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Background/aim: The aim of this study was to compare metabolite levels of the dorsolateral prefrontal cortex (DLPFC), anterior cingulate gyrus (ACG), thalamus, and hippocampus in patients with chronic schizophrenia (CSPs) and first psychotic episode patients (FEPs) by the use of magnetic resonance spectroscopy (MRS). Materials and methods: Thirty CSPs, 20 FEPs, and 30 healthy subjects participated in this study. N-Acetylaspartate (NAA), creatine, choline (Cho), and myoinositol levels of the DLPFC, ACG, thalamus, and hippocampus were measured by 1H-MRS. Results: It was determined that the NAA/Cho ratio was lower in both the FEPs and CSPs than the healthy controls in the DLPFC. DLPFC Cho levels were also higher in CSPs than healthy controls. NAA levels in CSPs were significantly lower than in the control group in the hippocampus. There was no significant difference in neurometabolite levels and ratios in the ACG and thalamus between the groups. Conclusion: This study supports neuronal dysfunction or loss of neuronal integrity in the DLPFC and hippocampus in CSPs. FEPs showed less neuronal dysfunction in the DLPFC, but not in the hippocampus. Our results suggest that schizophrenic patients show brain metabolic changes with the onset of the disorder in the DLPFC; these changes could be more apparent in the hippocampus as the disease progresses to chronic stages. © TÜBİTAK.