Care for schizophrenia improving
MedWire News: Between 1996 and 2005 schizophrenia was diagnosed earlier, use of polypharmacy for the illness increased, and outpatient visits became more frequent, Danish study results show.
Over the same period, the number of hospital admissions and bed days decreased, as did the proportion of patients who were institutionalized.
The findings paint an “encouraging” picture of care, the researchers say, but they caution that further studies are needed to determine the relationship between earlier diagnosis, treatment type, and outcomes.
Jimmi Nielsen (Aalborg Psychiatric Hospital, Denmark) and colleagues reviewed data on all newly diagnosed patients with schizophrenia (n=13,600) in a Danish cohort between 1996 and 2005.
They looked at prescriptions, medical charts, and hospital records in the first year after diagnosis.
During the study period there was a significant decrease in the mean age at schizophrenia diagnosis, from 35.1 years in 1996 to 31.3 years in 2005. The decrease was especially pronounced in females, falling from 38.3 to 32.0 years.
The percentage of patients filling at least one antipsychotic prescription within the first year increased from 67.2% to 80.7% during the study period, with prescription of second-generation antipsychotics increasing from 15.3% to 89.2% and antipsychotic polypharmacy increasing from 33.3% to 56.2%.
Notably, the proportion of patients receiving antidepressants increased from 24.3% to 40.6%.
There were significant decreases in the mean number of psychiatric admissions in the first year (from 1.6 to 1.4), the proportion of patients requiring inpatient treatment (80.3% to 74.2%), and the number of bed days.
The mean number of outpatient contacts per patient increased from 10.2 to 21.4, and the percentage of patients living in a board-and-care institution decreased from 5.6% to 4.4%, as did the proportion of patients living alone (from 81.3% to 77.3%).
“In light of these results, further, prospective studies are needed to determine the relationship between earlier diagnosis, treatment type and intensity and outcomes in first-episode schizophrenia,” Nielsen and colleagues comment in the journal Acta Psychiatrica Scandinavica.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Andrew Czyzewski