Psychopharmacologic treatment of in-patients with schizophrenia: comparing forensic and general psychiatry

Vasić, Nenad; Segmiller, Felix; Rees, Felix; Jäger, Markus; Becker, Thomas; Ormanns, Norbert; Otte, Stefanie; Streb, Judith; Dudeck, Manuela

doi:10.1080/14789949.2017.1332773

Cited by 8 publications

(11 citation statements)

References 49 publications

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“…In an analysis of available systematic reviews, Howner et al (22) concluded that none of the broad range of intervention categories they investigated had a sufficient evidence base in FMHS settings. Generalization from adjacent fields also appears problematic as grounds for service development, since FMHS differ in clinical practice (24,25), patient treatment needs (26), and patient characteristics (27,28). Length of compulsory inpatient care is also much longer for FMHS patients (29)(30)(31) than for patients in non-forensic services (32,33).…”

Section: Introductionmentioning

confidence: 99%

Perspectives on Recruitment and Representativeness in Forensic Psychiatric Research

et al. 2021

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Participant representativeness and statistical power are crucial elements of robust research with human participants, both of which relate to the successful recruitment of research participants. Nevertheless, such core features may often not be fully reported or duly considered in psychiatric research. Building on our experiences of collecting data in the context of forensic mental health services, we discuss issues regarding participant recruitment and representativeness in our field with its particular characteristics. A quick sampling and brief overview of the literature in four specialized forensic mental health journals is presented, demonstrating that published manuscripts rarely describe the data in sufficient detail for the reader to assess sample representativeness and statistical power. This lack of transparency leads not only to difficulties in interpreting the research; it also entails risks relating to the already meager evidence base of forensic mental health services being relevant only to a subset of patients. Accordingly, we provide suggestions for increased transparency in reporting and improved recruitment of research participants. We also discuss the balance of ethical considerations pertinent to the pursuit of increased participation rates in forensic mental health research.

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Section: Introductionmentioning

confidence: 99%

Perspectives on Recruitment and Representativeness in Forensic Psychiatric Research

et al. 2021

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“…Depotpräparate kommen oftmals auch in Kombination mit oralen Präparaten zur Anwendung, was einen basalen Schutz und die Möglichkeit einer zusätzlichen Feinabstimmung eröffnet. In der deutschen Untersuchung von schizophrenen Patienten [10] [9]. Allerdings wurde in einerebenfalls in den Leitlinien zitierten -Metaanalyse ein begrenzter Nachweis für eine Steigerung der Respons und eine Reduktion von Erregung und Aggression unter Augmentation mit Valproat berichtet [22].…”

Section: Rangunclassified

“…In einer deutschen Untersuchung zum Vergleich der Psychopharmakotherapie schizophrener Patienten in Allgemeinpsychiatrie und Maßregelvollzug wurde ebenfalls ein höherer Anteil von Kombinationsbehandlungen unter den allgemeinpsychiatrischen Patienten im Vergleich zu den Maßregelvollzugspatienten gefunden [10].…”

Section: Diskussionunclassified

“…Depotpräparate kommen oftmals auch in Kombination mit oralen Präparaten zur Anwendung, was einen basalen Schutz und die Möglichkeit einer zusätzlichen Feinabstimmung eröffnet. In der deutschen Untersuchung von schizophrenen Patienten [10] hatte sich demgegenüber kein höherer Anteil an Depotmedikationen finden lassen; es handelte sich hierbei allerdings um eine sehr kleine Stichprobe.…”

Section: Originalarbeitunclassified

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Psychopharmaka – Anwendungspraxis in Maßregelvollzug und Allgemeinpsychiatrie im Vergleich

Stübner¹,

Yundina

Mußmann

et al. 2021

Psychiatr Prax

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ZusammenfassungDie psychopharmakologische Anwendungspraxis in Maßregelvollzug und Allgemeinpsychiatrie sollte vergleichend untersucht werden.Die Medikamentenstichtagserhebungen 2014–2019 der Pharmakoepidemiologie und -Vigilanz (Pharmako-EpiVig) des Bayerischen Institut für Daten, Analysen und Qualitätssicherung (BIDAQ) aus Maßregelvollzug (n = 4590) und Allgemeinpsychiatrie (n = 5136) des Isar-Amper-Klinikums München Ost wurden ausgewertet.Mittleres Alter und Diagnoseverteilung der Patientenklientele unterschieden sich, ferner Substanzauswahl und Dosierung, die im Maßregelvollzug nahezu durchweg höher lag. Bei schizophren erkrankten forensischen Patienten wurde am häufigsten Clozapin gegeben. In beiden Fachbereichen fiel die häufige Anwendung von Valproat auf.Die Ergebnisse könnten als Hinweis gewertet werden, dass forensische Patienten schwerere und therapierefraktärere Erkrankungen aufweisen, und dass in der klinischen Praxis insgesamt eine symptombezogene antiaggressive Behandlung bedeutsam scheint.

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“…Evidence regarding psychopharmacological treatment strategies for schizophrenia in forensic settings is rare, focusing mainly on differences between general psychiatric and forensic samples (6,7). Vasic et al (8) not only examined the prescribed medication, but also the respective psychopathological status as well as neurological and metabolic side effects of inpatients with schizophrenia in either forensic (n = 29) or general psychiatry (n = 31) in two southern German clinics. They found that forensic patients received dosages of higher neuroleptic potency, albeit fewer psychopharmaceuticals.…”

Section: Introductionmentioning

confidence: 99%

Gender Differences in the Psychopharmacological Treatment of Forensic In-Patients With Schizophrenia

Mayer

Vasić²,

Wolf³

et al. 2022

Front. Psychiatry

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BackgroundIn forensic psychiatry, psychopharmacological treatment plays a crucial role for patients with schizophrenia in improving their medical as well as legal prognosis. However, an increase in the number of females entering forensic treatment has yet to yield empirical research on the outcome of psychopharmacological treatment of female patients with schizophrenia in terms of efficacy and tolerability.AimsThe aim of the present study is to elucidate pharmacological treatment strategies of women with schizophrenia in forensic psychiatry in comparison with men.MethodsThis study compares psychopharmacological treatment strategies, psychopathological features, as well as neurological and metabolic side effects of treatment between 29 female and 29 male in-patients with schizophrenia in three forensic facilities in Bavaria, Germany.ResultsResults show significant differences between genders. Poorer psychopathological and neurological features were found in the female sample, while men registered worse metabolic parameters. In terms of psychopharmacological treatment strategies, female in-patients were more often prescribed second-generation depot antipsychotics. Surprisingly, the potency of the dosages did not differ between genders. The results suggest that female forensic patients with schizophrenia have more severe and refractory diseases than their male counterparts.ConclusionRecommendations for gender-specific treatment strategies are derived.

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Psychopharmacologic treatment of in-patients with schizophrenia: comparing forensic and general psychiatry

Cited by 8 publications

References 49 publications

Perspectives on Recruitment and Representativeness in Forensic Psychiatric Research

Perspectives on Recruitment and Representativeness in Forensic Psychiatric Research

Psychopharmaka – Anwendungspraxis in Maßregelvollzug und Allgemeinpsychiatrie im Vergleich

Gender Differences in the Psychopharmacological Treatment of Forensic In-Patients With Schizophrenia

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