Psychotropic drug use in an Italian psychiatric hospital: a two-year follow-up study

RIASSUNTOScopo - Documentare la possibilità di migliorare la qualità delle prescrizioni di psicofarmaci in una coorte di pazienti ricoverati presso l'ex ospedale psichiatrico di Milano. Disegno - Studio prospettico con follow-up a due anni. La razionalizzazione delle prescrizioni psicofarmacologiche è stata realizzata seguendo criteri generali di uso razionale degli psicofarmaci. Nel corso dei due anni di studio sono stati registrati i cambiamenti nella terapia psicofarmacologica ed eventuali variazioni psicopatologiche rilevate mediante la somministrazione della Brief Psychiatric Rating Scale (BPRS). Setting - Tre reparti dell'ex ospedale psichiatrico «Paolo Pini» di Milano. Principali misure utilizzate - Numero di pazienti in terapia psicofarmacologica, numero di pazienti in politerapia, dosaggio di neurolettico in equivalenti di clorpromazina, and amento psicopatologico. Risultati - Sono stati reclutati 70 pazienti. Al follow-up si è verificata una riduzione del numero dei pazienti in terapia con neurolettici; il numero di pazienti in terapia con due neurolettici si è dimezzato, e nessun paziente assumeva tre neurolettici al termine dello studio. In aggiunta, si è ridotto l'uso di formulazioni depot. Per quanto riguarda gli altri psicofarmaci, il numero di pazienti in terapia con benzodiazepine si è praticamente dimezzato. A fronte di queste modifiche farmacologiche, non si sono evidenziati cambiamenti psicopatologici di rilievo, come documentato dall'and amento dei punteggi alia BPRS. Conclusioni - Questo lavoro evidenzia la possibilità di trasferire nella pratica clinica di routine indicazioni di uso razionale degli psicofarmaci. Viene inoltre suggerita l'utilità di un monitoraggio longitudinale di tutte le pratiche assistenziali e terapeutiche che quotidianamente vengono messe in atto.

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A comparative study of the efficacy of amisulpride and olanzapine in patients with schizophrenia attending the outpatient Department of Psychiatry in a tertiary care hospital, Silchar, Assam, India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20190149 ◽

2019 ◽

Vol 8 (2) ◽

pp. 284

Author(s):

Ali N. Yashin ◽

Dolly Roy ◽

Prosenjit Ghosh

Keyword(s):

Atypical Antipsychotics ◽

Rating Scale ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Brief Psychiatric Rating Scale ◽

Parallel Group ◽

Psychiatric Rating ◽

Psychiatric Rating Scale

Background: Schizophrenia is one of the most commonly encountered psychiatric disorders. It is characterized by impairment in perception or expression of reality, leading to occupational and social dysfunction. Now a day’s mainstay of treatment of schizophrenia is by using atypical antipsychotics. Amisulpride and olanzapine are atypical antipsychotics which are commonly used in treatment of schizophrenia. The current study is undertaken to assess the efficacy of amisulpride which is a relatively newer antipsychotics against existing antipsychotic olanzapine.Methods: This was designed as a single-blind, prospective, parallel-group, observational study. Eighty adult patients of either sex were randomized to receive standard doses of the two drugs orally for 12 weeks, with follow up at 4 and 8 weeks. Effectiveness was assessed by change in the score of Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) score during the treatment period. Data were entered in Microsoft excel and statistical analysis were done using graph pad and p value <0.05 considered to be statistically significant.Results: Out of 80 adults patients 76 patients were evaluated by dividing into two groups, 38 patients were included in each group. Final BPRS score was less for olanzapine as compared to amisulpride (p<0.001). Improvement in CGI score is more in olanzapine group than amisulpride group which became statistically significant from 8th weeks onwards.Conclusions: Both amisulpride and olanzapine are very effective in controlling the symptoms of schizophrenia which is evident by significant decrease in BPRS, CGI-S and CGI-I score, but efficacy of amisulpride is still inferior to olanzapine.

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Belgian Schizophrenia Outcome Survey – Results of a 2-year naturalistic study in patients stabilised on monotherapy with olanzapine, risperidone or haloperidol

European Psychiatry ◽

10.1016/j.eurpsy.2008.11.002 ◽

2009 ◽

Vol 24 (3) ◽

pp. 154-163 ◽

Cited By ~ 7

Author(s):

J. Peuskens ◽

B. Gillain ◽

D. De Graeve ◽

B. Van Vleymen ◽

A. Albert

Keyword(s):

