PharmacopsychiatryPub Date : 2024-03-01Epub Date: 2024-03-12DOI: 10.1055/a-2262-8297
Dhouha Sahnoun, Ahlem Ghanmi, Soumaya Gazzeh, Bochra Saguem, Raoudha Slim, Jaafar Nakhli, Chaker Ben Salem
{"title":"Risperidone-Induced Leukoneutropenia: Evidence from a Positive Rechallenge and Review of the Literature.","authors":"Dhouha Sahnoun, Ahlem Ghanmi, Soumaya Gazzeh, Bochra Saguem, Raoudha Slim, Jaafar Nakhli, Chaker Ben Salem","doi":"10.1055/a-2262-8297","DOIUrl":"10.1055/a-2262-8297","url":null,"abstract":"<p><p>Antipsychotics can cause hematologic disorders, and they can have life-threatening consequences. Risperidone, less commonly associated with hematologic adverse effects, is an atypical antipsychotic medication used to treat conditions such as schizophrenia, bipolar disorder and irritability associated with autism. While risperidone primarily affects the central nervous system, it can have some hematologic adverse effects, although these are relatively rare. It is crucial to note that these side effects are not common, and most people taking risperidone do not experience hematologic disorders. The reporting of such disorders may be more frequent with clozapine compared to other atypical antipsychotics because clozapine treatment necessitates regular hematological monitoring 1.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PharmacopsychiatryPub Date : 2024-03-01Epub Date: 2024-02-22DOI: 10.1055/a-2258-0379
Xenia M Hart, Yasue Mitsukura, Robert R Bies, Hiroyuki Uchida
{"title":"Unraveling the Influence of Age, IQ, Education, and Negative Symptoms on Neurocognitive Performance in Schizophrenia: A Conditional Inference Tree Analysis.","authors":"Xenia M Hart, Yasue Mitsukura, Robert R Bies, Hiroyuki Uchida","doi":"10.1055/a-2258-0379","DOIUrl":"10.1055/a-2258-0379","url":null,"abstract":"<p><strong>Introduction: </strong>The complex nature of neurocognitive impairment in schizophrenia has been discussed in light of the mixed effects of antipsychotic drugs, psychotic symptoms, dopamine D<sub>2</sub> receptor blockade, and intelligence quotient (IQ). These factors have not been thoroughly examined before.</p><p><strong>Methods: </strong>This study conducted a comprehensive re-analysis of the CATIE data using machine learning techniques, in particular Conditional Inference Tree (CTREE) analysis, to investigate associations between neurocognitive functions and moderating factors such as estimated trough dopamine D<sub>2</sub> receptor blockade with risperidone, olanzapine, or ziprasidone, Positive and Negative Syndrome Scale (PANSS), and baseline IQ in 573 patients with schizophrenia.</p><p><strong>Results: </strong>The study reveals that <i>IQ, age</i>, and <i>education</i> consistently emerge as significant predictors across all neurocognitive domains. Furthermore, higher severity of <i>PANSS-negative symptoms</i> was associated with lower cognitive performance scores in several domains. CTREE analysis, in combination with a genetic algorithm approach, has been identified as particularly insightful for illustrating complex interactions between variables. Lower neurocognitive function was associated with factors such as age>52 years, IQ<94/95,<12/13 education years, and more pronounced negative symptoms (score<26).</p><p><strong>Conclusions: </strong>These findings emphasize the multifaceted nature of neurocognitive functioning in patients with schizophrenia, with the PANSS-negative score being an important predictor. This gives rise to a role in addressing negative symptoms as a therapeutic objective for enhancing cognitive impairments in these patients. Further research must examine nonlinear relationships among various moderating factors identified in this work, especially the role of D<sub>2</sub> occupancy.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139932317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PharmacopsychiatryPub Date : 2024-01-01Epub Date: 2023-11-23DOI: 10.1055/a-2195-1499
Sigrid Breit, Agnes Meyer, Wolfgang Schmitt, Tobias Bracht, Sebastian Walther
