PANSS-8 and PANSS-6 are clinically useful measures. Early improvement, regardless of whether PANSS-30, PANSS-8, or PANSS-6 is used, is a statistically significant predictor of response/remission.

Monotherapy is recommended for schizophrenia treatment, but the risk-benefit issue of antipsychotic drug combination (except for clozapine) remains unclear. Risperidone, an atypical antipsychotic drug, has a lower incidence of extrapyramidal syndrome but higher risks of prolactinemia and metabolic syndrome than haloperidol, a typical agent. This study compared efficacy and safety of risperidone monotherapy versus low-dose risperidone plus low-dose haloperidol in schizophrenia. In this 6-week, double-blind study, patients were randomized to the combination group (2-mg/d risperidone plus 2-mg/d haloperidol, n = 46) or the monotherapy group (4-mg/d risperidone, n = 42). Efficacy assessments included Clinical Global Impression-Severity, Positive and Negative Syndrome Scale and subscales, Calgary Depression Scale, Global Assessment of Functioning, and Medical Outcomes Study Short-Form 36. Safety was rigorously monitored. Response was defined as 30% reduction in the Positive and Negative Syndrome Scale total score. The 2 treatment groups were similar in (1) demographic and clinical characteristics at baseline, (2) response rate, and (3) improvement in various psychopathological measures and quality of life at end point. The monotherapy group had a higher increase in prolactin levels (P = 0.04) and Simpson-Angus Scale scores (P = 0.04) and a higher percentage of biperiden use (P = 0.045). There were no significant between-group difference in changes in weight, vital signs, corrected QT interval, liver/renal function, fasting glucose level, and lipid profiles. The findings suggest that risperidone monotherapy may yield higher prolactin levels than a combination of low-dose risperidone plus low-dose haloperidol. The 2 treatment groups are similar in efficacy, life quality, and other safety profiles. Future long-term studies are warranted.

Background We examined the utilization of rehabilitation resources among children with autism spectrum condition (ASC), a neurodevelopmental condition, in Taiwan. Methods We derived from the National Health Insurance Research Database of Taiwan data pertaining to 3- to 12-year-old children for the period 2008–2010. Based on diagnoses executed in accordance with the International Classification of Diseases, Ninth Revision, Clinical Modification, we classified these data into the ASC and non-ASC groups and analyzed them through multiple linear regression model, negative binomial model, independent sample t testing, and χ 2 testing. Results Compared with the non-ASC group, the ASC group exhibited higher utilization of rehabilitation resources. Because hospitals are constrained by overall expenditure limits, expenditure on rehabilitation resources has plateaued, preventing any increase in the utilization of rehabilitation resources. In our ASC group, preschool-aged children significantly outnumbered ( p < 0.001) school-aged children. When stratified by the hospital level, district hospitals reported the highest utilization ( p < 0.001). When stratified by region, the highest utilization was in Taipei, whereas the lowest was in the East region ( p < 0.001). The total annual cost, average frequency of visits, utilization of rehabilitation resources, and average cost were all affected by such elements as patient demographics, hospital type and location ( p < 0.001). Conclusions For improving treatment outcomes among children with ASC and decreasing treatment expenditure, policies that promote the timely ASC detection and treatment should be implemented.

Objective: Bipolar disorder is a recurrent disorder for the vast majority of patients, and hospitalization is normally used to control severe symptoms. The goals of treating bipolar disorder include symptomatic remission, full return of psychosocial functioning, and prevention of relapses/recurrences. Rehospitalization, however, becomes necessary with the relapse/recurrence of severe symptoms. The purpose of the present study was therefore to investigate the risk factors affecting the time to rehospitalization. Method: Rehospitalization status was monitored for all patients with bipolar I disorder discharged from Kai-Suan Psychiatric Hospital between 1 January 2002 and 31 December 2004. Patients were followed up with respect to rehospitalization until 31 December 2005. The KaplanÁMeier method was used to calculate the mean time to rehospitalization within 1 year after discharge. Risk factors associated with rehospitalization were examined using Cox proportional hazards regression model. Results: Four hundred and twenty patients were recruited for the study. Two hundred and eleven patients (50.2%) were readmitted, and the mean time to rehospitalization was 231 days (SD 07). Bipolar depression at index hospitalization, age at onset, and the number of previous hospitalizations were found to be predictors for time to rehospitalization. Conclusion: Bipolar depression at index hospitalization, the earlier the onset of an affective episode, and a higher number of previous hospitalizations were associated with a shorter time to rehospitalization. Further studies in this field should test risk factors in a prospective study and be conducted in various mental health systems.

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