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  • Eberhard, J., et al. (författare)
  • Prolactin level during 5 years of risperidone treatment in patients with psychotic disorders.
  • 2007
  • Ingår i: Acta Psychiatrica Scandinavica. - Wiley-Blackwell. - 1600-0447. ; 115:4, s. 268-276
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To investigate prolactin levels and related side effects in 128 men and 90 women initially treated with risperidone. Method: Patients initially treated with risperidone were followed over 5 years, during which 45% were switched to other antipsychotic drugs. Results: Initially, prolactin levels were fivefold the norm in women, and threefold in men. Diagnosis did not affect the prolactin level if adjustment for sex, current age, and age at onset of psychosis was applied. Prolactin levels did not correlate significantly neither with any Positive and Negative Symptom Scale item or subscale, nor with side effects. Drugs other than risperidone were not associated with high prolactin levels. For patients on continuous monotherapy risperidone treatment, there was a marked linear reduction of prolactin level over all 5 years. Conclusion: Risperidone induces a higher prolactin elevation than other atypical antipsychotics, but the effect adapts over time. Prolactin was not associated with expected side effects (e.g. sexual, mental, or weight gain).
  • Lindström, Eva, et al. (författare)
  • Costs of schizophrenia during five years
  • 2007
  • Ingår i: Acta Psychiatrica Scandinavica. - Wiley-Blackwell. - 1600-0447. ; 116:S435, s. 33-40
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To explore the direct and Indirect costs in a cohort of 225 risperidone-treated patients with schizophrenia followed up annually during 5 years. Method: Data on costs for medication, hospitalization, sheltered living and productivity losses, as well as degree of social isolation, were collected. Results: The direct costs were dominated by hospitalization and sheltered living expenses, while drug costs only represented 7% of the direct costs. Indirect costs represented 43% of the total costs during the 5 years. About 12% worked full-time, and 12% worked part-time, implying large productivity losses. As a consequence of the national mental health care reform, a substantial shift of costs from hospital care to sheltered living took place on the national level, but the reduction of hospital days for the study patients over time was much larger suggesting that the switch from first to second generation compounds was therapeutically successful. A high degree of social isolation was seen, with more than 20% being completely without social contacts and 30% seeing friends/relatives less often than once a week. Conclusion: The economic costs of schizophrenia are high and driven by the need for assisted living and hospitalizations, together with productivity losses. In addition, the intangible costs, such as social contacts, are also high.
  • Nielsen, R. E., et al. (författare)
  • Effects of sertindole on cognition in clozapine-treated schizophrenia patients
  • 2012
  • Ingår i: Acta Psychiatrica Scandinavica. - Wiley-Blackwell. - 1600-0447. ; 126:1, s. 31-39
  • Tidskriftsartikel (refereegranskat)abstract
    • Nielsen RE, Levander S, Thode D, Nielsen J. Effects of sertindole on cognition in clozapine-treated schizophrenia patients. Objective: To assess the cognitive effects of sertindole augmentation in clozapine-treated patients diagnosed with schizophrenia. Cognition is secondary outcome of the trial. Method: A 12-week, double-blinded, randomized, placebo-controlled, augmentation study of patients treated with clozapine. Participants were randomized 1:1 to receive 16 mg of sertindole or placebo as adjunctive treatment to clozapine. Results: Participants displayed substantial cognitive deficits, ranging from 1.6 standard deviation below norms at baseline to more than three standard deviations on tests of response readiness and focused attention. There were no significant differences between sertindole augmentation and placebo groups at study end. Correlation analysis of Positive and Negative Syndrome (PANSS) subscales, Global Assessment of Functioning subscale (GAF-F) and Clinical Global Impression (CGI) with 20 neurocognitive indices was conducted, but no significant correlations were found. Second, we tested change from baseline to endpoint for the PANSS, GAF-F, and CGI, vs. the concomitant changes in cognitive test performance, and found no significant correlations. Conclusion: The clozapine-treated patients displayed marked cognitive deficits at baseline. Adding sertindole did not improve or worsen cognitive functioning, which is in line with previous negative studies of the effect on cognition of augmenting clozapine treatment with another antipsychotic drug.