{"title":"The Effect of Electroconvulsive Therapy on Specific Catatonia Symptoms and Predictors of Late Response.","authors":"Sigrid Breit, Agnes Meyer, Wolfgang Schmitt, Tobias Bracht, Sebastian Walther","doi":"10.1055/a-2195-1499","DOIUrl":"10.1055/a-2195-1499","url":null,"abstract":"<p><strong>Introduction: </strong>Electroconvulsive therapy (ECT) is known to be effective in the treatment of catatonia, reaching response rates of about 80 to 100%. It is indicated in cases of treatment resistance to benzodiazepines and in life-threatening conditions such as malignant catatonia. Beneficial effects on specific symptoms or predictors of response are less clear. The objective of this retrospective study is to examine the ECT effect on specific catatonia symptoms in the acute phase of the illness and to identify predictors of response.</p><p><strong>Methods: </strong>A retrospective study examined data from 20 patients with catatonia, 18 associated with schizophrenia and 2 with bipolar disorder, who underwent ECT from 2008 to 2021. Ten subjects had more than one ECT-series, resulting in a total of 31 ECT-series. Catatonia symptom severity was assessed with the Bush Francis Catatonia Rating Scale (BFCRS).</p><p><strong>Results: </strong>ECT yielded excellent response. Nineteen of 20 patients and 30 of 31 ECT-series achieved response. The mean number of ECT sessions to response was 4.2. Response to ECT was more pronounced for motor inhibition symptoms such as stupor and mutism, while echophenomena, dyskinesia, stereotypy and perseveration responded less well. A predictor of late response was the presence of grasp reflex.</p><p><strong>Discussion: </strong>The present study corroborates the high and rapid effectiveness of ECT in the treatment of catatonia. Focus on single catatonia signs may help to identify those who are most likely to achieve remission quickly, as well as those who might need longer ECT-series.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138299809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PharmacopsychiatryPub Date : 2024-01-01Epub Date: 2023-09-18DOI: 10.1055/a-2153-4370
Vincent Eggart, Matin Mortazavi, Sophie-Kathrin Kirchner, Daniel Keeser, Lisa Brandstetter, Alkomiet Hasan, Elias Wagner
{"title":"Association of Four Medication Classes and Non-suicidal Self-injury in Adolescents with Affective Disorders - A Retrospective Chart Review.","authors":"Vincent Eggart, Matin Mortazavi, Sophie-Kathrin Kirchner, Daniel Keeser, Lisa Brandstetter, Alkomiet Hasan, Elias Wagner","doi":"10.1055/a-2153-4370","DOIUrl":"10.1055/a-2153-4370","url":null,"abstract":"<p><strong>Background: </strong>Non-suicidal self-injury (NSSI) behaviour is frequently observed in children and adolescents with psychiatric conditions. Affected individuals are regularly treated with psychotropic drugs, although the impact of these agents on NSSI behaviour remains elusive.</p><p><strong>Methods: </strong>We performed a retrospective chart review from clinical routine data in a large cohort (N=1140) of adolescent inpatients with primary affective and non-affective psychiatric disorders according to ICD-10 (mean age=15.3±1.3 years; 72.6% female). Four separate mixed regression models compared the frequency of NSSI between treatment periods without any medication and four medication categories (benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), high- and low-potency antipsychotics).</p><p><strong>Results: </strong>In those individuals with affective disorders as the primary diagnosis, periods without medication were associated with significantly lower NSSI/day compared to all four other medication conditions (benzodiazepines p<10<sup>-8</sup>, antidepressants/SSRIs p=0.0004, high-potency antipsychotics p=0.0009, low-potency antipsychotics p<10 <sup>-4</sup>). In individuals with a primary diagnosis other than an affective disorder, NSSI was significantly lower during the period without medication compared to the treatment periods with benzodiazepines (p=0.005) and antidepressants/SSRIs (p=0.01). However, NSSI rates in the no-medication condition were comparable to NSSI rates under high-potency (p=0.89) and low-potency antipsychotics (p=0.53).</p><p><strong>Conclusions: </strong>The occurrence of NSSI correlates with the treatment with a psychotropic drug in children and adolescents with psychiatric disorders. Due to the retrospective design, it remains elusive to what extent psychotropic drugs might alter the frequency of NSSI in adolescents or if NSSI might indicate a transdiagnostic feature of more pronounced disease severity.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10308026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PharmacopsychiatryPub Date : 2024-01-01Epub Date: 2023-11-23DOI: 10.1055/a-2197-9635
Peter Nyhuis, Dorothea Mücke, Michael Specka, Norbert Scherbaum
