Medication In Schizophrenia Patients Research Articles

Pengaruh Pemberian Token Ekonomi terhadap Kepatuhan Minum Obat pada Klien Skizofrenia di Ruang Kunti Rumah Sakit Jiwa Provinsi Bali

Treatment for schizophrenia clients requires a long period of time so that it causes saturation of taking medication and the client's level of compliance taking the drug decreases. One therapeutic technique to improve compliance behavior is to provide positive reinforcement through economic tokens. This study aims to determine the effect of economic tokens on adherence to taking medication in schizophrenic clients. This type of research is quasi experiment using One-group pre-post test design. The sample in this study were schizophrenic patients who were not compliant to take medication as many as 28 people using purposive sampling technique. Data collection uses observation sheets. The results showed the majority of pre-test medication adherence were 67.9% in the low category. Compliance with taking the post-test medication showed that most were 57.1% in the high category. Wilcoxon Sign Rank Test results obtained z count is 4.882 more than z table is 1.96 and p is 0.001, the results of this analysis indicate there is an effect of giving economic tokens on adherence to taking medication in schizophrenia patients. The study concluded that economic tokens had a significant effect on adherence to taking medication in schizophrenia patients. It is recommended to apply SPO economic token therapy, provide economic token therapy on an ongoing basis and develop further research by increasing the number of meetings in each therapy session.

The impact of self-stigmatization on medication attitude in schizophrenia patients

Negative attitudes towards medication in schizophrenia patients are one major factor contributing to non-adherence behavior. Besides, self-stigmatization represents another frequent and important obstacle in patients suffering from psychotic disorders. Here, we investigated possible associations between medication adherence attitude and the extent of self-stigmatization, while also exploring factors related to self-stigmatization. Sociodemographic characteristics, clinical variables, medication attitude and self-stigmatization were assessed among 81 subjects with schizophrenia or schizoaffective disorder. The cross-sectional data was then analyzed by multivariate analyses. A more positive attitude towards medication was predicted by better insight into illness, lower degree of self-stigmatization and good subjective knowledge about medication (adjusted R2 = 0.23). Furthermore, a higher level of self-stigmatization was associated with lower subjective wellbeing, more severe depressive symptoms and male gender (adjusted R2 = 0.58). Other clinical variables had no additional predictive value for medication adherence attitude or the extent of self-stigmatization. Our findings support the notion that self-stigmatization is an influential factor on medication attitude that should therefore be appreciated in clinical practice. Besides this, special emphasis should be taken on depressive symptoms and reduced wellbeing, especially in male patients, to lower the extent of self-stigmatization.

Delayed drug interactions in psychiatry: armodafinil and risperidone as a potential case in point.

Modafinil or armodafinil (ar/mod) augmentation of antipsychotic medication in schizophrenia patients may be considered with a view to reduce negative symptoms associated with the illness or excessive daytime drowsiness due to any cause. The available data suggest that there is no role for ar/mod in reducing negative symptom burden. A recent pharmacokinetic (PK) study suggested that armodafinil (250 mg/d) reduces key PK parameters of risperidone by about 50%, and key PK parameters of 9-hydroxyrisperidone (paliperidone) by about 20%-30%, probably through induction of CYP3A4. Ar/mod augmentation is therefore best avoided in patients receiving risperidone or paliperidone (and most other atypical antipsychotic drugs, as well, because most atypical antipsychotics are metabolized by enzymes that ar/mod induce). If the ar/mod-antipsychotic drug combination is necessary, for whatever reason, then the dose of the atypical antipsychotic drug may need to be appropriately raised. If this is not done, relapse may occur; because the relapse may postdate the introduction of ar/mod by many months, the causal role of a metabolic drug interaction may not be suspected, and physicians may attribute the relapse to the natural course of the illness. Physicians need to be aware that any agent that induces the metabolism of psychotropic drugs that are used in maintenance therapy may, through lowered psychotropic drug levels, result in a delayed drug interaction that is characterized by illness relapse.

Measuring adherence to medication in schizophrenia: the relationship between attitudes toward drug therapy and plasma levels of new-generation antipsychotics.

Background:Nonadherence to medication is still a major problem in the treatment of schizophrenia. The current longitudinal study investigated whether the patients’ attitudes toward treatment correlated with the ratio of observed vs expected plasma levels of antipsychotic drugs as an objective measurement of adherence.Methods:Data of patients starting monotherapy with a new-generation antipsychotic were collected 2, 4, and 12 weeks after the initiation of treatment. Next to the assessment of patients’ attitudes toward medication by means of the Drug Attitude Inventory, the ratio of the observed vs expected plasma level was calculated. Antipsychotic-induced side effects were evaluated by means of the Udvalg for Kliniske Undersogelser Side Effect Rating Scale.Results:A total of 93 patients were eligible for statistical analysis. About one-half of the ratios of observed vs expected plasma levels ranged from 0.5 to 2 and were considered normal, whereas the other ratios were considered either too low (<0.5) or too high (>2). No consistent correlation between patients’ attitude toward drug therapy and the individual ratios of observed vs expected plasma levels of medication was detected. This finding was not affected by side effects.Conclusions:Our results highlight the importance of recognizing the complex nature of adherence to medication in schizophrenia patients. Importantly, we found no consistent correlation between subjective and objective measures of medication adherence. Therefore, monitoring adherence to medication remains a challenge in clinical practice.

