title: Electrocardiographic signs of autonomic imbalance in medicated patients with first-episode schizophrenia spectrum disorders--relations to first treatment discontinuation and five-year remission status.
abstract: OBJECTIVE
  To explore measures in electrocardiograms (ECG) influenced by autonomic balance in early schizophrenia spectrum disorders and to examine their relation to subsequent first antipsychotic pharmacotherapy discontinuation and five-year remission status.
  
  
  METHODS
  Twelve-lead ECGs were recorded at baseline in 58 patients with first-episode schizophrenia spectrum disorders and in 47 healthy controls of similar age. Selected ECG variables included heart rate and measures of repolarization. Pharmacotherapy data were extracted from medical records. At a five-year follow-up the patients were interviewed and assessed with the positive and negative syndrome scale.
  
  
  RESULTS
  Patients had higher heart rate and a different ST-T pattern than the controls. High T-wave amplitudes in the leads aVF and V5 and ST-elevations in V5 were associated both with higher risk of an earlier discontinuation of first antipsychotic pharmacotherapy and with non-remission five years later.
  
  
  CONCLUSIONS
  In this longitudinal cohort study, simple ECG measures influenced by autonomic balance in the early phase of schizophrenia spectrum disorders contained prognostic information. As this is the first report of this association and is based on a relatively small sample, the results should be interpreted with caution.
authors.affiliation: Department of Neuroscience Psychiatry, Uppsala University Hospital, 751 85 Uppsala, Sweden. robert.boden@neuro.uu.se
authors.forename: Robert
authors.initials: R
authors.lastname: Bodén
authors.forename: Leif
authors.initials: L
authors.lastname: Lindström
authors.forename: Pentti
authors.initials: P
authors.lastname: Rautaharju
authors.forename: Johan
authors.initials: J
authors.lastname: Sundström
mesh_terms: D000293:Adolescent; D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000188:drug therapy / Q000503:physiopathology*; D012559:Schizophrenia / Q000188:drug therapy / Q000503:physiopathology*