{"title":"Augmentation of Electroconvulsive Therapy with Oral Caffeine: A Retrospective Analysis of 40 Patients with Major Depression.","authors":"Peter Nyhuis, Dorothea Mücke, Michael Specka, Norbert Scherbaum","doi":"10.1055/a-2197-9635","DOIUrl":"10.1055/a-2197-9635","url":null,"abstract":"<p><strong>Objective: </strong>Studies have demonstrated the efficacy of injectable caffeine as an augmentation method in electroconvulsive therapy (ECT). This study investigated whether orally administered caffeine increases seizure duration during ECT.</p><p><strong>Methods: </strong>Medical records of 40 patients treated with a series of ECT were retrospectively analyzed. Patients whose electroencephalogram (EEG) seizure duration had dropped<30 s, or motor seizure duration<15 s were included. They subsequently received oral caffeine (0.2 g) before ECT sessions. Primary outcomes were EEG seizure duration and motor seizure duration, compared with those from the last pre-caffeine session (baseline) and the first five caffeine-augmented sessions. The mental state was assessed with the Global Assessment of Functioning (GAF). In addition, data on maximum heart rate, maximal arterial pressure, and adverse effects were collected.</p><p><strong>Results: </strong>The EEG seizure duration increased by 14.9 s (52%) on average between baseline and the first caffeine-augmented session. The increased length remained widely stable over the subsequent ECT sessions. EEG seizure duration was>30 s in more than 80% of sessions. A statistically significant increase in motor seizure duration appeared only in the 2<sup>nd</sup> and 3<sup>rd</sup> of five sessions with augmentation. Oral caffeine pretreatment was overall well tolerated. The percentage of patients with at least serious mental impairment (GAF score≤50) dropped from 77.5 to 15%.</p><p><strong>Conclusions: </strong>Results suggest the utility of oral caffeine (0.2 g) to increase ECT-induced seizures in patients with durations below clinically significant thresholds.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138299808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PharmacopsychiatryPub Date : 2024-01-01Epub Date: 2023-10-16DOI: 10.1055/a-2179-8884
Kengo Yonezawa, Hiroyuki Uchida, Taisuke Yatomi, Yohei Ohtani, Kie Nomoto-Takahashi, Shinichiro Nakajima, Masaru Mimura, Hideaki Tani
{"title":"Factors Associated with Antidepressant Effects of Ketamine: A Reanalysis of Double-Blind Randomized Placebo-Controlled Trial of Intravenous Ketamine for Treatment-Resistant Depression.","authors":"Kengo Yonezawa, Hiroyuki Uchida, Taisuke Yatomi, Yohei Ohtani, Kie Nomoto-Takahashi, Shinichiro Nakajima, Masaru Mimura, Hideaki Tani","doi":"10.1055/a-2179-8884","DOIUrl":"10.1055/a-2179-8884","url":null,"abstract":"<p><strong>Introduction: </strong>Predictors of treatment response to intravenous ketamine remain unclear in patients with treatment-resistant depression (TRD); therefore, this study aimed to clarify these predictors using the US National Institutes of Health database of clinical trials.</p><p><strong>Methods: </strong>Data from a placebo-controlled, double-blind, randomized controlled trial were used to assess the efficacy of intravenous ketamine in adult patients with TRD (NCT01920555). For the analysis, data were used from the participants who had received therapeutic doses of intravenous ketamine (i. e., 0.5 and 1.0 mg/kg). Logistic and multivariable regression analyses were conducted to explore the demographic and clinical factors associated with response to treatment or changes in the Hamilton Depression Rating Scale 6 items (HAM-D-6) total score.</p><p><strong>Results: </strong>This study included 31 patients with TRD (13 women; mean±standard deviation age, 48.4±10.9 years). Logistic regression analysis showed that the age of onset was positively correlated with treatment response after three days of ketamine administration (β=0.08, p=0.037); however, no association was observed between treatment response and age, sex, baseline HAM-D-6 total score, or dissociative score assessed with the Clinician-Administered Dissociative States Scale 40 min after ketamine infusion. Multiple regression analysis showed that no factors were correlated significantly with the percentage change in the HAM-D-6 total score three days after ketamine administration.</p><p><strong>Discussion: </strong>Later disease onset correlates with a better treatment response three days after ketamine infusion in patients with TRD. Glutamatergic signal transmission may be impaired in patients with an earlier onset of depression, resulting in decreased neuroplasticity, which diminishes ketamine response.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41237454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PharmacopsychiatryPub Date : 2024-01-01Epub Date: 2023-12-05DOI: 10.1055/a-2190-4842
Julian Wellensiek, Michael Specka, Johannes Just, Markus Banger, Udo Bonnet, Norbert Scherbaum
