TY - JOUR
T1 - Relationship of the factor structure of psychopathology in schizophrenia to the timing of initial intervention with antipsychotics
AU - Meagher, David
AU - Quinn, John
AU - Murphy, Patrice
AU - Kinsella, Anthony
AU - Mullaney, James
AU - Waddington, John L.
PY - 2001/5/30
Y1 - 2001/5/30
N2 - Timing of intervention with antipsychotic medication may influence long-term outcome in schizophrenia in a manner that is poorly understood. This study evaluated psychopathology, its factor structure, and cognitive dysfunction in older patients with chronic schizophrenia in relation to the intervals from onset of psychosis to initiation of treatment with antipsychotics, and from initiation of antipsychotic treatment to current assessments. The subjects were 129 patients with schizophrenia, many of whom became ill in the preneuroleptic era. Their current psychopathology was assessed using the Positive and Negative Syndrome Scale, and its factor structure examined using principal component analysis. Current general and executive cognitive function was evaluated using the Mini-Mental State Examination and the Executive Interview, respectively. Using multiple regression modelling, increasing duration of initially unmedicated psychosis, but not the much longer duration of subsequently treated illness, was the primary predictor of psychomotor poverty (negative symptoms) but not of reality distortion or disorganisation over the three domains of psychopathology resolved; duration of initially unmedicated psychosis marginally predicted the severity of general, but not of executive, cognitive dysfunction. Delayed intervention with antipsychotics appears associated with poorer long-term course in terms of increased severity of psychopathology in the psychomotor poverty domain.
AB - Timing of intervention with antipsychotic medication may influence long-term outcome in schizophrenia in a manner that is poorly understood. This study evaluated psychopathology, its factor structure, and cognitive dysfunction in older patients with chronic schizophrenia in relation to the intervals from onset of psychosis to initiation of treatment with antipsychotics, and from initiation of antipsychotic treatment to current assessments. The subjects were 129 patients with schizophrenia, many of whom became ill in the preneuroleptic era. Their current psychopathology was assessed using the Positive and Negative Syndrome Scale, and its factor structure examined using principal component analysis. Current general and executive cognitive function was evaluated using the Mini-Mental State Examination and the Executive Interview, respectively. Using multiple regression modelling, increasing duration of initially unmedicated psychosis, but not the much longer duration of subsequently treated illness, was the primary predictor of psychomotor poverty (negative symptoms) but not of reality distortion or disorganisation over the three domains of psychopathology resolved; duration of initially unmedicated psychosis marginally predicted the severity of general, but not of executive, cognitive dysfunction. Delayed intervention with antipsychotics appears associated with poorer long-term course in terms of increased severity of psychopathology in the psychomotor poverty domain.
KW - Factor structure
KW - Initially unmedicated psychosis
KW - Psychomotor poverty
KW - Psychopathology
KW - Schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=0035972732&partnerID=8YFLogxK
U2 - 10.1016/S0920-9964(00)00050-5
DO - 10.1016/S0920-9964(00)00050-5
M3 - Article
C2 - 11378318
AN - SCOPUS:0035972732
SN - 0920-9964
VL - 50
SP - 95
EP - 103
JO - Schizophrenia Research
JF - Schizophrenia Research
IS - 1-2
ER -