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2 results

  • Duration of therapy and treatment compliance of depressive patients at clinical high-risk for psychosis

  • M. Omelchenko
  • Journal:
    European Psychiatry / Volume 65 / Issue S1 / June 2022
    Published online by Cambridge University Press:
    01 September 2022, p. S680
    • Article
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  • Introduction

    It is known that early withdrawal can lead to a worsening of mental health. This is particularly relevant for depressive patients with clinical high-risk for psychosis (CHR) for whom the recommended duration of treatment has not been established.

    Objectives

    Analyze the actual treatment duration of depressive patients at CHR after their discharge from hospital and compare it with the group of depressive patients without CHR.

    Methods

    A comparative study of 124 depressive patients with CHR and 27 depressive patients without CHR was conducted within a year after discharge from hospital to assess the therapy duration and treatment compliance.

    Results

    Within a year after discharge only 12.1% depressive patients with CHR and 29.6% ones without CHR continued to receive the therapy. The average duration of treatment after discharge was 7.4 months in the first group and 11.7 months in the second group. The majority of patients stopped treatment for the following reasons (in descending order of importance): lack of awareness of their mental condition (51.9% vs 40.3%), side effects (38.7% vs 11.1%), and negative attitudes towards the treatment on the part of patients’ immediate family members (8.9% vs 7.4%).

    Conclusions

    It has been found out that depressive patients with CHR are less likely to follow medical prescriptions than ones without CHR, they are more likely to have the lack of awareness of their mental condition, they are more likely to have side effects of the therapy. These findings require the development of a universal approach to the treatment of such patients after discharge from hospital.

    Disclosure

    No significant relationships.

  • Anosognosia and Alzheimer's Disease

  • Lorenzo Pia, Paul M. Conway
  • Journal:
    Brain Impairment / Volume 9 / Issue 1 / 01 May 2008
    Published online by Cambridge University Press:
    21 February 2012, pp. 22-27

  • Neurological patients can be entirely unaware of their disease; this phenomenon is called anosognosia and it has been shown in different sensory-motor and cognitive domains. Lack of awareness has been investigated in Alzheimer's disease (AD) and within different domains of it. In the present article we review the literature on anosognosia for AD that had been indexed on the Medline database until the end of 2004. Historical introduction to the subject is followed by a brief description of the anatomy and clinical characteristics of AD. An analysis of a number of studies that focus on the relationship between anosognosia and AD then follows. This review shows that anosognosia is typical in AD, compared with other types of dementia, and it is a distinctive feature in the most severe cases and particularly in the beginning phases of illness. From an anatomical point of view, anosognosia seems to be strictly connected to frontal lobe areas; in fact, patients with anosognosia and AD show a reduction of cerebral haematic flow in the frontal regions, as well as deficits of executive functions and extrapyramidal signs. Interestingly, co-occurring depression could be interpreted as an adaptive behavior to counter the effects of perceived loss of cognitive abilities. Finally, self-awareness in AD could have some common mechanisms with auto-monitoring in schizophrenia.