Change of psychotropic drug prescription for schizophrenia in a psychiatric institution in Beijing, China between 1999 and 2008.

BACKGROUND: To date, no study has investigated how prescription patterns change over time in Chinese patients with schizophrenia. This study aimed to determine psychotropic drug prescription patterns and the use of electroconvulsive therapy (ECT) for schizophrenia and their changes over time in a large psychiatric institution in Beijing, China. METHODS: The case notes of inpatients with schizophrenia were scrutinized to identify psychotropic drug prescription patterns and the use of ECT on November 10, 1999 and the same calendar day in 2008 and to compare the two surveys. RESULTS: In 1999, 45.1% of inpatients with schizophrenia were on first-generation antipsychotic drugs (FGA), while 52.9% were on second-generation antipsychotic drugs (SGA). In 2008, the percentage of patients on FGAs decreased to 15.1%, while those on SGAs increased to 77.2%. The proportion of schizophrenia patients on mood stabilizers and antidepressants rose from 3.3% and 4.3% in 1999 to 18% and 9.5% by 2008, respectively. Use of ECT grew from 0.5% in 1999 to 5.6% by 2008. The proportion of schizophrenia patients not prescribed antipsychotic drugs changed from 5.6% in 1999 to 13.7% in 2008. CONCLUSIONS: The prescription pattern of psychotropic drugs changes considerably over time, even in the same clinical setting. Mental health professionals need to keep up with changes in the prescription patterns of psychotropic drugs in order to serve their patients at the best possible level. The socio-economic reasons for not prescribing antipsychotic drugs to schizophrenia patients should be further explored.

Acceptability and psychometric properties of Brøset Violence Checklist in psychiatric care settings in China.

ACCESSIBLE SUMMARY: Short-term risk assessment instrument owns great importance for psychiatric nurses in China; however, the lack of a standardized violence risk assessment instrument has disadvantaged them in clinical practice. The Brøset Violence Checklist (BVC), a behavioural observation tool, is the most frequently cited instrument available for evaluating violence risk in psychiatric inpatients, then worth to be tested in Chinese culture. This study, conducted in two closed wards in a psychiatric hospital in Beijing, revealed that the instrument has favourable reliability, validity and predictive accuracy in Chinese population. BVC provides nurses with a quick and easily administered method to screening out patients with violence potential, thus allowing for early intervention. Feedback from the nurses was quite encouraging and the further use of BVC seems promising. The lack of standardized violence risk assessment instrument has disadvantaged nurses in clinical practice in China, where violent behaviour is an increasing problem. This study conducted a validation of the Brøset Violence Checklist that has proven effective in violence risk prediction in other countries. A sample of 296 patients consecutively admitted to two wards of a psychiatric hospital in Beijing was recruited. These patients were assessed on day shift and evening shift for the first seven days of hospitalization. Violence data and preventive measures were concurrently collected from nursing records and case reports. A total of 3707 assessments for 281 patients were collected revealing 93 episodes of violence among 55 patients. Receiver operating characteristics yielded an area under the curve of 0.85. At the cut-off point of one, its sensitivity/specificity was 78.5%/88.2% and the corresponding positive/negative predictive value was 14.6%/99.4%. In some false positive cases, intense preventive measures had been implemented. Positive feedback from the nurses was gained. The Brøset Violence Checklist was proved as an easy-to-use and time-saving instrument, therefore, regarded as a promising tool to determine if the psychiatric users are potentially violent in the short term.

Pharmacokinetics of anastrozole in Chinese male volunteers.

AIM: To compare pharmacokinetics of domestic and imported tablets of anastrozole. METHODS: Twenty male Chinese volunteers were enrolled in a randomized crossover study with a single oral dose of 1 mg of the two formulations respectively. The anastrozole in plasma was measured by gas chromatography with electron-captured detector. Area under the drug concentration-time curve was evaluated by variance analysis and two one-side t-test. RESULTS: A two-compartment model was adopted in anastrozole plasma concentration-time data analysis. The paramaters such as Cmax, Tmax, T1/2beta, and AUC(0-infinity) were (10 +/- 3) and (10.2 +/- 2.5) microg/L, (1.2 +/- 0.5) and (1.3 +/- 0.4) h, (42 +/- 14) and (41 +/- 26) h, (443 +/- 141) and (429 +/- 121) microg . h . L-1, respectively, and there were no significant differences between the two formulations. CONCLUSION: Domestic and imported anastrozole were of bioequivalence. The relative bioavailability of the domestic tablet was 100 % +/- 9 %.