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Kristian Wahlbeck - One of the best experts on this subject based on the ideXlab platform.
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Validity of Simpson-Angus Scale (SAS) in a naturalistic schizophrenia population
BMC neurology, 2005Co-Authors: Sven Janno, Matti Holi, Katinka Tuisku, Kristian WahlbeckAbstract:Background Simpson-Angus Scale (SAS) is an established instrument for neuroleptic-induced parkinsonism (NIP), but its statistical properties have been studied insufficiently. Some shortcomings concerning its content have been suggested as well. According to a recent report, the widely used SAS mean score cut-off value 0.3 of for NIP detection may be too low. Our aim was to evaluate SAS against DSM-IV diagnostic criteria for NIP and objective motor assessment (actometry).
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Validity of Simpson-Angus Scale (SAS) in a naturalistic schizophrenia population
BMC Neurology, 2005Co-Authors: Sven Janno, Matti Holi, Katinka Tuisku, Kristian WahlbeckAbstract:Background Simpson-Angus Scale (SAS) is an established instrument for neuroleptic-induced parkinsonism (NIP), but its statistical properties have been studied insufficiently. Some shortcomings concerning its content have been suggested as well. According to a recent report, the widely used SAS mean score cut-off value 0.3 of for NIP detection may be too low. Our aim was to evaluate SAS against DSM-IV diagnostic criteria for NIP and objective motor assessment (actometry). Methods Ninety-nine chronic institutionalised schizophrenia patients were evaluated during the same interview by standardised actometric recording and SAS. The diagnosis of NIP was based on DSM-IV criteria. Internal consistency measured by Cronbach's α, convergence to actometry and the capacity for NIP case detection were assessed. Results Cronbach's α for the Scale was 0.79. SAS discriminated between DSM-IV NIP and non-NIP patients. The actometric findings did not correlate with SAS. ROC-analysis yielded a good case detection power for SAS mean score. The optimal threshold value of SAS mean score was between 0.65 and 0.95, i.e. clearly higher than previously suggested threshold value. Conclusion We conclude that SAS seems a reliable and valid instrument. The previously commonly used cut-off mean score of 0.3 has been too low resulting in low specificity, and we suggest a new cut-off value of 0.65, whereby specificity could be doubled without loosing sensitivity.
Moshe Kotler - One of the best experts on this subject based on the ideXlab platform.
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Increased suicidal risk among smoking schizophrenia patients.
Clinical neuropharmacology, 2006Co-Authors: Iulian Iancu, Anna Piccone Sapir, Ginette Shaked, Amir Poreh, Pinhas N. Dannon, Joseph Chelben, Moshe KotlerAbstract:INTRODUCTION:: Schizophrenia patients display a high suicidal risk, although this risk is difficult to predict. One of the variables associated with increased suicide risk is smoking. In the present study, we assessed the suicidal risk in schizophrenia patients, smokers and nonsmokers. We also evaluated the impact of various variables such as psychotic symptoms, impulsivity, and extra-pyramidal side effects on suicidal risk. METHODS:: Sixty-one schizophrenia patients responded to a battery of measures, including the suicidal risk Scale (SRS), the positive and negative syndrome Scale (PANSS), the impulsivity control Scale, and the Simpson Angus Scale for extrapyramidal side effects. The effect of smoking on the various measures, especially suicidal risk, was examined. RESULTSCOLON;: Schizophrenia patients who smoke obtained higher PANSS scores (both total score and positive and negative subScales), but did not differ on the Simpson Angus Scale of extrapyramidal side effects. They also exhibited higher suicide risk as reflected by higher scores on the SRS, and a trend for higher impulsivity as measured by the impulsivity control Scale. Women that smoked had higher SRS scores as compared with female nonsmokers, and also higher than in males, smokers and nonsmokers. Smoking and a history of suicide attempt predicted in our regression analysis a higher SRS score. When conducting separate analyses for the male and female patients, the significant contributors were the PANSS total score among the males and the number of pack-years among the female patients. CONCLUSIONS:: Despite hints toward the role of smoking in suicidal behavior in Schizophrenia, especially among female patients, more studies are needed to elucidate the association between smoking and suicidality in schizophrenia patients. Language: en
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Vitamin B6 in treatment of tardive dyskinesia: a preliminary case series study.
