- Email: [email protected]
Responsiveness to antipsychotic treatment in first-episode psychotic patients, relation with duration of untreated psychosis (DUP)
2. Phenomenology
23
IV criteria for drug abuse or dependence consented to participate in the study. All of the women were administered the Structured Diagnostic Interview for DSM-IV (SCID), the Clinician Administered PTSD Scale (CAPS), and several other clinical assessments. The results confirm high lifetime rates of trauma, especially physical abuse (81%) and sexual abuse (61%). In fact, close to the entire sample (96%) reported experiencing at least one lifetime traumatic event, and the average number of traumatic life events reported was 8. The prevalence of PTSD in the sample was 47%. This rate is noticeably higher compared to similar studies of PTSD in persons with schizophrenia (30%) and drug using women with SMI (30-37%). The results illustrate the increased risk of trauma and PTSD in substance abusing women with schizophrenia. Childhood sexual abuse and sexual assault in adulthood were strongly related to PTSD, as was revictimization. When contextual variables were examined closer to highlight any differences between physical and sexual abuse, the results were astoundingly distinctive for the perpetrator of the abuse. While the vast majority of women reported being sexually abused by a stranger (94%), physical abuse was more likely to happen by someone close to the study participant (94%). These findings highlight how little is known about the context of abuse. Further results will elaborate on the relationship between PTSD and TLEs, including the association between TLEs mad psychiatric symptoms. The treatment implications of these findings will also be discussed.
A VIDEOTAPED NEUROLOGIC EXAM IN SCHIZOPHRENIA, SCHIZOAFFECTIVE, BIPOLAR AND CONTROL SUBJECTS S. C. Olson,* H. A. N a s r a l l a h
Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA Abnormalities on neurological examination have been found in patients with schizophrenia and their relatives. We studied patients with schizophrenia (SZ, n=51), schizoaffective disorder (SZAF, n=23), bipolar disorder (BE n=28), and controls (CTL, n=36). Subjects were diagnosed by DSM-IIIR criteria based on SCID and all available information. Patients were stabilized clinically before examination and most were treated with typical antipsychotics. A neurological exam was videotaped and rated later blind to diagnosis. The examination covered alternating movements, balance, gait, primitive and tendon reflexes and cerebellar function. Global neurologic rating on a 0-4 scale showed that all patient groups had more neurologically abnormal (N+: score >= 2) subjects (SZ, 27%; SZAF, 48%; BE 32%) than in controls (0%). Tardive dyskinesia was diagnosed in 12/32 subjects who were N+ vs. 7/62 of the N- neurologically intact subjects (Fisher's exact p=.0055). N+ and N- subjects did not differ in age, age of onset, SANS, SAPS, family history of psychosis, maternally-reported perinatal complications, or lateral or 3rd ventricle VBR. Primitive reflexes were rare and did not discriminate between diagnostic groups. Rapid alternating movements and motor sequencing were timed from the video, converted to standard scores and averaged for six separate movement tasks. All patient groups performed the repetitive movements slower than CTL, but patient groups were not significantly different from each other (ANOVA, p<.0001, post-hoc analysis SZ=SZAF=BP
OBSESSIVE-COMPULSIVE SYMPTOMS AMONG PEOPLE WITH SCHIZOPHRENIA: RELATION TO PSYCHOTIC SYMPTOMS, COGNITIVE PERFORMANCE AND ANTIPSYCHOTIC MEDICATIONS D. Ongur,* O. Freudenreich, D. C. H e n d e r s o n , D. C. G o f f
Schizophrenia Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA In this study, we examined the relationship between obsessive-compulsive (OC) symptoms and clinical features of patients with schizophrenia. Subjects were outpatients at a community mental health clinic (n=119; 31 female; age=44.0±9.5 (mean±SD]) who completed a clinical and neuropsychological test battery. Obsessive-compulsive symptoms were assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Obsessive and compulsive subscales of the Y-BOCS were also recorded (Y-BO and Y-BC, respectively). Clinical status was assessed using the Positive and Negative Symptom Scale (PANSS). Eighty subjects (67.2%) had a Y-BOCS score of zero while 27 (22.7%) had a Y-BOCS score of eight or higher, indicating at least mild OC symptoms. Because of a strongly skewed Y-BOCS score distribution, subjects were grouped into two categories (high vs. low Y-BOCS score) with a cutoff score arbitrarily set at 12 (6 on the Y-BO or Y-BC). Subjects with high Y-BOCS scores had significantly higher PANSS scores than those with low Y-BOCS scores (69.9_+14.7 vs. 62.2_+12.9; p=0.04). This difference was accounted for by a higher score on the positive symptoms subscale of the PANSS in subjects with high Y-BOCS scores (19.2+_5.8 vs. 14.3+5.4; p=0.002) while the same group