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Chiara Samele

Publications and source records attributed to Chiara Samele.

6 recordsLinked to original sources
PubMed2006

Physical illness and lifestyle risk factors in people with their first presentation of psychosis.

BACKGROUND: There is an increased prevalence of physical illness and poor lifestyle in patients with chronic schizophrenia. It is unclear whether these are present at the onset of psychosis or develop over the course of illness. We aimed to establish whether patients experiencing their first episode of psychosis have worse physical health and lifestyle than community controls without psychosis. METHOD: Eighty-nine patients with new onset illness were compared to age and sex matched controls for self-reported physical illness and cardiovascular and respiratory risk factors. RESULTS: Patients reported more physical health complaints, mainly respiratory, compared with age and gender matched controls (odds ratio 2.85, 95% confidence interval 1.2-6.7). Patients were more likely to be cigarette smokers (1.82, 95% CI 1.0-3.3) and eat a fast food diet (1.04, 95% CI 1.0-1.1), but these differences were accounted for by patients' unemployment status. CONCLUSIONS: Some risk factors for physical health problems are present at the onset of psychosis, but these may be explained by unemployment.

Adult↗
PubMed2004

Predicting violence in schizophrenia: a prospective study.

BACKGROUND: People with schizophrenia are more violent than the general population, but this increased risk is attributable to the actions of a small subgroup. Identifying those at risk has become an essential part of clinical practice. AIMS: To estimate the risk factors for assault in patients with schizophrenia. METHODS: Two hundred seventy-one patients with schizophrenia were interviewed using an extensive battery of instruments. Assault was measured from multiple data sources over the next 2 years and criminal records were obtained. Multiple sociodemographic and clinical variables measured at baseline were examined as possible predictors of assault during follow-up. RESULTS: Sixty-nine (25%) patients committed assault during the 2-year follow-up. The model that best predicted assault included a history of recent assault (OR 2.33, 95% CI 1.17-4.61), a previous violent conviction (OR 2.02, 95% CI 1.04-3.87), having received special education (OR 2.76, 95% CI 1.22-6.26) and alcohol abuse (OR 3.55, 95% CI 1.24-10.2). CONCLUSIONS: Previously established risk factors including a history of violence and alcohol abuse are replicated in this study. Although low premorbid IQ did not predict violence, a need for special education did.

Adolescent↗
PubMed2004

Prognostic indicators for early discontinuation of risperidone long-acting injection.

Although efficacy trials have been conducted on risperidone long-acting injection (RLAI), its most appropriate utilization in clinical practice remains unclear. This 6-month, follow-up study investigated prognostic indicators for early discontinuation of RLAI. Consecutive sampling was conducted for adult patients with a psychotic disorder commenced on RLAI, whose injection was dispensed by one of three South London psychiatric hospital pharmacies. Prescription data were collected prospectively and clinical data retrospectively. Eightly-one out of 88 (92.0%) eligible patients were included, of whom 29 (35.8%) had treatment refractoriness and 30 (37.0%) discontinued within 6 months. Patients with a preceding oral antipsychotic were more likely to discontinue RLAI than those with a preceding depot; treatment refractoriness weakly confounded this relationship [summary adjusted odds ratio (OR) 2.68, 95% confidence interval (CI) 0.95-7.53, P=0.061]. After adjusting for preceding antipsychotic type, patients with treatment refractoriness were no more likely to discontinue than those without (summary adjusted OR 1.55, 95% CI 0.59-4.11, P=0.376). Sociodemographic factors and other clinical factors were non-predictive of discontinuation. For this first wave of patients commenced on RLAI, many had treatment refractoriness. RLAI discontinuation is high early on but subsequently tapers off. Preceding antipsychotic type (depot versus oral) is a stronger prognostic indicator than treatment refractoriness for RLAI discontinuation.

Administration, Oral↗
PubMed2002

Patients' perceptions of intensive case management.

OBJECTIVE: The authors examined patients' perceptions of their case management care and the factors that influenced those perceptions. METHODS: A nine-item patients' perceptions questionnaire was administered to 225 patients with severe psychosis who were enrolled in a randomized controlled trial evaluating the efficacy of intensive versus standard case management. RESULTS: Factor analysis of the responses to the perceptions questionnaire revealed two principal components: quality of care received (including relationship and contact with the case manager) and overall perception of case management. Patients had a better overall perception of intensive case management compared with standard case management, but no significant differences were noted in perceived quality of care. Patients with female case managers had more positive perceptions of the quality of the care they received than those with male case managers. Several clinical and social variables were strongly associated with perceived quality of care but less so with overall perception of case management. CONCLUSIONS: Patients' general perceptions of intensive case management seemed more favorable than patients' general perceptions of standard case management, but no difference was noted in their perceptions of quality of care.

Adult↗