Time course and biologic correlates of treatment response in first-episode schizophrenia.
OBJECTIVE
To examine the course and potential predictors of treatment response in the early phase of schizophrenia.


METHODS
Prospective study of an inception cohort.


METHODS
Psychiatric division of an academic medical center with a suburban metropolitan catchment area.


METHODS
Seventy first-episode patients who had undergone four biologic assessment procedures (brain magnetic resonance imaging, behavioral response to methylphenidate hydrochloride, growth hormone levels, eye tracking) were treated with a standardized antipsychotic drug protocol until recovery. Response was measured in terms of psychopathology and degree of remission.


RESULTS
Using survival analysis, the proportion of patients remitting by 1 year was estimated at 83%. Mean and median times to remission were 35.7 weeks and 11 weeks, respectively. No baseline demographic or psychopathologic measure significantly predicted time to or level of remission. However, males tended to be nonresponders to treatment and have diagnoses of schizophrenia rather than schizoaffective disorder. Brain pathomorphology and abnormal basal growth hormone significantly predicted time to remission.


CONCLUSIONS
These results indicate that the antipsychotic treatment response of first-episode schizophrenics is better than chronic multiepisode patients and suggest that specific pathobiologic markers reflect pathophysiologic processes that mediate antipsychotic treatment response.
Lieberman
J
J
Department of Psychiatry, Hillside Hospital, Glen Oaks, NY.
Jody
D
D
Geisler
S
S
Alvir
J
J
Loebel
A
A
Szymanski
S
S
Woerner
M
M
Borenstein
M
M
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D015415:Biomarkers; D015331:Cohort Studies; D005133:Eye Movements; D005260:Female; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D008297:Male; D008774:Methylphenidate; D011336:Probability; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis
D014150:Antipsychotic Agents; D015415:Biomarkers; D008774:Methylphenidate; D013006:Growth Hormone