Determination of blood enzyme activity and evaluation of the effectiveness of psychopharmacotherapy in children with schizophrenia spectrum disorders: a pilot study

Background. Schizophrenia spectrum disorders (SSD) in childhood represent a pressing issue in modern child psy-chiatry. They are characterized by a severe course and are often resistant to psychopharmacotherapy, which particularly complicates the work of clinical psychiatrists. Pharmacological correction of mental disorders in children is the main method of treatment and provides the opportunity for further psychological and pedagogical work and social adaptation of the child. Therefore, its success is extremely important in the rehabilitation of patients and will always remain a sought-after object of scientific research. Recently, the identification of biological markers that help evaluate the effec-tiveness of psychopharmacotherapy and act as predictors of an individual patient’s response to treatment has become increasingly important. Objective: To study the relationship between platelet and erythrocyte enzyme activity levels and assessments of the effectiveness of psychopharmacotherapy in children with SSD. Materials and Methods. The sample consisted of 30 children hospitalized due to deterioration of their mental state, with diagnoses of schizophrenia (F20.x, n=11) and schizotypal personality disorder (SPD, F21.x, n=19). Clinical and psychopathological assessment of the con-dition was conducted at two control points (before and after the course of therapy) using individual interviews and the PANSS rating scale. As biological markers, the activity levels of glutamate, glutathione, and energy metabolism en-zymes in platelets and erythrocytes were determined only at the first control point. Statistical analysis was performed using the nonparametric analysis modules of the Statistica program (Statsoft 10). Results. In patients with schizophrenia and STD, under the influence of pharmacotherapy, clinical improvement was observed at the 2nd control point, with a slight advantage in the group of patients with STD (p=0.00004) compared to patients with schizophrenia (p=0.003, Wil-coxon test). Statistically significant correlations were found between the activity levels of glutamate, glutathione, and energy metabolism enzymes and (1) the PANSS scores at time point 2: these scores directly correlated with the activity levels of glutathione peroxidase (Spearman R=0.45, p=0.014) and glutathione-S-transferase (R=0.40, p=0.030) and in-versely correlated with the activity levels of cytochrome-c oxidase (R=-0.43, p=0.016), as well as (2) with the degree of clinical improvement, i.e., with the reduction in scores on the PANSS and its subscales: the magnitude of reduction in the total score on the PANSS and its subscales inversely correlated with the activity levels of glutamate dehydrogenase (R=-0.43; p=0.018). Conclusion. The statistically significant correlations obtained in this pilot study represent innova-tive data that are of particular importance in modern psychiatry; however, they require further development and ex-panded study in larger representative samples. The use of the identified markers as predictors of individual therapeu-tic response may be used in the future for practical purposes as a routine study to improve the quality of psychophar-macotherapy.