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Treatment with antipsychotics: The impact on the patient in the community

Published online by Cambridge University Press:  16 April 2020

W Rössler
Affiliation:
Sector West, Psychiatric University Hospital, POB 1930, 8021 Zurich, Switzerland
HJ Salize
Affiliation:
Central Institute of Mental Health, J5, 68159Mannheim, Germany
I Reinhard
Affiliation:
Central Institute of Mental Health, J5, 68159Mannheim, Germany
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Summary

The assessment of new treatment strategies such as the atypical antipsychotic agents goes far beyond the assessment of psychopathology, and includes evaluation of their effects on a variety of needs associated with living in the community. This article provides some empirical data for such a multidimensional perspective in analysing drug treatment with conventional antipsychotics. We focus on two groups of schizophrenic patients discharged from a psychiatric hospital, who were followed up for one year. One group was treated with oral and the other with depot medication. The two groups were assessed on their needs for care, quality of life, and rehospitalisation rates. We found few significant differences between depot- and orally-medicated patients. However, patients treated with depot antipsychotics were receiving higher mean daily doses. Patients taking oral medication had a lower rate of adverse effects but were more non-compliant, which resulted in a higher rehospitalisation rate, confirming our assumpt on that patients take different risk-to-benefit decisions. Orally-medicated patients did not have a better functional status than depot-medicated patients.

