TIME-COURSE AND BIOLOGIC CORRELATES OF TREATMENT RESPONSE IN 1ST-EPISODE SCHIZOPHRENIA

Objective: To examine the course and potential predictors of treatment response in the early phase of schizophrenia. Design: Prospective stu dy of an inception cohort. Setting: Psychiatric division of an academi c medical center with a suburban metropolitan catchment area. Patients and Interventions: Seventy first-episode patients who had undergone f our biologic assessment procedures (brain magnetic resonance imaging, behavioral response to methylphenidate hydrochloride, growth hormone l evels, eye tracking) were treated with a standardized antipsychotic dr ug protocol until recovery. Response was measured in terms of psychopa thology and degree of remission. Results: Using survival analysis, the proportion of patients remitting by 1 year was estimated at 83%. Mean and median times to remission were 35.7 weeks and 11 weeks, respectiv ely. No baseline demographic or psychopathologic measure significantly predicted time to or level of remission. However, males tended to be nonresponders to treatment and have diagnoses of schizophrenia rather than schizoaffective disorder. Brain pathomorphology and abnormal basa l growth hormone significantly predicted time to remission. Conclusion s: These results indicate that the antipsychotic treatment response of first-episode schizophrenics is better than chronic multiepisode pati ents and suggest that specific pathobiologic markers reflect pathophys iologic processes that mediate antipsychotic treatment response.