Sir: Two studies have reported a substantial reduction of symptoms when the anticonvulsant drug l... more Sir: Two studies have reported a substantial reduction of symptoms when the anticonvulsant drug lamotrigine was added to clozapine in patients with treatment-resistant schizophrenia. 1,2 We report on 6 inpatients with persistent and severe psychotic symptoms who were treated for 24 weeks with a combination of lamotrigine and clozapine.
... assessment, and diagnosis is heartening; it identifies the ethical responsibilities as well as... more ... assessment, and diagnosis is heartening; it identifies the ethical responsibilities as well as dilemmas and pitfalls we face as practitioners. Philip Erdberg, PhD, ABPP, Former President, Society for Personality Assessment A comprehensive and practical guide for practitioners ...
Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis and Pharmacotherapy, 2009
... of relapse in bipolar disorder. Biol Psychiatry 56: 957963 23 Maj M, Pirozzi R, Magliano L, ... more ... of relapse in bipolar disorder. Biol Psychiatry 56: 957963 23 Maj M, Pirozzi R, Magliano L, Fiorillo A, Bartoli L (2006) Agitated unipolar major depression: prevalence, phenomenology, and outcome. J Clin Psychiatry 67: 712 ...
To compare the effectiveness and tolerability of olanzapine and other antipsychotic treatments (6... more To compare the effectiveness and tolerability of olanzapine and other antipsychotic treatments (6 months after enrollment) in Polish patients with schizophrenia participating in the IC-SOHO (the Intercontinental Schizophrenia Outpatient Health Outcomes) study. IC-SOHO is a 3-year, global, prospective, observational study examining health outcomes in outpatients with schizophrenia undergoing treatment with antipsychotics. Patients were offered enrollment by a psychiatrist if they initiated or changed antipsychotic medication for the treatment of schizophrenia. The study was designed to provide two patient cohorts of approximately equal size: patients who initiated or switched to olanzapine, and patients who initiated or switched to non-olanzapine antipsychotic therapy. Mean changes in positive, negative, cognitive, depressive and overall symptoms from baseline to 6 months, as measured using the CGI scale, were assessed. The incidence of extrapyramidal symptoms and sexual dysfunctions...
Patient Preference and Adherence 2013:7 987-995 Patient Preference and Adherence Dovepress submit... more Patient Preference and Adherence 2013:7 987-995 Patient Preference and Adherence Dovepress submit your manuscript | www.dovepress.com
... Hungarian Psychotherapists about Psychotherapy: The Results of a Survey Tamás Treuer, AttilaN... more ... Hungarian Psychotherapists about Psychotherapy: The Results of a Survey Tamás Treuer, AttilaNémeth, János Füredi National Institute of Psychiatry and Neurology and Haynal Imre University of Health Sciences, Department of Psychiatry, Budapest, Hungary. ...
