Non-adherence to antipsychotic medication, relapse and rehospitalisation in recent-onset schizophrenia

<p>Abstract</p> <p>Background</p> <p>The aims of this study were to describe outcome with respect to persistent psychotic symptoms, relapse of positive symptoms, hospital admissions, and application of treatment by coercion among patients with recent onset schizophrenia being adherent and non-adherent to anti-psychotic medication.</p> <p>Materials and methods</p> <p>The study included 50 patients with recent onset schizophrenia, schizoaffective or schizophreniform disorders. The patients were clinically stable at study entry and had less than 2 years duration of psychotic symptoms. Good adherence to antipsychotic medication was defined as less than one month without medication. Outcomes for poor and good adherence were compared over a 24-month follow-up period.</p> <p>Results</p> <p>The Odds Ratio (OR) of having a psychotic relapse was 10.27 and the OR of being admitted to hospital was 4.00 among non-adherent patients. Use of depot-antipsychotics were associated with relapses (OR = 6.44).</p> <p>Conclusion</p> <p>Non-adherence was associated with relapse, hospital admission and having persistent psychotic symptoms. Interventions to increase adherence are needed.</p> <p>Trial registration</p> <p>Current Controlled Trials NCT00184509. Key words: Adherence, schizophrenia, antipsychotic medication, admittances, relapse.</p

Clusters of personality traits and psychological symptoms associated with later benzodiazepine prescriptions in the general population: the HUNT cohort study

OBJECTIVE: The aim of this population-based study was to identify factors associated with later benzodiazepine prescriptions, including clusters of personality traits, self-esteem characteristics, sleep difficulties, depression and anxiety symptoms. METHODS: A 13year historical cohort study (n=58,967) was carried out and baseline measures of self-reported depression and anxiety symptoms, sleep difficulties, self-esteem and personality traits were obtained from the second wave of the Nord-Trøndelag Health Study (HUNT 2, 1995-1997), Norway. Data on benzodiazepine prescriptions were collected from the Norwegian Prescription Database (NorPD, 2004-2008) for each case in the cohort. RESULTS AND CONCLUSIONS: We found that a combined high extraversion and high neuroticism personality score at baseline was associated with increased benzodiazepine prescription rates. Further, sleep difficulties, low self-esteem and high depression and anxiety scores were also linked to later prescriptions of benzodiazepines, in particular chronic and high dose benzodiazepine prescriptions patterns. The findings are discussed in relation to prescription practice and policy

Integrated treatment vs. treatment-as-usual for recent onset schizophrenia; 12 year follow-up on a randomized controlled trial

Background: The aim of this study is to compare the 12-year follow-up effects on in- and outpatient services of 2 years of integrated treatment for recent-onset schizophrenia versus treatment as usual in a randomized controlled trial. Methods: 50 patients aged 18–35 years were randomized to Integrated Treatment (IT) (N = 30) or Treatment-as-Usual (TAU) (N = 20) for two years. TAU comprised optimal pharmacotherapy and outreach assertive treatment, while IT also included cognitive-behavioural family treatment, skills training, strategies for residual psychotic and non-psychotic problems and home-based crisis management. Results: There were no differences in number of days in hospital, time to readmission, number of admittances to psychiatric wards, number of involuntarily psychiatric admissions or number of outpatient contacts over a period of 12 years following the initial 2-year treatment trial. Fewer patients in the IT group were, however, involuntary admitted to hospital in the period. Conclusions: The intensive two-year psychosocial intervention seemed to have little long-term effects on use of in- and outpatient services.<p>© 2013 Sigrúnarson et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p