[A clinical study of emergent anxiety in neuroleptic-naïve, first-episode schizophrenia patients following treatment with risperidone].

Risperidone (RIS) alone was administered to patients with neuroleptic-naïve, first-episode schizophrenia who visited the outpatient clinic of the Department of Psychiatry, Jikei University School of Medicine Hospital between April 1998 and December 2001, and the effectiveness of the drug in alleviating anxiety symptoms was prospectively examined. The study population comprised 42 patients (24 males and 18 females). Their mean age at first visit was 26.0 +/- 6.5 years, DUP (Duration of Untreated Psychosis) was 41.1 +/- 60.0 weeks, and the mean total BPRS (Brief Psychiatric Rating Scale) score at first visit was 60.5 +/- 8.5 points. The rating "effective" (a total BPRS score improvement at week 8 of 50% or more) was given to 32 out of the 42 patients (76.2%). Among these 32 patients, a 25% improvement in the PANSS (Positive and Negative Syndrome Scale) positive scale was achieved at 1. 53 +/- 0.72 weeks and a 50% improvement at 2.93 +/- 2.10 weeks, suggesting early onset of the effects of RIS. The present study focused on the anxiety complained of by some of the patients in whom treatment was rated as effective (increase of 2 points in anxiety BPRS score), dividing these patients into an anxiety group and a non-anxiety group. The anxiety group comprised 17 patients (53.1%). The anxiety observed during the course of treatment with RIS tended to develop early after the disappearance of positive symptoms. A comparison of demographic factors and GAF between the two groups revealed a significant difference in mean age at first visit, DUP and GAF score, the anxiety group tending to be younger, to have shorter DUP and to have social dysfunction compared to the non-anxiety group. Although it cannot be concluded that these anxiety symptoms are characteristic of risperidone, the effect of chemotherapy with other atypical antipsychotic drugs remains as an interesting theme for future investigation.