Дисертації з теми "Schizophrenics Treatment"
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Marschinke, Kathleen. "Family interventions in the treatment of schizophrenia." Online version, 1999. http://www.uwstout.edu/lib/thesis/1999/1999marschinkek.pdf.
Повний текст джерелаFranco, Michelle E. "A behavioral treatment program for chronic schizophrenics." Scholarly Commons, 1997. https://scholarlycommons.pacific.edu/uop_etds/2305.
Повний текст джерелаSchock, Sandra Lynn. "Difficulties in psychotherapy with a residual schizophrenic." Thesis, Rhodes University, 1991. http://hdl.handle.net/10962/d1007457.
Повний текст джерелаGreen, Asha M. "Participant Perspectives: Investigating the Experience of Low-Income Schizophrenics in Clinical Research Trials." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc799519/.
Повний текст джерелаChun, Wai Kwong. "Voice hearing among Chinese people with schizophrenia in Hong Kong." HKBU Institutional Repository, 2009. http://repository.hkbu.edu.hk/etd_ra/985.
Повний текст джерелаConner, Dianna Holden. "Social skills training for individuals with schizophrenia: Evaluation of treatment outcome and acquisition of social and cognitive skills." Thesis, University of North Texas, 2004. https://digital.library.unt.edu/ark:/67531/metadc4713/.
Повний текст джерелаTheron, Janina. "Pragmatic assessment of schizophrenic bilinguals' L1 and L2 use : a comparison of three assessment tools." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/1783.
Повний текст джерелаENGLISH ABSTRACT: The term "schizophrenia" refers to a psychiatric condition which affects an individual's thought and speech (Eaton and Chen 2006). The verbal expression of schizophrenics can therefore be used as a tool for insight into the nature of schizophrenia as well as the cognitive processes of schizophrenics (Wróbel 1990:1). This thesis reports on a comparative evaluation of three pragmatic assessment tools, namely the Pragmatic Protocol (Prutting and Kirchner 1987), the Profile of Communicative Appropriateness (Penn 1985), and the Framework for Assessing (Children's) Conversational Skills (Rumble 1988), in order to establish which of these tools is most suitable for assessing the first language (L1) and second language (L2) pragmatic abilities of late bilingual schizophrenics. Four late bilingual schizophrenic patients participated in this study. A thirty minute informal interview was conducted with each of the participants in both their L1 and L2 and the speech samples were transcribed and then analysed by means of each of the pragmatic assessment tools. A careful examination of the results yielded by the three assessment tools, showed, firstly, that when presenting the results of a pragmatic assessment of schizophrenic speech, it is crucial that both quantitative and qualitative information be included: if the latter is excluded, a significant amount of information is hidden from the clinicians and/or linguists doing the assessment, as well as the people to whom they report their findings. Secondly, with respect to the characteristics of schizophrenic speech, the three instruments used in this study show that whereas most of the aspects of schizophrenics' linguistic abilities seem intact, their pragmatic skills are definitely impaired. Thirdly, regarding differential symptomatology in bilingual schizophrenics, this study concludes that none of the three assessment tools contributes to a better understanding of this phenomenon, and that, in fact, it is highly unlikely that any pragmatic assessment tool would be able to capture this phenomenon. Finally, it is recommended that clinicians assess bilingual patients in both languages, whenever possible, in order to determine the full range of symptoms experienced by the patient, to gain a better indication of the severity of the illness and to track the progress of the illness.
