Open AccessEarly improvements of individual symptoms as a predictor of treatment response to asenapine in patients with schizophrenia
Author(s) -
Ogyu Kamiyu,
Noda Yoshihiro,
Yoshida Kazunari,
Kurose Shin,
Masuda Fumi,
Mimura Yu,
Nishida Hana,
Plitman Eric,
Tarumi Ryosuke,
Tsugawa Sakiko,
Wada Masataka,
Miyazaki Takahiro,
Uchida Hiroyuki,
GraffGuerrero Ariel,
Mimura Masaru,
Nakajima Shinichiro
Publication year - 2020
Publication title -
neuropsychopharmacology reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.661
H-Index - 13
ISSN - 2574-173X
DOI - 10.1002/npr2.12103
Subject(s) - positive and negative syndrome scale , asenapine , schizophrenia (object oriented programming) , logistic regression , placebo , psychiatry , medicine , psychology , clinical psychology , antipsychotic , psychosis , alternative medicine , pathology
Aim It is well accepted that early improvement with antipsychotics predicts subsequent response in patients with schizophrenia. However, no study has examined the contribution of individual symptoms rather than overall symptom severity as the predictors. Thus, we aimed to detect individual symptoms whose improvements could predict subsequent response in patients with schizophrenia during treatment with asenapine and examine whether a prediction model with individual symptoms would be superior to a model using overall symptom severity. Methods This study analyzed a dataset including 532 patients with schizophrenia enrolled in a 6‐week double‐blind, placebo‐controlled, randomized trial of asenapine. Response to asenapine was defined as a ≥30% decrease in Positive and Negative Syndrome Scale (PANSS) total score from baseline to week 6. Stepwise logistic regression analyses were performed to investigate the associations among response and PANSS total/individual item score improvements at week 1 or week 2. Results Response was associated with early improvement in the following PANSS items: disturbance of volition, active social avoidance, poor impulse control at week 1; and active social avoidance, poor attention, lack of judgment and insight at week 2. Prediction accuracy was almost compatible between the model with individual symptoms and the model with PANSS total score both at weeks 1 and 2 (Nagelkerke R 2 : .51, .42 and .55, .54, respectively). Conclusion Early improvement in negative symptoms, poor attention and impulse control, and lack of insight, in particular predicted subsequent treatment response in patients with schizophrenia during treatment with asenapine as accurately as prediction based on overall symptom severity.