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A 4-fold risk of metabolic syndrome in patients with schizophrenia: the Northern Finland 1966 Birth Cohort study.

https://arctichealth.org/en/permalink/ahliterature49604
Source
J Clin Psychiatry. 2005 May;66(5):559-63
Publication Type
Article
Date
May-2005
Author
Kaisa M Saari
Sari M Lindeman
Kaisa M Viilo
Matti K Isohanni
Marjo-Riitta Järvelin
Liisa H Laurén
Markku J Savolainen
Hannu J Koponen
Author Affiliation
Department of Psychiatry, University of Oulu, PO Box 5000, 90014 Oulu, Finland. kaisa.saari@oulu.fi
Source
J Clin Psychiatry. 2005 May;66(5):559-63
Date
May-2005
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - adverse effects - therapeutic use
Cohort Studies
Comorbidity
Diet Therapy
Exercise
Female
Finland - epidemiology
Humans
Logistic Models
Male
Metabolic Syndrome X - epidemiology - prevention & control - therapy
Prevalence
Psychiatric Status Rating Scales
Research Support, Non-U.S. Gov't
Risk factors
Schizophrenia - diagnosis - drug therapy - epidemiology
Weight Loss
Abstract
OBJECTIVE: Schizophrenia is associated with a shortened life expectancy and increased somatic comorbidity with, e.g., cardiovascular disorders. One major risk factor for these disorders is the metabolic syndrome, which has been reported to have a higher frequency in schizophrenic patients. Our objective was to study the prevalence of metabolic syndrome in a population-based birth cohort. METHOD: The study sample consisted of 5613 members of the Northern Finland 1966 Birth Cohort who participated in the field study from 1997 to 1998. Subjects were divided into 4 diagnostic categories (DSM-III-R): (1) schizophrenia (N = 31), (2) other functional psychoses (N = 22), (3) nonpsychotic disorders (N = 105), and (4) no psychiatric hospital treatment (N = 5455, comparison group). Subjects were assessed for the presence of metabolic syndrome according to the criteria of the National Cholesterol Education Program. RESULTS: The prevalence of metabolic syndrome was higher in subjects with schizophrenia compared with the comparison group (19% vs. 6%, p = .010). The prevalence of metabolic syndrome in subjects with other psychoses was 5%. After controlling for sex, the results of logistic regression analysis showed that the risk of metabolic syndrome in schizophrenia was 3.7 (95% CI = 1.5 to 9.0). CONCLUSIONS: The high prevalence of metabolic syndrome in schizophrenia even at such a relatively young age underscores the need to select antipsychotic medications with no or little capability to induce metabolic side effects. Also, developing comprehensive efforts directed at controlling weight and diet and improving physical activity are needed.
PubMed ID
15889940 View in PubMed
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Antipsychotic polypharmacy: a survey of discharge prescriptions from a tertiary care psychiatric institution.

https://arctichealth.org/en/permalink/ahliterature194469
Source
Can J Psychiatry. 2001 May;46(4):334-9
Publication Type
Article
Date
May-2001
Author
R M Procyshyn
N B Kennedy
G. Tse
B. Thompson
Author Affiliation
Division of Medical Services, 422 Henry Esson Young Building, Riverview Hospital, 500 Lougheed Highway, Port Coquitlam, BC V3C 4J2. rprocyshyn@bcmhs.bc.ca
Source
Can J Psychiatry. 2001 May;46(4):334-9
Date
May-2001
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - administration & dosage - adverse effects
British Columbia
Drug Prescriptions - statistics & numerical data
Drug Therapy, Combination
Drug Utilization
Female
Hospitals, Psychiatric
Humans
Male
Middle Aged
Patient Discharge
Psychiatric Status Rating Scales
Retrospective Studies
Schizophrenia - diagnosis - drug therapy
Schizophrenic Psychology
Abstract
To perform a retrospective survey of discharge medications at a tertiary care psychiatric facility and to assess the incidence of antipsychotic polypharmacy.
This is a retrospective survey that used the Department of Pharmacy's computer database to obtain relevant discharge information on all nongeriatric patients with schizophrenia discharged from Riverview Hospital between November 1, 1996 and October 31, 1998. From a total of 492 eligible patients, 229 met the inclusion criteria and formed the database for the survey.
The main finding of the survey was that 27.5% of our discharged patients diagnosed with schizophrenia left our facility on an antipsychotic polypharmacy regimen. Compared with patients discharged on a single antipsychotic, the pooled data revealed a significantly greater use of anticholinergic agents in those patients prescribed an antipsychotic polypharmacy regimen. Further, of the atypical agents, only risperidone showed a statistically significant reduction in dosage when coprescribed with a second antipsychotic.
Although antipsychotic polypharmacy persists today, as it has over the past 30 years, evidence-based data to support this controversial treatment strategy is lacking. As a result clinicians are relying on their clinical experience, and perhaps intuition, to design antipsychotic polypharmacy treatment protocols. Efforts should be made to replace subjective clinical impression with a more rational approach to antipsychotic polypharmacy--one that is based on pharmacodynamic and pharmacokinetic understanding of drug action.
PubMed ID
11387789 View in PubMed
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Association between financial strain, social network and five-year recovery from first episode psychosis.

