抗精神病药物多巴胺 D2 亲和力与初发精神病缓解期患者的阴性症状。

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research Pub Date : 2024-10-20 DOI:10.1016/j.schres.2024.09.030

Franciska de Beer , Ben Wijnen , Lotte Wouda , Sanne Koops , Shiral Gangadin , Wim Veling , Nico van Beveren , Lieuwe de Haan , Marieke J.H. Begemann , HAMLETT-OPHELIA consortium, Iris E.C. Sommer

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引用次数: 0

摘要

阴性症状可能是精神分裂症谱系病理学的一个组成部分，也可能继发于其他精神症状或由抗精神病药物引起。由于抗精神病药物对多巴胺受体的亲和力不同，而且有些抗精神病药物具有部分激动作用，因此抗精神病药物引起阴性症状的能力也会有所不同。我们在 310 名缓解的首次发作精神病（FEP）患者中评估了阴性症状与抗精神病药物（分为部分激动剂或具有高或低 D2 亲和力的拮抗剂）之间的关系。阴性症状的严重程度通过症状和病史综合评估以及阳性和阴性综合量表进行评估。在进行线性回归分析的同时，使用治疗的反概率加权法控制了组间临床和社会人口学特征的差异。与使用高亲和力拮抗剂的患者（n = 84）相比，使用部分激动剂的患者（n = 78）表现出较少的阴性症状。与使用低亲和力拮抗剂的患者（n = 148）相比，使用部分激动剂的患者表现出的阴性症状严重程度较低，呈趋势水平（p = 0.051）。抗精神病药物剂量较高的患者的阴性症状严重程度更高。在病情缓解的 FEP 患者中，我们发现使用部分激动剂类抗精神病药物与较低的阴性症状严重程度相关，而使用高 D2 亲和力拮抗剂与较严重的阴性症状相关。

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Antipsychotic dopamine D2 affinity and negative symptoms in remitted first episode psychosis patients

Negative symptoms can be an integral part of schizophrenia spectrum pathology and can be secondary to other psychotic symptoms or caused by antipsychotic medication. As antipsychotic drugs differ in their affinity to dopamine receptors and some antipsychotics have partial agonistic effects, antipsychotic drugs are expected to vary in their ability to cause negative symptoms.

The association between negative symptoms and antipsychotic medication divided into partial agonists, or antagonists with high or low D₂ affinity was assessed in 310 remitted first episode psychosis (FEP) patients. Severity of negative symptoms was assessed with the Comprehensive Assessment of Symptoms and History, and the Positive and Negative Syndrome Scale. Linear regression analyses were performed while controlling for differences in clinical and sociodemographic characteristics between the groups using inverse probability of treatment weighting.

Patients using partial agonists (n = 78) showed fewer negative symptoms compared to those using high affinity antagonists (n = 84). Patients using partial agonists displayed less severe negative symptoms compared to those using low affinity antagonists (n = 148) at a trend level (p = 0.051). Negative symptom severity was higher in patients who had higher antipsychotic doses.

In remitted FEP patients, we observed that the use of antipsychotic medication classified as partial agonists was associated with lower severity of negative symptoms, while the use of antagonists with high D₂ affinity was associated with more severe negative symptoms.

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来源期刊

Schizophrenia Research 医学-精神病学

CiteScore

7.50

自引率

8.90%

发文量

429

审稿时长

10.2 weeks

期刊介绍： As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership! Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue. The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.