Objective:revealing the role of morphophenotypic indices in the development of visceral obesity in patients with schizophrenia receiving quetiapine and risperidone therapy.Materials and methods.56 indoor patients with schizophrenia who received quetiapine (n= 23) or risperidone (n= 33) at medium doses were examined. Included persons were from 18 to 65 years old with at least a 1 year history of disease, the condition of which met the criteria of schizophrenia according to ICD-10. The Basis map of sociodemographic and clinical-dynamic signs for patients with schizophrenia was filled in, PANSS in the adapted Russian version – SCI-PANSS, noninvasive bioimpedancemetry, measurement of growth, transversethoracic, biacromial and bicrystal diameter, with calculation of body mass indexes, Tanner and Rees – Eysenk and definition of integral morphophenotypic indicators were carried out. Statistical processing was performed using Student’s t-test with a preliminary estimate of Pearson’s χ2 normal distribution, the Mann – Whitney U test to compare independent samples, the Spearman correlation analysis, the two-sided Fisher test.Results.There were no significant differences in both subgroups in terms of bioimpedancemetry. The correlation between the level of visceral fat and the Rees – Eysenk index in patients receiving risperidone was a moderate inverse: the greater the value of the Rees – Eysenk index, the lower the level of visceral fat (r= –0.73381,t= –4.70833,p= 0.00015). The correlation between the Tanner index and the level of visceral fat in the quetiapine subgroup was strong: the larger the Tanner index, the higher the visceral fat level (r= 0.7763,t= 4.08481,p= 0.00181); in the risperidone subgroup, there was an average direct correlation (r= 0.48133,t= 2.39356,p= 0.02716).Conclusion.The magnitude of the Rees – Eysenk index of schizophrenic patients can be considered among other factors in the management of risperidone in individuals with asthenic physique. The determination of the Tanner index at the beginning of treatment can play the role of a prognostic factor in the development of visceral obesity in patients with schizophrenia in the planned use as a basic therapy for quetiapine.
Акатизиянейропсихиатрический синдром, развивающийся в результате применения антипсихотической терапии и негативно влияющий на течение шизофрении и клинико-социальные показатели. Цель: выявление частоты встречаемости акатизии у пациентов с шизофренией, принимающих антипсихотическую терапию, с оценкой клинической динамики и клинико-социальных факторов. Обследовано 198 больных шизофренией в возрасте от 18 до 65 лет, проходивших лечение в психиатрических стационарах Томска и Кемерова, с применением Шкалы позитивного и негативного синдромов (Positive and Negative Syndrome Scale-PANSS), Шкалы акатизии Барнса (Barnes Akathisia Rating Scale-BARS, BAS), Шкалы социальной адаптации (The Social Adaptation Self-Evaluation Scale-SSAS), а также с использованием базисной карты формализованных социодемографических и клинико-динамических признаков, разработанной в НИИ психического здоровья (Томск). Достоверность статистических различий оценивалась с помощью двустороннего критерия Фишера, U-критерия Манна-Уитни и χ 2. Частота встречаемости акатизии у больных шизофренией составила 36%. Было установлено статистически значимое влияние таких факторов, как длительность заболевания, наличие негативной симптоматики и табакокурение. Полученные данные необходимы для выбора персонализированных подходов к антипсихотической терапии для снижения риска развития акатизии у больных шизофренией.
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