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المؤلفون: Gregory P. Strauss, Nina V. Kraguljac, Adrienne C. Lahti, Raktima Datta, William Armstrong, Ian M. Raugh
المصدر: Eur Neuropsychopharmacol
مصطلحات موضوعية: Psychosis, medicine.medical_treatment, Article, 03 medical and health sciences, 0302 clinical medicine, First episode psychosis, Humans, Learning, Medicine, Reinforcement learning, Pharmacology (medical), Antipsychotic, Biological Psychiatry, Avolition, Pharmacology, business.industry, Antipsychotic naive, Anhedonia, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Psychotic Disorders, Neurology, Schizophrenia, Chronic schizophrenia, Neurology (clinical), medicine.symptom, business, Reinforcement, Psychology, 030217 neurology & neurosurgery, Antipsychotic Agents, Clinical psychology
الوصف: Prior studies indicate that chronic schizophrenia (SZ) is associated with a specific profile of reinforcement learning abnormalities. These impairments are characterized by: 1) reductions in learning rate, and 2) impaired Go learning and intact NoGo learning. Furthermore, each of these deficits are associated with greater severity of negative symptoms, consistent with theoretical perspectives positing that avolition and anhedonia are associated with impaired value representation. However, it is unclear whether these deficits extend to earlier phases of psychotic illness and when individuals are unmedicated. Two studies were conducted to examine reinforcement learning deficits in earlier phases of psychosis and in high risk patients. In study 1, participants included 35 participants with first episode psychosis (FEP) with limited antipsychotic medication exposure and 25 healthy controls (HC). Study 2 included 17 antipsychotic naïve individuals who were at clinical high-risk for psychosis (CHR) (i.e., attenuated psychosis syndrome) and 18 matched healthy controls (HC). In both studies, participants completed the Temporal Utility Integration Task, a measure of probabilistic reinforcement learning that contained Go and NoGo learning blocks. FEP displayed impaired Go and NoGo learning. In contrast, CHR did not display impairments in Go or NoGo learning. Impaired Go learning was not significantly associated with clinical outcomes in the CHR or FEP samples. Findings provide new evidence for areas of spared and impaired reinforcement learning in early phases of psychosis.
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المؤلفون: Olabisi Owoeye, David J. Browne, Paul Scully, John L. Waddington, Tara Kingston, Anthony Kinsella, Vincent Russell, Eadbhard O'Callaghan, Patrizia A. Baldwin, Nnamdi Nkire
المصدر: European Neuropsychopharmacology. 47:20-30
مصطلحات موضوعية: congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Psychosis, Time Factors, Neurology, 03 medical and health sciences, 0302 clinical medicine, Quality of life, First episode psychosis, medicine, Humans, Pharmacology (medical), Psychiatry, Biological Psychiatry, Pharmacology, Psychopathology, business.industry, Neuropsychology, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Psychotic Disorders, dup, Quality of Life, Schizophrenia, Population study, Neurology (clinical), business, 030217 neurology & neurosurgery
الوصف: This study systematically compared duration of untreated illness (DUI) with duration of untreated psychosis (DUP) in prediction of impairment at first-episode psychosis and investigated the extent to which these relationships are influenced by premorbid features. The Cavan-Monaghan First Episode Psychosis Study ascertained cases of first-episode psychosis in rural Ireland via all routes to care with limited variations in socioeconomic milieu. Cases were evaluated for DUI and DUP and assessed clinically for psychopathology, neuropsychology, neurology, insight and quality of life, together with premorbid features. Analyses then determined prediction of clinical assessments by DUI versus DUP. The study population consisted of 163 cases of first episode psychosis, among which 74 had a schizophrenia spectrum disorder. Shorter DUI but not DUP predicted less severe positive and general symptoms, while shorter DUP and particularly DUI predicted less severe negative symptoms; neither shorter DUP nor shorter DUI predicted less severe cognitive impairment or fewer neurological soft signs; shorter DUP and DUI predicted increased quality of life; shorter DUI but not DUP predicted greater insight. Only prediction of quality of life was weakened by consideration of premorbid features. Results were generally similar across the two diagnostic groupings. The present findings systematically delineate associations with DUI versus DUP across domains of impairment in first episode psychosis. They suggest that DUI may reflect a more insidious process than DUP and that reduction in DUI may be associated with more consistent and broader diminutions in impairment than for DUP.
