Miroslav Lorenc

The changes of biological markers and treatment efficacy in schizophrenia

1. In a group of schizophrenic patients, the effect and selected parameters of biological markers were evaluated during the index hospitalisation in the acute phase of schizophrenia (n = 30) and then after one year of ambulatory treatment. 2. During the acute treatment, a significant drop in symptomatology was recorded in average; an analogical tendency was observed further on, too. Apart from that, a significant change was observed in 5/41 parameters being monitored (the pair t-test): I) decrease in the total NES score, II) decrease in the sensorial integration subscale NES score, III) increase in psychomotor speed, IV) decrease in auditory reaction time, V) increase in basal cortisol. 3. In the comparison of the successfully (severity of illness after one year = 1, 2) and unsuccessfully (severity of illness after one year > or =3) treated patients in the beginning of treatment in the acute phase, the unsuccessful group had a significantly higher score of negative symptomatology, and by the end of the acute treatment, again, a significantly higher score of negative symptomatology, a higher total PANSS score and a greater severity of illness. 4. In the acute phase, the successful group had a significantly better score in individual items of the Contemporary Memory Scale and a significantly worse performance and goal-aimed concentration in the Bourdon test than the unsuccessfully treated one; apart from that, it had a significantly higher cortisol level after dexamethasone, which was also reflected in the lower percentage rate of dexamethasone nonsupression. 5. In the course of the year, a drop in the total NES score for the individual subscales occurred; a significant drop was observed in the sensory integration subscale. The worse concentration items improved significantly in the successful group in contrast to the unsuccessful group, where they showed a downgrade tendency. Changes in Contemporary Memory Scale were negligible and mostly below statistical significance. Apart from that, a drop in basal cortisolemia occurred in the successful group and an increase in cortisolemia after administering dexamethasone was registered in the unsuccessful group. 6. The more successful group had a significantly lower NES score, a significantly better visual reaction time and a smaller forgetting item (in percentiles) after the one-year period.