AFRIKAANS OPSOMMING: Die term "skisofrenie" verwys na 'n psigiatriese toestand wat 'n individu se denkprosesse en spraak beïnvloed (Eaton en Chen 2006). Die verbale uitinge van skisofrene kan dus gebruik word om insig oor die aard van skisofrenie, sowel as die kognitiewe prosesse van skisofrene, te verkry (Wróbel 1990:1). Hierdie tesis lewer verslag oor 'n vergelykende evaluering van drie pragmatiese assesseringsinstrumente, naamlik die "Pragmatic Protocol" (Prutting en Kirchner 1987), die "Profile of Communicative Appropriateness" (Penn 1985), en die "Framework for Assessing (Children's) Conversational Skills" (Rumble 1988), om sodoende vas te stel watter een van hierdie drie die mees gepaste instrument is vir die assessering van tweetalige skisofrene se pragmatiese vaardighede in hul eerstetaal (T1) en tweedetaal (T2), spesifiek in gevalle waar die T2 later (d.w.s. nie binne die eerste sewe lewensjare nie) verwerf is. Vier sulke tweetalige skisofrene het deelgeneem aan die studie. Daar is met elkeen van die deelnemers 'n informele onderhoud gevoer vir 30 minute in hul T1, gevolg deur 30 minute in hul T2. Die onderhoude is getranskribeer en daarna geanaliseer deur middel van elk van die drie assesseringsinstrumente. 'n Noukeurige ondersoek en vergelyking van die resultate van die drie instrumente het eerstens getoon dat dit belangrik is om die resultate van 'n pragmatiese analise van skisofreniese spraak op beide 'n kwantitatiewe en kwalitatiewe wyse aan te bied: wanneer kwalitatiewe inligting weggelaat word, bly 'n betekenisvolle hoeveelheid van die informasie verborge vir die klinici en/of taalwetenskaplikes wat die assessering doen, asook die mense aan wie hulle hulle bevindinge rapporteer. Tweedens, met betrekking tot die eienskappe van skisofreniese spraak, wys die drie instrumente wat in hierdie studie gebruik is dat alhoewel meeste aspekte van skisofrene se taalvaardighede ongeskonde is, hulle pragmatiese vaardighede ooglopend aangetas is. Derdens, rakende differensiële simptomatologie in tweetalige skisofrene kom hierdie studie tot die gevolgtrekking dat geen van die drie instrumente bydra tot 'n beter begrip van hierdie verskynsel nie, en dat dit selfs hoogs onwaarskynlik is dat enige pragmatiese assesseringsinstrument hierdie verskynsel sou kon vaslê. Uiteindelik word daar aanbeveel dat klinici, wanneer dit ookal moontlik is, tweetalige pasiënte in beide tale behoort te assesseer om sodoende die volledige reeks van simptome wat 'n pasiënt ervaar vas te stel, om 'n beter aanduiding te bekom oor die erns van die siekte, en om die progressie van die siekte te volg.
Steinberg, Marc L. 1971. "Engaging smokers with schizophrenia in treatment for tobacco dependence [electronic resource] : a brief motivational interviewing intervention / by Marc L. Steinberg." University of South Florida, 2003. http://purl.fcla.edu/fcla/etd/SFE0000075.
Повний текст джерелаTitle from PDF of title page.
Document formatted into pages; contains 114 pages.
Thesis (Ph.D.)--University of South Florida, 2003.
Includes bibliographical references.
Text (Electronic thesis) in PDF format.
ABSTRACT: The purpose of this study was to determine how to best motivate smokers with schizophrenia or schizoaffective disorder to seek treatment for tobacco dependence. Smokers with schizophrenia or schizoaffective disorder (N=78) were randomly assigned to receive a Motivational Interviewing, Psychoeducational, or Minimal Control intervention. A greater proportion of participants receiving the Motivational Interviewing intervention followed through on a referral for tobacco dependence treatment within one-week and one-month post-intervention. Mixed model Analyses of Variance found no differences between groups at one-week or at one-month with respect to tobacco use or motivation to quit. Within group analyses indicated that participants in the Motivational Interviewing and Psychoeducational groups reported significant decreases in cigarettes smoked per day.
ABSTRACT: Only participants in the Motivational Interviewing group showed significant increases in confidence in their ability to quit smoking.
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Wills, Jack Blanton. "Effects of stress management instruction and anxiety monitoring in adult day treatment population." PDXScholar, 1986. https://pdxscholar.library.pdx.edu/open_access_etds/3698.
