ORCID Profile
0000-0001-6549-3713
Current Organisation
Beijing Anding Hospital, Capital Medical University
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Publisher: Cambridge University Press (CUP)
Date: 03-02-2012
DOI: 10.1017/S1041610211002791
Abstract: Background: This study examined the use of low doses of antipsychotic medications (300 mg/day CPZeq or less) in older Asian patients with schizophrenia and its demographic and clinical correlates. Methods: Information on hospitalized patients with schizophrenia, aged 55 years or older, was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study (2001–2009). Data on 1,452 patients in eight Asian countries and territories including China, Hong Kong, Japan, Korea, Singapore, Taiwan, India, and Malaysia were analyzed. Sociodemographic and clinical characteristics and antipsychotic prescriptions were recorded using a standardized protocol and data collection procedure. Results: The prescription frequency for low doses of antipsychotic medications was 40.9% in the pooled s le. Multiple logistic regression analysis of the whole s le showed that patients on low doses of antipsychotic medications were more likely to be female, have an older age, a shorter length of illness, and less positive symptoms. Of patients in the six countries and territories that participated in all the surveys between 2001 and 2009, those in Japan were less likely to receive low doses of antipsychotics. Conclusion: Low doses of antipsychotic medications were only applied in less than half of older Asian patients with schizophrenia.
Publisher: SAGE Publications
Date: 2020
Publisher: Georg Thieme Verlag KG
Date: 2008
Abstract: Clozapine remains one of the most commonly used antipsychotic medications in China. As China has the largest population internationally on clozapine treatment, its experience and research findings are of keen interest to Western psychiatrists. However, most of the related papers have hitherto been published only in Chinese language journals. Here we review mainly Chinese-language publications on the use of clozapine in China. A descriptive study based on literature identified from searches of Medline and the China National Knowledge Infrastructure (CNKI) databases (1979-2007), and other hand-picked references. Unlike the situation in other countries, clozapine is still widely used for a number of psychiatric disorders in China, though the prescription of other second-generation antipsychotics (SGAs) is also increasing. About 25-60% of all treated patients with schizophrenia receive clozapine and clozapine is preferred by some as a first-line treatment for schizophrenia. Clozapine is also used for other conditions such as mania, treatment-resistant depression and drug abuse. The average daily dose is between 200 and 400 mg. The incidence of leukopenia is 3.92% and agranulocytosis 0.21% in China, with about one third of reported cases of patients with agranulocytosis dying. Weight gain and clozapine-associated diabetes are also commonly reported in the Chinese population. Clozapine is currently the most commonly used treatment for schizophrenia in China. Chinese psychiatrists need to pay more attention to its potential toxic side effects when they make drug choices.
Publisher: Public Library of Science (PLoS)
Date: 03-11-2014
Publisher: SAGE Publications
Date: 11-07-2012
Abstract: This study examined the prescribing patterns of several first- (FGAs) and second-generation antipsychotic (SGAs) medications administered to older Asian patients with schizophrenia during the period between 2001 and 2009. Information on hospitalized patients with schizophrenia aged 65 or older was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study (2001–2009). There were no older patients in Thailand, therefore data on 467 patients in eight Asian countries and territories including China, Hong Kong SAR, India, Japan, Korea, Malaysia, Singapore, and Taiwan were analysed. Cross-sectional socio-demographic data, clinical characteristics and antipsychotic prescriptions were assessed using a standardized protocol and data collection procedure. Of the 467 patients, 192 patients (41.1%) received FGAs only, 166 (35.5%) received SGAs only and 109 (23.3%) received a combination of FGAs and SGAs. Of the FGAs, haloperidol was the most commonly used (31.3% mean 9.4 ± 6.7 mg/day), followed by chlorpromazine (15.4% mean 126.4 ± 156.4 mg/day) and sulpiride (6.6% mean 375.0 ± 287.0 mg/day). Of the SGAs, risperidone was the most commonly used (31.5% mean 4.5 ± 2.7 mg/day), followed by olanzapine (13.1% mean 13.6 ± 6.5 mg/day), quetiapine (7.3% mean 325.0 ± 237.3 mg/day) and aripiprazole (1.9% mean 17.6 ± 7.7 mg/day). FGAs and higher doses of certain SGAs (risperidone, olanzapine and quetiapine) were still commonly dispensed to older Asian patients with schizophrenia. Considering older patients’ reduced tolerability of potentially severe side effects associated with FGAs and higher doses of certain SGAs, continuing education and training addressing the rational use of antipsychotics in this population is clearly needed.
