Investigating Predictors of Clozapine Response in Adolescents with Schizophrenia and Schizoaffective Disorder
JOURNAL OF CHILD AND ADOLESCENT PSYCHOPHARMACOLOGY, cilt.31, sa.7, ss.504-510, 2021 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 31 Sayı: 7
- Basım Tarihi: 2021
- Doi Numarası: 10.1089/cap.2021.0009
- Dergi Adı: JOURNAL OF CHILD AND ADOLESCENT PSYCHOPHARMACOLOGY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Animal Behavior Abstracts, CINAHL, EMBASE, MEDLINE, Psycinfo
- Sayfa Sayıları: ss.504-510
- Anahtar Kelimeler: schizophrenia, adolescent, clozapine
- Dokuz Eylül Üniversitesi Adresli: Evet
Özet
Objectives: We aimed to determine the clinical predictors of clozapine response in patients with early-onset schizophrenia (EOS)/schizoaffective disorder and the effect of substance use disorder (SUD) on treatment outcomes. Methods: Medical records of patients with treatment-resistant EOS receiving clozapine were identified for data analysis dated between January 2015 and April 2020. Patients on clozapine were followed in an inpatient unit of a tertiary care mental health hospital. Using the Positive and Negative Symptom Scale (PANSS), >= 30% reduction was defined as the response criteria after clozapine treatment. Results: Of 50 subjects (age: 16.3 +/- 1.3 years, 36.0% female), 22 subjects (44.0%) met the defined response criteria. Clozapine responder (CLZ-R) and clozapine nonresponder (CLZ-NR) groups were similar regarding age at illness onset, sex, and duration of untreated psychosis. The CLZ-R group had higher baseline positive PANSS scores (24.8 +/- 8.1 vs. 17.1 +/- 6.6, p = 0.001, d = 1.0) and total PANSS scores (94.8 +/- 17.2 vs. 80.1 +/- 19.8, p = 0.008, d = 0.8) compared with the CLZ-NR counterparts. The duration of hospital stay was longer in the CLZ-NR group (122.3 +/- 48.2 vs. 87.3 +/- 36.2 days, p = 0.007). Among 32 male patients, the presence of SUD (n = 9, 28.1%) was associated with a less reduction in total PANSS scores (F = 7.5, p = 0.010) and higher levels of positive symptoms at the end of the treatment (12.8 +/- 4.1 vs. 18.8 +/- 7.4, p = 0.006, d = 1.0). Synthetic cannabinoids were the most common substance type used among males with treatment-refractory EOS (25.0%). Conclusions: Our results did not support the role of sociodemographic variables in clozapine response. Positive symptoms and SUD yielded a prognostic value in patients receiving clozapine.