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المؤلفون: Gerdina H. M. Pijnenborg, Frederike Jörg, Frits A. J. Muskiet, Eva Corpeleijn, Richard Bruggeman, Jojanneke Bruins, E. R. van den Heuvel, Agna A. Bartels-Velthuis
المساهمون: Reproductive Origins of Adult Health and Disease (ROAHD), Lifestyle Medicine (LM), Clinical Psychology and Experimental Psychopathology, Perceptual and Cognitive Neuroscience (PCN), Clinical Cognitive Neuropsychiatry Research Program (CCNP), Stochastic Operations Research, Statistics
المصدر: Schizophrenia Research, 195, 513-518. ELSEVIER SCIENCE BV
Schizophrenia Research, 195, 513-518. Elsevierمصطلحات موضوعية: Male, medicine.medical_treatment, Physiology, NUTRITION EXAMINATION SURVEY, 030204 cardiovascular system & hematology, SDG 3 – Goede gezondheid en welzijn, Cholesterol, HDL/metabolism, 0302 clinical medicine, 3RD NATIONAL-HEALTH, Vitamin D, HDL/metabolism, ALL-CAUSE MORTALITY, education.field_of_study, Dopaminergic, BIPOLAR DISORDER, Middle Aged, Metabolic Diseases/etiology, Vitamin D/administration & dosage, ADULT BRAIN, Psychiatry and Mental health, Cholesterol, Schizophrenia, Psychotic Disorders/complications, Female, Psychology, Antipsychotic Agents, Adult, medicine.medical_specialty, Psychosis, D SUPPLEMENTATION, Population, 03 medical and health sciences, D DEFICIENCY, Metabolic Diseases, SDG 3 - Good Health and Well-being, medicine, Genetic predisposition, Vitamin D and neurology, Humans, Bipolar disorder, Antipsychotic, Psychiatry, education, Biological Psychiatry, Psychiatric Status Rating Scales, CARDIOVASCULAR-DISEASE MORTALITY, Cholesterol, HDL, medicine.disease, Vitamin D Deficiency, Psychotic Disorders, ANTIPSYCHOTIC-DRUGS, SERUM 25-HYDROXYVITAMIN D, Vitamin D Deficiency/epidemiology, 030217 neurology & neurosurgery, Antipsychotic Agents/therapeutic use
الوصف: People with psychotic disorders have an increased metabolic riskand their mean life expectancy is reduced with circa 28 years (Olfsonet al., 2015).Predictors of this increased metabolic risk are genetic predisposition (Liu et al., 2013), lifestyle factors such as unhealthy diet,physical inactivity and smoking (Bobes et al., 2010), and the side effectsof antipsychotic medication (Werner and Coveñas, 2014;Chadda et al.,2013). Low vitamin D status might also contribute to an increased metabolicrisk (Ginde et al., 2009;Kendrick et al., 2009;Kilkkinen et al.,2009;Ford et al., 2009) and all-cause mortality by promoting atherosclerosis,hypertension, inflammation and activation of the renin-angiotensinsystem (Wang et al., 2012;Garland et al., 2014;Lee et al., 2008). Also,one review demonstrated cardiovascular mortality rates in the generalpopulation were higher during winter than in summer (Zittermann etal., 2005).Vitamin D interacts with dopaminergic, cholinergic and noradrenergicneurotransmitter systems, which have all been implicated inSchizophrenia Research 195 (2018) 513–518⁎ Corresponding author at: University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research center, P.O. Box 30.001 (CC72), 9700 RB Groningen, The Netherlands.E-mail addresses: j.bruins@lentis.nl (J. Bruins), f.jorg@umcg.nl (F. Jörg),e.r.v.d.heuvel@tue.nl (E.R. van den Heuvel), a.a.bartels@umcg.nl (A.A. Bartels-Velthuis),e.corpeleijn@umcg.nl (E. Corpeleijn), f.a.j.muskiet@umcg.nl (F.A.J. Muskiet),g.h.m.pijnenborg@rug.nl (G.H.M. Pijnenborg), r.bruggeman@umcg.nl (R. Bruggeman).experiencing psychotic symptoms (Eyles et al., 2013). When vitaminD is low, dopamine signalling in the brain appears to decrease (Eyleset al., 2013;Cui et al., 2015;Cui et al., 2013;Groves et al., 2014), whichin its turn could lead to more severe negative symptoms of psychosis(Buchanan et al., 2007). Indeed, several studies found that vitamin D insufficiencywas strongly associated with negative symptoms of psychosis(Graham et al., 2015;Yüksel et al., 2014;Cieslak et al., 2014;OttesenBerg et al., 2010).Vitamin D is thus associated with both metabolic risk and negativesymptom severity. Negative symptoms have also been shown to interferewith patients' ability to be physically active and make healthy lifestylechoices, which can increase their metabolic risk (Bergqvist et al.,2013). Negative symptom severity may therefore mediate the associationbetween low vitamin D and increased metabolic risk in peoplewith a psychotic disorder.Vitamin D is mostly produced in the skin by exposure to ultravioletBradiation in sunlight (Brown et al., 1999;Holick, 2007). Absorption ofvitamin D and levels of circulation differ among individuals and can beinfluenced by determinants such as latitude, season, time of day, skincolor (Holick et al., 