A cross-sectional study of prescribing patterns in chronic psychiatric patients living in sheltered housing facilities

Schorr, Susanne Gabriele; Loonen, Antonius; Brouwers, Jacobus; Taxis, Katja

doi:10.5414/cpp46146

Cited by 10 publications

(10 citation statements)

References 24 publications

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“…Compared to earlier studies in the same clinical environment (Tomasi et al 2006;Schorr et al 2008), a significant increase in the use of psychotropic polypharmacy and antipsychotic polypharmacy was observed. According to our results, patients receiving antipsychotic polypharmacy were 77.5% v. 53% (Tomasi et al 2006) and those receiving antipsychotic polypharmacy were 57.2% v. 23% (Schorr et al 2008) and 39.3% (Tomasi et al 2006).…”

Section: Discussioncontrasting

confidence: 79%

“…Recent studies based on psychotropic drug use give rise to growing concern about the trend towards psychotropic and antipsychotic polypharmacy, contrary to treatment recommendations drawn up in international guidelines. An increase in the number of psychotropic medications prescribed over the course of years has been noted in all psychiatric settings: in office-based psychiatric practices (Mojtabai & Olfson, 2010), in hospitals (McCue, Waheed & Urcuyo, 2004; Barbui et al 2005;Centorrino et al 2008) and in residential facilities (Tomasi et al 2006;Schorr et al 2008).…”

Section: Introductionmentioning

confidence: 99%

“…To our knowledge only two recent studies have been conducted, both of them in 2004 (Tomasi et al 2006; Schorr et al 2008), the results of which show a psychotropic polypharmacy rate of 50% (Tomasi et al 2006) and an antipsychotic polypharmacy rate of 25% (Schorr et al 2008) and 39% (Tomasi et al 2006), respectively.…”

Section: Introductionmentioning

confidence: 99%

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Antipsychotic utilisation and polypharmacy in Italian residential facilities: a survey

Ghio

Natta

Gotelli

et al. 2011

Epidemiol Psychiatr Sci

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Objective.To evaluate the prescribing practices in psychiatric residential facilities, with particular focus both on the antipsychotic dose and polypharmacy as well as the variation of antipsychotic patterns during a patient's stay within the facilities.Methods.Fifteen residential facilities of Liguria region in Italy were included. Data were collected through a chart review during a one-day census. Frequency of psychotropic patterns was estimated. Different non-parametric tests were used to analyse the changes in prescription patterns as well as the relationship among antipsychotic dose, the number of antipsychotics and anticholinergic use.Results.The study sample includes 362 patients, 61.9% males. On the census day 77.5% of patients received psychotropic polypharmacy and 57.2% antipsychotic polypharmacy. Antipsychotic polypharmacy was related to the total antipsychotic daily dose and to anticholinergic use. A trend towards an increase of antipsychotic and psychotropic polypharmacy and higher doses of antipsychotics over the period of stay within the facilities was noted. This tendency was related to the length of stay in the facility.Conclusions.Compared to earlier studies in the same clinical environment a significant increase in the use of psychotropic and antipsychotic polypharmacy was observed. The risk of prescribed polypharmacy seems to be related to time spent in the facility.

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Section: Discussioncontrasting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

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Antipsychotic utilisation and polypharmacy in Italian residential facilities: a survey

Ghio

Natta

Gotelli

et al. 2011

Epidemiol Psychiatr Sci

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“…[ 7 9 28 ] This difference in the findings could be due to the difference in the prescribing pattern of psychotropic medications and may be influenced by the number and type of psychiatric patients visiting the OPD as reported in other ADR monitoring studies. [ 29 ]…”

Section: Discussionmentioning

confidence: 99%

Monitoring of adverse drug reactions in psychiatry outpatient department of a Secondary Care Hospital of Ras Al Khaimah, UAE

