Literature DB >> 12729866

Are patients enrolled in first episode psychosis drug trials representative of patients treated in routine clinical practice?

Jonathan Rabinowitz1, Evelyn J Bromet, Michael Davidson.   

Abstract

BACKGROUND: Evidence on efficacy of antipsychotic medications comes primarily from controlled trials which select eligible consenting patients for experimental and regimented treatments, who do not abuse drugs, and are in good general health. Thus, it is not clear to what extent results are generalizable to most individuals treated for a psychotic illness who may not be eligible for such trials.
OBJECTIVE: This study compared characteristics of patients treated in a large randomized trial of persons with early psychosis to a cohort from a large epidemiological study of first episode psychosis.
METHODS: Included were the 535 patients enrolled in a controlled trial of antipsychotic medication and 179 similarly diagnosed persons from the Suffolk County Mental Health epidemiological study. Drug trial exclusion criteria were used to estimate the number of patients from the epidemiological study who would have been ineligible for the drug trial. The two samples were compared on key characteristics.
RESULTS: Thirty-three percent (n=59) of the epidemiological sample did not meet inclusion criteria for the drug trial (due to antidepressant treatment, n=26; current substance abuse, n=18; recent suicide attempt, n=9; and for more than one reason, n=6). There were no significant differences between the two study samples on age of onset, age, gender and premorbid functioning. Drug trial patients had higher Brief Psychiatric Rating Scale (BPRS), slightly lower Clinical Global Impression (CGI), and less formal education than those in the epidemiological study.
CONCLUSIONS: While some patients in the epidemiological sample would have been excluded from the drug trial, patients in the two studies were similar on several key variables.

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Year:  2003        PMID: 12729866     DOI: 10.1016/s0920-9964(02)00322-5

Source DB:  PubMed          Journal:  Schizophr Res        ISSN: 0920-9964            Impact factor:   4.939


  10 in total

1.  Trajectories and antecedents of treatment response over time in early-episode psychosis.

Authors:  Stephen Z Levine; J Rabinowitz
Journal:  Schizophr Bull       Date:  2008-10-09       Impact factor: 9.306

2.  Predicting Participation in Psychiatric Randomized Controlled Trials: Insights From the STEP-BD.

Authors:  Alisa B Busch; Yulei He; Katya Zelevinsky; Alistair J O'Malley
Journal:  Psychiatr Serv       Date:  2015-03-31       Impact factor: 3.084

3.  Generalizability of pharmacological and psychotherapy clinical trial results for borderline personality disorder to community samples.

Authors:  Nicolas Hoertel; Saioa López; Shuai Wang; Ana González-Pinto; Frédéric Limosin; Carlos Blanco
Journal:  Personal Disord       Date:  2015-01

4.  How Many Patients With Schizophrenia Do Not Respond to Antipsychotic Drugs in the Short Term? An Analysis Based on Individual Patient Data From Randomized Controlled Trials.

Authors:  Myrto T Samara; Adriani Nikolakopoulou; Georgia Salanti; Stefan Leucht
Journal:  Schizophr Bull       Date:  2019-04-25       Impact factor: 9.306

5.  Antipsychotic-Induced Weight Gain: Dose-Response Meta-Analysis of Randomized Controlled Trials.

Authors:  Hui Wu; Spyridon Siafis; Tasnim Hamza; Johannes Schneider-Thoma; John M Davis; Georgia Salanti; Stefan Leucht
Journal:  Schizophr Bull       Date:  2022-05-07       Impact factor: 7.348

6.  A comparison of neurocognition and functioning in first episode psychosis populations: do research samples reflect the real world?

Authors:  Emily Kline; Victoria Hendel; Michelle Friedman-Yakoobian; Raquelle I Mesholam-Gately; Ann Findeisen; Suzanna Zimmet; Joanne D Wojcik; Tracey L Petryshen; Tsung-Ung W Woo; Jill M Goldstein; Martha E Shenton; Matcheri S Keshavan; Robert W McCarley; Larry J Seidman
Journal:  Soc Psychiatry Psychiatr Epidemiol       Date:  2018-11-28       Impact factor: 4.328

7.  Generalizability of clinical trials for alcohol dependence to community samples.

Authors:  Carlos Blanco; Mark Olfson; Mayumi Okuda; Edward V Nunes; Shang-Min Liu; Deborah S Hasin
Journal:  Drug Alcohol Depend       Date:  2008-06-24       Impact factor: 4.492

Review 8.  The treatment of schizophrenia: from premorbid manifestations to the first episode of psychosis.

Authors:  Michael Davidson; Asaf Caspi; Shlomo Noy
Journal:  Dialogues Clin Neurosci       Date:  2005       Impact factor: 5.986

9.  Statistical validation of the criteria for symptom remission in schizophrenia: preliminary findings.

Authors:  Mark G A Opler; Lawrence H Yang; Sue Caleo; Philip Alberti
Journal:  BMC Psychiatry       Date:  2007-07-24       Impact factor: 3.630

10.  A literature review on the representativeness of randomized controlled trial samples and implications for the external validity of trial results.

Authors:  Tessa Kennedy-Martin; Sarah Curtis; Douglas Faries; Susan Robinson; Joseph Johnston
Journal:  Trials       Date:  2015-11-03       Impact factor: 2.279

  10 in total

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