2011), bodyweight, age, calcium intake(Zittermann et al., 2014), diet and genetics (Mazahery and von Hurst,2015).Vitamin D shows a natural fluctuation throughout the year, with vitaminD insufficiency more likely to occur during winter than in summer(Rosecrans and Dohnal, 2014). A recent study suggestsseasonality may also affect clinical symptoms of schizophrenia, althoughthe underlying mechanism is unknown (Byrne et al., 2015).In this study we aim to investigate whether vitamin D levels are associatedwith metabolic risk in people with psychotic disorders andwhether this effect was mediated by negative symptoms. We hypothesizethat vitamin D levels may influence the severity of metabolic disturbancesand negative symptoms. As vitamin D levels naturally fluctuatethroughout the seasons (Rosecrans and Dohnal, 2014), we examinewhether metabolic risk and negative symptom severity follow a similarseasonal fluctuation pattern. Furthermore, we investigate whether thehttp://dx.doi.org/10.1016/j.schres.2017.08.0590920-9964/© 2017 Elsevier B.V. All rights reserved.Contents lists available at ScienceDirectSchizophrenia Researchjournal homepage: www.elsevier.com/locate/schresseverity of metabolic risk and negative symptoms differ between patientsusing and patients not using vitamin D supplementation. In thiscross-sectional study, seasonal patterns and differences with regard tosupplementation may indicate an interdependent and potentially causalconnection between vitamin D, metabolic risk and negative symptomseverity
وصف الملف: application/pdf
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المؤلفون: Henrik Bøggild, Charlotte Overgaard, Jens Peter Garne, Kirsten Fonager, Laura Schärfe Jensen
المصدر: Jensen, L S, Overgaard, C, Garne, J P, Bøggild, H & Fonager, K 2019, ' The impact of prior psychiatric medical treatment on return to work after a diagnosis of breast cancer : A registry based study ', Scandinavian Journal of Public Health, vol. 47, no. 5, pp. 519-527 . https://doi.org/10.1177/1403494817722291
مصطلحات موضوعية: Adult, medicine.medical_specialty, Denmark, Population, Breast Neoplasms, Return to work, Cohort Studies, 03 medical and health sciences, symbols.namesake, Return to Work, breast cancer, 0302 clinical medicine, Breast cancer, Psychiatric medication, Journal Article, cohort study, medicine, Humans, Registries, 030212 general & internal medicine, Poisson regression, Psychiatry, education, education.field_of_study, 030505 public health, Return to Work/statistics & numerical data, business.industry, Mental Disorders, History of psychiatric treatment, Public Health, Environmental and Occupational Health, Breast Neoplasms/diagnosis, Cancer, return to work, General Medicine, Middle Aged, medicine.disease, Mental Disorders/drug therapy, Cohort, symbols, Female, 0305 other medical science, business, Antipsychotic Agents/therapeutic use, Antipsychotic Agents, Cohort study
الوصف: PURPOSE: Breast cancer and psychiatric disorders negatively impact work life, both positively associated with unemployment and early retirement. Our purpose was to assess whether being prescribed psychiatric medication, 2-4 yrs prior to a diagnosis of breast cancer, could impact the likelihood of returning to work after cancer therapy.METHODS: 16,868 self-supporting women, diagnosed with breast cancer in Denmark from 2000 to 2012, were identified from a population-based clinical database, then cross-referenced to data held for psychiatric medication usage, sociodemographics, and labour-market participation. The association between historic psychiatric medication and return to work was estimated using a modified Poisson regression model. 'Return to work' was defined as being self-supporting one year after diagnosis of breast cancer.RESULTS: 16% of our cohort had used psychiatric medical treatment 2-4 years before their diagnosis. Sixty-three per cent of these individuals had returned to work one year later, compared to 69% of the patient group with no prior history of using psychiatric medication treatments. In the fully adjusted model, prior use of psychiatric medication diminished the likelihood of returning to work one year after cancer diagnosis (RR = 0.91 (0.87-0.94)). High income and older age were positively associated with returning to work; negative correlates included those related to disease severity.CONCLUSIONS: Historic use of psychiatric medication provoked a minor, although statistically significant reduction in the resumption of working life one year after a diagnosis of breast cancer.IMPLICATIONS FOR CANCER SURVIVORS: Although historic use of psychiatric medication may incur a minor effect on working life, further research is needed on the long-term social consequences for sub-groups.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::62114ce257347550f501fcc253bb2e78
