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In this paper, we study a family of binomial ideals defining monomial curves in the n-dimensional affine space determined by n hypersurfaces of the form
$x_i^{c_i} - x_1^{u_{i1}} \cdots x_n^{u_{1n}}$
in
$\Bbbk [x_1, \ldots , x_n]$
with
$u_{ii} = 0, \ i\in \{ 1, \ldots , n\}$
. We prove that the monomial curves in that family are set-theoretic complete intersections. Moreover, if the monomial curve is irreducible, we compute some invariants such as genus, type and Frobenius number of the corresponding numerical semigroup. We also describe a method to produce set-theoretic complete intersection semigroup ideals of arbitrary large height.
During menopause, women undergo a series of physiological changes that include a redistribution of fat tissue. This study was designed to investigate the effect of adding 10 g of cocoa-rich chocolate to the habitual diet of postmenopausal women daily on body composition. We conducted a 6-month, two-arm randomised, controlled trial. Postmenopausal women (57·2 (sd 3·6) years, n 132) were recruited in primary care clinics. Participants in the control group (CG) did not receive any intervention. Those of the intervention group (IG) received 10 g daily of 99 % cocoa chocolate in addition to their habitual diet for 6 months. This quantity comprises 247 kJ (59 kcal) and 65·4 mg of polyphenols. The primary outcomes were the between-group differences in body composition variables, measured by impendancemetry at the end of the study. The main effect of the intervention showed a favourable reduction in the IG with respect to the CG in body fat mass (–0·63 kg (95 % CI –1·15, –0·11), P = 0·019; Cohen’s d = –0·450) and body fat percentage (–0·79 % (95 % CI –1·31, –0·26), P = 0·004; Cohen’s d = –0·539). A non-significant decrease was also observed in BMI (–0·20 kg/m2 (95 % CI –0·44, 0·03), P = 0·092; Cohen’s d = –0·345). Both the body fat mass and the body fat percentage showed a decrease in the IG for the three body segments analysed (trunk, arms and legs). Daily addition of 10 g of cocoa-rich chocolate to the habitual diet of postmenopausal women reduces their body fat mass and body fat percentage without modifying their weight.
Recent trends in the area of catalytic applications of metal–organic framework (MOF)-derived nanocarbons are covered. These highly porous nanostructures, convenient for the green chemistry processes, are generally formed by the direct carbonization of a variety of MOF, mainly MOF-5, ZIF-8, ZIF-67, UiO-66-NH2, MIL-101-NH2 at 700–1000 °C in argon or nitrogen flow. Differences between conventional porous carbons and MOF-derived carbons are in pore volumes, surface area, and presence of ad-atoms. The morphology of the MOF-derived nanocarbons can be adjustable with uniform dopant distribution. Resulting nanocarbons are widely applied in heterogeneous catalysis, photocatalysis and are very promising as electrocatalysts, having excellent performance in oxygen evolution reaction, oxygen reduction reaction, and hydrogen evolution reaction. Catalytic applications for environmental purposes are also discussed. Good catalytic performance is related with highly dispersed heteroatoms, density of catalytic active sites, controllable porosity, and high surface area. Opportunities for further research are indicated, in particular, the creation of low pH-stable electrocatalysts and novel strategies for the preparation of 1÷3D single-atom catalysts.
