A post-marketing surveillance study of risperidone as adjunctive therapy to mood stabilizers in the treatment of manic phase bipolar I disorder

Objectives: The purpose of this study was to assess symptom improvement with, and safety (measured as tolerability) of, risperidone as adjunctive therapy to mood stabilizers in the treatment of bipolar I disorder, manic phase. Methods: Eight hundred sixty seven Filipino patients, recruited from 46 centers across the Philippines and diagnosed according to DSM-IV criteria as having bipolar disorder, current phase manic, completed an 8-week open trial of risperidone as add-on therapy to mood stabilizers. Doses of risperidone were started at 0.5 - 2 mg per day for the first 2 days, and escalated or reduced based on clinical judgment on succeeding days. Treatment was evaluated 1, 2, 4 and 8 weeks after baseline assessment. The Young Mania Rating Scale (YMRS), Hamilton Depression Scale (HAM-D), Clinical Global Impression Scale for Severity (CGI-S) and Clinical Global Impression Scale for Improvement (CGI-I) were used to measure symptom reduction with risperidone use, while the Extrapyramidal Symptoms Rating Scale and incidence of adverse events were employed to determine drug safety. Results: Results showed significant reduction in manic and depressive symptoms throughout the study as measured by statistically significant decreases in mean YMRS and HAM-D scores. CGI scores likewise showed significant improvement from baseline to study end with an increasing percentage of patients who showed steady improvement throughout the trial. There was a low incidence of extrapyramidal symptoms (EPS), majority of which were mild. Only 2 other non-EPS adverse events occurred in the study. Conclusion: This study demonstrated reductions in manic and depressive symptoms with risperidone use and showed that risperidone was safe as adjunct therapy to mood stabilizers for the treatment of manic phase bipolar disorder.

Comparison between primary care evaluation of mental disorders patient questionnaire and the self-reporting questionnaire as screening tools for psychiatric disorders at the UP-PGH Pain Clinic

OBJECTIVE: To compare the validities of two instruments- the Primary Care Evaluation of Mental Disorders Patient Questionnaire (PRIME-MD PQ) and the Self-Reporting Questionnaire (SRQ)- in terms of discriminating between patients with and without psychiatric disorders seen at the UP-PGH Pain Clinic. DESIGN: Cross-sectional, criterion standard SETTING: Pain Clinic at the Department of Outpatient Services SUBJECTS: A total of 102 adult patients assessed by three pain fellow physicians MAIN OUTCOME MEASURES: Positive or negative results for mental disorders using PRIME-MD PQ and SRQ as screening procedure plotted against psychiatric interview whether positive or negative using a two-by-two contingency table RESULTS: There was good agreement between PRIME-MD PQ and psychiatric interview (k=0.67) whereas poor correlation between SRQ and psychiatric interview (k=0.51). However, with the removal of one item eliciting grandiosity from the "psychotic" items, agreement with the SRQ rose to k=0.76 when all items on psychosis are eliminated (shorter version of SRQ), agreement was almost excellent (k=0.79). CONCLUSION: The modified version of SRQ is slightly superior to the PRIME-MD PQ in discriminating between patients with and without psychiatric disorders at the Pain Clinic.

Stomach cancer incidence in Metro Manila and Rizal province: 1980-1992

Incidence was derived from published data from 2 population-based registries - the Philippine Cancer Society - Manila Cancer Registry and the Department of Health-Rizal Cancer Registry, which covered 8.5 million residents (1990 census) of a 1,674 square kilometer area that comprises Metro Manila and Rizal province. Thirteen registry clerks actively sought new cancer cases in 96 hospitals and 30 Civil Registry offices. Both registries are members of the International Association of Cancer Registries and received continuing professional assistance from the International Agency for Research on Cancer (IARC). For the period 1988-1992 the combined age-standardized incidence rate (ASR) was 9.9 per 100,000 for male stomach cancer (ranked fifth, 4.5% of all male cancers), and 5.9 per 100,000 among females (ranked ninth, 2.8% of all female cancers). Stomach cancer among Philippine residents had lower ASRs and age-specific rates compared to Japanese, Korean, Chinese, Singaporean Chinese and Vietnamese populations. Age-specific rates among Filipinos reached 10 per 100,000 or higher at age-group 50-54 years among males, and 55-59 years among females. Significant differences in incidence were observed in only few cities and municipalities. There were little differences in ASRs between 2 populations during 3 time periods between 1980-1992, in both males and females with an indication of a slight decrease. Incidence of male Philippine migrants to Hawaii, San Francisco and Los Angeles were comparable to those of white residents covered by the Manila registry. Among females, stomach cancer incidence of Philippine residents and Filipina migrants to Hawaii were similar, and were slightly higher than those of white residents in Hawaii and both migrants and white residents in San Francisco and Los Angeles

