Sociodemographic variables and efficacy study in psychotic patients after 12 months of outpatient treatment with paliperidone palmitate (PP)

IntroductionPsychotic disorders are serious mental illnesses that compromise the quality of life of patients. It is important to know the characteristics of the affected population, seek to improve the adhesion and functionality.ObjectivesTo describe the sociodemographic characteristics of patients treated with Palmitato Paliperidona (PP). Analyze the efficacy variables, adherence to treatment.MethodsCross-sectional study of 15 patients in outpatient follow-up after 12 months of treatment with PP. Sociodemographic characteristics are collected, mean dose of PP, through a mirror study. Scales to measure the functionality, clinical status and attitude towards medication apply: Scale of personal and social functioning (PSP), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression Scale (CGI-SI) and attitudes toward Inventory Medication (DAI).ResultsThe sample consists of 15 patients (54% male). 81% are single; 77% live alone and 94% not working. The mean dose of PP is 147 mg/month. DAI shows a good attitude to the treatment (80%). The PSP shows that 22% of patients have serious difficulties in its development. The CGI-SI shows that 67% are moderately sick and the BPRS that 33% of patients have a serious disorder.ConclusionsThe demographic profile of patients after 12 months of treatment with PP coincides with male, unmarried, unemployed, living alone. Most have good adherence. The variables measured by the CGI-SI, BPRS and PSP, displayed moderately ill patients with severe difficulties or marked on their autonomy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Aggressive behavior during the first 24 hours of psychiatric admission

Trends in Psychiatry and Psychotherapy ◽

10.1590/2237-6089-2014-0016 ◽

2014 ◽

Vol 36 (3) ◽

pp. 152-159 ◽

Cited By ~ 2

Author(s):

Vitor Crestani Calegaro ◽

Amanda Bolson Dotto ◽

Denise Freitas ◽

Anderson Barcellos Brum ◽

Andrei Garziera Valerio ◽

...

Keyword(s):

Rating Scale ◽

Psychiatric Patients ◽

Cross Sectional Study ◽

Psychiatric Admission ◽

Cross Sectional ◽

Brief Psychiatric Rating Scale ◽

Hospital Patients ◽

Psychiatric Rating ◽

Psychiatric Rating Scale ◽

Santa Maria

OBJECTIVE: To investigate the association between aggression in the first 24 hours after admission and severity of psychopathology in psychiatric inpatients.METHODS: This cross-sectional study included psychiatric patients admitted to Hospital Universitário de Santa Maria, in Santa Maria, southern Brazil, from August 2012 to January 2013. At their arrival at the hospital, patients were interviewed to fill in the Brief Psychiatric Rating Scale (BPRS) form, and any aggressive episodes in the first 24 hours after admission were recorded using the Overt Aggression Scale (OAS). The Mann-Whitney U test was used to compare patients according to aggressiveness: aggressive versus non-aggressive, hostile versus violent, and aggressive against others only versus self-aggressive.RESULTS: The sample was composed of 110 patients. Aggressive patients in general had higher BPRS total scores (p = 0.002) and individual component scores, and their results showed more activation (p < 0.001) and thinking disorders (p = 0.009), but less anxious-depression (p = 0.008). Violent patients had more severe psychomotor agitation (p = 0.027), hallucinations (p = 0.017) and unusual thought content (p = 0.020). Additionally, self-aggressive patients had more disorientation (p = 0.011) and conceptual disorganization (p = 0.007).CONCLUSIONS: Aggression in psychiatric patients in the first 24 hours after admission is associated with severity of psychopathology, and severity increases with severity of patient psychosis and agitation.

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The Relationship Between Insight and Internalized Stigma in Persons With Sever Mental Illness

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1648 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S453-S453

Author(s):

D. Szczesniak ◽

I. Wojciechowska ◽

M. Kłapciński ◽

E. Zwyrtek ◽

J. Rymaszewska

Keyword(s):

