scholarly journals Factors associated with adherence to guidelines of good clinical practice during hospital treatment of patients with the first episode of schizophrenia spectrum disorders

2019 ◽  
Vol 76 (10) ◽  
pp. 998-1006 ◽  
Author(s):  
Milena Stasevic ◽  
Ivana Stasevic-Karlicic ◽  
Nevena Divac ◽  
Anita Grgurevic ◽  
Igor Grbic
Keyword(s):  
Clinical Practice ◽  
Good Clinical Practice ◽  
Prescribing Patterns ◽  
Diagnosis And Treatment ◽  
National Guideline ◽  
Psychotic Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Factors Associated ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Background/Aim. Adherence to the guidelines of Good Clinical Practice (GCP) during the treatment of specific disorders is considered a guarantee of the implementation of a uniform, evidence-based clinical practice in psychiatry. The aim of this study was to analyze the concordance of prescribing patterns of antipsychotic drugs with the recommendations of good clinical practice in Serbia and an insight into the effects that introduction of the National Guideline for the Diagnosis and Treatment of Schizophrenia had on the prescribing practice in this area. Methods. Noninterventional, observational study was conducted at the Clinic for Mental Disorders ?Dr Laza Lazarevic? in Belgrade. It included a consecutive sample of 675 previously untreated patients, hospitalized from January 1st, 2012 to December 31st, 2015, dismissed with a discharge diagnosis of any of schizophrenia spectrum disorders. The data about demographic and clinical characteristics of patients, characteristics of prescribers and prescribed antipsychotics were obtained retrospectively, from the patients? medical records. For the analysis of primary data, the descriptive statistical methods and methods for testing statistical hypotheses were used. A method of logistic regression was used to identify the factors associated with adherence to the GCP recommendations. Results. Totaly, 446 (66.1%) of subjects were treated with antipsychotic monotherapy. After the introduction of National Guideline for the Diagnosis and Treatment of Schizophrenia prescribing of second generation antipsychotic monotherapy (78.41% vs. 63.5%, respectively; p < 0.001) increased significantly compared to the previous period. The factors independently associated with adherence to the recommendations of the GCP were the year of hospitalization, the age of the prescriber, and the age and education of the patient. Conclusion. After the introduction of the National Guide to Good Clinical Practice for the Diagnosis and Treatment of Schizophrenia there have been significant, but insufficient changes in the prescribing patterns of antipsychotics during the treatment of the first psychotic episode in Serbia.

Development of a suspicion index for secondary schizophrenia using the Delphi method

2021 ◽  
pp. 000486742110257
Author(s):  
Olivier Bonnot ◽  
Jose Luis Insua ◽  
Mark Walterfang ◽  
Juan Vincente Torres ◽  
Stefan Armin Kolb
Keyword(s):  
Clinical Practice ◽  
Sensitivity And Specificity ◽  
Delphi Method ◽  
Schizophrenia Spectrum Disorders ◽  
Differential Distribution ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Aids Diagnosis ◽  
Suspicion Index

Aim: The aim of this study was to develop a suspicion index that aids diagnosis of secondary schizophrenia spectrum disorders in regular clinical practice. Method: We used the Delphi method to rate and refine questionnaire items in consecutive rounds. Differences in mean expert responses for schizophrenia spectrum disorders and secondary schizophrenia spectrum disorders populations allowed to define low/middle/high predictive items, which received different weights. Algorithm performance was tested in 198 disease profiles by means of sensitivity and specificity. Results: Twelve experts completed the Delphi process, and consensus was reached in 19/24 (79.2%) items for schizophrenia spectrum disorders and 17/24 (70.8%) for secondary schizophrenia spectrum disorders. We assigned rounded values to each item category according to their predictive potential. A differential distribution of scores was observed between schizophrenia spectrum disorders and secondary schizophrenia spectrum disorders when applying the suspicion index for validation to 198 disease profiles. Sensitivity and specificity analyses allowed to set a >8/10/16 risk prediction score as a threshold to consider medium/high/very high suspicion of secondary schizophrenia spectrum disorders. Conclusion: Our final outcome was the Secondary Schizophrenia Suspicion Index, the first paper-based and reliable algorithm to discriminate secondary schizophrenia spectrum disorders from schizophrenia spectrum disorders with the potential to help improve the detection of secondary schizophrenia spectrum disorder cases in clinical practice.

