Browsing by Author "Fountoulakis, K.N."

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Bipolar I disorder in remission vs. schizophrenia in remission: Is there a difference in burden?
(Elsevier, 2017) Esan, O.B.; Osunbote, C.; Oladele, O.; Fakunle, S.; Ehindero, C.; Fountoulakis, K.N.
Introduction: Bipolar disorder (BD) is considered to have a better outcome in comparison to schizophrenia. However, recent data dispute this notion. The current study aimed to compare the burden of patients with BD type I (BD-I) in remission with similar patients with schizophrenia (SZ) in remission. Material and Methods: Patients with schizophrenia (n=75) and BD-I (n=54) aged 18-64 years were included in the study. The diagnosis was made with the SCID-I/P. Patients were assessed for sociodemographic variables, stigma, quality of life, disability, suicidality and current symptomatology. The statistical analysis included Analysis of Covariance (ANCOVA) and chi-square test. Results: ANCOVA with age at onset as a covariate and marital status and diagnosis as grouping variables returned no significant difference. Discussion: The results of the current study suggest that when in remission, BD-I patients do not differ from patients with schizophrenia with regards to stigma, quality of life, disability level and suicidality. Also, when in remission, they do not differ regarding the severity of their psychopathology.
Gender, age at onset, and duration of being ill as predictors for the long-term course and outcome of schizophrenia: an international multicenter study
(Cambridge University Press, 2021) Fountoulakis, K.N.; Dragioti, E.; Theofilidis, A. T.; Wiklund, T.; Atmatzidis, X.; Nimatoudis, I.; Thys, E.; Wampers, M.; Hranov, L.; Hristova, T.; Aptalidis, D.; Milev, R.; Iftene, F.; Spaniel, F.; Knytl, P.; Furstova, P.; From, T.; Karlsson, H.; Walta, M.; Salokangas, R. K. R.; Azorin, J. M.; Bouniard, J.; Montant, J.; Juckel, G.; Esan, B. O.
Background: The aim of the current study was to explore the effect of gender, age at onset, and duration on the long-term course of schizophrenia. Methods: Twenty-nine centers from 25 countries representing all continents participated in the study that included 2358 patients aged 37.21 11.87 years with a DSM-IV or DSM-5 diagnosis of schizophrenia; the Positive and Negative Syndrome Scale as well as relevant clinicodemographic data were gathered. Analysis of variance and analysis of covariance were used, and the methodology corrected for the presence of potentially confounding effects. Results: There was a 3-year later age at onset for females (P < .001) and lower rates of negative symptoms (P < .01) and higher depression/ anxiety measures (P < .05) at some stages. The age at onset manifested a distribution with a single peak for both genders with a tendency of patients with younger onset having slower advancement through illness stages (P = .001). No significant effects were found concerning duration of illness. Discussion: Our results confirmed a later onset and a possibly more benign course and outcome in females. Age at onset manifested a single peak in both genders, and surprisingly, earlier onset was related to a slower progression of the illness. No effect of duration has been detected. These results are partially in accord with the literature, but they also differ as a consequence of the different starting point of our methodology (a novel staging model), which in our opinion precluded the impact of confounding effects. Future research should focus on the therapeutic policy and implications of these results in more representative samples.
Staging of schizophrenia with the use of PANSS: an international multi-center study
(Oxford University Press, 2021) Fountoulakis, K.N.; Dragioti, E.; Theofilidis, A.T.; Wikilund, T.; Atmatzidis, X.; Nimatudis, I; Thys, E.; Wampers, M.; Hranov, L.; Hristova, T.; Aptalidis, D.; Milev, R.; Iftene, F.; Esan, O.B.; Oladele, O.B.; Osunbote, C.
Introduction: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method. Methods: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed. Results: Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients. Discussion: This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.