- Email: [email protected]
The involvement of the use of psychoactive substances in patient admitted in a psychiatric hospital
s31
Poster B. Psychophannaca
morphic psychotic disorder with symptoms of schizophrenia (ICD-10, Diagnostic criteria for research). Results: The 6-week trial was completed by 25 patients (92.5%). The mean dose of RSP at treatment endpoint was 4.7 mglday (range 3-10 mg). 20 patients (80%) were clinically improved (at least 50% reduction in total PANSS score), while 23 patients (92%) showed 50% reduction in Positive Subscale score. RSP produced statistically significant improvement on the PANSS and CGI scores (table 1). 17 patients (68%) didn’t develop at all EPS, while only 8 patients received anticholinergic agents for mild dosage related, EPS. No serious adverse events were reported during the study. Instrument
B&dine
(score range)
6th week
PANSS,Total PANSS,Positive PANS& Negative PANS&Gen. Psychopathology CC1
loo.64 26.52 24.00
(123-80)
44.40
t=20.51, p
(35-17) (39-11)
9.00 12.32
t=20.27. p
50.32 5.4
(62-40) (7-4)
23.44 1.92
t= 18.03,p
Conclusion: The results of this study indicate that RSP is an effective and safe antipsychotic drug in first-episode psychotic drug-naive patients, with a low incidence of EPS.
and 153 females). Out of them, 53 (17 males, 36 females) dropped out before the end of the diagnostic procedure or the beginning of the therapeutic intervention and 70 (42 males, 28 females) had an administrative claim (e.g. a certificate) or were referred to other services. For the remaining 125 cases (36 males, 89 females) in which we had therapeutic intervention, we examined the following parameters: sex, age, diagnosis, kind of therapy, final result. We analyzed the cases that we had used psychotropic drugs and we associated them with the above parameters. We have found the following: (a) in 44% we used only drugs, in 27.2% we used only some type of psychotherapy and in 28.8% a combination of drugs and psychotherapy, (b) 67% of the males who had received drugs were under the age of 40. In the corresponding ages of females who followed drug treatment, the percentage was 40% and (c) the most common scheme was the combination of drugs (minor tranquilizers with antidepressants or antipsychotics) (41.4% in males and 38.8% in females), followed by minor tranquilizers alone (20.7% in males and 32.2% in females) and antidepressants (13.8% in males and 19.3% in females). In conclusion, it seems that drug therapy is the most used therapeutic procedure either alone or in combination with psychotherapy of other social intervention.
B 81 El
References Kopala, L.C., Fredrikson, D., Good, KY, Honer, W.G., Symptoms in Neuroleptic-Naive, First-Episode Schizophrenia: Response to Risperidone. Biol. Psychiatry. 1996, 32: 296-298. Leysen, J.E., Gommeren, W., de Chaffy, E., De Courcelles, D., Stoof, J.C., Janssen, P., Biochemical profile of risperidone, a new antipsychotic. J. Pharm. Exp. Ther. 1988, 247: 661-670. Umbricht, D. & Kane, J.M. (1995). Risperidone: Efficacy and Safety. Schizophr. Bulletin, 21(4): 593-606.
B 79 L-J
The involvement of the use of psychoactive substances in patient admltted in a psychiatric hospital
A. Terentiou, C. Touloumis, A. Pachi, P. Vachtsevanos. Psychiatric Hospital of Athens, Greece
Acute word of the
A meta-analysis of antidepressant outcome studies in child and adolescent depression
K. Papanikolaou, Z. Papadopoulou Daifoti, A. Pehlivanidis”, S.C. Richardsonb. Department of Experimental Pharmacology, Medical School, University of Athens, Goudi, I1527 Athens, Greece; “Department of Psychiatry, Medical School, University of Athens; “Pantion University, Athens To date, evidence for the efficacy of antidepressants in child and adolescent depression is equivocal. Outcome trials have small sample sizes and results are controversial. Meta-analysis is a process of combining study results and is especially useful when results from several studies disagree and when sample sizes are individually too small to detect an effect. In this presentation we are using meta-analysis to examine the efficacy of antidepressant: drugs in treating child and adolescent depression. Eighteen controlled and twenty one open trials have been identified by computerized and manual literature searches. Quality scores were given by two researchers to all controlled studies, according to a system based on Chalmers et al. (1981) method for assessing the quality of randomized controlled trials and modified for psychopharmacological studies. When combining results from controlled studies, both random and fixed effects approaches were used. The statistical analysis was made both separately for children and adolescents and by pooling all studies together. Preliminary results do not prove the efficacy of antidepressant drugs especially for adolescents. Another analysis using a random effect model proposed by Z. Li and C.B. Begg (1994), where both controlled and uncontrolled studies are contained, is now in progress. Results from all analyses will be presented and treatment and research implications will be discussed.
