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99 – Predicting schizophrenia spectrum disorders with psychological scales – The Northern Finland 1966 Birth Cohort
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ABSTRACTS / Schizophrenia Research 98 (2008) 3–199 Presenting Author details: [email protected] PO Box 5000, 90014 Oulu, Finland, Tel.: +358 8 3156923; fax: +358 8 333167.
Finland as opposed to Sweden where it may also be used for the general schizophrenia population. The objective is to compare the clinical and economic effects of RLAI with relevant comparators in the Swedish and Finnish setting. Methods: An existing pharmacoeconomic model was adapted to reflect the treatment of schizophrenia in Sweden and Finland, based on expert opinion and literature search. RLAI is compared with olanzapine and haloperidol depot in Sweden and with perphenazine depot in Finland. Relevant model outputs include quality adjusted life years (QALYs) and costs. A scenario analysis was performed in which RLAI is compared with olanzapine in the Finnish general schizophrenia population. Univariate and multivariate sensitivity analyses were performed. Results: Predicted health gains and cost-savings generated by RLAI in Sweden as compared to haloperidol depot and olanzapine are 0.04 and 0.15 QALYs and €360 and €5900, respectively. The differences with olanzapine are explained by better compliance rates resulting in better symptom reduction and, therefore, higher QALY and lower hospitalization costs. Compared to haloperidol depot, RLAI will also decrease hospitalization costs due to a better symptom reduction. Better symptom reduction and safety profile also explain the higher QALY compared to haloperidol depot. In Finland, RLAI is predicted to generate health gains of 0.13 and cost savings of €2400 compared to perphenazine depot. The Finnish scenario analysis showed that RLAI will have a cost-effectiveness ratio of €20,000/QALY, which is very acceptable in Western countries. Conclusions: RLAI is likely to dominate haloperidol depot and olanzapine in general schizophrenia population in Sweden and perphenazine depot in the high risk noncompliant population in Finland. The scenario analysis showed that RLAI may be costeffective in the Finnish general schizophrenia population. Conclusions were insensitive to changes in the input parameters.
Background: The aim of the study was to evaluate concurrent and predictive validity of several psychological scales for schizophrenic psychoses. Methods: Psychological scales (Perceptual Aberration, Physical and Social Anhedonia, Hypomanic Personality, Schizoidi and “Bipolar II” scales) were filled in as part of the 31-year follow-up survey of the prospective Northern Finland 1966 Birth Cohort. In total 4926 participants (2203 males and 2723 females) filled in adequately at least one of the scales. We compared subjects without any previous hospitalizations by age 31 years to those with previous hospital diagnoses and to those who in the 8-year-long follow-up were hospitalized due to schizophrenic psychosis. We also compared the subjects with schizophrenia spectrum disorders and subjects with other psychiatric disorders. Results: In most scales, subjects with schizophrenia spectrum disorders differed from healthy subjects. The Perceptual Aberration Scale was the best scales for concurrent (effect size= 1.89) and discriminant validity (effect size = 0.64). Subjects having a high score in Hypomanic Personality Scale were in the highest risk for developing schizophrenic psychoses during the follow-up (OR 10.72; 2.87–40.06). Conclusions: Subjects with schizophrenia spectrum disorders differed statistically significantly in most of the scales from healthy controls and from subjects with other psychiatric disorders. Many of the scales were useful predictors for future hospitalizations due to schizophrenic psychoses. However scales were not very diagnosis specific. The scales are probably not useful as screening instruments but can be used as endophenotypes e.g. when studying risk factors of schizophrenic psychoses.
doi:10.1016/j.schres.2007.12.165
doi:10.1016/j.schres.2007.12.166
99 – PREDICTING SCHIZOPHRENIA SPECTRUM DISORDERS WITH PSYCHOLOGICAL SCALES – THE NORTHERN FINLAND 1966 BIRTH COHORT
100 – RECOVERY FROM SCHIZOPHRENIA – A META-ANALYSIS
J. Miettunen 1, J. Veijola 1,2, M.K. Isohanni 1,3, T. Paunio 4, N.B. Freimer 5, E. Lauronen 6, J. Ekelund 4,6, L. Peltonen 4, M. Joukamaa 7,8, D. Lichtermann 9. 1
Department of Psychiatry, Oulu University and Oulu University Hospital, Oulu, Finland 2 Academy of Finland, Helsinki, Finland 3 Department of Public Health and General Practice, University of Oulu, Oulu, Finland 4 Department of Molecular Medicine, National Public Health Institute, Helsinki, Finland 5 Center for Neurobehavioral Genetics, Semen Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, USA 6 Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland 7 Social Psychiatry Unit, Tampere School of Public Health, University of Tampere, Tampere, Finland 8 Department of Psychiatry, Tampere University Hospital, Tampere, Finland 9 Methadone maintenance clinic “Café Ersatz”, Bonn, Germany
J. Miettunen 1, J. Veijola 1, J. McGrath 2, S. Saha 2, J. Heikkinen 1, M. Isohanni 1, E. Lauronen 1. 1 Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland 2 Queensland Centre for Mental Health Research, Wacol, Australia
Presenting Author details: [email protected] PO Box 5000, 90014 Oulu, Finland, Tel.: +358 8 3156923; fax: +358 8 333167. Background: Recovery in schizophrenia is still a controversial issue. The aim was to collect the studies related to this topic and synthesize these data with meta-analytic techniques. Methods: Potentially relevant studies from seven electronic databases and from manual literature searching were identified. Studies in English, with primary data, not therapy/drug trials/interventions, with at least 15 subjects and follow-up data for at least 2 years were included. Recovery needed to be measured by utilizing both clinical and social dimensions. All abstracts and articles were critically analyzed by two of the authors.
