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Evolución de los pacientes en la esquizofrenia I: correlatos con variables sociodemográficas, manifestaciones psicopatológicas y efectos secundarios

Published online by Cambridge University Press:  12 May 2020

Alex Hofer
Affiliation:
Departamento de Psiquiatría Biológica, Universidad Médica de Innsbruck, Anichstrasse 35, A-6020Innsbruck, Austria
Susanne Baumgartner
Affiliation:
Departamento de Psiquiatría Biológica, Universidad Médica de Innsbruck, Anichstrasse 35, A-6020Innsbruck, Austria
Monika Edlinger
Affiliation:
Departamento de Psiquiatría General, Hospital General Bressanone, Bressanone, Italia
Martina Hummer
Affiliation:
Departamento de Psiquiatría Biológica, Universidad Médica de Innsbruck, Anichstrasse 35, A-6020Innsbruck, Austria
Georg Kemmler
Affiliation:
Departamento de Psiquiatría Biológica, Universidad Médica de Innsbruck, Anichstrasse 35, A-6020Innsbruck, Austria
Maria A. Rettenbacher
Affiliation:
Departamento de Psiquiatría Biológica, Universidad Médica de Innsbruck, Anichstrasse 35, A-6020Innsbruck, Austria
Hansjoerg Schweigkofler
Affiliation:
Departamento de Psiquiatría General, Hospital General Bressanone, Bressanone, Italia
Josef Schwitzer
Affiliation:
Departamento de Psiquiatría General, Hospital General Bressanone, Bressanone, Italia
W. Wolfgang Fleischhacker
Affiliation:
Departamento de Psiquiatría Biológica, Universidad Médica de Innsbruck, Anichstrasse 35, A-6020Innsbruck, Austria
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Resumen

Objetivo

El presente estudio transversal examinó las relaciones de las manifestaciones psicopatológicas, los efectos secundarios y los factores sociodemográficos con el resultado del tratamiento desde el punto de vista de la calidad de vida (CdV), el funcionamiento y las necesidades de asistencia de los pacientes.

Métodos

Se estudió a 60 pacientes ambulatorios con esquizofrenia crónica que habían tenido tratamiento con clozapina u olanzapina durante 6 meses al menos.

Resultados

La mayoría de los síntomas psicopatológicos, igual que los efectos secundarios psíquicos, el aumento de peso y el sexo femenino se asociaban con una CdV más baja, mientras que los síntomas cognitivos correlacionaban con una CdV mejor. El sexo femenino, los síntomas cognitivos y el parkinsonismo influían negativamente en el funcionamiento ocupacional, y los síntomas negativos determinaban una menor probabilidad de vida independiente. La edad, el nivel educativo, la depresión/ansiedad, los síntomas negativos y los efectos secundarios psíquicos eran predictores de las necesidades de asistencia de los pacientes.

Conclusión

Nuestros resultados destacan la naturaleza compleja de la evolución del paciente en la esquizofrenia y ponen de nuevo el énfasis en la necesidad de centrarse en la eficacia, es decir, en la mejoría de los síntomas y además la seguridad farmacológica, en estos pacientes.

Type
Artículo Original
Copyright
Copyright © European Psychiatric Association 2006