had a trend towards lower scores on the negative symptoms subscale of the PANSS (p=0.10). Subjects with high Y-BO (but not Y-BC or Y-BOCS) scores made significantly more elrors on the Stroop interference test than those with low Y-BO scores (1.9+-2.2 vs. 1.1+1.5; p=0.04). There were no other inter-group cognitive performance differences. When subjects were analyzed on the basis of taking olanzapine and/or clozapine (OLZ/CLZ) or not (no OLZ/CLZ) at the time of testing, the OLZ/CLZ group trended toward having significantly higher Y-BC (but not Y-BO or Y-BOCS) scores (1.8-+3.3 vs. 0.7+1.7; p=0.07). These results indicate that schizophrenics with more significant OC symptoms also have more positive symptoms. In addition, subjects with high obsession ratings are impaired in a test measuring frontal lobe function, consistent with past reports of selective cognitive impairment in schizophrenics with OC symptoms. Finally, patients on the two antipsychotics which have clinically been reported to induce or worsen OC symptoms had higher compulsive but not obsessive symptom ratings. This may be due to medication effects or patients with worse psychotic and OC symptoms may have been preferentially placed on these medications.
RESPONSIVENESS TO ANTIPSYCHOTIC TREATMENT IN FIRST-EPISODE PSYCHOTIC PATIENTS, RELATION WITH DURATION OF UNTREATED PSYCHOSIS (DUP) J. Pelayo-Teran,* I. Martfnez-Gonzfilez, C. GonzfilezBlanch, M. Alvarez, O. Martfnez, R. Pdrez-Iglesias, D. Sierra-Biddle, J. Vfizquez-Barquero, B. Crespo-Facorro
Psychiatry, HU Marques de Valdecilla, Santander, Cantabria, Spain To investigate responsiveness (measured as differences of scores between the baseline and 6th week) to acute treatment of patients
International Congress on Schizophrenia Research 2003
24
2. Phenomenology
with a first-episode of non-affective psychosis, and specify any relationships with duration of untreated psychosis (DUP). 46 individuals (27 M, 19 F) with non-affective psychosis in the early stages were included. Inclusion criteria were DSM IV diagnosis of schizophrenia, schizoaffective disorder or schizophreniform disorder. Exclusion criteria were nem'oleptic treatment superior to 12 weeks, diagnosis of substance abuse, mental retardation or organic brain disease. Efficacy and outcome measures included were BPRS, SANS and SAPS, and were recorded at baseline and after 6 weeks of neuroleptic treatment (randomly assigned to olanzapine, risperidone or haloperidol). The DUP was defined as follows: interval (in months) between the onset of marked delusions, hallucinations or formal thought disorder and the implementation of the first antipsychotic tl-eatment. The mean DUP was 14 months (SD: 35). Correlational analysis (Spearman rank-order) was use to detect associations between DUP and differences of scores in BPRS, SANS and SAPS between the baseline and 6 week. DUP was also treated as a dichotomous variable, with 12 months as the cut-offpoint and Student t-test were used to identify differences between groups. No significant associations were found between DUP and responsiveness to neuroleptic treatment. There were no significant correlations between DUP and the severity of symptomatology at the baseline or 6th week interviews. There were no significant differences in responsiveness to antipsychotic treatment between patients with a DUP < 1year and those with DUP >=1 year. Our results seem to point out DUP may not affect clinical response to neuroleptic treatment during the earlystages of the illness. Research grant: lnstituto Salud Carlos II1 -FISexp: 00/3075 DUP
> 1 YEAR n MEAN SD n
CORRELATION r
p
for using substances ('alcohol and cannabis most conmlon) were to relax and to increase pleasure. The normative development model, which hypothesizes that occasional users would have improved social and emotional adjustment compared to abstainers and frequent users, was only partially supported. Depression and substance use were found to have a curvilinear relationship (p<0.05), but social problems and substance use had a linear relationship (p<0.05). The deviance-prone model was supported (p<0.0t), indicating that rulebreaking behavior and aggression significantly predicted substance use. Thirdly, the affect-regulation model was also supported (p<0.05), indicating that negative affect significantly predicted substance use patterns. In conclusion, for adolescents with psychosis, deviant behavior and negative affect appear to play a large role in predicting increased substance use. Given that substance use can have detrimental effects on the functioning of individuals with psychotic disorders, it may be important to monitor deviant behavior and affective symptoms in adolescents with psychosis to try and prevent increased substance use. References: Addington J. & Addington D. 1998. The effects of substance abuse in early psychosis. B J Psych 172, Supplement 33: 134-136. Pencer A. & Addington J. In press. Substance abuse and cognition in early psychosis. J Psychiatry Neurosci.
