Incident infection during the first year of treatment – A comparison of clozapine and paliperidone palmitate long-acting injection

2022 ◽  
pp. 026988112110589
Author(s):  
Shubhra Mace ◽  
Olubanke Dzahini ◽  
Victoria Cornelius ◽  
Hadar Langerman ◽  
Ebenezer Oloyede ◽  
...  
Keyword(s):  
Mental Health ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Paliperidone Palmitate ◽  
First Year ◽  
Risk Of Infection ◽  
Long Acting ◽  
First Time ◽  
Health Trust ◽  
Incident Infection

Background: To examine the risk of infection in patients prescribed clozapine compared with patients prescribed paliperidone palmitate long-acting injection (PPLAI). Method: A retrospective, 1-year, cohort study conducted on events occurring in eligible patients beginning treatment for the first time with clozapine or PPLAI between June 2017 and June 2019 in a UK mental health trust providing in-patient and out-patient services. Results: The study included 64 patients starting clozapine and 120 patients starting PPLAI. Incidence of infection was greater in clozapine starters than in PPLAI starters (28% vs 6%; p = 0.001; adjusted odds ratio 5.82 (95% confidence interval (CI) = 2.15–15.76, p = 0.001). Infectious episodes in clozapine patients were not related to changes in neutrophil counts. Incident infection in the clozapine group was highest in the first 3 months of treatment. The most commonly reported infection in the clozapine group was chest infection; however, the majority of infections were non-chest-related. Conclusion: Patients starting clozapine showed a substantially increased likelihood of infection compared with patients starting PPLAI.

Abstract WP200: Post-operative Infection Does not Increase Risk of Post-operative Stroke: Analysis From a Nationwide Quality Initiative Program

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Benjamin R Kummer ◽  
Rebecca Hazan ◽  
Hooman Kamel ◽  
Alexander E Merkler ◽  
Joshua Z Willey ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Odds Ratio ◽  
Postoperative Infection ◽  
Adjusted Odds Ratio ◽  
Risk Of Infection ◽  
Postoperative Stroke ◽  
Increased Risk ◽  
Increase Risk ◽  
Initiative Program ◽  
The Relationship

Introduction: Infection has been described as a trigger for acute ischemic stroke, but the relationship between postoperative infection and the risk of postoperative stroke is unclear. We investigated the association between postoperative infection and stroke using the American College of Surgeons National Surgical Quality Initiative Program (NSQIP) database. Hypothesis: Postoperative infection is associated with an increased risk of postoperative stroke. Methods: We used the NSQIP database to identify all patients who underwent surgery between the years of 2000 and 2010 and developed a postoperative stroke within 30 days of surgery. The group was further stratified according to the presence of infection preceding stroke. Using a logistic regression model adjusted for age, race, sex, medical comorbidities, surgical type, and dichotomized functional status, we compared the risk of stroke in patients with and without preceding infections, and investigated the risk of infection following stroke. Results: 729,886 surgical patients were identified, of whom 2,703 (0.3%) developed postoperative stroke. 848 (0.12%) patients developed both postoperative stroke and infection. Among patients who had postoperative stroke, 100 (3.7%) had developed an infection prior to developing a stroke. Patients with infection prior to stroke had a lower risk of stroke than patients who did not develop infection prior to stroke (adjusted odds ratio [OR] 0.25, 95%CI 0.20-0.32). 748 patients (0.1%) developed an infection after having a postoperative stroke. These patients had a higher risk of infection (incidence rate ratio 2.76, 95%CI 2.57-2.97) and a higher odds of infection (adjusted odds ratio [OR] 3.47, 95%CI 3.18-3.78) than patients who did not have a stroke. Conclusions: We found that the presence of a preceding infection was associated with a low risk of postoperative stroke in a large surgical inpatient sample. Although the total number of strokes may have been under-reported, these results conflict with other studies that report that infection is a trigger for ischemic stroke. Further analyses using more granular data are needed to investigate the relationship between postoperative infection and the risk of postoperative stroke.

