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Respuesta subjetiva disfórica a los neurolépticos en la esquizofrenia: relación con los efectos secundarios extrapiramidales y los síntomas

Published online by Cambridge University Press:  12 May 2020

M. Gervin ,
S. Browne ,
J. Garavan ,
M. Roe ,
C. Larkin  and
E. O'Callaghan
M. Gervin
Affiliation:
The Theodore and Vada Stanley Research Unit, Cluain Mhuire Service, Hospitaller Order St John of God, Blackrock, Co. Dublin, Irlanda
S. Browne
Affiliation:
The Theodore and Vada Stanley Research Unit, Cluain Mhuire Service, Hospitaller Order St John of God, Blackrock, Co. Dublin, Irlanda
J. Garavan
Affiliation:
The Theodore and Vada Stanley Research Unit, Cluain Mhuire Service, Hospitaller Order St John of God, Blackrock, Co. Dublin, Irlanda
M. Roe
Affiliation:
The Theodore and Vada Stanley Research Unit, Cluain Mhuire Service, Hospitaller Order St John of God, Blackrock, Co. Dublin, Irlanda
C. Larkin
Affiliation:
The Theodore and Vada Stanley Research Unit, Cluain Mhuire Service, Hospitaller Order St John of God, Blackrock, Co. Dublin, Irlanda
E. O'Callaghan
Affiliation:
The Theodore and Vada Stanley Research Unit, Cluain Mhuire Service, Hospitaller Order St John of God, Blackrock, Co. Dublin, Irlanda
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Resumen

Objetivo:

Los informes subjetivos de respuestas disfóricas a la medicación neuroléptica son comunes en la práctica clínica. Sin embargo, los efectos secundarios cognitivos y afectivos de las medicaciones neurolépticas son difíciles de diferenciar de los síntomas de esquizofrenia. Tratamos de dilucidar la contribución relativa de los efectos secundarios extrapiramidales y los síntomas a la respuesta disfórica.

Método:

Se evaluó a 50 pacientes ambulatorios estables clínicamente con esquizofrenia que asistían a un centro de rehabilitación en cuanto a los efectos secundarios extrapiramidales y los síntomas antes de completar el inventario de actitud hacia los medicamentos (DAI).

Resultados:

La presencia de efectos secundarios extrapiramidales, encontrados en 28 pacientes (Z = -1,99, p = 0,05), y la gravedad de los síntomas negativos (r = -0,47, p = 0,001) se asociaban independientemente con la respuesta disfórica, explicando una proporción significativa de la varianza (R = 0,53, R2 = 25,2%, F = 9,27, gl = 2, p = 0,0004).

Conclusiones:

Los pacientes que comunican una respuesta disfórica que ellos asocian con las medicaciones neurolépticas tienen más efectos secundarios extrapiramidales y síntomas negativos más graves. Aunque estas respuestas pueden ser parte de los síntomas negativos de la enfermedad o deberse a otros factores como la depresión, planteamos la posibilidad de que puedan ser clínicamente indistinguibles del llamado "síndrome de déficit inducido por neurolépticos" y una medida subjetiva de él.

Keywords

disforiaextrapiramidalneurolépticosesquizofreniasíntomas
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 7 , Issue 3 , April 2000 , pp. 181 - 185
Copyright
Copyright © European Psychiatric Association 2000

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References

Bibliografía

Andreasen, NC. The scale for the assessment of negative symptoms (SANS). Iowa City, Iowa: The University of Iowa; 1983.Google Scholar
Andreasen, NC. The scale for the assessment of positive symptoms (SAPS). Iowa City, Iowa: The University of Iowa; 1984.Google Scholar
Awad, AG. Subjective response to neuroleptics in schizophrenia. Schizophr Bull 1993; 19: 609–18.CrossRefGoogle Scholar
Awad, AGHogan, TP. Subjective response to neuroleptics and the quality of life: implications for treatment outcome. Acta Psychiatr Scand 1994; 89: 27–32.CrossRefGoogle Scholar
Barnes, TREKane, JM. Choosing between oíd and new antipsychotics. Curr Opin Psychiatry 1996; 9: 41–4.CrossRefGoogle Scholar
Browne, SRoe, MLañe, A, et al. Quality of life in schizophrenia: relationship to sociodemographic factors, symptomatology and tardive dyskinesia. Acta Psychiatr Scand 1996; 94: 118–24.CrossRefGoogle ScholarPubMed
Carpenter, WTHeinrichs, DWWagman, AMI. Déficit and non-deficit forms of schizophrenia: the concept. Am J Psychiatry 1988; 145: 578–83-Google Scholar
Casey, DE. Motor and mental aspects of acute extrapyramidal syndromes. Acta Psychiatr Scand 1994; 89 Suppl 380: 14–20.CrossRefGoogle ScholarPubMed
Davis, JM. Comparative doses and costs of antipsychotic medication. Arch Gen Psychiatry 1976; 33: 858–60.CrossRefGoogle ScholarPubMed
Guy, W. ECDEU: Assessment Manual for Psychophar-macology. Washington DC: US Department of Health, Education and Welfare; 1976. p. 534–7.Google Scholar
Hogan, TPAwad, AG. Subjective response to neuroleptics and outcome in schizophrenia: a re-examination comparing two measures. Psychol Med 1992; 22: 347–52.CrossRefGoogle ScholarPubMed
Hogan, TPAwad, AGEastwood, MR. A self-report scale predictive of drug compliance in schizophrenics: reliability and descriminant validity. Psychol Med 1983; 13: 177–83.CrossRefGoogle Scholar
Hogan, TPAwad, AGEastwood, MR. Early subjective response and prediction of outcome to neuroleptic drug therapy in schizophrenia. Can J Psychiatry 1985; 30: 246–8.CrossRefGoogle Scholar
Kane, JM. Schizophrenia. N. Eng J Med 1996; 334: 34–9.CrossRefGoogle ScholarPubMed
Lader, M, The NIDS Working Group. Neuroleptic induced déficit syndrome (NIDS). J Clin Psychiatry 1993; 54: 494–500.Google Scholar
Lewander, LH. Neuroleptics and the neuroleptic induced déficit syndrome. Acta Psychiatr Scand 1994; 89 Suppl 380: 8–13.CrossRefGoogle ScholarPubMed
Lindstrom, LH. Long-term clinical and social outcome studies in schizophrenia in relation to the cognitive and emotional side effects of antipsychotic drugs. Acta Psycriatr Scand 1994; 89 Suppl 380: 74–6.CrossRefGoogle ScholarPubMed
Schooler, NR, Déficit symptoms in schizophrenia; negative sympyoms versus neuroleptic-induced déficits. Acta Psychiatr Scand 1994; 89 Suppl 380: 21–6.CrossRefGoogle Scholar
Schooler, NRKane, JM. Research diagnosis for tardive dyskinesia. Arch Gen Psychiatry 1982; 39: 789–94.Google ScholarPubMed
Van Putten, TMay, PRA. Subjective response as a predictor of outcome in pharmacotherapy. Arch Gen Psychiatry 1978; 35: 477–80.CrossRefGoogle ScholarPubMed
VanPutten, TMay, PRAMarder, SR, et al. Subjective response to antipsychotic drugs. Arch Gen Psychiatry 1981; 38: 187–90.CrossRefGoogle Scholar
Wojcik Doller, JGelenberg, AJLaBrie, RA. Prevalence of tardive dyskinesia in an outpatient population. Compr Psychiatry 1980; 21: 370–80.CrossRefGoogle Scholar