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P.3.c.022 Comparison of patients treated with antipsychotics and psychoeducation and those treated with antipsychotics only
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P.3.c. Psychotic disorders and antipsychotics − Antipsychotics (clinical)
side effect was assessed by Abnormal Involuntary Movement Scale (AIMS) and Simpson Angus Scale (SAS) medication. The data was analyzed on an intent to treat (ITT) basis with the last-observation-carried-forward (LOCF). For the endpoint the PANSS, YMRS and CGI-S scores were analyzed by repeated measures of analysis of variance (ANOVA) in terms of the withinsubject factors and the between-subject factors over the study periods. An interaction effect was also considered between time and the treatment group. SAS and AIMS scores were analyzed using the same ANOVA model in PANSS. Descriptive statistics and chi-square test were performed for the group difference in the frequencies of side effects. Results: There were no differences in gender, age, diagnoses, severity of symptoms before taking medication between two groups. The 5-item acute agitation cluster from PANSS and CGI-S scores were significantly decreased over time in both treatment groups without any significant group difference and time by the group interaction effect (F = 71.85, <0.0001). Tolerability and safety by SAS and AIMS were not different between two groups. There were no serious adverse events in both groups. Intramuscular Aripiprazole have the advantage instead of Intramuscular Haloperidol for the avoidance of side effects for extra pyramidal actions, dystonia and tardive dyskinesia regarding the quality of life of psychotic patients. The Inventory of Quality of Life (QL) was used after intramuscular use of Aripiprazole and Haloperidol for the psychotic agitation with delusional thoughts and ideas and first rank symptoms of schizophrenia. Conclusion: For the emergency treatment of psychotic agitation injectable Aripiprazole was as effective and tolerable as intramuscular administration of Haloperidol. Therefore, it is considerable to choose injectable Aripiprazole instead of intramuscular Haloperidol for treatment of patients with acute psychotic agitation. References [1] El-Sayeh HG, Morganti C (2006): Aripiprazole for Schizophrenia. Cohran Database Syst Rev (2); CD004578. [2] Currier GW (2000): Atypical antipsychotic medications in the psychiatric emergency service. J Clin Psychiatry 61:21−26.
P.3.c.022 Comparison of patients treated with antipsychotics and psychoeducation and those treated with antipsychotics only C. Istikoglou1 ° , D. Foutsitzis1 , G. Theodorakopoulos1 , P. Kanellos1 , N. Polonifis1 , A. Vlavianou1 , D. Vlissides2 , K. Michelidakis2 . 1 Konstantopouleion General Hospital of Nea Ionia, Psychiatric, Athens, Greece; 2 Asklepeion General Hospital of Voula, Psychiatric, Athens, Greece Objective: Psychoeducation is a complementary treatment of Psychotic Disorders. Per other researchers, it is Family Behavioural Treatment. The first to deal with Psychoeducation is Prof. Ian Faloon of New Zealand. Family Psychoeducation comprises three stages: 1) the briefing of the patient and his/her family on the nature of the psychological disorder, 2) the education of the patient and his/her family on basic social communication skills, mainly on solving problems), and 3) the psychological support of both the patient and his/her family. PANSS is a most used scale for positive and negative symptoms of Schizophrenia. Atypical antipsychotics is the last therapeutic proposal for the schizophrenia treatment and these are Clozapine, Amissulpride, Risperidone, Paliperidone, Olanzapine, Ziprasidone, Aripiprazone
and Quetiapine. Psychoeducation is concerning specially the resolution of daily problems of the patients and their families in correlation with the patient. Aim: The aim of the present dissertation is to uphold the role and importance of Psychoeducation as a complementary treatment of Psychotic Disorders. 