Kokurcan Ahmet
Health Sciences University, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Psychiatry Clinic, Ankara, Turkey.
Noro Psikiyatr Ars. 2019 Jul 16;56(3):219-223. doi: 10.29399/npa.23548. eCollection 2019 Sep.
The primary aim of this study was to compare clinical characteristics between the patients with schizophrenia on clozapine treatment with those under combination of long-acting injectable and oral antipsychotics (combined treatment), and the secondary aim was to evaluate the impact of obsessive-compulsive disorder (OCD) comorbidity on the clinical variables.
The patients with schizophrenia applied at Outpatient Psychiatry Clinic of the University between October 2017 and March 2018 taking clozapine or combined treatment were included in the study. The participants were administered Brief Psychiatric Rating Scale (BPRS), Clinical Global Impressions Scale, Scale for the Assessment of Positive and Negative Symptoms (SAPS/SANS), Calgary Depression Scale for Schizophrenia (CDSS), Yale-Brown Obsessive Compulsive Scale (YBOCS), Turkish version of Schedule for Assessing the three components of insight (SAI), and Global Assessment of Functioning Scale (GAF).
Patients on clozapine had higher Y-BOCS, BPRS, SANS, CDSS scores, and lower GAF scores compared to those taking combined antipsychotics (p<0.05). OCD comorbidity rate was 13% in the combination therapy group and 36% in clozapine users. The SAPS scores were higher but CDSS scores were lower in clozapine users with the presence of OCD comorbidity (p<0.05).
Clozapine and combined therapy groups differed widely by the clinical characteristics of the patients in this study. Both groups showed a high OCD comorbidity rate in this study and OCD comorbidity should be considered when schizophrenia treatment is initiated to obtain more satisfactory results. Furthermore, patients on clozapine seem to show a different relationship with OCD comorbidity compared to those under combined treatment.
本研究的主要目的是比较接受氯氮平治疗的精神分裂症患者与接受长效注射剂和口服抗精神病药物联合治疗(联合治疗)的患者之间的临床特征,次要目的是评估强迫症(OCD)共病对临床变量的影响。
纳入2017年10月至2018年3月在大学门诊精神科诊所接受氯氮平或联合治疗的精神分裂症患者。参与者接受了简明精神病评定量表(BPRS)、临床总体印象量表、阳性和阴性症状评定量表(SAPS/SANS)、精神分裂症卡尔加里抑郁量表(CDSS)、耶鲁-布朗强迫症量表(YBOCS)、土耳其版领悟三成分评定量表(SAI)和功能总体评定量表(GAF)。
与接受联合抗精神病药物治疗的患者相比,接受氯氮平治疗的患者YBOCS、BPRS、SANS、CDSS评分更高,GAF评分更低(p<0.05)。联合治疗组的强迫症共病率为13%,氯氮平使用者为36%。存在强迫症共病的氯氮平使用者的SAPS评分更高,但CDSS评分更低(p<0.05)。
在本研究中,氯氮平组和联合治疗组在患者临床特征方面存在很大差异。本研究中两组的强迫症共病率均较高,在开始精神分裂症治疗时应考虑强迫症共病以获得更满意的结果。此外,与联合治疗的患者相比,接受氯氮平治疗的患者似乎与强迫症共病表现出不同的关系。