https://arctichealth.org/en/permalink/ahliterature92848
Source
Soc Psychiatry Psychiatr Epidemiol. 2008 Dec;43(12):947-52
Publication Type
Article
Date
Dec-2008
Author
Mattsson Maria
Topor Alain
Cullberg Johan
Forsell Yvonne
Author Affiliation
Dept of Psychiatry, R & D Section, The Parachute Project, Danderyd Hospital, Stockholm, Sweden. maria.mattsson@sll.se
Source
Soc Psychiatry Psychiatr Epidemiol. 2008 Dec;43(12):947-52
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antipsychotic Agents - therapeutic use
Female
Follow-Up Studies
Humans
Income
Linear Models
Male
Middle Aged
Psychotic Disorders - diagnosis - drug therapy - rehabilitation
Questionnaires
Schizophrenia - diagnosis - drug therapy - rehabilitation
Schizophrenic Psychology
Social Support
Stress, Psychological - economics
Sweden
Treatment Outcome
Young Adult
Abstract
Despite much effort to positively affect long-term outcome in psychosis and schizophrenia many patients are still facing a poor outcome with persistent psychotic symptoms and decline in social functioning. The aim of this study was to examine the relationship between financial strain and social network and five-year outcome of first episode psychosis (FEP). FEP patients were divided into recovered (n = 52) and non-recovered (n = 19). Each person was matched according to age and gender with four persons (n = 284) from a longitudinal population-based study. All persons had answered an extensive questionnaire including social network, quantitative and qualitative, financial strain and mental health. Linear regression analysis showed that both financial strain and social network were associated, and had a unique contribution, to outcome. The results indicate that FEP patients might benefit from interventions that reduce financial strain thus facilitating daily life and cultural and social activities.
PubMed ID
18604620 View in PubMed
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Association study of cannabinoid receptor 1 (CNR1) gene in tardive dyskinesia.

https://arctichealth.org/en/permalink/ahliterature137613
Source
Pharmacogenomics J. 2012 Jun;12(3):260-6
Publication Type
Article
Date
Jun-2012
Author
A K Tiwari
C C Zai
O. Likhodi
A N Voineskos
H Y Meltzer
J A Lieberman
S G Potkin
G. Remington
D J Müller
J L Kennedy
Author Affiliation
Neurogenetics Section, Neuroscience Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Source
Pharmacogenomics J. 2012 Jun;12(3):260-6
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Antipsychotic Agents - adverse effects
Chi-Square Distribution
Chronic Disease
European Continental Ancestry Group - genetics
Female
Gene Frequency
Genetic Association Studies
Genetic Predisposition to Disease
Haplotypes
Humans
Linkage Disequilibrium
Male
Middle Aged
Movement Disorders - etiology - genetics
Odds Ratio
Ontario - epidemiology
Phenotype
Polymorphism, Single Nucleotide
Receptor, Cannabinoid, CB1 - genetics
Risk assessment
Risk factors
Schizophrenia - diagnosis - drug therapy - ethnology
Severity of Illness Index
United States - epidemiology
Abstract
Tardive dyskinesia (TD) is a severe, debilitating movement disorder observed in 25-30% of the patients treated with typical antipsychotics. Cannabinoid receptor 1 (CNR1) activators tend to inhibit movement, an effect prevented by rimonabant and other selective CNR1 antagonists. Furthermore, CNR1 receptor is downregulated in Huntington's disease and upregulated in Parkinson's disease. Twenty tagSNPs spanning the CNR1 gene were analyzed in schizophrenia patients of European ancestry (n=191; 74 with TD). Significant genotypic (P=0.012) and allelic (P=0.012) association was observed with rs806374 (T>C). Carriers of the CC genotype were more likely to be TD positive (CC vs TT+TC, odds ratio=3.4 (1.5-7.8), P=0.003) and had more severe TD (CC vs TT+TC; 9.52±9.2 vs 5.62±6.9, P=0.046). These results indicate a possible role of CNR1 in the development of TD in our patient population. However, these observations are marginal after correcting for multiple testing and need to be replicated in a larger patient population.
PubMed ID
21266946 View in PubMed
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Body mass index and functioning in long-term schizophrenia. Results of the DSP project.

