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Cognitive impairment in adults under compulsory psychiatric care: association with psychotic symptoms and high-dose antipsychotics
BACKGROUND: There is limited evidence on the association between cognitive function, psychotic symptoms and doses of antipsychotics in adults under compulsory psychiatric care. AIMS: We assessed (a) the degree of cognitive impairment in adults involuntarily hospitalised for compulsory psychiatric ca...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10305086/ https://www.ncbi.nlm.nih.gov/pubmed/37314021 http://dx.doi.org/10.1192/bjo.2023.83 |
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author | Karanikola, Maria Nystazaki, Maria Kaikoushi, Katerina Middleton, Nicos Chatzittofis, Andreas |
author_facet | Karanikola, Maria Nystazaki, Maria Kaikoushi, Katerina Middleton, Nicos Chatzittofis, Andreas |
author_sort | Karanikola, Maria |
collection | PubMed |
description | BACKGROUND: There is limited evidence on the association between cognitive function, psychotic symptoms and doses of antipsychotics in adults under compulsory psychiatric care. AIMS: We assessed (a) the degree of cognitive impairment in adults involuntarily hospitalised for compulsory psychiatric care and (b) correlation of Montreal Cognitive Assessment (MoCA) score with psychotic symptoms, polypharmacy and prescription of high-dose antipsychotics. METHOD: This was a nationwide, cross-sectional study, conducted at the only referral state hospital for compulsory psychiatric care in Cyprus (December 2016–February 2018). Τhe MoCA was applied for the assessment of cognitive functioning. The Positive and Negative Syndrome Scale (PANSS) was applied for the assessment of psychotic symptoms. RESULTS: The sample comprised 187 men and 116 women. The mean MoCA score was 22.09 (reported scale range (RSR): 3–30); the mean PANSS general symptoms subscale score was 49.60 (RSR = 41–162). The participants who reported positive psychiatric history (mean 21.71, s.d. 5.37), non-adherence to pharmacotherapy (mean 21.32, s.d. 5.56) and prescription of high-dose antipsychotics (with medication prescribed as needed: mean 21.31, s.d. 5.70; without medication prescribed as needed: mean 20.71, s.d. 5.78) had lower mean MoCA scores compared with those who reported negative psychiatric history (mean 23.42, s.d. 4.51; P = 0.017), adherence to pharmacotherapy (mean 23.10, s.d. 6.61; P = 0.003) and no prescription of high-dose antipsychotics (with medication prescribed as needed: mean 22.56, s.d. 4.90; without medication prescribed as needed: mean 22.60 s.d. 4.94; P = 0.045–0.005), respectively. Mean MoCA score was mildly and inversely associated with total PANSS score (r = −0.15, P = 0.03), PANSS general (r = −0.18, P = 0.002) and PANSS negative (r = −0.16, P = 0.005) symptoms subscales, respectively. CONCLUSIONS: Our findings support the evaluation of cognitive functioning in adults under compulsory psychiatric care via the MoCA tool, with focus on those prescribed high-dose antipsychotics, with positive mental health history and non-adherence to pharmacotherapy. |
format | Online Article Text |
id | pubmed-10305086 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-103050862023-06-29 Cognitive impairment in adults under compulsory psychiatric care: association with psychotic symptoms and high-dose antipsychotics Karanikola, Maria Nystazaki, Maria Kaikoushi, Katerina Middleton, Nicos Chatzittofis, Andreas BJPsych Open Paper BACKGROUND: There is limited evidence on the association between cognitive function, psychotic symptoms and doses of antipsychotics in adults under compulsory psychiatric care. AIMS: We assessed (a) the degree of cognitive impairment in adults involuntarily hospitalised for compulsory psychiatric care and (b) correlation of Montreal Cognitive Assessment (MoCA) score with psychotic symptoms, polypharmacy and prescription of high-dose antipsychotics. METHOD: This was a nationwide, cross-sectional study, conducted at the only referral state hospital for compulsory psychiatric care in Cyprus (December 2016–February 2018). Τhe MoCA was applied for the assessment of cognitive functioning. The Positive and Negative Syndrome Scale (PANSS) was applied for the assessment of psychotic symptoms. RESULTS: The sample comprised 187 men and 116 women. The mean MoCA score was 22.09 (reported scale range (RSR): 3–30); the mean PANSS general symptoms subscale score was 49.60 (RSR = 41–162). The participants who reported positive psychiatric history (mean 21.71, s.d. 5.37), non-adherence to pharmacotherapy (mean 21.32, s.d. 5.56) and prescription of high-dose antipsychotics (with medication prescribed as needed: mean 21.31, s.d. 5.70; without medication prescribed as needed: mean 20.71, s.d. 5.78) had lower mean MoCA scores compared with those who reported negative psychiatric history (mean 23.42, s.d. 4.51; P = 0.017), adherence to pharmacotherapy (mean 23.10, s.d. 6.61; P = 0.003) and no prescription of high-dose antipsychotics (with medication prescribed as needed: mean 22.56, s.d. 4.90; without medication prescribed as needed: mean 22.60 s.d. 4.94; P = 0.045–0.005), respectively. Mean MoCA score was mildly and inversely associated with total PANSS score (r = −0.15, P = 0.03), PANSS general (r = −0.18, P = 0.002) and PANSS negative (r = −0.16, P = 0.005) symptoms subscales, respectively. CONCLUSIONS: Our findings support the evaluation of cognitive functioning in adults under compulsory psychiatric care via the MoCA tool, with focus on those prescribed high-dose antipsychotics, with positive mental health history and non-adherence to pharmacotherapy. Cambridge University Press 2023-06-14 /pmc/articles/PMC10305086/ /pubmed/37314021 http://dx.doi.org/10.1192/bjo.2023.83 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial licence (http://creativecommons.org/licenses/by-nc/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use. |
spellingShingle | Paper Karanikola, Maria Nystazaki, Maria Kaikoushi, Katerina Middleton, Nicos Chatzittofis, Andreas Cognitive impairment in adults under compulsory psychiatric care: association with psychotic symptoms and high-dose antipsychotics |
title | Cognitive impairment in adults under compulsory psychiatric care: association with psychotic symptoms and high-dose antipsychotics |
title_full | Cognitive impairment in adults under compulsory psychiatric care: association with psychotic symptoms and high-dose antipsychotics |
title_fullStr | Cognitive impairment in adults under compulsory psychiatric care: association with psychotic symptoms and high-dose antipsychotics |
title_full_unstemmed | Cognitive impairment in adults under compulsory psychiatric care: association with psychotic symptoms and high-dose antipsychotics |
title_short | Cognitive impairment in adults under compulsory psychiatric care: association with psychotic symptoms and high-dose antipsychotics |
title_sort | cognitive impairment in adults under compulsory psychiatric care: association with psychotic symptoms and high-dose antipsychotics |
topic | Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10305086/ https://www.ncbi.nlm.nih.gov/pubmed/37314021 http://dx.doi.org/10.1192/bjo.2023.83 |
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