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3
المؤلفون: Celso Arango, Jan K. Buitelaar, Christoph U. Correll, Covadonga M. Díaz-Caneja, Maria L. Figueira, W. Wolfgang Fleischhacker, Daniele Marcotulli, Mara Parellada, Benedetto Vitiello
المصدر: European Neuropsychopharmacology, 59, pp. 45-55
European Neuropsychopharmacology, 59, 45-55مصطلحات موضوعية: Pharmacology, Adult, Mental Health Services, Neurodevelopmental disorders Donders Center for Medical Neuroscience [Radboudumc 7], Adolescent, Health Personnel, Psychosis, Europe, Psychiatry and Mental health, Mental health services, Schizophrenia, Transition, Neurology, Adolescent Health Services, 130 000 Cognitive Neurology & Memory, Humans, Pharmacology (medical), Neurology (clinical), Child, Biological Psychiatry
الوصف: Contains fulltext : 282515.pdf (Publisher’s version ) (Open Access) Schizophrenia is a severely debilitating neurodevelopmental disorder that requires continuous multidisciplinary treatment. Early onset schizophrenia (EOS, onset before 18) is associated with poorer outcomes than the adult-onset type. The transition from adolescent to adult mental healthcare services (AMHS) poses various challenges for maintaining continuity of care. The heterogeneous availability of specialized mental health services and resources for people with schizophrenia across Europe and the inadequacy of training programs in creating a shared culture and knowledge base between child and adult mental health professionals are major challenges at the policy level. More flexible and individualized transition timing is also needed. While changes in the relationship between patients, caregivers and mental health professionals at a time when young people should acquire full responsibility for their own care are challenges common to all mental health disorders, these are particularly relevant to the care of schizophrenia because of the severe associated disability. This Expert Opinion Paper examines the main aspects of transitioning of care in schizophrenia with the aim of identifying the challenges and the potential approaches that could enhance continuity of care.
وصف الملف: application/pdf
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المؤلفون: Laura Fusar-Poli, Lotta-Katrin Pries, Jim van Os, Rajiv Radhakrishnan, Ayşegül Yay Pençe, Gamze Erzin, Philippe Delespaul, Gunter Kenis, Jurjen J Luykx, Bochao D Lin, Berna Akdede, Tolga Binbay, Vesile Altınyazar, Berna Yalınçetin, Güvem Gümüş-Akay, Burçin Cihan, Haldun Soygür, Halis Ulaş, Eylem Şahin Cankurtaran, Semra Ulusoy Kaymak, Marina M Mihaljevic, Sanja Andric-Petrovic, Tijana Mirjanic, Miguel Bernardo, Gisela Mezquida, Silvia Amoretti, Julio Bobes, Pilar A Saiz, Maria Paz García-Portilla, Julio Sanjuan, Eduardo J Aguilar, José Luis Santos, Estela Jiménez-López, Manuel Arrojo, Angel Carracedo, Gonzalo López, Javier González-Peñas, Mara Parellada, Nadja P Maric, Cem Atbaşoğlu, Alp Üçok, Köksal Alptekin, Meram Can Saka, Eugenio Aguglia, Celso Arango, Bart PF Rutten, Sinan Guloksuz
المساهمون: RS: MHeNs - R2 - Mental Health, Psychiatry 1, Psychiatrie & Neuropsychologie, Basic Neuroscience 1, RS: MHeNs - R3 - Neuroscience, MUMC+: MA Niet Med Staf Psychiatrie (9), MUMC+: MA Psychiatrie (3)
المصدر: European Neuropsychopharmacology, 63, 47-59. Elsevier
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname
Scopusمصطلحات موضوعية: Pharmacology, Cannabinoid Receptor Agonists, Facial expression, Siblings, Emotions, Psychosis, Psychiatry and Mental health, Cognition, Cross-Sectional Studies, Neurology, Cognitive dysfunction, Psychotic Disorders, Schizophrenia, Humans, Pharmacology (medical), Neurology (clinical), Emotion recognition, Facial Recognition, Biological Psychiatry, Cannabis