Adverse Events ◽

Rating Scale ◽

Sexual Problem ◽

First Year ◽

Naturalistic Study ◽

Brief Psychiatric Rating Scale ◽

Survey Results ◽

Psychiatric Rating ◽

Psychiatric Rating Scale

AbstractObjectivesThis Schizophrenia Outcome Survey compared medical costs, psychopathology and adverse events in outpatients for 2 years following hospitalisation for an acute schizophrenic episode.MethodsAdults stabilised with haloperidol, olanzapine or risperidone entered this observational study ≤1 month after discharge and were assessed at baseline, 3, 6, 12, 18 and 24 months using Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), Global Assessment of Functioning and adverse events reporting.ResultsAmong 323 patients (haloperidol 32, olanzapine 149, risperidone 142), baseline characteristics were similar in the olanzapine and risperidone groups, except for more first episodes in the risperidone group (p = 0.01). Haloperidol patients were more often single and institutionalised, less educated, had more residual schizophrenia, were longer hospitalised in the previous year, took more corrective and psychotropic drugs and had more extrapyramidal symptoms (EPS) and gynaecomastia (all significantly). Sixty-eight percent of patients completed a 2-year follow-up. In all groups, CGI and GAF improved during the first 3 months (both p < 0.0001) while BPRS deteriorated in the first year (all within group changes p < 0.05, between group changes NS) before it stabilised. There were no significant differences in hospitalisations and no change in social profile. At the last visit, 66% of haloperidol (p < 0.01), 35% of olanzapine (NS) and 39% (NS) of risperidone patients had ≥1 EPS; 69% (p < 0.013), 40 and 44%, respectively, had ≥1 sexual problem (NS). Mean weight gain was 0.4 (NS), 2.6 (p < 0.05) and 2.6 kg (p < 0.05), respectively.ConclusionsIn this naturalistic study, treatment allocation might have introduced a bias in the interpretation of efficiency results, but olanzapine and risperidone caused less EPS than haloperidol during 2 years of outpatient follow-up.

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Long-stay patients in a psychiatric hospital in Southern Brazil

Revista de Saúde Pública ◽

10.1590/s0034-89102007000100017 ◽

2007 ◽

Vol 41 (1) ◽

pp. 124-130 ◽

Cited By ~ 9

Author(s):

Marcelo Pio de Almeida Fleck ◽

Luciane Wagner ◽

Mário Wagner ◽

Miriam Dias

Keyword(s):

Quality Of Life ◽

Social Functioning ◽

Psychiatric Hospital ◽

Physical Disability ◽

Rating Scale ◽

Southern Brazil ◽

Brief Psychiatric Rating Scale ◽

Psychiatric Rating ◽

Psychiatric Rating Scale

OBJECTIVE: To describe the demographic profile, social functioning, and quality of life of a population of long-stay care patients in a psychiatric hospital. METHODS: A study was carried out in Porto Alegre, Southern Brazil, in 2002. A total of 584 (96%) long-stay patients were assessed by means of the following instruments: the World Health Organization Quality of Life, the Social Behavior Schedule, the Independent Living Skills Survey, the Brief Psychiatric Rating Scale and another instrument for assessing disability (Questionnaire for Assessing Physical Disability). RESULTS: The average hospital stay was 26 years (SD: 15.8) and 46.6% of inpatients had no physical disability. Patients had their social functioning skills and autonomy largely impaired. Few of them (27.7%) answered the instrument for assessing quality of life, and showed significant impairments in all domains. The Brief Psychiatric Rating Scale evidenced a low prevalence of positive symptoms in this population. CONCLUSIONS: The institutionalized population studied presented significantly impaired social functioning, autonomy, and quality of life. These aspects need to be taken into consideration while planning for their deinstitutionalization.

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Prevalence, factors and reasons associated with missed first appointments among out-patients with schizophrenia at the Federal Neuro-Psychiatric Hospital, Benin City

BJPsych Open ◽

10.1192/bjo.2017.11 ◽

2018 ◽

Vol 4 (2) ◽

pp. 49-54 ◽

Cited By ~ 2

Author(s):

Felicia Ibironke Thomas ◽

Sunday Osasu Olotu ◽

Joyce Ohiole Omoaregba

Keyword(s):

Psychiatric Hospital ◽

Rating Scale ◽

Missed Appointments ◽

Cross Sectional ◽

Psychiatric Interview ◽

Benin City ◽

Brief Psychiatric Rating Scale ◽

Psychiatric Rating ◽

Psychiatric Rating Scale ◽

To Come

BackgroundNon-attendance to clinic appointments is associated with poorer treatment outcomes. There is a dearth of information about missed first clinic appointments among patients with schizophrenia in Nigeria.AimsTo determine the prevalence, correlates and reasons for missed first appointment among out-patients with schizophrenia at the Federal Neuro-Psychiatric Hospital, Benin City, Nigeria.MethodA cross-sectional descriptive study among 275 out-patients with schizophrenia, using the Mini International Neuro-Psychiatric Interview and the Brief Psychiatric Rating Scale.ResultsThe prevalence of missed first appointment was 31%. Higher BPRS score was associated with missing the appointment. The main reasons for missed appointments were: forgetting the appointment date and patient's refusal to come to the clinic.ConclusionsMissed first out-patient clinic appointment is common among patients with schizophrenia at the study site, forgetting appointment dates being a common reason. Among other recommendations, methods of reminding patients and caregivers of appointment dates at the study location may need to be explored.Declaration of interestNone.

