| 1. |
- Levander, Sten, et al.
(författare)
-
Clinical decision-making during 5 years of antipsychotic treatment
- 2007
-
Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447 .- 0065-1591 .- 1600-5473. ; 116, s. 17-26
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Explore how clinicians select drug treatment based on symptoms, side effects and patient factors, including patient participation in the process, and the association between these factors and attitudes towards drugs. Method: A cohort of 166 patients initially treated with risperidone was followed with yearly assessments over 5 years. At the end of the study, 101 patients were evaluated of whom 58 were still treated with risperidone. Results: More women than men remained in the study, and on the initial medication. The most common reason for medication switch was lack of efficacy. Clinicians and patients agreed well in their global ratings of medication effects and side effects. Robust associations between switch decisions and patient characteristics including symptoms and side effects could not be identified. The effects of switches were rated as better by the clinicians than by the patients. Negative drug attitudes were associated with pronounced positive symptoms (threshold effect), whereas the corresponding association with 'lack of judgment and insight' was linear over the whole range. Conclusion: The decision-making process appears to have many unknown components, and may benefit from more active patient involvement by using structured clinician and patient rating scales for monitoring the treatment. Such shared decision-making may improve compliance.
|
|
| 2. |
- Levander, Sten, et al.
(författare)
-
Nicotine use and its correlates in patients with psychosis
- 2007
-
Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447 .- 0065-1591 .- 1600-5473. ; 116, s. 27-32
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine nicotine use and its correlates among psychotic patients. Method: Longitudinal naturalistic study of 176 patients, diagnosed with schizophrenia or schizophrenia-related psychotic disorders, and treated with risperidone at study entry. Levels of nicotine use (smoking, snuffing) were measured along with other relevant ratings and measurements (symptoms, drug treatment, side effects, weight, cognitive functions and outcome) at baseline and once yearly for 5 years. Results: Nicotine use was twice as common as in the general population. Only few nicotine users had started after onset of psychoses. We could not find any differences among nicotine users and non-users in diagnosis, symptoms, side effects, weight, cognitive functions, personality and outcome, cross-sectionally and longitudinally, ruling against the 'self-medication' hypothesis. Conclusion: A parsimonious interpretation of the findings is that patients suffering from psychosis fail to desist from nicotine rather than experience significant positive effects of the usage.
|
|
| 3. |
- Lindström, Eva, et al.
(författare)
-
Five-year follow-up during antipsychotic treatment : efficacy, safety, functional and social outcome
- 2007
-
Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447 .- 0065-1591 .- 1600-5473. ; 116, s. 5-16
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Explore the long-term course of schizophrenia and related disorders. Method: Naturalistic study of 225 patients initially treated with risperidone (monotherapy or in combination with other psychotropic drugs) over 5 years. Results: Stable symptomatology and side effects were observed. Clinician GAF scores were 55-61, but patients' self-ratings were higher. Clinician and patient CGI scores were at the same level. Annual in-patient days decreased but days in sheltered accommodations increased still more. Only 12% of the patients studied or worked fulltime. One in four had no social contacts except with staff. Eight patients died during the 5 years. Conclusion: The findings underline the chronicity and seriousness of psychotic disorders in terms of social outcome and, indirectly, the low quality of life of this group of persons. Patients were generally well aware of their illness and able to sort out symptoms from drug side effects. This opens for more active involvement of patients in monitoring their own treatment.
|
|
| 4. |
- Eberhard, Jonas, et al.
(författare)
-
Prolactin level during 5 years of risperidone treatment in patients with psychotic disorders
- 2007
-
Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 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).
|
|
| 5. |
|
|
| 6. |
- Brådvik, Louise, et al.
(författare)
-
Late mortality in severe depression
- 2001
-
Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 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.
|
|
| 7. |
- Brådvik, Louise, et al.
(författare)
-
Long-term suicide risk of depression in the Lundby cohort 1947-1997 - severity and gender.
- 2008
-
Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 117:3, s. 185-191
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The long-term suicide risk of depression was evaluated in a community sample by severity and gender. Method: The Lundby study is a prospective, longitudinal cohort study on a population consisting of 3563 subjects. In 1947-1997 medium or severe depression according to the Lundby diagnostic system were registered in 503 subjects. The same subjects were also diagnosed according to DSM-IV showing major depressive disorder (MDD) in 293 and depressive disorder not otherwise specified (DDNOS) in 131 subjects. Results: The overall long-term suicide risk varied from 5.6% to 6.8%. The long-term suicide risk was 3.1% for medium and 11.4% for severe 'Lundby depression', 3.7% for medium and 13.8% for severe MDD + DDNOS, 3.1% for medium and 13.7% for severe MDD. Severity and male sex were risk factors for suicide. Conclusion: Males with a severe depression showed a high long-term risk for suicide, around 20%.
|
|
| 8. |
- Brådvik, Louise, et al.
(författare)
-
Seasonal distribution of suicide in alcoholism.
- 2002
-
Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 106:4, s. 299-302
-
Tidskriftsartikel (refereegranskat)abstract
- Brådvik L, Berglund M. Seasonal distribution of suicide in alcoholism. Acta Psychiatr Scand 2002: 106: 299-302. Copyright Blackwell Munksgaard 2002. Objective: To investigate the seasonal distribution of suicide in alcohol dependence and to make a comparison with unnatural death in alcoholism and suicide in other diagnostic groups. Method: Multiaxial ratings of all patients admitted to the Department of Psychiatry in Lund enabled the selection of patients with alcohol dependence (n=1312) during 1949-1969. When followed up to 1997 a total of 102 (99 men) alcoholic patients had taken their own life. Reference groups were patients with severe depression and autopsy cases with other diagnoses. Results: The alcoholic patients showed a peak during the second quarter of the year (34%, P < 0.05). Other diagnostic groups of suicide and unnatural death in alcoholism did not show any overrepresentation in the spring. Conclusion: Male alcoholics showed a spring peak of suicide as opposed to other diagnostic groups.
|
|
| 9. |
- Carlsson, Rickard, et al.
(författare)
-
Neuropsychological functions predict 1-and 3-year outcome in first-episode psychosis
- 2006
-
Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 113:2, s. 102-111
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine neuropsychological performance as a possible predictor of course and outcome in first-episode psychotic (FEP) patients. Method: A group of consecutive FEP patients (n = 120) tested with Wechsler Adult Intelligence Scales-Revised (WAIS-R) at baseline was compared with a healthy group (n = 30) matched for age, education and gender. Relationship between WAIS-R and both Brief Psychiatric Rating Scale and Global Assessment of Function (GAF) ratings were studied at baseline and at 1- and 3-year follow-ups. Results: The performance of FEP patients was significantly lower (P < 0.001) than that of healthy comparison subjects on all WAIS-R subtests except for Information and Comprehension. The WAIS-R scores of patients with schizophrenia syndromes (DSM-IV) were lower than those of patients with non-schizophrenia syndromes on Block Design. Low WAIS-R Full-Scale IQ scores in FEP patients predicted the presence of negative symptoms at 1-year follow-up and of low GAF ratings at 3-year follow-up. Conclusion: Neurocognitive performance at admission appears to predict various aspects of functional outcome in FEP.
|
|
| 10. |
|
|
