Method: A 43 patients group, 30 male and 13 female, mean age 42.1, admitted during an acute phase of chronic schizophrenia (DSM-IV-TR), were distributed on flexible dose of olanzapine (N¼12) 10-20 mg/day, aripiprazole (N¼11) 15-30 mg/day, risperidone (N¼10) 4-8 mg/day or haloperidol (N¼10) 10-20 mg/day. Weight, fasting glucose and HDL-cholesterol were weekly monitored during the first month and monthly after that. Inclusion criteria: baseline glucose and HDL-cholesterol levels within normal range. Exclusion criteria: familial history of diabetus mellitus or obesity. Results: Regarding the weight gain, the safest antipsychotic is aripiprazole (+0.4+/-0.2 kg at endpoint), followed by haloperidol (+1.9+/-0.2 kg), while olanzapine (+5.6+/-1.1 kg) and risperidone (+3.4+/-0.5 kg) are less tolerated. The glucose level >125 mg/dl was observed at endpoint in 3 patients with risperidone, 6 with olanzapine, 2 with haloperidol. The HDL-cholesterol over 40 mg/dl (men) and over 50 mg/dl (female) appeared in 4 cases of olanzapine and 3 cases of risperidone treated patients. Conclusions: There are quantitative differences in the level of weight gain, HDL-cholesterol and glucose level induced by antipsychotics. The safest antipsychotic agent is aripiprazole because it doesn't induce significant weight gain or other metabolic complications.

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Lost to follow up in psychiatric practice represents a serious problem. Patients who are not cared often will worsen, are linked to more hospitalizations, risk of violence and higher cost for the community.During three months we collect data of all new patients who were known from a psychiatric outpatient clinic located in the 14th district of Paris. We provide seven days a week free psychiatric care (medical, nurse and social consultations, treatment delivery, psychotherapy…). More than half of the nearly 2,700 annual outpatients are diagnosed with psychosis.The future of 298 contacts with our structure has been studied.209 first appointments have been given after a first contact. The non attendance rate of the 209 is 11%. Women and patients who have called by themselves without medical prescription are overrepresented in this first category of patientson the 185 attending patients, 167 were given an appointment with a psychiatrist. The non attendance rate is 13%. Men are overrepresented in this second category of patientson the 145 patients attending their appointment with the psychiatrist. 120 were given a second appointment with a psychiatrist. 6% of them did not attend itWe aim to set up a strategy to make the lost to follow up rate to decrease.Simple actions that have shown evidence are now routinely implemented, as computerized traceability of patients' pathway, from the first contact to the follow-up.Prevention aim of our mission for chronic disease: lost to follow up / lost of chance.