Prevalence and epidemiological associates of novel psychedelic use in the United States adult population

2019 ◽  
Vol 33 (9) ◽  
pp. 1058-1067 ◽  
Author(s):  
James D Sexton ◽  
Michael S Crawford ◽  
Noah W Sweat ◽  
Allyson Varley ◽  
Emma E Green ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Psychological Distress ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Adult Population ◽  
The United States ◽  
Psychosocial Characteristics ◽  
Illicit Use ◽  
Directed Research

Background: Novel psychedelics approximate classic psychedelics, but unlike classic psychedelics, novel psychedelics have been used by humans for a shorter period of time, with fewer data available on these substances. Aims: The purpose of this study was to determine the prevalence of novel psychedelic use and the associations of novel psychedelic use with mental health outcomes. Methods: We estimated the prevalence of self-reported, write-in lifetime novel psychedelic use and evaluated the associations of novel psychedelic use with psychosocial characteristics, past month psychological distress, and past year suicidality among adult respondents pooled from years 2008–2016 of the National Survey on Drug Use and Health (weighted n=234,914,788). Results: A fraction (weighted n=273,720; 0.12%) reported lifetime novel psychedelic use. This cohort tended to be younger, male, and White, have greater educational attainment but less income, be more likely to have never been married, engage in self-reported risky behavior, and report lifetime illicit use of other drugs, particularly classic psychedelics (96.9%). (2-(4-Bromo-2,5-dimethoxyphenyl)ethanamine) (2C-B) (30.01%), (2,5-dimethoxy-4-iodophenethylamine) (2C-I) (23.9%), and (1-(2,5-dimethoxy-4-ethylphenyl)-2-aminoethane) (2C-E) (14.8%) accounted for the majority of lifetime novel psychedelic use. Although lifetime novel psychedelic use was not associated with psychological distress or suicidality compared to no lifetime novel psychedelic use or classic psychedelic use, relative to lifetime use of classic psychedelics but not novel psychedelics, lifetime novel psychedelic use was associated with a greater likelihood of past year suicidal thinking (adjusted Odds Ratio (aOR)=1.4 (1.1–1.9)) and past year suicidal planning (aOR=1.6 (1.1–2.4)). Conclusion: Novel psychedelics may differ from classic psychedelics in meaningful ways, though additional, directed research is needed.

scholarly journals The effect of the 2008 recession on well-being and employment status of people with and without mental health problems

2019 ◽  
Vol 30 (4) ◽  
pp. 761-766 ◽  
Author(s):  
Unnur Jónsdóttir ◽  
Edda Björk þórðardóttir ◽  
Thor Aspelund ◽  
þórarinn Jónmundsson ◽  
Kristjana Einarsdóttir
Keyword(s):  
Mental Health ◽  
Perceived Stress ◽  
Odds Ratio ◽  
Employment Status ◽  
Adjusted Odds Ratio ◽  
Mental Health Problems ◽  
Well Being ◽  
Health Problems ◽  
Study Cohort ◽  
Increased Risk

Abstract Background The world was hit hard by the 2008 recession which led to increased unemployment and financial strain. However, how the recession affected people with pre-existing mental health problems has been understudied. This study investigates the effect of the 2008 recession in Iceland on stress, well-being and employment status of people with regard to whether they are suffering from mental health problems. Methods The study cohort included participants (18–69 years old) of the ‘Health and Wellbeing of Icelanders’, a 3-wave survey conducted before (in 2007) and after (in 2009 and 2012) the recession in 2008. Self-assessed well-being was measured with the Short Warwick-Edinburgh Mental Well-being Scale and the 4-item Perceived Stress Scale. Logistic regression was used to assess the effect of the 2008 recession on self-assessed well-being and employment status in 2009 and 2012, using 2007 as a reference year. Results Participants with no pre-recession mental health problems were at increased risk of both poor well-being, (with adjusted odds ratio at 1.66, in 2009 and 1.64 in 2012) and higher perceived stress, (with adjusted odds ratio at 1.48 in 2009 and 1.53 in 2012), after the recession. Interestingly, no significant change in well-being and perceived stress was observed among participants suffering from pre-recession mental health problems. Both groups had increased risk of unemployment after the recession. Conclusion Results indicate that after recessions, the risk of stress and poor well-being increases only among those who do not suffer from pre-recession mental health problems.

scholarly journals Ethnicity and quality of antipsychotic prescribing among in-patients in south London

2008 ◽  
Vol 193 (2) ◽  
pp. 161-162 ◽  
Author(s):  
Anne Connolly ◽  
David Taylor
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
High Dose ◽  
Median Dose ◽  
Black And White ◽  
Prescribing Quality ◽  
Black Patients

