Trajectories of antipsychotic response in drug‐naive schizophrenia patients: results from the 6‐month ESPASS follow‐up study. (18th April 2013)

• Record Type: Journal Article
• Authors: Nordon, C.; Rouillon, F.; Azorin, J. M.; Barry, C.; Urbach, M.; Falissard, B.
• Is Part Of: Acta psychiatrica Scandinavica. Volume 129:Number 2(2014:Feb.)
• Page Start: 116
• Page End: 125
• Publication Date: 2013-04-18
• Subjects: Psychiatry -- Periodicals; 616.89
• DOI: 10.1111/acps.12135
• Languages: English
• ISSNs: 0001-690X

Abstract

<abstract abstract-type="main" id="acps12135-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="acps12135-sec-0001" sec-type="section"> <title>Objective</title> <p>The aim of this study was to explore any heterogeneity in the 6‐month clinical response in patients with antipsychotic drug‐naive schizophrenia and to determine predictors of that outcome.</p> </sec> <sec id="acps12135-sec-0002" sec-type="section"> <title>Method</title> <p>467 patients with antipsychotic drug‐naive schizophrenia were included in France nationwide and followed up over 6 months. To identify trajectories of clinical response, a latent class growth analysis (LCGA) was performed using the Clinical Global Impression‐Severity (CGI‐S) scores at baseline, 1, 3, and 6 months. Regression models were used to identify predictors of trajectory membership.</p> </sec> <sec id="acps12135-sec-0003" sec-type="section"> <title>Results</title> <p>Five trajectory groups were identified: a rapid response group (<italic>n</italic> = 45), a gradual response group (<italic>n</italic> = 204), patients remaining mildly ill (<italic>n</italic> = 133), patients remaining very ill (<italic>n</italic> = 23), and a group with unsustained clinical response (<italic>n</italic> = 62). Predictors of the 6‐month clinical response were baseline CGI‐S score (odds ratio: 3.1; 95% confidence interval, 2.1–4.4) and negative symptoms (OR, 1.5; 95% CI, 1.2–1.9). The sole predictor of rapid response as compared to gradual response was employment (OR, 2.5; 95% CI, 1.2–4.9).</p> </sec> <sec id="acps12135-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Clinical response in patients with schizophrenia 6 months after a first‐ever antipsychotic drug initiation is heterogeneous. Therapeutic strategies in first episode should take account of symptom severity and early clinical response, to maximize the chances of recovery.</p> </sec> </abstract>