Antipsychotics are widely used in treatment of elderly related psychiatric disorders such as delirium, organic hallucinosis. The long-term uses of such drugs are related with increased risks. The objective of this study is to determine efficiency of small doses of antipsychotics in relieving target symptoms and monitoring short-term use in patients diagnosed with dementia receiving palliative care. The study was conducted in a clinical department for palliative care reserved for patients with severe dementia over a period of 1 year. The study sample comprised 56 patients, 31 of which received antipsychotics. Measures used included Mini-Mental State Exam (MMSE), Neuropsychiatric Inventory Nursing Home Version (NPI-NH), Fall-Risk (FR) Scale, patient records, medication records and fall incidents. We found a significant improvement on NPI-NH Scale (p<0.05) for patients that received antipsychotics and had psychosis, agitation, aggressiveness in accordance with clinical observations. There were no significant changes for MMSE (p=0.56) or FR Scale (p=0.87). Small doses of antipsychotics have a beneficial impact in treating psychosis and agitation with aggressive behavior in patients with Dementia receiving palliative care. The study showed that the use of antipsychotic medication doesn't correlate with increased cognitive degradation or fall risk. The particularities of these cases need to be further explored. 80/Bulletin of Integrative Psychiatry New Series December 2019 Year XXV No. 4 (83)
Objectives: Out of all clinical forms of schizophrenia, the hebephrenic type is the least responsive to antipsychotic treatment and most difficult to manage. This characteristic results in a high average number of hospitalizations, more frequent institutionalization, generating additional cost for health care providers. With this argument in mind, we want to determine if there is a correlation between the primary hospitalization indicators and differences in antipsychotic treatment. Methods: We anonymously collected data on all patients admitted in the Socola Institute of Psychiatry over the last five years with a confirmed diagnosis of hebephrenic schizophrenia. We logged the data regarding the age and sex of the patients, admission and discharge date, type of admission (inpatient or outpatient) as well as data regarding treatment recommendations at discharge. We performed statistical analysis, calculating for basic statistical indicators as well as variance, confidence interval, standard error and p-values. Results: We included in our study 34 inpatients with hebephrenic schizophrenia, 19 outpatients and 4 institutionalized patients. Variance on all of the parameters we tested was 102/Bulletin of Integrative Psychiatry New Series December 2019 Year XXV No. 4 (83) high resulting weak statistical significance. Statistically significant correlations were found between the type of antipsychotic treatment (typical, atypical, both) and hospitalization period and between the type of antipsychotic treatment (oral, depot) and duration between hospitalizations. Conclusion: Our study found multiple correlations between the type of antipsychotic prescribed and hospitalization indicators, but due to the high variance of the samples, many of them proved not significant statistically. In the cases where a statistical significance was found, further investigation is necessary in order to establish the causal relationship between the parameters that we tested, and to establish if these correlations have a beneficial impact on the cost of the medical assistance and patients' quality of life. KEYWORDS: Hebephrenic schizophrenia, antipsychotic treatment, hospitalization indicators INTRODUCTION Schizophrenia is arguably one of the most puzzling, yet disabling of all mental disorders, with its severe and persistent psychotic manifestations accompanied by capricious cognitive deficits and profound psychosocial impairment. Although schizophrenia is discussed as if it is a single disease, it probably embodies a group of disorders with diverse etiologies, and it includes patients whose clinical presentations, treatment response, and illness trajectory vary. (1, 2, 3) According to the DSM-IV-TR nosology, the subtypes in schizophrenia include the paranoid, disorganized (hebephrenic), catatonic, undifferentiated and residual. Although they are defined by the predominant symptomatology at the time of evaluation, the schizophrenia subtypes offer a limited value in clinical and research setting (e.g., prediction of illness trajectory, ...
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