SummaryEthnicity may influence treatment decisions in mental disorders. We undertook a survey of the prescribing of antipsychotics for in-patients in three south London mental health trusts. A total of 255 patients (152 White, 103 Black) were included. Median dose of antipsychotic (% of licensed dose) was 58.3% for White and 50.0% for Black patients (adjusted effect size=0.14, 95% CI −0.34 to 0.63). High-dose antipsychotics were prescribed to 15.1% of White and 11.7% of Black patients (adjusted odds ratio (OR)=0.5, 95% CI 0.19–1.33), and antipsychotic polypharmacy was recorded for 25.7% and 31.1% respectively (adjusted OR=3.05, 95% CI 1.44–6.46). Prescribing quality was similar for Black and White patients.

Paliperidone palmitate: Experience in a community mental health unit

2017 ◽  
Vol 41 (S1) ◽  
pp. s804-s805
Author(s):  
L. Carrión Expósito ◽  
G.M. Chauca Chauca ◽  
E.L. Guadalupe
Keyword(s):  
Mental Health ◽  
Retrospective Study ◽  
Maintenance Dose ◽  
Lower Number ◽  
Paliperidone Palmitate ◽  
Health Unit ◽  
Dose Number ◽  
Competing Interest ◽  
Long Acting ◽  
Mental Health Unit

IntroductionThere are many jobs that offer advantages of treatment with long-acting injectable in psychosis.ObjectiveTo know the changes in the different variables after the start of paliperidone palmitate (PP).Material and methodWe performed a descriptive and retrospective study. Were evaluated patients who received maintenance therapy with PP during 48 months.ResultsThe sample was composed of 29 patients: 72.4% men and 27.6% women. Average age of 46.21 years. In Figures 1, 2 and 3 show data obtained in relation to compliance with treatment, relapse, maintenance dose, number of admissions and visits to emergency departments respectively.ConclusionsThe administration of PP is associated with a higher level of compliance with treatment. The patients presented a lower number of relapses, hospitalizations and visits to the emergency room. The maintenance dose more used is 150 mg.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Factors Associated With Increased Dissemination of Positive Mental Health Messaging On Social Media

Crisis ◽  
2020 ◽  
Vol 41 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Steven A. Sumner ◽  
Daniel A. Bowen ◽  
Brad Bartholow
Keyword(s):  
Mental Health ◽  
Social Media ◽  
Logistic Regression ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Positive Mental Health ◽  
Affective States ◽  
Factors Affecting ◽  
Linguistic Style ◽  
Factors Associated

Abstract. Background: The dissemination of positive messages about mental health is a key goal of organizations and individuals. Aims: Our aim was to examine factors that predict increased dissemination of such messages. Method: We analyzed 10,998 positive messages authored on Twitter and studied factors associated with messages that are shared (re-tweeted) using logistic regression. Characteristics of the account, message, linguistic style, sentiment, and topic were examined. Results: Less than one third of positive messages (31.7%) were shared at least once. In adjusted models, accounts that posted a greater number of messages were less likely to have any single message shared. Messages about military-related topics were 60% more likely to be shared (adjusted odds ratio [AOR] = 1.6, 95% CI [1.1, 2.1]) as well as messages containing achievement-related keywords (AOR = 1.6, 95% CI [1.3, 1.9]). Conversely, positive messages explicitly addressing eating/food, appearance, and sad affective states were less likely to be shared. Multiple other message characteristics influenced sharing. Limitations: Only messages on a single platform and over a focused period of time were analyzed. Conclusion: A knowledge of factors affecting dissemination of positive mental health messages may aid organizations and individuals seeking to promote such messages online.

scholarly journals Associations Between Reproductive Coercion, Partner Violence, and Mental Health Symptoms Among Young Black Women in Baltimore, Maryland

2019 ◽  
pp. 088626051986090
Author(s):  
Kamila A. Alexander ◽  
Tiara C. Willie ◽  
Raegan McDonald-Mosley ◽  
Jacquelyn C. Campbell ◽  
Elizabeth Miller ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Black Women ◽  
Partner Violence ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Care Practice ◽  
Ptsd Symptoms ◽  
Community Based ◽  
Reproductive Coercion

