Course of treatment response in first-episode and chronic schizophrenia.
OBJECTIVE
The timing and clinical correlates of symptom change following antipsychotic treatment were examined in first-episode and chronic schizophrenia.


METHODS
The subjects were 36 first-episode schizophrenic patients who had received minimal or no neuroleptics and 34 patients with chronic illness whose neuroleptics had been withdrawn. They were followed for 2 years and assessed with the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms. Treatment decisions during follow-up were made clinically by the treating physicians.


RESULTS
At 6-month follow-up, both the neuroleptic-naive and previously treated patients showed significant improvement in positive symptoms (52% and 44% reductions from baseline, respectively). The previously treated but not the neuroleptic-naive patients also showed a significant reduction in negative symptoms (19% from baseline). A longer duration of illness before baseline assessment and inconsistent treatment during follow-up were independently associated with poorer treatment outcome in terms of positive symptoms in both groups. There were no significant changes on the outcome measures in either group after the 6-month follow-up.


CONCLUSIONS
The results suggest that maximum symptomatic improvement occurs within the first 6 months of treatment and that disease progression may blunt treatment efficacy in both first-episode and chronic schizophrenia.
Szymanski
S R
SR
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, USA.
Cannon
T D
TD
Gallacher
F
F
Erwin
R J
RJ
Gur
R E
RE
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011336:Probability; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D016896:Treatment Outcome
D014150:Antipsychotic Agents