Biomedical subjects

S Farah

Publications and source records attributed to S Farah.

38 records · Page 3Linked to original sources

PubMedDate not supplied

[What information do patients with schizophrenia have about their illness and treatment?].

Improved compliance with antipsychotic medication is a major issue in schizophrenic management. For this purpose educational programs have been used, but up to now, little or no information has been gathered or published in France concerning schizophrenic patients' opinion on information they have about their disease and their treatment. Thus we conducted a survey in concert with 78 psychiatrists from the French psychiatric health service. From this cross sectional survey we assessed 336 outpatients (male: 72%; mean age: 36 +/- 10.4 years) with schizophrenia according to the DSM IV (paranoid sub type: 57%, disorganized: 12%, catatonic: 1%, undifferentiated: 12%, residual: 18%). The mean duration of the illness was 11.6 years (sd: 8.5) and the mean duration of the follow up with the same psychiatrist was 5.4 years (sd: 5.1). Patients completed a questionnaire which assessed their level of information on mental illness and treatment. The diagnosis of schizophrenia has been told to their patients by 39% of the psychiatrists, and treatment has been explained to the patients by 96% of the practitioners. Results indicate less than half of the patients (45%) felt ill, only 46% thought they knew their illness well or very well (nevertheless only 31% of them named spontaneously the diagnosis of schizophrenia or psychosis), and 61% considered that they had been given sufficient information. Most of the patients (79%) were persuaded that their treatment was useful, and 75% of patient were completely satisfied with their treatment. Surprisingly 92% reported taking their medication regularly. Most patients think that a high level of information about their illness (74%) and treatment (79%) help them to cope better with their schizophrenia. Analysis performed according to patients characteristics indicated that paranoid patients felt more ill (p = 0.035) than others, thought to know less about their illness (p = 0.0065), and were less satisfied with their treatment (p = 0.04) and their level of information (p = 0.03). Patients with a duration of their illness longer than 10 years were more convinced of the utility of their treatment (p = 0.02) and had debated more on the choice of their treatment with their psychiatrist (p = 0.047). Patients older than 35 years were more satisfied with their information (p = 0.002). More patients with atypical antipsychotics accepted to take their treatment on a regular basis (p = 0.035) compared to patients under classical neuroleptics. This survey underlines that mental health consumers' opinions can be obtained even in the field of schizophrenia, and argues in favour of further such investigations. It also highlights the need for educational programs on schizophrenia and antipsychotic medications.

Adaptation, Psychological↗

PubMedDate not supplied

[Evaluation of efficacy and tolerance of amisulpride in treatment of schizophrenic psychoses].

Amisulpride is a benzamide derivative atypical antipsychotic characterized by selective blockade of dopamine D3 and D2 receptors, limbic selectivity and preferential blockade of dopamine autoreceptors at low doses. Its efficacy on predominant negative symptoms of schizophrenia at low doses, and on the positive symptoms at doses from 400 to 1,200 mg/day has been demonstrated in several controlled studies. The aim of our study was to assess the use in psychiatric clinical practice under naturalistic conditions, efficacy and safety of amisulpride and patient's ability to cope with social skills during a 3-month period of treatment with a follow-up at 6 months. A total of 445 patients (293 men and 152 women), between 18 and 45 years of age, were included in the study DSM III-R criteria of schizophrenia, paranoid type (295.3), or schizophreniform disorder (295.4) were required for inclusion. The patients received amisulpride with flexible dosage between 600 and 1,200 mg/d during a 3-month period (792 mg/d +/- 318). Evaluation was based on the Brief Psychiatric Rating Scale (BPRS), on the Positive And Negative Symptoms Scale (PANSS), and on Clinical Global Improvement scale, completed at D0, D14, D28, D60 and D90. Safety was also assessed with a comprehensive statement of adverse events and with the Simpson-Angus scale of extra pyramidal symptoms. A scale of social adaptation (Echelle d'Adaptation PsychoSociale) was completed at D0, D90 and D180. During the 3-month period of treatment, 124 patients (27.9%) dropped out the trial, including 24 cases of inefficacy and 27 cases of concomitant events. Intent-to-treat analysis showed a significant improvement of BPRS scores (40.2 vs 67.6; p < 0.0001), of positive PANSS scores (13.9 vs 27.7; p < 0.0001), and negative PANSS scores (17.45 vs 28.3; p < 0.0001) between D0 and D90. CGI results confirmed these figures. Follow-up assessment at D180 showed a sustained response on BPRS ans PANSS scores. Amisulpride was well tolerated in the study, with 21% of patients reporting adverse events, in majority psychiatric or endocrine disturbances. Only seven adverse events were assessed as serious. Extra pyramidal symptoms remained low during the study, as measured with Simpson-Angus scale. The EAPS scale showed a significant improvement of social adaptation during the treatment, with a sustained response during the 3-month follow-up period. In conclusion, 600-1 200 mg/d of amisulpride is an effective and well tolerated treatment of schizophrenic disorders, as demonstrated through this 3-month study carried in a large sample of 445 patients. Besides results suggest that under treatment with amisulpride in schizophrenic patients patients' ability to social adaptation can be improved, which could facilitate their rehabilitation.

Adolescent↗