[Clinical and psychopathological characteristics of patients with late-onset schizophrenia and schizophrenia-like psychoses in clusters identified by biological parameters].

Autor:	Prokhorova TA; Mental Health Research Center, Moscow, Russia., Androsova LV; Mental Health Research Center, Moscow, Russia., Tereshkina EB; Mental Health Research Center, Moscow, Russia., Boksha IS; Mental Health Research Center, Moscow, Russia., Savushkina OK; Mental Health Research Center, Moscow, Russia., Pochueva VV; Mental Health Research Center, Moscow, Russia., Sheshenin VS; Mental Health Research Center, Moscow, Russia., Burbaeva GS; Mental Health Research Center, Moscow, Russia., Klyushnik TP; Mental Health Research Center, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova [Zh Nevrol Psikhiatr Im S S Korsakova] 2024; Vol. 124 (4), pp. 137-144.
DOI:	10.17116/jnevro2024124041137
Abstrakt:	Objective: To assess clinical and psychopathological characteristics of late-aged female patients with late-onset psychoses in clusters formed on the basis of biochemical and immunological blood parameters. Material and Methods: We examined 59 women with schizophrenia and schizophrenia-like psychoses with onset after 40 years (ICD-10 F20, F22.8, F25, F23, F06.2), including 34 women with late-onset (40-60 years) and 25 with very late onset psychoses (after 60 years). At the time of hospitalization, a clinical/ psychopathological study was carried out using CGI-S, PANSS, CDSS, and HAMD-17, as well as the activities of glutathione reductase (GR) and glutathione-S-transferase (GT) have been determined in erythrocyte hemolysates, and the activities of leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI) have been assessed in blood plasma. Biochemical and immunological parameters have been also determined in 34 age-matched mentally healthy women. Results: Clustering by signs such as GR, GT, LE and α1-PI has yielded two clusters of objects (patients) significantly different in GT ( p <0.0001), LE ( p <0.0001), and α1-PI ( p <0.001) activities. Relatively to the controls, in the cluster 1 patients, the activities of GST and α1-PI are increased, the activity of LE is decreased, whereas, in the cluster 2 patients, the activity of GR is decreased, and the activities of LE and α1-PI are increased. Cluster 1 patients differ from cluster 2 patients in greater severity of the condition (CGI-S, p =0.04) and higher total scores on PANSS subscales' items. Cluster 1 includes 76% of patients with very late onset. Different correlations between clinical and biological signs are found in two clusters. Conclusion: The identified clusters have different clinical and psychopathological characteristics. Dividing patients into subgroups according to biochemical and immunological parameters is promising for the search for differentiated therapeutic approaches.
Databáze:	MEDLINE
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