الوصف: European Community, FP7 [HEALTH-F2-2009-241909]; Spanish Ministry of Science and Innovation; Instituto de Salud Carlos III [SAM16PE07CP1, PI16/02012, PI19/024]; CIBERSAM; Madrid Regional Government [B2017/BMD-3740 AGES-CM-2]; Fundación Familia Alonso and Fundación Alicia Koplowitz
Fusar-Poli, L., Pries, L.-K., van Os, J., Radhakrishnan, R., Pençe, A.Y., Erzin, G., Delespaul, P., Kenis, G., Luykx, J.J., Lin, B.D., Akdede, B., Binbay, T., Altınyazar, V., Yalınçetin, B., Gümüş-Akay, G., Cihan, B., Soygür, H., Ulaş, H., Cankurtaran, E.Ş., Kaymak, S.U., Mihaljevic, M.M., Andric-Petrovic, S., Mirjanic, T., Bernardo, M., Mezquida, G., Amoretti, S., Bobes, J., Saiz, P.A., García-Portilla, M.P., Sanjuan, J., Aguilar, E.J., Santos, J.L., Jiménez-López, E., Arrojo, M., Carracedo, A., López, G., González-Peñas, J., Parellada, M., Maric, N.P., Atbaşoğlu, C., Üçok, A., Alptekin, K., Saka, M.C., Aguglia, E., Arango, C., Rutten, B.P., Guloksuz, S., Genetic Risk and Outcome of Psychosis (GROUP) investigators -
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المؤلفون: Ana González-Pinto, Clemente Garcia-Rizo, Silvia Amoretti, Gisela Mezquida, Iluminada Corripio, Inmaculada Baeza, Romina Cortizo, Laura Pina-Camacho, Manuel J. Cuesta, Jessica Merchán-Naranjo, Eduard Vieta, Fe Barcones, C. Mar Bonnín, Miguel Bernardo, Miquel Bioque, Adriane R. Rosa, Carla Torrent
المصدر: European Neuropsychopharmacology. 47:98-111
مصطلحات موضوعية: Psychosis, Bipolar Disorder, Psychometrics, Concurrent validity, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Pharmacology (medical), Biological Psychiatry, Cognitive reserve, Pharmacology, First episode, business.industry, Discriminant validity, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Psychotic Disorders, Neurology, Schizophrenia, Linear Models, Neurology (clinical), business, Psychosocial, 030217 neurology & neurosurgery, Clinical psychology
الوصف: Functional impairment is a defining feature of psychotic disorders. The Functional Assessment Short Test (FAST) is one of the most widely used instruments to measure psychosocial functioning. However, cut-offs of impairment have been well-established for bipolar disorders, but not for other clinical populations. This study aims to analyse psychometric properties of the FAST and establish their corresponding cut-off values for the different severity gradations in a first-episode of non-affective psychosis (FEP) patients. Global Assessment Functioning (GAF) and FAST ratings from 212 non-affective FEP and 204 healthy controls were analyzed. The psychometric properties of FAST (internal consistency, concurrent validity, discriminant validity, factorial analyses and sensitivity to change) were analyzed. The severity gradations of the FAST were defined by the congruence between two grading methods: linear regression analysis (LRA) and percentiles. The FAST showed strong psychometric properties. LRA with the GAF scores yielded the following equation: GAFscore= 80.83 – 0.639*FASTscore. The FAST ranges in non-affective FEP patients derived from LRA and percentiles, were as follows: 0-9 (No impairment); 10-19 (Minimal impairment); 20-34 (Mild impairment); 35-45 (Moderate impairment); 46-72 (Severe impairment). Patients with no functional impairment had a higher socioeconomic status, fewer depressive and negative symptoms, lower severity of illness and higher cognitive reserve level than the others groups. In conclusion, the FAST shows optimal psychometric properties which corroborate its applicability in FEP populations. It is a well-demonstrated valid instrument and the present cut-off scores could be implemented in clinical and research practice to assess properly the psychosocial functional outcome of non-affective FEP populations.