ABSTRACTS / Schizophrenia Research 98 (2008) 3–199 Presenting Author details: [email protected] PO Box 5000, 90014 Oulu, Finland, Tel.: +358 8 3156923; fax: +358 8 333167.
Finland as opposed to Sweden where it may also be used for the general schizophrenia population. The objective is to compare the clinical and economic effects of RLAI with relevant comparators in the Swedish and Finnish setting. Methods: An existing pharmacoeconomic model was adapted to reflect the treatment of schizophrenia in Sweden and Finland, based on expert opinion and literature search. RLAI is compared with olanzapine and haloperidol depot in Sweden and with perphenazine depot in Finland. Relevant model outputs include quality adjusted life years (QALYs) and costs. A scenario analysis was performed in which RLAI is compared with olanzapine in the Finnish general schizophrenia population. Univariate and multivariate sensitivity analyses were performed. Results: Predicted health gains and cost-savings generated by RLAI in Sweden as compared to haloperidol depot and olanzapine are 0.04 and 0.15 QALYs and €360 and €5900, respectively. The differences with olanzapine are explained by better compliance rates resulting in better symptom reduction and, therefore, higher QALY and lower hospitalization costs. Compared to haloperidol depot, RLAI will also decrease hospitalization costs due to a better symptom reduction. Better symptom reduction and safety profile also explain the higher QALY compared to haloperidol depot. In Finland, RLAI is predicted to generate health gains of 0.13 and cost savings of €2400 compared to perphenazine depot. The Finnish scenario analysis showed that RLAI will have a cost-effectiveness ratio of €20,000/QALY, which is very acceptable in Western countries. Conclusions: RLAI is likely to dominate haloperidol depot and olanzapine in general schizophrenia population in Sweden and perphenazine depot in the high risk noncompliant population in Finland. The scenario analysis showed that RLAI may be costeffective in the Finnish general schizophrenia population. Conclusions were insensitive to changes in the input parameters.
Background: The aim of the study was to evaluate concurrent and predictive validity of several psychological scales for schizophrenic psychoses. Methods: Psychological scales (Perceptual Aberration, Physical and Social Anhedonia, Hypomanic Personality, Schizoidi and “Bipolar II” scales) were filled in as part of the 31-year follow-up survey of the prospective Northern Finland 1966 Birth Cohort. In total 4926 participants (2203 males and 2723 females) filled in adequately at least one of the scales. We compared subjects without any previous hospitalizations by age 31 years to those with previous hospital diagnoses and to those who in the 8-year-long follow-up were hospitalized due to schizophrenic psychosis. We also compared the subjects with schizophrenia spectrum disorders and subjects with other psychiatric disorders. Results: In most scales, subjects with schizophrenia spectrum disorders differed from healthy subjects. The Perceptual Aberration Scale was the best scales for concurrent (effect size= 1.89) and discriminant validity (effect size = 0.64). Subjects having a high score in Hypomanic Personality Scale were in the highest risk for developing schizophrenic psychoses during the follow-up (OR 10.72; 2.87–40.06). Conclusions: Subjects with schizophrenia spectrum disorders differed statistically significantly in most of the scales from healthy controls and from subjects with other psychiatric disorders. Many of the scales were useful predictors for future hospitalizations due to schizophrenic psychoses. However scales were not very diagnosis specific. The scales are probably not useful as screening instruments but can be used as endophenotypes e.g. when studying risk factors of schizophrenic psychoses.
doi:10.1016/j.schres.2007.12.165
doi:10.1016/j.schres.2007.12.166
99 – PREDICTING SCHIZOPHRENIA SPECTRUM DISORDERS WITH PSYCHOLOGICAL SCALES – THE NORTHERN FINLAND 1966 BIRTH COHORT
100 – RECOVERY FROM SCHIZOPHRENIA – A META-ANALYSIS
J. Miettunen 1, J. Veijola 1,2, M.K. Isohanni 1,3, T. Paunio 4, N.B. Freimer 5, E. Lauronen 6, J. Ekelund 4,6, L. Peltonen 4, M. Joukamaa 7,8, D. Lichtermann 9. 1
Department of Psychiatry, Oulu University and Oulu University Hospital, Oulu, Finland 2 Academy of Finland, Helsinki, Finland 3 Department of Public Health and General Practice, University of Oulu, Oulu, Finland 4 Department of Molecular Medicine, National Public Health Institute, Helsinki, Finland 5 Center for Neurobehavioral Genetics, Semen Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, USA 6 Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland 7 Social Psychiatry Unit, Tampere School of Public Health, University of Tampere, Tampere, Finland 8 Department of Psychiatry, Tampere University Hospital, Tampere, Finland 9 Methadone maintenance clinic “Café Ersatz”, Bonn, Germany
J. Miettunen 1, J. Veijola 1, J. McGrath 2, S. Saha 2, J. Heikkinen 1, M. Isohanni 1, E. Lauronen 1. 1 Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland 2 Queensland Centre for Mental Health Research, Wacol, Australia
Presenting Author details: [email protected] PO Box 5000, 90014 Oulu, Finland, Tel.: +358 8 3156923; fax: +358 8 333167. Background: Recovery in schizophrenia is still a controversial issue. The aim was to collect the studies related to this topic and synthesize these data with meta-analytic techniques. Methods: Potentially relevant studies from seven electronic databases and from manual literature searching were identified. Studies in English, with primary data, not therapy/drug trials/interventions, with at least 15 subjects and follow-up data for at least 2 years were included. Recovery needed to be measured by utilizing both clinical and social dimensions. All abstracts and articles were critically analyzed by two of the authors.