RESUMEN
The use of telemedicine is becoming increasingly popular in assisting with the home management of People with Dementia (PwD) by offering services to the carers that may enhance their ability to care for their relative for longer. A computerized platform, ALADDIN, was evaluated in its usefulness to reduce carer burden and distress and to improve their quality of life, in an attempt to delay institutionalization of PwD. ALADDIN offers educational material about dementia to carers and provides the opportunity to contact other carers and clinicians. ALADDIN also facilitates remote monitoring of the PwD and their carers by the clinicians to enable speedy delivery of appropriate intervention. The ALADDIN platform was piloted at three European sites, and used by thirty carers of PwD living in the community (platform group). The platform group and a control group of thirty PwD and their carers were assessed at baseline, 3 months, and 6 months. The results showed a significant improvement in the quality of life of the carers in the platform group, with some reduction in carer burden and distress. The platform was useful in monitoring the patients and facilitating contact with other professionals. Access to and use of the ALADDIN platform was rated positively by carers and clinicians. The ALADDIN platform's usefulness and applicability for prolonging the home management of PwD are discussed.
Asunto(s)
Cuidadores , Computadores , Demencia/terapia , Anciano , Cuidadores/psicología , Comunicación , Demencia/psicología , Europa (Continente) , Femenino , Educación en Salud , Servicios de Atención de Salud a Domicilio , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Calidad de Vida , Apoyo Social , Telemedicina/instrumentación , Telemedicina/métodos , Factores de Tiempo , Resultado del TratamientoRESUMEN
BACKGROUND AND AIMS: Caregivers of patients with schizophrenia experience increased levels of psychological distress. This study investigated the impact of caring for patients with chronic schizophrenia on the mental health status of the caregivers and described the relationship between various socio-demographic and clinical characteristics and caregiving psychological distress. METHODS: The study was carried out at the Psychiatric Hospital of Athens. The Symptom Check List Revised (SCL-90-R) was administered to 87 caregivers of chronic schizophrenia patients and 90 healthy controls. The Positive and Negative Syndrome Scale (PANSS) was administered to schizophrenia patients in order to assess illness severity. RESULTS: The group of caregivers scored higher on the majority of symptom dimensions of the SCL-90-R than the control group. Clinical features of schizophrenia, i.e. duration of illness and PANSS positive and negative symptoms significantly predicted caregiving psychological distress. Caregivers' and patients' socio-demographic characteristics were not associated with caregivers' distress, with the exception of caregivers' sex: female caregivers experienced significantly higher levels of psychological distress than males. CONCLUSIONS: The study suggests that clinical features of schizophrenia influence distress levels in caregivers of patients with chronic schizophrenia. The stronger predictors of distress appear to be female caregiver's gender, duration of illness as well as positive and negative symptomatology.
Asunto(s)
Cuidadores/psicología , Esquizofrenia/enfermería , Estrés Psicológico/enfermería , Estrés Psicológico/psicología , Adulto , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Índice de Severidad de la Enfermedad , Factores Sexuales , Estrés Psicológico/etiologíaRESUMEN
OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of vardenafil in outpatients with chronic schizophrenia and erectile dysfunction and to investigate any effect on quality of life in this population. METHOD: In this 12-week, open-label, flexible-dose study, 25 outpatients with chronic schizophrenia (DSM-IV criteria) and erectile dysfunction received vardenafil 10 mg as needed (at a maximum of 1 dose per day) with the option to maintain current dose or to titrate to 5 mg or 20 mg at 4 and 8 weeks. Assessment was performed with the International Index of Erectile Function (IIEF) at base line and at weeks 4, 8, and 12. The Quality of Life Scale (QLS) was administered at baseline and at week 12. The study was carried out at the Psychiatric Hospital of Athens, Greece, between October 2005 and November 2006. RESULTS: Vardenafil produced a statistically significant improvement in all IIEF domains [erectile function (p < .001), orgasmic function (p < .05), sexual desire (p < .05), intercourse satisfaction (p < .01), and overall satisfaction (p < .001)] and QLS (p < .003). Results were similar for the intention-to-treat (N = 25) and completer (N = 21, 84%) groups. Adverse events were infrequent and decreased in incidence over the course of the study. CONCLUSION: Vardenafil was generally well tolerated and highly effective in outpatients with chronic schizophrenia and erectile dysfunction. The response to vardenafil was not influenced by certain patient characteristics, such as erectile dysfunction severity or serum prolactin levels. Improvement in sexual function was correlated with improvement in the quality of life.
Asunto(s)
Disfunción Eréctil/complicaciones , Disfunción Eréctil/tratamiento farmacológico , Imidazoles/uso terapéutico , Pacientes Ambulatorios , Piperazinas/uso terapéutico , Calidad de Vida , Esquizofrenia/complicaciones , Adulto , Anciano , Análisis de Varianza , Enfermedad Crónica , Esquema de Medicación , Disfunción Eréctil/sangre , Grecia , Humanos , Imidazoles/administración & dosificación , Imidazoles/efectos adversos , Masculino , Persona de Mediana Edad , Orgasmo , Satisfacción del Paciente , Erección Peniana/efectos de los fármacos , Inhibidores de Fosfodiesterasa/uso terapéutico , Piperazinas/administración & dosificación , Piperazinas/efectos adversos , Prolactina/sangre , Estudios Prospectivos , Proyectos de Investigación , Sulfonas/administración & dosificación , Sulfonas/efectos adversos , Sulfonas/uso terapéutico , Factores de Tiempo , Resultado del Tratamiento , Triazinas/administración & dosificación , Triazinas/efectos adversos , Triazinas/uso terapéutico , Diclorhidrato de VardenafilRESUMEN
OBJECTIVE: The aim of this study was to investigate whether augmentation of clozapine with aripiprazole improves clinically significant residual symptoms in stabilized outpatients with chronic schizophrenia. METHODS: Twenty seven stabilized outpatients meeting criteria for chronic schizophrenia, who had residual symptoms despite clozapine treatment, were assigned to receive oral aripiprazole (15 mg/day) for a period of 16 weeks. Patients remained on clozapine (100-900 mg/day) for at least 12 months, prior to study initiation. Symptoms assessments were made with the Positive and Negative Symptom Scale (PANSS), the Montgomery-Asberg Depression Rating Scale (MADRS), and the Mini-Mental State Examination (MMSE), at baseline and at weeks 4, 8, 12, and 16. The Quality of Life Scale (QLS) was administered at baseline and at week 16. RESULTS: There was a statistically significant improvement in the mean scores for PANSS (p<0.05), PANSS negative (p<0.001), MADRS (p<0.05), MMSE (p<0.01), and QLS (p<0.05), but not for PANSS positive (p>0.05). Extrapyramidal side effects (as assessed by the Simpson-Angus Scale and the Abnormal Involuntary Movement Scale) did not vary significantly at any point of the study. No statistically significant change was observed in prolactin levels and body weight. Results were similar for the intention-to-treat (n=27) and completer (n=23) groups. CONCLUSIONS: Aripiprazole augmentation in a group of chronic schizophrenic outpatients treated with clozapine led to a substantial improvement in clinically significant residual symptoms, such as negative-depressive symptoms, cognitive impairment and quality of life, without worsening the side effect burden.