrease in the PANSS G12 item score was because of an improvement in positive, negative and excitement symptoms. A decrease in the PANSS G12 item score was also related to an increase in the severity of depressive symptomatology. Our results indicate that antipsychotics exert similar effects on insight in acute psychosis. These effects are likely because of an improvement in psychopathological manifestation. The improvement in insight might be related to the development of depressive symptoms.
我们旨在调查抗精神病药物对自知力的影响是否存在差异，以及这些影响是否因132例首发精神分裂症患者和201例急性复发精神分裂症患者的精神病理表现改善而出现，这些患者接受了为期12周的随访。首发精神分裂症患者服用奥氮平和利培酮，而急性复发精神分裂症患者接受奥氮平、奋乃静和齐拉西酮治疗。采用阳性和阴性症状量表（PANSS）评估精神病理学。使用PANSS的G12项评估自知力。未经调整的混合模型回归分析表明，两组患者的PANSS G12项得分均有显著改善。在PANSS G12项得分改善方面，不同治疗亚组的患者之间没有显著差异。在对症状维度变化轨迹进行调整后，PANSS G12项得分的降低是由于阳性、阴性和兴奋症状的改善。PANSS G12项得分的降低也与抑郁症状严重程度的增加有关。我们的结果表明，抗精神病药物对急性精神病患者的自知力有相似的影响。这些影响可能是由于精神病理表现的改善。自知力的改善可能与抑郁症状的发展有关。