{"title":"Patient Perspectives on Pharmacotherapy of Alcohol Dependence.","authors":"Julian Wellensiek, Michael Specka, Johannes Just, Markus Banger, Udo Bonnet, Norbert Scherbaum","doi":"10.1055/a-2190-4842","DOIUrl":"10.1055/a-2190-4842","url":null,"abstract":"<p><strong>Introduction: </strong>Pharmacotherapy with drugs like naltrexone or acamprosate is a well-evaluated element in the treatment of alcohol dependence (AD). However, in many countries, these medications are rarely administered. The objective of the present study was to identify from patients' perspective factors that prevent the initiation and compliance with pharmacological treatment of AD.</p><p><strong>Methods: </strong>Patients from inpatient alcohol withdrawal treatment underwent a standardized interview. Questions included socio-demographic data, history of AD, treatment history, knowledge and personal experience regarding pharmacotherapy of AD, and personal views about the causes of AD.</p><p><strong>Results: </strong>Three hundred patients (mean age 47.3 years, 27.7% female, mean duration of AD 8.9 years, 67% with a history of previous inpatient withdrawal treatment) were included. The majority of patients (58.7%) already knew drugs for the pharmacotherapy of AD. Thirty percent had ever used such medications, most often acamprosate. Except for disulfiram, pharmacotherapy of AD had lasted only a few weeks, on average. Medication usually had been applied without additional psychotherapy. No severe side effects were reported. Patients had often stopped pharmacotherapy on their own, when assuming they had reached stable abstinence. Openness to start pharmacotherapy for AD was currently stated by 67% of the total sample. In multiple logistic regression, openness was predicted by having a concept of AD as a medical disease and by a shorter duration of AD.</p><p><strong>Discussion: </strong>To improve the administration of pharmacotherapy for AD implementation strategies should be systematically developed and evaluated with a focus on the concept of AD as a medical disease.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PharmacopsychiatryPub Date : 2023-11-01Epub Date: 2023-08-29DOI: 10.1055/a-2142-9325
Scott Monteith, Tasha Glenn, John R Geddes, Eric D Achtyes, Peter C Whybrow, Michael Bauer
{"title":"Challenges and Ethical Considerations to Successfully Implement Artificial Intelligence in Clinical Medicine and Neuroscience: a Narrative Review.","authors":"Scott Monteith, Tasha Glenn, John R Geddes, Eric D Achtyes, Peter C Whybrow, Michael Bauer","doi":"10.1055/a-2142-9325","DOIUrl":"10.1055/a-2142-9325","url":null,"abstract":"Abstract This narrative review discusses how the safe and effective use of clinical artificial intelligence (AI) prediction tools requires recognition of the importance of human intelligence. Human intelligence, creativity, situational awareness, and professional knowledge, are required for successful implementation. The implementation of clinical AI prediction tools may change the workflow in medical practice resulting in new challenges and safety implications. Human understanding of how a clinical AI prediction tool performs in routine and exceptional situations is fundamental to successful implementation. Physicians must be involved in all aspects of the selection, implementation, and ongoing product monitoring of clinical AI prediction tools.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10115210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PharmacopsychiatryPub Date : 2023-11-01Epub Date: 2023-09-12DOI: 10.1055/a-2154-0828
Isabella Berardelli, Elena Rogante, Salvatore Sarubbi, Maria Anna Trocchia, Ludovica Longhini, Denise Erbuto, Marco Innamorati, Maurizio Pompili
{"title":"Interpersonal Needs, Mental Pain, and Hopelessness in Psychiatric Inpatients with Suicidal Ideation.","authors":"Isabella Berardelli, Elena Rogante, Salvatore Sarubbi, Maria Anna Trocchia, Ludovica Longhini, Denise Erbuto, Marco Innamorati, Maurizio Pompili","doi":"10.1055/a-2154-0828","DOIUrl":"10.1055/a-2154-0828","url":null,"abstract":"<p><strong>Introduction: </strong>Suicide is a leading cause of death worldwide and models may help the understanding of the phenomenon and ultimately reduce its burden through effective suicide prevention strategies. The Interpersonal Theory of Suicide and Shneidman's Model have tried to describe different unmet needs related to suicidal ideation. The study aims to assess the association between thwarted belongingness, perceived burdensomeness, and suicidal ideation in a sample of psychiatric inpatients and the mediating role of hopelessness and mental pain in this association.</p><p><strong>Methods: </strong>112 consecutive adult psychiatric inpatients were administered the Columbia Suicide Severity Rating Scale (C-SSRS), the Italian version of the Interpersonal Needs Questionnaire-15-I (INQ-15-I), the Physical and Psychological Pain Scale, and the Beck Hopelessness Scale (BHS).