Publisher: Wiley
Date: 27-03-2015
DOI: 10.1111/PCN.12283
Abstract: Little is known about electroconvulsive therapy (ECT) use in Asian inpatients with schizophrenia. This study examined trends of ECT use for schizophrenia patients in Asia between 2001 and 2009 and its independent demographic and clinical correlates. Data on 6761 hospitalized schizophrenia patients (2001 = 2399, 2004 = 2136, and 2009 = 2226) in nine Asian countries and territories were collected by either chart review or interviews during a 1-month period. Patients' sociodemographic and clinical characteristics, prescriptions of psychotropic drugs and ECT use were recorded using a standardized protocol and data-collection procedure. The frequency of ECT was 3.3% in the whole s le rising from 1.8% in 2001 to 3.3% in 2004 and 4.9% in 2009 (P < 0.0001). However, this increased trend was driven solely by increased ECT use in China (P < 0.0001), and the inclusion of India in the 2009 survey. There were wide inter-country variations: 2001, 0% (Hong Kong, Korea) to 5.9% (China) 2004, 0% (Singapore) to 11.1% (China) 2009, 0% (Hong Kong) to 13.8% (India) and 15.2% (China). Multiple logistic regression analysis of the whole s le revealed that patients receiving ECT were less likely in the 35-64-year age group, had shorter length of current hospitalization and fewer negative symptoms, and were more likely to receive second-generation antipsychotic medications compared to those who were not treated with ECT (R(2) = 0.264, P < 0.001). ECT use for schizophrenia has increased over the past decade in China, being low/relatively stable in other Asian countries/regions. Reasons for substantial variations in ECT frequency in Asia require further study.
Publisher: Wiley
Date: 06-2011
DOI: 10.1002/HUP.1213
Abstract: The purpose of the study was to evaluate the frequency of reported sexual dysfunction (SD) in schizophrenia and its associations with sociodemographic and clinical variables in selected Asian countries. A total of 5877 schizophrenia patients in nine Asian countries and territories were examined between 2001 and 2009. The patients' sociodemographic and clinical characteristics, prescription of psychotropic drugs, and drug-induced side effects were recorded using a standardized protocol and data collection. SD was evaluated as "present" or "absent" according to the clinical judgment of experienced psychiatrists. The frequency of reported SD in the whole s le in women and men was 3.0%, 0.8%, and 4.6%, respectively, with variations across study sites. In the multivariate analyses, male sex, more second-generation antipsychotics, benzodiazepines, and antidepressants were independently associated with higher likelihood of reported SD, whereas negative symptoms had an inverse association with reported SD. The results of this study indicate that SD was seldom recorded as a side effect by Asian psychiatrists while treating patients with schizophrenia. It is unclear whether the low prevalence of reported SD compared with Western data is real or whether the results are being insufficiently recognized.
Publisher: Oxford University Press (OUP)
Date: 18-04-2011
Publisher: Wiley
Date: 07-05-2012
DOI: 10.1002/GPS.3827
Abstract: This study surveyed the use of anticholinergic medications (ACMs) in older Asian patients with schizophrenia and examined its demographic and clinical correlates. A total of 1452 hospitalized patients with schizophrenia aged 55 years or older in nine Asian countries and territories were surveyed between 2001 and 2009. The cross-sectional data of patients' socio-demographic and clinical characteristics and the prescriptions of antipsychotic drugs and ACM were recorded using a standardized protocol and data collection procedure. The frequency of ACM prescription was 64.6% in the pooled s le, with 72.4%, 61.9%, and 59.5% in 2001, 2004, and 2009, respectively. Multiple logistic regression analysis of the whole s le revealed that patients on ACM had a higher dose of antipsychotic medications, and were more likely to have extrapyramidal side effects and receive first-generation antipsychotic medications. Anticholinergic medications were frequently used in older Asian patients with schizophrenia. Considering the potential side effects of ACM, the rationale for their widespread use in this patient population should be revisited.
