Pharmacoepidemiological survey of schizophrenia in a tertiary care teaching hospital
Keywords:Atypical antipsychotics, Epidemiology, Olanzapine, Schizophrenia
Background: Prevalence of chronic schizophrenia is somewhat less than 1% of the population but this is one of the most important psychiatric illness due to its early onset, chronicity and associated disability.
Methods: A prospective and observational study was carried out on 76 patients for 12 months. Patients of either sex, aged between 18 to 50 years who were diagnosed as schizophrenia according to DSM IV-TR were screened and recruited for the study. Prescriptions were analyzed for socio demographic details and psychotropic drugs prescribed.
Results: Out of 76 patients 46 (60.53%) were males, maximum occurred 19 (41.30%) between 18 and 25 years of age. Females were 30 (39.47%), maximum occurred 12 (40%) between 34 - 39 years of age. 52 (68.42%) were from urban area and 24 (31.57%) were from rural area. 26 (34.21%) were illiterate, 24 (31.58%) primary educated, 16 (21.05%) secondary educated and 10 (13.16%) higher secondary and above. 20 (26.32%) were unemployed, students 9 (11.84%), housewives 19 (25%), agricultural workers 10 (13.16%), nonagricultural outdoor workers 4 (5.26%) and nonagricultural indoor workers were 14 (18.42%). Only atypical antipsychotics were prescribed .Olanzapine was prescribed in 30 (39.47%), risperidone 16 (21.05%), amisulpride 13 (17.11%), aripiprazole 11 (14.47%) and quetiapine 06 (7.89%) respectively.
Conclusions: The sociodemographic factors associated with schizophrenia are urban locality, illiteracy, low socioeconomic status and unemployment. The treatment pattern observed correlates with the changing trends in the treatment of schizophrenia worldwide.
Rode SB, Salankar HV, Verma PR, Sinha U, Ajagallay RK. Pharmacoepidemiological survey of schizophrenia in Central India. Int J Res Med Sci. 2014;2(3):1058-62.
Ruggeri M, Lasalvia A, Tansella M, Bonetto C, Abate M, Thomicroft G, et al, Heterogenicity of outcomes in schizophrenia: 3- year follow-up of treated prevalent cases. Br J Psychiat. 2004;184:48- 57.
Jaaskelainen E, Haapea M, Rautio N, Juola P, Penttila M. Twenty Years of Schizophrenia Research in the Northern Finland Birth Cohort 1966: A Systematic Review. Schizophr Res Treatment. 2015;1-12.
Galani VJ, Patel J, Patel K, Patel D. An epidemiological survey of patients suffering from schizophrnia in Gujrat. Mintage J Pharmaceut Med Sci. 2013; 2(1):15-7.
Das S, Hazarika M, Bardhan N, Talukdar U, Bhagabati D, Bora U. Fifth revolution of psychiatry. In: Das S, Medhi D, Dutta J, Chakravarty S, editors. Brain understanding of mental illness. Guwahati: Academy Publisher; 2015:1-10.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed. Washington DC: American Psychiatric Association, 2000.
The Maudsley Prescribing Guidelines in Psychiatry, 11th edition. New Delhi, India: John Wiley & Sons, Ltd., Publication; 2012:16-30.
Tandon R, Keshavan MS, Nasrallah HA. Schizophrenia, "just the facts": what we know in 2008. 2. Epidemiology and etiology. Schizophr Res. 2008;102:1-18.
Ali A. Disability in schizophrenia and its relationship with duration of illness and age of onset. Int J Psychosocial Rehab. 2009;14(1):37-41.
Bhowmick S, Hazara A, Ghosh M. Amisulpride versus olanzapine in the treatment of schizophrenia in Indian patients: randomized controlled trial. Aust NZ J Psychiatry. 2010;44(3):237-42.
Pawar GR, Phadnis P, Paliwal A. Evaluation of efficacy, safety, and cognitive profile of amisulpride per se and its comparison with olanzapine in newly diagnosed schizophrenic patients in an 8-week, double-blind, single-centre, prospective clinical trial. ISRN Psychiatry. 2012 Mar 14;2012.
McGrath J, Saha S, Welham J, El Saadi O, MacCauley C, Chant D. A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Med. 2004 Dec;2(1):13.
Aleman A, Kahn RS, Selten JP. Sex differences in the risk of schizophrenia: evidence from meta-analysis. Arch General Psychiatry. 2003;60(6):565-71.
Galani VJ, Patel J, Patel K, Patel D. An epidemiological survey of patients suffering from schizophrenia in Gujarat. Mintage J Pharmaceut Med Sci. 2013; 2(1):15-7.
Abay R. Estrogens action on cognitive function, memory processes, neuro-degenerative disease: A Review. Int J Pharma Sci Res. 2015;6(12):1428-32.
Baldessarini RJ, Tarazi FI. Pharmacotherapy of psychosis and mania. In: Hardman JG, Limbird LE, Gilman AG, editors. Goodman and Gilman’s the pharmacological basis of therapeutics. 11th ed. New York: McGraw-Hill; 2006:429-54.
Mahmuda Naheed, Khondker Ayesha Akter, Fatema Tabassum, Rumana Mawla, Mahmudur Rahman. Factors contributing the outcome of Schizophrenia in developing and developed countries: A brief review. Int Curr Pharmaceut J 2012,1(4): 81-85.
Vassos E, Pedersen CB, Murray RM, Collier DA, Lewis CM. Meta-analysis of the association of urbanicity with schizophrenia. Schizophr Bull. 2012;38(6):1118-23.
Grover S, Kumar V, Avasthi A, Kulhara P. An audit of first prescription of new patients attending a psychiatry walk-in-clinic in north India. Indian J Pharmacol. 2012 May;44(3):319.
Sariaslan A, Larsson H, D’onofrio B, Långström N, Fazel S, Lichtenstein P. Does population density and neighborhood deprivation predict schizophrenia? A nationwide Swedish family-based study of 2.4 million individuals. Schizophr Bull. 2014 Jul 22;41(2):494-502.
Folsom D, Jeste DV. Schizophrenia in homeless persons: a systematic review of the literature. Acta Psychiatr Scand. 2002 Jun;105(6):404-13.
Werner S, Malaspina D, Rabinowitz J. Socioeconomic status at birth is associated with risk of schizophrenia: population-based multilevel study. Schizophr Bull. 2007 Apr 18;33(6):1373-8.
Chakravarty P, Neog P, Dewan B. Study of adverse drug reactions of atypical antipsychotic drugs in the department of psychiatry in a tertiary care hospital of Assam. Open J Psychiatr Allied Sci. 2017;8(1):25-8.
Dutta SB, Dhasmana DC, Bhardwaj R. Psychotropic drug utilization pattern among patients with schizophrenia. Indian J Psychiat. 2005;47:243-4.
Hollingworth SA, Siskind DJ, Nissen LM, Robinson M, Hall WD. Patterns of antipsychotic medication use in Australia 2002–2007. Australian New Zealand J Psychiatr. 2010;44(4):372-7.
Rittmannsberger H, Meise U, Schauflinger K, Horvath E, Donat H, Hinterhuber H. Polypharmacy in psychiatric treatment. Patterns of psychotropic drug use in Austrian psychiatric clinics. Eur Psychiatr. 1999;14(1):33-40.
National list of essential medicines of India. Ministry of Health and Family welfare. Government of India, 2011. Available at: http://cdsco.nic.in/National List of Essential Medicine- final copy.pdf. Accessed 8 June 2017.