engleski

Clinical and metabolic implications of disease onset among unmedicated patients with schizophrenia

Patients with early onset of schizophrenia (≤ 18 years) reportedly manifest greater cognitive impairment and increased negative symptom severity compared to those with adult-onset (> 18 years). Antipsychotic medications are the main class of medication to treat schizophrenia patients and many of them have been causatively linked to iatrogenic negative symptoms, cognitive impairment, and metabolic disturbances, such as weight gain, lipid disturbance, and glucose dysregulation. To elucidate the potential associations between the onset of schizophrenia (early vs. adult), clinical psychopathology, and metabolic parameters, among unmedicated schizophrenia patients, may be of clinical relevance when prescribing antipsychotic medications. We investigated whether and to what extent the onset of schizophrenia might contribute to Positive and Negative Syndrome Scale (PANSS) scores, body mass index values, and plasma lipid and glucose concentrations among two groups of unmedicated patients from the Croatian population: antipsychotic-naïve first- episode patients (N = 64) and nonadherent chronic patients (N = 107). Age of onset was defined as the patient’s age at their first hospital admission due to a psychotic episode, at which the diagnosis of schizophrenia was first used. PANSS data were recorded during a psychotic state of the illness requiring hospitalization. Plasma total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, and glucose levels were determined after a 12-hour fasting period. The onset of schizophrenia was significantly associated with negative factor scores only. Specifically, patients with early onset of schizophrenia manifested higher negative factor scores compared to those with adult-onset (P < 0.01). After adjustment for the possible effect of gender, age, illness duration, and number of psychotic episodes, the onset of schizophrenia accounted for ~8% of the variability of the negative factor. Our present results suggest that medications that are more effective for negative symptoms should be considered when prescribing antipsychotic medications to unmedicated patients with early onset of schizophrenia.

age of onset ; antipsychotic agents ; schizophrenia

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