Akathisia and atypical antipsychotics. Relation to suicidality, agitation and depression in a clinical trial

Objective: Akathisia is among the most unpleasant side effects related to antipsychotic drug (AP) use, and possible associations between akathisia and agitation, depression and suicidal behaviour, respectively, have been described in previous literature. New generation antipsychotics are however regarded less prone to induce this particular adverse effect compared to older drugs, but evidence is incomplete and in need of confirmation from clinically relevant samples and settings. We, therefore, aim to investigate akathisia at hospital discharge for patients consecutively admitted with acute-phase psychosis and treated with atypical antipsychotics according to guideline-concordant clinical practice. Methods: This exploratory study is part of a naturalistic randomised controlled study in patients admitted with acute phase psychosis (N = 109). We report cross-sectional data at discharge/first follow-up after acute psychiatric hospital admission for patients with schizophrenia and related psychotic disorders. Results: There were statistically significant positive associations between akathisia and the following; suicidality in men (Beta 0.306, p = 0.048), but not in women; agitation in those previously unexposed to antipsychotics (Beta 0.288, p = 0.047) and depression in those exposed to antipsychotics before hospital admittance (Beta 0.375, p = 0.031). Conclusion: Main findings were that akathisia is still a prevalent side effect in a clinically relevant sample of patients treated with atypical antipsychotics. Our results suggest that akathisia is significantly associated with depression, suicidality and agitation in different subgroups of patients receiving APs. Akathisia can be detrimental and the relations between akathisia and depression, suicidality and agitation should be investigated further in prospective, hypothesis-testing studies with larger samples.publishedVersio

Den sårbare tiden etter utskrivelse fra psykiatrisk sykehus – selvmordsrisiko og dokumentasjonspraksis

Tiden like etter utskrivelse fra psykiatrisk døgnenhet innebærerforhøyet selvmordsrisiko. Nasjonale retningslinjer for selvmordsforebyggingi psykisk helsevern anbefaler at når selvmordsrisiko harvært en problemstilling under oppholdet eller tidligere skal pasienterselvmordsrisikovurderes og det er en fordel med timeavtale hosoppfølgende instans. Hensikten med denne studien var å kartleggedokumentert etterlevelse av disse anbefalingene og identifisering avprediktorer for manglende timeavtale.En journalstudie i Divisjon psykisk helsevern, Haukeland Universitetssykehus,ble gjennomført for å vurdere i hvilken grad dokumentasjonspraksisi epikriser og overføringsnotat samsvarte medretningslinjeanbefalingene. Opplysninger om selvmordsrisikovurderingog timeavtale ble kartlagt sammen med kjønn, alder, tidligereselvmordsforsøk, andre risikofaktorer og mulige beskyttende faktorerfor selvmord, hoveddiagnoser, henvisnings- og mottaksformalitet.Analyser var deskriptiv statistikk og Generalized Estimating Equation.Selvmordsrisikovurdering var dokumentert i nesten alle epikriser/overføringsnotat. Begrunnelser for selvmordsrisikovurderingene vari liten grad dokumentert. Lavere sannsynlighet for dokumentasjon avtimeavtale var knyttet til utskrivelser med rus som hoveddiagnose,schizofrenidiagnose for kvinner, samt å bli henvist til tvangsinnleggelsemen mottatt til frivillig sykehusopphold for kvinner.Dokumentasjonspraksis vedrørende selvmordsrisikovurdering vargod, men vurderingene inneholdt i liten grad utdypende beskrivelserslik retningslinjen anbefaler. Gode beskrivelser gir oppfølgendeinstans viktig informasjon for videre pasientbehandling. Bedret dokumentasjonspraksis kan bidra til økt kontinuitet i helsetjenestetilbudetfor pasientene

Original Contribution Association of Adiposity Genetic Variants With Menarche Timing in 92,105 Women of European Descent

Obesity is of global health concern. There are well-described inverse relationships between female pubertal timing and obesity. Recent genome-wide association studies of age at menarche identified several obesity-related variants. Using data from the ReproGen Consortium, we employed meta-analytical techniques to estimate th