https://arctichealth.org/en/permalink/ahliterature165954
Source
Eur Psychiatry. 2007 Jul;22(5):313-8
Publication Type
Article
Date
Jul-2007
Author
Raimo K R Salokangas
Teija Honkonen
Eija Stengård
Jarmo Hietala
Author Affiliation
Department of Psychiatry, University of Turku Psychiatric Clinic, Turku University Central Hospital, Turku Psychiatric Clinic, Kiinamyllynkatu 4-8, FI-20520 Turku, Finland. raimo.k.r.salokangas@tyks.fi
Source
Eur Psychiatry. 2007 Jul;22(5):313-8
Date
Jul-2007
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - adverse effects - therapeutic use
Body mass index
Chronic Disease
Female
Finland
Humans
Long-Term Care
Male
Middle Aged
Psychiatric Status Rating Scales
Schizophrenia - diagnosis - drug therapy
Schizophrenic Psychology
Sex Factors
Social Adjustment
Statistics as Topic
Abstract
The study evaluates the association of body mass index (BMI) with functioning in male and female patients with long-term schizophrenia.
722 long-term schizophrenia patients were interviewed three years after discharge from hospital. Their weight and height were recorded and data on their background, illness history, psychosocial functioning (Global Assessment Scale; GAS), health behaviour, daily doses of neuroleptics, and psychiatric symptoms were collected.
BMI correlated significantly with GAS scores in male (r=0.202, p=0.000) but not in female patients. In male patients, BMI associated significantly (p=0.005) with GAS scores even when the effects of psychiatric symptoms and other confounding variables were taken into account.
In male but not in female long-term patients with schizophrenia, low BMI associates with poor functioning. It is suggested that among male schizophrenia patients, low BMI may be an indicator of poor functioning.
PubMed ID
17188843 View in PubMed
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Characteristics and predictors of long-term institutionalization in patients with schizophrenia.

https://arctichealth.org/en/permalink/ahliterature135676
Source
Schizophr Res. 2011 Sep;131(1-3):120-6
Publication Type
Article
Date
Sep-2011
Author
Peter Uggerby
René Ernst Nielsen
Christoph U Correll
Jimmi Nielsen
Author Affiliation
Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aarhus University Hospital, Mølleparkvej 10, PO Box 210, DK-9100 Aalborg, Denmark. peug@rn.dk
Source
Schizophr Res. 2011 Sep;131(1-3):120-6
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Aged
Antipsychotic Agents - therapeutic use
Clozapine - therapeutic use
Cohort Studies
Denmark - epidemiology
Diabetes Mellitus, Type 2 - epidemiology
Educational Status
Female
Humans
Institutionalization - methods - statistics & numerical data
International Classification of Diseases
Logistic Models
Male
Middle Aged
Predictive value of tests
Retrospective Studies
Risk factors
Schizophrenia - diagnosis - drug therapy - epidemiology - physiopathology
Abstract
Patients with schizophrenia requiring long-term institutionalization represent those with the worst outcome, leading to personal costs for patients and relatives and constituting a large economical burden for society.
To identify characteristics and predictors of outcome of institutionalized patients with schizophrenia.
One-year follow-up cohort study, utilizing the Danish national registers, of all institutionalized and non-institutionalized patients with schizophrenia in Denmark with an ICD-10 lifetime diagnosis of schizophrenia (F20.0-F20.9) since 1969 and alive at the index date of January 1st 2006 (total number 22,395).
Compared with non-institutionalized patients, institutionalized patients (n=2188; 9.8%) had earlier onset of schizophrenia and lower scholastic achievements, were more often diagnosed with a hebephrenic subtype (odds ratio (OR), 2.34; 95% confidence interval (CI), 1.95-2.80; p
PubMed ID
21458239 View in PubMed
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Comparisons of psychotropic drug prescribing patterns in acute psychiatric wards across Europe.