Recently, the validity range of the approximations commonly used in neoclassical calculation has been reconsidered. One of the primary motivations behind this trend is observation of an impurity hole in LHD (Large Helical Device), i.e. the formation of an extremely hollow density profile of an impurity ion species, such as carbon
$\text{C}^{6+}$
, in the plasma core region where a negative radial electric field (
$E_{r}$
) is expected to exist. Recent studies have shown that the variation of electrostatic potential on the flux surface,
$\unicode[STIX]{x1D6F7}_{1}$
, has significant impact on neoclassical impurity transport. Nevertheless, the effect of
$\unicode[STIX]{x1D6F7}_{1}$
has been studied with radially local codes and the necessity of global calculation has been suggested. Thus, we have extended a global neoclassical code, FORTEC-3D, to simulate impurity transport in an impurity hole plasma including
$\unicode[STIX]{x1D6F7}_{1}$
globally. Independently of the
$\unicode[STIX]{x1D6F7}_{1}$
effect, an electron root of the ambipolar condition for the impurity hole plasma has been found by global simulation. Hence, we have considered two different cases, each with a positive (global) and a negative (local) solution of the ambipolar condition, respectively. Our result provides another support that
$\unicode[STIX]{x1D6F7}_{1}$
has non-negligible impact on impurity transport. However, for the ion-root case, the radial
$\text{C}^{6+}$
flux is driven further inwardly by
$\unicode[STIX]{x1D6F7}_{1}$
. For the electron-root case, on the other hand, the radial particle
$\text{C}^{6+}$
flux is outwardly enhanced by
$\unicode[STIX]{x1D6F7}_{1}$
. These results indicate that how
$\unicode[STIX]{x1D6F7}_{1}$
affects the radial particle transport crucially depends on the profile of the ambipolar-
$E_{r}$
, which is found to be susceptible to
$\unicode[STIX]{x1D6F7}_{1}$
itself and the global effects.
Although dried orange pulp (DOP) may conveniently replace cereals in ruminant diets, few studies have considered similar diet substitution for goats. We hypothesised that DOP could replace cereal-based concentrate in goat diets without detrimental effects on growth performance and carcass quality of suckling kids and milk performance and blood biochemical parameters of dams in early lactation. We also hypothesised that DOP substitution may increase the levels of antioxidants, such as phenolic compounds and vitamin E, in milk and improve its total antioxidant capacity (TAC). Therefore, 44 primiparous Payoya dairy goats were allocated to three experimental groups, each fed a different diet: control (CD, n = 14) based on a commercial concentrate with alfalfa hay as forage; and DOP40 (n = 16) in which 40% and DOP80 (n = 14) in which 80% of the cereal in the concentrate were replaced by DOP. The experiment lasted from the final month of pregnancy to 55 days postpartum. The DOP diets did not affect suckling kids’ carcass quality, but at 28 days, led to improvement in live weight (LW) and average daily gain (ADG) from birth, although no differences were found between DOP40 and DOP80 (for CD, DOP40 and DOP80, LW at 28 days was 8.00, 8.58 and 8.34 kg and ADG was 184, 199 and 195 g/day, respectively). Diet had no significant effect on milk yield (average daily milk yield and total yield at 55 days were 1.66 l/day and 90.6 l, respectively) and commercial and fatty acid composition. Nevertheless, α-tocopherol, total phenolic compound (TPC) and TAC concentration in milk increased with substitution of cereals by DOP (for CD, DOP40 and DOP80, concentration of α-tocopherol was 21.7, 32.8 and 42.3 μg/100 g, TPCs was 63.5, 84.1 and 102 mg gallic acid equivalents/l, and TAC was 6.63, 11.1 and 12.8 μmol Trolox equivalents/ml, respectively). Every plasma biochemistry parameter considered was within reference values for healthy goats; therefore, no pathological effect was detected for these variables due to dietary treatment. However, DOP diets caused a reduction in plasmatic creatine kinase and aspartate aminotransferase, implying reduced oxidative damage to muscles. In conclusion, DOP may be an interesting alternative to cereals in early lactation goat diets for increasing farmers’ income and the healthy antioxidant capacity of milk.
Mixed Bipolar patients are those who have co-existing depressive symptoms during mania. These patients are supposed to have a worse evolution.
Objective
The objective of this study was to compare the long-term outcomes of patients who had at least one mixed episode with those who experienced only pure manic episodes.
Methods
169 outpatients diagnosed of Bipolar I disorder and treated at least during two years were included. 120 patients (71%) complited the follow-up over 10 years. Baseline demographic and clinical variables were included.
