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Biomedical subjects

B Wistedt

Publications and source records attributed to B Wistedt.

At least 55 records · Page 3Linked to original sources
PubMed1986

Suicide and violent death among patients with schizophrenia.

From the Stockholm County in-patient register we selected all patients with schizophrenia, discharged from all hospitals in the county during 1971, in voluntary and compulsory care. The cohort of 1,190 patients was followed for 10 years in the national cause-of-death register. 231 deaths were identified and 68 came under the ICD chapter XVII, "Injuries...". These 68 deaths were analysed through medical records and death certificates in order to find out detailed causes of death, evidence of misclassification, and information on suicides during psychiatric care. Of the 68 deaths 33 were classified as suicides, 14 undetermined, 20 accidents and one homicide. Suicides predominated among the younger patients and accidents among the elderly. By scrutinizing medical records we identified seven deaths we judged to be suicides but which had been classified as accidents or undetermined. 36% of all deaths and 44% of those classified as suicides occurred during psychiatric care. The record-linkage method proved valuable for identifying deaths among psychiatric patients and for obtaining data on hospital care, thus giving access to medical records, and should be useful in further research.

Adult↗
PubMed1986

A comparative trial of haloperidol decanoate and fluphenazine decanoate in chronic schizophrenic patients.

A twenty-week double-blind study was conducted to compare the efficacy and side-effect profile of haloperidol decanoate and fluphenazine decanoate, both given four-weekly, in fifty-one chronic schizophrenic patients. The mean dose of fluphenazine decanoate was 84 mg compared to 122 mg for the haloperidol decanoate group--suggesting a potency ratio of 1.0 : 1.4 in this study population. The CPRS sub-scale for schizophrenic symptoms showed a statistically significant improvement (p. less than 0.05) for the haloperidol decanoate group after twenty weeks treatment. A significant difference favouring haloperidol decanoate (p. less than 0.05) was also shown in the CPRS depression sub-scale at the end of the study. No significant between-group differences were found in the incidence of extrapyramidal side-effects at week 20, though consumption of the antiparkinsonian medication orphenadrine was significantly higher (p. less than 0.05) in the fluphenazine decanoate group (mean dose 102 mg) compared to a mean dose of 58 mg for the haloperidol decanoate group. More patients on fluphenazine decanoate gained weight than patients on haloperidol decanoate, but the difference was not statistically significant.

Adult↗
PubMed1985

Incidence of rheumatoid arthritis among patients with schizophrenia, affective psychosis and neurosis.

The aim of the study was to determine the incidence of hospital care with the diagnosis rheumatoid arthritis (RA) among patients with schizophrenia, affective psychosis and neurosis compared with that among hospitalized patients in general. By means of the in-patient register of Stockholm County, a cohort was formed comprising all patients discharged with the diagnoses schizophrenia, affective psychosis and neurosis in Stockholm County during 1971, and a sample of all patients discharged for any diagnosis during the same year. We followed the groups in the in-patient register through 1981 in order to identify hospital episodes with the diagnosis RA. Observed and expected incidences of RA in hospital care were obtained using all hospitalized patients as a reference group. For schizophrenia and affective psychosis the incidence of RA was around half the expected, whereas for neurosis it was close to the expected incidence. With reservation for small numbers of observed cases, the results support the hypothesis of a reduced incidence of RA among patients with schizophrenia. The finding regarding affective psychosis was based on a smaller number of cases and merits further investigations.

Adolescent↗
PubMed1983

A depot neuroleptic withdrawal study neurological effects.

A double-blind withdrawal trial in 41 chronic schizophrenic outpatients was carried out over 6 months. Depot neuroleptics (fluphenazine decanoate or flupenthixol decanoate) were compared with placebo to evaluate neurological side effects during continued therapy and during withdrawal. The drugs were significantly more effective than placebo in preventing relapse and rehospitalization. In the placebo group 62% relapsed compared to 27% in the drug group. A difference was observed in the occurrence of extrapyramidal symptoms (EPS) between the neuroleptics in the study. Akathasia was observed in 9/38 (23.7%) cases, significantly more frequent in the fluphenazine decanoate group. Tardive dyskinesia (TD) was observed in six cases (15.8%); four cases existed at the start of the study and two others were observed after 3-6 weeks of withdrawal. There was no relation between TD symptoms and relapse. There was a significant decrease in the EPS scores during the placebo treatment and also a significant weight decrease.

Adult↗
PubMed1983

Nomifensine and amitriptyline in the treatment of depression. A multi-centre double-blind comparison.

Nomifensine, an antidepressive agent acting like a dopamine agonist, was investigated in a randomized double-blind comparison with amitriptyline in 29 patients fulfilling the RDC criteria for major depression. The dosage was 150 mg daily in both treatment groups. Assessments were made at weekly intervals for 6 weeks with the Comprehensive Psychopathological Rating Scale. No significant difference could be demonstrated between the two drugs in overall therapeutic efficiency, and only one item, Fatiguability, differed significantly in favour of amitriptyline. Physical and laboratory variables showed no statistically significant differences. Neither drug elicited serious unwanted effects.

Adult↗
PubMed1983

Comparative double-blind study of flupenthixol decanoate and fluphenazine decanoate in the treatment of patients relapsing in a schizophrenic symptomatology.