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References

Bibliografía

[1]Addington, J, Addington, DPremorbid functioning, cognitive functioning, symptoms, and outcome in schizophrenia. J Psychiatry Neurosci 1993;18:1823.Google Scholar
[2]Allison, DB, Mackell, JA, McDonnell, DDThe impact of weight gain on quality of life among persons with schizophrenia. Psychiatr Serv 2003;54:565-7.CrossRefGoogle ScholarPubMed
[3]Beiser, M, Bean, G, Erickson, D, Zhang, J, lacono, WG, Rector, NABiological and psychosocial predictors of job performance following a first episode of psychosis. Am J Psychiatry 1994;151:857-63.Google ScholarPubMed
[4]Breier, A, Sctreiber, JL, Dyer, J, Pickar, DNational Institute of Mental Health longitudinal study of chronic schizophrenia: prognosis and predictors of outcome. Arch Gen Psychiatry 1991;48:239-46.CrossRefGoogle ScholarPubMed
[5]Brekke, JS, Kohrt, B, Green, MENeuropsychological functioning as a moderator of the relationship between psychosocial functioning and the subjective experience of self and life in schizophrenia. Schizophr Bull 2001;27:697708.CrossRefGoogle Scholar
[6]Browne, S, Roe, M, Lane, A, Gervin, M, Morris, M, Kinsella, A et al. Quality of life in schizophrenia: relationship to sociodemographic factors, symptomatology, and tardive dyskinesia. Acta Psychiatr Scand 1996;94:118-24.CrossRefGoogle ScholarPubMed
[7]DeJong, A, Giel, R, Slooff, CJ, Wiersma, DRelationship between symptomatology and social disability. Empirical evidence from a follow-up study of schizophrenic patients. Soc Psychiatry 1986;21: 200-5.CrossRefGoogle ScholarPubMed
[8]Dickerson, F, Boronow, JJ, Ringel, N, Parente, ESocial functioning and neurocognitive deficits in outpatients with schizophrenia: a 2 - year follow-up. Schizophr Res 1999;37:1320.CrossRefGoogle ScholarPubMed
[9]Fleischhacker, WWPharmacological treatment of schizophrenia: a review. In: Maj, M, Sartorius, N editors. Schizophrenia. WPA series evidence and experience in psychiatry. Chichester, NY, Weinheim, Brisbane, Singapore, Toronto: Wiley; 2002. p. 75-113.Google Scholar
[10]Fleischhacker, WW, Rabinowitz, J, Kemmler, G, Lasser, RA, Mehnert, APerceiving functioning, well-being and association with psychiatric symptomatology in clinically stable schizophrenia patients treated with loog-acting risperidone for 1 year. Br J Psychiatry 2005; [in press].CrossRefGoogle Scholar
[11]Foldemo, A, Bogren, LNeed assessment and quality of life in outpatients with schizophrenia: a 5-year follow-up study. Scand J Caring Sci 2002;16:393-8.CrossRefGoogle ScholarPubMed
[12]Hofer, A, Kemmler, G, Eder, U, Edlinger, M, Hummer, M, Fleischhacker, WWQuality of life in schizophrenia: the impact of psychopathology, drug attitude and side effects. J Clin Psychiatry 2004;65: 932-9.CrossRefGoogle ScholarPubMed
[13]Hoffmann, K, Priebe, SWelche Beduerfnisse nach Hilfe haben schizophrene Langzeitpatienten? Probleme der Selbst- und Fremdbeurteilung von “Needs”. Fortschr Neurol Psychiat 1996;64:473-81.CrossRefGoogle Scholar
[14]Kallert, TW, Leisse, MBe treuungsbeduerfnisse schizophrener Patienten im Jahr nach Klinikentlassung in der Versorgungsregion Dresden. Fortschr Neurol Psychiat 2000;68:176-87.CrossRefGoogle Scholar
[15]Kay, SR, Fiszbein, A, Opler, LAThe Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261-76.CrossRefGoogle Scholar
[16]Kemmler, G, Holzner, B, Neudorfer, C, Meise, U, Hinterhuber, HGeneral life satisfaction and domain-specific quality of life in chronic schizophrenic patients. Qual Life Res 1997;6:265-73.CrossRefGoogle ScholarPubMed
[17]Lambert, M, Naber, DCurrent issues in schizophrenia: overview of patient acceptability, functioning capacity and quality of life. CNS Drugs 2004;18(Suppl 2):517.CrossRefGoogle ScholarPubMed
[18]Lehman, AF, Goldberg, R, Dixon, LB, McNary, S, Postrado, L, Hackman, A et al. Improving employment outcomes for persons with severe mental illnesses. Arch Gen Psychiatry 2002;59:165-72.CrossRefGoogle ScholarPubMed
[19]Leung, A, Chue, PSex differences in schizophrenia, a review of the literature. Acta Psychiatr Scand 2000;101:338.CrossRefGoogle Scholar