Повний текст джерелаEichelberger, James R. "A Christian counselor's experience in working with schizophrenics in the state hospital system and preliminary treatment suggestions." Theological Research Exchange Network (TREN), 2005. http://www.tren.com.
Повний текст джерелаWessels, Margaretha J. "The role of the clinical social worker in a treatment and rehabilitation programme for schizophrenic patients and their families." Master's thesis, University of Cape Town, 1988. http://hdl.handle.net/11427/17161.
Повний текст джерелаContinued study towards understanding schizophrenia and the impairments it can cause, is regarded as essential in the meaningful fulfilment of the educative and diagnostic contributions which the social worker can make in a comprehensive treatment and rehabilitation programme (involving patients and their families). The first section of this descriptive dissertation focuses on aspects like terminology, definition, and the most recent diagnostic criteria, in an endeavour to contribute theoretically towards understanding the illness. The complexity of the diagnostic process is emphasized, and the recent revision of the criteria (1987) is seen as indicative of continuous efforts towards improved diagnosis, treatment and rehabilitation. Previous studies, improved pharmacology and more sophisticated neurophysiological examining led to a change in focus with regard to aetiology and the development of the vulnerability-stress-coping-competence model which brought new hope with regard to outcome of treatment. Section Two highlights several interventions which the clinical social worker can undertake as psychotherapist, group and family therapist, as well as educator on primary, secondary and tertiary levels, from this model and within the psycho-educative perspective. The Neuro B programme, Stikland Hospital, Bellville, is described in section Three, as an example of a presently operating, comprehensive programme where these interventions can be holistically implemented. Particulars about 56 patients who have been involved in the programme are highlighted in Section Four, while Section Five deals with the opinions of former patients and their families concerning involvement in the programme - elicited by two sets of questionnaires. The final chapter focuses on a summary of the dissertation, conclusions and implications for practice.
Steinberg, Marc L. "Engaging Smokers with Schizophrenia in Treatment for Tobacco Dependence: A Brief Motivational Interviewing Intervention." [Tampa, Fla. : s.n.], 2003. http://purl.fcla.edu/fcla/etd/SFE0000075.
Повний текст джерелаSteuber, Lucas Carl. "Disordered Thought, Disordered Language: A corpus-based description of the speech of individuals undergoing treatment for schizophrenia." PDXScholar, 2011. https://pdxscholar.library.pdx.edu/open_access_etds/63.
Повний текст джерелаWindell, Deborah L. "Treatment and recovery in first-episode psychosis : a qualitative analysis of client experiences." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=100177.
Повний текст джерелаContexte: Il y a actuellement peu de recherche sur la rétablissement du point de vue d'individusaprès un premier épisode de psychose. La formation d'une meilleure compréhension de senssubjectif des expériences de rétablissement pendant cette première phase de rétablissement peutinformer le design efficace et expressif des services et des pratiques.Méthode: Trente individus se rétablissement de la psychose et recevant un traitement depremière intervention spécialisé ont été interviewés à propos du sens et de l'expérience derétablissement de la psychose pendant la première phase (2-5 ans) du cours de maladie.Résultats: La rétablissement a été décrite comme une expérience multidimensionnelle qui ainclus des aspects de "la rétablissement de maladie," "la rétablissement psychologique," et "larétablissement sociale." Identifiées ont été sept premières expériences de rétablissementcommunes. Les variations individuelles dans l'étendue de perturbation décrite de soi et defonctionnement social, la durée du processus d'acceptation de maladie et de la négociation duprocessus de traitement ont beaucoup influencé l'expérience de rétablissement.Conclusions : Les différences dans les trajectoires d'acceptation de maladie et de rétablissementsociale ont des implications importantes pour comprendre les réponses individuelles àl'expérience de psychose, sa diagnose et traitement. Ces différences accentuent l'importanced'assister les individus avec la construction de sens et avec le réengagement dans les rôlessociaux après l'expérience de maladie initiale.
