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Clinical predictors of treatment effectiveness in late onset schizophrenia and schizophrenia-like psychosis

Published online by Cambridge University Press:  27 August 2024

V. Pochueva*
Affiliation:
1FSBSI “Mental Health Research Center”, Moscow, Russian Federation
T. Safarova
Affiliation:
1FSBSI “Mental Health Research Center”, Moscow, Russian Federation
V. Sheshenin
Affiliation:
1FSBSI “Mental Health Research Center”, Moscow, Russian Federation
*
*Corresponding author.

Abstract

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Introduction

Clinical features and structural changes in the brain of patients with late-onset schizophrenia and schizophrenia-like psychosis are important in predicting the effectiveness of treatment.

Objectives

Identification the dependence of effectiveness of psychopharmacotherapy on the clinical features and structural brain changes in late-onset schizophrenia and schizophrenia-like psychosis.

Methods

111 patients, age from 52 to 89 years with ICD-10 diagnosis F20, F25, F22.8, F06.2 were investigated for 28 days. Clinical, psychometric methods with PANSS, CGI, HAMD, CDSS, MMSE scales were used. MRI/CT were performed. Effectiveness of treatment was measured in two ways: 1. Percentage ratio of reduction in total scores to the 1st value of scales. 2. The number of responders (patients with a decrease in PANSS by 30% or more).

Results

The effectiveness of treatment in the overall group was 29,4% on the PANSS scale (from -13,6% to 77,2%). The greatest effectiveness was on subscale of positive syndromes (34,9%), the lowest – on the subscale of negative syndromes (18,6%). The number of responders (R) was 43 patients (38,7%), non-responders(NR) – 68 patients (61,3%). The responder group was characterized by a greater severity of acute psychosis before the begging of treatment. Early insomnia, excitement and anxiety, decreased appetite, valuated by HAMD scale were significantly more pronounced. Treatment effectiveness had negative correlates (p<0,05) with number of acute attacks, number of hospitalizations and the duration of current attack. The predominance of negative symptoms has a negative correlation with effectiveness by PANSS and CGI scales. According to the results of MRI/CT examination, cortical atrophy, vascular changes and leucoaraiosis were more often represented in NR group.

Conclusions

The connection between the effectiveness of treatment and the clinical and psychopathological features and structural changes in late onset schizophrenia and schizophrenia-like psychosis was shown.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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