Self-reported treatment adherence among psychiatric in- and outpatients.

Background: Poor adherence to psychiatric treatment is a common clinical problem, leading to unfavourable treatment outcome and increased healthcare costs.

Aim: The aim of this study was to investigate the self-reported adherence and attitudes to outpatient visits and pharmacotherapy in specialized care psychiatric patients.

Methods: Within the Helsinki University Psychiatric Consortium (HUPC) pilot study, in- and outpatients with schizophrenia or schizoaffective disorder (SSA, n  =  113), bipolar disorder (BD, n  =  99), or depressive disorder (DD, n  =  188) were surveyed about their adherence and attitudes towards outpatient visits and pharmacotherapy.

Psychoactive substance use in specialized psychiatric care patients.

Objective Life expectancy of psychiatric patients is markedly shorter compared to the general population, likely partly due to smoking or misuse of other substances. We investigated prevalence and correlates of substance use among psychiatric patients. Methods Within the Helsinki University Psychiatric Consortium Study, data were collected on substance use (alcohol, smoking, and illicit drugs) among patients with schizophrenia or schizoaffective disorder (n = 113), bipolar (n = 99), or depressive disorder (n = 188).

Social Cognition and Interaction Training (SCIT) for Adults with Psychotic Disorders: A Feasibility Study in Finland.

Background: Social Cognition and Interaction Training (SCIT) is a psychosocial treatment designed to improve social functioning in schizophrenia by improving social cognition. Positive results have been reported from several studies, mainly from the USA, but more studies are needed to determine the feasibility of SCIT in different cultural contexts.

Aims: The objective of this study was to evaluate the feasibility and acceptability of the Finnish translation of SCIT in Finland.

[Supporting adherence to drug therapy in psychiatry].

Maintenance therapy to reduce the risk of recurrence is an essential part of treatment of schizophrenia, bipolar disorder and major depressive disorder, but poor treatment adherence is common, impairing the treatment outcome. Improvement in the adherence to drug therapy requires a good therapeutic relationship. The patient and her/his family must be provided with information about the illness and its treatment.

[Psychoeducation in the treatment and rehabilitation of psychoses].

Psychoeducation is one of the most effective psychosocial forms of treatment for psychoses. It appears to prevent recurrence of psychosis and hospitalization periods and to increase treatment compliance. Psychoeducation should be included in the treatment and rehabilitation of psychoses as part of the overall rehabilitation, and is particularly important for persons with first-episode psychosis and their family.

[Update on current care guidelines: schizophrenia].

Early recognition and treatment of persons at risk of psychosis is emphasized in the updated Current Care Schizophrenia guideline. Antipsychotic medication is effective in the treatment. To avoid side-effects, the lowest possible effective dosage is recommended.

[Psychosocial treatment of bipolar disorder].

Psychosocial treatment is an essential part of maintenance treatment of bipolar disorder. It aims to improve cooperation in treatment, to provide support to the family and to teach illness self-management skills. Group psychoeducation and cognitive-behavioural treatment have shown the best efficacy in controlled studies of specific treatment programs developed for this disorder.

Topiramate add-on in treatment-resistant schizophrenia: a randomized, double-blind, placebo-controlled, crossover trial.

Objective: We tested the hypothesis that topiramate is more effective than placebo in reducing symptoms in patients with treatment-resistant schizophrenia when combined with ongoing antipsychotic medication.

Method: Twenty-six hospitalized treatment-resistant patients with chronic DSM-IV-diagnosed schizophrenia participated in a randomized, double-blind, placebo-controlled trial in which 300 mg/day of topiramate was gradually added to their ongoing treatment (clozapine, olanzapine, risperidone, or quetiapine) over two 12-week crossover treatment periods. Data were collected from April 2003 to November 2003.