Truter, Erika. "Genetic association analysis of polymorphisms in four cytochrome P450 genes, the MDR1 gene and treatment-outcome in Xhosa schizophrenia patients." Thesis, Link to online version, 2007. http://hdl.handle.net/10019/350.
Повний текст джерелаWalla, Berit. "Family perspectives in treatment of schizophrenia." Thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for sosialt arbeid og helsevitenskap, 2010. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-12268.
Повний текст джерела2. Impact of a psychoeducative intervention on caregiver burden Objective: intervention on negative appraisal of caregiving experience, positive appraisal of caregiving experience, and health and functioning in relatives of patients with psychotic disorders compared to a waiting list control. Methods: Family members (N=68) of patients with psychosis received a six-session (a total of 15 hours), multi-family format psychoeducative intervention, - and completed an Experience of Caregiving Inventory (ECI) and COOP/WONCA (CW), which is a self reporting measure of the general state of health and functioning at the beginning, and at the end of the intervention. Those who went directly to the intervention (N=36) was used as intervention group and those who had to be on a waiting list (N=32) was used as a control group. Results: The study revealed significant differences between the psychoeducative intervention group on the ECI subcategory “problems with services” after the intervention period compared to the change in the control group (reduction mean -0.10v. 2.36; P= 0.043, effect size 0.062). There were no significant differences at the ECI total negative, the ECI positive subcategories, or on the C/W. Conclusion: The findings in this study suggest that psychoeducational intervention have reduced the relatives’ negative appraisal of the mental health services, but not increased the positive appraisals of experiences or the health and functional level.
Wiker, Charlotte. "Novel pharmacological treatment alternatives for schizophrenia /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-343-6/.
Повний текст джерелаGumley, Andrew Ian. "Psychological aspects of relapse in schizophrenia." Thesis, University of Stirling, 2002. http://hdl.handle.net/1893/12115.
Повний текст джерелаSmith, Michelle. "The role of Lorikeet Clubhouse in psychiatric rehabilitation." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2001. https://ro.ecu.edu.au/theses/1063.
Повний текст джерелаMatthiasson, Páll. "Dealing with treatment resistance to clozapine : characteristics of treatment response in schizophrenia." Thesis, King's College London (University of London), 2006. https://kclpure.kcl.ac.uk/portal/en/theses/dealing-with-treatment-resistance-to-clozapine--characteristics-of-treatment-response-in-schizophrenia(f43c968b-8789-44e7-9161-3cab811ee429).html.
Повний текст джерелаTuninger, Eva. "Depot neuroleptic maintenance treatment clinical, pharmacological and neuropsychological aspects /." Lund : Dept. of Psychiatry, Lund University, University Hospital MAS, 1997. http://catalog.hathitrust.org/api/volumes/oclc/40281424.html.
Повний текст джерелаDemjaha, Arsime. "Biological and clinical determinants of treatment resistant schizophrenia." Thesis, King's College London (University of London), 2014. https://kclpure.kcl.ac.uk/portal/en/theses/biological-and-clinical-determinants-of-treatment-resistant-schizophrenia(eeabcaab-e9c7-4d41-99e6-8428569f57d0).html.
Повний текст джерелаHaddock, Gillian. "Auditory hallucinations : cognitive processes, phenomenology and psychological treatment." Thesis, University of Liverpool, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.240522.
Повний текст джерелаDavis, Kimberly Ann. "Best practices for the treatment and management of schizophrenia /." Full-text of dissertation on the Internet (319.70 KB), 2010. http://www.lib.jmu.edu/general/etd/2010/masters/davis3ka/davis3ka_masters_04-21-2010_01.pdf.
Повний текст джерелаAlladin, Waseem Jamal. "Social dysfunction in chronic schizophrenia : nature, treatment and generalization." Thesis, University of Hull, 2005. http://hydra.hull.ac.uk/resources/hull:5633.
Повний текст джерелаJoubert, Andre Francois. "Implementation of international treatment guidelines in the treatment of schizophrenia : a study of the effects of an evidence-based seminar on the knowledge and treatment habits of a sample of international psychiatrists." Thesis, Stellenbosch : University of Stellenbosch, 2007. http://hdl.handle.net/10019.1/1322.