Publisher: Georg Thieme Verlag KG
Date: 15-12-2021
DOI: 10.1055/A-1625-6388
Abstract: This international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by agranulocytosis or myocarditis. For trough steady-state clozapine serum concentrations, the therapeutic reference range is narrow, from 350 to 600 ng/mL with the potential for toxicity and ADRs as concentrations increase. Clozapine is mainly metabolized by CYP1A2 (female non-smokers, the lowest dose male smokers, the highest dose). Poor metabolizer status through phenotypic conversion is associated with co-prescription of inhibitors (including oral contraceptives and valproate), obesity, or inflammation with C-reactive protein (CRP) elevations. The Asian population (Pakistan to Japan) or the Americas' original inhabitants have lower CYP1A2 activity and require lower clozapine doses to reach concentrations of 350 ng/mL. In the US, daily doses of 300-600 mg/day are recommended. Slow personalized titration may prevent early ADRs (including syncope, myocarditis, and pneumonia). This guideline defines six personalized titration schedules for inpatients: 1) ancestry from Asia or the original people from the Americas with lower metabolism (obesity or valproate) needing minimum therapeutic dosages of 75-150 mg/day, 2) ancestry from Asia or the original people from the Americas with average metabolism needing 175-300 mg/day, 3) European/Western Asian ancestry with lower metabolism (obesity or valproate) needing 100-200 mg/day, 4) European/Western Asian ancestry with average metabolism needing 250-400 mg/day, 5) in the US with ancestries other than from Asia or the original people from the Americas with lower clozapine metabolism (obesity or valproate) needing 150-300 mg/day, and 6) in the US with ancestries other than from Asia or the original people from the Americas with average clozapine metabolism needing 300-600 mg/day. Baseline and weekly CRP monitoring for at least four weeks is required to identify any inflammation, including inflammation secondary to clozapine rapid titration.
Publisher: Public Library of Science (PLoS)
Date: 10-06-2013
Publisher: Wiley
Date: 13-08-2013
DOI: 10.1002/GPS.4011
Abstract: This study aimed to examine the use of high doses of antipsychotic medications (≥600 mg/day chlorpromazine equivalent) in older Asian patients with schizophrenia and its demographic and clinical correlates. Information on hospitalized patients with schizophrenia aged ≥50 years was extracted from the database of the Research on Asian Psychotropic Prescription Patterns study (2001-2009). Data on 2203 patients in six Asian countries and territories, including China, Hong Kong, Japan, Korea, Singapore and Taiwan, were analyzed. Socio-demographic and clinical characteristics and antipsychotic prescriptions were recorded. The frequency for high-dose antipsychotic medications was 36.0% overall, with 38.4% in 2001, 33.3% in 2004 and 36.0% in 2009. Multiple logistic regression analysis of the whole s le showed that compared to patients receiving low-medium antipsychotic doses, those on high doses had a longer illness duration (odds ratio (OR): 2.0, 95% confidence interval (CI):1.2-3.3, p = 0.008), were more likely in the 50-59-year group (OR: 0.95, 95% CI: 0.94-0.97, p < 0.001), more often had current positive (OR: 1.5, 95% CI: 1.2-1.8, p < 0.001) or negative symptoms (OR: 1.3, 95% CI: 1.03-1.6, p = 0.03), and more commonly received antipsychotic polypharmacy (OR: 5.3, 95% CI: 4.1-6.7, p < 0.001). Extrapyramidal symptoms (p = 0.25) and tar e dyskinesia (p = 0.92) were not more frequent in the high-dose group. High doses of antipsychotic medications were used in more than one third of older Asian patients with schizophrenia. The reasons for the frequent use of high antipsychotic doses in older Asian patients warrant further investigation.