https://arctichealth.org/en/permalink/ahliterature9540
Source
Eur J Clin Pharmacol. 2004 Mar;60(1):29-35
Publication Type
Article
Date
Mar-2004
Author
Len Bowers
Patrick Callaghan
Nicola Clark
Catharine Evers
Author Affiliation
Department of Mental Health and Learning Disability, City University London, Philpot Street, London E1 2EA, UK. L.Bowers@city.ac.uk
Source
Eur J Clin Pharmacol. 2004 Mar;60(1):29-35
Date
Mar-2004
Language
English
Publication Type
Article
Keywords
Adult
Benzodiazepines - therapeutic use
Biperiden - therapeutic use
Chlorpromazine - therapeutic use
Clozapine - therapeutic use
Comparative Study
Cyclohexanols - therapeutic use
Diazepam - therapeutic use
Drug Administration Schedule
Drug Therapy, Combination
Drug Utilization Review - methods
Europe
Female
Humans
Male
Mood Disorders - diagnosis - drug therapy - epidemiology
Pharmacoepidemiology - methods - statistics & numerical data
Physician's Practice Patterns - statistics & numerical data
Prescriptions, Drug - statistics & numerical data
Psychiatric Department, Hospital - statistics & numerical data
Psychotropic Drugs - therapeutic use
Schizophrenia - diagnosis - drug therapy - epidemiology
Time Factors
Abstract
OBJECTIVE: To compare prescribed daily doses (PDDs) of psychotropic drugs in several European centres. METHOD: A one-day census of psychotropic drug prescriptions to 613 patients in 39 acute psychiatric wards in ten countries. RESULTS: Patients in Spain were on most drugs; patients in Germany were on the fewest. Chlorpromazine equivalents in Denmark, England, Germany and Spain were at high levels as were diazepam equivalents in Belgium, Finland, The Netherlands and Norway. Newer anti-psychotics were used in the majority of centres, although older anti-psychotics were used commonly in three centres. CONCLUSION: The high doses of psychotropic drugs patients receive in some centres may be having little additional therapeutic effect and could increase their risk of side effects. The use of older anti-psychotics in some centres may be causing side effects that could be reduced by using newer anti-psychotics.
PubMed ID
14747883 View in PubMed
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Cost-effectiveness analysis of atypical long-acting antipsychotics for treating chronic schizophrenia in Finland.

https://arctichealth.org/en/permalink/ahliterature108774
Source
J Med Econ. 2013 Sep;16(9):1096-105
Publication Type
Article
Date
Sep-2013
Author
Thomas R Einarson
Hanna Pudas
Roman Zilbershtein
Rasmus Jensen
Colin Vicente
Charles Piwko
Michiel E H Hemels
Author Affiliation
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada. t.einarson@rogers.com
Source
J Med Econ. 2013 Sep;16(9):1096-105
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - economics - therapeutic use
Benzodiazepines - economics - therapeutic use
Chronic Disease
Cost-Benefit Analysis
Decision Support Techniques
Delayed-Action Preparations - economics - therapeutic use
Drug Costs
Economics, Pharmaceutical
Female
Finland
Humans
Isoxazoles - economics - therapeutic use
Male
Multivariate Analysis
Palmitates - economics - therapeutic use
Quality-Adjusted Life Years
Risperidone - economics - therapeutic use
Schizophrenia - diagnosis - drug therapy - economics
Young Adult
Abstract
In Finland, regional rates of schizophrenia exceed those in most countries, impacting the healthcare burden. This study determined the cost-effectiveness of long-acting antipsychotic (LAI) drugs paliperidone palmitate (PP-LAI), olanzapine pamoate (OLZ-LAI), and risperidone (RIS-LAI) for chronic schizophrenia.
This study adapted a decision tree analysis from Norway for the Finnish National Health Service. Country-specific data were sought from the literature and public documents, guided by clinical experts. Costs of health services and products were retrieved from literature sources and current price lists. This simulation study estimated average 1-year costs for treating patients with each LAI, average remission days, rates of hospitalization and emergency room visits and quality-adjusted life-years (QALY).
PP-LAI was dominant. Its estimated annual average cost was €10,380/patient and was associated with 0.817 QALY; OLZ-LAI cost €12,145 with 0.810 QALY; RIS-LAI cost €12,074 with 0.809 QALY. PP-LAI had the lowest rates of hospitalization, emergency room visits, and relapse days. This analysis was robust against most variations in input values except adherence rates. PP-LAI was dominant over OLZ-LAI and RIS-LAI in 77.8% and 85.9% of simulations, respectively. Limitations include the 1-year time horizon (as opposed to lifetime costs), omission of the costs of adverse events, and the assumption of universal accessibility.
In Finland, PP-LAI dominated the other LAIs as it was associated with a lower cost and better clinical outcomes.
Notes
Erratum In: J Med Econ. 2013 Nov;16(11):1366
PubMed ID
23844621 View in PubMed
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Determinants of poor dental care in patients with schizophrenia: a historical, prospective database study.

