Adherence to treatment and number of relapses in patients treated with atypical antipsychotic prolonged release

IntroductionThe extended release injectable offers a good alternative for those patients with no or poor adherence to treatment. Numerous studies indicate that decrease the number of relapses in such individuals. Our aim is to check whether a group of our patients diagnosed with dual pathology coincide with these data.MethodsWe followed a group of 5 patients diagnosed with paranoid schizophrenia or delusional disorder with drug consumption in the last year. We measured the number of relapses, understood as the number of visits to emergency and outpatient devices Mental Health Hospitals and hospitalizations six months before the start of treatment with aripiprazole injectable extended release and six months after.ResultsThe preliminary results point to a significant reduction in the number of emergency room visits and hospitalizations after starting sustained release injectable treatment.ConclusionsOur preliminary results are consistent with the literature, we found also reduced consumption of toxic and better adherence to drug addiction devices. The new antipsychotics extended release is a good alternative for patients with dual diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Therapeutic compliance in patients with psychosis in an outpatient setting

European Psychiatry ◽

10.1016/s0924-9338(11)72871-1 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1166-1166

Author(s):

M.A. Ruiz Feliu ◽

M.C. Campos Mangas

Keyword(s):

Extended Release ◽

Psychotic Disorders ◽

Hospital Admissions ◽

Mental Health Center ◽

Outpatient Setting ◽

Functional Improvement ◽

Psychotic Symptoms ◽

Prolonged Release ◽

Adherence To Treatment ◽

One Year

IntroductionNumerous studies show that patients with psychotic disorders have low rates of adherence, which is the main cause of relapses and hospital admissions. It is fundamental to long-term drug treatment in the management of patients with psychosis, both in preventing relapses and the consequences that flow from them (hospital admissions, clinical deterioration, loss of functionality and quality of life of patients)ObjectivesAssess the benefits to be derived from the use of extended-release injectable antipsychotics in regard to adherence to treatment, the persistent improvement of psychotic symptoms and reducing the number of hospital admissionsMethodsDescriptive study. Sample: 40 patients diagnosed with schizophrenia or schizoaffective disorder treated at a mental health center. Patients are divided into two treatment groups: 20 patients are treated with risperidone in prolonged release of more than one year duration and the other group treated with oral antipsychotics.ResultsAdherence to treatment is higher in the group treated with injectable antipsychotics (90%) than with oral (50%). The age range from 20 to 61 years. The average hospitalization was greater for the group treated with antipsychotic injections in the period prior to treatment (17) compared to post-injection treatment outcome (5). In patients with oral antipsychotics were 20 hospitalizations in total.ConclusionsConfirms the results on adherence and hospitalizations compared to other similar studies. There is a clinical and functional improvement, fewer hospitalizations, shorter average stays and higher outpatient adherence in patients with extended-release injectable antipsychotics compared with the group of patients with oral antipsychotics.

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Agitation in the patient with dual pathology

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.243 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S143-S143

Author(s):

L. Hernández Plaza ◽

M. García Navarro ◽

E. Delgado Parada ◽

E. Ochoa Mangado ◽

E. Salvador Vadillo ◽

...

Keyword(s):

Male Patient ◽

Paranoid Schizophrenia ◽

Good Alternative ◽

Toxic Substances ◽

Pharmacological Treatments ◽

Pharmacological Management ◽

Dual Pathology ◽

Feasible Option ◽

Competing Interest ◽

New Formulation

IntroductionThe consumption of toxic substances often causes agitation, which makes more difficult the pharmacological management of the symptoms.ObjectiveAbout one case, a search was performed of the different therapeutic options in the agitation takes place in the context of intoxication.MethodsThirty-five-year-old male patient diagnosed of dual pathology under treatment since 2003 in our outpatient. The patient shows paranoid schizophrenia disorder due to alcohol, cannabis and cocaine use disorder, summing up different pharmacological treatments with no remission. Whilst the examination is taking place the patient is under alcohol and cannabis effects. His physical and verbal behaviour are aggressive showing psychotic instability. The therapeutic team administers loxapine to its patient.ResultsThe inhaled loxapine turned out to be a good alternative in the case given.ConclusionHandling agitation when toxics are involved is complex. The new formulation of inhaled loxapine helps to control agitation quickly and it might be a feasible option for this kind of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Reflection of local and universal historical time in symptoms of paranoid schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.674 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S515-S516

Author(s):

E. Molchanova ◽

R. Tsoy ◽

I. Sim

Keyword(s):

Clinical Picture ◽

Paranoid Schizophrenia ◽

Historical Time ◽

Political Events ◽

The Social ◽

Significant Phenomenon ◽

History Of ◽

Competing Interest ◽

Clinical Cases

Psychopathological signs reflect general and significant phenomenon, the whole “extract” of a particular historical time, consisting of a bizarre set of events, influential characters twisted in an individual history of a patient. Except detailed “real” clinical picture reflecting socio-political events, authors consider formatting mechanisms of “unreal” content of hallucinatory-delusional symptoms. In such cases, main heroes are mythological characters for example gins or intimidating heroes of modern movies like vampires and zombies. Events in the social sets, such as Facebook and Instagram are also reflected in experiences of patients. Authors focus their attention on a paradox of logical reflection of events in the context of delusional symptoms versus paralogical interpretations. Research is based on clinical cases, and shows up a spectrum of mechanisms of how events are either included or ignored in the forming a content of psychopathological experiences.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Major psychotrauma and social stress–risk factors for the unfavorable course of paranoid schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1664 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s842-s843

Author(s):

T. Udristoiu ◽

I. Udristoiu ◽

F. Militaru ◽

S. Ristea ◽

A.G. Vilcea ◽

...