Introduction: Reports from non-Asian populations indicate that painful physical symptoms are asso... more Introduction: Reports from non-Asian populations indicate that painful physical symptoms are associated with poorer clinical and functional outcomes in patients with Major Depressive Disorder (MDD). This paper shows the changes in disease characteristics and quality of life in Taiwanese MDD patients, with or without painful physical symptoms, over 3 months' observation. Methods: Taiwanese patients from an observational study of six East Asian countries/regions were classified as painful physical symptom positive (PPS1) or negative (PPS À) based on a mean score of Z2 or o 2, respectively, on the modified Somatic Symptom Inventory. Changes from baseline in outcomes were compared between the groups. Results: Of 194 patients with MDD, 69% were PPS1 at baseline. These PPS1 patients were more depressed 17-item Hamilton Depression Rating Scale total; mean [SD] 27.1 [6.26] versus 21.8 [5.94] PPS À , P o 0.001), in more pain (Visual Analog Scale overall; median [range] 73.5 [9-100] versus 40 [0 to 80] PPS À , P o 0.001) and had poorer quality of life at baseline (EuroQoL; mean [SD] 42.9 [18.26] versus 59.8 [18.21] PPS À, P o 0.001). At endpoint (n = 118), PPS À patients showed greater improvement on depression outcomes (Clinical Global Impression of Severity; P = 0.011) and had a higher remission rate (52.8 % versus 14.6% PPS1, P = 0.007). Discussion: Painful physical symptoms were frequently observed in Taiwanese patients with MDD. As PPS are associated with more severe depression, poorer quality of life, and poorer remission outcomes, clinical management should address both the mental and physical symptoms associated with this disorder. SSRI (n = 76) SNRI (n = 58) Mean difference/odds ratio (95% CI) P-value CGI-S Baseline (unadjusted), mean (SD) 4.7 (0.75) 4.6 (0.65) 0.838 w Change from baseline, mean (95% CI) À 1.3 ( À 1.59, À 0.92) À 1.5 ( À 1.89, À 1.16) 0.3 ( À 0.22, 0.74) 0.276 z HAMD 17 Total Baseline (unadjusted), mean (SD) 25.0 (6.19) 25.4 (6.84) 0.768 w Change from baseline, mean (95% CI) À 12.9 ( À 14.97, À 10.88) À 12.2 ( À 14.38, À 9.94) À 0.8 ( À 3.67, 2.15) 0.603 z VAS overall Baseline (unadjusted), mean (SD) 54.9 (29.99) 61.6 (30.51) 0.339 w Change from baseline, mean (95% CI) À 12.7 ( À 21.08, À 4.22) À 25.6 ( À 34.73, À 16.39) 12.9 (0.85, 24.98) 0.036 z EQ-5D Health State Score Baseline (unadjusted), mean (SD) 48.8 (20.17) 46.3 (18.74) 0.575 w Change from baseline, mean (95% CI) 11.2 (4.35, 18.13) 15.9 (8.41, 23.40) À 4.7 ( À 14.51, 5.17) 0.347 z Responders, n (%) 23 (53.5) 19 (55.9) 0.9 (0.37, 2.36) ‰ 0.877 z Remitters, n (%) 9 (20.9) 9 (26.5) 0.8 (0.27, 2.30) ‰ 0.660 z w P-value using t-test for comparisons of means.
This post-hoc analysis was to investigate the impact of treatment discontinuation on clinical out... more This post-hoc analysis was to investigate the impact of treatment discontinuation on clinical outcomes in patients with attention-deficit/hyperactivity disorder (ADHD). Data are from a 12-month, observational, multinational study that included outpatients aged 6-17 years who were diagnosed with ADHD and treated with atomoxetine, methylphenidate, or nootropic agents. Treatment effectiveness and proportions of patients who discontinued treatment were compared between China and the other non-Western countries/regions combined. Propensity score matching was used to further estimate the association between treatment discontinuation and effectiveness. Of the 546 patients who entered the study, 337 patients had complete data and were included in the analyses. Compared with the other countries/regions, China subgroup had a higher treatment discontinuation rate (odds ratio = 25.80; P < 0.0001) and poorer treatment effectiveness: least-squares (LS) mean changes were 5.74 versus 8.56 (P = 0.0225) for the Child Health and Illness Profile-Child Edition (CHIP-CE) Achievement domain and -1.87 versus -2.13 (P = 0.0401) for Clinical Global Impressions-ADHD-Severity (CGI-ADHD-S). Further analyses of matched discontinuer-maintainer pairs showed that discontinuers demonstrated poorer effectiveness: LS mean changes for the CHIP-CE Achievement domain and CGI-ADHD-S (discontinuer versus maintainer) were 5.36 versus 9.10 (P = 0.0255) and -1.32 versus -1.96 (P = 0.0179) for overall population, respectively, and 4.40 versus 10.17 (P = 0.0065) and -1.48 versus -2.45 (P = 0.0089), respectively, for China subgroup. This analysis found that early treatment discontinuation was associated with worse clinical outcomes for patients with ADHD. China subgroup had substantially higher discontinuation rates and poorer effectiveness outcomes. Strategies to improve medication persistence have the potential to improve outcomes for ADHD patients in China.