[20]Lindenmayer, JP, Bernstein-Hyman, R, Grochowski, SFive-factor raodel of schizophrenia. J Nerv Ment Dis 1994;182:631-8.CrossRefGoogle ScholarPubMed
[21]Lindenmayer, JP, Grochowski, S, Hyman, RBFive factor model of schizophrenia: replication across samples. Schizophr Res 1995; 14: 229-34.CrossRefGoogle ScholarPubMed
[22]Lingjaerde, O, Ahlfors, UG, Bech, P, Dencker, SJ, Elgen, KThe UKU Side Effect Rating Scale—a new comprehensive rating scale for psychotropic drugs and a cross-sectional study of side effects in neurolepdc-treatedpatients. Acta Psychiatr Scand Suppl 1987;334:1100.CrossRefGoogle Scholar
[23]McGurk, S, Moriarty, PJ, Harvey, PD, Parrella, M, White, L, Davis, KLThe longitudinal relationship of clinical symptoms, cognitive functioning, and adaptive life in geriatric schizophrenia. Schizophr Res 2000;42:4755.CrossRefGoogle ScholarPubMed
[24]McGurk, SR, Mueser, KTCognitive functioning and employment in severe mental illness. J Nerv Ment Dis 2003;191:789-98.CrossRefGoogle ScholarPubMed
[25]Mercier, C, Peladeau, N, Tempier, RAge, gender and quality of life. Community Ment Health J 1998;34:487500.CrossRefGoogle ScholarPubMed
[26]Mueser, KTCognitive functioning, social adjustment, and long-term outcome in schizophrenia. In: Sharma, T, Harvey, P editors. Cognition in schizophrenia. New York NY: Oxford University Press; 2000. p. 157-77.Google Scholar
[27]Mueser, KTCognitive impairment, symptoms, social functioning, and vocational rehabilitation in schizophrenia. In: Kashima, H, Falloon, IRH, Mizuno, M, Asai, M editors. Comprehensive treatment of schizophrenia: linking neurobehavioral findings to psychosocial approaches. Tokyo: Springer; 2002. p. 344-51.CrossRefGoogle Scholar
[28]Norman, RM, Malla, AKCorrelations over time between dysphoric mood and symptomatology in schizophrenia. Compr Psychiatry 1994;35:34-8.CrossRefGoogle Scholar
[29]Norman, RMG, Malla, AK, McLean, T, Voruganti, LP, Cortese, L, Mclntosh, E et al. The relationship of symptoms and level of functioning in schizophrenia to general wellbeing and the Quality of Life Scale. Acta Psychiatr Scand 2000;102:303-9.CrossRefGoogle ScholarPubMed
[30]Ochoa, S, Haro, JM, Autonell, J, Pendas, A, Teba, F, Marquez, M et al. Met and unmet needs of schizophrenia patients in a Spanish sample. Schizophr Bull 2003;29:201-10.CrossRefGoogle Scholar
[31]Priebe, S, Heinze, M, Jakel, ABerliner Bedurfnis Inventar (BeBI). FU Berlin: Abteilung fbr Sozialpsychiatrie; 1993.Google Scholar
[32]Prudo, R, Monroe Blum, HFive year outcome and prognosis in schizophrenia; a report from the London field centre of the international pilot study of schizophrenia. Br J Psychiatry 1987;150:345-54.CrossRefGoogle ScholarPubMed
[33]Racenstein, JM, Harrow, M, Reed, R, Martin, E, Herbener, E, Penn, DLThe relationship between positive symptoms and instrumental work functioning in schizophrenia: a 10 year follow-up study. Schizophr Res 2002;56:95103.CrossRefGoogle ScholarPubMed
[34]Sartorius, N, Fleischhacker, WW, Gjerris, U, Kern, U, Knapp, M, Leonhard, BE et al. The usefulness and use of second generation antipsychotic medications—an update. Curr Opin Psychiatry 2003;16(Suppl l):144.Google Scholar
[35]Slade, M, Thornicroft, G, Loftus, L et al. CAN: The Camberwell Assessment of Need. London: Gaskell; 1999.Google Scholar
[36]Swartz, MS, Perkins, DO, Stroup, TS, McEvoy, JP, Nieri, JM, Haak, DCAssessing clinical and functional outcomes in the Clinical Antipsychotic Triais of Intervention Effectiveness (CATIE) schizophrenia trial. Schizophr Bull 2003;29:3343.CrossRefGoogle Scholar
[37]Thornicroft, G, Tansella, M, Becker, T, Knapp, M, Leese, M, Schene, A et al. The personal impact of schizophrenia in Europe. Schizophr Res 2004;69:125-32.CrossRefGoogle ScholarPubMed
[38]The, WHOQOL GroupDevelopment of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998;28:551-8.Google Scholar
[39]Voruganti, LNP, Heslegrave, RJ, Awad, AGQuality of life measurement during antipsychotic drug therapy of schizophrenia. J Psychiatr Neurosci 1997;22:267-74.Google ScholarPubMed