Clinical and biological markers for outcome in schizophrenia - A review of a longitudinal follow-up study in Uppsala Schizophrenia Research Project

被引:35
作者
Lindstrom, LH [1 ]
机构
[1] UNIV UPPSALA HOSP,DEPT PSYCHIAT RES,S-72189 VASTERAS,SWEDEN
关键词
schizophrenia; outcome; symptoms; monoamines; neuropeptides; electrodermal activity (EDA);
D O I
10.1016/0893-133X(95)00201-N
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
During a 10-year period, 120 drugfree DSM-III-R schizophrenic patients were consecutively and unselectively admitted to a ward for young psychotic patients and subjected to a battery of examinations including symptomatology, cerebrospiral fluid (CSF)-biochemistry, computed tomography (CT)-scan, neurophysiologic and psychophysiologic (Electrodermal activity, EDA) parameters before antipsychotic treatment was initiated. After discharge, the patients were longitudinally followed with rating of outcome (Strauss-Carpenters outcome scale) at years 1, 3, and 5 after index admission. The aim of the study was to find possible early markers for outcome in schizophrenia. At 5 years, 30% of the patients had a good outcome (total score >13) and 15% a poor outcome (total score <8). Poor premorbid adjustment and low level of education as well as negative schizophrenic symptomatology at index admission were associated with a poor outcome 5 years later. Positive symptomatology and a family history of schizophrenia did not predict outcome. Patients with a poor outcome (total score <8) had a significantly more deviant CSF HVA/5-HIAA quotient than those with a very good outcome (total score >15) as compared with healthy controls. Further, the CSF-peptides neuropeptide Y, dynorphin A, and CRF were predictable for outcome at the 5-year follow-up evaluation. Male schizophrenics who were ''nonresponders'' on the EDA test showed an almost 100% poor outcome, which was not found in females. In summary, several clinical and biological variables seem to have a predictable value for outcome in schizophrenia and, early identification of them might be a challenge for our future treatment strategies.
引用
收藏
页码:S23 / S26
页数:4
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