International Journal of Psychiatry in Clinical Practice, Jun 1, 2010
Objectives: To better understand the burden and management of attention-deicit hyperactivity diso... more Objectives: To better understand the burden and management of attention-deicit hyperactivity disorder in East Asia, this subanalysis of the baseline characteristics of a large prospective, observational, nonrandomised study investigating the relationships between symptom severity, treatments, co-morbidities, and health outcomes provides information about the diagnosis of, and treatment patterns for, attentiondeicit hyperactivity disorder in this region. Methods: Outpatients with attention-deicit hyperactivity disorder symptoms participated in this 12month study performed in China, Korea, and Taiwan. Patients were grouped according to whether they received conventional treatment or no or other treatment. Attention-deicit hyperactivity disorder symptom severity and co-morbidities were assessed using the Clinical Global Impressions-Attention-deicit Hyperactivity Disorder-Severity scale and Child Symptom Inventory-4: Parent Checklist (categories B to J) / Adolescent Symptom Inventory-4: Parent Checklist (categories L and O), respectively. Results: A total of 502 patients aged 6 to 18 years were enrolled. Investigators were psychiatrists (69%) and paediatricians (31%), who used the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (86%), the 10th revision of the International Classiication of Diseases (6%), and other attention-deicit hyperactivity disorder diagnostic criteria (8%) for diagnosis. Pharmacotherapy was the most commonly prescribed treatment (n = 251; 50%), and treated patients were older (9.1 vs. 8.2 years; p < 0.001) and more severely ill (Clinical Global Impressions-Attention-deicit Hyperactivity Disorder-Severity scale, 4.6 vs. 4.2; p < 0.001) than those who were not treated. Anxiety and oppositional comorbidities were commonly reported. Conclusions: These data provide an insight into the demographics, diagnosis, and treatment of paediatric patients with attention-deicit hyperactivity disorder in East Asia, and provide a baseline for assessing changes in treatment practices in this population.
Several psychotic disorders, including schizophrenia, may be associated with symptoms of acute ag... more Several psychotic disorders, including schizophrenia, may be associated with symptoms of acute agitation and aggression. While drug treatment of agitation is oten essential, non-pharmacological interventions, both environmental and behavioral, also play important roles in the complex management of agitated patients. he most extensively used psychotropic drugs are parenteral formulas of conventional antipsychotics and benzodiazepines. Recently, injection forms of two second generation antipsychotics, olanzapine and ziprasidone, have become available. Both drugs have shown adequate eicacy and tolerability in several double-blind trials of intramuscular administration in acutely agitated psychotic patients. Compared to conventional medication, injection forms of the new antipsychotics may have a faster onset of action and more favorable proile of adverse events. Alternative approaches to injection administration include liquid drug formula, orally disintegrating tablets and wafers, treatment initiation with high doses, or rapid dose escalation. Evidence suggests that second-generation antipsychotics should be among the irst-line choices in the treatment of agitation in acute psychosis.
Objectives. To examine the comparative outcomes associated with the antipsychotic treatment of ou... more Objectives. To examine the comparative outcomes associated with the antipsychotic treatment of outpatients with schizophrenia and to describe changes in clinical status over the first 6 months of treatment in participating patients from the Middle East and Africa (MEA).
Many patients with schizophrenia and bipolar disorder have impaired insight and low medication ad... more Many patients with schizophrenia and bipolar disorder have impaired insight and low medication adherence. The aim of this post hoc analysis was to explore the relationship between insight and medication adherence. We included 903 patients with schizophrenia or bipolar disorder who participated in an observational study conducted in Europe on the outcomes of patients treated with two oral formulations of olanzapine over a 1-year period. Evaluations included Clinical Global Impression (CGI), Global Assessment of Functioning (GAF), insight (Scale to Assess Unawareness of Mental Disorder, SUMD) medication adherence (Medication Adherence Rating Scale, MARS), and therapeutic alliance (Working Alliance Inventory, WAI). Medication adherence was higher in bipolar patients (mean MARS score (SD) 6.5 (2.8) versus 5.8 (2.7) in schizophrenia; p < 0.001). Patients with schizophrenia had lower insight (i.e., SUMD item 1, unawareness of mental disorder, mean (SD) of 2.5 (1.3) in schizophrenia ver...