Keyword(s):

Physical Abuse ◽

Social Stress ◽

Suicide Attempts ◽

Paranoid Schizophrenia ◽

Childhood And Adolescence ◽

Social Interventions ◽

Prophylactic Measures ◽

Endogenous Cortisol ◽

Icd 10 ◽

Competing Interest

IntroductionRecent studies in the neurobiology of schizophrenia highlighted the role of neuropsychoendocrine activations as a consequence of psychostress followed by the activation of the HPA axis with an excess of endogenous cortisol. The relation endogenous cortisol–glutamatergic hyperactivation enhances the excito-toxic mechanisms and the cortical-subcortical alterations in schizophrenia.MethodWe conducted a retrospective study on 40 patients, with ages between 25 and 55 years, admitted in the university clinic of Craiova between January 1, 2015 and December 31, 2015 for paranoid schizophrenia according to ICD-10 criteria and with positive history of psychotrauma and physical abuse in childhood and adolescence.ResultsThe frequency of psychotraumas, social stress and physical abuse in our group was significantly higher in women (63.33%), in patients with urban residence (80.00%) and age group 36–45 years (46.67). There was a pattern of residual defectuality reflected by positive symptoms (83.33%), alcohol abuse (80.00%), aggressive behavior (66.67%) and suicide attempts (30.00%). The poor course with minimal social functioning (GAFS < 40; 36.67%) was correlated with a high number of relapses and hospitalizations (> 9 hospitalizations; 43.33%), cognitive deficit (MMSE < 23; 76.67%). The psychosocial factors involved in the pathogenesis and course of schizophrenia were social stress (60.00%), physical abuse in childhood and adolescence (20.00%) and psychotraumas (20.00%).Conclusions.Psychotrauma and physical abuse in childhood and adolescence and during the course of paranoid schizophrenia constitute a risk factor for a poor outcome with cognitive deterioration, aggressive and suicidal behavior that call for prophylactic measures and qualified psycho-social interventions associated to the pharmacological treatments.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Alcohol and dual disorder. Paliperidone palmitate effectiveness

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1074 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S314-S315

Author(s):

M.R. Raposo ◽

V. Ivanov ◽

I. Martínez ◽

A.L. González ◽

M.D. Piqueras ◽

...

Keyword(s):

Alcohol Use ◽

Dual Diagnosis ◽

Extended Release ◽

Health Centre ◽

Total Sample ◽

Paliperidone Palmitate ◽

First Episode ◽

Mental Health Centre ◽

Dual Disorder ◽

Competing Interest

IntroductionAlcohol use is a common behavior in most people in our society. A first episode of alcoholism can be fully recovered through specialized treatment and other protective factors and need not become a relapse later.ObjectivesWhether there are differences in alcohol use after 1, 3 and 6 months after the administration of paliperidone palmitate extended-release injectable suspension in a sample of patients.Material and methodsThis is a descriptive study that analyzed the differences observed with respect to alcohol use after administration of paliperidone palmitate in a sample of 98 patients attending in a Mental Health Centre, in the Unit for drug dependency to present pathology dual.ResultsThe percentage of alcohol use at baseline is 56.1% of the total sample.One month after treatment with paliperidone palmitate the percentage of use is reduced to 31.6%. At 3 months of treatment the reduction is more significant assuming only the 6.1% of the total sample. Finally after 6 months of treatment the percentage of patients maintaining alcohol use is 4.1%, which represents a 52% reduction compared to the initial rate of use.ConclusionsThe data reflect a 92% reduction in alcohol use after 6 months of the administration of paliperidone palmitate.We can say that paliperidone palmitate is effective in reducing alcohol use in patients with dual diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Characterization of a Referral to Psycho-Oncology Liaison Consults in a General Hospital

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1839 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S499-S500

Author(s):

J. Ramos ◽

A. Oliveira

Keyword(s):