https://doi.org/10.1177/1403494817722291 -
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المؤلفون: Benedicto Crespo-Facorro, W. Wolfgang Fleischhacker, René S. Kahn, Delbert Robinson, Todd Lencz, John M. Kane, Javier Vázquez-Bourgon, Juan A. Gallego, Anil K. Malhotra, Jin Yu, Jian-Ping Zhang
المصدر: American Journal of Psychiatry, 176(1), 21. American Psychiatric Association
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Multifactorial Inheritance, medicine.medical_treatment, Episode of Care, Genome-wide association study, Research Support, Risk Assessment, Article, N.I.H, 03 medical and health sciences, 0302 clinical medicine, Research Support, N.I.H., Extramural, Predictive Value of Tests, Schizophrenia/diagnosis, medicine, Journal Article, Humans, Non-U.S. Gov't, Antipsychotic, Psychiatry, Risk Assessment/methods, Psychopathology, business.industry, Research Support, Non-U.S. Gov't, Extramural, medicine.disease, Prognosis, 030227 psychiatry, Psychiatry and Mental health, Treatment Outcome, Psychotic Disorders, Schizophrenia, Predictive value of tests, Pharmacogenomics, Polygenic risk score, Female, Schizophrenic Psychology, business, Psychotic Disorders/diagnosis, 030217 neurology & neurosurgery, Antipsychotic Agents/therapeutic use, Antipsychotic Agents, Genome-Wide Association Study
الوصف: OBJECTIVE: Pharmacogenomic studies of antipsychotics have typically examined effects of individual polymorphisms. By contrast, polygenic risk scores (PRSs) derived from genome-wide association studies (GWAS) can quantify the influence of thousands of common alleles of small effect in a single measure. The authors examined whether PRSs for schizophrenia were predictive of antipsychotic efficacy in four independent cohorts of patients with first-episode psychosis (total N=510). METHOD: All study subjects received initial treatment with antipsychotic medication for first-episode psychosis, and all were genotyped on standard single-nucleotide polymorphism (SNP) arrays imputed to the 1000 Genomes Project reference panel. PRS was computed based on the results of the large-scale schizophrenia GWAS reported by the Psychiatric Genomics Consortium. Symptoms were measured by using total symptom rating scales at baseline and at week 12 or at the last follow-up visit before dropout. RESULTS: In the discovery cohort, higher PRS significantly predicted higher symptom scores at the 12-week follow-up (controlling for baseline symptoms, sex, age, and ethnicity). The PRS threshold set at a p value
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URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4d54deb4a67cd4b5f7108f6e4b4c4874
https://dspace.library.uu.nl/handle/1874/388048 -
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المؤلفون: Lei Su, Zhiyu Chen, F. Yang, Xijin Wang, Jisheng Tang, Shi-Ping Xie, Xin Yu, Tiebang Liu, Xuanzi Li, Ying Liang, Fang Dong, Xueyi Wang, Hong Deng, Li-Min Xin, Ling Hong, Muni Tang, Yong Zhang, Yi Li, Chuanyue Wang, Xiaojin Xu, Changan Cao, Congpei Zhang, Shuiping Lu, Cheng Zhu, Minglong Gao, Jingjie Yu
المصدر: Asia-Pacific Psychiatry
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, mental disorders, medicine, Clinical endpoint, Humans, antipsychotic agents/adverse effects, Prospective Studies, Amisulpride, Young adult, Adverse effect, Prospective cohort study, Psychiatry, antipsychotic agents/therapeutic use, Chinese, Positive and Negative Syndrome Scale, Brief Report, General Medicine, Middle Aged, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Treatment Outcome, amisulpride, Schizophrenia, Female, Brief Reports, Sulpiride, Psychology, 030217 neurology & neurosurgery, Antipsychotic Agents, medicine.drug
الوصف: Introduction This study evaluated the effectiveness and safety of amisulpride in Chinese schizophrenia patients. Methods A multicenter, single-arm Phase IV study (NCT01795183). Chinese patients with schizophrenia received amisulpride for 8 weeks. The primary endpoint was ≥50% decrease in Positive and Negative Syndrome Scale total score from Baseline to Week 8. Results A total of 316 patients were enrolled; 295 were included in the effectiveness analysis; 66.8% (197/295) achieved ≥50% decrease in Positive and Negative Syndrome Scale total score from Baseline to Week 8. Nine patients discontinued treatment because of adverse events. Discussion Amisulpride had clinical effectiveness and was relatively well tolerated in Chinese patients with schizophrenia.
