ABSTRACT
This study assessed the relationship between pharmacological regimens at hospital discharge and hospital readmission among schizophrenia patients. The records reviewed were all consecutive admissions (N=720) from a specific catchment area during the period 1991-2005. Two main groups were selected for analysis: the first group (N=537) included patients discharged with first-generation antipsychotics (FGA), and the second group (N=183) included patients with second-generation antipsychotics (SGA). Data on clinical and demographic characteristics at discharge, including a brief psychiatric rating scale and pharmacological treatment, were collected. The rate of readmission within 12 months was analyzed in relation to the specific pharmacological treatment at discharge. There was no significant difference in the risk of readmission in patients treated with SGA compared with FGA. Adjuvant psychotropic medications to either FGA or SGA did not attenuate the risk of readmission. The readmission rate in patients treated with clozapine (N=74) was significantly lower in comparison with depot FGA (N=293) medications (P=0.016). There was no advantage of SGA over FGA, with or without adjuvant psychotropic treatment, with regard to rehospitalization risk during the 12-month follow-up. Clozapine was found to reduce the risk for readmission in comparison with depot FGA.
Subject(s)
Antipsychotic Agents/therapeutic use , Clozapine/therapeutic use , Patient Readmission , Psychotropic Drugs/therapeutic use , Schizophrenia/drug therapy , Adult , Delayed-Action Preparations , Drug Therapy, Combination , Female , Humans , Israel , Kaplan-Meier Estimate , Male , Middle Aged , Patient Discharge , Proportional Hazards Models , Psychiatric Status Rating Scales , Retrospective Studies , Risk Assessment , Risk Factors , Schizophrenia/diagnosis , Schizophrenia/mortality , Schizophrenic Psychology , Time Factors , Treatment OutcomeABSTRACT
BACKGROUND: A series of epidemiological, clinical and laboratory findings suggest an autoimmune process in schizophrenia and include, among others, high titers of various autoantibodies in the sera of patients. Antiribosomal P antibody is known to exist in systemic lupus erythematosus (SLE) patients with a psychiatric presentation, including psychosis, rationalizing the examination of its existence in patients with schizophrenia. METHODS: Sera of 59 patients, 48 diagnosed with schizophrenia and 11 diagnosed with a schizoaffective disorder, were examined for the presence of antiribosomal P antibody titers using ELISA. The control group consisted of 94 healthy subjects with similar age and gender distribution. RESULTS: Anti-ribosomal P antibody titers were below cut-off level in 58 patients and borderline in one patient, similar to the low titers of the control group. CONCLUSIONS: Previous investigations have demonstrated high specificity for anti-ribosomal P antibody in SLE patients with psychosis. In view of the results of this study, however, anti-ribosomal P antibody is not a biological marker for schizophrenia.
Subject(s)
Autoantibodies , Psychotic Disorders/immunology , Ribosomal Proteins/immunology , Schizophrenia/immunology , Adult , Autoantibodies/blood , Biomarkers/blood , Female , Humans , Male , Psychotic Disorders/blood , Schizophrenia/bloodABSTRACT
BACKGROUND: Accumulating data suggest that schizophrenia patients' mental status might be modulated by their core/brain temperature. Hence, we intended to assess in vivo brain temperature (Tb) of schizophrenia patients vs. healthy subjects and to evaluate its potential association with patients' mental status. METHODS: Absolute values of Tb were measured in 9 neuroleptic-treated schizophrenia patients and 10 healthy comparison subjects using 1H magnetic resonance spectroscopy (MRS). Values were extracted by measuring the chemical shift between the peaks of water and N-acetyl-aspartate in the 1H MRS spectra. RESULTS: A substantial (about 1.1 degrees C) and significantly higher occipital-frontal temperature-gradient was found in the schizophrenia patients compared to the healthy controls (1.27 degrees C vs. 0.18 degrees C; p=0.032). Furthermore, a trend was found between the above mentioned occipital-frontal temperature-gradient in the schizophrenia patients and the severity of their psychopathology, as assessed by the total Positive and Negative Syndrome Scale (PANSS) scores (r=0.61; p=0.08). CONCLUSIONS: Our findings corroborate previous results indicating putative correlation between core/brain temperature and the mental status of schizophrenia patients, emphasizing the possible role of within patients decreased frontal temperature and a significant occipital-frontal temperature-gradient as modulators of psychopathology. In addition, the MRS technique used for brain temperature assessment seems to be a potential non-invasive method to assess in vivo absolute Tb in schizophrenia.