PREDICTORS OF ANTIPSYCHOTIC TREATMENT RESPONSE IN PATIENTS WITH FIRST EPISODE SCHIZOPHRENIA, SCHIZOAFFECTIVE, AND SCHIZOPHRENIFORM DISORDERS D. O. Perkins,* J. A. Lieberman, H. Gu, M. Tohen,
Psychosisdiff
3.75
6.86 36 -0.33 5.22 10 0.072 0.656
J. M c E v o y , A. Green, R. Zipursky, S. M. Strakowski, T. S h a r m a , R. Kahn, R. Gut, G. Tollefson
Negative_diff
5,t3
2,95 36
4,78
1,92 l0
Psychiatry, UNC Chapel Hill, Chapel Hill, NC, USA
Desorgan_diff 4,38
3.21 36
4,22
1,99 10 0.029 0.859
BPRS_diff
0.045 0.779
27,19 13,50 36 20,67 6,63 10! 0.017
(I.917
MODELS OF SUBSTANCE USE IN ADOLESCENTS EXPERIENCING A FIRST EPISODE OF PSYCHOSIS A. H. Pencer,* J. A d d i n g t o n
University of Calgary, Calgary, AB, Canada The use of substances is a major concern with individuals with psychotic disorders, as it can have detrimental effects on psychotic symptoms and other aspects of functioning (Addington & Addington, 1998; Pencer & Addington, in press). The purpose of this study is to increase our understanding of the association between substance use and psychosis in adolescents by testing three models of substance use that have been investigated in the general adolescent population: the normative development model, the deviance-prone model, and the affect-regulation model. Subjects were 35 outpatient adolescents (age 15-20) who had recently been admitted for a first episode of psychosis to an early psychosis program. Assessment measures included the Personal Experience Screening Questionnaire (for substance use), the Reasons for Use Scale, the Youth Self-Report (for social adjustment, rule-breaking behavior, aggression, depression, anxiety, and withdi'awal), the Beck Depression Inventory, and the BeckAnxiety Inventory. Results indicated that the two main reasons
INTRODUCTION: Response of a first psychotic episode to treatment is heterogeneous. Several studies find that duration of untreated psychosis (DUP) prior to initial pharmacological treatment is associated with treatment response consistent with the hypothesis that clinical deterioration in schizophrenia may result from a progressive process. However DUP may also be influenced by other factors that affect treatment outcome, particularly poor premorbid function and premorbid course, and thus these variables need to be simultaneously evaluated to determine their independent effects oil outcome. METHOD: Data for this study were collected as part of a randomized mutticenter clinical trial comparing olanzapine with haloperidol in 262 first episode patients. The relationships between DUE premorbid function, and premorbid course to 12-week, l-year, and 2-year antipsychotic response are reported. RESULTS: Shorter DUP and good premorbid function (PF) both independently predicted better clinical response at 12 weeks, as measured by improvement in overall psychopathology [DUP: F(1,182)=5.5, P=.02; PF: F(1,182)=24.9, P<.0001], and negative symptoms [DUP: F(1,182)=4.9, P=.03; PF: F(I,182)= 11.6, P<.001]. Good premorbid function also predicted positive symptom improvement IF(l, 182)=26.7, P<.0001 ]. Analyses of long term (1 and 2 yea') treatment are underway, and will be presented. DISCUSSION: Earlier institution of antipsychotic treatment is associated with better acute symptomatic improvement in first episode patients. In addition, poor premorbid function may indicate an illness subtype that is less likely to respond to antipsychotic treatment regardless of when it is instituted.
