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- Prevalence of COVID-19 and Psychotropic Drug Treatment in Psychiatric
In-patients in Germany in 2020: Results from a Nationwide Pilot Survey-
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Authors: Mueller; Juliane K., Ahrens, Kira F., Bauer, Michael, Baune, Bernhard T., Borgwardt, Stefan, Deckert, Jürgen, Domschke, Katharina, Ellwanger, Regina, Fallgatter, Andreas, Frodl, Thomas, Gallinat, Jürgen, Gottschalk, René, Grabe, Hans J, Hasan, Alkomiet, Herpertz, Sabine C, Hurlemann, Rene, Jessen, Frank, Kambeitz, Joseph, Kircher, Tilo, Kornhuber, Johannes, Lieb, Klaus, Meyer-Lindenberg, Andreas, Rupprecht, Rainer, Scherbaum, Norbert, Schlang, Christiane, Schneider, Anja, Schomerus, Georg, Thoma, Andreas, Unterecker, Stefan, Walter, Martin, Walter, Henrik, Reif, Andreas, Reif-Leonhard, Christine
Pages: 227 - 238
Abstract: Introduction In patients with a pre-existing mental disorder, an increased risk for a first manifestation of a psychiatric disorder in COVID-19 patients, a more severe course of COVID-19 and an increased mortality have been described. Conversely, observations of lower COVID-19 incidences in psychiatric in-patients suggested protective effects of psychiatric treatment and/or psychotropic drugs against COVID-19. Methods A retrospective multi-center study was conducted in 24 German psychiatric university hospitals. Between April and December 2020 (the first and partly second wave of COVID-19), the effects of COVID-19 were assessed on psychiatric in-patient care, the incidence and course of a SARS-CoV-2 infection, and treatment with psychotropic drugs. Results Patients (n=36,322) were admitted to the hospitals. Mandatory SARS-CoV-2 tests before/during admission were reported by 23 hospitals (95.8%), while 18 (75%) conducted regular testing during the hospital stay. Two hundred thirty-two (0.6%) patients were tested SARS-CoV-2-positive. Thirty-seven (16%) patients were receiving medical treatment for COVID-19 at the psychiatric hospital, ten (4.3%) were transferred to an intermediate/intensive care unit, and three (1.3%) died. The most common prescription for SARS-CoV-2-positive patients was for second-generation antipsychotics (n=79, 28.2%) and antidepressants (SSRIs (n=38, 13.5%), mirtazapine (n=36, 12.9%) and SNRIs (n=29, 10.4%)). Discussion Contrary to previous studies, our results showed a low number of infections and mortality in SARS-CoV-2-positive psychiatric patients. Several preventive measures seem effective to protect this vulnerable group. Our observations are compatible with the hypothesis of a protective effect of psychotropic drugs against COVID-19 as the overall mortality and need for specific medical treatment was low.
Citation: Pharmacopsychiatry 2023; 56: 227-238
PubDate: 2023-11-09T11:33:17+0100
DOI: 10.1055/a-2177-3056
Issue No: Vol. 56, No. 06 (2023)
- Clozapine-Induced Stuttering: Case Report and Literature Review
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Pharmacopsychiatry 2023; 56: 240-243
DOI: 10.1055/a-2189-5597
Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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Pharmacopsychiatry 2023; 56: 240-2432023-11-09T11:33:17+0100
Issue No: Vol. 56, No. 06 (2023)
- Longitudinal Digital Mood Charting in Bipolar Disorder: Experiences with
ChronoRecord Over 20 Years-
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Authors: Bauer; Michael, Glenn, Tasha, Alda, Martin, Grof, Paul, Bauer, Rita, Ebner-Priemer, Ulrich W., Ehrlich, Stefan, Pfennig, Andrea, Pilhatsch, Maximilian, Rasgon, Natalie, Whybrow, Peter C.
Pages: 182 - 187
Abstract: Introduction Longitudinal study is an essential methodology for understanding disease trajectories, treatment effects, symptom changes, and long-term outcomes of affective disorders. Daily self-charting of mood and other illness-related variables is a commonly recommended intervention. With the widespread acceptance of home computers in the early 2000s, automated tools were developed for patient mood charting, such as ChronoRecord, a software validated by patients with bipolar disorder. The purpose of this study was to summarize the daily mood, sleep, and medication data collected with ChronoRecord, and highlight some of the key research findings. Lessons learned from implementing a computerized tool for patient self-reporting are also discussed. Methods After a brief training session, ChronoRecord software for daily mood charting was installed on a home computer and used by 609 patients with affective disorders. Results The mean age of the patients was 40.3±11.8 years, a mean age of onset was 22±11.2 years, and 71.4% were female. Patients were euthymic for 70.8% of days, 15.1% had mild depression, 6.6% had severe depression, 6.6% had hypomania, and 0.8% had mania. Among all mood groups, 22.4% took 1–2 medications, 37.2% took 3–4 medications, 25.7 took 5–6 medications, 11.6% took 7–8 medications, and 3.1% took >8 medications. Conclusion The daily mood charting tool is a useful tool for increasing patient involvement in their care, providing detailed patient data to the physician, and increasing understanding of the course of illness. Longitudinal data from patient mood charting was helpful in both clinical and research settings.