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المؤلفون: Grunze, Heinz, Vieta, Eduard, Goodwin, Guy M., Bowden, Charles, Licht, Rasmus W., Azorin, Jean-Michel, Yatham, Lakshmi, Mosolov, Sergey, Moeller, Hans-Juergen, Kasper, Siegfried, Affective, WFSBP Task Force Bipolar
المساهمون: European Network of Bipolar Research Expert Centres (ENBREC), ENBREC, Psychiatry, Pôle de psychiatrie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-CHU Marseille, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)
المصدر: World Journal of Biological Psychiatry
World Journal of Biological Psychiatry, Taylor & Francis, 2018, 19 (1), pp.2-58. ⟨10.1080/15622975.2017.1384850⟩
Grunze, H, Vieta, E, Goodwin, G M, Bowden, C, Licht, R W, Azorin, J-M, Yatham, L, Mosolov, S, Möller, H-J, Kasper, S & Members of the WFSBP Task Force on Bipolar Affective Disorders Working on this topic 2018, ' The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders : Acute and long-term treatment of mixed states in bipolar disorder ', World Journal of Biological Psychiatry, vol. 19, no. 1, pp. 2-58 . https://doi.org/10.1080/15622975.2017.1384850
World Journal of Biological Psychiatry, 2018, 19 (1), pp.2-58. ⟨10.1080/15622975.2017.1384850⟩مصطلحات موضوعية: medicine.medical_specialty, Psychotherapist, Long term treatment, Bipolar Disorder, Mixed states, medicine.medical_treatment, Societies, Medical/standards, Antimanic Agents/therapeutic use, mood stabiliser, electroconvulsive therapy, 03 medical and health sciences, pharmacotherapy, 0302 clinical medicine, Pharmacotherapy, Electroconvulsive therapy, Antimanic Agents, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Biological Psychiatry/standards, Electroconvulsive Therapy/methods, mental disorders, Medicine, Humans, Bipolar disorder, guidelines, Psychiatry, Electroconvulsive Therapy, Biological Psychiatry, Societies, Medical, bipolar disorder, maintenance treatment, business.industry, acute treatment, Guideline, medicine.disease, Bipolar Disorder/drug therapy, 030227 psychiatry, 3. Good health, Psychiatry and Mental health, antipsychotics, antidepressants, Practice Guidelines as Topic, Biological psychiatry, Practice Guidelines as Topic/standards, business, 030217 neurology & neurosurgery, Antipsychotic Agents/therapeutic use, Antipsychotic Agents
الوصف: Objectives: Although clinically highly relevant, the recognition and treatment of bipolar mixed states has played only an underpart in recent guidelines. This WFSBP guideline has been developed to supply a systematic overview of all scientific evidence pertaining to the acute and long-term treatment of bipolar mixed states in adults. Methods: Material used for these guidelines is based on a systematic literature search using various data bases. Their scientific rigour was categorised into six levels of evidence (A–F), and different grades of recommendation to ensure practicability were assigned. We examined data pertaining to the acute treatment of manic and depressive symptoms in bipolar mixed patients, as well as data pertaining to the prevention of mixed recurrences after an index episode of any type, or recurrence of any type after a mixed index episode. Results: Manic symptoms in bipolar mixed states appeared responsive to treatment with several atypical antipsychotics, the best evidence resting with olanzapine. For depressive symptoms, addition of ziprasidone to treatment as usual may be beneficial; however, the evidence base is much more limited than for the treatment of manic symptoms. Besides olanzapine and quetiapine, valproate and lithium should also be considered for recurrence prevention. Limitations: The concept of mixed states changed over time, and recently became much more comprehensive with the release of DSM-5. As a consequence, studies in bipolar mixed patients targeted slightly different bipolar subpopulations. In addition, trial designs in acute and maintenance treatment also advanced in recent years in response to regulatory demands. Conclusions: Current treatment recommendations are still based on limited evidence, and there is a clear demand for confirmative studies adopting the DSM-5 specifier with mixed features concept.