Objectives: Comparative outcomes associated with antipsychotic treatment of outpatients with schi... more Objectives: Comparative outcomes associated with antipsychotic treatment of outpatients with schizophrenia and changes in clinical status over the first 6 months of treatment in participating patients from Central and Eastern Europe (CEE) are presented. Methods: The Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study is a 3-year, prospective, observational study of health outcomes associated with antipsychotic medication in outpatients treated for schizophrenia. This article reports on the 6-month interim results in the region of CEE (n=2252). Subjects aged >18 years and undergoing treatment for schizophrenia were enrolled if, at the discretion of the treating psychiatrist, they initiated or changed antipsychotic medication. For primary analyses, two treatment groups were established: olanzapine and 'other antipsychotics' (non-olanzapine including risperidone) treatment. Subanalysis of olanzapine versus risperidone groups was also done as secondary c...
Recent meta-analyses have provided a comprehensive overview of studies investigating Toxoplasma g... more Recent meta-analyses have provided a comprehensive overview of studies investigating Toxoplasma gondii antibodies in schizophrenic patients, thus attempting to clarify the potential role these infections might play in causing schizophrenia. Issues for further research have been suggested. Associations and theories that may enrich the current level of knowledge with regard to this significant subject deserve attention. Anti-parasitic agents as well as antipsychotics are effective in treating parasitosis. Both classes of drugs have been shown to exert dopaminergic activity. Parasites and human organisms have a long history of mutual contact. The effect of parasitosis on the host and the host's response to infection are undoubtedly the product of a long evolutionary process. The neurochemical background of delusions of parasitosis is potentially similar to ancient evolutionary traces of altered neurotransmission and neuropeptide gene expression caused by parasites; these include fu...
Sir: Two studies have reported a substantial reduction of symptoms when the anticonvulsant drug l... more Sir: Two studies have reported a substantial reduction of symptoms when the anticonvulsant drug lamotrigine was added to clozapine in patients with treatment-resistant schizophrenia. 1,2 We report on 6 inpatients with persistent and severe psychotic symptoms who were treated for 24 weeks with a combination of lamotrigine and clozapine.
... assessment, and diagnosis is heartening; it identifies the ethical responsibilities as well as... more ... assessment, and diagnosis is heartening; it identifies the ethical responsibilities as well as dilemmas and pitfalls we face as practitioners. Philip Erdberg, PhD, ABPP, Former President, Society for Personality Assessment A comprehensive and practical guide for practitioners ...
Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis and Pharmacotherapy, 2009
... of relapse in bipolar disorder. Biol Psychiatry 56: 957963 23 Maj M, Pirozzi R, Magliano L, ... more ... of relapse in bipolar disorder. Biol Psychiatry 56: 957963 23 Maj M, Pirozzi R, Magliano L, Fiorillo A, Bartoli L (2006) Agitated unipolar major depression: prevalence, phenomenology, and outcome. J Clin Psychiatry 67: 712 ...
To compare the effectiveness and tolerability of olanzapine and other antipsychotic treatments (6... more To compare the effectiveness and tolerability of olanzapine and other antipsychotic treatments (6 months after enrollment) in Polish patients with schizophrenia participating in the IC-SOHO (the Intercontinental Schizophrenia Outpatient Health Outcomes) study. IC-SOHO is a 3-year, global, prospective, observational study examining health outcomes in outpatients with schizophrenia undergoing treatment with antipsychotics. Patients were offered enrollment by a psychiatrist if they initiated or changed antipsychotic medication for the treatment of schizophrenia. The study was designed to provide two patient cohorts of approximately equal size: patients who initiated or switched to olanzapine, and patients who initiated or switched to non-olanzapine antipsychotic therapy. Mean changes in positive, negative, cognitive, depressive and overall symptoms from baseline to 6 months, as measured using the CGI scale, were assessed. The incidence of extrapyramidal symptoms and sexual dysfunctions...
