ABSTRACT
Objective: To evaluate the effectiveness of 6-month treatment with aripiprazole long-acting injectable (LAI) in improving psychotic symptoms, social functioning and side effects and reducing co-administered antipsychotic drugs.Methods: Multicentre, observational, prospective study that enrolled 53 patients with diagnosis of schizophrenia spectrum disorders who initiated or switched to aripiprazole LAI. The effectiveness of aripiprazole LAI was assessed through the Positive and Negative Syndrome Scale (PANSS), the Udvalg for Kliniske Undersogelser scale for side effects, the Global Assessment of Functioning and the Clinical Global Impression-Schizophrenia (CGI-SCH).Results: Upon treatment with aripiprazole LAI, patients significantly improved all the domains of PANSS (p < .05). Adverse event severity significantly improved after a 6-month aripiprazole LAI treatment (p < .05). Differences from baseline to month 6 in Global Assessment of Functioning score were significant (p = .0002). The proportion of severely ill patients decreased upon treatment with aripiprazole LAI (CGI-SCH scale). Prolactin levels were normalised after a 6-month treatment (from 43.0 to 14.7 ng/mL). Co-administered antipsychotic drugs significantly decreased after a 6-month treatment with aripiprazole LAI.Conclusion: A 6-month treatment with aripiprazole LAI improved the clinical status of our patients without modifying their metabolic profile, and allowed the reduction of co-administered antipsychotic drugs.Practice implicationsLong-acting injectable antipsychotics are effective treatment options for the maintenance of patients with schizophrenia and related disorders, and to ensure treatment adherence. This study describes the evolution of patients over six months of treatment with aripiprazole long-acting injectable. The results from this study support previous data on the efficacy and safety of this atypical antipsychotic. This study may be of wide interest to the community of psychiatrists and may help clinicians optimise treatment adherence in patients with schizophrenia spectrum disorders.Key pointsAripiprazole long-acting injectable is an atypical antipsychotic intended to improve treatment adherence and prevent relapses.This multicentre prospective study evaluated the effectiveness of aripiprazole long-acting injectable over six months of treatment on the control of a comprehensive set of clinical variables.Clinical rating scales showed that treatment with aripiprazole long-acting injectable improved clinical symptoms and social functioning, and reduced the severity of adverse events.Aripiprazole long-acting injectable contributed to the maintenance of adequate metabolic profiles and the normalisation of prolactin levels.Patients significantly decreased co-administered antipsychotic drugs after 6-month treatment with aripiprazole.
Subject(s)
Antipsychotic Agents/pharmacology , Aripiprazole/pharmacology , Outcome Assessment, Health Care , Psychotic Disorders/drug therapy , Schizophrenia/drug therapy , Adult , Antipsychotic Agents/administration & dosage , Antipsychotic Agents/adverse effects , Aripiprazole/administration & dosage , Aripiprazole/adverse effects , Delayed-Action Preparations , Drug Therapy, Combination , Female , Humans , Injections , Male , Middle Aged , Prolactin/blood , Prospective Studies , Psychotic Disorders/blood , Psychotic Disorders/physiopathology , Schizophrenia/blood , Schizophrenia/physiopathology , Severity of Illness IndexSubject(s)
Dibenzothiazepines/administration & dosage , Quality of Life/psychology , Schizophrenia/drug therapy , Sulpiride/analogs & derivatives , Adult , Amisulpride , Disease Management , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Quetiapine Fumarate , Sulpiride/administration & dosage , Treatment OutcomeABSTRACT
OBJECTIVE: This case-control study used both healthy blood donors and psychiatric inpatients as controls and controlled for gender, age, low body mass index, alcohol and nicotine use, and aggressive and impulsive behaviors to examine the association between low serum cholesterol levels and suicide attempts. METHOD: At a Spanish general hospital, the recruitment included 417 patients with suicide attempt history (138 men and 279 women), 155 psychiatric inpatient controls without suicide history (68 men and 87 women), and 358 healthy controls (220 men and 138 women). All participants were aged 18 years or older. To study the association between low serum cholesterol levels (fasting < 160 mg/dL) and suicide attempts, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in univariate analyses. Logistic regression models adjusted ORs for confounding variables in male, female, and total samples. The study was conducted from January 1996 to December 1997. RESULTS: The ORs in the total sample (for psychiatric and healthy controls respectively) were 1.8 (95% CI = 1.2 to 2.9, p = .007) and 1.9 (95% CI = 1.4 to 2.6, p < .001) for the univariate analyses, and 1.6 (95% CI = 0.95 to 2.6, p = .08) and 1.6 (95% CI = 1.0 to 2.4, p = .04) after variable adjustment. In women, the adjusted OR was 1.8 (95% CI = 0.90 to 3.5, p = .09) for psychiatric controls. In men, the adjusted OR was 2.0 (95% CI = 0.99 to 4.1, p = .05) for healthy controls. All ORs were in the hypothesized direction but some subsamples appeared too small to reach significance. CONCLUSION: This study, somewhat limited by the small sample size, suggests that low cholesterol may be associated with suicide attempts. Low cholesterol level in suicide attempts may be more important from a pathophysiologic than from a diagnostic point of view.
