Acta Neuropsychiatrica最新文献

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Systematic review of gene expression studies in people with Lewy body dementia. 路易体痴呆患者基因表达研究的系统综述。
IF 3.8 4区 医学
Acta Neuropsychiatrica Pub Date : 2020-12-01 Epub Date: 2020-03-17 DOI: 10.1017/neu.2020.13
Anisa Chowdhury, Anto P Rajkumar
{"title":"Systematic review of gene expression studies in people with Lewy body dementia.","authors":"Anisa Chowdhury,&nbsp;Anto P Rajkumar","doi":"10.1017/neu.2020.13","DOIUrl":"https://doi.org/10.1017/neu.2020.13","url":null,"abstract":"<p><strong>Objectives: </strong>Lewy body dementia (LBD) is the second most prevalent neurodegenerative dementia and it causes more morbidity and mortality than Alzheimer's disease. Several genetic associations of LBD have been reported and their functional implications remain uncertain. Hence, we aimed to do a systematic review of all gene expression studies that investigated people with LBD for improving our understanding of LBD molecular pathology and for facilitating discovery of novel biomarkers and therapeutic targets for LBD.</p><p><strong>Methods: </strong>We systematically reviewed five online databases (PROSPERO protocol: CRD42017080647) and assessed the functional implications of all reported differentially expressed genes (DEGs) using Ingenuity Pathway Analyses.</p><p><strong>Results: </strong>We screened 3,809 articles and identified 31 eligible studies. In that, 1,242 statistically significant (p < 0.05) DEGs including 70 microRNAs have been reported in people with LBD. Expression levels of alternatively spliced transcripts of SNCA, SNCB, PRKN, APP, RELA, and ATXN2 significantly differ in LBD. Several mitochondrial genes and genes involved in ubiquitin proteasome system and autophagy-lysosomal pathway were significantly downregulated in LBD. Evidence supporting chronic neuroinflammation in LBD was inconsistent. Our functional analyses highlighted the importance of ribonucleic acid (RNA)-mediated gene silencing, neuregulin signalling, and neurotrophic factors in the molecular pathology of LBD.</p><p><strong>Conclusions: </strong>α-synuclein aggregation, mitochondrial dysfunction, defects in molecular networks clearing misfolded proteins, and RNA-mediated gene silencing contribute to neurodegeneration in LBD. Larger longitudinal transcriptomic studies investigating biological fluids of people living with LBD are needed for molecular subtyping and staging of LBD. Diagnostic biomarker potential and therapeutic promise of identified DEGs warrant further research.</p>","PeriodicalId":48964,"journal":{"name":"Acta Neuropsychiatrica","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/neu.2020.13","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37742338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Monocyte count in schizophrenia and related disorders: a systematic review and meta-analysis. 单核细胞计数在精神分裂症和相关疾病中的作用:一项系统综述和荟萃分析。
IF 3.8 4区 医学
Acta Neuropsychiatrica Pub Date : 2020-10-01 Epub Date: 2020-03-17 DOI: 10.1017/neu.2020.12
Mario Gennaro Mazza, Martina Capellazzi, Sara Lucchi, Ilaria Tagliabue, Aurora Rossetti, Massimo Clerici
{"title":"Monocyte count in schizophrenia and related disorders: a systematic review and meta-analysis.","authors":"Mario Gennaro Mazza,&nbsp;Martina Capellazzi,&nbsp;Sara Lucchi,&nbsp;Ilaria Tagliabue,&nbsp;Aurora Rossetti,&nbsp;Massimo Clerici","doi":"10.1017/neu.2020.12","DOIUrl":"https://doi.org/10.1017/neu.2020.12","url":null,"abstract":"<p><strong>Objective: </strong>Increasing evidence suggests that immunological and inflammatory dysfunctions may play an important role in predisposition, onset, and progression of schizophrenia and related psychosis. The activation of cells of the mononuclear phagocyte system, especially microglia and monocytes, has been reported in schizophrenia. We carried out this systematic review and meta-analysis to investigate if there are significant differences in monocyte count comparing healthy controls with people suffering from schizophrenia and related disorders.</p><p><strong>Methods: </strong>We searched main electronic databases; nine records met all our criteria and were included in the meta-analysis. Meta-analyses based on random effects models have been carried out generating pooled standardised mean differences (SMDs) of monocyte count in peripheral blood between schizophrenia and related psychosis and healthy controls. Heterogeneity was estimated. Relevant sensitivity and subgroup analyses were conducted.