Clinical neuropharmacology, 1999Co-Authors: Vladimir Lerner, Chanoch Miodownik, Alexander Kaptsan, Moshe KotlerAbstract:Tardive dyskinesia (TD) remains a significant problem for patients and physicians. Several reports have suggested that vitamin B6 (pyridoxine) can be helpful in the treatment of some neuroleptic-induced movement disorders, including parkinsonism and TD. This report presents the results of a preliminary study of five patients with TD who underwent a four week open-label clinical trial of vitamin B6 (100 mg/d) in addition to their regular medications. The severity of the involuntary movements was assessed using the Abnormal Involuntary Movement Scale (AIMS), Barnes Akathisia Rating Scale (BARS) and the Simpson-Angus Scale (SAS). The patients' clinical status was assessed with the Brief Psychiatric Rating Scale (BPRS). With the addition of vitamin B6 to their treatment, four patients had clinically significant (greater than 30%) improvement on the measures of involuntary movement and, in three cases, there was also clinically significant improvement on the BPRS. None of the patients had side effects attributable to vitamin B6. The results suggest that vitamin B6 may alleviate TD, but it will need to be further tested in controlled double-blind trials.
Rob J. Van Marum - One of the best experts on this subject based on the ideXlab platform.
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Parkinsonism in elderly users of haloperidol : Associated with dose, plasma concentration, and duration of use
Journal of clinical psychopharmacology, 2012Co-Authors: Wilma Knol, Paul A. F. Jansen, Rob J. Van Marum, Toine C. G. Egberts, Alfred F. A. M. SchobbenAbstract:Factors that influence the variation in occurrence of antipsychotic-induced parkinsonism (AIP) in the elderly have not been well elucidated. The aim of this study was to investigate the association between parkinsonism in elderly users of haloperidol and prescribed dose, plasma concentration, and duration of use of haloperidol in a cross-sectional design. This study included 150 inpatients aged 65 years and older who were treated with haloperidol. Parkinsonism assessed by the Simpson Angus Scale was present in 46% of the included patients. Prescribed haloperidol dose varied from 0.3 to 5 mg/d. Plasma concentration ranged from 0.13 to 4.11 μg/L, with one outlying measurement (21.43 μg/L). Dose is moderate but significantly associated with haloperidol plasma concentration (weighted R2 = 0.32; P < 0.001). Variability in the total score on the Simpson Angus Scale could not be explained by the variability in dose, concentration (respectively R2 = 0.003 and 0.001) nor duration of use of haloperidol. Smoking showed to be not significantly protective in the development of AIP (crude odds ratio, 0.39; 95% confidence interval, 0.15-0.997; and adjusted odds ratio, 0.44; 95% confidence interval, 0.17-1.17). In a clinical practice-setting dose, neither plasma concentration nor duration of use of haloperidol is associated with an increased occurrence of AIP. This study does not support the hypothesis of the peripheral pharmacokinetic explanation for the high prevalence of AIP and differences in AIP sensitivity in the elderly during treatment with haloperidol.
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Quality of life of elderly patients with antipsychotic-induced parkinsonism: a cross-sectional study.
