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Psychopathology and Treatment Response

Amy R. Koreen, MD; Jeffrey Lieberman, MD; Jose Alvir, DrPH; David Mayerhoff, MD; Antony Loebel, MD; Miranda Chakos, MD; Farooq Amin, MD; Thomas Cooper, MA

Arch Gen Psychiatry. 1994;51(2):132-138.

Abstract
Objectives
To examine plasma homovanillic acid (pHVA) levels in first-episode schizophrenia, to compare pHVA levels in patients and controls, and to assess the association of pHVA levels with psychopathology and treatment response.

Methods
Forty-one patients entered the study, and pHVA levels were measured at baseline and on a weekly basis for up to 6 weeks of open standardized neuroleptic treatment. Psychopathology was evaluated with the Schedule for Affective Disorders and Schizophrenia, the Scale for Assessment of Negative Symptoms, and the Clinical Global Impressions scale. Ten healthy controls were used for comparison of baseline pHVA levels.

Results
No differences were observed between patients and controls. Baseline pHVA level was not associated with psychopathology but was associated with time to reach remission. Baseline pHVA levels and week-1 pHVA levels were higher in responders than nonresponders. Regardless of responsiveness, female participants had higher pHVA levels than male participants throughout the study. The pattern of pHVA levels with treatment was similar in all patients with a short-term rise initially and then a decrease toward baseline values.

Conclusions
These findings suggest that pHVA levels have prognostic significance for response and time to reach remission. Qualitative and quantitative differences between first-episode patients' pHVA levels and studies using a long-term, neuroleptic-exposed population suggest that changes occur with neuroleptic treatment or the progression of the illness.

Author Affiliations
From Departments of Psychiatry, Hillside Hospital Division of Long Island Jewish Medical Center, Glen Oaks, NY (Drs Koreen, Lieberman, Alvir, Mayerhoff, Loebel, and Chakos), and Bronx (NY) Veterans Administration (Dr Amin); and the Analytical Psychopharmacology Division, Nathan Kline Research Center (Mr Cooper), and the New York Psychiatric Institute (Mr Cooper), New York, NY.

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