  • Alsén, Margot, et al. (författare)
  • Medicine self-poisoning and the sources of the drugs in Lund, Sweden
  • 1994
  • Ingår i: Acta Psychiatrica Scandinavica. - Wiley-Blackwell. - 1600-0447. ; 89:4, s. 255-261
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this study was to investigate the prevalence of toxic agents in attempted and completed suicides. The purpose was also to explore the sources of the drugs taken by suicide attempters. Verbal information on drug intake was collected from 280 suicide attempters during 1987-1990 in the Lund-Orup catchment area. Information on the sources of the drugs was collected from 143 of these attempters. The study also includes toxicological screening from 73 fatal poisonings in southern Sweden during 1989. According to verbal information, the most common drugs used by suicide attempters were benzodiazepines (51%), analgesics (29%) and antidepressants (20%). In suicide attempters, diazepam and levomepromazine were reported more than expected from prescription data. Toxicological screenings of fatal poisonings showed that benzodiazepines were most common (55%), followed by analgesics (38%), mainly propoxyphene (29%) and antidepressants (30%), mainly amitriptyline (22%). Amitriptyline and diazepam were more commonly detected in completed suicides than expected from prescription data. The most common sources of drugs to attempted suicides were physicians, and especially psychiatrists. We therefore conclude that continuous information to physicians on drug overdose is important, and it is also important to introduce alternative strategies to prevent suicidal behaviour.
  • Andersson, Lena, 1965-, et al. (författare)
  • Association of IQ scores and school achievement with suicide in a 40-year follow-up of a Swedish cohort.
  • 2008
  • Ingår i: Acta psychiatrica Scandinavica. - 1600-0447. ; 118:2, s. 99-105
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Few studies have investigated the association of childhood IQ and school achievement with suicide. The aim of this study was to investigate the association of childhood IQ with suicide in a cohort of Swedish women and men. METHOD: 21 809 subjects born in 1948 and 1953 who completed IQ and school tests at age 13 years have been followed until 2003. Information on paternal education and in-patient care for psychosis was linked using the Swedish personal identification number. RESULTS: There were 180 suicides amongst subjects with measured IQ. High IQ was associated with reduced suicide risk among men (OR per unit increase in age-adjusted model 0.90, 95% CI 0.83-0.99), while there was no statistical evidence of an association in women (OR 1.04, 95% CI 0.90-1.20). Among men with a history of psychosis, high IQ was associated with an increased risk of suicide. CONCLUSION: Low childhood IQ at age 13 years is associated with an increased risk of suicide in men but not in women; however, amongst those with psychosis, low IQ appears to be protective.
  • Blomstedt, P., et al. (författare)
  • Deep brain stimulation in the treatment of depression
  • 2011
  • Ingår i: Acta Psychiatrica Scandinavica. - 0001-690X .- 1600-0447. ; 123:1, s. 4-11
  • Forskningsöversikt (övrigt vetenskapligt)abstract
    • Objective: To present the technique of deep brain stimulation (DBS) and to evaluate the studies conducted on DBS in the treatment of therapy-refractory major depressive disorder (MDD). Method: A review of the literature on DBS in the treatment of MDD was conducted. Results: The results of DBS in MDD have been presented in 2 case reports and 3 studies of 47 patients operated upon in 5 different target areas. Positive effects have been presented in all studies and side effects have been minor. DBS in the nucleus accumbens resulted in a mean reduction of Hamilton depression rating scale (HDRS) of 36% after 1 year and 30% of the 10 patients achieved remission. DBS in the internal capsule/ventral striatum resulted in a reduction of 44% after 1 year, and at the last evaluation after in mean 2 years, 40% of the 15 patients were in remission. The 20 patients with subcallosal cingulated gyrus DBS had a reduction of HDRS of 52% after 1 year, and 35% were within 1 point from remission or in remission. Conclusion: DBS is a promising treatment for therapy-refractory MDD. The published experience is, however, limited, and the method is at present an experimental therapy.
  • Brådvik, Louise, et al. (författare)
  • Late mortality in severe depression
  • 2001
  • Ingår i: Acta Psychiatrica Scandinavica. - Wiley-Blackwell. - 1600-0447. ; 103:2, s. 111-116
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To assess late mortality among psychiatric in-patients with severe depression/melancholia.METHOD: 1,206 in-patients rated at discharge on a multidimensional diagnostic schedule had received the diagnosis severe depression/ melancholia between 1956 and 1969. A first follow-up was made in 1984. The present follow-up constitutes 675 survivors 15-42 years after the first admission. They were followed-up by means of the general population register and local parish registers to January 1st 1998.RESULTS: At this second follow-up another 279 patients were deceased, standardized mortality ratio 1.3, indicating a continuous increased mortality late in the course of depression. Eleven suicides (4%) were included, eight men and three women, which was less than the 22% found in the first investigation. Male patients showed a higher suicide rate than female patients late in the course.CONCLUSION: The general mortality and suicide rate remain increased late in the course.
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