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المؤلفون: Søren Dinesen Østergaard, Ole Mors, Christiane Gasse, Louise B. Bjørklund, Henriette Thisted Horsdal
المصدر: Bjørklund, L B, Horsdal, H T, Mors, O, Gasse, C & Østergaard, S D 2017, ' Psychopharmacological treatment of psychotic mania and psychotic bipolar depression compared to non-psychotic mania and non-psychotic bipolar depression ', Bipolar disorders, vol. 19, no. 6, pp. 505–512 . https://doi.org/10.1111/bdi.12504
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Bipolar Disorder, Lithium (medication), medicine.medical_treatment, Denmark, Bipolar Disorder/diagnosis, Drug Therapy, Combination/methods, Psychotic depression, Antidepressive Agents/therapeutic use, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, mental disorders, medicine, Humans, Bipolar disorder, Registries, Age of Onset, Psychiatry, Antipsychotic, Biological Psychiatry, Depression (differential diagnoses), Psychiatric Status Rating Scales, Anticonvulsants/therapeutic use, Middle Aged, medicine.disease, Antidepressive Agents, Denmark/epidemiology, 030227 psychiatry, Psychiatry and Mental health, Socioeconomic Factors, Antidepressant, Anticonvulsants, Drug Therapy, Combination, Female, Age of onset, medicine.symptom, Psychology, Mania, 030217 neurology & neurosurgery, Antipsychotic Agents/therapeutic use, medicine.drug, Clinical psychology, Antipsychotic Agents
الوصف: OBJECTIVES: An evidence base for the treatment of mania and bipolar depression with psychotic symptoms is lacking. Nevertheless, clinicians may have a preference for treating episodes of bipolar disorder with or without psychotic symptoms in different ways, which is likely to reflect notions of differential efficacy of treatments between these subtypes. This study aimed to investigate whether the psychopharmacological treatment of psychotic and non-psychotic episodes of mania and bipolar depression, respectively, differs in clinical practice.METHODS: We conducted a register-based study assessing the psychopharmacological treatment of all individuals receiving their first diagnosis of mania or bipolar depression between 2010 and 2012. The psychopharmacological treatment within 3 months following the time of diagnosis was considered. Potential differences in psychopharmacological treatment between the psychotic and non-psychotic subtypes of mania and bipolar depression, respectively, were investigated by means of Pearson's χ(2) test and logistic regression adjusted for sex and age at diagnosis of bipolar disorder.RESULTS: A total of 827 patients were included in the analyses. The adjusted odds ratio (aOR) for treatment with an antipsychotic was 1.71 (95% confidence interval [CI]: 1.18-2.48, PCONCLUSIONS: It would be of interest to conduct studies evaluating whether antipsychotics represent the superior pharmacological treatment for psychotic mania and psychotic bipolar depression.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a0f797f1caffa60f79297723c580a52e
https://pure.au.dk/portal/da/publications/psychopharmacological-treatment-of-psychotic-mania-and-psychotic-bipolar-depression-compared-to-nonpsychotic-mania-and-nonpsychotic-bipolar-depression(56a758ab-3190-489a-80c3-f2114ef1c704).html -
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المؤلفون: Pierre-Alexis Geoffroy, Louise Carton, Nicolas Simon, Benjamin Rolland, Olivier Cottencin, Jonathan Favre, Régis Bordet, Maryse Lapeyre-Mestre
المساهمون: Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 (SCALab), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365 (GRITA), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Sciences Cognitives et Sciences Affectives (SCALab) - UMR 9193 (SCALab), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille
المصدر: Current Pharmaceutical Design
Current Pharmaceutical Design, 2015, Current Pharmaceutical Design, 21 (23), pp.3280-3297. ⟨10.2174/1381612821666150619092903⟩
Scopus-Elsevier
Current Pharmaceutical Design, Bentham Science Publishers, 2015, Current Pharmaceutical Design, 21 (23), pp.3280-3297. ⟨10.2174/1381612821666150619092903⟩مصطلحات موضوعية: Mesh:Off-Label Use, pharmacoepidemiology, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Inappropriate Prescribing, Mesh:Adult, off-label, [SCCO]Cognitive science, Mesh:Adolescent, 0302 clinical medicine, Risk Factors, Mesh:Risk Factors, Mesh:Antipsychotic Agents/therapeutic use, Drug Discovery, Practice Patterns, Physicians', Child, Mesh:Aged, Mesh:Practice Patterns, Mesh:Treatment Outcome, Mesh:Mental Disorders/psychology, Mental Disorders, Age Factors, Middle Aged, Mesh:Inappropriate Prescribing/trends, 3. Good health, Treatment Outcome, Mesh:Age Factors, Anxiety, Aripiprazole, Patient Safety, medicine.symptom, Mesh:Mental Disorders/drug therapy, Mesh:Antipsychotic Agents/adverse effects, Mesh:Patient Safety, Antipsychotic Agents, Mesh:Risk Assessment, medicine.drug, Adult, safety, medicine.medical_specialty, Adolescent, Mesh:Child, Mesh:Young Adult, Drug Prescriptions, Risk Assessment, elderly, Young Adult, 03 medical and health sciences, children, stomatognathic system, Mesh:Middle Aged, medicine, Humans, Adults, Attention deficit hyperactivity disorder, Medical prescription, Antipsychotic, Psychiatry, Aged, Pharmacology, Risperidone, business.industry, Off-Label Use, Mesh:Drug Prescriptions, medicine.disease, 030227 psychiatry, antipsychotics, Mesh:Humans, stomatognathic diseases, Mood disorders, Mesh:Physicians''/trends, Quetiapine, business, Mesh:Mental Disorders/diagnosis, 030217 neurology & neurosurgery