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المؤلفون: Lena Brundin, Neda Khanlarkhani, Ada Trepci, Carl M. Sellgren, Mikael Landén, Erik Pålsson, Sophie Erhardt, Lilly Schwieler
المصدر: European Neuropsychopharmacology. 43:52-62
مصطلحات موضوعية: endocrine system, medicine.medical_specialty, Psychosis, Bipolar Disorder, Kynurenine pathway, Kynurenic Acid, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Cerebrospinal fluid, Kynurenic acid, Tandem Mass Spectrometry, Internal medicine, medicine, Humans, Pharmacology (medical), Bipolar disorder, Kynurenine, Biological Psychiatry, Pharmacology, Tryptophan, biochemical phenomena, metabolism, and nutrition, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Endocrinology, Neurology, chemistry, Neurology (clinical), 030217 neurology & neurosurgery, Chromatography, Liquid, Quinolinic acid
الوصف: The kynurenine pathway of tryptophan degradation produces several neuroactive metabolites such as kynurenic acid (KYNA), quinolinic acid (QUIN), and picolinic acid (PIC) thought to be involved in the pathophysiology of psychosis, major depression, and suicidal behavior. Here, we analyzed cerebrospinal fluid (CSF) concentrations of tryptophan, kynurenine, KYNA, QUIN, and PIC utilizing ultra-performance liquid chromatography – tandem mass spectrometry system (UPLC-MS/MS) in persons with bipolar disorder (n = 101) and healthy controls (n = 80) to investigate if the metabolites correlated with depressive symptoms or to the history of suicidal behavior. Furthermore, we analyzed if genetic variants of the enzyme amino-β-carboxymuconate-semialdehyde-decarboxylase (ACMSD) were associated with the CSF concentrations of PIC and QUIN. We found that CSF KYNA and PIC concentrations, as well as the kynurenine/tryptophan ratio were increased in bipolar disorder compared with controls. CSF PIC concentrations were lower in subjects with a history of suicidal behavior than those without, supporting the hypothesis that low CSF PIC is a marker of vulnerability for suicidality. Bipolar subjects taking antidepressants had higher CSF concentrations of kynurenine and KYNA than subjects not given these medications. A negative association was found between a genetic variant of ACMSD and the ratio of PIC/QUIN, indicating that a polymorphism in ACMSD is associated with excess of QUIN formation at the expense of PIC. The present results confirm that the kynurenine pathway is activated in bipolar disorder, and suggest that shifting the activity of the kynurenine pathway away from QUIN production towards a production of KYNA and PIC might be a beneficial therapeutic strategy.
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المؤلفون: Adjia Hamadjida, Imane Frouni, Sébastien Belliveau, Woojin Kang, Dominique Bédard, Jim C. Gourdon, Stephen G. Nuara, Cynthia Kwan, Philippe Huot
المصدر: Journal of Neural Transmission. 128:73-81
مصطلحات موضوعية: 0301 basic medicine, Psychosis, Parkinson's disease, Allosteric modulator, CBiPES, Pharmacology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Medicine, Biological Psychiatry, business.industry, Parkinsonism, MPTP, medicine.disease, nervous system diseases, Psychiatry and Mental health, 030104 developmental biology, Metabotropic receptor, Neurology, Dyskinesia, chemistry, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery
الوصف: Advanced Parkinson’s disease (PD) is often complicated by the occurrence of dyskinesia, motor fluctuations and psychosis. To this day, few treatment options are available for each of these phenomena, and they are at times not effective or elicit adverse events, leaving some patients short of therapeutic options. We have recently shown that positive allosteric modulation of metabotropic 2 (mGlu2) receptors with the prototypical positive allosteric modulator (PAM) LY-487,379 is efficacious at alleviating both dyskinesia and psychosis-like behaviours (PLBs), while simultaneously enhancing the anti-parkinsonian action of L-3,4-dihydroxyphenylalanine (L-DOPA), in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned marmoset. Here, we assessed the effects of CBiPES, a mGlu2 PAM derived from LY-487,379, but with improved pharmacokinetic properties. Six MPTP-lesioned marmosets with reproducible dyskinesia and PLBs were administered L-DOPA in combination with vehicle or CBiPES (0.1, 1 and 10 mg/kg), after which their behaviour was rated. CBiPES 10 mg/kg reduced global dyskinesia by 60% (P
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::3ce71a226053805a7d777dc6b0d9db1b
https://doi.org/10.1007/s00702-020-02287-8 -
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المؤلفون: Jan-Bernard C Marsman, Lisette van der Meer, Marie-José van Tol, Esther M. Opmeer, Daouia I Larabi, Gerdina H. M. Pijnenborg, Branislava Ćurčić-Blake, André Aleman, Betty M. Tijms
المساهمون: Neurology, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Neurodegeneration, Perceptual and Cognitive Neuroscience (PCN), Clinical Cognitive Neuropsychiatry Research Program (CCNP), Clinical Neuropsychology, Clinical Psychology and Experimental Psychopathology, Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE)
المصدر: Larabi, D I, Marsman, J-B C, Aleman, A, Tijms, B M, Opmeer, E M, Pijnenborg, G H M, van der Meer, L, van Tol, M-J & Ćurčić-Blake, B 2021, ' Insight does not come at random: Individual gray matter networks relate to clinical and cognitive insight in schizophrenia ', Progress in Neuro-Psychopharmacology and Biological Psychiatry, vol. 109, 110251 . https://doi.org/10.1016/j.pnpbp.2021.110251
Progress in neuro-psychopharmacology & biological psychiatry 109, 110251-(2021). doi:10.1016/j.pnpbp.2021.110251
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 109:110251. Elsevier Inc.
