Psychopathological characteristics and treatment response of first episode compared with multiple episode schizophrenic disorders.
OBJECTIVE
The aim was to investigate the hypothesis that patients with first episode schizophrenic disorders have a more favorable treatment response than those with multiple episodes.


METHODS
A total of 400 inpatients from an ongoing multi-centre, follow-up program who fulfilled ICD-10 criteria for schizophrenic disorders (F2) were assessed at admission to and discharge from hospital using the Positive and Negative Syndrome Scale (PANSS).


RESULTS
At admission, first episode patients (n = 121) showed higher levels of positive symptoms (PANSS positive subscore) and lower ones of negative symptoms (PANSS negative subscore) than multiple episode patients (n = 279), whereas the global disease severity (PANSS total score) was comparable. Analyses of covariance revealed that treatment response (adjusted symptom levels at discharge) was more favorable in first-episode patients, with respect to both positive and negative symptoms.


CONCLUSIONS
The results are compatible with the hypothesis that treatment response becomes less favorable during the course of schizophrenic illness. This finding might be associated with progressive neurobiological alterations.
Jäger
Markus
M
Department of Psychiatry, Ludwig-Maximilians University, Nussbaumstr 7, D-80336 Munich, Germany. markus.jaeger@med.uni-muenchen.de
Riedel
Michael
M
Messer
Thomas
T
Laux
Gerd
G
Pfeiffer
Herbert
H
Naber
Dieter
D
Schmidt
Lutz G
LG
Gaebel
Wolfgang
W
Huff
Wolfgang
W
Heuser
Isabella
I
Kühn
Kai-Uwe
KU
Lemke
Matthias R
MR
Rüther
Eckart
E
Buchkremer
Gerhard
G
Gastpar
Markus
M
Bottlender
Ronald
R
Strauss
Anton
A
Möller
Hans-Jürgen
HJ
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D011569:Psychiatric Status Rating Scales; D011599:Psychopathology; D012008:Recurrence; D012559:Schizophrenia / Q000188:drug therapy / Q000628:therapy*; D012565:Schizophrenic Psychology; D012919:Social Behavior; D016896:Treatment Outcome
D014150:Antipsychotic Agents