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The condition of the families of patients with schizophrenia in Italy: burden, social network and professional support

Epidemiologia e Psichiatria Sociale ◽

10.1017/s1121189x00005170 ◽

2001 ◽

Vol 10 (2) ◽

pp. 96-106 ◽

Cited By ~ 11

Author(s):

Lorenza Magliano ◽

Claudio Malangone ◽

Manuela Guarneri ◽

Cecilia Marasco ◽

Andrea Fiorillo ◽

...

Keyword(s):

Social Network ◽

Rating Scale ◽

Professional Support ◽

Brief Psychiatric Rating Scale ◽

Sono Stati ◽

Psychiatric Rating ◽

Dsm Iv ◽

Psychiatric Rating Scale

RIASSUNTOScopo – Questo studio ha inteso documentare: a) gli interventi che i pazienti con schizofrenia ricevono nei Servizi di Salute Mentale (SSM); b) il carico e la rete sociale dei familiari nonché il sostegno professionale che essi ricevono dai servizi. Disegno – Lo studio è stato condotto in 30 CSM selezionati in maniera randomizzata e stratificati per area geografica e densita di popolazione sull'intero territorio nazionale. In ciascun CSM selezionato, sono stati consecutivamente reclutati 25 pazienti con diagnosi DSM-IV di schizofrenia in fase di compenso clinico e altrettanti familiari-chiave. Il carico dei familiari è stato esplorato in relazione alia zona geografica, agli interventi ricevuti dai pazienti e al sostegno professionale e sociale prestato ai loro familiari. Principal misure utilizzate – a) paziente: Brief Psychiatric Rating Scale (BPRS) e intervista per 1'Accertamento delta Disabilita (AD); b) familiare-chiave: Questionari auto-compilati sui Problemi Familiari (QPF) e sulla Rete Sociale (QRS); c) interventi: Scheda di Rilevazione degli Interventi (SRI). Risultati – Sono stati raccolti dati relativi a 709 pazienti e altrettanti familiari-chiave. Nei due mesi precedenti la rilevazione dei dati, il 35% dei pazienti aveva partecipato a programmi riabilitativi, l'80% dei familiari era stato in contatto regolare con i CSM e P8% aveva ricevuto un intervento psicoeducativo familiare. I livelli di carico familiare erano maggiori al Sud. Tale differenza veniva meno quando la presa in ca-rico comprendeva interventi psico-riabilitativi e di sostegno familiare. Conclusioni – Questo studio mette in evidenza che la situazione delle famiglie dei pazienti con schizofrenia è attualmente più difficile al Sud, ed è sensibilmente influenzata dai tipo di presa in carico.

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Commentary

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2008.novdec02 ◽

2008 ◽

Vol 13 (6) ◽

pp. 8-8

Author(s):

Richard T. Katz

Keyword(s):

Mental Illness ◽

Behavioral Disorders ◽

Rating Scale ◽

Behavioral Disorder ◽

Sixth Edition ◽

Diagnostic And Statistical Manual ◽

Brief Psychiatric Rating Scale ◽

Psychiatric Rating ◽

Psychiatric Rating Scale ◽

Mental And Behavioral Disorders

Abstract The author, who is the editor of the Mental and Behavioral Disorders chapter of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, comments on the previous article, Assessing Mental and Behavioral Disorder Impairment: Overview of Sixth Edition Approaches in this issue of The Guides Newsletter. The new Mental and Behavioral Disorders (M&BD) chapter, like others in the AMA Guides, is a consensus opinion of many authors and thus reflects diverse points of view. Psychiatrists and psychologists continue to struggle with diagnostic taxonomies within the Diagnostic and Statistical Manual of Mental Disorders, but anxiety, depression, and psychosis are three unequivocal areas of mental illness for which the sixth edition of the AMA Guides provides M&BD impairment rating. Two particular challenges faced the authors of the chapter: how could M&BD disorders be rated (and yet avoid an onslaught of attorney requests for an M&BD rating in conjunction with every physical impairment), and what should be the maximal impairment rating for a mental illness. The sixth edition uses three scales—the Psychiatric Impairment Rating Scale, the Global Assessment of Function, and the Brief Psychiatric Rating Scale—after careful review of a wide variety of indices. The AMA Guides remains a work in progress, but the authors of the M&BD chapter have taken an important step toward providing a reasonable method for estimating impairment.