Publisher: Dustri-Verlgag Dr. Karl Feistle
Date: 06-2011
DOI: 10.5414/CP201505
Abstract: The aim of the study was to survey the frequency of tar e dyskinesia (TD) in patients with schizophrenia and its demographic and clinical correlates in selected Asian countries. A total of 6,761 hospitalized schizophrenia patients in nine Asian countries and territories were examined from 2001 to 2009. TD was evaluated as "present" or "absent" according to the clinical judgment of experienced psychiatrists. The patients' socio-demographic and clinical characteristics and the prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure. The frequency of TD in the whole s le was 5.0% with wide variations between countries (0 - 14.9%). Multiple logistic regression analysis showed that the following variables were independently associated with TD: study time, study site, older age, male gender, more severe negative and extrapyramidal symptoms and less anticholinergic drugs. A generally low frequency of TD in Asian schizophrenia patients with inter-ethnic variations was recorded. It is unclear whether the low prevalence of TD compared with Western data is real or the result of it being insufficiently recognized.
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.SCHRES.2011.12.001
Abstract: The aim of this study was to examine prospective memory (PM) and its socio-demographic, clinical, and neurocognitive correlates in first episode schizophrenia (FES). Fifty-one FES patients and 42 healthy controls formed the study s le. Time- and event-based PM (TBPM and EBPM) performance were measured with the Chinese version of the Cambridge Prospective Memory Test (C-CAMPROMPT). A battery of neuropsychological tests was also administered. Patients' clinical symptoms were evaluated with the Positive and Negative Symptom Scale (PANSS). Patients performed significantly worse in both TBPM (8.7 ± 5.3 vs. 14.8 ± 3.5) and EBPM (11.3 ± 4.7 vs. 15.7 ± 2.7) than the controls. After controlling for age, gender, education level and neurocognitive test score, the difference in performance on the two types of PM tasks between patients and controls was no longer present. In multiple linear regression analyses, longer duration of untreated psychosis (DUP), lower scores of the Hopkins Verbal Learning Test-Revised (HVLT-R) and the categories completed of the Wisconsin Card Sorting Test (WCST-CC) and higher score of the Color Trails Test-2 (CTT-2) contributed to poorer TBPM performance, while lower score of HVLT-R, higher score of the perseverative errors of the Wisconsin Card Sorting Test (WCST-PE) and longer DUP contributed to worse performance on EBPM. Both subtypes of PM are impaired in first-episode schizophrenia suggesting that PM deficits are an integral part of the cognitive dysfunction in the disease process.
Publisher: SAGE Publications
Date: 03-2011
DOI: 10.3109/00048674.2010.538839
Abstract: Objective: The aim of this study was to investigate the sex differences in prescribing patterns of psychotropic drugs and drug-induced side effects in schizophrenia patients in Asia using the data of the Research on Asian Psychotropic Prescription Pattern (REAP) surveys. Method: The prescription patterns of 6,441 schizophrenia inpatients in six Asian countries and regions were investigated during the 2001–2009 period. The patients' socio-demographic and clinical characteristics and their prescriptions for psychotropic drugs were recorded using a standardized protocol and data collection procedure. Results: Univariate analyses found the following factors to be significantly associated with the male sex: a younger age, higher doses of antipsychotics, less prominent delusions and hallucinations, more prominent negative symptoms, less likelihood of a prescription for second-generation antipsychotics (SGAs), greater use of antipsychotic polypharmacy, mood stabilizers and depot antipsychotics, more frequent tar e dyskinesia (TD), and less weight gain. In multivariate analyses, fewer prescriptions for SGAs, greater use of mood stabilizers, anticholinergics, antipsychotic polypharmacy and depot antipsychotics, extrapyramidal side effects (EPS) and TD, and less weight gain were independently associated with the male sex. Conclusions: Sex is one of the independent contributors to psychotropic prescription and side effects in Asian schizophrenia patients. Psychopharmacological treatment guidelines for schizophrenia should consider the sexes separately.
