Explaining treatment response in Schizophrenia : integration of genetic and environmental factors

Response to antipsychotic (AP) medication is critical to predicting long-term outcome in schizophrenia. This study examined the relationship between treatment response (TR) and four risk factors for schizophrenia. Method. Twenty-six outpatients were interviewed to assess childhood trauma and substance use. Patients' mothers completed interviews concerning family history of schizophrenia spectrum disorders and obstetric complications. TR was evaluated through information gleaned from medical records. Results. Family history of schizophrenia spectrum disorders (FH) was associated with decreased response to typical APs (r = -.37, p < .05). More severe childhood trauma was associated with worse TR (r = -.51, p < .001) while premorbid LSD use was associated with better TR (r = .52, p < .01). Further examination revealed that FH moderated the effects of trauma and LSD use on response to typical APs. None of the putative risk factors explained variance in TR to atypical APs. Conclusion. Childhood trauma and premorbid LSD use may cause permanent neurochemical changes responsible for altered TR in some individuals