Повний текст джерелаThis study reports on the effect of seminar education by studying changes in knowledge, attitude and behaviour to haloperidol prescribing patterns of psychiatrists who In summary, this study demonstrated a direct relationship between seminar attendance and changes to selected minimum effective haloperidol dose and duration of treatment. However, seminar attendance did not appear to be a significant factor in changes to antipsychotic class used for treatment and changes in optimal effective haloperidol dose: rather a change in the level of “background” knowledge of participants was most likely responsible. This study also found individual participant characteristic differences in those who did change treatment duration and minimum effective dose. In conclusion, this study showed that the successful integration of international treatment recommendations into daily psychiatric practise could be facilitated by the use of appropriate educational seminars. Not all attendees benefit i.e. “learn”, but those needing to “learn” most do - i.e. those who need to change their prescribing habits most to meet internationally accepted guidelines. The peer exposure provided allows a format for informed discussion and the practise of evidence-based medicine. The judicious use of such seminars should result in better treatment options and outcomes for patients.attended evidence-based schizophrenia seminars presented by the Lundbeck Institute in Denmark. The objectives of the study were two-fold. Firstly, it set out to determine whether changes actually occurred in the post-seminar haloperidol prescribing behaviour of participants. This was done by analysing changes in choice of optimal haloperidol dose (both in acute treatment i.e. most effective dose and maintenance treatment i.e. minimum effective dose), selected duration of treatment (for first- and multi-episode schizophrenia patients) and drug-class used (conventional versus new generation antipsychotic). The study then investigated whether these changes (if they occurred) could be ascribed wholly or in part to the effect of schizophrenia seminar attendance, or whether other factors e.g. scientific progress over time in understanding schizophrenia and its treatment (“background” knowledge) and differences between participant datasets studied (only paired pre- and post-seminar data were used in this study) also played a role. Secondly, it attempted to identify factors predictive of seminar participants changing their haloperidol prescribing behaviour post-seminar i.e. what were the factors that predisposed some attendees to change their prescribing behaviour? This was done by analysing the effect that pre-seminar prescribing behaviour, participant nationality, patient caseload, work experience and workplace environment had on post-seminar behaviour. Results show that changes did occur in post-seminar haloperidol prescribing behaviour, but that they were not always due to an effect of seminar attendance. Only the changes in the minimum effective haloperidol dose and duration of treatment for first- and multi-episode schizophrenia patients could validly be ascribed to the effects of schizophrenia seminar attendance. Furthermore, multivariate analysis of the factors relating to these changes found that a participant was most likely to change their selected minimum effective haloperidol dose to be more in line with internationally accepted standards if they i) selected above the target dose pre-seminar, ii) had a relatively low caseload comprised mainly of schizophrenia patients and iii) came from either Greece, Germany, Britain, Spain, Italy or some other Eastern European country. The single most important factor related to changes in duration of treatment was found to be pre-seminar behaviour: respondents below the recommended duration of treatment increased their duration of treatment significantly.
Leung, Mei-kei. "MRI brain abnormality in first episode schizophrenia before and after treatment." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43572303.
Повний текст джерелаDeng, Yi, and 鄧藝. "From neuroimaging to proteomics in schizophrenia." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43278516.
Повний текст джерелаDuarte, Eugenio A. "General Religiosity and Use of Religious Coping as Predictors of Treatment Gains for Patients with Schizophrenia and Their Relatives." Scholarly Repository, 2009. http://scholarlyrepository.miami.edu/oa_dissertations/299.
Повний текст джерелаThacker, Stephanie K. "Chronic Olanzapine Treatment Eliminates Cognitive Deficits Produced by Neonatal Quinpirole Treatment." Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etd/1011.
Повний текст джерелаMojtabai, Ramin. "Psychosocial treatments for schizophrenia : meta-analytic review of controlled outcome studies /." Access abstract and link to full text, 1995. http://0-wwwlib.umi.com.library.utulsa.edu/dissertations/fullcit/9635176.
