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Clinical aspects of super-refractory schizophrenia: a 6-month cohort observational study
Jorge Henna Neto1, Hélio Elkis
1Institute of Psychiatry, Hospital das Clínicas, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil. henna@usp.br
Objective:
Approximately 30% of treatment-resistant schizophrenic patients do not fully respond to Clozapine and such patients are termed Clozapine non-responders or super-refractory schizophrenics. The aim of this study was to characterize patients with super-refractory schizophrenia according to demographic and psychopathological variables, as compared with patients with refractory schizophrenia or non-refractory subjects.
Method:
One hundred two outpatients meeting DSM-IV criteria for schizophrenia were followed-up for 6 months. Subjects were classified into 3 groups: non-refractory (n=25), refractory (n=43) and super-refractory (n=34). Psychopathology was assessed by the Positive and Negative Syndrome Scale, the Schedule for Deficit Syndrome, the Calgary Depression Scale and the Quality of Life Scale. Patients were rated at 2-month intervals.
Results:
Higher levels of severity at the disease onset as well as higher severity of positive symptoms were found to be predictive of super-refractoriness.
Conclusions:
The super-refractory schizophrenia patients have psychopathological predictive factors that need studies comparing brain images, genetical features and other clinical comparisons.
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