Gary R. Bond, Ph.D.
Hea-Won Kim, Ph.D. Piper S. Meyer, Ph.D. P. Joseph Gibson, Ph.D., M.P.H.
Sandra Tunis, Ph.D.
Jovier D. Evans, Ph.D.
Paul Lysaker, Ph.D.
Marion L. McCoy, Ph.D.
Jerry Dincin, Ph.D.
Haiyi Xie, Ph.D.
Objective: Second-generation antipsychotics may enhance the rehabilita-
tion of individuals with schizophrenia. The authors hypothesized that
clients receiving second-generation antipsychotics would use vocational
rehabilitation services more effectively and would have better employ-

tutionalization era, many mentalhealth professionals have been ment outcomes than those receiving first-generation antipsychotics.
Methods: Ninety unemployed clients with schizophrenia and related dis-
orders who were beginning a vocational rehabilitation program were fol-
lowed for nine months. Three groups were defined according to the med-
ication in use at study entry: olanzapine (N=39), risperidone (N=27), or
first-generation antipsychotics only (N=24). Participants were inter-
viewed monthly. Results: The olanzapine and risperidone groups did not
differ on any employment outcomes. On most vocational indicators,
clients receiving second-generation agents did not differ from those re-
ceiving first-generation agents. However, at nine months the second-gen-
eration group had a significantly higher rate of participation in vocation-
al training; a trend was found toward a higher rate of paid employment.
All groups showed substantial improvement in employment outcomes af-
ter entering a vocational program. Conclusions: The hypothesis that sec-
ond-generation antipsychotics promote better employment outcomes
than first-generation antipsychotics was not upheld. However, second-
generation agents appear to be associated with increased participation in
vocational rehabilitation. (Psychiatric Services 55:59–66, 2004)
medications in combination with bestpractices in psychiatric rehabilitationlead to greater improvements in reha-bilitation outcomes than does either Dr. Bond and Dr. Evans are affiliated with the department of psychology at Indiana Uni- versity–Purdue University Indianapolis, 402 North Blackford Street, Indianapolis, Indi- ana 46202-3275 (e-mail, Dr. Kim is with Indiana University School of Social Work in Indianapolis. Dr. Meyer is with the University of North Carolina Cecil G. Sheps Center for Health Services Research in Chapel Hill. Dr. Gibson is with the Health and Hospital Corporation of Marion County in Indianapolis. Dr. Tunis is with Eli Lilly and Company in Indianapolis. Dr. Lysaker is with Roudebush Veterans AffairsMedical Center in Indianapolis. Dr. McCoy is with Westat in Rockville, Maryland. Dr. Dincin is with Thresholds in Chicago. Dr. Xie is with the New Hampshire-Dartmouth Psychiatric Research Center in Lebanon. PSYCHIATRIC SERVICES ♦ ♦ January 2004 Vol. 55 No. 1 est in the role of medications in the re- University institutional review board.
PSYCHIATRIC SERVICES ♦ ♦ January 2004 Vol. 55 No. 1 were corroborated by agency records.
ized records and caseworker reports.
total score and five subscales (42).
PSYCHIATRIC SERVICES ♦ ♦ January 2004 Vol. 55 No. 1 Characteristics at baseline interview of 90 unemployed persons with schizophrenia enrolled in a vocational rehabilitation pro-gram, by medication group a The Positive and Negative Syndrome Scale; possible scores range from 30 to 210, with higher scores indicating greater symptom severity. For the five PANSS factors, possible score ranges are as follows: positive, –6 to 42; negative, –8 to 56; emotional, –4 to 28; hostility, –4 to 28; cognitive, –7to 49. b Data were missing for three clients in the olanzapine group, two clients in the risperidone group, and two clients in the first-generation group.
c Data were missing for two clients in the olanzapine group and one client in the risperidone group.
d F=17.328, df= 2, 82, p<.001; data were missing for three clients in the olanzapine group and two clients in the risperidone group. Post-hoc compar- isons using Tukey’s least significant difference test indicated significant differences (p<.001) between both second-generation groups and the first-gen-eration group, but not between the olanzapine and risperidone groups.