Publisher: Georg Thieme Verlag KG
Date: 30-01-2012
Abstract: This study surveyed the use of adjunctive mood stabilizers (MS) and benzodiazepines (BZD) in older Asian schizophrenia patients and examined their demographic and clinical correlates. Information on hospitalized schizophrenia patients aged 55 years or more were extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study. A total of 1,452 patients from 9 Asian countries and territories was included in the study. The patients' sociodemographic and clinical characteristics and the prescriptions of antipsychotics, MS and BZD were recorded using a standardized protocol and data collection procedure. The frequency of MS prescription was 26.7% in the pooled s le, with 25.5% in 2001, 26.9% in 2004 and 27.7% in 2009. The corresponding figures for BZD were 20.7%, 20.2%, 18.4% and 23.1%, respectively. Multiple logistic regression analysis of the whole s le revealed that patients on MS were younger and more likely to be men and to have extrapyramidal side effects (EPS) and a longer duration of illness. Compared to patients in China, those in Japan were more likely to receive MS, while Korean patents were prescribed less MS. In contrast, there were no significant sociodemographic or clinical correlates of BZD use. Compared to patients in China, their Korean and Singaporean counterparts were more likely to be on BZD. The use of MS and BZD is not uncommon in older Asian patients with schizophrenia. Given the paucity of empirical data on the efficacy of these agents in in iduals with schizophrenia of any age and concerns about added side effects in older patients in particular, the rationale for the prescription of these agents in this population warrants further examination.
Publisher: Georg Thieme Verlag KG
Date: 13-04-2011
Abstract: The aim of this study was to survey the use of anticholinergic medication (ACM) in Asia between 2001 and 2009 and examine its demographic and clinical correlates. A total of 6 761 hospitalized schizophrenia patients in 9 Asian countries and territories were examined between 2001 and 2009. The patients' socio-demographic and clinical characteristics and the prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure. The frequency of ACM prescription decreased from 66.3% in 2001, to 52.8% in 2004 and 54.6% in 2009, with wide inter-country variations at each time period. Multiple logistic regression analysis of the whole s le showed that patients taking ACM presented with more severe positive, negative, and extrapyramidal symptoms. They were also more likely to receive first-generation and depot antipsychotics and antipsychotic polypharmacy, and less likely to receive second-generation ones. The wide variation in ACM prescription across Asia suggests that a combination of clinical, social, economic and cultural factors play a role in determining the use of these drugs. Regular reviews of ACM use are desirable to reveal the discrepancy between treatment guidelines and clinical practice.
Publisher: Oxford University Press (OUP)
Date: 21-03-2023
Abstract: There is limited evidence to guide the approaches to clozapine treatment. Accordingly, an international initiative was undertaken with the aim of developing consensus recommendations for the optimization of clozapine monotherapy. We conducted an online Delphi survey among members of the Treatment Response and Resistance in Psychosis (TRRIP) working group comprising experts from twenty-nine countries. The threshold criterion for a consensus recommendation was ≥ 75% agreement (“agree” and “strongly agree” responses) on a question. Agreement of ≥ 50% but & 75% in a second or third Delphi round was deemed to provide guidance. Forty-nine (first round), 32 (second round), and 48 (third round) of the 91 current TRRIP members participated. Expert recommendations at ≥ 75% comprised second-line treatment with clozapine in cases of persistent positive symptoms with co-occurring extrapyramidal symptoms, tar e dyskinesia, or suicidality/aggression. There was considerable disagreement on myocarditis screening parameters. The management of somatic and neuropsychiatric adverse drug reactions warrants further research for more evidence-based recommendations. Rechallenge with clozapine was recommended for eosinophilia, sinus tachycardia and fever and guidance (agreement ≥ 50%) was reached for pneumonia and thrombocytopenia. Given the limited evidence available, this consensus-based series of recommendations and guidance statements supports clinical decision-making to optimize clozapine monotherapy and provides guidance for future research in treatment-resistant schizophrenia.
