Clinical Characteristics, Comorbid Medical Diagnoses, and Causes of Death of Individuals with Severe Mental Illness Who Died During Follow-up in Community Mental Health Centers: A Multicenter, Retrospective Study. / Toplum Ruh Sagligi Merkezlerinde Takipleri Sirasinda Ölen Siddetli Ruhsal Hastaligi Olan Bireylerin Klinik Özellikleri, Ek Tibbi Tanilari ve Ölüm Nedenleri: Çok Merkezli, Geriye Dönük Bir Arastirma.

OBJECTIVE: In this study, it was aimed to define the clinical characteristics, causes of death, disease and treatment of patients who died while being followed for severe mental illness. METHOD: The study was carried out in ten community mental health centers from six provinces. The clinical characteristics, causes of death, course of the illness and treatment characteristics of the patients who had a death report from the date the community mental health centers were opened until the start date of the study were analyzed by retrospective file scanning method. RESULTS: In an average of 52 months, files of 3715 patients were examined. There were death declarations for 106 patients. The diagnosis of most patients with death declarations was schizophrenia (78%), most of them were male (66%), mean age was 57, mean disease duration was 24 years. The rate of multiple antipsychotic medication use was 61%. The most common comorbidities were metabolic syndrome (36%), hypertension (22%), diabetes (18%) and chronic obstructive pulmonary disease (15%). The most frequently reported causes of death were cardiovascular diseases (39%), infectious diseases (14%) and cancer (11%). CONCLUSION: Individuals with severe mental illness followed up in community mental health centers are mostly die due to preventable natural causes of death. Therefore, a sensitive approach should be taken to evaluate psychiatric and other medical conditions together. In our country, there is a need for natural follow-up studies investigating the average age of death and causes of death of individuals with severe mental illness.

Efficacy and Safety of Paliperidone Palmitate Treatment in Patients With Schizophrenia: A Real-World Multicenter, Retrospective, Mirror-Image Study.

PURPOSE: The aim of the study was to assess efficacy and safety of paliperidone palmitate (PP) in schizophrenic patients using real-life data. METHODS: This national, multicenter, retrospective, and mirror-image study was performed reviewing the medical records of patients in 18 centers. Adult schizophrenic patients receiving PP treatment (n = 205) were enrolled. Patients' data covering the last 12 months before the initial PP injection and the period until the end of study with at least 12 months after the initial PP injection were evaluated. Patients' characteristics, scale scores, and adverse events were recorded. RESULTS: Nonadherence to prior medication was the most frequent reason for switching to PP treatment. Comparing with the period before PP treatment, the rate of patients visiting the hospital for relapse (79.5% vs 28.9%, P < 0.001) and the median number of hospitalizations (2 vs 0, P < 0.001) were lower during PP treatment. During PP treatment, the Positive and Negative Syndrome Scale score decreased by 20% or more (response to treatment) in 75.7% of the patients. The frequency of adverse events did not differ between the period before and during PP treatment. Improvement in functionality was higher in those with disease duration of 5 years or less. CONCLUSIONS: Paliperidone palmitate is effective and safe in treatment of schizophrenic patients and in switching to PP treatment in patients with schizophrenia, which reduced the percentage of patients admitted to the hospital for relapse and the median number hospitalization, and has positive effects on functionality.

Brain mast cells and therapeutic potential of vasoactive intestinal peptide in a Parkinson's disease model in rats: brain microdialysis, behavior, and microscopy.

In the present study, the effect of systemically administered vasoactive intestinal peptide (VIP) (25 ng/kg i.p.) was investigated on drug-induced rotational behavior, extra-cellular dopamine levels and histology of corpus striatum in a 6-hydroxydopamine (6-OHDA)-induced rat model of Parkinson's disease. After 15 days of 6-OHDA lesion, apomorphine-induced (0.05 mg/kg s.c.) rotational behavior of the animals significantly increased and extra-cellular dopamine levels of corpus striatum were significantly reduced. VIP reversed the rotational deficits but did not alter the decrease in striatal dopamine levels. On the other hand, histological data indicate that VIP significantly reduced neuronal death and demyelination. Electron microscopic appearance of mast cells showed ultra-structural variety between VIP-treated and 6-OHDA lesioned groups. VIP activates mast cells without any evidence of typical exocytosis, and possibly mast cells could participate in neuroprotection. Our results suggest that systemically administered VIP can attenuate the motor response changes, neuronal cell death, and myelin sheet loss characteristically associated with 12 microg 6-OHDA administration into the rat striatum. Brain mast cells seem to participate in neuronal protection. Possibly, protective cues could be produced by brain mast cells.