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Clinical correlates of early onset antipsychotic treatment resistance

BACKGROUND: There is evidence of heterogeneity within treatment-resistant schizophrenia (TRS), with some people not responding to antipsychotic treatment from illness onset and others becoming treatment-resistant after an initial response period. These groups may have different aetiologies. AIM: Thi...

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Autores principales: Fonseca de Freitas, Daniela, Agbedjro, Deborah, Kadra-Scalzo, Giouliana, Francis, Emma, Ridler, Isobel, Pritchard, Megan, Shetty, Hitesh, Segev, Aviv, Casetta, Cecilia, Smart, Sophie E., Morris, Anna, Downs, Johnny, Christensen, Søren Rahn, Bak, Nikolaj, Kinon, Bruce J., Stahl, Daniel, Hayes, Richard D., MacCabe, James H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9643817/
https://www.ncbi.nlm.nih.gov/pubmed/36268751
http://dx.doi.org/10.1177/02698811221132537
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author Fonseca de Freitas, Daniela
Agbedjro, Deborah
Kadra-Scalzo, Giouliana
Francis, Emma
Ridler, Isobel
Pritchard, Megan
Shetty, Hitesh
Segev, Aviv
Casetta, Cecilia
Smart, Sophie E.
Morris, Anna
Downs, Johnny
Christensen, Søren Rahn
Bak, Nikolaj
Kinon, Bruce J.
Stahl, Daniel
Hayes, Richard D.
MacCabe, James H.
author_facet Fonseca de Freitas, Daniela
Agbedjro, Deborah
Kadra-Scalzo, Giouliana
Francis, Emma
Ridler, Isobel
Pritchard, Megan
Shetty, Hitesh
Segev, Aviv
Casetta, Cecilia
Smart, Sophie E.
Morris, Anna
Downs, Johnny
Christensen, Søren Rahn
Bak, Nikolaj
Kinon, Bruce J.
Stahl, Daniel
Hayes, Richard D.
MacCabe, James H.
author_sort Fonseca de Freitas, Daniela
collection PubMed
description BACKGROUND: There is evidence of heterogeneity within treatment-resistant schizophrenia (TRS), with some people not responding to antipsychotic treatment from illness onset and others becoming treatment-resistant after an initial response period. These groups may have different aetiologies. AIM: This study investigates sociodemographic and clinical correlates of early onset of TRS. METHOD: Employing a retrospective cohort design, we do a secondary analysis of data from a cohort of people with TRS attending the South London and Maudsley. Regression analyses were conducted to identify the correlates of the length of treatment to TRS. Predictors included the following: gender, age, ethnicity, problems with positive symptoms, problems with activities of daily living, psychiatric comorbidities, involuntary hospitalisation and treatment with long-acting injectable antipsychotics. RESULTS: In a cohort of 164 people with TRS (60% were men), the median length of treatment to TRS was 3 years and 8 months. We observed no cut-off on the length of treatment until TRS presentation differentiating between early and late TRS (i.e. no bimodal distribution). Having mild to very severe problems with hallucinations and delusions at the treatment start was associated with earlier TRS (~19 months earlier). In sensitivity analyses, including only complete cases (subject to selection bias), treatment with a long-acting injectable antipsychotic was additionally associated with later TRS (~15 months later). CONCLUSION: Our findings do not support a clear separation between early and late TRS but rather a continuum of the length of treatment before TRS onset. Having mild to very severe problems with positive symptoms at treatment start predicts earlier onset of TRS.
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spelling pubmed-96438172022-11-15 Clinical correlates of early onset antipsychotic treatment resistance Fonseca de Freitas, Daniela Agbedjro, Deborah Kadra-Scalzo, Giouliana Francis, Emma Ridler, Isobel Pritchard, Megan Shetty, Hitesh Segev, Aviv Casetta, Cecilia Smart, Sophie E. Morris, Anna Downs, Johnny Christensen, Søren Rahn Bak, Nikolaj Kinon, Bruce J. Stahl, Daniel Hayes, Richard D. MacCabe, James H. J Psychopharmacol Original Papers BACKGROUND: There is evidence of heterogeneity within treatment-resistant schizophrenia (TRS), with some people not responding to antipsychotic treatment from illness onset and others becoming treatment-resistant after an initial response period. These groups may have different aetiologies. AIM: This study investigates sociodemographic and clinical correlates of early onset of TRS. METHOD: Employing a retrospective cohort design, we do a secondary analysis of data from a cohort of people with TRS attending the South London and Maudsley. Regression analyses were conducted to identify the correlates of the length of treatment to TRS. Predictors included the following: gender, age, ethnicity, problems with positive symptoms, problems with activities of daily living, psychiatric comorbidities, involuntary hospitalisation and treatment with long-acting injectable antipsychotics. RESULTS: In a cohort of 164 people with TRS (60% were men), the median length of treatment to TRS was 3 years and 8 months. We observed no cut-off on the length of treatment until TRS presentation differentiating between early and late TRS (i.e. no bimodal distribution). Having mild to very severe problems with hallucinations and delusions at the treatment start was associated with earlier TRS (~19 months earlier). In sensitivity analyses, including only complete cases (subject to selection bias), treatment with a long-acting injectable antipsychotic was additionally associated with later TRS (~15 months later). CONCLUSION: Our findings do not support a clear separation between early and late TRS but rather a continuum of the length of treatment before TRS onset. Having mild to very severe problems with positive symptoms at treatment start predicts earlier onset of TRS. SAGE Publications 2022-10-21 2022-11 /pmc/articles/PMC9643817/ /pubmed/36268751 http://dx.doi.org/10.1177/02698811221132537 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Papers
Fonseca de Freitas, Daniela
Agbedjro, Deborah
Kadra-Scalzo, Giouliana
Francis, Emma
Ridler, Isobel
Pritchard, Megan
Shetty, Hitesh
Segev, Aviv
Casetta, Cecilia
Smart, Sophie E.
Morris, Anna
Downs, Johnny
Christensen, Søren Rahn
Bak, Nikolaj
Kinon, Bruce J.
Stahl, Daniel
Hayes, Richard D.
MacCabe, James H.
Clinical correlates of early onset antipsychotic treatment resistance
title Clinical correlates of early onset antipsychotic treatment resistance
title_full Clinical correlates of early onset antipsychotic treatment resistance
title_fullStr Clinical correlates of early onset antipsychotic treatment resistance
title_full_unstemmed Clinical correlates of early onset antipsychotic treatment resistance
title_short Clinical correlates of early onset antipsychotic treatment resistance
title_sort clinical correlates of early onset antipsychotic treatment resistance
topic Original Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9643817/
https://www.ncbi.nlm.nih.gov/pubmed/36268751
http://dx.doi.org/10.1177/02698811221132537
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