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Biomedical subjects

M Z Dernovsek

Publications and source records attributed to M Z Dernovsek.

11 recordsLinked to original sources
PubMed2001

Quality of life and treatment costs in schizophrenic outpatients, treated with depot neuroleptics.

Study aim was 1) to find out the influences on quality of life (QoL) of chronic outpatients with schizophrenia; 2) to calculate Quality Adjusted Life Years (QALY); and 3) to estimate direct 1-year treatment costs. In a 20% sample (100 males, 100 females) of schizophrenic outpatients from the Outpatients Clinic in Ljubljana, Slovenia receiving depot neuroleptics demographic, clinical, and treatment data were collected for the year 1996. The Krawiecka Scale, Global Assessment Scale (GAS), Abnormal Involuntary Movement Scale, Rating Scale for Drug-Induced Akathisia, Rating Scale for Extrapyramidal Side Effects, Quality of Life Scale (QLS), EQ-5D and QALY were used. Multivariate linear regression was used with the QLS score as dependent variable. The patients were on average 44 years old and had been treated for 14 years. The average GAS score was 70. GAS was positively related to the QLS score while the parkinsonism score was inversely correlated with QLS. The patients can expect to live for 10. 20 more QALY on average. The QoL on the EQ-5D scale was 0.73. The annual direct treatment costs amounted to $216,216 in 1996 prices. In well-adjusted chronic patients with schizophrenia the QoL seems to depend mostly on their psychosocial performance and side effects. Although rare, re-hospitalisations accounted for one-half of all treatment expenses.

Adult↗
PubMed2000

Choosing antipsychotic maintenance therapy--a naturalistic study.

Antipsychotic maintenance treatment is essential for preventing relapses of schizophrenia, but the variety of available antipsychotics may complicate the choice of drug. The aim of our naturalistic one-year follow-up study was to find out the factors predicting the choice of antipsychotics in discharged patients with schizophrenia or schizoaffective disorder and the predictors of one-year rehospitalization. The patients were receiving oral or depot classical antipsychotics or atypical agents clozapine or risperidone. Symptoms were assessed with Present State Examination. Included were 447 patients (202 males and 245 females) with a mean age of 39.1 years and 5.9 previous hospitalizations. The majority of patients (n = 322) were receiving depot antipsychotics and 43 were prescribed atypical agents. Two predictive models were built using the logistic regression analysis. Previously prescribed depot antipsychotics were positively related to further depot use, while patients who left the hospital against medical advice and those with slowness of speech at admission were less likely to receive depot drugs. On the other hand, previously used atypical antipsychotics and longer hospitalization predicted further use of atypical agents while patients discharged to community care facilities or nursing homes and those with more frequent previous hospitalizations were less likely to receive atypical agents. The Cox survival analysis showed the following one-year rehospitalization risk factors: diagnosis of schizoaffective disorder, frequent previous hospitalizations, inappropriate behavior, and oral classical antipsychotics versus depot or atypical agents. This study may yield some insight into the decision-making process in everyday clinical work regarding the choice of antipsychotic maintenance medication and its influence on rehospitalization rate.

Adult↗
PubMed2000

Olanzapine appears haematologically safe in patients who developed blood dyscrasia on clozapine and risperidone.

We report a 2-year experience with olanzapine treatment (20 mg daily) in a 65-year-old male patient with treatment-resistant paranoid schizophrenia, who had previously developed leucopenia and neutropenia first on clozapine and, subsequently, also on risperidone. Olanzapine seems to be safe in this patient, since no major decreases of haematological parameters were observed. The only exception was a brief decrease of leucocyte and neutrophil (but not erythrocyte or platelet) counts during influenza-like viral infection. However, the control of psychotic symptoms on olanzapine is not as good as on clozapine.

Aged↗
PubMed1999

Age at onset of schizophrenia and neuroleptic dosage.

BACKGROUND: Lower age at onset of schizophrenia has been traditionally associated with poorer response to treatment and less favourable prognosis. The aim of the study was to find out whether age at onset of schizophrenia is related to the dosage of typical neuroleptics in outpatients. METHOD: Age at onset was defined as age at first seeking of psychiatric help. Demographic, social and disease-related characteristics were studied in a group of 200 stable outpatients with schizophrenia (100 males and 100 females). Psychopathological symptoms were assessed with the Krawiecka Scale. Neuroleptic dosage was converted to milligrams of chlorpromazine equivalents and logarithmically transformed to obtain normal distribution. RESULTS: Onset of schizophrenia occurred earlier in males than in females. The average dosage was 251.7 (SD 303.9) mg chlorpromazine equivalents. In a multivariate linear regression model, lower age at onset and higher sum of symptoms were related to the drug dosage. CONCLUSION: The results confirm the findings of other authors that patients with lower age at onset are less responsive to typical neuroleptics. Some of the patients with early onset would be more appropriately treated with atypical neuroleptics, which may have better therapeutic efficacy.

Adult↗
PubMed1999

Predictors of suicide in psychiatric hospital.

OBJECTIVE: About 5% of all suicides occur in psychiatric hospitals. The aim of this study was to look for potential characteristics common to patients who committed suicide in psychiatric hospital. METHOD: All patients who committed suicide in University Psychiatric Hospital in Ljubljana, Slovenia, in the period 1984-1993 were included. The suicidal patients (SP) with schizophrenia (SCH) and affective psychoses (AP) were compared to an age-, sex- and diagnosis-matched control group. Data from files and (in control patients) patient interviews were gathered. Multivariate logistic regression analysis was used. RESULTS: A total of 79 patients (34 males and 45 females) committed suicide. The majority of them had SCH (n = 36) and AP (n = 23). The predictors of suicide among patients with AP and SCH were depression and lack of insight and, in addition in patients with SCH, past suicidal behaviour and poor relationships with family members. CONCLUSION: This study provides the clinician with information on risk factors for in-patient suicide.

Adult↗
PubMed1998

The effects of kainic acid in rats with spontaneous recurrent seizures.

1. Rats with spontaneous recurrent seizures (SRS) were obtained by injection of kainic acid (KA; 10 mg/kg SC) to drug-naive rats that regularly developed wet-dog shakes followed by complex partial seizures and status epilepticus. Three to five weeks later, the rats with manifest SRS were selected. 2. The SRS rats were challenged with KA (10 mg/kg SC). The seizures induced in SRS rats by KA were similar to SRS regarding their clinical stage and duration (mean duration of seizures: 44 sec and 43 sec, respectively). The frequency of seizures was, however, increased compared with the frequency of SRS in control, vehicle-treated SRS rats (mean frequency of seizures: 12.9 and 0.4 per 3 hr, respectively). The KA-induced seizures in SRS rats differ behaviorally from KA-induced seizures in naive rats-namely, neither wet-dog shakes nor the status epilepticus could be induced. 3. Repeated injection of an equal dose of KA, applied to the SRS rats 1 day after the previous KA challenge, did not induce seizures. The loss of seizure susceptibility to KA was only temporary, as shown after a 7-day drug-free period, when the repeated injection of KA regained its seizure-triggering capacity. 4. The results indicate that reactivity to the seizure-inducing agent kainic acid changes in rats with spontaneous recurrent seizures.

Animals↗