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The British Journal of Psychiatry (2005) 186: 26-31
© 2005 The Royal College of Psychiatrists

Duration of illness and treatment effects on hippocampal volume in male patients with schizophrenia

Miranda H. Chakos, MD

Department of Psychiatry, State University of New York at Downstate, Brooklyn, NY

Scott A. Schobel, MD

Department of Psychiatry, Columbia University, New York, NY

Hongbin Gu, PhD

Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina

Guido Gerig, PhD

Departments of Psychiatry and Computer Science, University of North Carolina, Chapel Hill, North Carolina

Daniel Bradford, MD

Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina

Cecil Charles, PhD

Department of Radiology, Duke University, Durham, North Carolina

Jeffrey A. Lieberman, MD

Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA

Correspondence: Dr Jeffrey A. Lieberman, University of North Carolina at Chapel Hill–CB 7160, Chapel Hill, North Carolina 27599-7160, USA. E-mail: jlieberman{at}unc.edu

Declaration of interest None.

Funding detailed in Acknowledgements.

Background Reduced hippocampal volume is a consistently described structural abnormality in schizophrenia but its cause and timing are not known.

Aims To examine the relationship of duration of schizophrenic illness and treatment effects with hippocampal volumes.

Method Quantitative 1.5 T magnetic resonance imaging brain scans of young male patients in the early stage of schizophrenic illness were compared with those of chronically ill older patients. Scans were also acquired for controls matched to both patient groups for age and handedness. Duration of illness was recorded and severity of symptoms assessed with the Positive and Negative Syndrome Scale.

Results The patients with schizophrenia had smaller hippocampal volumes than the controls. The volume reduction was larger in older patients than in young, compared with age-matched controls. In the early illness group atypical antipsychotics rather than haloperidol were associated with larger hippocampal volumes even after controlling for differences in illness severity.

Conclusions The greater reduction of hippocampal volume in people with chronic v. early illness, after controlling for illness severity and age, supports the hypothesis of progressive hippocampal reduction in males with schizophrenia. Atypical antipsychotics early in illness may protect against this.




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