Predictors of antipsychotic treatment response in patients with first-episode schizophrenia, schizoaffective and schizophreniform disorders*

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Abstract

Background

Duration of untreated psychosis (DUP) may contribute to the observed heterogeneity of the treatment response in first-episode schizophrenia.

Aims

To examine the relationship of DUP and premorbid function with clinical outcomes following up to 2 years of antipsychotic treatment.

Method

For a subsample (n=191) of subjects participating in a clinical trial, DUP and premorbid function were prospectively compared with clinical response to olanzapine or haloperidol.

Results

Shorter DUP and good premorbid function each independently are associated with better clinical response, including improvement in overall psychopathology and negative symptoms. Premorbid function also is associated with positive symptom, social and vocational outcomes.

Conclusions

Earlier antipsychotic treatment is associated with better outcomes in first-episode schizophrenia. Poor premorbid function could indicate an illness subtype less likely to respond to antipsychotic treatment regardless of when it is instituted.

Declaration of interest

This work was supported by Lilly Research Laboratories and USPHS grants MH01905-01 (D.O.P.) MH00537, MH33127 (J.A.L.) the UNC Mental Health and Neuroscience Clinical Research Centre, the North Carolina Foundation of Hope, MH52376 and MH62157 (A.I.G.).

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