Consistency of psychopathological dimensions in schizophrenia as determined by the BPRS: A multicenter factor analytic study

Schizophrenia I

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increased from .45 to .8 (p = 0.01). These and further results on the relationships between t ~ biologic variables and psychopathology and treatment outcome will be presented and discussed.

CONSISTENCY OF PSYCHOPATHOLOGICAL DIMENSIONS IN SCHIZOPHRENIA AS DETERIvlINED BY THE BPRS: A MULTICENTER FACTOR ANALYTIC STUDY R. Goldman, R. Tandon, I. Woodard, W. Faustman, F. Hohagen, W.F. Gattaz, M.S. Keshavan, S. Mukherjee University of Michigan, Ann Arbor, MI 48109-0120, Stanford University, Palo Alto, CA, Central Institute of Mental Health, Mannheim, FRG, University of Pittsburgh, Pittsburgh, PA. New York State Psychiatric Research Institute, New York, NY. There now exists a plethora of specific symptom rating instruments in schizophrenia, but the Brief Psychiatric Rating Scale (BPRS) remains widely used. The BPRS was developed to broadly measure a range of symptoms and predated current concepts of schizophrenic symptom subtypes. The present multiple center study was undertaken to determine the extent to which the BPRS measures four characteri~stic psychopathological dimensions in schizophrenia (positive symptoms, negative symptoms, mood, agitation) and whether these dimensions ,,.~ consistent across centers. A total of 403 well-diagnosed schizophrenic patients across the four centers were administered the 18-item BPRS while drag free. Preliminary findings revealed relatively clear and distinct negative symptom and mood dimensions across the four centers. There was greater overlap between positive symptoms and agitation items. The findings of the confirmatory analytic procedures be discussed in terms of the validity of a dimensionai model of psychopathology in schizophrenia and the role of rating instruments.

SEROTONIN FUNCTION IN TREATMENT OF REFRACTORY SCHIZOPHRENIA M. Davidson, R.S. Kahn, R. Stem, R.F. McQueeny, M. Duffelmeyer, L. Siever, K.L. Davis Department of Psychiatry, Mount Sinai School of Medicine~Bronx Veterans Admim'stration Hospital, New York, NY 19468. Over 20% of schizophrenic patients are refractory to treatment with antidopaminergic drugs. Clozapine, the only compound proven to be effective in these treatment refractory schizophrenics, is a potent serotonin (:SliT) antagonist. This study tested the hypothesis that 5HT dysfunction is related to treatment refractory schizophrenia, using m-cldorophenyl piperazine (MCPP) as a probe to examine 5HT function. Behavioral, neuroendocrine, and temperature responses to MCPP were measured in schizophrenic patients and normal subjects after a 4-week drug-free period. Following this assessment of 5ITf function, patients were treated with haloperidol. The MCPP test was repeated during the 5th week of haloperidol treatment. Patients who failed to respond to haloperidol were then treated with clozapine. The MCPP test was repeated after 5 weeks on clozapine. Preliminary results from this ongoing study suggest that 1) as a group, chronic schizophrenic patients (n = 14) have blunted temperature and behavioral responses to MCPP as compared to normal subjects (n = 13); 2) clozapine, but not haloperidol blocks MCPP-induced ACTH, cortisol, and prolactin release. These results suggest that chronic schizophrenic patients may have blunted 5HT receptor function and suggest that neuroendocrine ~-esponses to MCPP may be used to assess the effects of clozapine on 5HT receptors.