Margo D M Faay1, G Caroline M van Baal2, Celso Arango3, Covadonga M Díaz-Caneja3, Gregor Berger4, Stefan Leucht5, Julio Bobes6, Pilar A Sáiz6, María Paz García-Portilla6, Resy van de Brug7, Jocelyn Petter7, Inge Winter-van Rossum7, Iris E Sommer8. 1. Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: m.d.m.faay@umcutrecht.nl. 2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. 3. Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain. 4. University Hospital of Psychiatry Zurich, Department of Child and Adolescent Psychiatry and Psychotherapy, Zurich, Switzerland. 5. Department of Psychiatry and Psychotherapy, Technical University Munich, Munich, Germany. 6. Department of Medicine-Psychiatry, University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), INEUROPA, CIBERSAM, Oviedo, Spain. 7. Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands. 8. Department of Neuroscience, University Medical Center Groningen, Deusinglaan 2, Groningen, the Netherlands; Department of Medical and Biological Psychology, University of Bergen, Norway.
Abstract
AIM: The aim of this paper is to determine clinical factors related to hostility and disturbing and aggressive behaviour and to examine the effect of medication on these behaviours in FEP. METHODS: Data from phase I and II of the OPTiMiSE trial are used. Outcome measures are the hostility item of the Positive and Negative Syndrome Scale (PANSS P7) and the disturbing and aggressive behaviour domain of the Personal and Social Performance scale (PSP-D). RESULTS: Moderate, severe or extreme hostility (PANSS P7 > 3) was present in 42 patients (9.4%). The PANSS P7 and PSP-D were low to moderate but significantly associated with the selected PANSS items: delusions, hallucinatory behaviour, excitement, tension, uncooperativeness, unusual thought content, impulsivity, and lack of judgement and insight. In a subsample of 185 patients (41.5%) with baseline PANSS P7 > 1, the PANSS P7 and PSP-D scores improved in the first 4 weeks of amisulpride treatment. This effect remained significant after controlling for baseline positive symptoms (PANSS P1-P6). No significant differences were found between olanzapine and amisulpride in the second phase of the trial. CONCLUSION: Clinical risk factors such as poor impulse control, uncooperativeness and excitement could help clinicians in detecting and treating hostile and aggressive behaviour in FEP. Amisulpride could be an effective antipsychotic choice in the treatment of FEP patients who express hostile or aggressive behaviour. Future research is needed to compare the effects of amisulpride and olanzapine on hostility in FEP during the first weeks of treatment.
AIM: The aim of this paper is to determine clinical factors related to hostility and disturbing and aggressive behaviour and to examine the effect of medication on these behaviours in FEP. METHODS: Data from phase I and II of the OPTiMiSE trial are used. Outcome measures are the hostility item of the Positive and Negative Syndrome Scale (PANSS P7) and the disturbing and aggressive behaviour domain of the Personal and Social Performance scale (PSP-D). RESULTS: Moderate, severe or extreme hostility (PANSS P7 > 3) was present in 42 patients (9.4%). The PANSS P7 and PSP-D were low to moderate but significantly associated with the selected PANSS items: delusions, hallucinatory behaviour, excitement, tension, uncooperativeness, unusual thought content, impulsivity, and lack of judgement and insight. In a subsample of 185 patients (41.5%) with baseline PANSS P7 > 1, the PANSS P7 and PSP-D scores improved in the first 4 weeks of amisulpride treatment. This effect remained significant after controlling for baseline positive symptoms (PANSS P1-P6). No significant differences were found between olanzapine and amisulpride in the second phase of the trial. CONCLUSION: Clinical risk factors such as poor impulse control, uncooperativeness and excitement could help clinicians in detecting and treating hostile and aggressive behaviour in FEP. Amisulpride could be an effective antipsychotic choice in the treatment of FEP patients who express hostile or aggressive behaviour. Future research is needed to compare the effects of amisulpride and olanzapine on hostility in FEP during the first weeks of treatment.
Authors: Francesco Dal Santo; Eduardo Fonseca-Pedrero; María Paz García-Portilla; Leticia González-Blanco; Pilar A Sáiz; Silvana Galderisi; Giulia Maria Giordano; Julio Bobes Journal: Eur Psychiatry Date: 2022-06-10 Impact factor: 7.156