</p><p><strong>Results: </strong>Patients showed higher monocyte count as compared with healthy control (SMD = 0.393; p = 0.001). Heterogeneity across studies was from moderate to high (I2 = 65.952%); sensitivity analysis leaving out two studies responsible for most of the heterogeneity showed a slightly higher SMD. Subgroup analyses confirmed this result, showing no significant differences in the effect size across different study characteristics.</p><p><strong>Conclusions: </strong>Monocyte count can be considered an indirect marker of microglia activation in the central nervous system. Thus, the observed higher monocyte count in patients could be considered as a possible peripheral marker of microglia's activation in schizophrenia disorder.</p>","PeriodicalId":48964,"journal":{"name":"Acta Neuropsychiatrica","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/neu.2020.12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37742340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 19
How to increase the role of social workers in suicide preventive interventions. 如何提高社会工作者在自杀预防干预中的作用。
IF 3.8 4区 医学
Acta Neuropsychiatrica Pub Date : 2020-08-01 Epub Date: 2020-03-16 DOI: 10.1017/neu.2020.11
Joshua Levine, Leo Sher
{"title":"How to increase the role of social workers in suicide preventive interventions.","authors":"Joshua Levine,&nbsp;Leo Sher","doi":"10.1017/neu.2020.11","DOIUrl":"https://doi.org/10.1017/neu.2020.11","url":null,"abstract":"<p><strong>Objective: </strong>Suicide is a serious public health issue that affects individuals, families and societies all over the world. International studies provide consistent evidence that the presence of psychiatrists in a region is associated with lesser suicide rates. However, many psychiatric patients including suicidal patients do not have access to psychiatrists. This indicates that mental health and non-mental health social workers need to be involved in suicide prevention efforts. This paper is the first comprehensive work that discusses how to increase the role of social workers in the area of suicide prevention.</p><p><strong>Methods: </strong>A review of the relevant literature.</p><p><strong>Results: </strong>Increasing the role of social workers in suicide prevention efforts may reduce suicide risk in groups and people at elevated risk for suicide, as well as the general population.</p><p><strong>Conclusion: </strong>Recommendations are provided for how the social work profession can improve upon suicide prevention while incorporating universal, selective and indicated suicide preventive interventions. Social work research efforts should focus on how to increase the role of social workers in suicide prevention and the management of suicidal patients. Social work education programmes should modify their curricula and increase their attention on suicide prevention. Mental health social workers need to educate the patient and their family on suicide risk factors. Furthermore, mental health and non-mental health social workers need to educate the general public on suicide risk factors.</p>","PeriodicalId":48964,"journal":{"name":"Acta Neuropsychiatrica","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/neu.2020.11","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37739089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
The depressive state of Denmark during the COVID-19 pandemic. COVID-19大流行期间丹麦的抑郁状态。
IF 3.8 4区 医学
Acta Neuropsychiatrica Pub Date : 2020-08-01 Epub Date: 2020-04-22 DOI: 10.1017/neu.2020.15
Kim Mannemar Sønderskov, Peter Thisted Dinesen, Ziggi Ivan Santini, Søren Dinesen Østergaard
{"title":"The depressive state of Denmark during the COVID-19 pandemic.","authors":"Kim Mannemar Sønderskov,&nbsp;Peter Thisted Dinesen,&nbsp;Ziggi Ivan Santini,&nbsp;Søren Dinesen Østergaard","doi":"10.1017/neu.2020.15","DOIUrl":"https://doi.org/10.1017/neu.2020.15","url":null,"abstract":"1Department of Political Science, Aarhus University, Aarhus, Denmark; 2Department of Political Science, University of Copenhagen, Copenhagen, Denmark; 3The Danish National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; 4Department of Affective Disorders, Aarhus University Hospital – Psychiatry, Aarhus, Denmark and 5Department of Clinical Medicine, Aarhus University, Aarhus, Denmark","PeriodicalId":48964,"journal":{"name":"Acta Neuropsychiatrica","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/neu.2020.15","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37859090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 252