Subject(s)
Cholesterol/blood , Mental Disorders/blood , Suicide, Attempted/statistics & numerical data , Adult , Case-Control Studies , Cross-Sectional Studies , Depressive Disorder, Major/blood , Depressive Disorder, Major/epidemiology , Female , Hospitals, General/statistics & numerical data , Humans , Male , Mental Disorders/epidemiology , Middle Aged , Odds Ratio , Reference Values , Risk Factors , Spain , Suicide, Attempted/prevention & control , Suicide, Attempted/psychologyABSTRACT
Findings from animal and human studies suggest an association between low cholesterol levels and suicidal behaviors. The purpose of this case-control study was to test whether cholesterol levels in suicide attempters are lower than in controls without suicide attempt history matched by gender, age, and body mass index (BMI). Suicide attempters (n=177: 68 men and 109 women) and controls (177 blood donors) were assessed. Serum cholesterol levels were significantly lower in suicide attempters than in controls. After gender stratification, the difference remained significant in men, but not in women.
Subject(s)
Body Mass Index , Cholesterol/blood , Self-Injurious Behavior/blood , Sex Characteristics , Suicide, Attempted , Adult , Age Factors , Case-Control Studies , Female , Humans , Male , Mental Disorders/complications , Self-Injurious Behavior/etiologyABSTRACT
Impulsivity in suicidal behavior can describe the attempt (state) or the attempter (trait). There are no studies simultaneously measuring attempt impulsivity and attempter impulsivity in representative samples of suicide attempts. A one-year study of 278 suicide attempts in a general hospital tested the continuous versus dichotomous relationship between attempter impulsivity (Barratt Impulsiveness Scale) and attempt impulsivity (low scores in the planning subscale of Beck's Suicidal Intent Scale). Attempter impulsivity was not a good predictor of attempt impulsivity independently of how both dimensions were measured (continuous or dichotomous ways). Impulsive attempts were associated with low lethality and lack of depression. Opportunities for prevention of suicide attempts in major depression and some personality traits may exist but require attentive monitoring of suicidal ideation and intent.
Subject(s)
Impulsive Behavior/psychology , Suicide, Attempted/psychology , Adjustment Disorders/psychology , Adult , Alcoholism/psychology , Depressive Disorder, Major/psychology , Female , Humans , Male , Personality , Psychiatric Status Rating Scales , Suicide/psychology , Suicide/statistics & numerical data , Suicide, Attempted/statistics & numerical dataABSTRACT
OBJECTIVE: If premenstrual symptoms (PMS) are temporally and specifically associated with suicidal attempts, suicide attempts in women with PMS should occur more frequently in the luteal phase. METHOD: In a general hospital, 125 fertile female suicide attempters (and 83 blood donors as controls) with regular menstrual cycles were prospectively studied. A retrospective DSM-IV diagnosis of Premenstrual Dysphoric Disorder (PMDD) was made. RESULTS: Attempts during the luteal phase were not more frequent in females with PMDD (34%,23/68) than in those without PMDD (35%, 20/57). The sample had enough power to detect medium and large effect sizes. As expected, there was a significantly higher frequency of PMDD in suicide attempters than in the controls (54% vs 6%; Fisher's exact test, p < or = 0.001). CONCLUSION: This study was limited by the use of retrospective PMDD diagnosis but suggests that PMDD may not be associated with suicidal acts during the luteal phase,when PMS are present.
Subject(s)
Luteal Phase/psychology , Premenstrual Syndrome/psychology , Suicide, Attempted/psychology , Adult , Chi-Square Distribution , Demography , Female , Humans , Luteal Phase/blood , Personality Assessment , Phobic Disorders/etiology , Premenstrual Syndrome/diagnosis , Premenstrual Syndrome/epidemiology , Prospective Studies , Psychiatric Status Rating Scales , Retrospective StudiesABSTRACT
No disponible
Subject(s)
Humans , Restless Legs Syndrome , Psychotic Disorders , Skin Diseases, Parasitic , Delusions , Prognosis , Diagnosis, DifferentialSubject(s)
Apolipoproteins E/blood , Suicide, Attempted/statistics & numerical data , Adult , Cholesterol/blood , Female , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Mental Disorders/psychology , Psychiatric Status Rating Scales , Sex Factors , Spain/epidemiology , Suicide, Attempted/psychologyABSTRACT
The association between a polymorphism in the promoter area of the serotonin transporter (17q11.1-q12) with impulsivity and history of aggressive behavior was studied in a Spanish general hospital. Subjects comprised 216 suicide attempters (152 women and 64 men) and 223 control blood donors (124 women and 99 men). They were classified as S individuals (s/s or s/l) with low expression of the serotonin transporter, and L individuals (l/l) with high expression. The genotype was not associated with high levels of impulsivity (measured with the Barratt Impulsiveness Scale) or history of aggressive behavior (measured with the Brown-Goodwin scale). This lack of association did not appear to be explained by lack of statistical power. High scores on the Barratt Impulsiveness Scale (BIS) and the Brown-Goodwin Aggressive Behavior Scale were associated with being an attempter, male gender and borderline personality disorder. While our Spanish suicide attempters and published US suicide attempters have similar BIS scores, our Spanish suicide attempters have significantly lower aggressive behavior scores. If cross-cultural differences in aggressive behavior scores are definitively established, country norms for aggressive behavior scales will need to be developed to compare genetic studies in different countries.
