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Factors which can make Patients Difficult to Treat

  • John M. Kane (a1)


Despite considerable advances in the treatment of schizophrenia, there remains a sizeable subgroup of individuals with this illness who are considered difficult to treat. There are a number of factors which may contribute to this phenomenon and given increasing pressure to reduce health care expenditures, the challenge of managing this patient population is becoming increasingly pressing.



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Breier, A., Buchanan, R. W., Kirkpatrick, B., et al (1994) Effects of clozapine on positive and negative symptoms in outpatients with schizophrenia. American Journal of Psychiatry, 151, 2026.
Cole, J. O., Goldberg, S. C. & Davis, J. M. (1966) Drugs in the treatment of psychosis: controlled studies. In Psychiatric Drugs (ed. Solomon, P.), pp. 153180. New York: Groller and Stratton.
Drake, R. E., McLaughlin, P., Pepper, B., et al (1991) Dual diagnosis of major mental illness and substance abuse disorder: an overview. New Directions in Mental Health Services, 50, 312.
Essock, S. M., Hargreaves, W. A., Dohm, F. A., et al (1996) Clozapine eligibility among state hospital patients. Schizophrenia Bulletin, 22, 1525.
Galanter, M., Castenada, R. & Ferman, J. (1988) Substance abuse among general psychiatric patients: place of presentation, diagnosis and treatment. American Journal of Drug and Alcohol Abuse, 142, 211235.
Honigfeld, G., Gillis, R. D. & Klett, C. J. (1966) NOSIE-30: a treatment-sensitive ward behaviour scale. Psychological Reports, 19, 180182.
Jeste, D. V. & Caligiuri, M. P. (1993) Tardive dyskinesia. Schizophrenia Bulletin, 19, 303316.
Juarez-Reyes, M. G., Shumway, M., Battle, C., et al (1995) Effects of stringent criteria on eligibility for clozapine among public mental health clients. Psychiatric Services, 76, 801806.
Kane, J. M. (1985) Compliance issues in outpatient treatment. Journal of Clinical Psychopharmacology, 5, 22S27S.
Kane, J. M. (1995) Tardive dykinesia. Presented at the International Congress on Schizophrenia Research Meeting. Warm Springs, Virginia, April 12, 1995.
Kane, J. M., Honigfeld, G., Singer, J., et al (1988) Clozapine for the treatment-resistant schizophrenic: a double-blind comparison versus chlorpromazine/benztropine. Archives of General Psychiatry, 45, 789796.
Kane, J. M., Safferman, A. Z., Pollack, S., et al (1994) Clozapine, negative symptoms and extrapyramidal side effects. Journal of Clinical Psychiatry, 55 (Suppl. B), 7478.
Kane, J. M., Marder, S. R., Schooler, N., et al (1995) Efficacy of clozapine vs. haloperidol in a long-term clinical trial. Presented at the American Psychiatric Association Meeting. Miami, Florida, May 24, 1995.
Kinon, B. J., Kane, J. M., Johns, C., et al (1993) Treatment of neuroleptic resistant schizophrenic relapse. Psychopharmacology Bulletin, 29, 309314.
Levinson, D. F., Simpson, G. M., Singh, H., et al (1990) Fluphenazine dose, clinical response, and extrapyramidal symptoms during acute treatment. Archives of General Psychiatry, 47, 761768.
Lieberman, J. A., Jody, D., Alvir, J. M. J., et al (1991) Negative symptoms in schizophrenia: relationship to positive symptoms and outcome. In Negative versus Positive Schizophrenia (eds Marneros, A., Andreasen, N. C. & Tsuang, M. T.), pp. 109125. Berlin: Springer-Verlag.
Marder, S. R. & Meibach, R. C. (1994) Risperidone in the treatment of schizophrenia. American Journal of Psychiatry, 151, 825835.
McEvoy, J. P., Hogarty, G. & Steingard, S. (1991) Optimal dose of neuroleptic in acute schizophrenia: a controlled study of the neuroleptic threshold and higher haloperidol dose. Archives of General Psychiatry, 48, 739745.
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale. Psychological Reports, 10, 799812.
Regier, D. A., Farmer, M. E., Rae, D. S., et al (1990) Comorbidity of mental disorders with alcohol and other drug abuse. Journal of the American Medical Association, 264, 25112518.
Remington, G., Pollock, B., Voineskos, G., et al (1993) Acutely psychotic patients receiving high-dose haloperidol therapy. Journal of Clinical Psychopharmacology, 13, 4145.
Rifkin, A., Doddi, S., Karagi, B., et al (1991) Dosage of haloperidol for schizophrenia. Archives of General Psychiatry, 48, 166170.
Safferman, A. Z., Kane, J. M., Aronowitz, J. S., et al (1994) The use of clozapine in neurologic disorders. Journal of Clinical Psychiatry, 5 (Suppl. B), 98101.
Shaner, A., Khalsa, M. E., Roberts, L. J., et al (1993) Unrecognized cocaine use among schizophrenic patients. American Journal of Psychiatry, 150, 758762.
Siris, S. G., Morgan, V., Fagerstrom, R., et al (1987) Adjunctive imipramine in the treatment of post psychotic depression: a controlled trial. Archives of General Psychiatry, 44, 533539.
Terkelsen, K. G. & Grosser, R. C. (1990) Estimating clozapine's cost to the nation. Hospital and Community Psychiatry, 41, 863869.
Van Putten, T., Marder, S. R. & Mintz, J. A. (1990) Controlled dose comparison of haloperidol in newly admitted schizophrenic patients. Archives of General Psychiatry, 47, 754758.
Yesavage, J. & Zarcone, V. (1993) History of drug abuse and dangerous behaviour in inpatient schizophrenics. Journal of Clinical Psychiatry, 44, 259261.


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Factors which can make Patients Difficult to Treat

  • John M. Kane (a1)
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