e χ2=7.86, df=2, p=.020f χ2=6.10, df=2, p=.047g Data were missing for one client in the risperidone group and one client in the first-generation group.
PSYCHIATRIC SERVICES ♦ ♦ January 2004 Vol. 55 No. 1 Work outcomes at nine-month follow-up for 90 unemployed persons with schizophrenia enrolled in a vocational rehabilita-tion program, by medication group mission to first paid job(mean±SD weeks)b a Data were missing for one client in the risperidone group and three clients in the first-generation antipsychotics group.
b Data were from 29 clients in the olanzapine group, 17 clients in the risperidone group, and 13 clients in the first-generation antipsychotics group who obtained paid employment during the study period.
risperidone groups, the two groupswere aggregated into a single second-generation group and were comparedwith the first-generation group. The Employment status at nine-month follow-up for 90 unemployed persons with schizophrenia enrolled in a vocational rehabilitation program, by medication package employing random effectslogistic regression to model longitudi- the two groups. Time zero in themodels was set as the date a study PSYCHIATRIC SERVICES ♦ ♦ January 2004 Vol. 55 No. 1 were receiving oral medication only.
psychiatric rehabilitation services (8).
ation group (t=3.76, df=718, p=.001).
PSYCHIATRIC SERVICES ♦ ♦ January 2004 Vol. 55 No. 1 flect the “real world” nature of this Conclusions
This study was funded by a grant from Eli McGuire and Marc Lauritano for theirhelp in data analysis. References
prospective analysis of work in schizophre- nia. Schizophrenia Bulletin 27:281–296, support. Psychiatric Rehabilitation Journal 3. Bond GR, Drake RE, Mueser KT, et al: An ple with severe mental illness. PsychiatricServices 48:335–346, 1997 Handbook of Psychiatric Rehabilitation.
5. Bond GR, Drake RE, Becker DR, et al: Ef- PSYCHIATRIC SERVICES ♦ ♦ January 2004 Vol. 55 No. 1 fectiveness of psychiatric rehabilitation ap- 34. Hamilton SH, Edgell ET, Revicki DA, et al: severe mental illness. Journal of Disability fective and schizophreniform disorders: re- sults of an international collaborative trial.
in a European sample. International Clini- American Journal of Psychiatry 154:457– cal Psychopharmacology 15:245–255, 2000 35. Weiden PJ, Aquila R, Kinon BJ, et al: Ef- 21. Franz M, Lis S, Pluddemann K, et al: Con- fectiveness of olanzapine upon psychiatric ventional versus atypical neuroleptics: sub- and vocational rehabilitation outcomes.
7. Lehman AF: Vocational rehabilitation in jective quality of life in schizophrenic pa- Poster presented at the Institute on Psychi- schizophrenia. Schizophrenia Bulletin 21: tients. British Journal of Psychiatry 170: 36. Bond GR, Kim HW, Meyer P, et al: Longi- 8. Bond GR, Meyer PS: The role of medica- 22. Meltzer HY, Burnett S, Bastani B, et al: Ef- fects of six months of clozapine treatment tipsychotics and psychiatric rehabilitation: schizophrenia. Journal of Rehabilitation 65 on the quality of life of chronic schizo- final report submitted to Health Outcomes tories, Eli Lilly and Company. Indianapolis, 9. Corrigan PW, Penn DL: The effects of an- Ind, Indiana University–Purdue University 23. Meltzer HY, Cola P, Way L: Cost effective- tion on psychosocial skill learning. Clinical ness of clozapine in neuroleptic-resistant Psychology: Science and Practice 2:251– schizophrenia. American Journal of Psychi- 37. Koop J, Rollins AL, Bond GR, et al: Devel- opment of the DPA Fidelity Scale: using fi-delity to define an existing vocational mod- 10. Hogarty G, Goldberg S: Drug and socio- 24. Tunis SL, Johnstone BM, Gibson J, et al: el. Psychiatric Rehabilitation Journal, in therapy in the aftercare of schizophrenia Changes in perceived health and function- patients: one-year relapse rates. Archives of ing as a cost-effectiveness measure for olan- 38. Vogler KM: A fidelity study of the Indiana schizophrenia. Journal of Clinical Psychia- uals with severe mental illness in Psycholo- Prescriptive rehabilitation for severely dis- gy. Indianapolis, Ind, Indiana