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Correlates of late-onset antipsychotic treatment resistance

Published online by Cambridge University Press:  01 September 2022

D. Fonseca De Freitas ,
D. Agbedjro ,
G. Kadra-Scalzo ,
E. Francis ,
I. Ridler ,
M. Pritchard ,
H. Shetty ,
A. Segev ,
C. Casetta  and
S. Smart
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D. Fonseca De Freitas*
Affiliation:
King’s College London & University of Oxford College London, Psychological Medicine & Department Of Psychiatry And Nuffield Department Of Primary Care Health Sciences, London, United Kingdom Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Psychological Medicine, London, United Kingdom
D. Agbedjro
Affiliation:
Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Psychological Medicine, London, United Kingdom
G. Kadra-Scalzo
Affiliation:
Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, Department Of Psychological Medicine, London, United Kingdom
E. Francis
Affiliation:
University College London, Institute Of Epidemiology And Health Care, London, United Kingdom
I. Ridler
Affiliation:
Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Biostatistics And Health Informatics, London, United Kingdom
M. Pritchard
Affiliation:
Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Psychological Medicine, London, United Kingdom
H. Shetty
Affiliation:
South London and Maudsley NHS Foundation Trust, Maudsley Biomedical Research Centre, London, United Kingdom
A. Segev
Affiliation:
Tel Aviv University, Sackler Faculty Of Medicine, Tel Aviv-Yafo , Israel
C. Casetta
Affiliation:
Università degli Studi di Milano, Department Of Health Sciences, Milano, Italy
S. Smart
Affiliation:
Cardiff University, Mrc Centre For Neuropsychiatric Genetics And Genomics, Cardiff, United Kingdom
A. Morris
Affiliation:
King’s College London, Institute Of Psychiatry, Psychology & Neuroscience, London, United Kingdom
J. Downs
Affiliation:
King’s College London, Institute Of Psychiatry, Psychology & Neuroscience, London, United Kingdom
S. Christensen
Affiliation:
H. Lundbeck A/S, H. Lundbeck A/s, Copenhagen, Denmark
N. Bak
Affiliation:
H. Lundbeck A/S, H. Lundbeck A/s, Copenhagen, Denmark
B. Kinon
Affiliation:
Lundbeck Pharmaceuticals LLC, Lundbeck Pharmaceuticals Llc, Deerfield, United States of America
D. Stahl
Affiliation:
Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Biostatistics And Health Informatics, London, United Kingdom
R. Hayes
Affiliation:
Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Psychological Medicine, London, United Kingdom
J. Maccabe
Affiliation:
King’s College London, Academic Psychiatry, London, United Kingdom
*
*Corresponding author.

Abstract

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Introduction

There is emerging evidence of heterogeneity within treatment-resistance schizophrenia (TRS), with some people not responding to antipsychotic treatment from illness onset and a smaller group becoming treatment-resistant after an initial response period. It has been suggested that these groups have different aetiologies. Few studies have investigated socio-demographic and clinical differences between early and late onset of TRS.

Objectives

This study aims to investigate socio-demographic and clinical correlates of late-onset of TRS.

Methods

Using data from the electronic health records of the South London and Maudsley, we identified a cohort of people with TRS. Regression analyses were conducted to identify correlates of the length of treatment to TRS. Analysed predictors include gender, age, ethnicity, positive symptoms severity, problems with activities of daily living, psychiatric comorbidities, involuntary hospitalisation and treatment with long-acting injectable antipsychotics.

Results

We observed a continuum of the length of treatment until TRS presentation. Having severe hallucinations and delusions at treatment start was associated shorter duration of treatment until the presentation of TRS.

Conclusions

Our findings do not support a clear cut categorisation between early and late TRS, based on length of treatment until treatment resistance onset. More severe positive symptoms predict earlier onset of treatment resistance.

Disclosure

DFdF, GKS, EF and IR have received research funding from Janssen and H. Lundbeck A/S. RDH and HS have received research funding from Roche, Pfizer, Janssen and Lundbeck. SES is employed on a grant held by Cardiff University from Takeda Pharmaceutical Comp

Keywords

secondary TRSrefractory psychosis
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S781 - S782
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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