Clinical aspects of super-refractory schizophrenia: a 6-month cohort observational study.
OBJECTIVE
Approximately 30% of treatment-resistant schizophrenic patients do not fully respond to Clozapine and such patients are termed Clozapine non-responders or super-refractory schizophrenics. The aim of this study was to characterize patients with super-refractory schizophrenia according to demographic and psychopathological variables, as compared with patients with refractory schizophrenia or non-refractory subjects.


METHODS
One hundred two outpatients meeting DSM-IV criteria for schizophrenia were followed-up for 6 months. Subjects were classified into 3 groups: non-refractory (n=25), refractory (n=43) and super-refractory (n=34). Psychopathology was assessed by the Positive and Negative Syndrome Scale, the Schedule for Deficit Syndrome, the Calgary Depression Scale and the Quality of Life Scale. Patients were rated at 2-month intervals.


RESULTS
Higher levels of severity at the disease onset as well as higher severity of positive symptoms were found to be predictive of super-refractoriness.


CONCLUSIONS
The super-refractory schizophrenia patients have psychopathological predictive factors that need studies comparing brain images, genetical features and other clinical comparisons.
Henna Neto
Jorge
J
Institute of Psychiatry, Hospital das Clínicas, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil. henna@usp.br
Elkis
Hélio
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003024:Clozapine / Q000627:therapeutic use*; D004351:Drug Resistance; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000188:drug therapy* / Q000503:physiopathology; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003024:Clozapine