Results
The patients with mixed episodes (37%) had a significantly younger mean age at onset comparing with those with manic episodes (25.3 years vs. 30.8 years; p=0.025) they also had more previous mood- incongruent psychotic symptoms χ2= 6.77, p=0.034), more number of hospitalizations (OR= 1.36, 95% CI = 1.14; -1.63; p< 0.001), and more number of episodes (OR= 1.21, 95% CI = 1.10-1.31; p< 0.001). There were no significant differences relating to depressive episodes, alcohol use, drug abuse, suicidal behaviour and suicide attempts.
Discussion
Age at onset differed significantly between the mixed episode and pure mania groups, with mixed episode patients having a younger age of onset. This is interesting as one of the major results of the study we have found that age at onset mediates some of the factors classically related to outcome in mixed episodes like alcohol abuse and suicide attempts. However, independently of age at onset, these patients represent a especially severe type of bipolar disorder.
“Rite of passage” is an etnographic concept developed by VanGennep that defines the vital transition of an individual between two different status. It is divided in three stages: separation, liminal/threshold and aggregation. Turner described the liminal phase, and the terms of “communitas” and “liminoid” (structure of a rite without religious/spiritual elements). One widely-known Rite of Passage is the initiation of the shamans.
Objetives
Study the elements of a rite of passage present in Psychiatric Trainning.
Method
• Field study (observational, descriptive, non-experimental).
• Preliminary Sample=10trainees (5man+5women); last year of Psychiatric Trainning.
• “ad hoc” semi-structured interview (21items subdivided in open questions). 10interviews (average duration=75mins). Permanent register:digital recorder.
• Summary and analysis of the answers. Review of the literature.
Results
- Psychiatric Trainning shared the elements and tri-phasic structure of VanGennep's “rite of passage” concept
- Trainees saw themselves as more empathic(7/10) and humanistic(8/10) than other specialties colleagues. Stigma towards mental illness(8/10) and fear of suicide(9/10) were also considered as their distinctives.
- The collective behaved as a communitas(10/10)
- No spiritual elements(0/10): liminoid process
- Resemblances of the ancestral shamans' Initiation: Despite bloody practices were over, suffering was also present(7/10), but was seen as necessary(6/10) and well tolerated(7/10).
- Trainees felt that they grew spiritual and mentally(7/10) during the trainning years
Conclusions
Results suggest that Psychiatric Trainning has stable phenomena that:
• are compatible with the Rite of Passage schema
• Are considered exclusive of Psychiatry by trainees
• Have not been systematically studied as a whole, which could help to improve the training.
Despite lithium has been used for the last 50 years as a maintenance treatment for bipolar disorder during pregnancy, there is limited information about perinatal clinical outcomes from fetal exposure to lithium.
Objectives
1. To quantify the rate of lithium placental passage
2. To assess any association between plasma concentration of lithium at delivery and perinatal outcome.
Methods
Observational and prospective study. Subjects: Women in maintenance treatment with lithium, being attended during pregnancy at the Perinatal Psychiatry Programme of Hospital Clínic (Barcelona, Spain) between 2007 and 2009. Procedure: We assessed sociodemographical data; dose/day of lithium carbonate; other drugs doses; plasmatic concentration of lithium carbonate in maternal blood intrapartum and in the umbilical cord; obstetrical maternal complications; gestational age at delivery; weight at delivery; Apgar scores; congenital malformations; hospital stays, infant serum concetrations of thyroid-stimulating hormone.
Results
Eight mother-child diads. Mean age of the mother (SD): 32.1 (4,7); 100% caucasian and married. Mean dose of maternal lithium (SD): 675mg (237,5mg). Premature rupture of membranes (%):25. Gestational mean age (in weeks) (SD): 39,9 (1). Birth weight (SD) : 3625gr (451,2gr); Mean Apgar1min (SD): 8,38 (1,1); Mean Apgar5min (SD): 9,75 (0,4). Loss of fetal intrapartum wellness (%): 12,5. Days of hospitalization (mean) (SD):9,5(16,6). Lithium plasmatic concentration (mEq/L), mean (SD): maternal 0,45(0,1), umbilical cord 0,33(0,1), lithium ratio uc/m 0,93 (0,3); infant TSH μU/mL mean (SD): 4,9(4,6).