Citation: Pharmacopsychiatry 2023; 56: 182-187
PubDate: 2023-09-07T18:29:33+01:00
DOI: 10.1055/a-2156-5667
Issue No: Vol. 56, No. 05 (2023)
- Augmentation of Electroconvulsive Therapy with Oral Caffeine: A
Retrospective Analysis of 40 Patients with Major Depression-
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Authors: Nyhuis; Peter, Mücke, Dorothea, Specka, Michael, Scherbaum, Norbert
Abstract: Objective Studies have demonstrated the efficacy of injectable caffeine as an augmentation method in electroconvulsive therapy (ECT). This study investigated whether orally administered caffeine increases seizure duration during ECT. Methods Medical records of 40 patients treated with a series of ECT were retrospectively analyzed. Patients whose electroencephalogram (EEG) seizure duration had dropped
Citation: Pharmacopsychiatry ; : -
PubDate: 2023-11-23T10:07:51+0100
DOI: 10.1055/a-2197-9635
- The Effect of Electroconvulsive Therapy on Specific Catatonia Symptoms and
Predictors of Late Response-
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Authors: Breit; Sigrid, Meyer, Agnes, Schmitt, Wolfgang, Bracht, Tobias, Walther, Sebastian
Abstract: Introduction Electroconvulsive therapy (ECT) is known to be effective in the treatment of catatonia, reaching response rates of about 80 to 100%. It is indicated in cases of treatment resistance to benzodiazepines and in life-threatening conditions such as malignant catatonia. Beneficial effects on specific symptoms or predictors of response are less clear. The objective of this retrospective study is to examine the ECT effect on specific catatonia symptoms in the acute phase of the illness and to identify predictors of response. Methods A retrospective study examined data from 20 patients with catatonia, 18 associated with schizophrenia and 2 with bipolar disorder, who underwent ECT from 2008 to 2021. Ten subjects had more than one ECT-series, resulting in a total of 31 ECT-series. Catatonia symptom severity was assessed with the Bush Francis Catatonia Rating Scale (BFCRS). Results ECT yielded excellent response. Nineteen of 20 patients and 30 of 31 ECT-series achieved response. The mean number of ECT sessions to response was 4.2. Response to ECT was more pronounced for motor inhibition symptoms such as stupor and mutism, while echophenomena, dyskinesia, stereotypy and perseveration responded less well. A predictor of late response was the presence of grasp reflex. Discussion The present study corroborates the high and rapid effectiveness of ECT in the treatment of catatonia. Focus on single catatonia signs may help to identify those who are most likely to achieve remission quickly, as well as those who might need longer ECT-series.
Citation: Pharmacopsychiatry ; : -
PubDate: 2023-11-23T10:02:19+0100
DOI: 10.1055/a-2195-1499
- Factors Associated with Antidepressant Effects of Ketamine: A Reanalysis
of Double-Blind Randomized Placebo-Controlled Trial of Intravenous
Ketamine for Treatment-Resistant Depression-
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Authors: Yonezawa; Kengo, Uchida, Hiroyuki, Yatomi, Taisuke, Ohtani, Yohei, Nomoto-Takahashi, Kie, Nakajima, Shinichiro, Mimura, Masaru, Tani, Hideaki
Abstract: Introduction Predictors of treatment response to intravenous ketamine remain unclear in patients with treatment-resistant depression (TRD); therefore, this study aimed to clarify these predictors using the US National Institutes of Health database of clinical trials. Methods Data from a placebo-controlled, double-blind, randomized controlled trial were used to assess the efficacy of intravenous ketamine in adult patients with TRD (NCT01920555). For the analysis, data were used from the participants who had received therapeutic doses of intravenous ketamine (i. e., 0.5 and 1.0 mg/kg). Logistic and multivariable regression analyses were conducted to explore the demographic and clinical factors associated with response to treatment or changes in the Hamilton Depression Rating Scale 6 items (HAM-D-6) total score. Results This study included 31 patients with TRD (13 women; mean±standard deviation age, 48.4±10.9 years). Logistic regression analysis showed that the age of onset was positively correlated with treatment response after three days of ketamine administration (β=0.08, p=0.037); however, no association was observed between treatment response and age, sex, baseline HAM-D-6 total score, or dissociative score assessed with the Clinician-Administered Dissociative States Scale 40 min after ketamine infusion. Multiple regression analysis showed that no factors were correlated significantly with the percentage change in the HAM-D-6 total score three days after ketamine administration. Discussion Later disease onset correlates with a better treatment response three days after ketamine infusion in patients with TRD. Glutamatergic signal transmission may be impaired in patients with an earlier onset of depression, resulting in decreased neuroplasticity, which diminishes ketamine response.
Citation: Pharmacopsychiatry ; : -
PubDate: 2023-10-16T10:04:14+01:00
DOI: 10.1055/a-2179-8884
- Association of Four Medication Classes and Non-suicidal Self-injury in
Adolescents with Affective Disorders – A Retrospective Chart Review-
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Authors: Eggart; Vincent, Mortazavi, Matin, Kirchner, Sophie-Kathrin, Keeser, Daniel, Brandstetter, Lisa, Hasan, Alkomiet, Wagner, Elias
Abstract: Background Non-suicidal self-injury (NSSI) behaviour is frequently observed in children and adolescents with psychiatric conditions. Affected individuals are regularly treated with psychotropic drugs, although the impact of these agents on NSSI behaviour remains elusive. Methods We performed a retrospective chart review from clinical routine data in a large cohort (N=1140) of adolescent inpatients with primary affective and non-affective psychiatric disorders according to ICD-10 (mean age=15.3±1.3 years; 72.6% female). Four separate mixed regression models compared the frequency of NSSI between treatment periods without any medication and four medication categories (benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), high- and low-potency antipsychotics). Results In those individuals with affective disorders as the primary diagnosis, periods without medication were associated with significantly lower NSSI/day compared to all four other medication conditions (benzodiazepines p
Citation: Pharmacopsychiatry ; : -
PubDate: 2023-09-18T14:18:57+01:00
DOI: 10.1055/a-2153-4370
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