RESUMO
OBJECTIVE: The study aimed to determine clinical indicators that could be used to differentiate between patients diagnosed with substance-induced psychotic disorder (SIPD) and patients diagnosed with schizophrenia by comparing their psychotic symptoms and theory of mind (ToM). METHODS: The study included 43 male patients diagnosed with schizophrenia according to DSM-5 criteria and 43 male patients diagnosed with SIPD. The patients were administered the Sociodemographic and Clinical Data Form, Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), Psychotic Symptom Evaluation Scale (PSYRATS), and Reading the Mind in the Eyes Test (RMET). RESULTS: In patients diagnosed with schizophrenia, the scores on SAPS subscales for structural thought disorder and bizarre behavior, as well as SANS total scores, were significantly higher compared to patients diagnosed with SIPD (z=2.679, p=0.007; z=2.984, p=0.003; z=6.916, p<0.001). The scores for recognizing negative and neutral expressions on the RMET were significantly higher in patients with SIPD than in patients with schizophrenia (z=3.540; p<0.001; z=4.404, p<0.001). It was found that as the scores on the SANS total and Affect Blunting or Flattening subscale, as well as the scores on the SAPS Bizarre Behavior subscale decrease, the probability of having SIPD increases. CONCLUSION: In patients diagnosed with SIPD, there are fewer disorganized and negative symptoms compared to patients diagnosed with schizophrenia. Patients with SIPD can recognize negative and neutral expressions better than patients with schizophrenia. When making a differential diagnosis between SIPD and schizophrenia, as blunting in affect, total negative symptoms, and severity of bizarre behavior decrease, the probability of being diagnosed with SIPD increases relative to the probability of being diagnosed with schizophrenia.
RESUMO
OBJECTIVE: Regarding the patients using long acting injectable (LAI) antipsychotic treatment; we aimed to investigate the effect of attitude towards drugs, antipsychotic type and side effects on quality of life, caregiver burden and continuation of treatment. METHOD: Our study sample consisted of 110 patients in the age range of 18-65 using LAI antipsychotics for at least 12 weeks with the diagnosis of schizophrenia according to DSM-5 criteria. Sociodemographic and Clinical Data Form, Drug Attitude Inventory 10 (DAI-10), Positive and Negative Syndrome Scale (PANSS), UKU Side Effect Rating Scale, Quality of Life for Schizophrenia Scale were used for evaluation of patients. Sociodemographic Data Form, Zarit Caregiver Burden Scale (ZCBS) were used for the caregivers. RESULTS: It is observed that the patients with positive attitude against the treatment had longer antipsychotic treatment duration (13.7+9.1 years) compared to patients with negative attitude (7.7 + 6.6 years) (p<0.001). PANSS total scores of patients who were considering about treatment discontinuation (44.0+14.3) were higher than the other patients (38.6+9.0) (p=0.03) and DAI-10 scores of patients who were considering about treatment discontinuation were lower (1.4+4.9; 5.2+3.4; p<0.001). Duration of illness were also shorter (10.3+9.3 year) for the patients who were considering about treatment discontinuation than the other group (15.7 + 9.0 year) (p=0.01). There was no significant difference in caregiver burden, side effects, quality of life and reasons for treatment discontinuation between typical and atypical antipsychotics. According to the regression analysis results, PANSS score (ß=0.553, p<0.001) and male gender (ß= 0.225, p=0.003) were positive predictors of ZCBS scores. CONCLUSION: It is observed that the attitude towards drugs and psychotic symptom severity were the most important factors for treatment discontinuation in patients with schizophrenia using LAI antipsychotics. Atypical and typical antipsychotics were not different with respect to quality of life and caregiver burden for the patients on regular treatment with LAI antipsychotics.