Patient Preference and Adherence 2013:7 987-995 Patient Preference and Adherence Dovepress submit... more Patient Preference and Adherence 2013:7 987-995 Patient Preference and Adherence Dovepress submit your manuscript | www.dovepress.com
... Hungarian Psychotherapists about Psychotherapy: The Results of a Survey Tamás Treuer, AttilaN... more ... Hungarian Psychotherapists about Psychotherapy: The Results of a Survey Tamás Treuer, AttilaNémeth, János Füredi National Institute of Psychiatry and Neurology and Haynal Imre University of Health Sciences, Department of Psychiatry, Budapest, Hungary. ...
Introduction: Reports from non-Asian populations indicate that painful physical symptoms are asso... more Introduction: Reports from non-Asian populations indicate that painful physical symptoms are associated with poorer clinical and functional outcomes in patients with Major Depressive Disorder (MDD). This paper shows the changes in disease characteristics and quality of life in Taiwanese MDD patients, with or without painful physical symptoms, over 3 months' observation. Methods: Taiwanese patients from an observational study of six East Asian countries/regions were classified as painful physical symptom positive (PPS1) or negative (PPS À) based on a mean score of Z2 or o 2, respectively, on the modified Somatic Symptom Inventory. Changes from baseline in outcomes were compared between the groups. Results: Of 194 patients with MDD, 69% were PPS1 at baseline. These PPS1 patients were more depressed 17-item Hamilton Depression Rating Scale total; mean [SD] 27.1 [6.26] versus 21.8 [5.94] PPS À , P o 0.001), in more pain (Visual Analog Scale overall; median [range] 73.5 [9-100] versus 40 [0 to 80] PPS À , P o 0.001) and had poorer quality of life at baseline (EuroQoL; mean [SD] 42.9 [18.26] versus 59.8 [18.21] PPS À, P o 0.001). At endpoint (n = 118), PPS À patients showed greater improvement on depression outcomes (Clinical Global Impression of Severity; P = 0.011) and had a higher remission rate (52.8 % versus 14.6% PPS1, P = 0.007). Discussion: Painful physical symptoms were frequently observed in Taiwanese patients with MDD. As PPS are associated with more severe depression, poorer quality of life, and poorer remission outcomes, clinical management should address both the mental and physical symptoms associated with this disorder. SSRI (n = 76) SNRI (n = 58) Mean difference/odds ratio (95% CI) P-value CGI-S Baseline (unadjusted), mean (SD) 4.7 (0.75) 4.6 (0.65) 0.838 w Change from baseline, mean (95% CI) À 1.3 ( À 1.59, À 0.92) À 1.5 ( À 1.89, À 1.16) 0.3 ( À 0.22, 0.74) 0.276 z HAMD 17 Total Baseline (unadjusted), mean (SD) 25.0 (6.19) 25.4 (6.84) 0.768 w Change from baseline, mean (95% CI) À 12.9 ( À 14.97, À 10.88) À 12.2 ( À 14.38, À 9.94) À 0.8 ( À 3.67, 2.15) 0.603 z VAS overall Baseline (unadjusted), mean (SD) 54.9 (29.99) 61.6 (30.51) 0.339 w Change from baseline, mean (95% CI) À 12.7 ( À 21.08, À 4.22) À 25.6 ( À 34.73, À 16.39) 12.9 (0.85, 24.98) 0.036 z EQ-5D Health State Score Baseline (unadjusted), mean (SD) 48.8 (20.17) 46.3 (18.74) 0.575 w Change from baseline, mean (95% CI) 11.2 (4.35, 18.13) 15.9 (8.41, 23.40) À 4.7 ( À 14.51, 5.17) 0.347 z Responders, n (%) 23 (53.5) 19 (55.9) 0.9 (0.37, 2.36) ‰ 0.877 z Remitters, n (%) 9 (20.9) 9 (26.5) 0.8 (0.27, 2.30) ‰ 0.660 z w P-value using t-test for comparisons of means.
