An open-label study of algorithm-based treatment versus treatment-as-usual for patients with schizophrenia

Jinichi Hirano,1,2 Koichiro Watanabe,3 Takefumi Suzuki,1,4 Hiroyuki Uchida,1 Ryosuke Den,5 Taishiro Kishimoto,1 Takashi Nagasawa,5 Yusuke Tomita,4 Koichiro Hara,6 Hiromi Ochi,7 Yoshimi Kobayashi,1 Mutsuko Ishii,1 Akane Fujita,1 Yoshihiko Kanai,1 Megumi Goto,1 Hiromi Hayashi,1 Kanako Inamura,1 Fumiko...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Hirano J, Watanabe K, Suzuki T, Uchida H, Den R, Kishimoto T, Nagasawa T, Tomita Y, Hara K, Ochi H, Kobayashi Y, Ishii M, Fujita A, Kanai Y, Goto M, Hayashi H, Inamura K, Ooshima F, Sumida M, Ozawa T, Sekigawa K, Nagaoka M, Yoshimura K, Konishi M, Inagaki A, Saito T, Motohashi N, Mimura M, Okubo Y, Kato M
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2013
Materias:
Acceso en línea:https://doaj.org/article/9aa410a7ea374627b050765e53607259
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:9aa410a7ea374627b050765e53607259
record_format dspace
spelling oai:doaj.org-article:9aa410a7ea374627b050765e536072592021-12-02T00:59:33ZAn open-label study of algorithm-based treatment versus treatment-as-usual for patients with schizophrenia1176-63281178-2021https://doaj.org/article/9aa410a7ea374627b050765e536072592013-10-01T00:00:00Zhttp://www.dovepress.com/an-open-label-study-of-algorithm-based-treatment-versus-treatment-as-u-a14654https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Jinichi Hirano,1,2 Koichiro Watanabe,3 Takefumi Suzuki,1,4 Hiroyuki Uchida,1 Ryosuke Den,5 Taishiro Kishimoto,1 Takashi Nagasawa,5 Yusuke Tomita,4 Koichiro Hara,6 Hiromi Ochi,7 Yoshimi Kobayashi,1 Mutsuko Ishii,1 Akane Fujita,1 Yoshihiko Kanai,1 Megumi Goto,1 Hiromi Hayashi,1 Kanako Inamura,1 Fumiko Ooshima,1 Mariko Sumida,1 Tomoko Ozawa,1 Kayoko Sekigawa,1 Maki Nagaoka,1 Kae Yoshimura,1 Mika Konishi,1 Ataru Inagaki,1 Takuya Saito,8 Nobutaka Motohashi,9 Masaru Mimura,1 Yoshiro Okubo,8 Motoichiro Kato,11Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; 2Ohizumi Hospital, Tokyo, Japan; 3Department of Psychiatry School of Medicine, Kyorin University, Tokyo, Japan; 4Inokashira Hospital, Tokyo, Japan; 5Komagino Hospital, Tokyo, Japan; 6Asai Hospital, Chiba, Japan; 7Kurumegaoka Hospital, Tokyo, Japan; 8Department of Psychiatry School of Medicine, Nippon Medical School, Tokyo, Japan; 9Department of Psychiatry, School of Medicine, University of Yamanashi, Yamanashi, JapanObjective: The use of an algorithm may facilitate measurement-based treatment and result in more rational therapy. We conducted a 1-year, open-label study to compare various outcomes of algorithm-based treatment (ALGO) for schizophrenia versus treatment-as-usual (TAU), for which evidence has been very scarce.Methods: In ALGO, patients with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) were treated with an algorithm consisting of a series of antipsychotic monotherapies that was guided by the total scores in the positive and negative syndrome scale (PANSS). When posttreatment PANSS total scores were above 70% of those at baseline in the first and second stages, or above 80% in the 3rd stage, patients proceeded to the next treatment stage with different antipsychotics. In contrast, TAU represented the best clinical judgment by treating psychiatrists.Results: Forty-two patients (21 females, 39.0 ± 10.9 years-old) participated in this study. The baseline PANSS total score indicated the presence of severe psychopathology and was significantly higher in the ALGO group (n = 25; 106.9 ± 20.0) than in the TAU group (n = 17; 92.2 ± 18.3) (P = 0.021). As a result of treatment, there were no significant differences in the PANSS reduction rates, premature attrition rates, as well as in a variety of other clinical measures between the groups. Despite an effort to make each group unique in pharmacologic treatment, it was found that pharmacotherapy in the TAU group eventually became similar in quality to that of the ALGO group.Conclusion: While the results need to be carefully interpreted in light of a hard-to-distinguish treatment manner between the two groups and more studies are necessary, algorithm-based antipsychotic treatments for schizophrenia compared well to treatment-as-usual in this study.Keywords: algorithm, open-label clinical trial, measurement-based treatment, schizophrenia, treatment-as-usualHirano JWatanabe KSuzuki TUchida HDen RKishimoto TNagasawa TTomita YHara KOchi HKobayashi YIshii MFujita AKanai YGoto MHayashi HInamura KOoshima FSumida MOzawa TSekigawa KNagaoka MYoshimura KKonishi MInagaki ASaito TMotohashi NMimura MOkubo YKato MDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2013, Iss default, Pp 1553-1564 (2013)
