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Do patients with paranoid and disorganized schizophrenia respond differently to antipsychotic drugs?
Author(s) -
Corves C.,
Engel R. R.,
Davis J.,
Leucht S.
Publication year - 2014
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12231
Subject(s) - amisulpride , paranoid schizophrenia , brief psychiatric rating scale , schizophrenia (object oriented programming) , psychology , medicine , antipsychotic , psychiatry , antipsychotic drug , drug trial , clinical trial , psychosis
Objective The aim of this study was to compare the differential response to amisulpride in patients with paranoid versus disorganized schizophrenia. Method We reanalyzed the original data from five different randomized drug trials comparing Brief Psychiatric Rating Scale ( BPRS ) scores in a database containing 427 paranoid and 296 disorganized patients with schizophrenia. Results Both the disorganized and the paranoid group showed a substantial improvement of the BPRS total score within the first 4 weeks. In the paranoid group, mean (± SD ) BPRS reduction was 16.9 (±14.6) ( t = 24.06, df = 426, P < 0.001) and in the disorganized group 17.0 (±15.9) ( t = 18.49, df = 295, P < 0.001). An analysis of covariance ( ancova ) controlling for BPRS at baseline and the influence of different trial protocols showed significant differences between diagnostic groups ( F = 13.47, df = 1, P < 0.001), Cohen's D 0.31 ( CI = 0.16–0.46). Paranoid patients improved by 4.8 BPRS points more than disorganized patients (adjusted means 18.90 ( CI = 17.33–20.37) for the paranoid and 14.1 ( CI = 12.04 – 16.11) for the disorganized group. Conclusion We conclude that amisulpride is effective in disorganized as well as in paranoid schizophrenia, but that symptom reduction in the disorganized subtype is less pronounced.