Long-term outcomes in chronically hospitalized geriatric patients with schizophrenia

Retrospective comparison of first generation and second generation antipsychotics

Leonard White, Joseph I. Friedman, Christopher R. Bowie, Martin Evers, Philip D Harvey, Michael Parrella, Emilian Mihaila, Kenneth L. Davis

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Introduction: Some groups have reported the longitudinal course of elderly poor outcome schizophrenic patients to be characterized by progressive decline in cognitive functions and functional capacity. Although many of these patients experience minimal reduction of psychotic symptoms, there may be beneficial effects of antipsychotic treatments on cognitive functions and functional capacity. Methods: This naturalistic study compared the longitudinal course of psychotic symptoms, cognitive functions and functional impairment in geriatric schizophrenic patients treated with first generation (N = 97) or second generation (N = 78) antipsychotic medications. Mixed effects linear regression analyses were used to examine the effects of treatment (first generation vs. second generation antipsychotic), time and treatment × time. Results: Cognitive functions (Mini Mental State Examination time effect estimate = - .41, p < .001; ADAS-L Cog time effect estimate = .64, p < .001) and self-care skills (ADAS-L Self-Care time effect estimate = .65, p < .001) declined over time for the subject group as a whole and this decline was not modified by treatment with second generation antipsychotics relative to first generation antipsychotics. Similarly, second generation antipsychotic treatment produced no effect on the progressive worsening of negative symptom over time. Conclusion: This long-term naturalistic study of poor outcome geriatric patients with schizophrenia did not find atypical antipsychotics to produce any differential protective effect relative to typical antipsychotics on the long-term manifestations of symptoms, cognition and self-care in poor outcome geriatric schizophrenic patients.

Original languageEnglish
Pages (from-to)127-134
Number of pages8
JournalSchizophrenia Research
Volume88
Issue number1-3
DOIs
StatePublished - Dec 1 2006
Externally publishedYes

Fingerprint

Geriatrics
Antipsychotic Agents
Schizophrenia
Cognition
Self Care
Therapeutics
Longitudinal Studies
Linear Models
Regression Analysis
Outcome Assessment (Health Care)

Keywords

  • Antipsychotic
  • Cognition
  • Geriatric
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Behavioral Neuroscience
  • Biological Psychiatry
  • Neurology
  • Psychology(all)

Cite this

Long-term outcomes in chronically hospitalized geriatric patients with schizophrenia : Retrospective comparison of first generation and second generation antipsychotics. / White, Leonard; Friedman, Joseph I.; Bowie, Christopher R.; Evers, Martin; Harvey, Philip D; Parrella, Michael; Mihaila, Emilian; Davis, Kenneth L.

In: Schizophrenia Research, Vol. 88, No. 1-3, 01.12.2006, p. 127-134.

Research output: Contribution to journalArticle

White, Leonard ; Friedman, Joseph I. ; Bowie, Christopher R. ; Evers, Martin ; Harvey, Philip D ; Parrella, Michael ; Mihaila, Emilian ; Davis, Kenneth L. / Long-term outcomes in chronically hospitalized geriatric patients with schizophrenia : Retrospective comparison of first generation and second generation antipsychotics. In: Schizophrenia Research. 2006 ; Vol. 88, No. 1-3. pp. 127-134.
@article{28b39c258d8c4a2292b61b9a08cc19a3,
title = "Long-term outcomes in chronically hospitalized geriatric patients with schizophrenia: Retrospective comparison of first generation and second generation antipsychotics",
abstract = "Introduction: Some groups have reported the longitudinal course of elderly poor outcome schizophrenic patients to be characterized by progressive decline in cognitive functions and functional capacity. Although many of these patients experience minimal reduction of psychotic symptoms, there may be beneficial effects of antipsychotic treatments on cognitive functions and functional capacity. Methods: This naturalistic study compared the longitudinal course of psychotic symptoms, cognitive functions and functional impairment in geriatric schizophrenic patients treated with first generation (N = 97) or second generation (N = 78) antipsychotic medications. Mixed effects linear regression analyses were used to examine the effects of treatment (first generation vs. second generation antipsychotic), time and treatment × time. Results: Cognitive functions (Mini Mental State Examination time effect estimate = - .41, p < .001; ADAS-L Cog time effect estimate = .64, p < .001) and self-care skills (ADAS-L Self-Care time effect estimate = .65, p < .001) declined over time for the subject group as a whole and this decline was not modified by treatment with second generation antipsychotics relative to first generation antipsychotics. Similarly, second generation antipsychotic treatment produced no effect on the progressive worsening of negative symptom over time. Conclusion: This long-term naturalistic study of poor outcome geriatric patients with schizophrenia did not find atypical antipsychotics to produce any differential protective effect relative to typical antipsychotics on the long-term manifestations of symptoms, cognition and self-care in poor outcome geriatric schizophrenic patients.",
keywords = "Antipsychotic, Cognition, Geriatric, Schizophrenia",
author = "Leonard White and Friedman, {Joseph I.} and Bowie, {Christopher R.} and Martin Evers and Harvey, {Philip D} and Michael Parrella and Emilian Mihaila and Davis, {Kenneth L.}",
year = "2006",
month = "12",
day = "1",
doi = "10.1016/j.schres.2006.06.038",
language = "English",
volume = "88",
pages = "127--134",
journal = "Schizophrenia Research",
issn = "0920-9964",
publisher = "Elsevier",
number = "1-3",

