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Concomitant medication of psychoses in a lifetime perspective.

https://arctichealth.org/en/permalink/ahliterature133527
Source
Hum Psychopharmacol. 2011 Jun-Jul;26(4-5):322-31
Publication Type
Article
Author
Maria Vares
Peter Saetre
Pontus Strålin
Sten Levander
Eva Lindström
Erik G Jönsson
Author Affiliation
Department of Clinical Neuroscience, Karolinska Institutet and Hospital, Stockholm, Sweden.
Source
Hum Psychopharmacol. 2011 Jun-Jul;26(4-5):322-31
Language
English
Publication Type
Article
Keywords
Adult
Anti-Anxiety Agents - therapeutic use
Antidepressive Agents - therapeutic use
Antiparkinson Agents - therapeutic use
Antipsychotic Agents - therapeutic use
Diagnostic and Statistical Manual of Mental Disorders
Drug Therapy, Combination
Female
Hospitals, Urban
Humans
Hypnotics and Sedatives - therapeutic use
Male
Middle Aged
Outpatient Clinics, Hospital
Psychotic Disorders - drug therapy
Psychotropic Drugs - therapeutic use
Retrospective Studies
Schizophrenia - drug therapy
Sweden
Young Adult
Abstract
Patients treated with antipsychotic drugs often receive concomitant psychotropic compounds. Few studies address this issue from a lifetime perspective. Here, an analysis is presented of the prescription pattern of such concomitant medication from the first contact with psychiatry until the last written note in the case history documents, in patients with a diagnosis of psychotic illness.
A retrospective descriptive analysis of all case history data of 66 patients diagnosed with schizophrenia or schizophrenia-like psychotic disorders.
Benzodiazepines and benzodiazepine-related anxiolytic drugs had been prescribed to 95% of the patients, other anxiolytics, sedatives or hypnotic drugs to 61%, anti-parkinsonism drugs to 86%, and antidepressants to 56% of the patients. However, lifetime doses were small and most of the time patients had no concomitant medication. The prescribed lifetime dose of anti-parkinsonism drugs was associated with that of prescribed first-generation but not second-generation antipsychotics.
Most psychosis patients are sometimes treated with concomitant drugs but mainly over short periods. Lifetime concomitant add-on medication at the individual patient level is variable and complex but not extensive.
Notes
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PubMed ID
21695733 View in PubMed
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Drug attitude and other predictors of medication adherence in schizophrenia: 12 months of electronic monitoring (MEMS(®)) in the Swedish COAST-study.

https://arctichealth.org/en/permalink/ahliterature106886
Source
Eur Neuropsychopharmacol. 2013 Dec;23(12):1754-62
Publication Type
Article
Date
Dec-2013
Author
Cecilia Brain
Katarina Allerby
Birgitta Sameby
Patrick Quinlan
Erik Joas
Ulla Karilampi
Eva Lindström
Jonas Eberhard
Tom Burns
Margda Waern
Author Affiliation
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Sweden; Nå Ut-teamet, Psychosis Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address: cecilia.brain@vgregion.se.
Source
Eur Neuropsychopharmacol. 2013 Dec;23(12):1754-62
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antipsychotic Agents - therapeutic use
Area Under Curve
Attitude to Health
Female
Follow-Up Studies
Humans
Male
Medication Adherence - psychology
Micro-Electrical-Mechanical Systems
Middle Aged
Neuropsychological Tests
Predictive value of tests
Psychiatric Status Rating Scales
Questionnaires
Schizophrenia - drug therapy - epidemiology
Schizophrenic Psychology
Sweden - epidemiology
Young Adult
Abstract
The aim was to investigate clinical predictors of adherence to antipsychotics. Medication use was electronically monitored with a Medication Event Monitoring System (MEMS(®)) for 12 months in 112 outpatients with schizophrenia and schizophrenia-like psychosis according to DSM-IV. Symptom burden, insight, psychosocial function (PSP) and side effects were rated at baseline. A comprehensive neuropsychological test battery was administered and a global composite score was calculated. The Drug Attitude Inventory (DAI-10) was filled in. A slightly modified DAI-10 version for informants was distributed as a postal questionnaire. Non-adherence (MEMS(®) adherence =0.80) was observed in 27%. In univariate regression models low scores on DAI-10 and DAI-10 informant, higher positive symptom burden, poor function, psychiatric side effects and lack of insight predicted non-adherence. No association was observed with global cognitive function. In multivariate regression models, low patient-rated DAI-10 and PSP scores emerged as predictors of non-adherence. A ROC analysis showed that DAI-10 had a moderate ability to correctly identify non-adherent patients (AUC=0.73, p
PubMed ID
24091164 View in PubMed
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Stigma, discrimination and medication adherence in schizophrenia: results from the Swedish COAST study.

https://arctichealth.org/en/permalink/ahliterature264237
Source
Psychiatry Res. 2014 Dec 30;220(3):811-7
Publication Type
Article
Date
Dec-30-2014
Author
Cecilia Brain
Birgitta Sameby
Katarina Allerby
Patrick Quinlan
Erik Joas
Eva Lindström
Tom Burns
Margda Waern
Source
Psychiatry Res. 2014 Dec 30;220(3):811-7
Date
Dec-30-2014
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - therapeutic use
Female
Humans
Male
Medication Adherence - psychology
Middle Aged
Schizophrenia - drug therapy - epidemiology
Schizophrenic Psychology
Social Discrimination - psychology
Social Stigma
Sweden - epidemiology
Abstract
The aims of this naturalistic non-interventional study were to quantify the level of stigma and discrimination in persons with schizophrenia and to test for potential associations between different types of stigma and adherence to antipsychotics. Antipsychotic medication use was electronically monitored with a Medication Event Monitoring System (MEMS®) for 12 months in 111 outpatients with schizophrenia and schizophrenia-like psychosis (DSM-IV). Stigma was assessed at endpoint using the Discrimination and Stigma Scale (DISC). Single DISC items that were most frequently reported included social relationships in making/keeping friends (71%) and in the neighborhood (69%). About half of the patients experienced discrimination by their families, in intimate relationships, regarding employment and by mental health staff. Most patients (88%) wanted to conceal their mental health problems from others; 70% stated that anticipated discrimination resulted in avoidance of close personal relationships. Non-adherence (MEMS® adherence=0.80) was observed in 30 (27.3%). When DISC subscale scores (SD) were entered in separate regression models, neither experienced nor anticipated stigma was associated with adherence. Our data do not support an association between stigma and non-adherence. Further studies in other settings are needed as experiences of stigma and levels of adherence and their potential associations might vary by a healthcare system or cultural and sociodemographic contexts.
PubMed ID
25457284 View in PubMed
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