This study examined the associations of reproductive coercion (RC) with mental health of Black adolescent and young adult women. We tested RC as a predictor of depression and post-traumatic stress disorder (PTSD) symptoms. We also explored the interaction of exposure to RC and physical and sexual intimate partner violence (IPV) as they relate to depression and PTSD symptoms. A primarily community-based convenience sample of 188 self-identified Black women, aged 18 to 25 years, in Baltimore, Maryland, completed computer-based cross-sectional surveys. Lifetime RC (37.8%) and IPV (48.9%) were prevalent in this sample. Nearly 10% of the young women reported experiencing RC without IPV; 38% of the sample reported experiencing both types of violence. Depression (69%) and PTSD (47.1%) symptoms were more prevalent among women with RC than among women without RC. Adjusted results revealed RC and IPV were independently associated with depression (adjusted odds ratioRC = 2.86, 95% CI = [1.38, 5.94] and adjusted odds ratioIPV = 5.15, 95% CI = [2.47, 10.76]). Similarly, RC and IPV were independently associated with PTSD (adjusted odds ratioRC = 2.41, 95% CI = [1.15, 5.08] and adjusted odds ratioIPV = 3.04, 95% CI = [1.39, 6.63]). Findings suggest that RC and IPV independently contribute to mental health morbidities among this population of women. Current policies in health care practice increasingly recommend provision of screening for IPV, including RC. These practices should extend to women receiving services in community-based settings, thus strengthening the linkage to referral for further mental health treatment and victim service support. In the context of the social burdens affecting young Black women’s health, a comprehensive approach that integrates mental health and reproductive/sexual health care is essential for women reporting RC experiences.

scholarly journals Is There a Sex Gap in Surviving an Acute Coronary Syndrome or Subsequent Development of Heart Failure?

Circulation ◽  
2020 ◽  
Vol 142 (23) ◽  
pp. 2231-2239
Author(s):  
Justin A. Ezekowitz ◽  
Anamaria Savu ◽  
Robert C. Welsh ◽  
Finlay A. McAlister ◽  
Shaun G. Goodman ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
St Segment Elevation ◽  
Vessel Disease ◽  
St Segment ◽  
First Time ◽  
Angiographic Findings ◽  
Over Time

Background: We hypothesized that disparities between sexes in the management of myocardial infarction (MI) may have changed over time, and thus altered the prognoses after MI, especially the risk for the development of heart failure. Methods: Using a large population-based cohort of patients with MI between April 1, 2002, and March 31, 2016, we examined the incidence, angiographic findings, treatment (including revascularization), and clinical outcomes of patients with a first-time MI. To elucidate the differences between sexes, a series of multivariable models were created to explore all MI and non–ST-segment–elevation MI (NSTEMI) versus ST-segment–elevation MI (STEMI) over time. Results: Between 2002 and 2016, 45 064 patients (13 878 [30.8%] women) were hospitalized with a primary diagnosis of first-time MI (54.9% NSTEMI and 45.1% STEMI). Women were older (median age, 72 versus 61 years), had more comorbidities, and had lower rates of diagnostic angiography than did men (women, 74%, versus men, 87%). When angiography was performed, women had a lower proportion of left main, 2-vessel disease with proximal left anterior descending or 3-vessel disease compared with men (33.4% versus 40.9%, P <0.0001), and a higher frequency of 1-vessel disease or nonobstructive coronary artery disease (39.6% versus 29.1%, P <0.0001). Women had a higher unadjusted rate of in-hospital mortality than did men in both patients with STEMI (women, 9.4%, versus men, 4.5%) and patients with NSTEMI (women, 4.7%, versus men, 2.9%). After adjustment, this difference remained significant in STEMI (adjusted odds ratio, 1.42 [95% CI, 1.24–1.64]) but not in NSTEMI (adjusted odds ratio, 0.97 [95% CI, 0.83–1.13]). After discharge, women developed heart failure after STEMI (women, 22.5%, versus men, 14.9%) as well as after NSTEMI (women, 23.2%, versus men, 15.7%). The adjusted relative risk for women versus men of developing the outcomes of mortality and heart failure remained similar across years, although the differences were nonsignificantly attenuated over 5 years of follow-up. Conclusions: Although some attenuation of differences in clinical outcomes over time has occurred, women remain at higher risk than men of dying or developing heart failure in the subsequent 5 years after STEMI or NSTEMI, even after accounting for differences in angiographic findings, revascularization, and other confounders.

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