Progress in Neuro-Psychopharmacology & Biological Psychiatry, 109:110251. PERGAMON-ELSEVIER SCIENCE LTDمصطلحات موضوعية: Adult, Male, Psychosis, SYMPTOMS, Social connectedness, Neuroimaging, SPECTRUM DISORDERS, Young Adult, 03 medical and health sciences, Cognition, 0302 clinical medicine, Magnetic resonance imaging psychosis, PSYCHOTIC DISORDERS, Social cognition, medicine, Humans, ddc:610, Gray Matter, Biological Psychiatry, Small-world topology, Pharmacology, Connectivity, SELF-REFLECTION, Positive and Negative Syndrome Scale, Brain, Middle Aged, medicine.disease, Magnetic Resonance Imaging, 030227 psychiatry, Graph theory, BRAIN NETWORKS, SCALE BCIS, PSYCHOMETRIC PROPERTIES, SOCIAL COGNITION, Schizophrenia, Female, Schizophrenic Psychology, Nerve Net, STRUCTURAL COVARIANCE, Psychology, Social cognitive theory, Cognitive psychology
الوصف: Background: Impaired clinical and cognitive insight are prevalent in schizophrenia and relate to poorer outcome. Good insight has been suggested to depend on social cognitive and metacognitive abilities requiring global integration of brain signals. Impaired insight has been related to numerous focal gray matter (GM) abnormalities distributed across the brain suggesting dysconnectivity at the global level. In this study, we test whether global integration deficiencies reflected in gray matter network connectivity underlie individual variations in insight.Methods: We used graph theory to examine whether individual GM-network metrics relate to insight in patients with a psychotic disorder (n = 114). Clinical insight was measured with the Schedule for the Assessment of Insight & ndash;Expanded and item G12 of the Positive and Negative Syndrome Scale, and cognitive insight with the Beck Cognitive Insight Scale. Individual GM-similarity networks were created from GM-segmentations of T1weighted MRI-scans. Graph metrics were calculated using the Brain Connectivity Toolbox.Results: Networks of schizophrenia patients with poorer clinical insight showed less segregation (i.e. clustering coefficient) into specialized subnetworks at the global level. Schizophrenia patients with poorer cognitive insight showed both less segregation and higher connectedness (i.e. lower path length) of their brain networks, making their network topology more & ldquo;random & rdquo;.Conclusions: Our findings suggest less segregated processing of information in patients with poorer cognitive and clinical insight, in addition to higher connectedness in patients with poorer cognitive insight. The ability to take a critical perspective on one & rsquo;s symptoms (clinical insight) or views (cognitive insight) might depend especially on segregated specialized processing within distinct subnetworks.
وصف الملف: application/pdf
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المؤلفون: Chandni Hindocha, Katherine Beck, Oliver D. Howes, H. Valerie Curran, James M. Stone, Michael A P Bloomfield, Ryan J. Turner, Rachel Lees, Ellis Chika Onwordi, Tom P. Freeman, Neil Rane, Katherine Petrilli, David J. Lythgoe
المصدر: Bloomfield, M A P, Petrilli, K, Lees, R, Hindocha, C, Beck, K, Turner, R J, Onwordi, E C, Rane, N, Lythgoe, D J, Stone, J M, Curran, H V, Howes, O D & Freeman, T P 2021, ' The Effects of Acute Δ 9-Tetrahydrocannabinol on Striatal Glutamatergic Function : A Proton Magnetic Resonance Spectroscopy Study ', Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, vol. 6, no. 6, pp. 660-667 . https://doi.org/10.1016/j.bpsc.2021.04.013
مصطلحات موضوعية: cannabis, Psychosis, MRS, striatum, Cognitive Neuroscience, Clinical Neurology, glutamate, Striatum, Pharmacology, 050105 experimental psychology, tetrahydrocannabinol, 03 medical and health sciences, Glutamatergic, 0302 clinical medicine, Oral administration, mental disorders, Medicine, 0501 psychology and cognitive sciences, Radiology, Nuclear Medicine and imaging, psychosis, Tetrahydrocannabinol, Biological Psychiatry, Cannabis, biology, business.industry, organic chemicals, 05 social sciences, Glutamate receptor, Psychotomimetic, biology.organism_classification, medicine.disease, Radiology Nuclear Medicine and imaging, Neurology (clinical), Glutamate, business, 030217 neurology & neurosurgery, medicine.drug