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Brief Psychiatric Rating Scale

PsycTESTS Dataset ◽

10.1037/t01554-000 ◽

1962 ◽

Cited By ~ 10

Author(s):

J. E. Overall ◽

D. R. Gorham

Keyword(s):

Rating Scale ◽

Brief Psychiatric Rating Scale ◽

Psychiatric Rating ◽

Psychiatric Rating Scale

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Problèmes méthodologiques posés par la classification des formes de schizophrénie: recherche de corrélations ou de relations d'appartenance?

Psychiatry and Psychobiology ◽

10.1017/s0767399x00004260 ◽

1987 ◽

Vol 2 (3) ◽

pp. 174-187

Author(s):

Monique de Bonis ◽

Paul de Boeck ◽

Marie-Odile Lebeaux

Keyword(s):

Rating Scale ◽

Brief Psychiatric Rating Scale ◽

Psychiatric Rating ◽

Psychiatric Rating Scale

RésuméLe présent travail comporte une critique de la méthodologie employée pour définir une typologie des schizophrènes et une étude empirique de la distinction entre forme productive et forme déficitaire.Après avoir souligné que les études factorielles visant l’identification de deux types de schizophrènes reposaient sur des choix méthodologiques discutables: recherche de corrélations entre variables, alors qu’il s’agit de découvrir des corrélations entre sujets; préférence pour des relations symétriques, alors que les liaisons sont probablement d’ordre asymétrique, les auteurs présentent deux études empiriques.La première réalisée sur un échantillon de 99 schizophrènes s’appuie sur la factorisation des estimations de la symptomatologie (BPRS* á 42 items) à l’aide de la méthode factorielle en plan Q et d’une analyse des correspondances. La seconde a porté sur un sous-échantillon de 52 schizophrènes à l’aide d’une nouvelle méthode d’analyse hiérarchique (HICLAS). Les résultats de ces analyses aboutissent aux conclusions suivantes. Les résultats des analyses factorielles montrent: • qu’il existe plus de deux formes de schizophrènie et qu’à l’intérieur des classes formées par les individus l’opposition déficitaire -productif est stable quelle que soit la métrique utilisée; • que cette opposition repose principalement, pour ce qui est de la forme déficitaire sur 3 symptômes: l’émoussement affectif, le retrait affectif et le ralentissement, et pour ce qui est de la forme productive sur l’humeur expansive, l’attitude manipulatoire, l’excitation, la dramatisation et la labilit émotionnelle; • que contrairement aux travaux antérieurs ni les hallucinations ni la désorganisation conceptuelle ne permettent d’établir la différence entre les deux groupes de malades sans doute parce qu’elles sont communes à tous les schizophrènes; • qu’il n’y a pas de correspondance entre les diagnostics cliniques et les formes décrites; et, • que les malades les plus déficitaires (situés aux extrêmités du pole factoriel) se différencient des malades productifs essentiellement par des variables liées au sexe (plus d’hommes que de femmes dans le premier cas), un statut marital de célibat plus fréquent, et des antécédents psychiatriques plus importants. Les résultats des analyses factorielles soulignent d’une part que les types mixtes sont plus fréquents que les types purs et, d’autre part qu’il suffit de moins de 10 symptômes pour réaliser une opposition satisfaisante entre forme productive et forme déficitaire (Tableau 3, figure 1).Toutes ces conclusions sont valables aussi pour l’analyse hiérarchique. Mais de plus, cette méthode permet d’individualiser un groupe de malades “purs” dans la forme déficitaire seulement, groupe disjoint des autres individus sur la base d’un très petit nombre de symptômes. A côté de ces types purs figurent des types mixtes, qui possédent à la fois des symptômes déficitaires et des symptômes productifs suivant des combinaisons hiérarchiques précises, c’est-à-dire avec une dominance de l’une ou de l’autre forme. Il existe aussi des formes résiduelles dans lesquelles aucune hiérarchie ne peut être mise au jour (Tableau 4).En conclusion on a insisté, outre les problèmes méthodologiques négligés dans les précédentes recherches, sur l’existence d’une dissymétrie entre la forme déficitaire et la forme productive, dans la mesure où c’est seulement la forme déficitaire qui présente une grande singularité et sur l’importance des symptômes liés à la vie affective et à son appauvrissement qui ont un pouvoir discriminatif plus élevé que les symptômes productifs.*BPRS = Brief Psychiatric Rating Scale

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