Effectiveness and safety of olanzapine in the treatment of schizophrenia among Asian patients switching from conventional antipsychotics.

OBJECTIVES: The objectives of this study were: (1) to investigate, in a clinical practice setting, the effectiveness of olanzapine in the treatment of schizophrenia among partially-responding, symptomatic Asian patients who switch from conventional antipsychotic treatment, (2) to assess the safety of olanzapine and (3) to assess the change in quality of life in Asian patients with schizophrenia who switch to olanzapine. METHODS: Effectiveness, safety and quality of life were assessed in outpatients with schizophrenia (n=1267) who lacked symptomatic control with conventional antipsychotics and were switched to olanzapine therapy. Data for this prospective, observational study were collected for 12 months from Asian patients in China, Hong Kong, the Philippines, South Korea and Taiwan. RESULTS: Significant clinical improvements (P<0.05) were observed following 12 months of olanzapine treatment and 87.3% of the subjects responded to treatment at endpoint (i.e. Brief Psychiatric Rating Scale Total score reduced by > or =30% relative to baseline; last observation carried forward). Abnormal involuntary movements (mean change in Abnormal Involuntary Movement Scale: -3.20, P<0.001) and quality of life were significantly improved in patients treated with olanzapine. However, some patients experienced significant weight gain (3.60+/-4.50 kg, P<0.001) with olanzapine treatment, relative to baseline. CONCLUSIONS: This study shows that switching to olanzapine may be effective in improving symptoms, may be well-tolerated and may improve the quality of life in Asian patients who are only partially responsive to treatment with conventional antipsychotics. The pragmatic design and naturalistic setting of this large study make the findings relevant for treating patients from some Asian countries in routine clinical practice.

The prevalence of psychiatric disorders among the chronically-ill medical patients in selected tertiary hospitals in the Philippines

OBJECTIVE: This study was conducted to document the prevalence of psychiatric morbidity among chronically ill medical patients in selected hospitals in the Philippines. METHODS: This is a cross-sectional study of the chronically medically ill patients seen in selected Primary are Evaluation of Mental Disorders (PRIME-MD), 774 patients were screened for mental disorders. The prevalence of each of the psychiatric disorders were calculated using the formula for estimation of a proportion for stratified random sampling. The differences in the sample size from each of the study sites were taken into consideration in the estimation of the sitespecific prevalence of mental disorders. The 95 percent confidence intervals of the prevalence rates were computed. RESULTS: Almost half of the patients (47.8 percent) were diagnosed with at least one of the psychiatric disorders elicited from the PRIME-MD. Thirty two percent had depressive disorder, followed by anxiety disorder, somatoform disorders, alcohol-related disorder and eating disorder. According to hospital site, the overall prevalence rate of psychiatric disorder was noted to be highest at the Davao Medical Center. CONCLUSION: The overall prevalence of psychiatric disorder noted in this study was higher than that described in foreign literature, the most common of which was depression.

Obsessive-compulsive disorder in the Philippines: a descriptive study

Objective: This study aims to describe the socio-demographic profile of the Filipino OCD patient consulting a private psychiatrist, the nature of the obsessions and compulsions experienced, the character and severity of the symptoms associated with the disorder, and other co-morbid conditions. Methodology: Forty seven patients with OCD were identified in selected private clinics in Metro Manila. Information on the nature, character and severity of the obsessions and compulsions were gathered in 45 patients through chart review. Results and Conclusion: The OCD patient described in this study was more often male, single who has attained college level of education. The most common obsessions were contamination obsessions (in the form of concern with dirt or germs) and sexual obsessions (in the form of forbidden sexual thoughts, images or impulse). The most common compulsions were the cleaning washing compulsions in the form of excessive or ritualized handwashing. The severity and impact of obsessions were moderate to severe, so with compulsions although to a lesser degree. Over half of all the patients (59.6 percent) had at least one other illness aside from OCD. The most common co-morbid disorders were major depression and dysthymia.