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OBJECTIVE@#To compare the effect of 7 antipsychotic drugs on the life quality of schizophrenia patients including chlorpromazine, sulpiride, clozapine, risperidone, olanzapine, quetiapine, and aripiprazole.@*METHODS@#A total of 1,227 stable schizophrenic patients within 5 years onset who took 1 of the 7 study medications as maintenance treatment were followed up for 1 year at 10 China sites. Patients were evaluated by the short form-36 health survey (SF-36) at the baseline and at the end of 1 year.@*RESULTS@#The life quality was improved obviously at the end of the follow-up. There was significant difference in body pain, vitality, and mental health (P<0.05) among these antipsychotic drugs.@*CONCLUSION@#All 7 antipsychotic drugs can improve the life quality of schizophrenia patients. Atypical antipsychotic drugs, especially olazapine and quetiapine, are superior to typical antipsychotic drugs in improving life quality.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Antipsychotic Agents , Therapeutic Uses , Benzodiazepines , Therapeutic Uses , Dibenzothiazepines , Therapeutic Uses , Follow-Up Studies , Olanzapine , Quality of Life , Quetiapine Fumarate , Schizophrenia , Drug Therapy , Surveys and QuestionnairesABSTRACT
BACKGROUND: Interleukin-6 (IL-6) is a cytokine produced in the process of organic immune activities. The problems still need further exploration, including whether the changes of serum level of IL-6 after clozapine treatment ware induced directly by the drug, and whether IL-6 is directly correlated with the changes of the psychiatric symptoms in female patients.with first-episode schizophrenia.OBJECTIVE: To explore the changes of the serum level of IL-6 and its relation with the dose of clozapine and the amelioration of the symptoms in female patients with first-episode schizophrenia.DESIGN: A non-randomized case-control observation synchronically.SETTING: Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical College.PARTICIPANTS: Twenty female patients with first-episode schizophrenia (patient group) were selected from Henan Psychiatric Hospital. They all met the diagnostic standards of schizophrenia in the 3rd edition of Chinese Classification and diagnostic criteria of Mental Disorders (CCMD-3), their score of positive and negative syndrome scale (PANSS)was above 60 points, and had not been treated or at least not taking medicine for 2 weeks during clinical treatment.Patients with physical disease, endocrine and immune system diseases, malnutrition and other mental problems, those with the history of being allergic and hormone treatment, those receiving immune pharmaceutical treatment, and recently having been vaccinated preventively, and the pregnant and breast-feeding women were excluded. Twenty healthy female volunteers, who had no significnat difference in age and gender from the subjects in the patient group,were taken as the control group, and the exclusive standards were the same as those in the patient group. All the subjects were enrolled with the approval of themselves and their guardians.METHODS: All the patients were adminsitrated with clozapine only, with the dose being added by 25-50 mg per day,and the maximal dose was reached within 3 weeks. The principle for the administration was the maximal effectiveness and the minimal side effect. ① Serum level of IL-6 in the patient group was detected using enzyme-linked immunoabsorbent assay (ELISA) before treatment and at 1, 2 and 4 weeks after treatment respectively. ② High performance liquid chromatography (HPLC) was used to determine the content of clozapine, and the levels of IL-6 in serum of the controls were taken as controls. ③ Correlations were analyzed in the patient group between the serum level of IL-6 before treatment and at 1, 2 and 4 weeks after treatment and the PANSS scores (scores of positive and negative symptoms, and general pathology, and the total score) at corresponding time points.MATN OUTCOME MEASURES: ① Serum levels of IL-6 before treatment and at each time point after treatment; ②Correlation analysis between the serum levels of IL-6 and clozapine content; ③ Correlation analysis between changes of schizophrenic symptoms and serum levels of IL-6.RESULTS: ① Serum level of IL-6 before treatment in the patient group was significantly higher than that in the control group [(137.72±18.84), (65.05±20.95) ng/L, t =11.53, P ＜ 0.01], those in the patient group at 1, 2 and 4 weeks after treatment were significantly lower than that in the control group [(28.11±5.42), (8.48±1.14), (13.90±2.55), (65.05±20.95) ng/L, t =7.63, 12.01, 10.84, P ＜ 0.01]. ② Correlation analysis between the serum levels of IL-6 and clozapine content: The results showed that the serum level of IL-6 had no significant correlation with the clozapine content at 1, 2and 4 weeks after treatment (r =-0.15, 0.12, -0.29, P ＞ 0.05). ③ Correlation analysis between IL-6 level and schizophrenic symptoms: In the patient group, there was significant positive correlation before treatment between the serum level of IL-6 and the score of positive symptoms (r=0.386, P＜ 0.01), and there was no significant correlation between the serum level of IL-6 and the total scores of PANSS and each factor scores at 1, 2 and 4 weeks after treatment (r=0.136-0.237, P ＞ 0.05).CONCLUSION: The serum level of IL-6 in female patients with first-episode schizophrenia was higher than that in healthy females, and it could be decreased by clozapine, and the amelioration of the schizophrenic symptoms had no significant correlation with the changes of IL-6 levels.