International Congress on Schizophrenia Research 2003
23
IV criteria for drug abuse or dependence consented to participate in the study. All of the women were administered the Structured Diagnostic Interview for DSM-IV (SCID), the Clinician Administered PTSD Scale (CAPS), and several other clinical assessments. The results confirm high lifetime rates of trauma, especially physical abuse (81%) and sexual abuse (61%). In fact, close to the entire sample (96%) reported experiencing at least one lifetime traumatic event, and the average number of traumatic life events reported was 8. The prevalence of PTSD in the sample was 47%. This rate is noticeably higher compared to similar studies of PTSD in persons with schizophrenia (30%) and drug using women with SMI (30-37%). The results illustrate the increased risk of trauma and PTSD in substance abusing women with schizophrenia. Childhood sexual abuse and sexual assault in adulthood were strongly related to PTSD, as was revictimization. When contextual variables were examined closer to highlight any differences between physical and sexual abuse, the results were astoundingly distinctive for the perpetrator of the abuse. While the vast majority of women reported being sexually abused by a stranger (94%), physical abuse was more likely to happen by someone close to the study participant (94%). These findings highlight how little is known about the context of abuse. Further results will elaborate on the relationship between PTSD and TLEs, including the association between TLEs mad psychiatric symptoms. The treatment implications of these findings will also be discussed.
A VIDEOTAPED NEUROLOGIC EXAM IN SCHIZOPHRENIA, SCHIZOAFFECTIVE, BIPOLAR AND CONTROL SUBJECTS S. C. Olson,* H. A. N a s r a l l a h
Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA Abnormalities on neurological examination have been found in patients with schizophrenia and their relatives. We studied patients with schizophrenia (SZ, n=51), schizoaffective disorder (SZAF, n=23), bipolar disorder (BE n=28), and controls (CTL, n=36). Subjects were diagnosed by DSM-IIIR criteria based on SCID and all available information. Patients were stabilized clinically before examination and most were treated with typical antipsychotics. A neurological exam was videotaped and rated later blind to diagnosis. The examination covered alternating movements, balance, gait, primitive and tendon reflexes and cerebellar function. Global neurologic rating on a 0-4 scale showed that all patient groups had more neurologically abnormal (N+: score >= 2) subjects (SZ, 27%; SZAF, 48%; BE 32%) than in controls (0%). Tardive dyskinesia was diagnosed in 12/32 subjects who were N+ vs. 7/62 of the N- neurologically intact subjects (Fisher's exact p=.0055). N+ and N- subjects did not differ in age, age of onset, SANS, SAPS, family history of psychosis, maternally-reported perinatal complications, or lateral or 3rd ventricle VBR. Primitive reflexes were rare and did not discriminate between diagnostic groups. Rapid alternating movements and motor sequencing were timed from the video, converted to standard scores and averaged for six separate movement tasks. All patient groups performed the repetitive movements slower than CTL, but patient groups were not significantly different from each other (ANOVA, p<.0001, post-hoc analysis SZ=SZAF=BP
OBSESSIVE-COMPULSIVE SYMPTOMS AMONG PEOPLE WITH SCHIZOPHRENIA: RELATION TO PSYCHOTIC SYMPTOMS, COGNITIVE PERFORMANCE AND ANTIPSYCHOTIC MEDICATIONS D. Ongur,* O. Freudenreich, D. C. H e n d e r s o n , D. C. G o f f
Schizophrenia Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA In this study, we examined the relationship between obsessive-compulsive (OC) symptoms and clinical features of patients with schizophrenia. Subjects were outpatients at a community mental health clinic (n=119; 31 female; age=44.0±9.5 (mean±SD]) who completed a clinical and neuropsychological test battery. Obsessive-compulsive symptoms were assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Obsessive and compulsive subscales of the Y-BOCS were also recorded (Y-BO and Y-BC, respectively). Clinical status was assessed using the Positive and Negative Symptom Scale (PANSS). Eighty subjects (67.2%) had a Y-BOCS score of zero while 27 (22.7%) had a Y-BOCS score of eight or higher, indicating at least mild OC symptoms. Because of a strongly skewed Y-BOCS score distribution, subjects were grouped into two categories (high vs. low Y-BOCS score) with a cutoff score arbitrarily set at 12 (6 on the Y-BO or Y-BC). Subjects with high Y-BOCS scores had significantly higher PANSS scores than those with low Y-BOCS scores (69.9_+14.7 vs. 62.2_+12.9; p=0.04). This difference was accounted for by a higher score on the positive symptoms subscale of the PANSS in subjects with high Y-BOCS scores (19.2+_5.8 vs. 14.3+5.4; p=0.002) while the same group had a trend towards lower scores on the negative symptoms