Duration of untreated psychosis (DUP), pre-morbid functioning level, the presence or predominance of negative symptoms, co-morbid consumption of psychoactive substances and psychosocial state were the most influential characteristics for developing schizophrenia in patients presenting a first psychotic episode.

Background. Skin cancer is one of the most common cancers, and melanoma is a highly preventable cancer. In Ecuador, few studies have evaluated the awareness levels of the population about the disease. For this reason, the objective of this study was to measure the level of knowledge, attitudes, and practices regarding skin cancer and its determining factors. Methods. A cross-sectional analysis using an online self-assessment questionnaire containing 40 questions was delivered. A total of 537 participants were included in this study. Knowledge, attitude, and practice scores were assigned to each participant based on the number of correct or appropriate responses. Logistic regression analysis was used to calculate crude and adjusted odds ratios. Results. In total, 75% of participants referenced knowledge of the harmful effects related to noncontrolled solar exposure. Concerning sunscreen, 76.7% knew the reason for using it. The female group was 1.68 times more likely to get a higher score than the male group, and the groups between 61–70 and 71–80 years were 0.30 and 0.17 times less likely to get a higher score compared with the less than 20-years-old group, respectively. Conclusions. The findings of this study indicate the requirement to increase the population’s knowledge about skin cancer and possible protection measures. For this reason, the prevention and health promotion programs at a national level from primary healthcare centers are recommended. Due to the limitation of the representativeness of the sample, the use of more studies among Ecuadorian residents of the low socioeconomic level and replication in different provinces of Ecuador is justified.

No abstract

Improving treatment continuity and adherence to antipsychotic therapy in schizophrenia is a major challenge. The 3-monthly long-acting therapy of paliperidone palmitate (PP3M) has the longest dosing interval available compared to other antipsychotics whilst having the same active ingredient, as the existing 1-monthly long-acting therapy (PP1M). This study assessed the cost-effectiveness of PP3M versus PP1M in patients with schizophrenia in the UK. MethOds: A Markov model with monthly cycles encompassed a first treatment line (PP3M or PP1M) followed by a period off-treatment, and then a follow-up therapy (a mix of treatments reflecting UK practice). At each cycle, patients could either remain in stable disease, experience a relapse, experience temporary or permanent adverse events, or die. Relapse and adverse event rates were based on a non-inferiority head-to-head trial and were set equal in both arms; first line treatment discontinuation of PP1M was based on UK real-world evidence and assumed equivalent for PP3M. Accounting for differences in drug exposure length between PP1M and PP3M, a time-dependent relapse rate was applied during the period off-treatment. The benefits of a reduced administration frequency were reflected in the stable state utility for PP3M by applying an increment to the PP1M baseline utility. The perspective of the UK National Health Service was adopted throughout a two-year time horizon. Costs and effects were discounted at an annual rate of 3.5%. Results: PP3M is dominant compared to PP1M, showing cost savings (£-638) and an increase in QALYs (+0.069). Cost savings were driven by reductions in relapse and administration costs for PP3M, whilst QALY gains were derived from the reduced administration frequency. Results robustness was demonstrated via sensitivity and scenario analyses. cOnclusiOns: The introduction of PP3M to the UK setting constitutes an improvement, bringing savings and QoL benefits to the current LAI-based standard of care for schizophrenia patients.