The biological background of refractory schizophrenia: a study on clinical states, serum drug concentration, cognitive function and brain CT findings.

Inpatients who had been in the hospital for more than three years (refractory group, n = 53) were compared with outpatients who had not been admitted to the hospital in the last three years (remission group, n = 42). There were differences between the two groups in "blunted affect-thought disturbance" symptoms, "hallucination-delusion" symptoms, the score of behavior rating scale (BRS), the dosage and serum concentration of antipsychotics, the score of Hasegawa's Dementia Scale (HDS) and brain CT findings. "Blunted affect-thought disturbance" symptoms were strongly related to the BRS score, the dosage of antipsychotics and the HDS score. Sylvian fissures enlargement was related to "blunted affect-thought disturbance" symptoms. Sylvian fissures enlargement was thought to be a biological background of refractory schizophrenia.