subscale of the PANSS (p=0.10). Subjects with high Y-BO (but not Y-BC or Y-BOCS) scores made significantly more elrors on the Stroop interference test than those with low Y-BO scores (1.9+-2.2 vs. 1.1+1.5; p=0.04). There were no other inter-group cognitive performance differences. When subjects were analyzed on the basis of taking olanzapine and/or clozapine (OLZ/CLZ) or not (no OLZ/CLZ) at the time of testing, the OLZ/CLZ group trended toward having significantly higher Y-BC (but not Y-BO or Y-BOCS) scores (1.8-+3.3 vs. 0.7+1.7; p=0.07). These results indicate that schizophrenics with more significant OC symptoms also have more positive symptoms. In addition, subjects with high obsession ratings are impaired in a test measuring frontal lobe function, consistent with past reports of selective cognitive impairment in schizophrenics with OC symptoms. Finally, patients on the two antipsychotics which have clinically been reported to induce or worsen OC symptoms had higher compulsive but not obsessive symptom ratings. This may be due to medication effects or patients with worse psychotic and OC symptoms may have been preferentially placed on these medications.
RESPONSIVENESS TO ANTIPSYCHOTIC TREATMENT IN FIRST-EPISODE PSYCHOTIC PATIENTS, RELATION WITH DURATION OF UNTREATED PSYCHOSIS (DUP) J. Pelayo-Teran,* I. Martfnez-Gonzfilez, C. GonzfilezBlanch, M. Alvarez, O. Martfnez, R. Pdrez-Iglesias, D. Sierra-Biddle, J. Vfizquez-Barquero, B. Crespo-Facorro
Psychiatry, HU Marques de Valdecilla, Santander, Cantabria, Spain To investigate responsiveness (measured as differences of scores between the baseline and 6th week) to acute treatment of patients
International Congress on Schizophrenia Research 2003
24
2. Phenomenology
with a first-episode of non-affective psychosis, and specify any relationships with duration of untreated psychosis (DUP). 46 individuals (27 M, 19 F) with non-affective psychosis in the early stages were included. Inclusion criteria were DSM IV diagnosis of schizophrenia, schizoaffective disorder or schizophreniform disorder. Exclusion criteria were nem'oleptic treatment superior to 12 weeks, diagnosis of substance abuse, mental retardation or organic brain disease. Efficacy and outcome measures included were BPRS, SANS and SAPS, and were recorded at baseline and after 6 weeks of neuroleptic treatment (randomly assigned to olanzapine, risperidone or haloperidol). The DUP was defined as follows: interval (in months) between the onset of marked delusions, hallucinations or formal thought disorder and the implementation of the first antipsychotic tl-eatment. The mean DUP was 14 months (SD: 35). Correlational analysis (Spearman rank-order) was use to detect associations between DUP and differences of scores in BPRS, SANS and SAPS between the baseline and 6 week. DUP was also treated as a dichotomous variable, with 12 months as the cut-offpoint and Student t-test were used to identify differences between groups. No significant associations were found between DUP and responsiveness to neuroleptic treatment. There were no significant correlations between DUP and the severity of symptomatology at the baseline or 6th week interviews. There were no significant differences in responsiveness to antipsychotic treatment between patients with a DUP < 1year and those with DUP >=1 year. Our results seem to point out DUP may not affect clinical response to neuroleptic treatment during the earlystages of the illness. Research grant: lnstituto Salud Carlos II1 -FISexp: 00/3075 DUP
> 1 YEAR n MEAN SD n
CORRELATION r
p
for using substances ('alcohol and cannabis most conmlon) were to relax and to increase pleasure. The normative development model, which hypothesizes that occasional users would have improved social and emotional adjustment compared to abstainers and frequent users, was only partially supported. Depression and substance use were found to have a curvilinear relationship (p<0.05), but social problems and substance use had a linear relationship (p<0.05). The deviance-prone model was supported (p<0.0t), indicating that rulebreaking behavior and aggression significantly predicted substance use. Thirdly, the affect-regulation model was also supported (p<0.05), indicating that negative affect significantly predicted substance use patterns. In conclusion, for adolescents with psychosis, deviant behavior and negative affect appear to play a large role in predicting increased substance use. Given that substance use can have detrimental effects on the functioning of individuals with psychotic disorders, it may be important to monitor deviant behavior and affective symptoms in adolescents with psychosis to try and prevent increased substance use. References: Addington J. & Addington D. 1998. The effects of substance abuse in early psychosis. B J Psych 172, Supplement 33: 134-136. Pencer A. & Addington J. In press. Substance abuse and cognition in early psychosis. J Psychiatry Neurosci.
