METHODS: We measured prolactin levels in 221 non-affective FEP patients treated with antipsychotics (AP) and 224 healthy controls, at baseline and 2-year follow-up. We examined whether the relationships between clinical and functional variables were mediated by prolactin, controlling for antipsychotic use, according to sex.
RESULTS: Prolactin levels were higher in patients when compared to controls at both time points. Baseline factors associated with prolactin were chlorpromazine equivalents, attention, and executive functioning. In the FEP group, prolactin levels were associated with functioning and diminished expression in males, and with working memory in females. Prolactin levels (p=0.0134) played a role as a mediator between negative symptomatology (p=0.086) and functional outcome (p=0.008) only in FEP male patients at baseline.
CONCLUSIONS: Prolactin plays a role in the functionality and clinical symptomatology of FEP patients. Our results suggest that pharmacological counselling in patients with hyperprolactinemia at baseline and negative symptomatology might improve their functional and clinical outcomes.
方法:我们测量了221例用抗精神病药(AP)治疗的非情感性FEP患者和224例健康对照者的催乳素水平,在基线和2年随访。我们检查了临床变量和功能变量之间的关系是否由催乳素介导,控制抗精神病药的使用,根据性别。
结果:在两个时间点,患者的催乳素水平均高于对照组。与催乳素相关的基线因素是氯丙嗪当量,注意,和执行功能。在FEP组中,催乳素水平与男性的功能和表达减少有关,和女性的工作记忆。催乳素水平(p=0.0134)仅在基线时的FEP男性患者中在阴性症状学(p=0.086)和功能结果(p=0.008)之间起中介作用。
结论:催乳素在FEP患者的功能和临床症状中起作用。我们的结果表明,在基线和阴性症状下,高泌乳素血症患者的药物咨询可能会改善其功能和临床结局。