Optimizing early prediction for antipsychotic response in schizophrenia.
OBJECTIVE
Researchers, by studying first-generation antipsychotics, have established an early prediction model, which had a favorable specificity but a low sensitivity. This study aims to optimize early prediction of treatment response for schizophrenia using a novel statistic method that can be done even under the Microsoft Excel system of a personal computer.


METHODS
One hundred twenty-three inpatients with acutely exacerbated schizophrenia were given optimal therapy of risperidone, a commonly used second-generation antipsychotic agent. Response was defined as a reduction of 20% or more in the Positive and Negative Syndrome Scale total score. We applied the generalized estimating equation method's logistic regression to establish an early prediction model based on the treatment results of the first and the second weeks.


RESULTS
The proposed method correctly predicted nonresponse at 4 and 6 weeks in 80.8% and 81.8% of the patients, respectively. The method also identified responder at 4 and 6 weeks in 80.0% and 82.8%, respectively. The predictive powers (or correct prediction rates) at 4 and 6 weeks were 80.3% and 82.4%, respectively. In addition, the results based on the responses in Positive and Negative Syndrome Scale scores were slightly better than those in Brief Psychiatric Rating Scale scores.


CONCLUSIONS
Using the first 2 weeks' treatment results to predict the fourth or sixth week's treatment response is acceptable in terms of specificity, sensitivity, and predictive power. Further studies are needed. Moreover, whether this model could be applied to establish a prediction system for other psychotropics, such as antidepressants, also deserves research.
Chang
Yue-Cune
YC
Institute of Life Science and Department of Mathematics, Tamkang University, Tamsui, Taipei, Taiwan. ychang@math.tku.edu.tw
Lane
Hsien-Yuan
HY
Yang
Kung-Han
KH
Huang
Chieh-Liang
CL
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D019540:Area Under Curve; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D018967:Risperidone / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D018967:Risperidone