Factors associated with drug attitude in patients with schizophrenia spectrum disorders

2017 ◽  
Vol 188 ◽  
pp. 185-186 ◽  
Author(s):  
Lillian Harber ◽  
Hiroyoshi Takeuchi ◽  
Carol Borlido ◽  
Reza Hamidian ◽  
Gary Remington
Keyword(s):  
Schizophrenia Spectrum Disorders ◽  
Factors Associated ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Drug Attitude

MOTOR PERFORMANCE IN PATIENTS WITH SCHIZOPHRENIA AND SCHIZOPHRENIA SPECTRUM DISORDERS AFTER FIRST PSYCHOTIC EPISODE

2010 ◽  
Vol 117 (2-3) ◽  
pp. 448-449
Author(s):  
Yuliya Zaytseva ◽  
Nataliya Korsakova ◽  
Isaac Gurovich ◽  
Andreas Heinz ◽  
Michael Rapp
Keyword(s):  
Motor Performance ◽  
Psychotic Episode ◽  
Schizophrenia Spectrum Disorders ◽  
First Psychotic Episode ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

The diagnostic boundary between autism spectrum disorder, intellectual developmental disorder and schizophrenia spectrum disorders

2015 ◽  
Vol 9 (5) ◽  
pp. 243-264 ◽  
Author(s):  
Marco O. Bertelli ◽  
Micaela Piva Merli ◽  
Elspeth Bradley ◽  
Roberto Keller ◽  
Niccolò Varrucciu ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Clinical Practice ◽  
Developmental Disorder ◽  
Clinical Presentation ◽  
Autism Spectrum ◽  
Schizophrenia Spectrum Disorders ◽  
Content Type ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Intellectual Developmental Disorder

Purpose – During the last few years the prevalence of autism and Autism Spectrum Disorder (ASD) has increased greatly. A recurring issue is the overlap and boundaries between Intellectual Developmental Disorder (IDD), ASD and Schizophrenia Spectrum Disorders (SSD). In clinical practice with people with IDD, the alternative or adjunctive diagnosis of ASD or SSD is particularly challenging. The purpose of this paper is to define the boundaries and overlapping clinical characteristics of IDD, ASD and SSD; highlight the most relevant differences in clinical presentation; and provide a clinical framework within which to recognize the impact of IDD and ASD in the diagnosis of SSD. Design/methodology/approach – A systematic mapping of the international literature was conducted on the basis of the following questions: first, what are considered to be core and overlapping aspects of IDD, ASD and SSD; second, what are the main issues in clinical practice; and third, can key diagnostic flags be identified to assist in differentiating between the three diagnostic categories? Findings – Crucial clinical aspects for the differentiation resulted to be age of onset, interest towards others, main positive symptoms, and anatomical anomalies of the central nervous system. More robust diagnostic criteria and semeiological references are desirable. Originality/value – The present literature mapping provides a comprehensive description of the most relevant differences in the clinical presentation of ASD and SSD in persons with IDD.

scholarly journals Excess mortality in patients with schizophrenia spectrum disorders in Malaga (Spain): A cohort study

2021 ◽  
Vol 30 ◽  
Author(s):  
Berta Moreno-Küstner ◽  
Jose Guzman-Parra ◽  
Yolanda Pardo ◽  
Yolanda Sanchidrián ◽  
Sebastián Díaz-Ruiz ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Excess Mortality ◽  
Years Of Life Lost ◽  
Schizophrenia Spectrum Disorders ◽  
Case Register ◽  
Factors Associated ◽  
Life Expectancy At Birth ◽  
Schizophrenia Spectrum ◽  
Causes Of Mortality ◽  
Spectrum Disorders

Abstract Aims There is evidence that patients with schizophrenia spectrum disorders present higher mortality in comparison with the general population. The aim of this study was to analyse the causes of mortality and sociodemographic factors associated with mortality, standardised mortality ratios (SMRs), life expectancy and potential years of life lost (YLL) in patients with schizophrenia spectrum disorders in Spain. Methods The study included a cohort of patients from the Malaga Schizophrenia Case Register (1418 patients; 907 males; average age 42.31 years) who were followed up for a minimum of 10 years (median = 13.43). The factors associated with mortality were analysed with a survival analysis using Cox's proportional hazards regression model. Results The main causes of mortality in the cohort were circulatory disease (21.45%), cancer (17.09%) and suicide (13.09%). The SMR of the cohort was more than threefold that of the population of Malaga (3.19). The life expectancy at birth was 67.11 years old, which is more than 13 years shorter than that of the population of Malaga. The YLL was 20.74. The variables associated with a higher risk of mortality were age [adjusted hazard ratio (AHR) = 1.069, p < 0.001], male gender (AHR = 1.751, p < 0.001) and type of area of residence (p = 0.028; deprived urban zone v. non-deprived urban area, AHR = 1.460, p = 0.028). In addition, receiving welfare benefit status in comparison with employed status (AHR = 1.940, p = 0.008) was associated with increased mortality. Conclusions There is excess mortality in patients with schizophrenia spectrum disorders and also an association with age, gender, socioeconomic inequalities and receiving welfare benefits. Efforts directed towards improved living conditions could have a positive effect on reducing mortality.