Patients who are admitted in psychiatric clinics in our hospital for the cure of a major psychiatric disorder are revealed to be current or previous users of psychoactive substances, in high frequencies. So, from the 227 patients admitted in a three months’ time, one in every four of them was involved in the use of substances (except alcohol) beyond his or her psychiatric disorder. Sex, age and the type of the psychiatric disorder influence the frequency since: male psychiatric patients have a four fold frequency of use versus females, young patients are involved in a frequency of 60 percent, whereas older patients, (aged 41-50 years old) are involved in a frequency of only 6 percent. Patients suffering from schizophrenic disorder as compared to patients suffering from mood disorder, in equal average ages, are found to be more frequent users of psychoactive substances with a trend of significance, P=O.lO. Finally, the finding that the use of substances precedes the onset of the psychiatric disorder, in the strong statistical significance of P=O.O03, in combination with the already mentioned ten fold frequency of use from the young psychiatric patients, may indicate that the psychiatric disorder in a number of our patients was induced by the substances and not that the use was in the spectrum of the psychiatric disorder.
Chalmers, T.C., Smith, H., Blackburn, B., Schroeder, B., Reitman, D., Ambroz, A. (1981): A Method for Assessing the Quality of a Randomized Control Trial. Controlled Clinical Tnals 2: 31-49 Li, Z. and B egg, C.B. (1994): Random Effects Models for Combining Results from Controlled and Uncontrolled Studies in a Meta-analysis. Journal of the American Statistical Association 89 (428): 1523-l 527.
B-80 El
IB-82
The usage of psychopharmaca in a community mental health center
Panagoulias, of Peristeri,
E., Papadopoulos, I?, Tychopoulos, G. Mental Health Center Ploutonos & Hephaestou str, 12135 Athens, Greece
It is well known that the complexity
of psychiatric diseases demands a variety and flexibility of means for their management. The aim of this paper is the evaluation of the psychotropic drugs either alone or in combination with other therapeutic processes. We examined the files of our adult clients who had visited our Center during a period of one year. The total number was 248 patients (95 males
Reference
A method for evaluating the quality of psychopharmacological controlled trials
K. Papanikolaou, S.C. Richardson”, A. Pehlivanidish and Z. Papadopoulou Daifotis. Department of Experimental Pharmacology, Medical School, University of Athens, Got& 11527 Athens, Greece; “Pantion University, Athens; bDepartment of Psychiatry, Medical School, University of Athens Based on Chalmers et al. (1981) method for assessing the quality of randomized controlled trials (RCTs), a system has been developed to evaluate the quality of children and adult psychopharmacological RCTs.
Poster B. Psychophannaca
morphic psychotic disorder with symptoms of schizophrenia (ICD-10, Diagnostic criteria for research). Results: The 6-week trial was completed by 25 patients (92.5%). The mean dose of RSP at treatment endpoint was 4.7 mglday (range 3-10 mg). 20 patients (80%) were clinically improved (at least 50% reduction in total PANSS score), while 23 patients (92%) showed 50% reduction in Positive Subscale score. RSP produced statistically significant improvement on the PANSS and CGI scores (table 1). 17 patients (68%) didn’t develop at all EPS, while only 8 patients received anticholinergic agents for mild dosage related, EPS. No serious adverse events were reported during the study. Instrument
B&dine
(score range)
6th week
PANSS,Total PANSS,Positive PANS& Negative PANS&Gen. Psychopathology CC1
loo.64 26.52 24.00
(123-80)
44.40
t=20.51, p
(35-17) (39-11)
9.00 12.32
t=20.27. p
50.32 5.4
(62-40) (7-4)
23.44 1.92
t= 18.03,p
Conclusion: The results of this study indicate that RSP is an effective and safe antipsychotic drug in first-episode psychotic drug-naive patients, with a low incidence of EPS.
and 153 females). Out of them, 53 (17 males, 36 females) dropped out before the end of the diagnostic procedure or the beginning of the therapeutic intervention and 70 (42 males, 28 females) had an administrative claim (e.g. a certificate) or were referred to other services. For the remaining 125 cases (36 males, 89 females) in which we had therapeutic intervention, we examined the following parameters: sex, age, diagnosis, kind of therapy, final result. We analyzed the cases that we had used psychotropic drugs and we associated them with the above parameters. We have found the following: (a) in 44% we used only drugs, in 27.2% we used only some type of psychotherapy and in 28.8% a combination of drugs and psychotherapy, (b) 67% of the males who had received drugs were under the age of 40. In the corresponding ages of females who followed drug treatment, the percentage was 40% and (c) the most common scheme was the combination of drugs (minor tranquilizers with antidepressants or antipsychotics) (41.4% in males and 38.8% in females), followed by minor tranquilizers alone (20.7% in males and 32.2% in females) and antidepressants (13.8% in males and 19.3% in females). In conclusion, it seems that drug therapy is the most used therapeutic procedure either alone or in combination with psychotherapy of other social intervention.