PREDICTORS OF ANTIPSYCHOTIC TREATMENT RESPONSE IN PATIENTS WITH FIRST EPISODE SCHIZOPHRENIA, SCHIZOAFFECTIVE, AND SCHIZOPHRENIFORM DISORDERS D. O. Perkins,* J. A. Lieberman, H. Gu, M. Tohen,
Psychosisdiff
3.75
6.86 36 -0.33 5.22 10 0.072 0.656
J. M c E v o y , A. Green, R. Zipursky, S. M. Strakowski, T. S h a r m a , R. Kahn, R. Gut, G. Tollefson
Negative_diff
5,t3
2,95 36
4,78
1,92 l0
Psychiatry, UNC Chapel Hill, Chapel Hill, NC, USA
Desorgan_diff 4,38
3.21 36
4,22
1,99 10 0.029 0.859
BPRS_diff
0.045 0.779
27,19 13,50 36 20,67 6,63 10! 0.017
(I.917
MODELS OF SUBSTANCE USE IN ADOLESCENTS EXPERIENCING A FIRST EPISODE OF PSYCHOSIS A. H. Pencer,* J. A d d i n g t o n
University of Calgary, Calgary, AB, Canada The use of substances is a major concern with individuals with psychotic disorders, as it can have detrimental effects on psychotic symptoms and other aspects of functioning (Addington & Addington, 1998; Pencer & Addington, in press). The purpose of this study is to increase our understanding of the association between substance use and psychosis in adolescents by testing three models of substance use that have been investigated in the general adolescent population: the normative development model, the deviance-prone model, and the affect-regulation model. Subjects were 35 outpatient adolescents (age 15-20) who had recently been admitted for a first episode of psychosis to an early psychosis program. Assessment measures included the Personal Experience Screening Questionnaire (for substance use), the Reasons for Use Scale, the Youth Self-Report (for social adjustment, rule-breaking behavior, aggression, depression, anxiety, and withdi'awal), the Beck Depression Inventory, and the BeckAnxiety Inventory. Results indicated that the two main reasons
INTRODUCTION: Response of a first psychotic episode to treatment is heterogeneous. Several studies find that duration of untreated psychosis (DUP) prior to initial pharmacological treatment is associated with treatment response consistent with the hypothesis that clinical deterioration in schizophrenia may result from a progressive process. However DUP may also be influenced by other factors that affect treatment outcome, particularly poor premorbid function and premorbid course, and thus these variables need to be simultaneously evaluated to determine their independent effects oil outcome. METHOD: Data for this study were collected as part of a randomized mutticenter clinical trial comparing olanzapine with haloperidol in 262 first episode patients. The relationships between DUE premorbid function, and premorbid course to 12-week, l-year, and 2-year antipsychotic response are reported. RESULTS: Shorter DUP and good premorbid function (PF) both independently predicted better clinical response at 12 weeks, as measured by improvement in overall psychopathology [DUP: F(1,182)=5.5, P=.02; PF: F(1,182)=24.9, P<.0001], and negative symptoms [DUP: F(1,182)=4.9, P=.03; PF: F(I,182)= 11.6, P<.001]. Good premorbid function also predicted positive symptom improvement IF(l, 182)=26.7, P<.0001 ]. Analyses of long term (1 and 2 yea') treatment are underway, and will be presented. DISCUSSION: Earlier institution of antipsychotic treatment is associated with better acute symptomatic improvement in first episode patients. In addition, poor premorbid function may indicate an illness subtype that is less likely to respond to antipsychotic treatment regardless of when it is instituted.
International Congress on Schizophrenia Research 2003