الوصف: International audience; BACKGROUND: New antipsychotics continuously arrive on the market, which thereby influences the approved and off-label prescribing (OLP) schemes. We aimed to identify the recent trends in the OLP of antipsychotics. We conducted a literature review based on three different populations: adult, pediatric, and elderly patients.METHODS: A literature search was performed in the PubMed and ScienceDirect databases using the following keyword algorithm: "offlabel" AND ("antipsychotic*" OR "neuroleptic*"). The period investigated ranged from January 2000 to January 2015. Only Englishwritten pharmacoepidemiological studies were included.RESULTS: Seventy-seven relevant results were identified. Among adults, OLP consisted of 40 to 75% of all antipsychotic prescriptions. The main indications were mood disorders, anxiety disorders, insomnia and agitation. Quetiapine was the most frequently prescribed offlabel antipsychotic, especially for anxiety and insomnia. Among children, OLP was estimated between 36 and 93.2% of all antipsychotic prescriptions. Risperidone and aripiprazole were primarily used and were most often prescribed for attention deficit hyperactivity disorder, anxiety, or mood disorders. Among elderly individuals, OLP consisted of 22 to 86% of all antipsychotic prescriptions. Antipsychotic OLP was particularly frequent for agitation; however, a recent decrease in this OLP was identified.CONCLUSIONS: Antipsychotics have largely been prescribed off-label in recent years. The types of antipsychotic OLP practices differ according to the age category of patients. OLP is often used in cases of therapeutic dead-ends or for specific disorders with few or no currently approved medications. However, other OLP practices only reflect temporary prescription trends for mild symptoms, which may induce safety concerns.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ea35d614bfaac7fb7f37eff90b3efd11
https://doi.org/10.2174/1381612821666150619092903 -
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المؤلفون: Jacolien Kruizinga, Edith Liemburg, Huibert Burger, Andrea Cipriani, John Geddes, Lindsay Robertson, Beatrix Vogelaar, Willem A Nolen
المصدر: The Cochrane Library
Cochrane Database Syst Revمصطلحات موضوعية: medicine.medical_treatment, Psychotic depression, law.invention, DOUBLE-BLIND, Electroconvulsive therapy, Randomized controlled trial, law, OLANZAPINE PLUS SERTRALINE, Pharmacology (medical), COMPARING IMIPRAMINE, Randomized Controlled Trials as Topic, Antidepressive Agents [*therapeutic use], PLACEBO, Depression, RANDOMIZED CONTROLLED-TRIAL, Antidepressive Agents, Psychiatry and Mental health, Systematic review, Meta-analysis, Drug Therapy, Combination, Antipsychotic Agents, medicine.medical_specialty, Antidepressive Agents [therapeutic use], Placebo, DELUSIONAL DEPRESSION, Drug Therapy, Internal medicine, medicine, Antipsychotic Agents [therapeutic use], Major [*drug therapy] [etiology], Humans, Major [drug therapy, etiology], Antipsychotic, Psychiatry, Depressive Disorder, Major, Depressive Disorder, business.industry, MIFEPRISTONE, CLINICAL-RESPONSE, ANTIDEPRESSANT, Antipsychotic Agents [*therapeutic use], MAJOR DEPRESSION, medicine.disease, Psychotic Disorders [complications, drug therapy], Psychotic Disorders, Psychotic Disorders [complications] [*drug therapy], Relative risk, Combination [methods], business, Systematic Reviews as Topic
الوصف: BACKGROUND: Evidence is limited regarding the most effective pharmacological treatment for psychotic depression: monotherapy with an antidepressant, monotherapy with an antipsychotic, another treatment (e.g. mifepristone), or combination of an antidepressant plus an antipsychotic. This is an update of a review first published in 2005 and last updated in 2015. OBJECTIVES: 1. To compare the clinical efficacy of pharmacological treatments for patients with an acute psychotic depression: antidepressant monotherapy, antipsychotic monotherapy, mifepristone monotherapy, and the combination of an antidepressant plus an antipsychotic versus placebo and/or each other. 2. To assess whether differences in response to treatment in the current episode are related to non‐response to prior treatment. SEARCH METHODS: A search of the Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library; the Cochrane Common Mental Disorders Controlled Trials Register (CCMDCTR); Ovid MEDLINE (1950‐); Embase (1974‐); and PsycINFO (1960‐) was conducted on 21 February 2020. Reference lists of all included studies and related reviews were screened and key study authors contacted. SELECTION CRITERIA: All randomised controlled trials (RCTs) that included participants with acute major depression with psychotic features, as well as RCTs consisting of participants with acute major depression with or without psychotic features, that reported separately on the subgroup of participants with psychotic features. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed risk of bias in the included studies, according to criteria from the Cochrane Handbook for Systematic Reviews of Interventions. Data were entered into RevMan 5.1. We used intention‐to‐treat data. Primary outcomes were clinical response for efficacy and overall dropout rate for harm/tolerance. Secondary outcome were remission of depression, change from baseline severity score, quality of life, and dropout rate due to adverse effects. For dichotomous efficacy outcomes (i.e. response and overall dropout), risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. Regarding the primary outcome of harm, only overall dropout rates were available for all studies. If the study did not report any of the response criteria as defined above, remission as defined here could be used as an alternative. For continuously distributed outcomes, it was not possible to extract data from the RCTs. MAIN RESULTS: The search identified 3947 abstracts, but only 12 RCTs with a total of 929 participants could be included in the review. Because of clinical heterogeneity, few meta‐analyses were possible. The main outcome was reduction in severity (response) of depression, not of psychosis. For depression response, we found no evidence of a difference between antidepressant and placebo (RR 8.40, 95% CI 0.50 to 142.27; participants = 27, studies = 1; very low‐certainty evidence) or between antipsychotic and placebo (RR 1.13, 95% CI 0.74 to 1.73; participants = 201, studies = 2; very low‐certainty evidence). Furthermore, we found no evidence of a difference in overall dropouts with antidepressant (RR 1.24, 95% CI 0.34 to 4.51; participants = 27, studies = 1; very low‐certainty evidence) or antipsychotic monotherapy (RR 0.79, 95% CI 0.57 to 1.08; participants = 201, studies = 2; very low‐certainty evidence). No evidence suggests a difference in depression response (RR 2.09, 95% CI 0.64 to 6.82; participants = 36, studies = 1; very low‐certainty evidence) or overall dropouts (RR 1.79, 95% CI 0.18 to 18.02; participants = 36, studies = 1; very low‐certainty evidence) between antidepressant and antipsychotic. For depression response, low‐ to very low‐certainty evidence suggests that the combination of an antidepressant plus an antipsychotic may be more effective than antipsychotic monotherapy (RR 1.83, 95% CI 1.40 to 2.38; participants = 447, studies = 4), more effective than antidepressant monotherapy (RR 1.42, 95% CI 1.11 to 1.80; participants = 245, studies = 5), and more effective than placebo (RR 1.86, 95% CI 1.23 to 2.82; participants = 148, studies = 2). Very low‐certainty evidence suggests no difference in overall dropouts between the combination of an antidepressant plus an antipsychotic versus antipsychotic monotherapy (RR 0.79, 95% CI 0.63 to 1.01; participants = 447, studies = 4), antidepressant monotherapy (RR 0.91, 95% CI 0.55 to 1.50; participants = 245, studies = 5), or placebo alone (RR 0.75, 95% CI 0.48 to 1.18; participants = 148, studies = 2). No study measured change in depression severity from baseline, quality of life, or dropouts due to adverse events. We found no RCTs with mifepristone that fulfilled our inclusion criteria. Risk of bias is considerable: we noted differences between studies with regards to diagnosis, uncertainties around randomisation and allocation concealment, treatment interventions (pharmacological differences between various antidepressants and antipsychotics), and outcome criteria. AUTHORS' CONCLUSIONS: Psychotic depression is heavily under‐studied, limiting confidence in the conclusions drawn. Some evidence indicates that combination therapy with an antidepressant plus an antipsychotic is more effective than either treatment alone or placebo. Evidence is limited for treatment with an antidepressant alone or with an antipsychotic alone. Evidence for efficacy of mifepristone is lacking.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6d75c925d026b7ba001414d0bfe8ca7b
https://doi.org/10.1192/apt.23.1.2 -
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المؤلفون: Philippe Golay, Pierre Progin, Luis Alameda, Philipp S. Baumann, Philippe Conus, Julien Elowe, Andrea Polari
المصدر: Journal of psychiatric research, vol. 77, pp. 15-21
مصطلحات موضوعية: Adult, Male, Pediatrics, medicine.medical_specialty, congenital, hereditary, and neonatal diseases and abnormalities, Adolescent, medicine.medical_treatment, Poison control, Medication Adherence, Time-to-Treatment, Antipsychotic Agents/therapeutic use, Female, Follow-Up Studies, Humans, Prospective Studies, Psychiatric Status Rating Scales, Psychotic Disorders/epidemiology, Psychotic Disorders/psychology, Psychotic Disorders/therapy, Schizophrenia/epidemiology, Schizophrenia/therapy, Schizophrenic Psychology, Treatment Outcome, Young Adult, Duration of untreated psychosis, Early psychosis, First episode psychosis, Treatment adherence, 03 medical and health sciences, 0302 clinical medicine, Injury prevention, medicine, Young adult, Antipsychotic, Prospective cohort study, Psychiatry, Biological Psychiatry, business.industry, Human factors and ergonomics, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Psychotic Disorders, Schizophrenia, dup, business, 030217 neurology & neurosurgery, Antipsychotic Agents