}

TY - JOUR

T1 - Long-term outcomes in chronically hospitalized geriatric patients with schizophrenia

T2 - Retrospective comparison of first generation and second generation antipsychotics

AU - White, Leonard

AU - Friedman, Joseph I.

AU - Bowie, Christopher R.

AU - Evers, Martin

AU - Harvey, Philip D

AU - Parrella, Michael

AU - Mihaila, Emilian

AU - Davis, Kenneth L.

PY - 2006/12/1

Y1 - 2006/12/1

N2 - Introduction: Some groups have reported the longitudinal course of elderly poor outcome schizophrenic patients to be characterized by progressive decline in cognitive functions and functional capacity. Although many of these patients experience minimal reduction of psychotic symptoms, there may be beneficial effects of antipsychotic treatments on cognitive functions and functional capacity. Methods: This naturalistic study compared the longitudinal course of psychotic symptoms, cognitive functions and functional impairment in geriatric schizophrenic patients treated with first generation (N = 97) or second generation (N = 78) antipsychotic medications. Mixed effects linear regression analyses were used to examine the effects of treatment (first generation vs. second generation antipsychotic), time and treatment × time. Results: Cognitive functions (Mini Mental State Examination time effect estimate = - .41, p < .001; ADAS-L Cog time effect estimate = .64, p < .001) and self-care skills (ADAS-L Self-Care time effect estimate = .65, p < .001) declined over time for the subject group as a whole and this decline was not modified by treatment with second generation antipsychotics relative to first generation antipsychotics. Similarly, second generation antipsychotic treatment produced no effect on the progressive worsening of negative symptom over time. Conclusion: This long-term naturalistic study of poor outcome geriatric patients with schizophrenia did not find atypical antipsychotics to produce any differential protective effect relative to typical antipsychotics on the long-term manifestations of symptoms, cognition and self-care in poor outcome geriatric schizophrenic patients.

AB - Introduction: Some groups have reported the longitudinal course of elderly poor outcome schizophrenic patients to be characterized by progressive decline in cognitive functions and functional capacity. Although many of these patients experience minimal reduction of psychotic symptoms, there may be beneficial effects of antipsychotic treatments on cognitive functions and functional capacity. Methods: This naturalistic study compared the longitudinal course of psychotic symptoms, cognitive functions and functional impairment in geriatric schizophrenic patients treated with first generation (N = 97) or second generation (N = 78) antipsychotic medications. Mixed effects linear regression analyses were used to examine the effects of treatment (first generation vs. second generation antipsychotic), time and treatment × time. Results: Cognitive functions (Mini Mental State Examination time effect estimate = - .41, p < .001; ADAS-L Cog time effect estimate = .64, p < .001) and self-care skills (ADAS-L Self-Care time effect estimate = .65, p < .001) declined over time for the subject group as a whole and this decline was not modified by treatment with second generation antipsychotics relative to first generation antipsychotics. Similarly, second generation antipsychotic treatment produced no effect on the progressive worsening of negative symptom over time. Conclusion: This long-term naturalistic study of poor outcome geriatric patients with schizophrenia did not find atypical antipsychotics to produce any differential protective effect relative to typical antipsychotics on the long-term manifestations of symptoms, cognition and self-care in poor outcome geriatric schizophrenic patients.

KW - Antipsychotic

KW - Cognition

KW - Geriatric

KW - Schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=33750605155&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750605155&partnerID=8YFLogxK

U2 - 10.1016/j.schres.2006.06.038

DO - 10.1016/j.schres.2006.06.038

M3 - Article

VL - 88

SP - 127

EP - 134

JO - Schizophrenia Research

JF - Schizophrenia Research

SN - 0920-9964

IS - 1-3

ER -