40 (n = 40) patients (24 men and 16 women) were studied as outpatients in the Daycare Psychiatric Departments of “Konstantopouleion” General Hospital in Nea Ionia, and the “Asklepeion” Hospital in Voula, Greece, for a period of one year. 20 of them were treated with a combination of Psychoeducation and neuroleptics, while 20 of them were receiving solely neuroleptics. All the said patients were submitted to the PANSS (Positive and Negative Symptoms of Schizophrenia) scale, at the beginning of their treatment, and after 3, 6, 9, and 12 months respectively. Results: From 40 patients that solely received neuroleptics, in 22 patients (55%) the PANSS scale was reduced, in 10 patients (25%) the PANSS remained unchanged, and in 8 patients (20%) the PANSS scale showed a relapse during the year. In the group of 40 patients that were treated with a combination of neuroleptics and psychoeducation, the results were as follows: in 32 patients (80%) the PANSS scale was significantly reduced, therefore the positive and negative symptoms improved in them. Therefore, the improvement observed in comparison with the group of patients that received solely neuroleptics is statistically important. In 6 of the remaining patients no alteration has been observed to the PANSS scores (15%) during the one-year time period, while from the last 2 patients, one interrupted the psychological treatment (5%), and the other relapsed (5%). It is worthy noting that a significant improvement has been observed in the negative symptom items of the PANSS scale for the group of patients that was treated with a combination of neuroleptics and psychoeducation. One of the parameters of PANSS regards the Quality of Life of Schizophrenic patients. Psychoeducation improves the Quality of Life of schizophrenic patients and their families. Conclusion: The combination of neuroleptics and psychoeducation has better results than the sole administration of antipsychotics and contributes at the prompt improvement and social rehabilitation of the patients with psychological disorders. References [1] Faloon IR, Boyd JL, McGill CW et al. Family management in the prevention of morbidity of schizophrenia. Arch Gen Psychiatry 1985; 35:1160–1177. [2] Joseph Baum, Teresa Frabose, Sibylle Kraemer, Michael Rentropam, Gabrielle Pitschel-Waltz. Psychoeducation: a family psychotherapeutic intervention for patients with schizophrenia and their families. Schiz Bull 2006; vol. 32(51):S1-S9. [3] Pharoah FM, Rathbone J, Mari JJ, Steiner D. Family intervention of schizophrenia. Cohrane Database Syst Rev (Serial Online) 2003; 4:CD000088.
P.3.c.023 Glycine plasma levels are not a useful predictor of recovery in patients treated with glycine and neuroleptics D. Strzelecki1 ° , J. Rabe-Jablonska1 . 1 Medical University of Lodz, Department of Affective and Psychotic Disorders, Lodz, Poland Introduction: Ionotropic glutamatergic NMDA receptor participate in mechanisms of control of neurotransmitter systems as dopaminergic, noradrenergic, serotoninergic and plays important role in cognitive functioning and schizophrenia. Glycine is a natural coagonist of NMDA receptor and according to hypoNMDA
P.3.c. Psychotic disorders and antipsychotics − Antipsychotics (clinical)
side effect was assessed by Abnormal Involuntary Movement Scale (AIMS) and Simpson Angus Scale (SAS) medication. The data was analyzed on an intent to treat (ITT) basis with the last-observation-carried-forward (LOCF). For the endpoint the PANSS, YMRS and CGI-S scores were analyzed by repeated measures of analysis of variance (ANOVA) in terms of the withinsubject factors and the between-subject factors over the study periods. An interaction effect was also considered between time and the treatment group. SAS and AIMS scores were analyzed using the same ANOVA model in PANSS. Descriptive statistics and chi-square test were performed for the group difference in the frequencies of side effects. Results: There were no differences in gender, age, diagnoses, severity of symptoms before taking medication between two groups. The 5-item acute agitation cluster from PANSS and CGI-S scores were significantly decreased over time in both treatment groups without any significant group difference and time by the group interaction effect (F = 71.85, <0.0001). Tolerability and safety by SAS and AIMS were not different between two groups. There were no serious adverse events in both groups. Intramuscular Aripiprazole have the advantage instead of Intramuscular Haloperidol for the avoidance of side effects for extra pyramidal actions, dystonia and tardive dyskinesia regarding the quality of life of psychotic patients. The Inventory of Quality of Life (QL) was used after intramuscular use of Aripiprazole and Haloperidol for the psychotic agitation with delusional thoughts and ideas and first rank symptoms of schizophrenia. Conclusion: For the emergency treatment of psychotic agitation injectable Aripiprazole was as effective and tolerable as intramuscular administration of Haloperidol. Therefore, it is considerable to choose injectable Aripiprazole instead of intramuscular Haloperidol for treatment of patients with acute psychotic agitation. References [1] El-Sayeh HG, Morganti C (2006): Aripiprazole for Schizophrenia. Cohran Database Syst Rev (2); CD004578. [2] Currier GW (2000): Atypical antipsychotic medications in the psychiatric emergency service. J Clin Psychiatry 61:21−26.
