Attitude towards second-generation antipsychotics among patients with schizophrenia and their relatives.

OBJECTIVE: Given the paucity of research in this area, this study attempted to assess attitudes towards second-generation antipsychotic medications and their correlates among the patients with schizophrenia and their relatives. METHODS: Structured assessments of attitudes to medications, psychopathology, insight/knowledge, side effects, functioning and treatment satisfaction were carried out in a random sample of 50 patients with DSM-IV schizophrenia and their relatives. All, except one of the patients, were on second-generation antipsychotics. RESULTS: Most patients had positive attitudes towards second-generation antipsychotics. Severity of positive symptoms and higher burden of side effects (e.g. sexual dysfunction, weight gain and sedation) emerged as the principal correlates of negative attitudes among patients. Greater awareness of illness, being employed, better social functioning and greater treatment satisfaction were all associated with positive attitudes among patients. Relatives had significantly more positive attitudes towards antipsychotics than patients and were more satisfied with the treatment. They were well informed about the illness, and their level of knowledge had a significant association with positive attitudes. CONCLUSIONS: Effective antipsychotic treatment, which improves functioning and minimises side effects could lead to more favourable attitudes towards antipsychotics among patients. Increasing awareness of illness, enhancing treatment satisfaction and involving relatives in treatment could also be of help.

Impairment of cognitive functions in congestive cardiac failure patients.

BACKGROUND: Congestive cardiac failure (CCF) patients show several neuropsychological impairments and reduced quality of life and impairment of functioning. OBJECTIVE: The objective of this study was to recognize the deficits in cognition in CCF patients and comparing this cognitive function in the same number of healthy participants. MATERIALS AND METHODS: A case-control study design was adopted. The study was conducted in the cardiology department of a tertiary care hospital. Convenience sampling was done. Twenty-one participants with CCF (New York Cardiac Association - Class III severity) and 21 healthy participants participated in the study. Each participant in the control group was screened by the General Health Questionnaire-12-item version. We evaluated both groups for the various domains of their cognitive function using a comprehensive battery of neuropsychological tests. Student's t-test was used to analyze the difference between the means for the study variables. RESULTS: We observed that attention, executive function, working memory, psychomotor speed, and visuospatial ability were impaired in the patients with CCF compared to the controls. However, they did not differ significantly in language function. CONCLUSIONS: Cognitive functioning is significantly impaired in CCF patients.

Attitudes towards antipsychotics among patients with schizophrenia on first- or second-generation medications.

BACKGROUND: Given the paucity of research in this area, this study attempted to assess attitudes toward antipsychotic medications and its correlates among patients with schizophrenia, either on first-generation antipsychotics (FGAs) or second-generation antipsychotics (SGAs) medications. MATERIALS AND METHODS: Structured assessments of attitudes to antipsychotics, psychopathology, insight and side-effects were carried out in 120 patients with DSM-IV schizophrenia; 89 of these were on SGAs and 31 on FGAs. RESULTS: Patients had predominantly positive attitudes toward antipsychotics. Severity of side-effects was the principal correlate of attitudes, explaining 19.5% of the variance, followed by greater insight (4.2% of the variance). Other factors such as younger age, male gender, employment, higher family income, urban residence and lower symptom-severity explained only a negligible proportion of the variance (0.2%) in attitudes. Patients on SGAs had more positive views of their medications than those on FGAs. They felt more normal on their medications, believed that their thoughts were clearer on medications, felt that good things about their medications outweighed the bad and believed that their medications helped them from falling ill again. In addition, they did not feel as tired and sluggish on their medications and did not believe that medications were unnatural or controlled their bodies. CONCLUSIONS: Positive attitudes toward antipsychotics were common among patients with schizophrenia. Attitudes were principally determined by severity of side-effects and insight levels. Patients on SGAs had better attitudes, possibly because of less severe side-effects and greater insight among them. The importance of exploring patients' attitudes toward their antipsychotics is highlighted by this study.