Association between GLP-1 receptor gene polymorphisms with reward learning, anhedonia and depression diagnosis. GLP-1受体基因多态性与奖励学习、快感缺乏和抑郁症诊断的关系
IF 3.8 4区 医学
Acta Neuropsychiatrica Pub Date : 2020-08-01 Epub Date: 2020-03-26 DOI: 10.1017/neu.2020.14
Hale Yapici-Eser, Vivek Appadurai, Candan Yasemin Eren, Dilek Yazici, Chia-Yen Chen, Dost Öngür, Diego A Pizzagalli, Thomas Werge, Mei-Hua Hall
{"title":"Association between GLP-1 receptor gene polymorphisms with reward learning, anhedonia and depression diagnosis.","authors":"Hale Yapici-Eser,&nbsp;Vivek Appadurai,&nbsp;Candan Yasemin Eren,&nbsp;Dilek Yazici,&nbsp;Chia-Yen Chen,&nbsp;Dost Öngür,&nbsp;Diego A Pizzagalli,&nbsp;Thomas Werge,&nbsp;Mei-Hua Hall","doi":"10.1017/neu.2020.14","DOIUrl":"https://doi.org/10.1017/neu.2020.14","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptors (GLP-1Rs) are widely expressed in the brain. Evidence suggests that they may play a role in reward responses and neuroprotection. However, the association of GLP-1R with anhedonia and depression diagnosis has not been studied. Here, we examined the association of GLP-1R polymorphisms with objective and subjective measures of anhedonia, as well as depression diagnosis.</p><p><strong>Methods: </strong>Objective [response bias assessed by the probabilistic reward task (PRT)] and subjective [Snaith-Hamilton Pleasure Scale (SHAPS)] measures of anhedonia, clinical variables and DNA samples were collected from 100 controls and 164 patients at McLean Hospital. An independent sample genotyped as part of the Psychiatric Genomics Consortium (PGC) was used to study the effect of putative GLP-1R polymorphisms linked to response bias in PRT on depression diagnosis.</p><p><strong>Results: </strong>The C allele in rs1042044 was significantly associated with increased PRT response bias, when controlling for age, sex, case-control status and PRT discriminability. AA genotype of rs1042044 showed higher anhedonia phenotype based on SHAPS scores. However, analysis of PGC major depressive disorder data showed no association between rs1042044 and depression diagnosis.</p><p><strong>Conclusion: </strong>Findings suggest a possible association of rs1042044 with anhedonia but no association with depression diagnosis.</p>","PeriodicalId":48964,"journal":{"name":"Acta Neuropsychiatrica","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/neu.2020.14","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37771908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Pharmacological treatments for social anxiety disorder in adults: a systematic review and network meta-analysis. 成人社交焦虑障碍的药物治疗:系统综述和网络荟萃分析。
IF 3.8 4区 医学
Acta Neuropsychiatrica Pub Date : 2020-08-01 Epub Date: 2020-02-10 DOI: 10.1017/neu.2020.6
Taryn Williams, Michael McCaul, Guido Schwarzer, Andrea Cipriani, Dan J Stein, Jonathan Ipser
{"title":"Pharmacological treatments for social anxiety disorder in adults: a systematic review and network meta-analysis.","authors":"Taryn Williams,&nbsp;Michael McCaul,&nbsp;Guido Schwarzer,&nbsp;Andrea Cipriani,&nbsp;Dan J Stein,&nbsp;Jonathan Ipser","doi":"10.1017/neu.2020.6","DOIUrl":"https://doi.org/10.1017/neu.2020.6","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this paper was to provide a systematic review and update on the pharmacotherapy of social anxiety disorder (SAD), including the efficacy and tolerability of these agents, the ranking of interventions, and the grading of results by quality of evidence.</p><p><strong>Methods: </strong>The Common Mental Disorder Controlled Trial Register and two trial registries were searched for randomised controlled trials (RCTs) comparing any pharmacological intervention or placebo in the treatment of SAD. We performed a standard pairwise meta-analysis using a random effects model and carried out a network meta-analysis (NMA) using the statistical package, R. Quality of evidence was also assessed.</p><p><strong>Results: </strong>We included 67 RCTs in the review and 21 to 45 interventions in the NMA. Paroxetine was most effective in the reduction of symptom severity as compared to placebo. Superior response to treatment was also observed for paroxetine, brofaromine, bromazepam, clonazepam, escitalopram, fluvoxamine, phenelzine, and sertraline. Higher dropout rates were found for fluvoxamine. Brofaromine, escitalopram, fluvoxamine, paroxetine, pregabalin, sertraline, and venlafaxine performed worse in comparison to placebo for the outcome of dropouts due to adverse events. Olanzapine yielded a relatively high rank for treatment efficacy and buspirone the worse rank for dropouts due to any cause.