Publisher: Georg Thieme Verlag KG
Date: 20-01-2022
DOI: 10.1055/A-1737-1527
Publisher: Oxford University Press (OUP)
Date: 04-02-2011
Publisher: Wiley
Date: 22-01-2015
DOI: 10.1002/HUP.2458
Abstract: Little is known about the pattern of QT interval (QTc) prolongation in Asian patients with schizophrenia. This study examined trends of QTc prolongation in schizophrenia inpatients in six Asian countries and territories between 2004 and 2008/2009 and its independent demographic and clinical correlates. Data on 3482 hospitalized schizophrenia patients (2004 = 1826 and 2008/2009 = 1656) in six Asian countries and territories were collected by either chart review or interviews during a 1-month period. Patients' sociodemographic and clinical characteristics, prescriptions of psychotropic drugs, and QTc interval were recorded using a standardized protocol and data collection procedure. The frequency of QTc prolongation (>456 ms) was 2.4% in the whole s le, decreasing from 3.1% in 2004 to 1.6% in 2008/2009 (p = 0.004) with wide intercountry variations. However, this decreased trend was driven by decreased QTc prolongation detected in China and Hong Kong (both p-values < 0.05). Multiple logistic regression analysis of the whole s le revealed that patients having more likely to have an illness lasting longer than 5 years and received antipsychotics classified as list-1 drugs according to the Arizona Centre for Education and Research on Therapeutics. Compared with 2004, patients in 2008/2009 were less likely to have QTc prolongation. Thioridazine caused QTc prolongation most frequently (odds ratio (OR) 4.4 95% confidence interval (CI) 1.2-15.2), followed by sulpiride (OR 2.4 95% CI 1.3-4.5), clozapine (OR 2.4 95% CI 1.4-4.2), and chlorpromazine (OR 1.9 95% CI 1.07-3.5). Frequency of QTc prolongation was low in Asian patients with schizophrenia. QTc prolongation in schizophrenia decreased in China and Hong Kong between 2004 and 2008/2009 but increased in Taiwan over the same period, remaining low in the other countries.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-04-2015
Publisher: Hindawi Limited
Date: 20-06-2013
DOI: 10.1111/PPC.12027
Abstract: The study examined the rate of remission in in iduals experiencing a first episode of schizophrenia (FES) in China and explored predictors of remission in the acute phase of the illness. Fifty-five FES patients were randomly treated with risperidone, olanzapine, or aripiprazole at therapeutic doses for 8 weeks, and their clinical profiles and cognition were assessed using standardized assessment instruments at entry and the end of the study. Of the 55 patients, 30 (54.5%) remitted by the end of the 8-week study. In univariate analyses, shorter duration of untreated psychosis, higher scores on both the time-based prospective memory (TBPM) and event-based prospective memory tasks and the Hopkins Verbal Learning Test-revised, and less severe negative symptoms were significantly associated with remission. In stepwise multiple logistic regression analyses, only higher scores on the TBPM significantly predicted remission. In iduals having higher scores reflecting better TBPM at baseline were more likely to achieve remission after 8 weeks of optimized antipsychotic treatment. TPBM may be useful in helping clinicians identify those FES patients most likely to achieve a favorable treatment response.
Publisher: SAGE Publications
Date: 11-2011
DOI: 10.3109/00048674.2011.607426
Abstract: Objective: Optimizing treatment and outcomes for people with schizophrenia requires understanding of how evidence-based treatments are utilized. Clozapine is the most effective antipsychotic drug for treatment-refractory schizophrenia, but few studies have investigated trends and patterns of its use over time internationally. This study examined the prescription patterns of clozapine and its demographic and clinical correlates in Asia from 2001 to 2009. Method: Clozapine prescriptions were collected in a s le of 6761 hospitalized schizophrenia patients in nine Asian countries and regions using a standardized protocol and data collection procedure. Results: Overall, the proportion of patients receiving clozapine prescriptions was stable across the three surveys from 2001 to 2009, ranging from 14.5% to 15.9%. However, the rates and patterns observed within different regions and countries at each survey differed considerably. Clozapine use decreased significantly over time in China, while it increased in Korea and Singapore. Multiple logistic regression analysis revealed that patients taking clozapine were significantly younger, had a higher dose of antipsychotic drugs in chlorpromazine equivalents, were more likely to be female, had fewer extrapyramidal symptoms, and had more negative symptoms, admissions and weight gain in the past month than those not receiving clozapine. Conclusion: The variability in overall rates and changes in prescription rates over time in these s les suggest that factors other than psychopharmacological principles play an important role in determining the use of clozapine in schizophrenia in Asia.
