Schizophrenia Research
Volume 88, Issue 1 , Pages 127-134, December 2006

Long-term outcomes in chronically hospitalized geriatric patients with schizophrenia: Retrospective comparison of first generation and second generation antipsychotics☆☆☆

  • Leonard White

      Affiliations

    • Clinical Neuroscience Center, Pilgrim Psychiatric Center, West Brentwood, NY, USA
    • Department of Psychiatry, Mt Sinai School of Medicine, New York, NY, USA
    • Corresponding Author InformationCorresponding author. Pilgrim Psychiatric Center, 998 Crooked Hill Road, Bldg 47, Brentwood, NY, 11717, USA. Tel.: +1 631 761 2144; fax: +1 631 761 2718.
    • ,
  • Joseph I. Friedman

      Affiliations

    • Clinical Neuroscience Center, Pilgrim Psychiatric Center, West Brentwood, NY, USA
    • Department of Psychiatry, Mt Sinai School of Medicine, New York, NY, USA
    • Joseph I. Friedman, MD has a financial interest/relationship or affiliation in the form of: Grant Research Support from Eli Lilly and Company.
    • ,
  • Christopher R. Bowie

      Affiliations

    • Department of Psychiatry, Mt Sinai School of Medicine, New York, NY, USA
    • ,
  • Martin Evers

      Affiliations

    • Department of Psychiatry, Mt Sinai School of Medicine, New York, NY, USA
    • ,
  • Philip D. Harvey

      Affiliations

    • Department of Psychiatry, Mt Sinai School of Medicine, New York, NY, USA
    • Philip D. Harvey, PhD has a financial interest/relationship or affiliation in the form of: Consultant for AstraZeneca Pharmaceuticals LP; Janssen Pharmaceutica Products LP; Eli Lilly and Company and Novartis Pharmaceuticals.
    • ,
  • Michael Parrella

      Affiliations

    • Clinical Neuroscience Center, Pilgrim Psychiatric Center, West Brentwood, NY, USA
    • Department of Psychiatry, Mt Sinai School of Medicine, New York, NY, USA
    • ,
  • Emilian Mihaila

      Affiliations

    • Department of Psychiatry, Mt Sinai School of Medicine, New York, NY, USA
    • ,
  • Kenneth L. Davis

      Affiliations

    • Department of Psychiatry, Mt Sinai School of Medicine, New York, NY, USA
    • Kenneth L. Davis MD has a financial interest/ relationship or affiliation in the form of: Consultant for Janssen Pharmaceutica Products, L.P.

Received 24 February 2006; received in revised form 23 June 2006; accepted 26 June 2006. published online 22 August 2006.

Abstract 

Introduction

Some groups have reported the longitudinal course of elderly poor outcome schizophrenic patients to be characterized by progressive decline in cognitive functions and functional capacity. Although many of these patients experience minimal reduction of psychotic symptoms, there may be beneficial effects of antipsychotic treatments on cognitive functions and functional capacity.

Methods

This naturalistic study compared the longitudinal course of psychotic symptoms, cognitive functions and functional impairment in geriatric schizophrenic patients treated with first generation (N=97) or second generation (N=78) antipsychotic medications. Mixed effects linear regression analyses were used to examine the effects of treatment (first generation vs. second generation antipsychotic), time and treatment × time.

Results

Cognitive functions (Mini Mental State Examination time effect estimate=−.41, p<.001; ADAS-L Cog time effect estimate=.64, p<.001) and self-care skills (ADAS-L Self-Care time effect estimate=.65, p<.001) declined over time for the subject group as a whole and this decline was not modified by treatment with second generation antipsychotics relative to first generation antipsychotics. Similarly, second generation antipsychotic treatment produced no effect on the progressive worsening of negative symptom over time.

Conclusion

This long-term naturalistic study of poor outcome geriatric patients with schizophrenia did not find atypical antipsychotics to produce any differential protective effect relative to typical antipsychotics on the long-term manifestations of symptoms, cognition and self-care in poor outcome geriatric schizophrenic patients.

Keywords: Schizophrenia, Geriatric, Antipsychotic, Cognition

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☆ Earlier versions of this paper were presented at the Mt. Sinai Cognition Conference, Savannah, Georgia, March 31–April 1, 2005 and XX International Conference on Schizophrenia Research Savannah, Georgia, April 2–April 6, 2005.

☆☆ This work was supported by grant number P50 MH 66392-01 awarded by the NIMH to Kenneth Davis.

PII: S0920-9964(06)00305-7

doi:10.1016/j.schres.2006.06.038

Schizophrenia Research
Volume 88, Issue 1 , Pages 127-134, December 2006

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