Riverview Refractory Psychosis Data Presented at International Psychiatry Congress

WIN_20150329_113434

 

View the poster in a PDF file here

Abstract

Treatment-resistant psychosis is a challenge to psychiatry and a substantial burden to health-care systems. The province of British Columbia in Canada has publicly funded, universal health care, and patients with treatment-resistant psychosis may receive care in a specialized residential program. Between 1993 and 2011, 663 patients were admitted to this program; this cohort contains one of the largest known series of patients with treatment-resistant schizoaffective disorder.

All patients were evaluated by a psychiatrist, social worker, pharmacist, nurse, general physician, and neuropsychologist. Records from previous hospital admissions were reviewed and all information was presented at a multidisciplinary conference. This resulted in a consensus DSM-III or -IV multiaxial diagnosis and a detailed treatment plan. Ratings of symptoms and functioning at admission and discharge included the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning Scale, the Social and Occupational Functioning Scale, and the Clinical Global Impression of Severity. A research psychologist compiled all data at the time of each patient’s hospitalization.

Patients who did not complete treatment or had a diagnosis other than schizophrenia (SZ), schizoaffective (SZA) or mood disorder (MD) were excluded; the following describes 551 included patients (SZ = 63%, SZA = 29%, MD = 8%). More than half were male (59%), and the mean duration of hospitalization was 30 weeks. The proportion receiving clozapine increased from 21% at admission to 61% at discharge. Those with a MD were less likely to receive clozapine than either SZ or SZA (SZ = 64%, SZA = 61%, MD = 41%). In each diagnostic group, both antipsychotic polypharmacy and the ratio of prescribed daily dose to defined daily dose (PDD/DDD) of antipsychotic medication decreased during hospital stay (polypharmacy: SZ: 52% to 16%, SZA: 52% to 14%, MD: 43% to 0%; PDD/DDD: SZ: 2.1 to 1.6, SZA: 2.1 to 1.4, MD: 1.6 to 1.1). The use of mood stabilizers declined in all groups, but antidepressant use declined only in SZ and SZA. Mean total PANSS score declined in all diagnostic groups, but most in MD, least in SZ, and intermediate in SZA.

In an intensive inpatient program for treatment-resistant psychosis, aggregate improvement occurred despite global reduction in medications while clozapine use nearly tripled. Lower total antipsychotic dose correlated with greater improvement at discharge.

66th Annual American Psychiatric Association Institute on Psychiatric Services in San Francisco

66th Annual American Psychiatric Association Institute on Psychiatric Services in San Francisco

Randall is pleased to be attending the 66th Annual American Psychiatric Association Institute on Psychiatric Services in San Francisco. He presented findings on 630 patients treated during 1993-2010 on the refractory psychosis ward at Riverview Hospital, British Columbia.

To view his abstract, click here.

Follow the conference on Twitter: #IPS2014

Health Care is a Human Right

On July 19th, 2014, Dr. Randall White was invited to speak at  The Western Washington Chapter of Physicians for a National Health Program’s Ninth Annual Public Meeting. This year’s theme was: “Health Care is a Human Right: Making it Real in Washington State.” As a physician who has practiced both in Canada and the US, Randall brings a unique perspective to the table. Dr. White is a known advocate for health care equality, and stresses that financial access to health care is a major source of inequality. He says “Inequality has greater effects on Health Care than the actions of doctors and caregivers. In Canada, Health Care is a human right.” He goes on to encourage his American colleagues to continue to strive for universal health care.

Health Care is a Human Right: Making it Real in Washington State

We are pleased to announce that Dr. Randall White has been invited to be the third speaker at The Western Washington Chapter of Physicians for a National Health Program’s Ninth Annual Public Meeting. This year’s theme is: “Health Care is a Human Right: Making it Real in Washington State”, and includes a promising keynote to be delivered by Kshama Sawant, PHD, Seattle City Council Member. Sawant champions the rights of the working poor and disenfranchised, and is most recently recognized for her work on the successful $15Now campaign, a grass-roots living wage campaign.

Another highlight will be Philip Caper, MD, who was a staff member on Senator Edward Kennedy’s US Senate Labor and Human Resources Subcommittee on Health, a PNHP national Board Member and active in Maine AllCare.

Randall will be contributing “Remarks from a Canadian / American Perspective.” He will mention how commercialized mental health care compromises quality, provides less service for the severely mentally ill, and has been implicated in known corruption in the U.S.

We hope you will join us!

Attending the event? Or following from home? Use hashtag #HCHR2014 and @BCPsychosis

Saturday, July 19th, at 7PM at
Kane Hall Room 120, on the University of Washington Campus
Admission is free and open to the public.
There is free parking beneath Kane Hall.