This post-hoc analysis was to investigate the impact of treatment discontinuation on clinical out... more This post-hoc analysis was to investigate the impact of treatment discontinuation on clinical outcomes in patients with attention-deficit/hyperactivity disorder (ADHD). Data are from a 12-month, observational, multinational study that included outpatients aged 6-17 years who were diagnosed with ADHD and treated with atomoxetine, methylphenidate, or nootropic agents. Treatment effectiveness and proportions of patients who discontinued treatment were compared between China and the other non-Western countries/regions combined. Propensity score matching was used to further estimate the association between treatment discontinuation and effectiveness. Of the 546 patients who entered the study, 337 patients had complete data and were included in the analyses. Compared with the other countries/regions, China subgroup had a higher treatment discontinuation rate (odds ratio = 25.80; P &amp;amp;amp;amp;lt; 0.0001) and poorer treatment effectiveness: least-squares (LS) mean changes were 5.74 versus 8.56 (P = 0.0225) for the Child Health and Illness Profile-Child Edition (CHIP-CE) Achievement domain and -1.87 versus -2.13 (P = 0.0401) for Clinical Global Impressions-ADHD-Severity (CGI-ADHD-S). Further analyses of matched discontinuer-maintainer pairs showed that discontinuers demonstrated poorer effectiveness: LS mean changes for the CHIP-CE Achievement domain and CGI-ADHD-S (discontinuer versus maintainer) were 5.36 versus 9.10 (P = 0.0255) and -1.32 versus -1.96 (P = 0.0179) for overall population, respectively, and 4.40 versus 10.17 (P = 0.0065) and -1.48 versus -2.45 (P = 0.0089), respectively, for China subgroup. This analysis found that early treatment discontinuation was associated with worse clinical outcomes for patients with ADHD. China subgroup had substantially higher discontinuation rates and poorer effectiveness outcomes. Strategies to improve medication persistence have the potential to improve outcomes for ADHD patients in China.
International Journal of Psychiatry in Clinical Practice, Jun 1, 2010
Objectives: To better understand the burden and management of attention-deicit hyperactivity diso... more Objectives: To better understand the burden and management of attention-deicit hyperactivity disorder in East Asia, this subanalysis of the baseline characteristics of a large prospective, observational, nonrandomised study investigating the relationships between symptom severity, treatments, co-morbidities, and health outcomes provides information about the diagnosis of, and treatment patterns for, attentiondeicit hyperactivity disorder in this region. Methods: Outpatients with attention-deicit hyperactivity disorder symptoms participated in this 12month study performed in China, Korea, and Taiwan. Patients were grouped according to whether they received conventional treatment or no or other treatment. Attention-deicit hyperactivity disorder symptom severity and co-morbidities were assessed using the Clinical Global Impressions-Attention-deicit Hyperactivity Disorder-Severity scale and Child Symptom Inventory-4: Parent Checklist (categories B to J) / Adolescent Symptom Inventory-4: Parent Checklist (categories L and O), respectively. Results: A total of 502 patients aged 6 to 18 years were enrolled. Investigators were psychiatrists (69%) and paediatricians (31%), who used the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (86%), the 10th revision of the International Classiication of Diseases (6%), and other attention-deicit hyperactivity disorder diagnostic criteria (8%) for diagnosis. Pharmacotherapy was the most commonly prescribed treatment (n = 251; 50%), and treated patients were older (9.1 vs. 8.2 years; p < 0.001) and more severely ill (Clinical Global Impressions-Attention-deicit Hyperactivity Disorder-Severity scale, 4.6 vs. 4.2; p < 0.001) than those who were not treated. Anxiety and oppositional comorbidities were commonly reported. Conclusions: These data provide an insight into the demographics, diagnosis, and treatment of paediatric patients with attention-deicit hyperactivity disorder in East Asia, and provide a baseline for assessing changes in treatment practices in this population.
