Does the change of psychopathology during the placebo period predict the response to subsequent treatment with active medication.
We examined whether deterioration in psychiatric symptoms during the placebo period predicted short-term response to subsequent treatment. Acutely exacerbated chronic schizophrenic or schizoaffective patients (n = 123) received placebo for 6.2 days on average. Afterwards, fixed haloperidol plasma levels were maintained for 6 weeks. Psychopathology was evaluated on the basis of the Brief Psychiatric Rating Scale (BPRS), which was administered weekly by trained raters. The global BPRS score at the beginning of the active treatment accounted for 11% of the end-point variance of the global BPRS score (p < 0.0002) and the change of psychopathology during the preceding placebo period explained additional 3.1% (p < 0.053) of it. The change in most of the BPRS factor scores contributed significantly to the prediction of the end-point BPRS score. The patients who had low scores on admission to the study and high scores at the end of the placebo period showed the greatest improvement. The results suggest that in addition to the baseline severity of psychopathology, the change of psychopathology that occurs during the pretreatment placebo period can partially account for treatment response.
Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY.
J
J
Libiger
P
P
Czobor
J
J
Volavka
D000328:Adult; D006220:Haloperidol / Q000097:blood* / Q000627:therapeutic use*; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D007902:Length of Stay; D015990:Placebo Effect; D010919:Placebos / Q000008:administration & dosage / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000097:blood* / Q000188:drug therapy* / Q000534:rehabilitation; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy* / Q000534:rehabilitation
D010919:Placebos; D006220:Haloperidol