B 81 El
References Kopala, L.C., Fredrikson, D., Good, KY, Honer, W.G., Symptoms in Neuroleptic-Naive, First-Episode Schizophrenia: Response to Risperidone. Biol. Psychiatry. 1996, 32: 296-298. Leysen, J.E., Gommeren, W., de Chaffy, E., De Courcelles, D., Stoof, J.C., Janssen, P., Biochemical profile of risperidone, a new antipsychotic. J. Pharm. Exp. Ther. 1988, 247: 661-670. Umbricht, D. & Kane, J.M. (1995). Risperidone: Efficacy and Safety. Schizophr. Bulletin, 21(4): 593-606.
B 79 L-J
The involvement of the use of psychoactive substances in patient admltted in a psychiatric hospital
A. Terentiou, C. Touloumis, A. Pachi, P. Vachtsevanos. Psychiatric Hospital of Athens, Greece
Acute word of the
A meta-analysis of antidepressant outcome studies in child and adolescent depression
K. Papanikolaou, Z. Papadopoulou Daifoti, A. Pehlivanidis”, S.C. Richardsonb. Department of Experimental Pharmacology, Medical School, University of Athens, Goudi, I1527 Athens, Greece; “Department of Psychiatry, Medical School, University of Athens; “Pantion University, Athens To date, evidence for the efficacy of antidepressants in child and adolescent depression is equivocal. Outcome trials have small sample sizes and results are controversial. Meta-analysis is a process of combining study results and is especially useful when results from several studies disagree and when sample sizes are individually too small to detect an effect. In this presentation we are using meta-analysis to examine the efficacy of antidepressant: drugs in treating child and adolescent depression. Eighteen controlled and twenty one open trials have been identified by computerized and manual literature searches. Quality scores were given by two researchers to all controlled studies, according to a system based on Chalmers et al. (1981) method for assessing the quality of randomized controlled trials and modified for psychopharmacological studies. When combining results from controlled studies, both random and fixed effects approaches were used. The statistical analysis was made both separately for children and adolescents and by pooling all studies together. Preliminary results do not prove the efficacy of antidepressant drugs especially for adolescents. Another analysis using a random effect model proposed by Z. Li and C.B. Begg (1994), where both controlled and uncontrolled studies are contained, is now in progress. Results from all analyses will be presented and treatment and research implications will be discussed.
Patients who are admitted in psychiatric clinics in our hospital for the cure of a major psychiatric disorder are revealed to be current or previous users of psychoactive substances, in high frequencies. So, from the 227 patients admitted in a three months’ time, one in every four of them was involved in the use of substances (except alcohol) beyond his or her psychiatric disorder. Sex, age and the type of the psychiatric disorder influence the frequency since: male psychiatric patients have a four fold frequency of use versus females, young patients are involved in a frequency of 60 percent, whereas older patients, (aged 41-50 years old) are involved in a frequency of only 6 percent. Patients suffering from schizophrenic disorder as compared to patients suffering from mood disorder, in equal average ages, are found to be more frequent users of psychoactive substances with a trend of significance, P=O.lO. Finally, the finding that the use of substances precedes the onset of the psychiatric disorder, in the strong statistical significance of P=O.O03, in combination with the already mentioned ten fold frequency of use from the young psychiatric patients, may indicate that the psychiatric disorder in a number of our patients was induced by the substances and not that the use was in the spectrum of the psychiatric disorder.
Chalmers, T.C., Smith, H., Blackburn, B., Schroeder, B., Reitman, D., Ambroz, A. (1981): A Method for Assessing the Quality of a Randomized Control Trial. Controlled Clinical Tnals 2: 31-49 Li, Z. and B egg, C.B. (1994): Random Effects Models for Combining Results from Controlled and Uncontrolled Studies in a Meta-analysis. Journal of the American Statistical Association 89 (428): 1523-l 527.
B-80 El
IB-82
The usage of psychopharmaca in a community mental health center
Panagoulias, of Peristeri,
E., Papadopoulos, I?, Tychopoulos, G. Mental Health Center Ploutonos & Hephaestou str, 12135 Athens, Greece
It is well known that the complexity
of psychiatric diseases demands a variety and flexibility of means for their management. The aim of this paper is the evaluation of the psychotropic drugs either alone or in combination with other therapeutic processes. We examined the files of our adult clients who had visited our Center during a period of one year. The total number was 248 patients (95 males
Reference
A method for evaluating the quality of psychopharmacological controlled trials
K. Papanikolaou, S.C. Richardson”, A. Pehlivanidish and Z. Papadopoulou Daifotis. Department of Experimental Pharmacology, Medical School, University of Athens, Got& 11527 Athens, Greece; “Pantion University, Athens; bDepartment of Psychiatry, Medical School, University of Athens Based on Chalmers et al. (1981) method for assessing the quality of randomized controlled trials (RCTs), a system has been developed to evaluate the quality of children and adult psychopharmacological RCTs.