The Effects of Risperidone on the Five Dimensions of Schizophrenia Derived by Factor Analysis

利培酮 氟哌啶醇 心理学 敌意 锥体外系症状 阳性与阴性症状量表 精神分裂症(面向对象编程) 安慰剂 抗精神病药 焦虑 内科学 精神科 多巴胺拮抗剂 精神病 医学 临床心理学 多巴胺 替代医学 病理
作者
Stephen R. Marder,John M. Davis,Guy Chouinard
出处
期刊:The Journal of Clinical Psychiatry [Physicians Postgraduate Press, Inc.]
卷期号:58 (12): 538-546 被引量:656
标识
DOI:10.4088/jcp.v58n1205
摘要

In two double-blind trials conducted in North America, 513 patients with chronic schizophrenia received risperidone, haloperidol, or placebo. In the present study, combined data from the two trials were analyzed.Patients were randomly assigned to receive placebo, fixed doses of risperidone (2, 6, 10, and 16 mg/day) or 20 mg/day of haloperidol for 8 weeks. Factor analysis of scores on the Positive and Negative Syndrome Scale (PANSS) produced five dimensions (negative symptoms, positive symptoms, disorganized thought, uncontrolled hostility/excitement, and anxiety/depression), similar to the five dimensions of previous factor-analytic studies of PANSS data.Mean changes (symptom reductions) in PANSS factor scores from baseline to treatment Weeks 6 and 8 were significantly greater in patients receiving 6-16 mg/day of risperidone than in patients receiving placebo or haloperidol. The advantages of risperidone were greatest for negative symptoms, uncontrolled hostility/excitement, and anxiety/depression. Even at the lowest dose, 2 mg/day, risperidone was significantly (p < or = .05) superior to haloperidol in reducing negative symptoms. The differences in outcomes between risperidone and haloperidol on PANSS scores were not related to extrapyramidal symptoms.Risperidone produced significantly (p < or = .05) greater improvements than haloperidol on all five dimensions. The large between-group differences on negative symptoms, hostility/excitement, and anxiety/depression suggest that risperidone and other serotonin/dopamine antagonists have qualitatively different effects from those of conventional antipsychotic agents.
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