RESUMEN
This paper examines the clinical and demographic data of patients in the Clozapine Distribution System in Metropolitan Toronto in the first year after its inception. One hundred and thirty-seven patients were approved for funding during the year. They tended to be young, chronically and markedly ill patients suffering from schizophrenia, primarily with treatment resistance as the reason for clozapine therapy. Only 55 patients completed at least six months of therapy; 15 patients discontinued clozapine before six months of treatment, mainly because of side-effects and/or patients' noncompliance with bloodwork. Three patients discontinued clozapine because of haematological compromise. Clozapine was efficacious for the majority of patients who took it for at least six months, with improvement in all six clinical dimensions examined in the study. Nevertheless, the number of early discontinuation patients significantly lowered the overall effectiveness of clozapine in actual clinical practice.
Asunto(s)
Clozapina/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Psicología del Esquizofrénico , Población Urbana , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Clozapina/efectos adversos , Monitoreo de Drogas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ontario , Cooperación del Paciente/psicología , Escalas de Valoración Psiquiátrica , Resultado del TratamientoRESUMEN
Positive and negative symptoms are measurable characteristics that may represent core features of schizophrenia and offer a quantitative approach for studying the genetics of schizophrenia and related disorders. The Positive and Negative Syndrome Scale (PANSS) was used to assess 72 members of five families segregating schizophrenia. The study confirmed high internal reliability of PANSS scales in this sample with diverse lifetime diagnoses. Gender but not alcoholism affected scores. Schizophrenia/schizoaffective and schizophrenia spectrum disorder groups had higher mean scores for the positive and negative scales than other lifetime diagnostic groups, consistent with genetic transmission of these symptoms. Positive and negative symptom patterns did not subtype families. The results support the validity of positive and negative symptom measures as independent dimensions in familial schizophrenia.