RESUMEN
BACKGROUND: Not only the prevalence, but also the progress of metabolic abnormalities in schizophrenic patients is of importance for treatment planning and policy making. However, there have been very few prospective studies of metabolic disturbance in schizophrenic patients. This study aimed to assess the progress of metabolic abnormalities in Thai individuals with schizophrenia by estimating their one-year incidence rate of metabolic syndrome (MetS). METHODS: We screened all schizophrenic patients who visited our psychiatric clinic. After the exclusion of participants with MetS at baseline, each subject was reassessed at 6 and 12 months to determine the occurrence of MetS. The definition of MetS, as proposed by the International Diabetes Federation (IDF), was applied. RESULTS: Fifty-seven participants (24 males and 33 females) had a mean of age and duration of antipsychotic treatment of 37.5 years old and 8.4 years, respectively. At baseline, 13 subjects met the MetS definition. Of 44 subjects who had no MetS at baseline, 35 could be followed up. Seven of these 35 subjects (20.0%) had developed MetS at the 6- or 12-month visit, after already having 2 MetS components at baseline. The demographic data and characteristics of those developing and not developing MetS were not different in any respect. CONCLUSION: Thai schizophrenic patients are likely to develop MetS. Their metabolic abnormalities may progress rapidly and fulfill the MetS definition within a year of follow-up. These findings support the importance of assessing and monitoring metabolic syndrome in schizophrenic patients.
Asunto(s)
Síndrome Metabólico/complicaciones , Síndrome Metabólico/epidemiología , Esquizofrenia/complicaciones , Adulto , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Tailandia/epidemiologíaRESUMEN
Many trials of naltrexone have been carried out in alcohol-dependent patients. This paper is aimed to systematically review its benefits, adverse effects, and discontinuation of treatment. We assessed and extracted the data of double-blind, randomized controlled trials (RCTs) comparing naltrexone with placebo or other treatment in people with alcoholism. Two primary outcomes were subjects who relapsed (including heavy drinking) and those who returned to drinking. Secondary outcomes were time to first drink, drinking days, number of standard drinks for a defined period, and craving. All outcomes were reported for the short, medium, and long term. Five common adverse effects and dropout rates in short-term treatment were also examined. A total of 2861 subjects in 24 RCTs presented in 32 papers were included. For short-term treatment, naltrexone significantly decreased relapses [relative risk (RR) 0.64, 95% confidence interval (CI) 0.51-0.82], but not return to drinking (RR 0.91, 95% CI 0.81-1.02). Short-term treatment of naltrexone significantly increased nausea, dizziness, and fatigue in comparison to placebo [RRs (95% CIs) 2.14 (1.61-2.83), 2.09 (1.28-3.39), and 1.35 (1.04-1.75)]. Naltrexone administration did not significantly diminish short-term discontinuation of treatment (RR 0.85, 95% CI 0.70-1.01). Naltrexone should be accepted as a short-term treatment for alcoholism. As yet, we do not know the appropriate duration of treatment continuation in an alcohol-dependent patient who responds to short-term naltrexone administration. To ensure that the real-world treatment is as effective as the research findings, a form of psychosocial therapy should be concomitantly given to all alcohol-dependent patients receiving naltrexone administration.
Asunto(s)
Alcoholismo/tratamiento farmacológico , Naltrexona/uso terapéutico , Antagonistas de Narcóticos/uso terapéutico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Terapia Cognitivo-Conductual , Intervalos de Confianza , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Placebos , Estudios Prospectivos , Factores de Tiempo , Resultado del TratamientoRESUMEN
On December 26, 2004, tsunamis hit Southeast Asia and caused serious damage and loss of lives. In Thailand, six provinces (Ranong, Phang-Nga, Phuket, Krabi, Trang, and Satun) were impacted. The present study reports the psychiatric assessments such as Thai GHQ-60 and IES. It also reports management techniques of both cognitive behavior therapy and medication. Those were provided to a Thai female patient who was 54 years old. The patient responded to treatment quickly because of early management. The tsunami victim with Posttraumatic Stress Disorder (PTSD) is not an individual. A mass of people who faced or witnessed the tsunami are vulnerable to get PTSD any time during 6 months after trauma. These early management techniques are useful and practical for a mass of victims and survivors.