de Freitas, Daniela Fonseca;
Agbedjro, Deborah;
Kadra-Scalzo, Giouliana;
Francis, Emma;
Ridler, Isobel;
Pritchard, Megan;
Shetty, Hitesh;
... MacCabe, James H; + view all
(2022)
Clinical correlates of early onset antipsychotic treatment resistance.
Journal of Psychopharmacology
, 36
(11)
pp. 1226-1233.
10.1177/02698811221132537.
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Abstract
Background: There is evidence of heterogeneity within treatment-resistant schizophrenia (TRS), with some people not responding to antipsychotic treatment from illness onset and others becoming treatment-resistant after an initial response period. These groups may have different aetiologies. Aim: This study investigates sociodemographic and clinical correlates of early onset of TRS. Method: Employing a retrospective cohort design, we do a secondary analysis of data from a cohort of people with TRS attending the South London and Maudsley. Regression analyses were conducted to identify the correlates of the length of treatment to TRS. Predictors included the following: gender, age, ethnicity, problems with positive symptoms, problems with activities of daily living, psychiatric comorbidities, involuntary hospitalisation and treatment with long-acting injectable antipsychotics. Results: In a cohort of 164 people with TRS (60% were men), the median length of treatment to TRS was 3 years and 8 months. We observed no cut-off on the length of treatment until TRS presentation differentiating between early and late TRS (i.e. no bimodal distribution). Having mild to very severe problems with hallucinations and delusions at the treatment start was associated with earlier TRS (~19 months earlier). In sensitivity analyses, including only complete cases (subject to selection bias), treatment with a long-acting injectable antipsychotic was additionally associated with later TRS (~15 months later). Conclusion: Our findings do not support a clear separation between early and late TRS but rather a continuum of the length of treatment before TRS onset. Having mild to very severe problems with positive symptoms at treatment start predicts earlier onset of TRS.
| Type: | Article |
|---|---|
| Title: | Clinical correlates of early onset antipsychotic treatment resistance |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/02698811221132537 |
| Publisher version: | https://doi.org/10.1177/02698811221132537 |
| Language: | English |
| Additional information: | © The Author(s) 2022. This article is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/02698811221132537 journals.sagepub.com/home/jop |
| Keywords: | Psychotic disorders, schizophrenia, treatment refractory, antipsychotic agents, clozapine |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Mental Health Neuroscience |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10167746 |
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