Pancreas cancer incidence in Metro Manila and Rizal province: 1980-1992

Incidence was derived from published data from 2 population-based registries-the Philippine Cancer Society-Manila Cancer Registry and the Department of Health-Rizal Cancer Registry, which covered 8.5 million residents (1990 census) of a 1,674 square kilometer area that comprises Metro Manila and Rizal province. Thirteen registry clerks actively sought new cancer cases in 96 hospitals and 30 Civil Registry offices. Both registries are members of the International Association of Cancer Registries and receive continuing professional assistance from the International Agency for Research on Cancer (IARC). For the period 1988-1992 the combined age-standardized incidence rates (ASR) of pancreas cancer in males was 4.2 per 100,000 (ranked eleventh) and 3.2 per 100,000 in females (ranked fourteenth). Pancreas cancer rates for both sexes were lower than those observed among North America and European populations. Within region, Philippine rates were lower than Japanese, Korean, Chinese and Singaporean Chinese, but were higher than Vietnamese and Thai populations. Among males, the increase in age-specific rates were highest among those 55 years and older, and at age-group 65 years and older among females. There were significant differences in rates between some cities and municipalities, with the rates in some highly urbanized cities two to three times those seen in rural areas. Average annual rates among males and females had hardly changed in the 13-year period between 1980-1992 but total cases had tripled. ASRs of Filipino male migrants of the U.S.A were similar to that observed among Filipinos residing in the Philippines. Female migrants to San Francisco and Los Angeles had higher rates than Philippine residents

Prostate cancer incidence in Metro Manila and Rizal province: 1980-1992

Incidence was derived from published data from 2 population-based registries-the Philippine Cancer Society-Manila Cancer registry and the Department of Health-Rizal Cancer Registry, which covered 8.5 million residents (1990 census) of a 1,674 square kilometer area that comprises Metro Manila and Rizal province. Thirteen registry clerks actively sought new cancer cases in 96 hospitals and 30 Civil Registry offices. Both registries are members of the International Association of Cancer Registries and receive continuing professional assistance from the International Agency for Research on Cancer (IARC). For the period of 1988-1992 the combined age-standardized incidence rate (ASR) was 17.0, prostate cancer ranked third and comprised 6.1 per cent of all male cancers. Prostate cancer rates were lower than those observed among North American and European populations, but within the Asian region, Philippine rates were higher than most Asian populations. Age-specific rates increased considerably at age-group 66-59 years and continued to increase with increasing age. There were significant differences in rates between cities and municipalities, with the rates in some highly urbanized cities double those seen in urbanizing areas, and triple those seen in rural areas. Rates had increased slightly in the 13-year period between 1980-1992 but total cases had triples. Incidence rates among Filipino migrants to Hawaii, San Francisco and Los Angeles were almost 3 times higher than rates seen in Philippines residents, but were still only half of those seen among the white populations.

Nasopharynx cancer incidence in Metro Manila and Rizal provinces: 1980-1992

Incidence was derived from published data from 2 population-based registries-the Philippine Cancer Society-Manila Cancer Registry and Department of Health-Rizal Cancer Registry, which covered 8.5 million residents (1990 census) of a 1,674 square kilometer area that comprises Metro Manila and Rizal province. Thirteen registry clerks actively sought new cancer cases in 96 hospitals and 30 Covil Registry offices. Both registries are members of the International Association of Cancer Registries and receive continuing professional assistance from the International Agency for Research on Cancer (IARC). For the period of 1988-1992 the combined age-standardized incidence rates (ASR) were: 6.8 for male nasopharynx cancer (NPC) (ranked sixth) and 3.2 among females (ranked thirteenth). NPC for both sexes were highest among Asian populations. Within the region, Philippine rates were third highest, following the Singapore Chinese and Vietnamese. Age-specific rates in males reached 10 per 100,000 at age-group 40-49 years, and 5 per 100,000 females at age-group 45-49 years, continuing to rise with increasing age. There were some significant differences in ASRs between some cities and municipalities but the differences were more striking among males as female rates were lower. Rates had increased only very slightly in the 13-year period between 1980-1992 but total cases had triples. NPC ASRs among male Filipino migrants to the USA were only half of that observed in Philippine residents, but were still higher than the rates among White residents. A similar decrease was seen among female migrants, and in Los Angeles the rates of Filipinos and non-Hispanic White females were already similar

Liver cancer incidence in Metro Manila and Rizal province: 1980-1992

Incidence was derived from published data from 2 population-based registries-the Philippine Cancer Society-Manila Cancer Registry and the Department of Health-Rizal Cancer Registry, which covered 8.5 million residents (1990 census) of a 1,674 square kilometer area that comprises Metro Manila and Rizal province. Thirteen registry clerks actively sought new cancer cases in 96 hospitals and 30 Civil Registry offices. Both registries are members of the International Association of Cancer Registries and receive continuing professional assistance from the International Agency for Research on Cancer (IARC). For the period 1988-1992 the combined age-standardized incidence rates (ASR) were 21.2 for male liver cancer (ranked second), and 7.3 in females (ranked seventh). Liver cancer rates for both sexes were higher than those observed among North American and European populations. Within the region, high rates were observed in both males and females in Thailand, Japan, China, Korea, Philippines, Singapore and Viet Nam. The rate begins to rise steeply at age-group 40-44 years among males and females. There were significant differences in rates between some cities and municipalities, with the rates in some areas double those seen in low incidence areas. Rates observed among Filipino migrants to the USA had decreased by around half of those seen among Philippine residents