Treatment response of neurological soft signs in drug-naïve patients with a first psychotic episode
Fecha
2012Autor
Versión
Acceso abierto / Sarbide irekia
Tipo
Artículo / Artikulua
Versión
Versión aceptada / Onetsi den bertsioa
Impacto
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10.1016/j.schres.2012.05.019
Resumen
Background: Neurological soft signs (NSS) are intrinsic features of psychosis that appear years before beginning a
drug treatment. However, whether NSS respond to antipsychotics and whether these changes are clinically
reliable and significant remains to be seen.
Objective: We sought to determine the effect of antipsychotics on NSS in a first-episode psychosis (FEP) sample
who had never expos ...
[++]
Background: Neurological soft signs (NSS) are intrinsic features of psychosis that appear years before beginning a
drug treatment. However, whether NSS respond to antipsychotics and whether these changes are clinically
reliable and significant remains to be seen.
Objective: We sought to determine the effect of antipsychotics on NSS in a first-episode psychosis (FEP) sample
who had never exposed to antipsychotics.
Methods: We included 100 antipsychotic-naïve patients with FEP in this study. 77 patients completed the
study assessments at baseline, 1 month and 6 months. The Neurological Evaluation Scale (NES) evaluated
NSS. Patients were alternatively selected to receive risperidone or olanzapine treatments and continued participation in their mental health setting during follow-up with one of four treatment groups: risperidone,
olanzapine, mixed antipsychotics or no medication. We also included a control group of 28 healthy volunteers.
Results: Treatment groups showed a statistically significant improvement on total NES scores and most NES
subscales except for ‘frontal signs’, regardless of antipsychotic allocation. NSS changes were reliable; however,
there was great variation in the total NES scores between treatment groups, ranging from 4% to 24%. Clinically
meaningful changes (CMCs) on total NES scores ranged from 25% to 50%. Six patients (7.8%) demonstrated a
reliable change (RC) and CMC on total NES scores.
Conclusions: NSS improved significantly over follow up regardless of the treatment regimen assigned to
antipsychotic-naïve patients with a FEP. However, only 6 (7.8%) achieved a reliable and clinically meaningful
improvement. The pattern of response of NSS to antipsychotic drugs evidenced both state and trait
characteristics. [--]
Materias
Neurological soft signs,
Psychosis,
Schizophrenia,
First-episode psychosis,
Drug-naïve patients,
Never-treated patients
Editor
Elsevier
Publicado en
Schizophrenia Research 139 (2012) 144-150
Departamento
Universidad Pública de Navarra. Departamento de Ciencias de la Salud /
Nafarroako Unibertsitate Publikoa. Osasun Zientziak Saila
Versión del editor
Entidades Financiadoras
This work was supported by The Government of Navarra— grants 946/2005 and 55/2007; the “National Plan of Drugs” of the Ministry of Health of Spain— grant 2008/030 and the Ministry of Science and Innovation of Spain— grant SAF2008-05674-C03-02.