Type
Research Article
Copyright
Copyright © Elsevier, Pari 1998

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References

Awad, AG, Hogan, TPSubjective response to neuroleptics and the quality of life: implications for treatrment outcome Acta Psychiatrica Scand 89 suppl 380 1994 2732CrossRefGoogle Scholar
Brewin, CR, Wing, JK, Mangen, SP, Bruha, TS, MacCarthy, BPrinciples and practice of measuring needs in the long-term mentally ill: The MRC Needs for Care Assessment Psychol Med 1987; 17: 971981CrossRefGoogle ScholarPubMed
Carpenter, WT, Conley, RR, Buchanan, RX, Breier, A, Tamminga, CAPatient response and resource management: another view of clozapine treatment of schizophrenia Am J Psychiatry 1995; 152: 827832Google ScholarPubMed
Davis, JMComparative doses and costs of antipsychotic medication Arch Gen Psychiatry 1976; 33: 858861CrossRefGoogle ScholarPubMed
Falloon, IRH, Boyd, JL, McGill, CW, Williamson, M, Razani, J, Moss, HB, et al.Family management in the prevention of morbidity of schizophrenia. Clinical outcome of a two year longitudinal study Arch Gen Psychiatry 1985; 42: 887896CrossRefGoogle ScholarPubMed
Falloon, IRH, McGill, CW, Boyd, JL, Pederson, JFamily management in the prevention of morbidity of schizophrenia: social outcome of a two-year longitudinal study Psychol Med 1987; 17: 5966CrossRefGoogle ScholarPubMed
Glazer, WM, Kane, JMDepot antipsychotic therapy: an underutilised treatment option J Clin Psychiatry 1992; 53: 426433Google Scholar
Haase, H.J.Therapien mit Psychopharnuika und anderen seelischesn Befinden beeinflussendern Medikamentern Oxford: FK Schattauer Verlag, 1982Google Scholar
Heinisch, M, Ludwig, M, Bullinger, MPsychometrische Testung der Münchner Lebensqualitäts Dimensic nen Liste (MLDL)Bullinger, M, Ludwig, M, von Steinbächel, NLebensqualität bei kardiovaskulären Erkrankungen. Grundlagen, Messverfahren und Ergebnisse Stuttgart, New York: Hogrefe, 1990 7390Google Scholar
Hogarty, GE, Anderson, CM, Reiss, DJ, Kornblith, SJ, Greenwald, DP, Javna, CD, Madonia, MJFamily psychoeducation, social skills training and maintenance chemotherapy in the aftercare treatment of schizophrenia Arch Gen Psychiatry 1986; 43: 633642CrossRefGoogle ScholarPubMed
Hogarty, GE, Anderson, CM, Reiss, DJ, Kornblith, SJ, Greenwald, DP, Ulrich, RF, Carter, MFamily psychoeducation, social skills training and maintenance chemotherapy in the aftercare treatment of schizophrenia. II. Two years effects of a controlled study on relapse and adjustment Arch Gen Psychiatry 1991; 48: 340347CrossRefGoogle Scholar
Hogg, LI, Marshall, MCan we measure need in the homeless mentally ill? Using the MRC Needs for Care Assessment in hostels for the homeless Psychol Med 1992; 22: 10271034CrossRefGoogle ScholarPubMed
Holloway, FDay care in an inner city. II. Quality of the services Br J Psychiatry 1991; 158: 810816CrossRefGoogle Scholar
Jahn, T, Mussgay, LDie statistische Kontrolle möglicher Medikamenteneinflüsse in experimentalpsychologischen Schizophreniestudien: ein Vorschlag zur Berechnung von Chlorpromazinäquivalenten Z Klin Psychol 1989; 18: 257267Google Scholar
Kane, JM, Lieberman, JAMaintenance pharmacotherapy in schizophreniaMeltzer, HYPsychopharmacology: The Third Generation of Progress Göttingen, Toronto, Zürich: Raven, 1987 11031109Google Scholar
Leff, J, Kuipers, L, Berkowitz, R, Sturgeon, DA controlled trial of social intervention in the families of schizophrenic patients: two year follow-up Br J Psychiatry 1985; 146: 594600CrossRefGoogle ScholarPubMed
Lesage, AD, Cope, SJ, Pezeshgi, SAssessing the needs for care of non-psychotic patients. A trial with a new standardized procedure Soc Psychiatry Psychiatr Epidemiol 1991; 26: 281286Google ScholarPubMed
Meltzer, HYDimensions of outcome with clozapine Br J Psychiatry 160suppl 171992 4653CrossRefGoogle Scholar
Meltzer, HY, Cola, P, Way, L, Thompson, PA, Bastani, B, Davies, MA, Snitz, BCost effectiveness of clozapine in neuroleptic-resistant schizophrenia Am J Psychiatry 1993; 150: 16301638Google ScholarPubMed
Pryce, IG, Griffiths, RD, Gentry, RM, Hughes, ICT, Montague, LR, Watkins, SE, et al.The nature and severity of disabilities in long-stay psychiatric inpatients in South Glamorgan Br J Psychiatry 1991; 158: 817821CrossRefGoogle Scholar
Tarrier, N, Barrowclough, C, Vaughn, C, Bamrah, JS, Porceddu, K, Watts, S, Freeman, HThe community management of schizophrenia. A controlled trial of a behavioural intervention with families to reduce relapse Br J Psychiatry 1988; 153: 532542CrossRefGoogle ScholarPubMed
Tarrier, N, Barrowclough, C, Vaughn, C, Bamrah, JS, Porceddu, K, Watts, S, Freeman, HCommunity management of schizophrenia. A two year follow-up of a behavioural intervention with families Br J Psychiatry 1989; 154: 625628CrossRefGoogle ScholarPubMed
Van Haaster, I, Lesage, AD, Cyr, M, Toupin, JFurther reliability and validity studies of a procedure to assess the needs for care of the chronically mentally ill Psychol Med 1994; 24: 215222CrossRefGoogle ScholarPubMed
Weiden, PJ, Olfson, MCost of relapse in schizophrenia Schizoph Bull 1995; 21: 419429CrossRefGoogle Scholar
Wing, JK, Babor, T, Brugha, TS, Burke, J, Cooper, JE, Giel, R, et al.SCAN. Schedules for Clinical Assessment in Neuropsychiatry Arch Gen Psychiatry 1990; 47: 589593CrossRefGoogle ScholarPubMed
WHO (World Health Organisation) Schedule for clinical assessment in neuropsychiatry (SCAN) New York: WHO, 1992Google Scholar
Wyatt, RJBiochemistry and schizophrenia, part IV. The antipsychotics — their mechanism of action: a review of the biochemical literature Psychopharmacological Bulletin 1976; 12: 550Google ScholarPubMed
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