Conclusions
Lithium placental passsage was 0,93 (0,63-1,07). ≤At umbilical cord lithium levels ≤ 0.60 mEq/L, we didn't have any preterm deliveries, low birth weight newborns, nor neonatal complications.
Outpatient group psychotherapy began in our department in 2002 as a complement to the acute inpatient unit. Patients with heterogeneous diagnoses were included before or after a short-duration stay in the unit. Clinicians’ impression was that re-entries to the acute unit were less frequent and shorter after group therapy.
Objectives
The objective is to determine the real impact of group psychotherapy on the number and mean duration of these re-entries.
Methods
Data was collected for 156 patients during period of two years. The number and mean duration of hospitalization in the psychiatric acute unit were registered for each patient during the year before and in the year after therapy to be analyzed and compared.
Results
Before attending group psychotherapy 60.3% of the patients were hospitalized in the acute unit (39.1% once, 12.8% twice, 6.4% three times, 1.9% four times). 65.4% had no re-entries in the following year; 71% of those who did had one re-entry. The mean number of entries per year in the acute unit before therapy was 0.92, while the mean after therapy was 0.52. The mean stay was 7.86 days before therapy, and 4.62 days after. The mean differences between before and after entries were significant in statistical analyses.
Conclusions
Group psychotherapy seems to have effects on number and duration of re-entries to the acute unit for most patients in the different diagnostic categories. These findings have important implications, as this form of therapy is cost-effective and available for a wide range of psychiatric patients.
Fiction films offer unexplored opportunities of rehabilitation for schizophrenia and other psychoses. Schizophrenia produces deficits y distortions in the perception and comprehension of reality, also expressed in the perception and comprehension of films. After a year of an “ad hoc” experience, the following technique was developed:
1) Selecting a fiction film for its narrative, affective, cognitive and social cognitive content
2) Briefly presenting of the film to a group of 8-16 patients with diverse psychosis.
3) Screening of the film to the patients and the therapeutic team.
4) Summarizing of the plot by a patient. Group correcting of distortions and deficits caused by problems of attention and working memory, as well as positive, negative, affective and social cognitive symptoms (emotional perception, theory of mind, attributive style)
5) Selecting 1-2 sequences by each patient, and group commenting using the same technique.
6) Field recording of all the commentaries obtained.
7) Second screening of the film two days after, repeating points 2 to 6.
8) Comparing both field records.
An experimental study using this technique is presented. 8 patients with schizophrenia and other psychoses watched 4 fiction films (“The 39 Steps”, “Charade”, “M”, “The General”). The differences founded in both viewings by two external evaluators (using CGI and analogical scales of the main variables) are presented and commented. An evaluation of the perceived usefulness and satisfaction of the participants was included.
To find out the frequency of medical conditions presented by a population of institutionalized chronic schizophrenic patients.
Methods
The target population is a total of 220 schizophrenic patients, 48 men and 172 women, diagnosed following the ICD-10 criteria, institutionalized at least during 5 years in a 76,8% of the patients. The average age was of 64,64 years.
Specific survey applied by the group of investigators aiming to collect socio-demographical data and the medical conditions, using the following psychometric scales: Cumulative Index of Illnesses (CII), Global Assessment Scale (GAS), and Clinical Global Impression (CGI).
Statistical analysis was performed with SPSS v 15.0, including descriptive statistics and correlation analysis.
Results
Diabetes was found in 15% of cases, obesity in 31,7%, overweight in 39%, high blood pressure in 24,5%, high cholesterol serum levels in 21%, high triglyceride serum levels in 8,7%. A 26% of the patients were smokers.
