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Biomedical subjects

G E Hogarty

Publications and source records attributed to G E Hogarty.

At least 37 records · Page 2Linked to original sources
PubMed1984

Differences in the nature of relapse and subsequent inpatient course between medication-compliant and noncompliant schizophrenic patients.

Two subgroups of relapsed and rehospitalized schizophrenic patients were separated on the basis of preadmission compliance or noncompliance with prescribed antipsychotic medications. Noncompliant patients had a gradual onset of episode with prominent psychotic features, required involuntary commitment, and remained in hospital longer. Compliant patients had a rapid onset of symptoms with prominent affective features (anxiety and depression) which were frequently associated with environmental stressors independent of the patient. Compliant patients were usually voluntary admissions and recovered quickly with minimal or no change in their antipsychotic pharmacotherapy. The pathogenesis of relapse among drug-compliant patients remains unknown, but likely includes aspects of environmental stress, an emergent affective syndrome, and, to some less clear extent, akinesia and akathisia. Implications for the inpatient and community treatment of these patients are discussed.

Antipsychotic Agents↗
PubMed1984

Pharmacogenic depression among outpatient schizophrenic patients: a failure to substantiate.

Impaired affect in recovering schizophrenic patients has been viewed as either an integral part of the disease, a postpsychotic depression, or, increasingly, as a pharmacogenically determined effect secondary to the use of antipsychotics. Two months following hospital discharge, operationally defined groups of "depressed" and "not depressed" drug-treated and nonrelapsed schizophrenic patients were randomly assigned to chlorpromazine or placebo and followed for 4 months. Among depressed schizophrenic patients, there was no evidence that drug either contributes to the depression or that depressive signs are primarily extrapyramidal symptom phenomena (akinesia). Equal numbers of nondepressed patients on drug and placebo manifested a subsequent postpsychotic depression.

Adolescent↗
PubMed1984

Depot neuroleptics: the relevance of psychosocial factors--a United States perspective.

The need for psychosocial strategies in the treatment of schizophrenic patients after discharge is discussed in terms of relapse rates associated with maintenance neuroleptic therapy in the United States and elsewhere. The history of drug and psychosocial treatment is reviewed, and the rationale of psychosocial treatment is explained. New psychosocial approaches are explored, including the "expressed emotion" concept, the possible influence of environmental stress conditions, and the use of family therapy and social skills training to lower relapse rates.

Antipsychotic Agents↗
PubMed1980

Family treatment of adult schizophrenic patients: a psycho-educational approach.

As part of a long-term study in schizophrenia, a model of family intervention has been developed which attempts to diminish relapse rates of schizophrenic patients. This model reflects theoretical and research findings which suggest that certain patients have a "core psychological deficit" that might increase vulnerability to external stimuli. While a program of maintenance chemotherapy attempts to decreae patient vulnerability, a series of highly structured, supportive, psycho-educational family interventions are aimed at de-intensifying the family environment in which the patient lives.

Activities of Daily Living↗
PubMed1979

Day treatment and psychotropic drugs in the aftercare of schizophrenic patients. A Veterans Administration cooperative study.

Schizophrenic patients referred for day treatment at the time of discharge from ten hospitals were randomly assigned to receive day treatment plus drugs or to receive drugs alone. They were tested before assignment and at 6, 12, 18, and 24 months on social functioning, symptoms, and attitudes. Community tenure and costs were also measured. The ten day centers were described on process variables every six months for the four years of the study. Some centers were found to be effective in treating chronic schizophrenic patients and others were not. All centers improved the patients' social functioning. Six of the centers were found to significantly delay relapse, reduce sumptoms, and change some attitudes. Costs for patients in these centers were not significantly different from the group receiving only drugs. More professional staff hours, group therapy, and a high patient turnover treatment philosophy were associated with poor-result centers. More occupational therapy and a sustained nonthreatening environment were more characteristic of successful outcome centers.

Adult↗
PubMed1979

Fluphenazine and social therapy in the aftercare of schizophrenic patients. Relapse analyses of a two-year controlled study of fluphenazine decanoate and fluphenazine hydrochloride.

The ability of long-acting fluphenazine decanoate and oral fluphenazine hydrochloride to forestall relapse among newly discharge schizophrenic patients is examined in the context of high and low degrees of social therapy (ST). A total of 105 patients were randomly assigned to the various treatments and maintained under controlled conditions for two years or until relapse. Relapse rates for all treatments remained traditionally high. Relpase rates for long-acting fluphenazine decanoate and oral fluphenazine hydrochloride are nearly identical in the first year, indicating that drug noncompliance does not adequately explain early schizophrenic relapse. However, patients who received long-acting fluphenazine decanoate and ST have a reduced risk of relapse over time. Relapsers who received long-acting fluphenazine decanoate appeared more affectively disturbed than other relapsers, yet both groups were diagnostically and symptomatically equivalent prior to treatment. Personal discomfort and intrafamilial stress are important predictors.

Administration, Oral↗
PubMed1977

Prediction of relapse in schizophrenic outpatients treated by drug and sociotherapy.

Despite the established efficacy of neuroleptics for maintaining schizophrenics in the community, there are data suggesting that those with very good prognostic signs may do as well without drugs. In testing this, we find no evidence that patients with good signs are not in need of drugs; instead they profit most from drug treatment. Patients who benefit little (1) are men whose families were disrupted earlier in their lives, (2) live alone or with extended families whose attitudes toward the study are not positive, and (3) are irregular in taking their medication. The practical implication is that the drug nonresponder can be helped by some means to ensure regularity of medication taking, such as a visiting nurse or long-acting medication. A second research question is whether major role therapy (MRT, a combination of social casework and vocational rehabilitation) can lengthen the time until relapse. Major role therapy affected time to relapse in a disordinal manner; asymptomatic patients benefited from MRT, while in patients with greater symptom severity MRT- suprisingly--hastened relapse. It is hypothesized that symptomatic patients are suffering from an inability to manage an expanded and enriched cognitive field; MRT, a therapy that urges the patient to become more responsible and to expand his horizons, may actually induce a state with which the patient cannot cope. It is recommended that a therapy such as MRT be deferred until the patient is essentially asymptomatic.

Ambulatory Care↗
PubMed1977

Temporal effects of drug and placebo in delaying relapse in schizophrenic outpatients.

The potential for unwanted side effects, particularly tardive dyskinesia, following long-term after care maintenance with antipsychotic medication has led to serious questioning of its continued use for schizophrenic patients. Does the risk of relapse decline with the passage of time? If so, is the advantage of drug therapy sustained and large enough to justify continued treatment beyond one or two years? More appropriate methods for analyzing the after care experience of 374 schizophrenic patients treated with drug or placebo reveals that while the risk of relapse does decline substantially, it remains twice as high for placebo-treated patients than drug-treated patients even after two years of treatment. The prophylactic effect of maintenance chemotherapy appears to be one to two times larger than generally estimated by the less precise "cumulative percentage" method.

Aftercare↗