institution DOAJ
collection DOAJ
language EN
topic Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Hirano J
Watanabe K
Suzuki T
Uchida H
Den R
Kishimoto T
Nagasawa T
Tomita Y
Hara K
Ochi H
Kobayashi Y
Ishii M
Fujita A
Kanai Y
Goto M
Hayashi H
Inamura K
Ooshima F
Sumida M
Ozawa T
Sekigawa K
Nagaoka M
Yoshimura K
Konishi M
Inagaki A
Saito T
Motohashi N
Mimura M
Okubo Y
Kato M
An open-label study of algorithm-based treatment versus treatment-as-usual for patients with schizophrenia
description Jinichi Hirano,1,2 Koichiro Watanabe,3 Takefumi Suzuki,1,4 Hiroyuki Uchida,1 Ryosuke Den,5 Taishiro Kishimoto,1 Takashi Nagasawa,5 Yusuke Tomita,4 Koichiro Hara,6 Hiromi Ochi,7 Yoshimi Kobayashi,1 Mutsuko Ishii,1 Akane Fujita,1 Yoshihiko Kanai,1 Megumi Goto,1 Hiromi Hayashi,1 Kanako Inamura,1 Fumiko Ooshima,1 Mariko Sumida,1 Tomoko Ozawa,1 Kayoko Sekigawa,1 Maki Nagaoka,1 Kae Yoshimura,1 Mika Konishi,1 Ataru Inagaki,1 Takuya Saito,8 Nobutaka Motohashi,9 Masaru Mimura,1 Yoshiro Okubo,8 Motoichiro Kato,11Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; 2Ohizumi Hospital, Tokyo, Japan; 3Department of Psychiatry School of Medicine, Kyorin University, Tokyo, Japan; 4Inokashira Hospital, Tokyo, Japan; 5Komagino Hospital, Tokyo, Japan; 6Asai Hospital, Chiba, Japan; 7Kurumegaoka Hospital, Tokyo, Japan; 8Department of Psychiatry School of Medicine, Nippon Medical School, Tokyo, Japan; 9Department of Psychiatry, School of Medicine, University of Yamanashi, Yamanashi, JapanObjective: The use of an algorithm may facilitate measurement-based treatment and result in more rational therapy. We conducted a 1-year, open-label study to compare various outcomes of algorithm-based treatment (ALGO) for schizophrenia versus treatment-as-usual (TAU), for which evidence has been very scarce.Methods: In ALGO, patients with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) were treated with an algorithm consisting of a series of antipsychotic monotherapies that was guided by the total scores in the positive and negative syndrome scale (PANSS). When posttreatment PANSS total scores were above 70% of those at baseline in the first and second stages, or above 80% in the 3rd stage, patients proceeded to the next treatment stage with different antipsychotics. In contrast, TAU represented the best clinical judgment by treating psychiatrists.Results: Forty-two patients (21 females, 39.0 ± 10.9 years-old) participated in this study. The baseline PANSS total score indicated the presence of severe psychopathology and was significantly higher in the ALGO group (n = 25; 106.9 ± 20.0) than in the TAU group (n = 17; 92.2 ± 18.3) (P = 0.021). As a result of treatment, there were no significant differences in the PANSS reduction rates, premature attrition rates, as well as in a variety of other clinical measures between the groups. Despite an effort to make each group unique in pharmacologic treatment, it was found that pharmacotherapy in the TAU group eventually became similar in quality to that of the ALGO group.Conclusion: While the results need to be carefully interpreted in light of a hard-to-distinguish treatment manner between the two groups and more studies are necessary, algorithm-based antipsychotic treatments for schizophrenia compared well to treatment-as-usual in this study.Keywords: algorithm, open-label clinical trial, measurement-based treatment, schizophrenia, treatment-as-usual
format article
author Hirano J
Watanabe K
Suzuki T
Uchida H
Den R
Kishimoto T
Nagasawa T
Tomita Y
Hara K
Ochi H
Kobayashi Y
Ishii M
Fujita A
Kanai Y
Goto M
Hayashi H
Inamura K
Ooshima F
Sumida M
Ozawa T
Sekigawa K
Nagaoka M
Yoshimura K
Konishi M
Inagaki A
Saito T
Motohashi N
Mimura M
Okubo Y
Kato M
author_facet Hirano J
Watanabe K
Suzuki T
Uchida H
Den R
Kishimoto T
Nagasawa T
Tomita Y
Hara K
Ochi H
Kobayashi Y
Ishii M
Fujita A
Kanai Y
Goto M
Hayashi H
Inamura K
Ooshima F
Sumida M
Ozawa T
Sekigawa K
Nagaoka M
Yoshimura K
Konishi M
Inagaki A
Saito T
Motohashi N
Mimura M
Okubo Y
Kato M
author_sort Hirano J
title An open-label study of algorithm-based treatment versus treatment-as-usual for patients with schizophrenia
title_short An open-label study of algorithm-based treatment versus treatment-as-usual for patients with schizophrenia
title_full An open-label study of algorithm-based treatment versus treatment-as-usual for patients with schizophrenia