Several psychotic disorders, including schizophrenia, may be associated with symptoms of acute ag... more Several psychotic disorders, including schizophrenia, may be associated with symptoms of acute agitation and aggression. While drug treatment of agitation is oten essential, non-pharmacological interventions, both environmental and behavioral, also play important roles in the complex management of agitated patients. he most extensively used psychotropic drugs are parenteral formulas of conventional antipsychotics and benzodiazepines. Recently, injection forms of two second generation antipsychotics, olanzapine and ziprasidone, have become available. Both drugs have shown adequate eicacy and tolerability in several double-blind trials of intramuscular administration in acutely agitated psychotic patients. Compared to conventional medication, injection forms of the new antipsychotics may have a faster onset of action and more favorable proile of adverse events. Alternative approaches to injection administration include liquid drug formula, orally disintegrating tablets and wafers, treatment initiation with high doses, or rapid dose escalation. Evidence suggests that second-generation antipsychotics should be among the irst-line choices in the treatment of agitation in acute psychosis.
Objectives. To examine the comparative outcomes associated with the antipsychotic treatment of ou... more Objectives. To examine the comparative outcomes associated with the antipsychotic treatment of outpatients with schizophrenia and to describe changes in clinical status over the first 6 months of treatment in participating patients from the Middle East and Africa (MEA).
Many patients with schizophrenia and bipolar disorder have impaired insight and low medication ad... more Many patients with schizophrenia and bipolar disorder have impaired insight and low medication adherence. The aim of this post hoc analysis was to explore the relationship between insight and medication adherence. We included 903 patients with schizophrenia or bipolar disorder who participated in an observational study conducted in Europe on the outcomes of patients treated with two oral formulations of olanzapine over a 1-year period. Evaluations included Clinical Global Impression (CGI), Global Assessment of Functioning (GAF), insight (Scale to Assess Unawareness of Mental Disorder, SUMD) medication adherence (Medication Adherence Rating Scale, MARS), and therapeutic alliance (Working Alliance Inventory, WAI). Medication adherence was higher in bipolar patients (mean MARS score (SD) 6.5 (2.8) versus 5.8 (2.7) in schizophrenia; p < 0.001). Patients with schizophrenia had lower insight (i.e., SUMD item 1, unawareness of mental disorder, mean (SD) of 2.5 (1.3) in schizophrenia ver...
Objectives: Comparative outcomes associated with antipsychotic treatment of outpatients with schi... more Objectives: Comparative outcomes associated with antipsychotic treatment of outpatients with schizophrenia and changes in clinical status over the first 6 months of treatment in participating patients from Central and Eastern Europe (CEE) are presented. Methods: The Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study is a 3-year, prospective, observational study of health outcomes associated with antipsychotic medication in outpatients treated for schizophrenia. This article reports on the 6-month interim results in the region of CEE (n=2252). Subjects aged >18 years and undergoing treatment for schizophrenia were enrolled if, at the discretion of the treating psychiatrist, they initiated or changed antipsychotic medication. For primary analyses, two treatment groups were established: olanzapine and 'other antipsychotics' (non-olanzapine including risperidone) treatment. Subanalysis of olanzapine versus risperidone groups was also done as secondary c...
Recent meta-analyses have provided a comprehensive overview of studies investigating Toxoplasma g... more Recent meta-analyses have provided a comprehensive overview of studies investigating Toxoplasma gondii antibodies in schizophrenic patients, thus attempting to clarify the potential role these infections might play in causing schizophrenia. Issues for further research have been suggested. Associations and theories that may enrich the current level of knowledge with regard to this significant subject deserve attention. Anti-parasitic agents as well as antipsychotics are effective in treating parasitosis. Both classes of drugs have been shown to exert dopaminergic activity. Parasites and human organisms have a long history of mutual contact. The effect of parasitosis on the host and the host's response to infection are undoubtedly the product of a long evolutionary process. The neurochemical background of delusions of parasitosis is potentially similar to ancient evolutionary traces of altered neurotransmission and neuropeptide gene expression caused by parasites; these include fu...
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