Mental Illness ◽

Psychotic Disorders ◽

Cross Sectional Study ◽

Mental Illnesses ◽

Internalized Stigma ◽

Related Factors ◽

Cross Sectional ◽

Stigma Of Mental Illness ◽

The Relationship ◽

Insight Into

IntroductionStigma is a multistage process that makes person marked by the stigma to be perceived as diminished or even as “not fully human”. The internalized stigmatization is seen as one of the levels of stigma to be present in persons with mental illness. A new perspective to mediation models between internalized stigma and illness-related factors is needed.AimTo assess the relationship between insight in mental illness and internalized stigma, as well to verify the knowledge of illness-related factors on the phenomenon of internalized stigma among patients with severe mental illnesses.MethodsA cross-sectional study design conducted among participants of both sexes between 18 years old and 65 years old with diagnosis of psychotic disorders (F20–29) and mood disorders (F30–39), who after reading the information about the study, give their written consent to participate. Among used methods were: a questionnaire of Internalized Stigma of Mental Illness (ISMI) by Ritsher [Boyed] et al. translated into Polish version and self-prepared interviews. Insight into mental illness was assessed using the Positive and Negative Syndrome Scale.ResultsThe preliminary results showed patients with the insight into the mental illness have significantly higher scores on the ISMI scale. Moreover, inpatient participants and those with the diagnosis of depression were characterized by higher level of stereotype endorsement compared with outpatients and psychotic patients.ConclusionsThe obtained results may contribute in the clinical and therapeutic fields, assuming that insight and the type of treatment are strongly linked with the process of recovery and the internalized stigma.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Sulpiride augmentation in people with schizophrenia partially responsive to clozapine

The British Journal of Psychiatry ◽

10.1192/bjp.171.6.569 ◽

1997 ◽

Vol 171 (6) ◽

pp. 569-573 ◽

Cited By ~ 166

Author(s):

Roni Shiloh ◽

Zvi Zemishlany ◽

Dov Aizenberg ◽

Marguerite Radwan ◽

Bruria Schwartz ◽

...

Keyword(s):

Negative Symptoms ◽

Rating Scale ◽

Clinical Status ◽

Chronic Schizophrenia ◽

Current Treatment ◽

Psychotic Symptoms ◽

Double Blind ◽

Clozapine Treatment ◽

Psychiatric Rating ◽

Psychiatric Rating Scale

BackgroundWe hypothesised that a combined regimen of clozapine, a relatively weak D2-dopaminergic antagonist, and sulpiride, a selective D2 blocker, would demonstrate a greater antipsychotic efficacy by enhancing the D2 blockade of clozapine.MethodTwenty-eight people with schizophrenia, previously unresponsive to typical antipsychotics and only partially responsive to current treatment with clozapine, received, double-blind, 600 mg/day sulpiride or placebo, in addition to an ongoing clozapine treatment. The clinical status was evaluated before, during, and at the end of 10 weeks of sulpiride addition using the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms, and Hamilton Rating Scale for Depression.ResultsThe clozapine–sulpiride group exhibited substantially greater and significant improvements in positive and negative psychotic symptoms. About half of them, characterised by a younger age and lower baseline SAPS scores, had a mean reduction of 42.4 and 50.4% in their BPRS and SAPS scores, respectively.ConclusionsA subgroup of patients with chronic schizophrenia may substantially benefit from sulpiride addition to clozapine.

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Cross-sectional similarities and differences between schizophrenia, schizoaffective disorder and mania or mixed mania with mood-incongruent psychotic features

European Psychiatry ◽

10.1016/j.eurpsy.2003.07.007 ◽

2004 ◽

Vol 19 (1) ◽

pp. 8-14 ◽

Cited By ~ 70

Author(s):

Stefano Pini ◽

Valeria de Queiroz ◽

Liliana Dell'Osso ◽

Marianna Abelli ◽

Concettina Mastrocinque ◽

...

Keyword(s):