title_fullStr An open-label study of algorithm-based treatment versus treatment-as-usual for patients with schizophrenia
title_full_unstemmed An open-label study of algorithm-based treatment versus treatment-as-usual for patients with schizophrenia
title_sort open-label study of algorithm-based treatment versus treatment-as-usual for patients with schizophrenia
publisher Dove Medical Press
publishDate 2013
url https://doaj.org/article/9aa410a7ea374627b050765e53607259
work_keys_str_mv AT hiranoj anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT watanabek anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT suzukit anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT uchidah anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT denr anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT kishimotot anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT nagasawat anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT tomitay anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT harak anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT ochih anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT kobayashiy anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT ishiim anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT fujitaa anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT kanaiy anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT gotom anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT hayashih anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT inamurak anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT ooshimaf anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT sumidam anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT ozawat anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT sekigawak anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT nagaokam anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT yoshimurak anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT konishim anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT inagakia anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT saitot anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT motohashin anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT mimuram anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT okuboy anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT katom anopenlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT hiranoj openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT watanabek openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT suzukit openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT uchidah openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT denr openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT kishimotot openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT nagasawat openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT tomitay openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT harak openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT ochih openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT kobayashiy openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT ishiim openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT fujitaa openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT kanaiy openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT gotom openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT hayashih openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT inamurak openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT ooshimaf openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT sumidam openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT ozawat openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT sekigawak openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT nagaokam openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT yoshimurak openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT konishim openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT inagakia openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT saitot openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT motohashin openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT mimuram openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT okuboy openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
AT katom openlabelstudyofalgorithmbasedtreatmentversustreatmentasusualforpatientswithschizophrenia
_version_ 1718403399458750464