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BACKGROUND:Delayed therapy widely occurs in patients with dementia praecox;therefore,it brings a series of difficulties for clinical treatment and rehabilitation.OBJECTIVE:To analyze the influential factors of delayed therapy in patients with dementia praecox.DESIGN:Cross-sectional study based on patients with dementia praecox.SETTING:The Second Affiliated Hospital of Xinxiang Medical College.PARTICIPANTS:A total of 96 patients with dementia praecox,including 52 males and 44 females,were selected from the Second Affiliated Hospital of Xinxiang Medical College from January to June 2005.Their ages ranged from 16 to 55 years and the mean age was (32.7±12.3) years.Among them,54 patients had middle-school education and 42 patients had high-school education.METHODS:A domestic inventory was used to carefully record basically clinical data of each patient.and the inventory included sex,marriage status,educational level,attack styles,home address,home environment,economic status,family history,etc.All data were classified and analyzed in details.In addition,condition of delayed therapy,which determined as the duration over 1 year from onset of psychiatric symptoms to accepted treatment,in each classification was surveyed gradually.MAIN OUTCOME MEASURES:Delayed therapeutic rate and occurent rate of related factors.RESULTS:Among 96 patients,60 patients had delayed therapy,and the delayed therapeutic rate was 62.5%.Influential factors of delayed therapy:Logistic regression analysis demonstrated that regression equation was involved in educational level,family history,attack style and economic status.Meanwhile,the standard regression coefficient was 0.332 1,0.210 1,0.190 3 and 0.101 2. CONCLUSION:Educationallevel,family history,attack style and economic status of patients with dementia praecox are risk factors of delayed therapy. It is of importance for strengthening these factors to interfere and reduce delayed therapeutic rate at an early phase.
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Background 5-hydroxytryptamine 2A receptor (5-HT2A) gene has been regarded as a candidate gene for susceptibility to schizophrenia. In particular, the 5-HT2A receptor has received much attention because it demonstrates to be an important site of action of atypical antipsychotic agents to alleviate negative symptoms. The current study investigated whether the 5-hydroxytryptamine 2A receptor (5-HT2A) gene T102C polymorphism was associated with treatment response to risperidone in the first episode Chinese patients with schizophrenia.Methods 201 first episode Chinese Han patients with schizophrenia were given risperidone for up to 56 days.Genotyping of 5-HT2A gene T102C polymorphism were performed by using PCR-RFLP. The Positive and Negative Symptom Scale (PANSS) was used for the evaluation of the severity of psychotic symptoms before and after 8 weeks treatment with risperidone.Results 5-HT2A receptor 102 -T/T genotype was significantly associated with both the PANSS total and negative syndrome subscale scores before treatment, and with the reduction rates in both the PANSS total and negative syndrome subscale scores after eight weeks risperidone treatment.Conclusions The results suggest that 5-HT2A T102C A/A1 genotype subgroup influences individual response to risperidone in first-episode Chinese patients with schizophrenia.
