| Executive function predicts response to antiaggression treatment in schizophrenia: a randomized controlled trial. | |
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MedLine Citation:
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PMID: 22152404 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: Despite extensive experience with antipsychotic medications, we have limited capacity to predict which patients will benefit from which medications and for what symptoms. Such prediction is of particular importance for the proper treatment of violence. Our goal was to determine whether executive function predicts outcome of treatment for aggressive behavior and whether such prediction varies across medication groups. METHOD: Ninety-nine physically aggressive inpatients (aged 18-60 years) with schizophrenia or schizoaffective disorder (diagnosed according to DSM-IV) who completed tests of executive function were randomly assigned in a double-blind, parallel-group, 12-week trial to clozapine (n = 32), olanzapine (n = 32), or haloperidol (n = 35). The number and severity of aggressive events as measured by the Modified Overt Aggression Scale (MOAS) were the outcome measures. Psychopathology and medication side effects were also assessed. The study was conducted from 1999 to 2004. RESULTS: Poor executive function predicted higher levels of aggression, as measured by MOAS scores over the 12-week period, in all 3 medication groups (F(1,98) = 222.2, P < .0001). There was, however, a significant interaction effect between medication grouping and executive function (F(1,98) = 15.32, P < .001): clozapine exerted an antiaggression effect even in the presence of executive dysfunction. CONCLUSIONS: Executive function was a strong predictor of response to antiaggression treatment in all medication groups, but clozapine still retained clinical efficacy in the presence of poor executive functioning. Olanzapine was particularly efficacious in the absence of executive dysfunction. These findings have important implications for a targeted approach to the treatment of aggression in patients with schizophrenia. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01123408. |
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Authors:
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Menahem I Krakowski; Pal Czobor |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-29 |
Journal Detail:
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Title: The Journal of clinical psychiatry Volume: - ISSN: 1555-2101 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-12-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7801243 Medline TA: J Clin Psychiatry Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© Copyright 2011 Physicians Postgraduate Press, Inc. |
Affiliation:
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The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, USA. krakow@nki.rfmh.org. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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