https://arctichealth.org/en/permalink/ahliterature142565
Source
J Clin Psychiatry. 2011 Feb;72(2):140-3
Publication Type
Article
Date
Feb-2011
Author
Jimmi Nielsen
Povl Munk-Jørgensen
Søren Skadhede
Christoph U Correll
Author Affiliation
Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aarhus University Hospital, Mølleparkvej 10, PO Box 210, DK-9100 Aalborg, Denmark. jin@rn.dk
Source
J Clin Psychiatry. 2011 Feb;72(2):140-3
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - adverse effects - therapeutic use
Cholinergic Antagonists - adverse effects - therapeutic use
Clozapine - adverse effects - therapeutic use
Denmark
Dental Care - utilization
Dental Health Surveys
Female
Humans
Male
Middle Aged
Patient Compliance - psychology - statistics & numerical data
Prospective Studies
Risk factors
Schizophrenia - diagnosis - drug therapy - epidemiology
Schizophrenic Psychology
Utilization Review - statistics & numerical data
Abstract
Oral health status is poor and a disregarded health issue among patients with schizophrenia that is associated with the risk for additional social stigmatization and potentially fatal infections.
A historical, prospective database study of dental visits, utilizing the Danish National Patient Registry, of 21,417 patients with ICD-10-diagnosed schizophrenia in the year 2006 and of 18,892 patients for the 3-year period of 2004-2006 was conducted. Multiple logistic regression analyses were used to identify risk factors for lack of dental care.
Only 43% of patients with schizophrenia (9,263/21,417)--compared to an annual dental visit rate of 68% in the general adult Danish population (2,567,634/3,790,446)-visited the dentist within 12 months in 2006 (OR = 2.8; 95% CI, 2.7-2.9; P 50 years were associated with a lower risk for inappropriate dental care.
Patients with schizophrenia visit dentists much less frequently than the general population in the same country. Health professionals should pay more attention to the dental health care of patients with schizophrenia, actively encourage patients to regularly visit the dentist, and establish a formal collaboration with dentists to improve the dental health aspects of this disadvantaged patient group.
PubMed ID
20584518 View in PubMed
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Determining rates of hepatitis C in a clozapine treated cohort.

https://arctichealth.org/en/permalink/ahliterature142375
Source
Schizophr Res. 2010 Dec;124(1-3):86-90
Publication Type
Article
Date
Dec-2010
Author
Sanjeev Sockalingam
Chekkera Shammi
Valerie Powell
Lucy Barker
Gary Remington
Author Affiliation
Psychiatry, Health and Disease Division, University Health Network, Toronto, Ontario, Canada. sanjeev.sockalingam@uhn.on.ca
Source
Schizophr Res. 2010 Dec;124(1-3):86-90
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Administration, Intranasal
Adult
Alcoholism
Antipsychotic Agents - therapeutic use
Canada - epidemiology
Clozapine - therapeutic use
Cocaine-Related Disorders - epidemiology
Cohort Studies
Female
Hepacivirus - genetics - isolation & purification - pathogenicity
Hepatitis C - epidemiology - virology
Humans
Male
Middle Aged
Prevalence
Psychotic Disorders - diagnosis - drug therapy - epidemiology
Questionnaires
Risk factors
Risk-Taking
Schizophrenia - diagnosis - drug therapy - epidemiology
Substance Abuse, Intravenous - epidemiology
Abstract
To determine the prevalence rates of hepatitis C in patients with schizophrenia and schizoaffective disorder being treated with clozapine.
Clozapine-treated outpatients and inpatients were recruited from the Centre for Addiction and Mental Health Schizophrenia Program in Toronto, Canada. All subjects had liver function tests, and positive HCV status was defined as a positive qualitative HCV RNA assay. Subjects completed a self-report questionnaire assessing HCV risk factors, past history of liver disease, previous diagnosis of human immunodeficiency virus (HIV), past hepatitis B virus (HBV) infection and current alcohol use.
110 subjects participated in the study and the HCV prevalence rate (antibody and viremia-positive) was 2.7%, compared to a 0.8% prevalence rate in Canada. All study subjects had established housing, none reported a history of HIV, and only one patient had a history of HBV infection. A total of 9% drank two or more drinks on a typical day drinking and 7% endorsed having six or more drinks on one occasion at least monthly. Two of 3HCV-viremia positive subjects had HCV risk factors, specifically intravenous drug use and intranasal cocaine use. There was no difference between HCV infected and HCV negative subjects on liver function tests.
Our study demonstrates elevated rates of HCV in clozapine-treated patients compared to the general population in Canada and are congruent with reports from United States centres. Our study highlights the importance of homelessness and patterns of high-risk behaviour when interpreting HCV prevalence rates in this sub-population of patients and should be explored in future studies.
PubMed ID
20605572 View in PubMed
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43 records – page 1 of 5.