Objective: This is a follow-up study designed to determine the predictive value of psychopathology and family-related variables in schizophrenia patients and their relatives. Methods: Forty-four schizophrenia patients and one of their relatives living with them were assessed one month and six-to-eight months after release from hospital. Sociodemographic characteristics were questioned and quality of life of patients was assessed using the World Health Organisation Quality of Life Scale Results: Depressive symptoms must be taken into consideration in order to improve the quality of life in schizophrenia patients. The importance of family environment should be emphasized, recommending that family rules should be flexible, and tolerance towards the patient should be increased for stable patients to improve their quality of lives. Conclusion: No changes were observed in the quality of life levels in schizophrenia patients and their relatives in time. In the same period, a decrease was observed in positive and negative symptoms, depressive symptoms, disorder severity and conflict in family environment, while insight and functionality were improved. Statistically, the most robust predictor of patients' quality of life was found to be the severity of depressive symptoms. Additionally, greater tolerance and less conflict in the family environment and family members' support to each other have been found to be related to various domains of the quality of life. The relatives' quality of life did not show any significant change in the follow-up controls as well. The most important predictor of their quality of life was less conflict in the family environment. (Archives of Neuropsychiatry 2010; 47: 292-6) Key words: Schizophrenia, quality of life, family environment, expressed emotion ÖZET Amaç: Bu izlem çal›flmas› flizofreni hastalar›nda öznel yaflam kalitesinin hastal›k ve aileye iliflkin etmenlerle iliflkisini saptamay› amaçlamaktad›r. Yöntemler: K›rkdört flizofreni hastas› ve birlikte yaflad›klar› birer akrabalar› taburculuktan bir ve alt›-sekiz ay sonra de¤erlendirilmifltir. Sosyodemografik özellikler sorgulanm›fl, hastalar›n yaflam kalitesi için Dünya Sa¤l›k Örgütü Yaflam Kalitesi Ölçe¤i K›sa Formu Türkçe Versiyonu (WHOQOL-BREF-TR); aileye iliflkin de¤iflkenler için Aile Ortam› Ölçe¤i (AOÖ) ve D›flavuran Duygudurum Düzeyi Ölçe¤i; hastal›¤a iliflkin de¤iflkenler için Calgary fiizofrenide Depresyon Ölçe¤i, fiizofrenide Negatif ve Pozitif Belirtileri De¤erlendirme Ölçekleri, Anormal ‹stemsiz Hareketler Ölçe¤i, ‹fllevselli¤in Genel De¤erlendirilmesi Ölçe¤i ve Klinik Global ‹zlem Ölçe¤i; içgörü için Markova-Berrios ‹çgörü Ölçe¤i kullan›lm›flt›r.Hasta akrabalar› da AOÖ, D›flavuran Duygudurum ve WHOQOL-BREF-TR ölçekleriyle de¤erlendirilmifltir. Bulgular: fiizofreni hastalar›n›n yaflam kalitesini art›rmak için depresif belirtilerin varl›¤› dikkate al›nmal›d›r. Aile ortam›n›n hastan›n yaflam kalitesi aç›s›ndan önemi ailelere aktar›lmal›, aile içi kurallar›n hastal›¤›n stabil dönemlerinde esnetilebilmesi ve hastaya gösterilen ho...

Objective: In this retrospective chart review study we aimed to investigate the effect of pimozide augmentation on schizophrenia patients with poor or partial response to clozapine therapy. Methods: Charts of 17 treatmentresistant schizophrenia patients who had poor or partial response to at least oneyear clozapine therapy and whose treatment was augmented with pimozide were evaluated. Patients who had Clinical Global ImpressionSeverity (CGIS) scores ≥4 and Positive and Negative Syndrome Scale (PANSS) scores ≥72 were considered as poor or partial clozapine responders. The scores on the PANSS, CGI scale, and Extrapyramidal Symptom Rating Scale (ESRS) obtained in the first and the third months of followup were evaluated. Results: The mean age of the 8 female and 9 male (total 17) patients was 32.23±7.87 years, the mean age at onset of illness was 19.94±4.19 years, the mean duration of illness was 12.29±6.12 years, the mean clozapine dose was 500±58.63 mg/day, and the mean pimozide dose was 3.88±0.60 mg /day. The mean PANSS scores decreased from 99.70±13.91 to 3.64±1.27 and the mean CGIS scores decreased from 4.82±0.80 to 3.64±1.27. ESRS scores did not change significantly after the addition of pimozide to the treatment. Conclusion: Pimozide augmentation of clozapine was found to be effective and safe in treatmentresistant schizophrenia patients with poor or partial response to clozapine therapy. (Archives of Neuropsychiatry 2010; 47: 302-6) Amaç: Bu çal›flmada klozapin tedavisine yan›t vermeyen ya da k›smi yan›t veren tedaviye dirençli flizofreni hastalar›nda klozapin tedavisini pimozid ile güçlendirme yaklafl›m›n›n etkisinin geriye dönük kay›t taramas› yöntemiyle ortaya konmas› amaçlanm›flt›r.Yöntemler: Çal›flma verileri klini¤imizde yatarak ya da ayaktan tedavi gören tedaviye dirençli flizofreni tan›s› ile en az 1 y›ld›r klozapin kullanan ve klozapin tedavisine yan›t vermeyen ya da k›sm› yan›t veren hastalarda tedaviye güçlendirme amac›yla pimozid eklenmifl hastalar›n dosyalar›ndan al›nd›. Hastalar›n Klinik Global ‹zlenim fiiddet alt ölçe¤i (KG‹fi) ≥4 ve Pozitif ve Negatif Sendrom Ölçe¤i (PANSS) ≥72 olmas› "klozapin tedavisine yan›t vermeyen ya da k›sm› yan›t veren" biçiminde de¤erlendirildi. Klozapin tedavisine pimozid eklenmifl araflt›rma ölçütlerine uyan, verileri tam olan 17 hastaya bafllang›çta, 1. ve 3. aylarda uygulanm›fl PANSS, KG‹ ve Ekstrapiramidal Belirtileri De¤erlendirme Ölçe¤i (EBDÖ) sonuçlar› de¤erlendirildi. Bulgular: Çal›flmay› al›nan 17 hastan›n yafl ortalamas› 32.23±7.87'idi. 8'i kad›n ve 9'u erkekti. Ortalama flizofreni bafllang›ç yafl› 19.94±4.19 ve ortalama ruhsal hastal›k süresi 12.29±6.12 idi. Klozapin kullan›m süresi 3.70±2.75 y›l olarak saptand›. Klozapin kullan›m dozu ortalama 500±58.63 mg/gün iken eklenen pimozid dozu ortalama 3.88±0.60 mg/gün idi. Bafllang›çta ve 3. ayda yap›lan PANSS ölçümleri 99.70±13.91'den 71.17±25.92'ye düflme gösterirken, ayn› flekilde KG‹fi ölçümlerinin de 4.82±0.80'den 3.64±1.27'ye düfltü¤ü saptand›. EBDÖ ölçümlerinde pimozid eklenmesiyle anlaml› bir de¤ifli...