Obsessive compulsive symptoms are related to lower quality of life in patients with Schizophrenia

Background. The aim of this study is to investigate the effects of obsessive–compulsive symptoms (OCS) on quality of life (QoL) and to identify the OCS with a particular effect on QoL, and whether there are any such symptoms for patients with schizophrenia. Methods. We studied three groups of patients with schizophrenia. One group of patients (n = 45) without OCS or obsessive–compulsive disorder (OCD), one group with OCS, not fulfilling the diagnostic criteria for OCD (n = 31), and one group with OCD as a comorbid condition (n = 24). Severity of clinical symptoms was evaluated with the Positive and Negative Symptom Scale and OCS was examined using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Symptom Checklist. We also administered the Y-BOCS. The patients’ QoL was assessed using the Quality of Life Scale (QLS). Results. QLS interpersonal relationships subscale scores of those with OCS were lower than those without OCS. There was no difference among OCS, non-OCS, and OCD groups in terms of QoL. There was no relationship between QLS scores and symmetry, contamination and causing harm obsessions, but those with cleaning and repeating compulsions had lower QoL. Conclusions. Questioning of comorbid OCS and treatment with specific medication in schizophrenia patients may increase QoL.

2696 – Functional capacity and subjective satisfaction with medication in schizophrenia patients

Objective The aim of our cross-sectional study was (1) to assess social and functional impairment in schizophrenia outpatients from the Czech and Slovak Republics, and (2) to examine a relationship between functional impairment and antipsychotic treatment and demographic variables. Method Enrolled were schizophrenia outpatients in a stable phase of illness, treated with current antipsychotic medication for a minimum of one month. Recorded were demographic and medication data, administered were Personal and Social Performance Scale (PSP), Subjective Well-being Under Neuroleptics (SWN), and CGI scale. Results The total number of study subjects was 926. Most PSP values were within the interval of moderate impairment. Functional performance correlated positively with subjective satisfaction with medication and negatively with symptom severity. Higher education predicted better functioning on PSP. The best performance was associated with a stable relationship and a useful work role. The patients who showed the best level of functioning were more likely to be treated with antipsychotic monotherapy. No difference among drugs in monotherapy was found in subjective satisfaction. Conclusion The PSP values of stable schizophrenia outpatients indicated moderate degree of impairment. Improvement of functional capacity remains one of the unmet needs of schizophrenia patients.

Psychometric evaluation of the Medication Satisfaction Questionnaire (MSQ) to assess satisfaction with antipsychotic medication among schizophrenia patients

The Medication Satisfaction Questionnaire (MSQ) is a single-item questionnaire which evaluates satisfaction with antipsychotic medication in schizophrenia patients. This study evaluated the reliability and validity for its use in research and clinical settings. Data pooled across treatment groups (control vs. Paliperidone ER) from a randomized 6-week study were used to conduct four psychometric assessments of the MSQ: (1) test–retest reliability, (2) convergent validity, (3) known-groups validity, and (4) minimally important difference (MID). This analysis included 191 randomized subjects. Test–retest reliability was evaluated for patients with no change in satisfaction from weeks 2 to 4 and weeks 4 to 6 (ICC=0.80; 0.83, respectively). Convergent validity was demonstrated through large correlations with Treatment Satisfaction Questionnaire for Medication (TSQM) global score (r=0.72–0.77), and through small correlations with variables measuring clinical symptoms and functioning (e.g., Positive and Negative Syndrome Scale (PANSS) total score [r=−0.30 to −0.17], CGI-S [r=−0.35 to −0.27], SF-36 Physical Functioning Score [r=0.18] and side effects and extrapiramidal measures (including UKU, ESRS-A, SAS). Mean MSQ scores were significantly different between those who completed and discontinued the study, and between different satisfaction groups based on TSQM, demonstrating good known-groups validity. MID estimates for the MSQ ranged from 0.47 (standard error of measurement) to 0.58 (anchor-based method). Results suggest that the MSQ has acceptable reliability and validity, making this single-item questionnaire appropriate and easy to use in clinical research and potentially in clinical practice. A 1-point change on the MSQ may be considered clinically meaningful.

Attention and medication in schizophrenia patients — An ERP study

Objectives: In the current study we investigated the habituation of the neuromagnetic auditory evoked field (AEF) component N100m and its dependence on stimulus duration.Methods: Fifteen subjects were stimulated monaurally in 3 blocks of 210 trials with 1000 Hz tones of different duration (50, 100, 200 ms) and in a single block of 70 trials with 1200 Hz tones. The order of blocks was counterbalanced within the total experiment. Tones were separated by a stimulus onset asynchrony of 2000 ms. AEF were recorded over both hemispheres by means of a 31 channel system (Philips) on two different days. The AEF were compared within and between the blocks and between the hemispheres. Additionally, the effects of block order were analyzed.Results: In the course of the experiment a pronounced decrease of N100m mean global field power (MGFP) and an increase of its latency were observed. While the order of blocks clearly affected the degree of habituation, stimulus duration did not have any influence on it. Within the blocks, habituation also had an impact on dipole location in inferior–superior direction. The application of the 1200 Hz stimulus led to a slight response recovery. The change in tone pitch affected the dipole orientation, as an indicator for the tonotopic organization of the auditory cortex.

Atypical medications in schizophrenia patients with a history of substance abuse

Atypical medications in schizophrenia patients with a history of substance abuse