الوصف: BACKGROUND: While reduction of DUP (Duration of Untreated Psychosis) is a key goal in early intervention strategies, the predictive value of DUP on outcome has been questioned. We planned this study in order to explore the impact of three different definition of "treatment initiation" on the predictive value of DUP on outcome in an early psychosis sample. METHODS: 221 early psychosis patients aged 18-35 were followed-up prospectively over 36 months. DUP was measured using three definitions for treatment onset: Initiation of antipsychotic medication (DUP1); engagement in a specialized programme (DUP2) and combination of engagement in a specialized programme and adherence to medication (DUP3). RESULTS: 10% of patients never reached criteria for DUP3 and therefore were never adequately treated over the 36-month period of care. While DUP1 and DUP2 had a limited predictive value on outcome, DUP3, based on a more restrictive definition for treatment onset, was a better predictor of positive and negative symptoms, as well as functional outcome at 12, 24 and 36 months. Globally, DUP3 explained 2 to 5 times more of the variance than DUP1 and DUP2, with effect sizes falling in the medium range according to Cohen. CONCLUSIONS: The limited predictive value of DUP on outcome in previous studies may be linked to problems of definitions that do not take adherence to treatment into account. While they need replication, our results suggest effort to reduce DUP should continue and aim both at early detection and development of engagement strategies.Copyright © 2016 Elsevier Ltd. All rights reserved. Language: en
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URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8d7310212aab2615987d534b84190410
https://serval.unil.ch/notice/serval:BIB_706A61AC7241 -
10
المؤلفون: Marco Boeri, Frank Kee, Jonathan J. Rolison, Riccardo Scarpa, Alan J McMichael, Francis A. O'Neill, Joseph Kane
المصدر: Value in health, 2017, Vol.20(1), pp.126-131 [Peer Reviewed Journal]
McMichael, A J, Boeri, M, Rolison, J J, Kane, J, O'Neill, F A, Scarpa, R & Kee, F 2017, ' The Influence of Genotype Information on Psychiatrists’ Treatment Recommendations: More Experienced Clinicians Know Better What to Ignore ', Value in Health, vol. 20, no. 1, pp. 126-131 . https://doi.org/10.1016/j.jval.2016.09.2395مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Response to therapy, Genotype, discrete choice, Attitude of Health Personnel, behavioral disciplines and activities, attribute nonattendance, 03 medical and health sciences, 0302 clinical medicine, Clinical decision making, 0502 economics and business, mental disorders, medicine, Humans, 030212 general & internal medicine, 050207 economics, Practice Patterns, Physicians', Psychiatry, Positive and Negative Syndrome Scale, business.industry, Health Policy, 05 social sciences, Public Health, Environmental and Occupational Health, Medical decision making, Middle Aged, medicine.disease, Response to treatment, medical decision making, Schizophrenia, Pharmacogenetics, Adult Antipsychotic Agents/*therapeutic use Attitude of Health Personnel Biomarkers Female *Genotype Humans Male Middle Aged Pharmacogenetics Practice Patterns, Physicians'/*statistics & numerical data Psychiatry/*statistics & numerical data Schizophrenia/*drug therapy *attribute nonattendance *discrete choice *medical decision making, Female, business, Biomarkers, Antipsychotic Agents
الوصف: Background This study applies attribute nonattendance to medical decision making. We aimed to demonstrate how this type of analysis can be used in medical decision making to assess whether psychiatrists were influenced in their treatment recommendations by information on the genotype of a patient, despite knowing the patient's response to treatment as measured by the Positive and Negative Syndrome Scale. A patient's genetic information may be used to predict their response to therapy; such information, however, becomes redundant, and should not influence decisions, once a clinician knows the patient's actual response to treatment. Methods Sixty-seven psychiatrists were presented with patients' pre- or post-treatment scores on the Positive and Negative Syndrome Scale for two hypothetical treatments for schizophrenia. Psychiatrists were also informed whether the patient possessed a genotype linked to hyper-responsiveness to one of the treatments, and were asked to recommend one of these two treatments. Attribute nonattendance assessed whether the information on genotype influenced psychiatrists' treatment recommendations. Results Years of experience predicted whether psychiatrists were influenced by the genetic information. Psychiatrists with 1 year or less of experience had a 46% probability of considering genetic information, whereas psychiatrists with at least 15 years of experience had a lower probability (7%). Conclusions Psychiatrists and other clinicians should be cautious about allowing a patient's genetic information to carry unnecessary weight in their clinical decision making.
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