Antipsychotic medication and cognitive function in schizophrenia.

Antipsychotic polypharmacy and excessive dosing still prevail worldwide in the treatment of schizophrenia, while their possible association with cognitive function has not well been examined. We examined whether the "non-standard" use of antipsychotics (defined as antipsychotic polypharmacy or dosage >1,000 mg/day of chlorpromazine equivalents) is associated with cognitive function. Furthermore, we compared cognitive function between patients taking only atypical antipsychotics and those taking only conventionals. Neurocognitive functions were assessed in 67 patients with chronic schizophrenia and 92 controls using the Wechsler Memory Scale-Revised (WMS-R), the Wechsler Adult Intelligence Scale-Revised (WAIS-R), the Wisconsin Card Sorting Test (WCST), and the Advanced Trail Making Test (ATMT). Patients showed markedly poorer performance than controls on all these tests. Patients on non-standard antipsychotic medication demonstrated poorer performance than those on standard medication on visual memory, delayed recall, performance IQ, and executive function. Patients taking atypical antipsychotics showed better performance than those taking conventionals on visual memory, delayed recall, and executive function. Clinical characteristics such as duration of medication, number of hospitalizations, and concomitant antiparkinsonian drugs were different between the treatment groups (both dichotomies of standard/non-standard and conventional/atypical). These results provide evidence for an association between antipsychotic medication and cognitive function. This association between antipsychotic medication and cognitive function may be due to differential illness severity (e.g., non-standard treatment for severely ill patients who have severe cognitive impairment). Alternatively, poorer cognitive function may be due in part to polypharmacy or excessive dosing. Further investigations are required to draw any conclusions.

Psychosocial factors associated with quality of life in Japanese patients with human immunodeficiency virus infection.

The purpose of this study was to identify psychosocial factors, including coping style, that are associated with quality of life (QOL) in Japanese patients with human immunodeficiency virus (HIV) infection and to clarify the difference in coping style between patients with hemophilia and patients with sexually transmitted infection. We administered the World Health Organization QOL-26 questionnaire, the Mental Adjustment Toward Cancer scale, and the Social Support scale to 50 patients with HIV infection. Regarding QOL scores, Fighting Spirit was the positive coping style; Helplessness/Hopelessness and Anxious Preoccupation were negative coping styles. Psychological QOL scores in patients with hemophilia were lower than those in patients with sexually transmitted infection. Patients with hemophilia had a significantly weaker Fighting Spirit than patients with sexually transmitted infection.