Journal of the American Medical Directors Association, 2011Co-Authors: Henrike J. Schouten, Wilma Knol, Paul A. F. Jansen, Alfred F. A. M. Schobben, Toine C. G. Egberts, Rob J. Van MarumAbstract:Abstract Objectives Antipsychotic-induced parkinsonism (AIP) is one of the most common adverse effects of haloperidol. The purpose of this study was to investigate the association between AIP and quality of life of elderly patients treated with haloperidol. Design Cross-sectional study design. Setting Eleven nursing homes, geriatric departments of 2 hospitals, and 3 mental health care centers in the Netherlands. Participants Participants were 140 elderly patients aged 65 years and older treated for at least 5 days with haloperidol. Measurements The presence of AIP was determined with the Simpson Angus Scale. Quality of life was scored with the QUALIDEM Scale. Multivariate linear regression analysis was used to assess whether the presence of AIP and quality of life were correlated. The data of patients with advanced dementia were analyzed separately. Results Of the 140 included patients, 65 (46%) were diagnosed with AIP. Patients with AIP scored lower than patients without AIP on the QUALIDEM subScales “positive affect,” “negative affect,” “social relations,” “social isolation,” and “having something to do.” In patients with advanced dementia, quality of life was not significantly different in patients with or without AIP. Conclusion The presence of AIP is negatively associated with the quality of life of elderly patients treated with haloperidol.
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Validity and reliability of the Simpson-Angus Scale (SAS) in drug induced parkinsonism in the elderly.
International journal of geriatric psychiatry, 2009Co-Authors: Wilma Knol, Carolina J. P. W. Keijsers, Paul A. F. Jansen, Svetlana V. Belitser, Alfred F. A. M. Schobben, Antoine C. G. Egberts, Rob J. Van MarumAbstract:Background Quantification of drug induced parkinsonism (DIP) for study purposes is difficult. The most often used Simpson Angus Scale (SAS) lacks proper clinimetric evaluation. The newer Schedule for Assessment of Drug-Induced Movement Disorders (SADIMoD) shows good clinimetric characteristics, but has not been used in published clinical studies, probably due to the complexity of the Scale. Objectives To evaluate internal consistency and inter-rater reliability of the SAS and the correlation ot f the SAS with the parkinsonism subScale of the SADIMoD in elderly. Method Fifteen elderly diagnosed with DIP were recruited. The patients were assessed three times with the SAS by three independent investigators. The resident also performed the SADIMoD. Internal consistency was measured by Cronbach's α-coefficient, inter-rater variability was examined with weighted kappa values and percentage of agreement and correlation to SADIMoD by Spearman's correlation coefficient. Results SAS demonstrated good internal consistency reliability (Cronbach's α coefficients 0.83). Inter-rater reliability for sum score was good. For individual items slight agreement on the item salivation and moderate to very good agreement on remaining items calculated by weighted kappa values was reached. We found 87–100% agreement on the individual items with acceptance of 1 point difference between raters. The SAS demonstrated acceptable correlation with the SADIMoD parkinsonism subScale scores (Spearman's rho = 0.66; p
Sven Janno - One of the best experts on this subject based on the ideXlab platform.
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Validity of Simpson-Angus Scale (SAS) in a naturalistic schizophrenia population
BMC neurology, 2005Co-Authors: Sven Janno, Matti Holi, Katinka Tuisku, Kristian WahlbeckAbstract:Background Simpson-Angus Scale (SAS) is an established instrument for neuroleptic-induced parkinsonism (NIP), but its statistical properties have been studied insufficiently. Some shortcomings concerning its content have been suggested as well. According to a recent report, the widely used SAS mean score cut-off value 0.3 of for NIP detection may be too low. Our aim was to evaluate SAS against DSM-IV diagnostic criteria for NIP and objective motor assessment (actometry).
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Validity of Simpson-Angus Scale (SAS) in a naturalistic schizophrenia population
BMC Neurology, 2005Co-Authors: Sven Janno, Matti Holi, Katinka Tuisku, Kristian WahlbeckAbstract:Background Simpson-Angus Scale (SAS) is an established instrument for neuroleptic-induced parkinsonism (NIP), but its statistical properties have been studied insufficiently. Some shortcomings concerning its content have been suggested as well. According to a recent report, the widely used SAS mean score cut-off value 0.3 of for NIP detection may be too low. Our aim was to evaluate SAS against DSM-IV diagnostic criteria for NIP and objective motor assessment (actometry). Methods Ninety-nine chronic institutionalised schizophrenia patients were evaluated during the same interview by standardised actometric recording and SAS. The diagnosis of NIP was based on DSM-IV criteria. Internal consistency measured by Cronbach's α, convergence to actometry and the capacity for NIP case detection were assessed. Results Cronbach's α for the Scale was 0.79. SAS discriminated between DSM-IV NIP and non-NIP patients. The actometric findings did not correlate with SAS. ROC-analysis yielded a good case detection power for SAS mean score. The optimal threshold value of SAS mean score was between 0.65 and 0.95, i.e. clearly higher than previously suggested threshold value. Conclusion We conclude that SAS seems a reliable and valid instrument. The previously commonly used cut-off mean score of 0.3 has been too low resulting in low specificity, and we suggest a new cut-off value of 0.65, whereby specificity could be doubled without loosing sensitivity.