</p><p><strong>Conclusion: </strong>The differences between drugs and placebo were small, apart from a significant reduction in symptom severity and response for paroxetine. We suggest paroxetine as a first-line treatment of SAD, with the consideration of future research on the drug olanzapine as well as brofaromine, bromazepam, clonazepam, escitalopram, fluvoxamine, phenelzine, and sertraline because we observed a response to treatment.</p>","PeriodicalId":48964,"journal":{"name":"Acta Neuropsychiatrica","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/neu.2020.6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37627536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 14
Auditory brainstem response (ABR) profiling in schizoaffective disorder. 分裂情感性障碍的听觉脑干反应(ABR)分析。
IF 3.8 4区 医学
Acta Neuropsychiatrica Pub Date : 2020-08-01 Epub Date: 2020-02-17 DOI: 10.1017/neu.2020.7
Eva Juselius Baghdassarian, Tommy Lewander
{"title":"Auditory brainstem response (ABR) profiling in schizoaffective disorder.","authors":"Eva Juselius Baghdassarian,&nbsp;Tommy Lewander","doi":"10.1017/neu.2020.7","DOIUrl":"https://doi.org/10.1017/neu.2020.7","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to assess whether the auditory brainstem response (ABR) profiling test for schizophrenia (SZ) would recognise schizoaffective disorder (SZA) patients as SZ or not.</p><p><strong>Method: </strong>Male and female SZA patients (n = 16) from the psychosis unit at Uppsala University Hospital were investigated. Coded sets of randomised ABR recordings intermingled with patients with SZ, adult attention-deficit hyperactivity disorder (ADHD) and healthy controls were analysed by an independent party blinded to clinical diagnoses.</p><p><strong>Results: </strong>The ABR profiling test for SZ was positive in 5/16 patients (31%) and negative in 11/16 patients (69%) with SZA. A surprising finding was that 4/16 (25%) SZA patients were positive for the ABR profiling test for ADHD.</p><p><strong>Conclusion: </strong>With the ABR profiling test, a minority of patients with SZA tested positive for SZ. In contrast, a majority (85%) of patients with SZ in a previous study tested positive. These preliminary results leave us ignorant whether SZA should be regarded as a SZ-like disorder or a psychotic mood disorder and add to the questions regarding the validity of this diagnostic entity. However, the ABR profiling method is still in its infancy and its exploration in a range of psychiatric disorders is warranted.</p>","PeriodicalId":48964,"journal":{"name":"Acta Neuropsychiatrica","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/neu.2020.7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37648522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Expression of 22 serotonin-related genes in rat brain after sub-acute serotonin depletion or reuptake inhibition. 亚急性血清素消耗或再摄取抑制后大鼠大脑中 22 个血清素相关基因的表达。
IF 3.8 4区 医学
Acta Neuropsychiatrica Pub Date : 2020-02-17 DOI: 10.1017/neu.2020.9
Jakob Näslund, Erik Studer, Staffan Nilsson, Elias Eriksson
{"title":"Expression of 22 serotonin-related genes in rat brain after sub-acute serotonin depletion or reuptake inhibition.","authors":"Jakob Näslund, Erik Studer, Staffan Nilsson, Elias Eriksson","doi":"10.1017/neu.2020.9","DOIUrl":"10.1017/neu.2020.9","url":null,"abstract":"<p><strong>Objective: </strong>Although the assessment of expression of serotonin-related genes in experimental animals has become a common strategy to shed light on variations in brain serotonergic function, it remains largely unknown to what extent the manipulation of serotonin levels causes detectable changes in gene expression. We therefore chose to investigate how sub-acute depletion or elevation of brain serotonin influences the expression of a number of serotonin-related genes in six brain areas.</p><p><strong>Methods: </strong>Male Wistar rats were administered a serotonin synthesis inhibitor, para-chlorophenylalanine (p-CPA), or a serotonin reuptake inhibitor, paroxetine, for 3 days and then sacrificed. The expression of a number of serotonin-related genes in the raphe nuclei, hypothalamus, amygdala, striatum, hippocampus and prefrontal cortex was investigated using real-time quantitative PCR (rt-qPCR).