Schizoaffective Disorder ◽

Negative Symptoms ◽

Rating Scale ◽

Cross Sectional ◽

Brief Psychiatric Rating Scale ◽

Patient Groups ◽

Psychiatric Rating ◽

Psychiatric Rating Scale ◽

Psychotic Features ◽

Mood And Cognition

AbstractBackground. – The cross-sectional clinical differentiation of schizophrenia or schizoaffective disorder from mood-incongruent psychotic mania or mixed mania is difficult, since pathognomonic symptoms are lacking in these conditions.Aims of the study. – To compare a series of clinical variables related to mood and cognition in patient groups with DSM-III-R diagnosis of schizophrenia, schizoaffective disorder, mood-incongruent psychotic mania and mood-incongruent psychotic mixed mania.Methods. – One hundred and fifty-one consecutive patients were evaluated in the week prior to discharge by using the structured clinical interview for DSM-III-R-patient edition (SCID-P). Severity of psychopathology was assessed by the 18-item version of the brief psychiatric rating scale (BPRS) and negative symptoms by the scale for assessment of negative symptoms (SANS). Level of insight was assessed with the scale to assess unawareness of mental disorders (SUMD).Results. – There were no differences in rates of specific types of delusions and hallucinations between subjects with schizophrenia, schizoaffective disorder, psychotic mania and psychotic mixed mania. SANS factors scores were significantly higher in patients with schizophrenia than in the bipolar groups. Patients with mixed state scored significantly higher on depression and excitement compared to schizophrenia group and, to a lesser extent, to schizoaffective group. Subjects with schizophrenia showed highest scores on the SUMD indicating that they were much more compromised on the insight dimension than subjects with psychotic mania or mixed mania.Conclusion. – Negative rather than affective symptomatology may be a useful construct to differentiate between schizophrenia or schizoaffective disorders from mood-incongruent psychotic mania or mixed mania.

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Psychotic Patients' Awareness of Mental Illness: Implications for Legal Defense Proceedings

The Journal of Psychiatry & Law ◽

10.1177/009318539602400305 ◽

1996 ◽

Vol 24 (3) ◽

pp. 421-442 ◽

Cited By ~ 6

Author(s):

Craig S. Neumann ◽

Elaine F. Walker ◽

Jay Weinstein ◽

Chris Cutshaw

Keyword(s):

Mental Illness ◽

Psychotic Disorders ◽

Rating Scale ◽

Insanity Defense ◽

Thought Disturbance ◽

Psychiatric Rating ◽

Psychiatric Rating Scale ◽

And Performance ◽

Willingness To Use ◽

Insight Into

This study examined the relationship between psychotic patients' insight into their mental illness and current symptoms, competency to stand trial, and willingness to use the insanity defense. Inpatients with psychotic disorders were grouped by whether they exhibited insight into their mental status (n=18) or denied being mentally ill (n=13). The majority of all patients, regardless of insight status, failed at least one item on a 16-item competency exam. However, the majority of insightful subjects (77%) were willing to consider using the insanity defense, while only a minority (31%) of the non-insightful subjects were willing to consider such a defense. Using the Brief Psychiatric Rating Scale (BPRS), univariate analyses indicated that the insightful subjects manifested significantly more Anxiety-Depression and less Thought Disturbance than the non-insightful subjects. Although there was no relationship between insight and performance on the competency exam, there were significant inverse correlations between competency scores and ratings on the BPRS symptom factors.

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Alcohol use in schizophrenia: prevalence, patterns, correlates and clinical outcomes in Goa, India

The Psychiatrist ◽

10.1192/pb.bp.111.036459 ◽

2012 ◽

Vol 36 (7) ◽

pp. 257-262 ◽

Cited By ~ 2

Author(s):

Anil Rane ◽

Abhijit Nadkarni ◽

Jaiprada Kanekar ◽

Wenona Fernandes ◽

Hirabai A. Borker ◽

...

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Clinical Outcomes ◽

Alcohol Use Disorder ◽

Rating Scale ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Middle Income ◽

Psychiatric Rating ◽

Psychiatric Rating Scale

Aims and methodTo explore the patterns of alcohol consumption and its impact on clinical outcomes in schizophrenia in low- and middle-income countries. We performed a cross-sectional survey of 315 patients with schizophrenia and calculated the prevalence of alcohol consumption and alcohol use disorder. The patients' sociodemographic profiles and clinical outcomes, including Brief Psychiatric Rating Scale (BPRS) scores, were compared between abstainers and drinkers using the χ2- andt-tests.ResultsThe 1-year prevalence of drinking, hazardous drinking and alcohol dependence was 16.8% (95% CI 12.9–21.4), 5.7% (95% CI 3.4–8.9) and 2.5% (95% CI 1.1–4.9), respectively. Male gender, single or post-marital status, higher education and being economically active were significantly associated with alcohol consumption. Alcohol drinkers were significantly more likely to be on combination psychotropics compared with abstainers. The mean total BPRS score was significantly lower in alcohol drinkers compared with abstainers. Drinking alcohol was associated with fewer deficit symptoms.Clinical implicationsCultural settings have a significant impact on the prevalence of alcohol use disorder in schizophrenia.