The average number of categories at the CII scale was 4,84 and the average total score was 11,96.
Conclusions
Our patients predominantly are of an advanced age, female sex, and long-term inpatients. The presence of comorbid physical illness is high. The relatively low number of smokers could be explained by the demographic characteristics of our sample.
Suicide is one of the most frequent causes of death. In 1993, Bleuler emphasized its importance in his “Suicidal behavior is the most serious symptom of schizophrenia”. Since then, various studies have confirmed importance of suicide in schizophrenia, and today it's clear that his research and knowledge is one of the great challenges of psychiatry.
Objectives
- Establish clinical-socio-demographic profile and risk factors for psychotic people with autolytic behaviors.
- Determine frequency of suicides in psychotic disorders in our area of care.
Material and methods
Retrospective study(3 years evolution) that includes psychotic patients(diagnosed according DSM IV-TR) admitted to the HCU of Valladolid. With data provided by hospital medical records, analyzed socio-demographic variables and clinics. Study consists of two groups:group of cases(those patients who have suicidal behavior) and control group (those that haven't autolytic gesture during the study period). Statistical evaluation was performed with SPSS.
Results
- The sample includes 191 patients:41(21%) have attempted suicide.
- Of them:73% are males;88% singles;51% have basic studies;61% we re unemployed;37% were 31-40 aged;54% started disease 21-30 aged and 63.5% are schizophrenic.
- Considering statistical study we find that suicidal patient profile is male(p = 0.039),diagnosed with schizophrenia(p = 0.033),with previous suicide attempts(p = 0.009)and lack of social support(p = 0.007).
Conclusions
:
- 21% of hospitalized psychotic patients have presented some autolytic attempt.
- Profile of suicidal psychotic patient is a male, single, 21-40 aged, primary education, unemployed, with a primary diagnosis of schizophrenia, particularly paranoid, with ten years evolution,without acceptable social support, number of revenues higher than non-suicidal psychotic and a personal history of previous autolytic attempts.
Course and outcome in schizophrenia are heterogeneous. Numerous studies have shown an association between the presence of negative symptoms and psychosocial and occupational functioning of patients.
Objectives
To analyse the prevalence of negative symptoms in the course of illness in first episode psychosis and chronic schizophrenia and to establish its relation with the functional outcome.
Methods
43 patients with a first-episode psychosis (FEP) from our area were compared with 43 chronic schizophrenic patients and 43 normal controls from a parallel area. They were matched one on one for age, gender and years of education. All subjects were compared regarding psychopathology and functional outcome terms. Patients were examined with Positive and Negative Syndrome Scale (PANSS) for clinical symptom. Longitudinal functionality was prospectively assessed with the Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) rating scales.
Results
We found significant differences between FEP and chronic patients in negative symptom severity (t = -4.97, p< 0.001) and global assessment of functioning (t = 7.58, p< 0.001). There was no statistically significant difference between the two groups in PANSS positive and general components or Clinical Global Impression. Negative symptom severity was associated with poorer GAF ratings in first episode psychosis and chronic schizophrenia.
Conclusions
Negative symptoms appear to be persistent. In our study negative symptom severity was associated with social and functional impairment, defined as Global Assessment of Functioning Scale score of less than or equal to 60.
The aim of this longitudinal study was to determine whether the depot formulation of an antipsychotic reduces violence in outpatients with schizophrenia as compared to oral administration of the same antipsychotic.
Methods
Forty-six previously violent patients with schizophrenia were randomised to receive treatment with oral or depot zuclopenthixol for 1 year. Clinicians interviewed patients at baseline and every month thereafter to assess treatment adherence. An interviewer blinded to treatment assignments interviewed an informant about any violent behaviour during the previous month.
Results
Violence during the follow-up year was inversely proportional to treatment adherence, better compliance, and greater reduction of positive symptoms. Lower frequency of violent acts was observed in the depot group. The level of insight at baseline was not significantly associated with violence recidivism. Regardless of route of administration, treatment non-adherence was the best predictor of violence.