</p><p><strong>Results: </strong>While most of the studied genes were uninfluenced by paroxetine treatment, we could observe a robust downregulation of tryptophan hydroxylase-2 in the brain region where the serotonergic cell bodies reside, that is, the raphe nuclei. p-CPA induced a significant increase in the expression of Htr1b and Htr2a in amygdala and of Htr2c in the striatum and a marked reduction in the expression of Htr6 in prefrontal cortex; it also enhanced the expression of the brain-derived neurotrophic factor (Bdnf) in raphe and hippocampus.</p><p><strong>Conclusion: </strong>With some notable exceptions, the expression of most of the studied genes is left unchanged by short-term modulation of extracellular levels of serotonin.</p>","PeriodicalId":48964,"journal":{"name":"Acta Neuropsychiatrica","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2020-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37648518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disregard the authorship criteria or perish. 无视作者标准,否则就会灭亡。
IF 3.8 4区 医学
Acta Neuropsychiatrica Pub Date : 2020-02-17 DOI: 10.1017/neu.2020.10
Søren Dinesen Østergaard
{"title":"Disregard the authorship criteria or perish.","authors":"Søren Dinesen Østergaard","doi":"10.1017/neu.2020.10","DOIUrl":"10.1017/neu.2020.10","url":null,"abstract":"","PeriodicalId":48964,"journal":{"name":"Acta Neuropsychiatrica","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2020-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37647599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post hoc analysis of a randomised, placebo-controlled, active-reference 6-week study of brexpiprazole in acute schizophrenia. 对布来哌唑治疗急性精神分裂症的一项为期 6 周的随机、安慰剂对照、活性参考研究进行事后分析。
IF 3.8 4区 医学
Acta Neuropsychiatrica Pub Date : 2020-02-14 DOI: 10.1017/neu.2020.8
Stephen R Marder, Hans Eriksson, Yudong Zhao, Mary Hobart
{"title":"<i>Post hoc</i> analysis of a randomised, placebo-controlled, active-reference 6-week study of brexpiprazole in acute schizophrenia.","authors":"Stephen R Marder, Hans Eriksson, Yudong Zhao, Mary Hobart","doi":"10.1017/neu.2020.8","DOIUrl":"10.1017/neu.2020.8","url":null,"abstract":"<p><strong>Objective: </strong>We provide a closer look at the result of a randomised, placebo-controlled, active-reference (quetiapine XR), flexible-dose, 6-week study of brexpiprazole in schizophrenia, which did not meet its primary endpoint - change from baseline in Positive and Negative Syndrome Scale (PANSS) total score. We also investigate potential expectancy bias from the well-known side-effect profile of the active reference that could have affected the study outcome.</p><p><strong>Methods: </strong>Pre-specified sensitivity analyses of the primary end point were performed using analysis of covariance (ANCOVA) last observation carried forward (LOCF) and observed cases (OC). Post hoc analyses of change from baseline in PANSS total score were performed using the mixed model for repeated measures approach with treatment groups split by having typical adverse events with potential for functional unblinding, for example, somnolence, increase in weight, dizziness, dry mouth and sedation.</p><p><strong>Results: </strong>Pre-specified sensitivity analyses showed separation from placebo for brexpiprazole at week 6: LOCF, ANCOVA: -4.3 [95% CI (-8.0, -0.5), p = 0.0254]. OC, ANCOVA: -3.9 [95% CI (-7.3, -0.5), p = 0.0260]. Patients treated with brexpiprazole experiencing typical adverse events with potential for functional unblinding before or at Week 2 had a least square (LS) mean PANSS change of -29.5 (improvement), with a difference in change from baseline to Week 6 in PANSS total score between brexpiprazole and placebo of -13.5 [95% CI (-23.1, -4.0), p = 0.0057], and those who did not had an LS mean change of -18.9 and a difference between brexpiprazole and placebo of -2.9 [95% CI (-7.2, 1.4), p = 0.1809].</p><p><strong>Conclusion: </strong>Pre-specified sensitivity analyses showed separation from placebo for brexpiprazole at Week 6. A post hoc analysis suggested a potential confounding of efficacy rating towards symptom improvement in patients who experience known side effects of quetiapine XR.</p>","PeriodicalId":48964,"journal":{"name":"Acta Neuropsychiatrica","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2020-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37640499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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