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Neuropsychiatric symptoms in patients with thymoma-associated and non-thymoma myasthenia gravis

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v20i2.519 ◽

2014 ◽

Vol 20 (2) ◽

pp. 4

Author(s):

Carla Freeman ◽

I Lewis ◽

J M Heckmann

Keyword(s):

Myasthenia Gravis ◽

Rating Scale ◽

Neuropsychiatric Symptoms ◽

Severe Disease ◽

Severe Depression ◽

Cross Sectional Study ◽

Depression Symptoms ◽

Young Mania ◽

Cross Sectional ◽

Psychiatric Rating Scale

Background. Around 10 - 15% of patients with myasthenia gravis (MG) have a thymoma, and non-motor symptoms are more frequent in these patients. We hypothesised that neuropsychiatric symptoms would also be more frequent. Methods. A cross-sectional study of 30 consecutive MG patients attending a clinic at Groote Schuur Hospital, Cape Town, South Africa, was done over a 6-month period in 2010. Each patient underwent a series of single-blinded neuropsychiatric assessments, including the 16-item, self-reported Flanagan Quality of Life (QOL) scale, the Beck Depression Inventory second version, the Young Mania Rating Scale, the Hamilton Anxiety Rating Scale and the Brief Psychiatric Rating Scale (BPRS). Results. The frequency and nature of neuropsychiatric symptoms were similar between thymoma (n=9) and non-thymoma (n=21) MG patients. Symptoms of moderate or severe depression and anxiety were present in around 30%. The severity of depression symptoms correlated with MG severity. Prednisone dosing was not associated with neuropsychiatric symptoms or QOL scores. Those with longer duration of MG were more likely to have higher scores on the BPRS and anxiety scales. Those with younger-onset MG had higher BPRS scores and a tendency to suicidal behaviour. Conclusion. Although no association with thyoma was found, this study shows that neuropsychiatric conditions may be underdiagnosed in patients with MG. Systematic depression screening should be done at outpatient clinics, particularly for those who developed symptoms at a young age, those with severe disease and those with a long duration of illness.

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The association between family dysfunction and admission to an acute mental health inpatient unit: a prospective study

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2019.41 ◽

2019 ◽

pp. 1-11

Author(s):

J. H. P. Tan ◽

C. Conlon ◽

A. Tsamparli ◽

D. O’Neill ◽

D. Adamis

Keyword(s):

Mental Health ◽

Family Dynamics ◽

Rating Scale ◽

Mental Illnesses ◽

Family Assessment ◽

Family Assessment Device ◽

Brief Psychiatric Rating Scale ◽

General Functioning ◽

Psychiatric Rating ◽

Psychiatric Rating Scale

Objectives:With the shift from deinstitutionalization to community care in mental health services, relatives of persons with severe and enduring mental illnesses have had to take over the role as primary caregivers. Disturbed family dynamics have been observed within families with an ‘ill’ member. Although schizophrenia and related mental illnesses are biologically based disorders, environmental stress (including stress within family relationships) plays a major role in the onset and maintenance of symptoms. With this study, we assume that family dynamics play a central role in the course of severe psychiatric illness and hypothesized that dysfunction within family systems is a prognostic indicator of hospitalization in the course of schizophrenia/bipolar and schizoaffective disorders.Methods:Prospective, observational cohort study evaluating family functioning of 121 patients (schizophrenia/bipolar and schizoaffective disorder) from community at baseline and followed-up over 12-month period after recruitment. Measurements included demographics, diagnosis, Family Assessment Device – General Functioning, Perceived Criticism Scale, Brief Psychiatric Rating Scale, Global Assessment of Functioning and Social Support Questionnaire-6.Results:Significant differences found between patients admitted and not admitted during the 12-month time period for age (p = 0.003), Brief Psychiatric Rating Scale (BPRS; p = 0.026), Family Assessment Device – General Functioning (FAD-GF; p = 0.007) and Social Support Questionnaire total satisfaction level (p = 0.042) at baseline. Bivariate analysis showed that those admitted into hospital were younger with a higher BPRS score, less social satisfaction and disturbed family dynamics. FAD-GF (p = 0.006) and age (p = 0.022) were significant independent predictors for admission.Conclusion:This provides further evidence supporting importance of promoting better family functioning through modified family dynamics, integrating and involving family into the care of such patients.

