Zhang Lin, Bai Aohan, Tang Zhongyu, Liu Xuebing, Li Yi, Ma Jun
Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.
Front Psychiatry. 2023 Apr 27;14:1173263. doi: 10.3389/fpsyt.2023.1173263. eCollection 2023.
Schizophrenia is a severe and persistent mental condition that causes disability. For subsequent clinical care, it is extremely practical to effectively differentiate between patients who respond to therapy quickly and those who do not. This study set out to document the prevalence and risk factors for patient early non-response.
The current study included 143 individuals with first-treatment and drug-naïve (FTDN) schizophrenia. Patients were classified as early non-responders based on a Positive and Negative Symptom Scale (PANSS) score reduction of less than 20% after 2 weeks of treatment, otherwise as early responders. Clinical subgroups' differences in demographic data and general clinical data were compared, and variables related to early non-response to therapy were examined.
Two weeks later, a total of 73 patients were described as early non-responders, with an incidence of 51.05%. The early non-response subgroup had significantly higher PANSS scores, Positive symptom subscale (PSS) scores, General psychopathology subscale (GPS) scores, Clinical global impression scale - severity of illness (CGI-SI) and Fasting blood glucose (FBG) levels compared to the early-response subgroup. CGI-SI and FBG were risk factors for early non-response.
High rates of early non-response have been seen in FTDN schizophrenia patients, and risk variables for predicting early non-response include CGI-SI scores and FBG levels. However, we need more in-depth studies to confirm the generalizable range of these two parameters.
精神分裂症是一种导致残疾的严重且持续性精神疾病。对于后续临床护理而言，有效区分对治疗反应迅速的患者和无反应的患者极具现实意义。本研究旨在记录患者早期无反应的患病率及危险因素。
本研究纳入了143例首次治疗且未使用过药物的精神分裂症患者（FTDN）。根据治疗2周后阳性和阴性症状量表（PANSS）评分降低少于20%将患者分类为早期无反应者，否则为早期反应者。比较了临床亚组在人口统计学数据和一般临床数据方面的差异，并检查了与治疗早期无反应相关的变量。
两周后，共有73例患者被描述为早期无反应者，发生率为51.05%。与早期反应亚组相比，早期无反应亚组的PANSS评分、阳性症状分量表（PSS）评分、一般精神病理学分量表（GPS）评分、临床总体印象量表 - 疾病严重程度（CGI - SI）和空腹血糖（FBG）水平显著更高。CGI - SI和FBG是早期无反应的危险因素。
FTDN精神分裂症患者中早期无反应的发生率较高，预测早期无反应的风险变量包括CGI - SI评分和FBG水平。然而，我们需要更深入的研究来确认这两个参数的可推广范围。
