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Electrocardiographic signs of autonomic imbalance in medicated patients with first-episode schizophrenia spectrum disorders – relations to first treatment discontinuation and five-year remission status

Published online by Cambridge University Press:  15 April 2020

Robert Bodén ,
Leif Lindström ,
Pentti Rautaharju  and
Johan Sundström
Robert Bodén*
Affiliation:
Department of Neuroscience Psychiatry, Uppsala University Hospital, 751 85Uppsala, Sweden
Leif Lindström
Affiliation:
Department of Neuroscience Psychiatry, Uppsala University Hospital, 751 85Uppsala, Sweden
Pentti Rautaharju
Affiliation:
Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina
Johan Sundström
Affiliation:
Department of Medical Sciences, Uppsala University Hospital, 751 85Uppsala, Sweden
*
*Corresponding author. Tel.: +46 70 611 09 14; fax: +46 18 51 58 10. [email protected]. (R. Bodén).
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Abstract

Purpose

To explore measures in electrocardiograms (ECG) influenced by autonomic balance in early schizophrenia spectrum disorders and to examine their relation to subsequent first antipsychotic pharmacotherapy discontinuation and five-year remission status.

Subjects and methods

Twelve-lead ECGs were recorded at baseline in 58 patients with first-episode schizophrenia spectrum disorders and in 47 healthy controls of similar age. Selected ECG variables included heart rate and measures of repolarization. Pharmacotherapy data were extracted from medical records. At a five-year follow-up the patients were interviewed and assessed with the Positive and Negative Syndrome Scale.

Results

Patients had higher heart rate and a different ST-T pattern than the controls. High T-wave amplitudes in the leads aVF and V5 and ST-elevations in V5 were associated both with higher risk of an earlier discontinuation of first antipsychotic pharmacotherapy and with non-remission five years later.

Discussion and conclusion

In this longitudinal cohort study, simple ECG measures influenced by autonomic balance in the early phase of schizophrenia spectrum disorders contained prognostic information. As this is the first report of this association and is based on a relatively small sample, the results should be interpreted with caution.

Keywords

ElectrocardiographyFirst-episodePsychosisRemissionAutonomic balancePrognosis
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 3 , April 2012 , pp. 213 - 218
Copyright
Copyright © Elsevier Masson SAS 2012

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