title: Dopamine supersensitivity psychosis as a pivotal factor in treatment-resistant schizophrenia.
abstract: There may be subtypes in treatment-resistant schizophrenia (TRS), and one of the subtypes may be related to dopamine supersensitivity psychosis (DSP). In developing strategies for prevention and treatment TRS, it is important to clarify the role of DSP in TRS. TRS patients were recruited from 3 hospitals for the present study. Through chart reviews, all patients were judged as either TRS or not, and then possible TRS patients were investigated about their past/present histories of DSP episode(s) by direct interviews. We then compared each factor between the groups with and without DSP episode(s). Out of 611 patients screened, 147 patients met the criteria for TRS and were included in the present analysis. These were divided into groups with and without DSP, comprising 106 (72.1%) and 41 patients (27.9%), respectively. Clinical characteristics in the two groups were similar, except for drug-induced movement disorders (DIMDs), which were significantly more important in DSP patients. Of the DSP patients, 42% and 56% experienced rebound psychosis and tolerance to antipsychotic effects, respectively. The present study revealed that approximately 70% of TRS patients experienced one or more DSP episodes, which may have a strong impact on the long-term prognosis of patients with schizophrenia.
authors: Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan; Department of Psychiatry, Koutoku-kai Sato Hospital, 948-1 Kunugizuka, Nanyo City, Yamagata 999-2221, Japan.
authors: Tomotaka
authors: T
authors: Suzuki
authors: Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan; Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan. Electronic address: kanahara@faculty.chiba-u.jp.
authors: Nobuhisa
authors: N
authors: Kanahara
authors: Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan; Department of Psychiatry, Chiba Psychiatric Medical Center, 5 Toyosuna, Mihama-ku, Chiba 261-0024, Japan.
authors: Hiroshi
authors: H
authors: Yamanaka
authors: Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan.
authors: Masayuki
authors: M
authors: Takase
authors: Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan.
authors: Hiroshi
authors: H
authors: Kimura
authors: Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan; Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan.
authors: Hiroyuki
authors: H
authors: Watanabe
authors: Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan; Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan.
authors: Masaomi
authors: M
authors: Iyo
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D004298:Dopamine; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis / Q000188:drug therapy; D011605:Psychoses, Substance-Induced / Q000175:diagnosis* / Q000188:drug therapy*; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D004298:Dopamine
keywords: Antipsychotics; Clinical course; Deficit syndrome; Dopamine D2 receptor; Prognosis; Tardive dyskinesia; Treatment-resistant