P.3.c.022 Comparison of patients treated with antipsychotics and psychoeducation and those treated with antipsychotics only C. Istikoglou1 ° , D. Foutsitzis1 , G. Theodorakopoulos1 , P. Kanellos1 , N. Polonifis1 , A. Vlavianou1 , D. Vlissides2 , K. Michelidakis2 . 1 Konstantopouleion General Hospital of Nea Ionia, Psychiatric, Athens, Greece; 2 Asklepeion General Hospital of Voula, Psychiatric, Athens, Greece Objective: Psychoeducation is a complementary treatment of Psychotic Disorders. Per other researchers, it is Family Behavioural Treatment. The first to deal with Psychoeducation is Prof. Ian Faloon of New Zealand. Family Psychoeducation comprises three stages: 1) the briefing of the patient and his/her family on the nature of the psychological disorder, 2) the education of the patient and his/her family on basic social communication skills, mainly on solving problems), and 3) the psychological support of both the patient and his/her family. PANSS is a most used scale for positive and negative symptoms of Schizophrenia. Atypical antipsychotics is the last therapeutic proposal for the schizophrenia treatment and these are Clozapine, Amissulpride, Risperidone, Paliperidone, Olanzapine, Ziprasidone, Aripiprazone
and Quetiapine. Psychoeducation is concerning specially the resolution of daily problems of the patients and their families in correlation with the patient. Aim: The aim of the present dissertation is to uphold the role and importance of Psychoeducation as a complementary treatment of Psychotic Disorders. 40 (n = 40) patients (24 men and 16 women) were studied as outpatients in the Daycare Psychiatric Departments of “Konstantopouleion” General Hospital in Nea Ionia, and the “Asklepeion” Hospital in Voula, Greece, for a period of one year. 20 of them were treated with a combination of Psychoeducation and neuroleptics, while 20 of them were receiving solely neuroleptics. All the said patients were submitted to the PANSS (Positive and Negative Symptoms of Schizophrenia) scale, at the beginning of their treatment, and after 3, 6, 9, and 12 months respectively. Results: From 40 patients that solely received neuroleptics, in 22 patients (55%) the PANSS scale was reduced, in 10 patients (25%) the PANSS remained unchanged, and in 8 patients (20%) the PANSS scale showed a relapse during the year. In the group of 40 patients that were treated with a combination of neuroleptics and psychoeducation, the results were as follows: in 32 patients (80%) the PANSS scale was significantly reduced, therefore the positive and negative symptoms improved in them. Therefore, the improvement observed in comparison with the group of patients that received solely neuroleptics is statistically important. In 6 of the remaining patients no alteration has been observed to the PANSS scores (15%) during the one-year time period, while from the last 2 patients, one interrupted the psychological treatment (5%), and the other relapsed (5%). It is worthy noting that a significant improvement has been observed in the negative symptom items of the PANSS scale for the group of patients that was treated with a combination of neuroleptics and psychoeducation. One of the parameters of PANSS regards the Quality of Life of Schizophrenic patients. Psychoeducation improves the Quality of Life of schizophrenic patients and their families. Conclusion: The combination of neuroleptics and psychoeducation has better results than the sole administration of antipsychotics and contributes at the prompt improvement and social rehabilitation of the patients with psychological disorders. References [1] Faloon IR, Boyd JL, McGill CW et al. Family management in the prevention of morbidity of schizophrenia. Arch Gen Psychiatry 1985; 35:1160–1177. [2] Joseph Baum, Teresa Frabose, Sibylle Kraemer, Michael Rentropam, Gabrielle Pitschel-Waltz. Psychoeducation: a family psychotherapeutic intervention for patients with schizophrenia and their families. Schiz Bull 2006; vol. 32(51):S1-S9. [3] Pharoah FM, Rathbone J, Mari JJ, Steiner D. Family intervention of schizophrenia. Cohrane Database Syst Rev (Serial Online) 2003; 4:CD000088.
P.3.c.023 Glycine plasma levels are not a useful predictor of recovery in patients treated with glycine and neuroleptics D. Strzelecki1 ° , J. Rabe-Jablonska1 . 1 Medical University of Lodz, Department of Affective and Psychotic Disorders, Lodz, Poland Introduction: Ionotropic glutamatergic NMDA receptor participate in mechanisms of control of neurotransmitter systems as dopaminergic, noradrenergic, serotoninergic and plays important role in cognitive functioning and schizophrenia. Glycine is a natural coagonist of NMDA receptor and according to hypoNMDA