Clinical and serotonergic predictors of non-affective acute remitting psychosis in patients with a first-episode psychosis

• Published in: Acta Psychiatrica Scandinavica Vol. 119; no. 1; pp. 71 - 77
• Main Authors: Arranz, B., San, L., Ramírez, N., Dueñas, R. M., Perez, V., Salavert, J., Corripio, I., Alvarez, E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-01-2009; Blackwell
• Subjects: 5-HT2A receptors; Acute Disease; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Biomarkers - blood; Blood Platelets - metabolism; Diagnosis, Differential; Female; first-episode psychosis; Humans; Male; Medical diagnosis; Medical sciences; Neurosciences; Neurotransmitters; non-affective acute remitting psychosis; Other psychotic disorders; Predictions; Predictive Value of Tests; Psychiatric Status Rating Scales; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Psychosis; Psychotic Disorders - blood; Psychotic Disorders - classification; Psychotic Disorders - diagnosis; Receptor, Serotonin, 5-HT2A - blood; Remission, Spontaneous; schizophrenia; Schizophrenia, Paranoid - blood; Schizophrenia, Paranoid - classification; Schizophrenia, Paranoid - diagnosis; serotonin; Serotonin - blood; Spain; Young Adult; Spain; Human; 5-HT2A serotonin receptor; 5-HT2A receptors; Serotonin; Acute; Paranoid schizophrenia; first-episode psychosis; Schizophrenia; Nosology; non-affective acute remitting psychosis; Psychosis; First episode; Criterion; Classification; Neurotransmitter; Duration of untreated psychosis; Diagnosis; Predictive factor; Subtype
• ISSN: 0001-690X; 1600-0447; 0065-1591
• DOI: 10.1111/j.1600-0447.2008.01253.x

Objective:  The study aimed to establish clinical predictors of non‐affective acute remitting psychosis (NARP) and assess whether these patients showed a distinct serotonergic profile.
Method:  First‐episode never treated psychotic patients diagnosed of paranoid schizophrenia (n = 35; 21 men and 14 women) or NARP (n = 28; 15 men and 13 women) were included.
Results:  NARP patients showed significantly lower negative symptomatology, better premorbid adjustment, shorter duration of untreated psychosis, more depressive symptomatology and a lower number of 5‐HT2A receptors than the paranoid schizophrenia patients. In the logistic regression, the four variables associated with the presence of NARP were: low number of 5‐HT2A receptors; good premorbid adjustment; low score in the item ‘hallucinatory behaviour’ and reduced duration of untreated psychosis.
Conclusion:  Our findings support the view that NARP is a highly distinctive condition different from either affective psychosis or other non‐affective psychosis such as schizophrenia, and highlight the need for its validation.