</p><p><strong>Results: </strong>Mediation models indicated a significant indirect effect of perceived burdensomeness (with thwarted belongingness as covariates) on suicidal ideation intensity with hopelessness as a mediator. When thwarted belongingness (controlling for perceived burdensomeness as a covariate) was included in a model as an independent variable, direct and indirect effects on suicidal ideation intensity were not significant.</p><p><strong>Conclusions: </strong>Psychosocial interventions focusing on identifying and decreasing the perception of being a burden for others and the feeling hopeless could represent a powerful pathway for reducing suicidal ideation. Moreover, the attention toward unmet interpersonal needs may help increase and focus clinical discussions on risk factors, which may help engagement toward psychiatric care and downsize the stigma related to suicide. Raising awareness toward mental health topics is a goal of healthcare services globally.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10226759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PharmacopsychiatryPub Date : 2023-11-01Epub Date: 2023-11-09DOI: 10.1055/a-2177-3056
Juliane K Mueller, Kira F Ahrens, Michael Bauer, Bernhard T Baune, Stefan Borgwardt, Jürgen Deckert, Katharina Domschke, Regina Ellwanger, Andreas Fallgatter, Thomas Frodl, Jürgen Gallinat, René Gottschalk, Hans J Grabe, Alkomiet Hasan, Sabine C Herpertz, Rene Hurlemann, Frank Jessen, Joseph Kambeitz, Tilo Kircher, Johannes Kornhuber, Klaus Lieb, Andreas Meyer-Lindenberg, Rainer Rupprecht, Norbert Scherbaum, Christiane Schlang, Anja Schneider, Georg Schomerus, Andreas Thoma, Stefan Unterecker, Martin Walter, Henrik Walter, Andreas Reif, Christine Reif-Leonhard
{"title":"Prevalence of COVID-19 and Psychotropic Drug Treatment in Psychiatric In-patients in Germany in 2020: Results from a Nationwide Pilot Survey.","authors":"Juliane K Mueller, Kira F Ahrens, Michael Bauer, Bernhard T Baune, Stefan Borgwardt, Jürgen Deckert, Katharina Domschke, Regina Ellwanger, Andreas Fallgatter, Thomas Frodl, Jürgen Gallinat, René Gottschalk, Hans J Grabe, Alkomiet Hasan, Sabine C Herpertz, Rene Hurlemann, Frank Jessen, Joseph Kambeitz, Tilo Kircher, Johannes Kornhuber, Klaus Lieb, Andreas Meyer-Lindenberg, Rainer Rupprecht, Norbert Scherbaum, Christiane Schlang, Anja Schneider, Georg Schomerus, Andreas Thoma, Stefan Unterecker, Martin Walter, Henrik Walter, Andreas Reif, Christine Reif-Leonhard","doi":"10.1055/a-2177-3056","DOIUrl":"10.1055/a-2177-3056","url":null,"abstract":"<p><strong>Introduction: </strong>In patients with a pre-existing mental disorder, an increased risk for a first manifestation of a psychiatric disorder in COVID-19 patients, a more severe course of COVID-19 and an increased mortality have been described. Conversely, observations of lower COVID-19 incidences in psychiatric in-patients suggested protective effects of psychiatric treatment and/or psychotropic drugs against COVID-19.</p><p><strong>Methods: </strong>A retrospective multi-center study was conducted in 24 German psychiatric university hospitals. Between April and December 2020 (the first and partly second wave of COVID-19), the effects of COVID-19 were assessed on psychiatric in-patient care, the incidence and course of a SARS-CoV-2 infection, and treatment with psychotropic drugs.</p><p><strong>Results: </strong>Patients (n=36,322) were admitted to the hospitals. Mandatory SARS-CoV-2 tests before/during admission were reported by 23 hospitals (95.8%), while 18 (75%) conducted regular testing during the hospital stay. Two hundred thirty-two (0.6%) patients were tested SARS-CoV-2-positive. Thirty-seven (16%) patients were receiving medical treatment for COVID-19 at the psychiatric hospital, ten (4.3%) were transferred to an intermediate/intensive care unit, and three (1.3%) died. The most common prescription for SARS-CoV-2-positive patients was for second-generation antipsychotics (n=79, 28.2%) and antidepressants (SSRIs (n=38, 13.5%), mirtazapine (n=36, 12.9%) and SNRIs (n=29, 10.4%)).</p><p><strong>Discussion: </strong>Contrary to previous studies, our results showed a low number of infections and mortality in SARS-CoV-2-positive psychiatric patients. Several preventive measures seem effective to protect this vulnerable group. Our observations are compatible with the hypothesis of a protective effect of psychotropic drugs against COVID-19 as the overall mortality and need for specific medical treatment was low.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72015031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}