Publisher: Georg Thieme Verlag KG
Date: 17-07-2017
Abstract: Introduction The purpose of this study is to systematically review the efficacy and safety of adjunctive erythropoietin (EPO) in treating cognitive deficits associated with schizophrenia, bipolar disorder, and major depression based on randomized controlled trials (RCTs). Methods Two evaluators independently and systematically searched and selected studies, extracted data, and conducted quality assessment. Results Four RCTs with 144 patients (71 in the EPO group and 73 in the placebo group) met the study entry criteria. Adjunctive EPO could improve schizophrenia-related cognitive performance. In patients with bipolar disorder, EPO could also enhance sustained attention, recognition of happy faces, and speed of complex information processing across learning, attention, and executive function when compared with placebo. In addition, EPO could enhance verbal recall, recognition, and memory in patients with major depression. Discussion This preliminary study found that adjunctive EPO appears to be effective in treating cognitive deficits associated with schizophrenia, bipolar disorder, and major depression without major adverse effects observed. Further higher quality RCTs with larger s les are needed to confirm the findings. Review registration: CRD42017058094
Publisher: Public Library of Science (PLoS)
Date: 28-02-2017
Publisher: Dustri-Verlgag Dr. Karl Feistle
Date: 27-04-2012
DOI: 10.5414/CP201683
Publisher: Hindawi Limited
Date: 31-05-2013
DOI: 10.1111/PPC.12024
Abstract: Little is known about quality of life (QOL) in Chinese patients with bipolar disorder (BD) in remission (euthymia). This study examined the QOL of such a cohort of BD patients and its demographic, clinical, and cognitive correlates. Forty-seven euthymic BD patients and 47 matched healthy controls formed the study s le. Socio-demographic characteristics, prospective memory, retrospective memory, intelligence quotient, and executive functioning were measured in all participants together with patients’ psychopathology ratings. Multivariate analyses revealed that compared to controls, euthymic BD patients had significantly lower satisfaction with physical QOL domain. Only subthreshold depressive symptoms independently contributed to reduced satisfaction with physical and environmental QOL domains, whereas no variable predicted its psychological and social domains. Contrary to findings from Western settings, demographic variables and cognitive deficits had no associations with any QOL domain in euthymic Chinese BD patients. Control of subthreshold depressive symptoms in euthymic BD patients might enhance their QOL.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2012
Publisher: Georg Thieme Verlag KG
Date: 11-10-2011
Abstract: This study aimed to identify trends in the use of antipsychotic polypharmacy (APP) and their demographic and clinical correlates in the treatment of schizophrenia in Asia between 2001 and 2009. A total of 6,761 schizophrenia inpatients in 9 Asian countries and territories were examined 2,399 in 2001, 2,136 in 2004, and 2,226 in 2009. Patients’ socio-demographic and clinical characteristics and prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure. The proportion of APP prescription decreased from 46.8 % in 2001, to 38.3 % in 2004, and increased to 43.4 % in 2009, with wide intercountry variations at each survey. Multiple logistic regression analysis of the whole s le revealed that patients on APP were younger, had a higher dose of antipsychotics in chlorpromazine equivalents, and more severe positive and negative symptoms. They were also more likely to receive depot and fi rst-generation antipsychotic drugs. The frequency of APP prescription varied between countries and territories, suggesting that a host of clinical and socio-cultural factors played a role in determining APP use in Asia. To resolve the discrepancy between treatment recommendation and clinical practice, regular reviews of prescription patterns are needed.
