Lithium response in good prognosis schizophrenia

The authors report the results of a 2-week lithium trial using 31 patients meeting Research Diagnostic Criteria for schizophrenia or schizoaffective disorder who were also diagnosed according to DSM-III criteria. One-third of the patients showed reduction of their schizophrenic-like symptoms during the lithium trial. Seven of the 9 responders (78%) met DSM-III criteria not for schizophrenia but for a schizophreniform disorder. Such patients also met McCabe and associates' criteria for good prognosis schizophrenia. This study lends further support to the growing body of evidence which suggests that schizophreniform disorder and good prognosis schizophrenia may be affective disorders with atypical schizophrenic-like features. The authors cautiously suggest that a lithium trial may be indicated in this subgroup of patients.