الوصف: Background: Cannabis and its main psychoactive component, Δ9-tetrahydrocannabinol (THC), can elicit transient psychotic symptoms. A key candidate biological mechanism of how THC induces psychotic symptoms is the modulation of glutamate in the brain. We sought to investigate the effects of acute THC administration on striatal glutamate levels and its relationship to the induction of psychotic symptoms. \ud \ud Methods: We used proton magnetic resonance spectroscopy to measure glutamate levels in the striatum in 20 healthy participants after THC (15 mg, oral) and matched placebo administration in a randomized, double-blind, placebo-controlled design. Psychotic symptoms were measured using the Psychotomimetic States Inventory. \ud \ud Results: We found that THC administration did not significantly change glutamate (glutamate plus glutamine relative to creatine) concentration in the striatum (p =.58; scaled Jeffreys-Zellner-Siow Bayes factor = 4.29). THC increased psychotic symptoms, but the severity of these symptoms was not correlated with striatal glutamate levels. \ud \ud Conclusions: These findings suggest that oral administration of 15 mg of THC does not result in altered striatal glutamate levels. Further work is needed to clarify the effects of THC on striatal glutamate.
وصف الملف: application/vnd.openxmlformats-officedocument.wordprocessingml.document; application/pdf
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المؤلفون: Jacqueline Mayoral-van Son, Marcos Gómez-Revuelta, Victor Ortiz-García de la Foz, Javier Vázquez-Bourgon, Benedicto Crespo-Facorro, Rosa Ayesa-Arriola, José María Pelayo-Terán
المساهمون: Instituto de Salud Carlos III
المصدر: Digital.CSIC. Repositorio Institucional del CSIC
instnameمصطلحات موضوعية: medicine.medical_specialty, Psychosis, Aripiprazole, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Antipsychotics, Pharmacology (medical), Prospective Studies, Adverse effect, First-episode-psychosis, Biological Psychiatry, Pharmacology, First episode, Risperidone, business.industry, medicine.disease, 030227 psychiatry, Discontinuation, Clinical trial, Psychiatry and Mental health, Treatment Outcome, Neurology, Psychotic Disorders, Schizophrenia, Neurology (clinical), business, 030217 neurology & neurosurgery, medicine.drug, Antipsychotic Agents
الوصف: Selecting the first antipsychotic agent for the acute phase of a first episode of psychosis (FEP) is a critical task that may impact on the long-term outcome. Despite that, there is a lack of research comparing head-to-head different second-generation antipsychotics at this stage. The aim of this study was to compare the effectiveness of aripiprazole and risperidone in the treatment of the acute phase after a FEP. For that purpose, from February 2011 to October 2018, a prospective, randomized, open-label study was undertaken. Two hundred-sixty-six first-episode, drug-naïve patients were randomly assigned to aripiprazole (n = 136), or risperidone (n = 130) and followed-up for 6-weeks. The primary effectiveness measure was all-cause treatment discontinuation. In addition, an analysis based on intention-to-treat principle was conducted to assess clinical efficacy. The overall dropout rate at 6-week reached 19.5%. Effectiveness measures were similar between both treatment groups as treatment discontinuation rates (χ2 = 1.863; p = 0.172) and mean time until all-cause discontinuation (log rank = 1.421; p = 0.233) showed no statistically significant differences. In terms of clinical efficacy, risperidone proved a statistically significant better performance according to BPRS mean change between baseline and 6-week total score (t = 3.187; p = 0.002). Patients under risperidone treatment were significantly more likely to suffer sex-related adverse events. In conclusion, no differences regarding effectiveness were found between aripiprazole and risperidone for the acute-phase treatment of FEP. Despite the importance of efficacy during this phase of treatment, selecting the most effective treatment for the long-term outcome, requires addressing safety and patient´s preferences.
This study was conducted as part of a the PAFIP-3 clinical trial “Effectiveness of Second Generation Antipsychotics in First Episode Psychosis Patients: 1-year Follow-up (PAFIP3_1Y)”. ClinicalTrials.gov Identifier: (NCT02532491). The authors wish to thank all “Programa Asistencial de las Fases Iniciales de Psicosis”(PAFIP) research team and all patients and family members who participated in the study.
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