Browsing by Author "Chiliza, B."

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Combining depot antipsychotic with an assertive monitoring programme for treating first-episode schizophrenia in a resource- constrained setting
(John Wiley & Sons Australia, Ltd, 2016) Chiliza, B.; Ojagbemi, A.; Esan, O.B.; Asmal, L.; Oosthuizen, P.; Kidd, M.; Gureje, O.; Emsley, R.
Aim: To assess the feasibility and effectiveness of depot antipsychotic (flupentixol decanoate) combined with an assertive monitoring programme (AMP) in first-episode schizophrenia. Methods: This was a prospective, non-comparative, longitudinal study conducted over 12 months assessing patient acceptance, adherence, outcome in domains of psychopathology, functionality and quality of life, and tolerability. Results: Of 207 participants, 149 (72%) completed 12 months of treatment. Acceptance of and adherence to depot was good. Treatment response was achieved by 170 (82%) participants and remission by 124 (60%). Thirty-three (19%) responders relapsed and10(5%) participants met a priori criteria for treatment resistance. Treatment was generally well tolerated. Conclusions: Combination of depot antipsychotic with an AMP maybe an effective and safe intervention linearly phase of schizophrenia, and may be particularly suitable for resource constrained settings.
Neurological Soft Signs, Spontaneous and Treatment Emergent Extrapyramidal Syndromes in Black Africans With First Episode Schizophrenia
(Frontiers Media S.A., 2018) Ojagbemi, A.; Chiliza, B.; Bello, T.; Asmal, L.; Esan, O.B.; Emsley, R.; Gureje, O.
Background: Very little is known about the relationship between spontaneous and treatment-induced motor syndromes in Africans with first episode schizophrenia. Objective: We investigated the association between spontaneous NSS and EPS, with treatment-induced EPS in a homogenous sample of Black Africans with first episode schizophrenia. Methods: We examined Xhosa (South Africa) and Yoruba (Nigeria) patients, using the Neurological Evaluation Scale and extrapyramidal symptoms scale before and at 3 months after exposure to low dose flupenthixol decanoate. Pearson’s correlations and Linear regression models, controlling for duration of untreated psychosis (D.U.P) and premorbid adjustments, were used in examining associations. Results: Among 99 participants in the baseline sample, 91 (91.8%) and 20 (20.2%) had at least one definite NSS and EPS, respectively, before exposure to antipsychotics. Treatment-induced EPS were recorded in 34 (38.6%). Spontaneous EPS was associated with treatment-emergent Akathisia in participants with a longer D.U.P (r = 0.75, β = 0.70, p=0.008). This association was specific for Parkinsonism (r =0.75, β=0.85, p=0.008) and dyskinesia (r = 0.75, β = 1.70, p = 0.008). Conclusion: Similar to previous findings for tardive dyskinesia in studies implementing longer-term follow-up, spontaneous EPS may also predict short-term antipsychotic induced EPS such as akathisia. These results may be important for early identification of patients at risk of treatment-induced Akathisia-linked psychomotor agitation in first episode schizophrenia.
Spontaneous and emergent extrapyramidal syndromes in Black Africans with first-episode schizophrenia and first exposure to antipsychotics
(Taylor & Francis, 2021) Ojagbemi, A.; Chiliza, B.; Bello, T.; Esan, O. B.; Asmal, L.; Emsley, R.; Gureje, O.
Background: Persons of African ancestry are thought to carry a higher risk for extrapyramidal syndromes (EPS) in schizophrenia. Aim: We investigated the phenomenon of spontaneous and treatment-emergent EPS in a sample comprising Xhosa (South Africa) and Yoruba (Nigeria) Africans with first-episode schizophrenia and first exposure to antipsychotics. Methods: The Extrapyramidal Symptom Rating Scale (ESRS) and a variety of validated tools were used for the assessment of participants before, and two-weekly after treatment with low dose flupenthixol decanoate. Participants were followed up for 12 months. Association of EPS with clinical characteristics was investigated using Pearson’s correlation and linear regression analyses. Results: Of 88 participants at baseline, 16 (18.1%) had at least one definite EPS prior to antipsychotic exposure and 34 (38.6%) had treatment-emergent EPS. While spontaneous Parkinsonism was associated with negative symptoms (r¼0.2, p¼0.043; b¼0.6, p¼0.043), treatment-emergent EPS demonstrated non-significant correlations with clinical characteristics. Apart from dyskinesia, the frequency of treatment-emergent EPS decreased over 12 months observation. Conclusion: These findings support the hypothesis suggesting that spontaneously occurring Parkinsonism in schizophrenia may be the motor spectrum of negative symptomatology. Future studies of this relationship may lead to early identification of patients who may be more sensitive to EPS.
The expression of neurological soft signs in two African populations with first-episode schizophrenia
(SAGE Publications, 2018) Ojagbemi, A.; Chiliza, B.; Bello, T.; Asmal, L.; Esan, O.B.; Emsley, R.; Gureje, O.
Information about patterns of expression of neurological soft signs (NSS) in schizophrenia among individuals belonging to the same genetic ancestry may provide new insight for the understanding of the disease’s genetic functions. This study aimed to investigate whether patterns of NSS expression in first episode schizophrenia are com parable in populations with dissimilar genetic ancestry. A sample of 207 patients with first episode schizophrenia were examined using the Neurological Evaluation Scale before they were exposed to anti-psychotics. They were allocated to two African ancestry groups: Black (81 Yoruba Nigerians, and 18 Xhosa South Africans), and non-Black (98 Colored, and 10 White South Africans). Assessments were carried out using validated measures of clinical characteristics of schizophrenia. We determined the frequency, severity, factor structure, and association of NSS with clinical characteristics. Factor derived categories were compared using the Pearson’s (r) and Tucker’s congruence methods. The associations between factor derived categories and clinical characteristics of schizophrenia were determined using Pearson’s correlations and multiple regression analyses. Neurological soft signs were more frequent and more severe in the Black African ancestry group. Also, the factor structure and presentation of NSS in the two ancestry groups were significantly different. Neurological soft signs, especially motor sequencing and cognitive-perceptual abnormalities, were independently associated with disorganization psychopathologies in all the participant groups. Differences in the profile of NSS in Black compared with non-Black African ancestry patients with first episode schizophrenia may suggest differing patterns of expression of NSS in schizophrenia according to genetic ancestry.