Symptom control, functioning, and hospitalization status in French patients changed from oral atypical antipsychotics to risperidone long-acting injectable.

Objective. To investigate efficacy and tolerability of risperidone long-acting injectable (RLAI) in French patients with schizophrenia or other psychotic disorders, who were all switching from previous treatment with oral atypical antipsychotics. The impact of treatment with RLAI on the hospitalization status of these patients was also examined. Methods. Clinically stable patients requiring a treatment change received 25 mg RLAI (increased to 37.5 or 50 mg if required) every 2 weeks for 6 months. Results. Of 130 patients (68.5% male, mean age 36.2 years), most (83.8%) had DSM-IV schizophrenia (mainly paranoid). Previous treatments were risperidone (80.8%), olanzapine (10.0%) and amisulpride (10.0%). Out of 66 patients hospitalized at baseline, 51 were outpatients at endpoint. Mean total PANSS, CGI-S and GAF scores were significantly reduced from baseline to treatment endpoint (p<0.001). Of those patients reported as moderate to severely ill at the beginning of the trial (81.3%), fewer had the same classification at endpoint (50.8%). Mean scores for total ESRS and Parkinsonism subscales were significantly reduced after only 1 month of treatment (p<0.001). Conclusion. Treatment with RLAI significantly improved disease symptoms, functioning, hospitalization status, and reduced movement disorders, in psychotic patients considered clinically stable on oral atypical antipsychotics.

[Frequency of psychotic-like symptoms among adults consulting general practitioners]. / Fréquence des symptômes d'allure psychotique observés chez l'adulte en consultation de médecine générale.

OBJECTIVES: To assess the frequency of the most frequently observed psychotic-like symptoms in adults consulting general practitioners and to describe their principal characteristics and management. METHODS: Observational epidemiologic survey of 1200 randomly selected general practitioners, distributed throughout France. The symptoms considered were those modified from the BPRS (Brief Psychiatric Rating Scale). During the two-week survey, practitioners recorded the total number of children and adults consulting them and the number with psychotic-like symptoms. They described the characteristics and management of the first three adults with these symptoms (chronological selection). RESULTS: The mean rate of adults with psychotic-like symptoms was 4.9 +/- 8.1% (95% confidence interval: 4.4, 5.4%) during the 12 618 consultation days assessed. The mean age of these patients was 52 years, with equal numbers of men and women. At the consultation, 18.6% were disabled or on short-term sick-leave from work because of the psychiatric disorder; 35.3% of the patients had no known history of psychiatric disorders. Nearly all these patients (95.2%) had more than one psychotic-like symptom. The principal such symptoms were: "changes in behavior, presentation, or interpersonal relations" (62.0%), "bizarre behavior" (48.2%), "depression" and "anxiety" (49.7 and 42.2%), "unusual thought content" or "conceptual disorganization" (29.3 and 26.9%). Most patients received outpatient pharmaceutical management. CONCLUSION: We observed a greater frequency of psychotic-like symptoms in adults consulting general practitioners than expected.