Conclusions
Some patients with schizophrenia and prior violent behaviour may benefit from the depot formulation of antipsychotic medication.
Two studies to date have been published regarding the prevalence of the metabolic syndrome in bipolar patients. The unadjusted prevalence rates reported were 30% and 32%. The aim of this study was to evaluate the prevalence of the metabolic syndrome in a group of 142 bipolar patients from Spain.
Methods:
Bipolar patients (ICD-10 criteria) from 11 centres in Spain were assessed cross-sectionally for metabolic syndrome according to the NCEP ATP III criteria.
Results:
The mean age was 47.3 (SD 14.5), 51.1% were male. On average, patients were receiving 2.8 (SD 1.3) drugs for the treatment of their bipolar disorder. Ninety-one percent were receiving mood stabilizers, 63.4% antipsychotics and 29.6 antidepressants. Eighty-seven percent of the antipsychotics prescribed were atypicals. The overall prevalence of metabolic syndrome in our sample was 24.6% Fifty-seven percent of the sample met the criterion for abdominal obesity, 37.4% for met the criterion for hypertriglyceridemia, 36.4% for low HDL-cholesterol, 25.2% for high blood pressure and 12.5% for high fasting glucose. No statistically significant difference was found between with and without the metabolic syndrome for gender, illness status (acute versus in remission), CGI-S-BP scores and number of medications used. Patients taking tow mood stabilizers had significantly higher metabolic syndrome rates than patients taking one mood stabilizer and than patients without mood stabilizer treatment (40% versus 17.8% and 11.1% respectively, p .02).
Conclusions:
The prevalence of the metabolic syndrome in bipolar patients is high. It appears to be higher than that estimated for the Spanish general population.
At present,the need of antipsychotic treatments for the improvement of the condition of people with psychotic disorders is unquestionable.Despite the current availability of highly effective drugs with few secondary effects,the main cause behind hospitalization is still the lack of compliance.
Objectives:
Analysis of the determining variables behind the need for hospitalization and the influence of the types of antipsychotic treatments.
Methods:
Retrospective and follow-up analysis of psychotic patients hospitalized in the Psychiatric Ward of the Hospital de Conxo (1998-2005).Three groups of patients:with Oral neuroleptics(170), with Depot typical neuroleptics (238),with Long-Acting Risperidone(60);and comparison based on treatment maintenance.
Results:
Males,day-to-day living with the family of origin and single status are predominant in all three groups,although in a higher proportion in the Long-Acting Risperidone one(75,71 and 85%respectively).Only 7% of the patients with Long-Acting Risperidone completed their university studies,62% were pensioners.The average duration of hospitalization periods is 21 days for the patients with Long-Acting Risperidone,23.3 days in the Oral group,29.5 days in the Depot group.The main cause behind re-hospitalization is the lack of compliance(68% in Depot group),whilst after the introduction of Long-Acting Risperidone,no compliance rate is 59%.If we compare the number of hospitalizations/year of the patients with Long-Acting Risperidone,before and after its introduction,the rate is reduced significantly from 0.89 to 0.73.
Conclusions:
Despite the fact that patients treated with Long-Acting Risperidone show a more seriously ill condition and less social capacity,they have less need for hospitalization than patients treated with Depot neuroleptics.Median lengths of stay were shorter than patients in the other two groups,and are less re-hospitalized after the introduction of this treatment.
Acute involuntary hospitalization is perceived as a threatening event for most of patients. Acute involuntary hospitalization of psychiatric patients is probably a major source of anxiety and may be related to anxiety disorders. Further knowledge on the anxiety disorders secondary to involuntary hospitalization may limit traumatic experience and is, indeed, of considerable importance.
Methods
Bibliographic review of the existing literature was conducted using MEDLINE/PubMed (1969-2010). The following key words were used “involuntary hospitalization”; “coercion”; “patient admission”; “stress disorder” “anxiety” and “posttraumatic stress disorder”. All papers in English and French were considered in this review.