Thirty-two chronic schizophrenics who had relapsed entered a double-blind randomised study and were followed-up for 2 years with the intention of measuring any difference in therapeutic effect and side effects between flupenthixol decanoate and fluphenazine decanoate. No differences could be seen as regards the global effect or the effect on the schizophrenic symptomatology during the first 6 months. After 1 year of treatment flupenthixol decanoate showed a trend towards a better effect on schizophrenic symptomatology. A corresponding result was seen for the depressive symptoms. There were no differences in the appearance of side effects. The need for additional neuroleptics in the initial phase seemed to be identical for both drugs. A possible slow antipsychotic effect with flupenthixol decanoate is probably due to the administered dose being somewhat low (in the present study approximately 31 mg flupenthixol corresponding to 27 mg fluphenazine). This suggests that flupenthixol should have been given in a somewhat higher dose (25 mg fluphenazine decanoate corresponding to 40 mg flupenthixol decanoate).

Adult↗
PubMed1983

Depressive symptoms in chronic schizophrenic patients after withdrawal of long-acting neuroleptics.

A double-blind randomized investigation compared withdrawal (placebo) with continued use of long-acting neuroleptics (fluphenazine decanoate or flupenthixol decanoate) in 41 chronic schizophrenic outpatients. After 6 weeks there was a tendency toward higher depressive scores in the placebo group, a difference which became statistically significant (p less than .05) at week 24. These results do not support earlier observations that neuroleptic drugs cause depression. Further analyses of the data indicated that depressive symptomatology could be an early sign of relapse.

Adult↗
PubMed1982

A depot neuroleptic withdrawal study. Plasma concentration of fluphenazine and flupenthixol and relapse frequency.

A double-blind withdrawal trial in 41 chronic schizophrenic outpatients was carried out during 6 months. Depot neuroleptics (fluphenazine decanoate or flupenthixol decanoate) were compared with placebo to evaluate clinical and neurological effects during continued therapy and during withdrawal. The drugs were significantly more effective than placebo in preventing relapse and rehospitalization. In the placebo group 62% relapsed compared to 27% in the drug group. There was a weak and nonsignificant tendency to a higher relapse frequency in the flupenthixol group compared to the fluphenazine group. After withdrawal for 6 months, plasma levels for fluphenazine were detectable. Plasma levels for flupenthixol were not detectable after 9 weeks of withdrawal. The differences in the plasma levels may possibly explain the difference in relapse rate between the two depot neuroleptics. Furthermore, it was found that the patients who relapsed during fluphenazine treatment had a significantly lower plasma level of the drug than patients who did not relapse during treatment. The results from this study provide some information on the therapeutic levels of fluphenazine and flupenthixol in schizophrenic patients.

Delayed-Action Preparations↗
PubMed1982

Elevated serum levels of lactoferrin and eosinophil cationic protein in schizophrenic patients.

The serum levels of lactoferrin, eosinophil cationic protein (ECP), lysozyme and beta 2-microglobulin have been measured in schizophrenic patients in an attempt to elucidate the activity and turnover of neutrophil and eosinophil granulocytes, macrophages/monocytes and lymphocytes, respectively. Serum-lactoferrin and serum-ECP levels were significantly (P less than 0.001) higher in the patient group as compared to healthy controls in contrast to blood cell counts and serum-lysozyme and serum- beta 2-microglobulin levels which all were within normal limits. The results were not affected by anti-psychotic therapy. A significant correlation was found between serum-ECP and serum-lactoferrin levels which may suggest a common underlying cause of the elevated levels. The findings suggest an increased eosinophil and neutrophil activity and/or turnover in schizophrenia and may have a bearing on the well-known altered inflammatory response associated with this syndrome.

Adult↗
PubMed1981

A depot neuroleptic withdrawal study. A controlled study of the clinical effects of the withdrawal of depot fluphenazine decanoate and depot flupenthixol decanoate in chronic schizophrenic patients.

A double-blind withdrawal trial in 41 chronic schizophrenic outpatients on neuroleptics was carried out during 6 months. Long-acting neuroleptics (fluphenazine decanoate or flupenthixol decanoate) were used in comparison with placebo to determine the value in maintenance therapy. Most patients had a rather low maintenance dose, about 12.5-25 mg fluphenazine decanoate or 20-40 mg flupenthixol decanoate every third week. Relapse was often characterized by a return of the dame symptoms as the patient had during his first schizophrenic attack. Drugs were significantly more effective than placebo in preventing relapse and readmission to hospital. 62% relapsed in the placebo groups as compared with 27% in the drug group. All patients on active substance and without relapse during the controlled study had their treatment discontinued for 24 months in an open follow-up investigation. This resulted in relapse of all patients but one, i.e. a final relapse frequency of 97%. A significant weight decrease was observed in the placebo group. The risk of withdrawal is discussed.

Adult↗
PubMed1981

Schizophrenia, a chronic disease.

About 10-15 per cent of schizophrenic patients are 5-15 years after onset still hospitalized, and more than 50 per cent will show some psychopathology and therefore be unable to work. The possibility of a permanent recovery from the schizophrenic illness is probably greater today than it was half a century ago when 50-60 per cent were chronically hospitalized. The diagnostic criteria, at least in the USA, are today, however, broader than they were half a century ago in Europe and therefore comparisons are difficult to make. Schizophrenia in some patients a chronic disease, and the risk of being permanently incapacitated is some way (unable to work) is still 50 per cent or more.

Adolescent↗