scholarly journals Switching antipsychotics: Results of 16-month non-interventional, prospective, observational clinical research of inpatients with schizophrenia spectrum disorders

2017 ◽  
Vol 67 (1) ◽  
pp. 99-112
Author(s):  
Cvetka Bačar Bole ◽  
Mitja Pišlar ◽  
Metka Šen ◽  
Rok Tavčar ◽  
Aleš Mrhar
Keyword(s):  
Clinical Practice ◽  
Psychiatric Hospital ◽  
Adverse Reactions ◽  
Treatment Strategies ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Switching Patterns ◽  
Common Causes ◽  
Spectrum Disorders ◽  
Switching Strategies

AbstractThe study aims to identify prescribing and switching patterns of antipsychotics in clinical practice. A 16-month, prospective study was conducted at the Psychiatric Hospital Idrija, Slovenia. Inpatients (N = 311) with schizophrenia spectrum disorders were observed. The causes for switching antipsychotics and switching strategies were analyzed. Analyzing a total of 3954 prescriptions, the collected data confirmed that treatment strategies in this psychiatric hospital are very complex. It was found that 37 percent of inpatients had at least one switch. Moreover, switches that included three or more antipsychotics were detected. The most common causes for switching antipsychotics were adverse reactions and inefficacy or lack of efficacy. Among switching options, abrupt switch was recorded several times. As some patients are receiving several antipsychotics at the same time, it is possible that unusual switching occurs in clinical practice. It seems that the choice of switching strategy is also affected by the cause and urgency for switching an antipsychotic.

scholarly journals Clinical, Biochemical and Genetic Variables Associated With Metabolic Syndrome in Patients With Schizophrenia Spectrum Disorders Using Second-Generation Antipsychotics: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Marius H. Sneller ◽  
Nini de Boer ◽  
Sophie Everaars ◽  
Max Schuurmans ◽  
Sinan Guloksuz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
Second Generation ◽  
Genetic Factors ◽  
Schizophrenia Spectrum Disorders ◽  
Factors Associated ◽  
Schizophrenia Spectrum ◽  
Increased Risk ◽  
Second Generation Antipsychotics ◽  
Spectrum Disorders

Background: Individuals with severe mental illness experience increased morbidity and mortality compared to the general population. Adverse effects of antipsychotics, including weight gain, may contribute to the development of metabolic syndrome (MetS), which is associated with increased risks of all-cause and cardiovascular disease mortality. We aim to provide a comprehensive overview of clinical, biochemical and genetic factors associated with MetS among patients with schizophrenia spectrum disorders using second-generation antipsychotics (SGA).Methods: A literature search was performed in Pubmed and Embase to identify all cohort studies, cross-sectional studies and clinical trials investigating associations with MetS in patients with schizophrenia spectrum disorders using SGAs. We extracted and enumerated clinical, biochemical and genetic factors reported to be associated with MetS. We defined factors associated with MetS as factors being reported as associated with MetS in two or more studies.Results: 58 studies were included in this review (n = 12,123). In total, 62 factors were found to be associated with increased risk of MetS. Thirty one out of 58 studies investigated factors that were reported as associated with MetS in two or more studies. With regard to clinical factors, we found gender, higher age, concomitant use of mood stabilizers, higher baseline and current BMI, earlier SGA exposure, higher dose, longer duration of treatment, psychosis and tobacco smoking to be significantly associated with MetS. Furthermore, the biochemical factors hypo-adiponectinemia, elevated levels of C-reactive protein (CRP) and higher white blood cell (WBC) count were identified as factors associated with MetS. Among pharmacogenetic factors, the rs1414334 C-allele of the HTR2C-gene was associated with MetS in patients using SGA.Conclusion: In this systematic review investigating clinical, biochemical and genetic factors associated with MetS in patients using SGAs we found that higher age, higher baseline BMI, higher current BMI and male as well as female gender were positively associated with MetS across all antipsychotics. This study may set the stage for the application of clinical, biochemical and genetic factors to predict the risk of developing MetS in patients using SGAs. Future research is needed to determine which patients using SGAs are at risk to develop MetS in clinical practice.

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