Results
Although the impact of diverse stressful or traumatic events has been the subject of numerous publications, we found only one study in the literature dealing with PTSD symptoms related to acute involuntary hospitalization. In this article involuntarily admitted patients were not more traumatized than voluntarily admitted ones. Although coercive measures can be traumatizing, but forced medication, seclusion, or application of any coercive measure were not significantly associated with traumatizing. Reviews on involuntary hospital admission’ demonstrated negative and positive consequences on various outcome domains. Findings highlight the predominantly negative impact of physical restraint on the person restrained and their family. These findings support minimal use of restraint in health care to a relatively vulnerable group of people. But coercion can also lead to positive outcomes.
Conclusions
Specific studies concerning the impact of involuntary hospitalization, coercitive measures and forced treatment causing anxiety disorders are still needed. Discussion about its methodology and ethical aspects remains necessary.
To describe validation process of the new apathy scale for institutionalized dementia patients (APADEM-NH).
Methods
100 elderly, institutionalized patients with diagnosis of probable Alzheimer Disease (AD) (57%), possible AD (13%), AD with cerebral vascular disease (CVD) (17%), Lewy Bodies Dementia (11%) and Parkinson associated to dementia (PDD) (2%). All stages of the disease severity according to the Global Deterioration Scale (GDS) and Clinical Dementia Rating (CDR) were assessed. The Apathy Inventory (AI), Neuropsychiatric Inventory (NPI), Cornell scale for depression, and the tested scale were applied. Re-test and inter-rater reliability was carried out in 50 patients. The feasibility and acceptability, reliability, validity, and measurement precision were analyzed.
Results
APADEM-NH final version consists of 26 items and 3 dimensions: Deficit of Thinking and Self-Generated behaviors (DT): 13 items, Emotional Blunting (EB): 7 items, and Cognitive Inertia (CI): 6 items. Mean application time was 9.56 minutes and 74% of applications were fully computable. All subscales showed floor and ceiling effect lower than 15%. Internal consistency was excellent for each dimension (Cronbach’s α DT = 0.88, α EB = 0.83, α CI= 0.88);Test-retest reliability for the items was kW=0,48-0,92; Inter-rater reliability reached kW values 0.84-1.00; The APADEM-NH total score showed a low/moderate correlation with apathy scales (Spearman ρ, AI =0.33; NPI-Apathy= 0,31), no correlation with depression scales (NPI-Dementia = -0.003; Cornell= 0,10), and high internal validity (ρ =0.69 0.80).
Conclusions
APADEM-NH is a brief, psychometrically acceptable, and valid scale to assess apathy in patients from mild to severe dementia and discerning between apathy and depression.
It is well stablished that therapeutic compliance is a fundamental predictive factor in the outcome of first-episode psychosis. Risperidone long-acting injection has demonstrated high remission rates and improvements in treatment adherence.
Objective
1- To analyse the efficacy of risperidone long-acting injection vs oral atypical antipsychotics in first-episode psychosis.
2- To describe in both groups the evolution of clinical and cognitive symptoms, functional outcome, quality of life, insight and treatment adherence.
Method
18 patients with a first-episode psychosis treated with long-acting risperidone were compared with 21 first-episode psychosis treated with oral atypical antipsychotic medication. They were matched one on one for age, gender and years of education. All subjects were compared regarding psychopathology and functional outcome terms. Patients were examined with Positive and Negative Syndrome Scale (PANSS) for clinical symptoms. Longitudinal functionality was prospectively assessed with the Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) rating scales.
Results
We found significant differences between both groups in negative symptom severity and global assessment of functioning. There was no statistically significant difference between the two groups in PANSS positive and general components. Negative symptom severity was associated with poorer GAF ratings.
Conclusions
Our data suggest that risperidone long-acting injection assures treatment compliance and therefore could improve clinical and functional outcome.