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Aripiprazole is effective for the improvement of psychotic symptoms in patients with dementia with lewy bodies

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2008 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S543-S543

Author(s):

Y. Kikuchi ◽

T. Kanbayashi ◽

T. Shimizu

Keyword(s):

Dementia With Lewy Bodies ◽

Rating Scale ◽

Clinical Status ◽

Lewy Bodies ◽

Study Endpoint ◽

Psychotic Symptoms ◽

Clinical Dementia Rating ◽

The Mean ◽

Competing Interest ◽

Psychiatric Rating Scale

ObjectiveDementia with lewy bodies (DLB) is commonly considered the second most common form of dementia. The purpose of this study is to investigate the treatment effects of aripiprazole in patients with DLB.MethodsEleven patients who had meet the criteria for DLB participated in this study. The presence of psychotic symptoms was confirmed by scores of either the delusions or hallucinations items of the Neuropsychiatric Inventory (NPI) score. Patients who had 25 or more on the Mini-mental State Examination Scale (MMSE) at the entry or having brain damage were excluded. Aripiprazole was initiated at a low dose (3 or 6 mg/day) and titrated to higher doses at 2-weeks intervals or more rapidly based on investigator's judgment. Previous medications prior to aripiprazole administration were not changed through this trial. Patient's clinical status was assessed at baseline, then 2 weeks during the study by using NPI, Clinical Global Impression (CGI) and Brief Psychiatric Rating Scale (BPRS) to measure psychotic behavioral symptoms, and Simpson-Angus Scale (SAS) to measure parkinsonism symptoms. Clinical Dementia Rating (CDR) and MMSE were carried out at screening and end point to evaluate cognitive function.ResultsThe mean scores of the SAS and CDR were significantly decreased at the study endpoint compared to baseline. The mean scores of the NPI and BPRS improved up until 4 weeks after having started aripiprazole. After 4 weeks, improvements slowed. The mean score of the CGI-S was decreased up until 8 weeks.ConclusionThis study shows that aripiprazole may be effective for the treatment of psychotic symptoms in patients with DLB.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Relationships Between Smoking, Psychopathology and Medication Outside Effects in Schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.105 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S273-S273

Author(s):

L. Ghanmi ◽

K. Zitoun ◽

L. Zouari ◽

M. Maalej

Keyword(s):

Negative Symptoms ◽

Rating Scale ◽

Age Of Onset ◽

Smoking Status ◽

Cross Sectional Study ◽

Cross Sectional ◽

Clinical Variables ◽

Extrapyramidal Signs ◽

Schizophrenic Patients ◽

Competing Interest

AimTo determine the relationship between smoking status and clinical characteristics of schizophrenic patients.MethodsIt was a cross-sectional study. One hundred and seventy-five schizophrenic outpatients were assessed by the Positive And Negative Syndrome Scale (PANSS), the Global Assessment of Functioning Scale (GAF), the scale of measurement of abnormal involuntary movements (AIMS) and by the rating scale akathisia caused by a drug Thomas Barnes. Current smokers (n = 85) were compared to non-smokers (n = 90) on clinical variables.ResultsThe mean number of cigarettes was 15 cig/day. In our sample, current smokers account for half of the patients and were exclusively men. Smokers were significantly more single patients (76.5 vs. 58.9, P = 0.01). There were no significant differences between smokers and non-smokers regarding clinical variables, including age of onset of the disease, the duration of the disease, the severity of positive and negative symptoms, and GAF scores. Smoking was significantly associated with more frequent prescription of conventional neuroleptics (98.8 vs. 92%, P = 0.03) and poorer adherence to treatment (77 vs. 62.2%, P = 0.02). There were no significant differences between the 2 groups regarding the average doses of neuroleptics, the presence of extrapyramidal signs, scores on the AIMS score and akathisia.ConclusionSmoking is common in patients suffering from schizophrenia. Smoking status should be considered in the assessment of neuroleptic treatment in schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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