Depressive Disorders ◽

Well Being ◽

Adherence To Treatment ◽

Liaison Psychiatry ◽

Cancer Disease ◽

Family Service ◽

Psychological Suffering ◽

Competing Interest ◽

Mental Well Being

IntroductionLiaison psychiatry is based on a practice that lies on the interface between psychological, sociological and biological factors of illness. Cancer is a devastating disease. For many patients the occurrence of it is synonymous of chronic, severe or lethal outcome. It is important for health professionals to be aware of the psychological suffering of these patients and promote a proper use of specialized consultations in order to increase and improve adherence to treatment.AimsTo make known the reality of referral to a Psycho-Oncology Liaison consult and its context in literature.MethodsData collection on applications for the 1st request to Psycho-Oncology liaison consults occurred between 2010–2012 in the variables, gender, age, reason for referral, psychiatric history, cancer diagnosis, knowledge of the referral and who does (patient/family/service) and psychiatric diagnosis. Statistical analysis with Microsoft Excel 2010®.ResultsIt was found that there were 83 applications during the three years, 24 men and 59 women. The most prevalent cancer diagnoses were breast cancer (29.89%) and colorectal carcinoma (19.28%). Most patients had knowledge of the request (75.9%). The reason was mostly for Anxiety and Depression (33.73%).ConclusionCancer disease coupled with feelings of loss of autonomy, hopelessness and pain can lead the patient to develop psychopathology of anxious-depressive disorders. This condition may hamper the normal recovery of the patient. The promotion of mental well-being in cancer patients is critical to recovery and leads to a better adherence to treatment, inclusive can influence survival.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Psychiatrists’ opinion on treatment adherence in Delusional Disorder

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2111 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S570-S570

Author(s):

B. Girela Serrano ◽

L. Aguado Bailón ◽

P. Calvo ◽

J.E. Muñoz Negro ◽

J. Cervilla Ballesteros

Keyword(s):

Treatment Adherence ◽

Health Care Services ◽

Delusional Disorder ◽

Poor Adherence ◽

Adherence To Treatment ◽

Care Services ◽

Active Compliance ◽

Competing Interest ◽

Long Acting ◽

High Level

IntroductionDelusional Disorder (DD) F22 is a disease with low prevalence, probably underdiagnosed by clinical specialists due to the high level of functionality, low awareness of disease, low deterioration of patients and poor adherence to prescribed treatment. Adherence to treatment is considered to be one of the major difficulties that stand in the way of the treatment of DD. The present paper assessed psychiatrists’ opinion of the adherence to treatment of patients with DD.Material and methodsA self-administered survey was conducted on a sample of psychiatrists proceeding on a wide array of mental health care services. Participants provided their opinions regarding adherence to treatment. Descriptive statistics were subsequently calculated with SPSS.ResultsIn the opinion of our participants none of the patients have an active compliance of the treatment, 36% consider that the participation is partial or passive. It is also estimated that 57.5% reject the treatment but not totally and 6.5% believe that rejection is absolute.ConclusionsLiterature informs of the association of poor adherence to treatment and little or no improvement of patients, suggesting the need to address the lack of compliance and adherence to treatment as a crucial aspect to improve the prognosis of DD. To address this problem Long Acting Injections (LAIs) of Atypical Antipsychotics are postulated to be a plausible solution as a good treatment strategy. In order to improve the clinical practice in DD and obtain information for further effectiveness we emphasize the need of implementing clinical studies.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Antipsychotic injectable treatment in patients with involuntary ambulatory treatment

European Psychiatry ◽

10.1016/s0924-9338(11)72935-2 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1230-1230

Author(s):

L. Borreda Belda ◽

L. Borreda ◽

R. Maravall ◽

J.F. Perez ◽

M. Grau ◽

...

Keyword(s):

Oral Treatment ◽

Demographic Variables ◽

Antipsychotic Treatment ◽

Adherence To Treatment ◽

Ambulatory Treatment ◽

Injectable Treatment ◽

Psychiatric Outpatient Clinic ◽

Schizophrenic Patients ◽

Long Acting ◽

Seriously Ill Patients

IntroductionInvoluntary Ambulatory Treatment (IAT) is a judicial measure existing in Spain. Its aim is to ensure the adherence to treatment of seriously ill patients, with poor insight and repeated hospitalization. This is done by means of the regular and involuntary administration of antipsychotic intramuscular medication.ObjectivesTo assess the treatment used in patients undergoing IAT in a local clinic, to assess the type of medicaments and their dosage and to verify adherence to treatment and evolution.Material and methodA revision was made of the clinical backgrounds of all the patients of a psychiatric outpatient clinic who have been submitted to IAT (n = 37). A note was made of socio-demographic variables as well as psychiatric diagnoses according to DSM-IV-TR criteria and the number of hospitalizations and treatments used.ResultsAll but one patient had been hospitalized and average of 3.53 times before IAT. Since undergoing IAT only 6 patients have been admitted (16%). Four of them relapsed having abandoned treatment.In seven cases (19%) the patients gained insight and the antipsychotic treatment was changed from injectable to oral treatment at the patients’ request. In these cases IAT was ceased.The antipsychotic prescribed in 59% of the cases was Long-Acting Injectable Risperidone. This percentage was higher in non- schizophrenic patients (84%).ConclusionsIn our environment IAT could be an effective tool for severe patients with nil insight, since it can bring about an improvement in treatment adherence and evolution, as well as insight.

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