University– abled psychiatric patients. New Directions 25. Rosenheck R, Tekell J, Peters J, et al: Does for Mental Health Services 45:3–7, 1990 39. CIDI-Auto Version 2.1: Administrator’s 12. Schwarzkopf SB, Crilly JF, Silverstein SM: augment the benefit of clozapine? Archives cotherapy and psychiatric rehabilitation to 26. Stroup TS, McEvoy JP, Swartz MS, et al: enhance functional outcome in schizophre- nia. Psychiatric Rehabilitation Skills 3:124– 40. First MB, Spitzer RL, Gibbon M, et al: Clinical Antipsychotic Trials of Interven- tion Effectiveness (CATIE) Project: schizo- 13. Weiden PJ, Aquila R, Standard J: Atypical phrenia trial design and protocol develop- antipsychotic drugs and long-term outcome in schizophrenia. Journal of Clinical Psychi- 27. Lindström LH, Lundberg T: Long-term ef- 14. Casey DE: Side effect profiles of new an- 41. Kay SR, Fiszbein A, Opler LA: The Positive tipsychotic agents. Journal of Clinical Psy- therapy-resistant schizophrenic patients.
15. Geddes J, Freemantle N, Harrison P, et al: Atypical antipsychotics in the treatment of 42. Bell MD, Lysaker PH, Beam-Goulet JL, et 28. Littrell K: Maximizing schizophrenia treat- ment outcomes: a model for integration.
meta-regression analysis. British Medical nia: assessing the factorial invariance of the Psychiatric Rehabilitation Journal 19:75– Positive and Negative Syndrome Scale.
16. Leucht S, Pitschel-Walz G, Abraham D, et 29. Noordsy D, O’Keefe C: Effectiveness of al: Efficacy and extrapyramidal side-effects 43. Cook J, Razzano L: Vocational rehabilita- combining atypical antipsychotics and psy- of the new antipsychotics olanzapine, que- tion for persons with schizophrenia: recent chosocial rehabilitation in a CMHC setting.
tiapine, risperidone, and sertindole com- research and implications for practice.
Journal of Clinical Psychiatry 60(suppl 19): 44. Littell R, Milliken G, Stroup W, et al: SAS controlled trials. Schizophrenia Research 30. Noordsy DL, O’Keefe C, Mueser KT, et al: 17. Moller HJ, Muller H, Borison RL, et al: A path-analytical approach to differentiate chiatric care. Poster presented at the Insti- between direct and indirect drug effects on tute on Psychiatric Services, Philadelphia, tients. A re-evaluation of the North Ameri- 31. Noordsy D, O’Keefe C, Mueser KT, et al: switched to olanzapine treatment. Psychi- search on Services for Severe Mental Ill- 32. McGurk SR, Meltzer HY: The role of cog- 46. Wang PS, West JC, Tanielian T, et al: Re- Short report: comparison of patients satis- nition in vocational functioning in schizo- cent patterns and predictors of antipsychot- faction and burden of adverse effects with phrenia. Schizophrenia Research 45:175– ic medication regimens used to treat schiz- novel and conventional neuroleptics: a nat- ophrenia and other psychotic disorders.
uralistic study. Schizophrenia Bulletin 27: Schizophrenia Bulletin 26:451–457, 2000 33. Meyer PS, Bond GR, Tunis SL, et al: Com- 19. Tamminga CA: The promise of new drugs parison between the effects of atypical and 47. Mellman TA, Miller AL, Weissman EM, et traditional antipsychotics on work status for clients in a psychiatric rehabilitation pro- ment for people with severe mental illness: A focus on guidelines and algorithms. Psy- 20. Tollefson GD, Beasley CM Jr, Tran PV, et PSYCHIATRIC SERVICES ♦ ♦ January 2004 Vol. 55 No. 1



SCHOOL OF GRADUATE STUDIES Health Products Sciences and Technologies PhD Day 2007 Tuesday, December 4 Departments of Chemistry and Pharmaceutical Sciences Oral Communications of PhD Students Nicola Andreoli Tutor: L.F.Agnati Physiological and pathological aspects of the communication in the cellular Cotutor: K.Fuxe, Departm. Neuroscience, Karolinska and molecular n

Microsoft word - gm 05-273

ACTION MEMO AC TRANSIT DISTRICT GM Memo No. 05-273 Board of Directors Committees: Planning Committee Board of Directors Financing Corporation SUBJECT: Execute Amendment #4 to Transit Priority Cooperative Agreement (San Pablo Corridor) between AC Transit and the Alameda County Congestion Management Agency (ACCMA) RECOMMENDED ACTION: Information Only

Copyright ©2018 Drugstore Pdf Search