Повний текст джерелаEltayb, Amani. "Experimental studies on novel pharmacological strategies in the treatment of schizophrenia /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-575-5/.
Повний текст джерелаHolowka, Darren W. "Explaining treatment response in Schizophrenia : integration of genetic and environmental factors." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=78380.
Повний текст джерелаLeung, Mei-kei, and 梁美琪. "MRI brain abnormality in first episode schizophrenia before and after treatment." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43572303.
Повний текст джерелаWahass, Saeed H. "A cross-cultural study of auditory hallucinations of schizophrenic patients: phenomenology and treatment." Thesis, University of Sheffield, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.483978.
Повний текст джерелаMunnik, James Barry. "Assessing the potential of submaximal extended duration exercise as an adjunct treatment for sub-acute schizophrenic in-patients : a pilot study /." Thesis, Rhodes University, 2006. http://eprints.ru.ac.za/889/.
Повний текст джерелаLi, Yiu-bun, and 李耀斌. "Comorbid obsessive-compulsive symptoms (OCSs) and obsessive-compulsive disorder (OCD) in patients with schizophrenia treated with clozapine or haloperidol." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/200383.
Повний текст джерелаpublished_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
Chiliza, Bonginkosi. "A prospective study of clinical, biological and functional aspects of outcome in first episode psychosis." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97904.
Повний текст джерелаENGLISH ABSTRACT: Prospective, longitudinal clinical studies in first-episode schizophrenia have become relatively commonplace over the past two decades or more and have provided a wealth of useful information regarding the clinical presentation, treatment, course and outcome of the illness. However, there remain several unanswered questions. The majority of the studies have been conducted in upper income countries using often costly medication with heterogeneous samples. While the overall outcome of patients showed some progress, there is room for improvement yet. The overall aim of the dissertation was to study the clinical, biological and functional aspects of outcome in first episode schizophrenia in a resource constrained setting. We conducted a prospective, non-comparative, longitudinal study over 12 months assessing the efficacy and tolerability of a cost effective, long-acting injectable antipsychotic (LAI; flupenthixol decanoate) combined with an assertive monitoring program (AMP) among first-episode schizophrenia patients. Efficacy was measured by examining rates of response, remission and relapse, as well as quality of life and social and occupational functioning. Tolerability of our intervention was assessed by measuring extrapyramidal symptoms, and weight and metabolic changes. We also examined the evolution of treatment refractoriness by studying the rates of non-response, and other associated predictor and outcome features. We found high rates of acceptance and adherence to the LAI and AMP. Seventy percent of our patients completed the 12 months of treatment. Treatment response was achieved by 82% of the participants and 60% achieved remission. Although 19% of our patients relapsed, the majority of the relapses were mild and did not require hospitalisation. Patients experienced significant quality of life and social and occupational functioning improvements. We found mild rates of extrapyramidal effects, present in only a third of our cohort. The majority of the extrapyramidal effects were treated with anticholinergics or propranolol. Only 3% of our patients developed transient dyskinesia over the duration of the study. However, our cohort gained considerable weight, with statistically significant increases in BMI (p< .0001) and waist circumference (p=0.0006). Our cohort also experienced significant deleterious changes to their lipid profiles. Of particular concern was the increase in triglycerides (p=0.03) and a significant decrease in high density lipoprotein (p=0.005) leading to a 91% increase in the triglyceride/high density lipoprotein ratio. With regards to emerging treatment refractoriness, 12% of our patients met our pre-defined criteria for non-response. Non-responders were younger and at baseline showed more prominent disorganised symptoms, poorer social and occupational functioning, poorer quality of life for psychological, social and environmental domains, more prominent neurological soft signs (NSS), and lower BMI. At endpoint the non-responders were characterised by higher levels of symptomatology in all domains; poorer functional outcome, poorer quality of life and greater cognitive impairments. They also had more prominent NSS and a lower BMI. The strongest predictors of non-response were prominent baseline NSS and poor early (7 weeks) treatment response. In conclusion, the combination of an LAI with an AMP may be an effective and safe intervention in firstepisode schizophrenia, and may be particularly suitable for resource-constrained settings. The risk of weight gain and metabolic syndrome associated with antipsychotic treatment in first-episode schizophrenia are not restricted to second generation antipsychotics and low-potency first-generation antipsychotics. Ensuring effective treatment for first episode schizophrenia patients is a global problem, and likely to be under-recognised in LMICs.
