Document Detail


Pituitary volume and early treatment response in drug-naïve first-episode psychosis patients.
MedLine Citation:
PMID:  19515535     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: An early response to antipsychotic treatment in patients with psychosis has been associated with a better course and outcome. However, factors that predict treatment response are not well understood. The onset of schizophrenia and related disorders has been associated with increased levels of stress and hyper-activation of the hypothalamic-pituitary-adrenal (HPA) axis. This study examined whether pituitary volume at the onset of psychosis may be a potential predictor of early treatment response in first-episode psychosis (FEP) patients.
METHODS: We investigated the relationship between baseline pituitary volume and symptomatic treatment response over 12 weeks using mixed model analysis in a sample of 42 drug-naïve or early treated FEP patients who participated in a controlled dose-finding study of quetiapine fumarate. Logistic regression was used to examine predictors of treatment response. Pituitary volume was measured from magnetic resonance imaging scans that were obtained upon entry into the trial.
RESULTS: Larger pituitary volume was associated with less improvement in overall psychotic symptoms (Brief Psychiatric Rating Scale (BPRS) P=0.031) and positive symptoms (BPRS positive symptom subscale P=0.010). Regardless of gender, patients with a pituitary volume at the 25th percentile (413 mm(3)) were approximately three times more likely to respond to treatment by week 12 than those at the 75th percentile (635 mm(3)) (odds ratio=3.07, CI: 0.90-10.48).
CONCLUSION: The association of baseline pituitary volumes with early treatment response highlights the importance of the HPA axis in emerging psychosis. Potential implications for treatment strategies in early psychosis are discussed.
Authors:
B Garner; G E Berger; J P Nicolo; A Mackinnon; S J Wood; C M Pariante; P Dazzan; T M Proffitt; C Markulev; M Kerr; M McConchie; L J Phillips; C Pantelis; P D McGorry
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-06-09
Journal Detail:
Title:  Schizophrenia research     Volume:  113     ISSN:  1573-2509     ISO Abbreviation:  Schizophr. Res.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-14     Completed Date:  2009-10-12     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  8804207     Medline TA:  Schizophr Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  65-71     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antipsychotic Agents / therapeutic use*
Dibenzothiazepines / therapeutic use*
Dose-Response Relationship, Drug
Female
Humans
Imaging, Three-Dimensional / methods
Logistic Models
Magnetic Resonance Imaging / methods
Male
Models, Statistical
Pituitary Gland / drug effects*,  pathology*
Psychiatric Status Rating Scales
Psychotic Disorders / drug therapy*,  pathology*
Severity of Illness Index
Time Factors
Young Adult
Grant Support
ID/Acronym/Agency:
G108/603//Medical Research Council
Chemical
Reg. No./Substance:
0/Antipsychotic Agents; 0/Dibenzothiazepines; BGL0JSY5SI/quetiapine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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