Opinions of French patients with schizophrenia regarding injectable medication.

BACKGROUND: Use of patient-reported outcomes to assess the care of individuals with schizophrenia is increasing. We describe a survey (questionnaire) that evaluates patient opinions on long-acting injectable antipsychotic medication. METHODS: Psychiatrists throughout France selected consenting patients with schizophrenia who had received at least three months' treatment with a long-acting injectable antipsychotic (either typical or atypical) as outpatients to be interviewed by professional interviewers. RESULTS: A total of 206 patients were interviewed at 19 sites. Ninety-five percent of the patients had been treated with more than one form of dosage; for these individuals, injections were the favored dosage form, being preferred by 47% (compared with 35%, 7%, and 1% expressing a preference for oral tablets, drinkable solutions, and orally disintegrating tablets, respectively, whilst 10% of patients did not express a preference). Over two-thirds of the interviewees (67%) said they felt better having received an injectable treatment than they felt before, and over half the patients (51%) considered injectable therapy to be more effective than other medication. In addition, the majority of the sample (70%) felt better supported in their illness by virtue of regular contact with the doctor or nurse who administered their injection. Patients also reported that injectable treatment could impact positively on their plans and aspirations, with the most frequent consideration for the future relating to finding a job (49% of the sample). CONCLUSION: In this survey, patients with schizophrenia had favorable opinions on injectable medication. Ultimately, positive experiences associated with the treatment of schizophrenia in patients receiving long-acting injectable medication may influence the prescription of such therapy by health care providers.

Factors associated with medication non-adherence in patients suffering from schizophrenia: a cross-sectional study in a universal coverage health-care system.

OBJECTIVE: To quantify the factors associated with non-adherence to medication among stable patients suffering from schizophrenia in the context of universal access to care. METHODS: This naturalistic, multicentric study was conducted in 15 French public hospitals in a region of south-eastern France during a 1 week period in 2008. All consecutive outpatients with stable schizophrenia were recruited. Adherence was assessed with the 10-item Drug Attitude Inventory (DAI). Measures included socio-demographic characteristics, clinical characteristics, insight using the Scale to assess Unawareness of Mental Disease (SUMD), and therapeutic alliance using the Patient Session Questionnaire (PSQ). Regression models were used to identify the risk factors associated with non-adherence. RESULTS: The study included 291 patients, 30% of whom were considered to be non-adherent. Non-adherence increased with duration of untreated psychosis (DUP) (OR = 1.12, 95%CI = 1.03-1.22), lack of insight only for the dimension 'effect of medication' (OR = 3.23, 95%CI = 1.05-9.89), and a low level of therapeutic alliance (OR = 0.45, 95%CI = 0.32-0.64). Individuals prescribed atypical antipsychotic drugs were more likely to be adherent than those prescribed typical antipsychotics (OR = 0.37, 95%CI = 0.13-1.0). CONCLUSIONS: DUP, prescription of typical antipsychotics, therapeutic alliance and insight were the most important features associated with non-adherence. This study also suggests that economic factors such as the service delivery system should not be neglected in public strategies aimed at addressing problems of non-adherence in non-universal coverage health systems.

An investigation of semantic priming in schizophrenia using a new priming paradigm.

In the present study, twenty schizophrenic patients and twenty healthy controls were tested in a new priming paradigm that allows a clear distinction to be made between automatic, perceptual priming effects and effects related to decision bias. Participants had to identify briefly presented masked target words preceded by clearly visible primes that were semantically related to the target or not. Target presentation duration corresponded to a pre-determined perceptual threshold for each participant, and a two-alternative forced-choice methodology was used. Equivalent amounts of semantic priming were found in schizophrenic patients compared with healthy controls. However, for the schizophrenic patients, a positive correlation was found between the size of automatic perceptual priming effects and formal thought disorders, as measured by Andreasen's Thought, Language and Communication (TLC) scale. The new paradigm tested in the present study overcomes some of the limitations of prior research on semantic priming in schizophrenia, and provides further evidence suggesting that an increased spreading of activation in the semantic network could partly underlie formal thought disorders in schizophrenia.