Sridhar

Al-Thamer

Jabbar

2016

J Basic Clin Pharma

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Background:Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality, resulting in increased healthcare cost. Association of psychotropic medications with ADRs is common. Pharmacovigilance can play a vital role in alerting the healthcare providers from the possible ADRs and thus protecting the patients receiving psychotropic medications.Aim:To monitor and report the incidence and nature of ADRs in psychiatry outpatient department (OPD).Materials and Methods:A prospective observational study was carried out in the psychiatry OPD. All the patients attending psychiatry outpatient and satisfying the inclusion criteria were monitored for ADRs. The causality, severity and preventability assessment of documented ADRs was done. Chi-square test was done to identify the association between ADRs and sociodemographic, disease and treatment-related variables. Paired Student's t-test was carried out to compare the significance difference in the weight of the patients who reported weight gain to psychotropic medications.Results:The incidence rate of ADR was found to be 10.2%. A total of 112 ADRs were documented. Weight gain 18 (16.07%) followed by somnolence 8 (7.14%) was the most commonly reported ADR. Atypical antipsychotics 37 (33.0%) were the most common class of psychotropic drugs implicated in ADRs. Escitalopram 16 (14.28%) followed by quetiapine 14 (12.5%) were associated with a maximum number of ADRs. No significant association (P > 0.05) documented between demographic and treatment-related variables with number of ADRs.Conclusion:Study revealed a moderate incidence of ADRs in patients attending the psychiatry OPD. Majority of the ADRs reported during the study were mild in nature and not preventable type.

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“…Children who receive multiple diagnoses as a result of complex emotional and behavioural problems often are refractory to focal treatment regimens and receive costly and fragmented multiple-component treatment regimens (Comer, Olfson, & Mojtabai, 2010;Grella & Joshi, 2003;Lau & Weisz, 2003;Mueser & Taub, 2008;Saldana et al, 2014). Polypharmacological and/or poly-psychotherapeutic treatment is at best only partially and temporarily effective with chronic and severe psychiatric disorders (Grella & Joshi, 2003;Holtmann et al, 2011;Jacobs et al, 2008;Jucksch et al, 2011) and may lead to severe adverse reactions (Barbui et al, 2007;Luo, Cappelleri, & Frush, 2007;Schorr, Loonen, Brouwers, & Taxis, 2008). Treatment targeted to address trauma-related symptoms could provide a complementary or alternative approach for poly-victimized and poly-diagnosed children and adolescents (D'Andrea et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Comorbidity of developmental trauma disorder (DTD) and post-traumatic stress disorder: findings from the DTD field trial

Kolk

Ford

Spinazzola³

2019

European Journal of Psychotraumatology

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Background: Developmental trauma disorder (DTD) has been proposed to describe the biopsychosocial sequelae of exposure to interpersonal victimization in childhood that extend beyond the symptoms of post-traumatic stress disorder (PTSD).Objective: To characterize the psychopathology comorbid with DTD and to determine whether this comorbidity is distinct from, and extends beyond, comorbidities of PTSD.Method: DTD was assessed by structured interview, and probable Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) psychiatric disorders were identified with screening modules on the Kiddie Schedule for Affective Disorders and Schizophrenia, Present/Lifetime version (K-SADS-PL), in a multi-site sample of 236 children (7–18 years old; 50% female) referred by paediatric or mental health providers.Results: DTD (N = 80, 34%) and PTSD (N = 69, 29%) were highly comorbid and shared several DSM-IV internalizing disorder and DSM, 5th Edition (DSM-5) dysregulation disorder comorbidities. However, DTD, but not PTSD, was associated with comorbid panic disorder and disruptive behaviour disorders. On a multivariate basis including all probable DSM-IV disorders and DSM-5 dysregulation disorders, DTD was associated with separation anxiety disorder and attention deficit hyperactivity disorder after controlling for PTSD, while PTSD was associated with major depression and generalized anxiety disorder after controlling for DTD.Conclusions: DTD’s comorbidities overlap with but extend beyond those of PTSD to include panic, separation anxiety, and disruptive behaviour disorders. DTD warrants further investigation as a potential diagnosis or a complex variant of PTSD in children, similar to the adult symptoms of disturbances of self-organization in the proposed International Classification of Diseases, 11th revision (ICD-11) complex post-traumatic stress disorder subtype.

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A cross-sectional study of prescribing patterns in chronic psychiatric patients living in sheltered housing facilities

Cited by 10 publications

References 24 publications

Antipsychotic utilisation and polypharmacy in Italian residential facilities: a survey

Antipsychotic utilisation and polypharmacy in Italian residential facilities: a survey

Monitoring of adverse drug reactions in psychiatry outpatient department of a Secondary Care Hospital of Ras Al Khaimah, UAE

Comorbidity of developmental trauma disorder (DTD) and post-traumatic stress disorder: findings from the DTD field trial

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