treatment resistant schizophrenia in slovenian population

Abstract

Background. Approximately 30 % of patients with schizophrenia do not achieve remission upon antipsychotic treatment. The purpose of this article is to present the differences between treatment resistant and treatment responsive patients in Slovenian population.

Methods. The prospective study included 138 patients diagnosed with schizophrenia according to DSM IV. They were divided in the treatment responsive (94 patients) and resistant group (44 patients). Groups were compared regarding the basic demographic and treatment related data.

Results. Our results showed gender-related differences; the treatment resistant group included more men than women (p = 0.021), and men were younger than women (p = 0.019). In the treatment resistant group  the first psychotic episode occurred at a younger age (p = 0.005), on average it occured 3.86 years earlier than in the treatment responsive group. Treatment resistant patients had more hospitalizations (p = 0.001) and received higher doses of antipsychotic therapy in the past (p = 0.030) and present (p = 0.001). They were also prescribed clozapine earlier than the responsive group (p = 0.001). Regardless of the treatment response, patients living in a relationship had lower levels of total PANSS positive symptoms (p = 0.013) and total general symptoms (p = 0.050) than single and widowed patients.

Conclusions. We made a comparative study of a group of treatment resistant and treatment responsive schizophrenia patients in slovenian population for the first time. An early onset of the disease, male gender, more pronounced psychopathological symptoms and low global functioning can indicate increased risk for unfavourable disease progress. It is important that these patients are recognised early to ensure optimal treatment.