Publisher: Wiley
Date: 03-12-2012
DOI: 10.1111/APPY.12019
Abstract: Prospective memory refers to the ability to remember to do something in the future. To date, little is known about prospective memory deficits in bipolar disorder (BD) in remission (euthymia). This study examined the nature and correlates of prospective memory in these patients. Forty-seven euthymic BD patients and 47 matched healthy controls formed the study s le. Socio-demographic and basic clinical characteristics, prospective memory (Cambridge Prospective Memory Test [CAMPROMPT]), retrospective memory (immediate Logical Memory subtests of the Wechsler Memory Scales-Revised [WMS-R]), IQ (Raven's Progressive Matrices) and executive functioning (Wisconsin Card Sorting Test) were measured in all participants patients' symptoms were rated with the 17-item Hamilton Depression Rating Scale and the 11-item Young Mania Rating Scale. Patients performed significantly worse on time-based prospective memory compared to controls. Multivariate analyses revealed that patients' lower score on Raven's Progressive Matrices significantly contributed to poor performance on time-based prospective memory, whereas lower scores on WMS-R Logical Memory subtest contributed to poor performance on event-based prospective memory in controls, lower education level and older age significantly contributed to poor performance on time-based and event-based prospective memory, respectively. Prospective memory deficits persist in remitted BD patients suggesting that prospective memory impairment constitutes a trait deficit in BD.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.SCHRES.2018.12.003
Abstract: The anhedonia paradox is consistently observed in in iduals with schizophrenia. However, the underlying mechanism of the dissociation between trait and state hedonic capacity remains unclear. In the present study, we aimed to re-examine anhedonia in patients with schizophrenia (SCZ) and in iduals with high schizotypy (HS) using the Monetary Incentive Delay (MID) task to assess different dimensions of anticipatory and consummatory pleasure. We recruited 44 SCZ patients, 46 matched healthy controls (HC), 30 in iduals with HS and 35 with low schizotypy (LS). The modified MID task was used to measure anticipatory and consummatory pleasure in terms of valence and arousal ratings. To measure the predictive value of anticipatory pleasure, participants were asked to predict their hedonic experience before the MID task. For SCZ patients, there was no significant Group main effect or Group × Prize interaction on consummatory pleasantness to reward received or loss avoidance. As expected, SCZ patients (particularly male patients) reported less pleasantness and arousal to future rewards in both the prediction and feeling dimensions compared with HC. Additionally, male patients reported less anticipatory and consummatory negativity than HC. In iduals with HS predicted more arousing experience to high-rewards than LS in iduals. They also reported and predicted more negativity to in-the-moment and future monetary losses. Further, the negative dimension of schizotypy predicted low levels of pleasantness and arousal towards future rewards, but the positive dimension predicted increased arousing experience towards future rewards. In conclusion, the anhedonia paradox in schizophrenia could be partially accounted for by the dissociation between anticipatory and consummatory pleasure.
Publisher: Wiley
Date: 29-08-2012
DOI: 10.1111/J.1758-5872.2012.00231.X
Abstract: Little is known about the prescription patterns of adjunctive antidepressants in Asian schizophrenia patients. This study aimed to examine trends in the use of antidepressants and their demographic and clinical correlates in the treatment of schizophrenia in Asia between 2001 and 2009. A total of 6,761 hospitalized schizophrenia patients in nine Asian countries and territories were examined: 2,399 in 2001, 2,136 in 2004 and 2,226 in 2009. Patients' socio-demographic and clinical characteristics and prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure. The proportion of antidepressant prescription was 6.8% in the whole s le 5.3% in 2001, 6.5% in 2004 and 8.7% in 2009. There were wide inter-country variations at each survey ranging from 0.9% in Hong Kong to 15.3% in Singapore in 2001 from 1.9% in Korea to 15.4% in Singapore in 2004 and from 2.7% in Japan to 22.0% in Singapore in 2009. Multiple logistic regression analysis of the whole s le revealed that patients on antidepressants were younger, more likely to receive benzodiazepines and have significant extrapyramidal side-effects and less likely to have significant positive symptoms. Unlike findings in Western countries, adjunctive antidepressant prescription for schizophrenia was not common in Asia. The frequency of antidepressant prescription varied among countries and territories, suggesting that a host of clinical and socio-cultural factors played a role in determining antidepressant use in Asia.
No related grants have been discovered for Chuan-Yue Wang.