RESUMEN
Purpose: To compare the efficacy and tolerability of different administration strategies of aripiprazole. Methods: We searched MEDLINE, EMBASE, the Cochrane Central, Web of Science, China National Knowledge Infrastructure(CNKI), and Wanfang Data Knowledge Service Platform(Wanfang) for randomized controlled trials (RCTs) of aripiprazole, using the terms: (aripiprazole) AND (schizophr* OR schizoaff*) AND ("syndrome scale" OR PANSS) AND (clini* OR trial). We retrieved study design, participant characteristics, comparison groups, and outcomes from each study. Results: In total, nine RCTs were selected for meta-analysis, which covered ~1,187 participants. We defined two treatment groups that represent different treatment strategies: (1) the high-dose group (the high-dose strategy) rapidly increased to doses higher than 15 mg/day in 2 weeks or began with doses higher than 15 mg/day, otherwise the group was defined as (2) the low-dose group (the low-dose strategy). If the initial or target doses of aripiprazole in a study were all higher than 15 mg/day, the high- and low-dose groups were created based on the relative level of the dose. The high-dose group showed significantly greater reductions in Positive and Negative Syndrome Scale (PANSS) total scores (standardized mean differences = -8.31, 95% confidence interval [CI] = -16.48, -0.13; P < 0.01; I 2 = 96%) than the low-dose group. The high-dose group showed superior effects compared with the low-dose group in long-term studies (more than 8 weeks) (standardized mean differences = -13.81, 95% CI = -25.07, -2.55; P < 0.01; I 2 = 96%). With exception of somnolence, we did not find significant differences in side effects or discontinuation due to adverse events. Sensitivity analyses produced similar results. Conclusion: The high-dose treatment strategy of aripiprazole for patients with schizophrenia or schizoaffective disorder may bring more benefits without obvious side effects.
RESUMEN
The Personal and Social Performance Scale (PSP) is a 100-point single-item rating scale that assesses four important domains of patients with mental disorders. This study was designed to examine the validity and reliability of a Chinese version of the PSP. The study was conducted in a sample of 157 patients with schizophrenia (confirmed by DSM-IV-TR criteria, SCID-P interview). The internal consistency (Cronbach's alpha=0.84) and the inter-rater reliability (kappa value=0.82, ICC=0.94 for PSP total score) was good. The test-retest reliability was high (intraclass correlation coefficient (ICC) of 0.95). The scale showed good construct validity with statistically significant correlations with the Global Assessment of Functioning Scale (GAF) (ICC of 0.95). The PSP score had a good negative correlation with the Positive and Negative Syndrome Scale (PANSS) total score. The improvement in PSP after 8 weeks of treatment was significantly correlated with the reduction in PANSS: after 8 weeks of treatment, the responders (defined as those with a reduction in PANSS total score ≥50%) experienced a greater improvement in PSP than the non-responders. The Chinese version of the PSP is a convenient and valid instrument to assess the personal and social functions of stabilized and acute patients with schizophrenia.