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BACKGROUND:Schizophrenia is a kind of psychosis which pathogenesis is unknown yet, and its pathogenesis is a key study theme all over the world. Recently it is concerned in genetic study, particularly in the molecular genetics. Among them, it shows a good prospect in researching the candidate functional gene. OBJECTIVE:To analyze the association between the T102C polymorphism of serotonin 2A (5-HT2A) receptor and schizophrenia. DESIGN: A diagnosis-based ease observation and association analysis. SETTING: Second Affiliated Hospital, Xinxiang Medical College and the 13 Branch of General Hospital of Zhongyuan Oil Field. PARTICIPANTS: In the patient group, there were 56 cases of schizophrenie probands, who were hospitalized in the Second Affiliated Hospital of Xinxiang Medical College from August 2003 to April 2004, and their healthy parents (n=112) were also enrolled as the parents group. METHODS:The nuclear family consisted of 56 probands, who met the diagnostic criteria of the third edition of Chinese Classification and diagnostic criteria of Mental Disorders (CCMD-3), and their parents were detected with polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP), the genotype and the T102C polymorphism of schizophrenic 5-HT2A receptor were detected with transmission disequilibrium test (TDT). MAIN OUTCOME MEASURES:The results of allele and genotypic frequency, and the goodness-of-fit for Hardy-Weinberg equilibrium of 5- HT2A receptor, as well as the TDT analytical results of 5-HT2A receptor gene, were observed. RESULTS:All the 56 patients and the 112 parents were involved in the analysis of results. ①No significant differences were found between the patient group and parents group in the genotypic frequencies (χ2 =4.423, P=0.110) and allele distribution (χ2=1.147, P=0.563), and there was a good goodness-of-fit for Hardy-Weinberg equilibrium. ② In the 56 families, the transmission disequilibrium of 39 nuclear families with paternal or maternal genotype of heterozygote detected by TDT showed no association between schizophrenia and 5-TH2A receptor gene (χ2=2.703, P=-0.10).CONCLUSION: There is no association between the 5-TH2A receptor gene T102C and schizophrenia in Chinese Han population.
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<p><b>OBJECTIVE</b>To explore the changes of soluble interleukin-2 receptor(sIL-2R) in serum and cerebrospinal fluid (CSF) of patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).</p><p><b>METHODS</b>There were 31 patients with DEACMP, 32 patients with other encephalopathy and 31 controls in this study. The levels of sIL-2R in serum and CSF were detected by ELISA.</p><p><b>RESULTS</b>Serum sIL-2R in patients with DEACMP[(329.21 +/- 160.99)U/ml] was significantly higher than that in control[(115.67 +/- 89.58) U/ml, P < 0.05)], but not significantly different from that in the other encephalopathy group[(367.50 +/- 123.14) U/ml, P > 0.05)]. CSF sIL-2R in patients with DEACMP[(54.48 +/- 43.04) U/ml] measured a little before discharge was significantly lower than that in patients with the other encephalopathy[(110.24 +/- 76.56) U/ml, P < 0.05)], but not significantly different from that in the control group[(34.96 +/- 22.70)U/ml, P > 0.05)]. At the pre-discharged period, CSF sIL-2R in patients with DEACMP[(100.26 +/- 93.65) U/ml] was significantly higher than that at the early stage of hospitalization[(52.28 +/- 43.31) U/ml, P < 0.05)]. No significant difference in serum sIL-2R was found between early stage of hospitalization[(338.34 +/- 161.53) U/ml] and pre-discharge [(351.31 +/- 175.93) U/ml, P > 0.05)].</p><p><b>CONCLUSION</b>The occurrence of DEACMP may be related with immunopathological damage. The sIL-2R levels in serum and CSF may give information about the state of immunological function of the patients with DEACMP and may contribute to determining the patient's condition and prognosis.</p>