AFRIKAANSE OPSOMMING: Oor die afgelope twee dekades het toenemend meer longitudinale kliniese studies, wat eerste episode skisofrenie bestudeer, die lig gesien. Die studies het ‘n magdom van waardevolle inligtng oor die kliniese voorkoms, behandeling, verloop en uitkomste van die siekte opgelewer. Die meerderheid van die studies is egter in hoë inkomste ontwikkelde lande gedoen met pasiënte wat duur medikasie gebruik en hoofsaaklik in heterogene steekproewe. Alhoewel dit blyk uit hierdie studies dat daar oor die algemeen vordering gemaak word ten opsigte van die behandeling van pasiënte is daar steeds ‘n gebrek aan voldoende inligting oor die onderwerp veral in minder gegoede, ontwikkelende lande. Die oorhoofse doel van hierdie proefskrif is om binne ‘n hulpbron beperkte konteks die kliniese, biologiese en funksionele aspekte van pasiënt -uitkomste in eerste episode skisofrenie te ondersoek. Ons het ‘n longitudinale studie gedoen waarin ons die effektiwiteit en toleransie van ‘n enkele antipsigotiese medikasie vir 12 maande nagevors het. Die medikasie wat ons ondersoek het, is flupenthixol decanoate en word deur ‘n inspuiting gegee en die medikasie word dan geleidelik deur die liggaam geabsorbeer. As deel van die behandeling het ons pasiënte ook streng gemonitor. Ons het die effektiwiteit van die behandeling gemeet nagelang van hoe pasiënte reageer op die behandeling, hoeveel pasiënte in remissie gaan en terugval, en ook pasiënte se kwaliteit van lewe en hulle sosiale en beroepsfunksionering. Ons het toleransie gemeet nagelang van pasiënte se gewig en metaboliese verandering sowel as die voorkoms van medikasie geïnduseerde newe-effekte. Verder het ons pasiënte wat nie op medikasie gereageer het nie ondersoek sowel as die aspekte wat moontlik hiernee verband hou. Ons het bevind dat die meerderheid van pasiënte hulle medikasie getrou geneem het en ook die streng monitering aanvaar het. Sewentig persent van die pasiënte het hulle 12 maande behandeling voltooi, 82% het op die medikasie gereageer en 60% het in remissie ingegaan. Alhoewel 19% van die pasiënte teruggeval het, was dit nie so ernstig dat ons hulle moes hospitaliseer nie. Pasiënte het beduidende verbetering ten opsigte van hulle kwaliteit van lewe en sosiale en beroepsfunksionering getoon. Ons het slegs ‘n gematigde mate van medikasie geïnduseerde newe-effekte opgemerk en alleenlik by ‘n derde van die kohort. In die meerderheid van gevalle het ons die newe-effekte met anticholinergics of propranolol behandel. Slegs 3% van die pasiënte het gedurende die verloop van 12 maande die kondisie transient dyskinesia ontwikkel. Ongelukkig het ons kohort geweldig baie gewig opgetel en die toename in pasiënte se BMI (p< .0001) en middellyf omtrek (p=0.0006) was statisties beduidend. Ons het ook bevind dat veranderinge in ons kohort se lipied profiele kommerwekkend is veral as in ag geneem word dat die toename in trigliseriede (p = 0,03) en die beduidende afname in die hoë digtheid lipoproteïen (p = 0,005) gelei het tot ‘n 91% verhoging in trigliseriede: hoë digtheid lipoproteïen verhouding.
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Повний текст джерела