George M Simpson - One of the best experts on this subject based on the ideXlab platform.
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paliperidone extended release tablets in schizophrenia patients previously treated with risperidone
International Clinical Psychopharmacology, 2008Co-Authors: Carla M Canuso, Ibrahim Turkoz, Cynthia A Bossie, Eriene Youssef, A Schreiner, George M SimpsonAbstract:To assess the effect of paliperidone extended-release (ER) tablets in patients with acute symptoms who had previously received risperidone. Data for this post-hoc analysis were pooled from three 6-week, double-blind, placebo-controlled trials in patients treated with paliperidone ER 3-12 mg/day or placebo. Patients had to have received risperidone for ≥ 4 weeks within 2 weeks of study entry. Assessments were done using the Positive and Negative Syndrome Scale, Clinical Global Impressions-Severity Scale, Personal and Social Performance Scale, the Simpson-Angus Scale, and adverse event (AE) reports. Altogether, 198 patients (paliperidone ER, n=142; placebo, n=56) met the established criteria. Mean (SD) duration of prior risperidone treatment and dose were 418.8 (572.8) days and 4.4 (2.5) mg/day for paliperidone ER and 527.0 (805.3) days and 4.1 (2.5) mg/day for placebo. Study completion rates were 61.3% for paliperidone ER versus 42.9% for placebo. At endpoint, paliperidone ER showed significant improvement versus placebo (P<0.05) in Positive and Negative Syndrome Scale, Clinical Global Impressions-Severity, and Personal and Social Performance scores. Mean baseline Simpson-Angus Scale scores were low, with no significant changes at endpoint in either group. AEs 2≥10% with paliperidone ER versus placebo were headache (16.2 vs.16.1%), insomnia (14.1 vs. 16.1%), and agitation (8.5 vs. 10.7%). AE-related discontinuations were 2.1 % with paliperidone ER and 5.4% with placebo. In patients who had received risperidone previously but remained sufficiently symptomatic for enrollment, paliperidone ER was significantly more effective than placebo in reducing symptoms and producing functional gains.
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Paliperidone extended-release tablets in schizophrenia patients previously treated with risperidone.
International clinical psychopharmacology, 2008Co-Authors: Carla M Canuso, Ibrahim Turkoz, Cynthia A Bossie, Eriene Youssef, A Schreiner, George M SimpsonAbstract:To assess the effect of paliperidone extended-release (ER) tablets in patients with acute symptoms who had previously received risperidone. Data for this post-hoc analysis were pooled from three 6-week, double-blind, placebo-controlled trials in patients treated with paliperidone ER 3-12 mg/day or placebo. Patients had to have received risperidone for ≥ 4 weeks within 2 weeks of study entry. Assessments were done using the Positive and Negative Syndrome Scale, Clinical Global Impressions-Severity Scale, Personal and Social Performance Scale, the Simpson-Angus Scale, and adverse event (AE) reports. Altogether, 198 patients (paliperidone ER, n=142; placebo, n=56) met the established criteria. Mean (SD) duration of prior risperidone treatment and dose were 418.8 (572.8) days and 4.4 (2.5) mg/day for paliperidone ER and 527.0 (805.3) days and 4.1 (2.5) mg/day for placebo. Study completion rates were 61.3% for paliperidone ER versus 42.9% for placebo. At endpoint, paliperidone ER showed significant improvement versus placebo (P
