T196. THERAPEUTIC MANAGEMENT IN MULTIPLE SCLEROSIS AND SCHIZOPHRENIA SPECTRUM DISORDERS DUAL DIAGNOSIS
Notice bibliographique
Résumé
Abstract Background Multiple sclerosis has been suggested as a potential vulnerability factor for schizophrenia and other psychotic disorders, and there is a hypothesis about a common etiology in a subgroup of schizophrenia and multiple sclerosis [1]. Immune-related single-nucleotide polymorphisms have been associated with schizophrenia and genetic pleiotropy between schizophrenia and multiple sclerosis has been reported, but not between bipolar disorder and multiple sclerosis (at the level of major histocompatibility complex) [2]. As new data about the involvement of genetically-determined immune factors in the susceptibility to schizophrenia appear (e.g., variants of complement factor 4 possibly linked to synaptic pruning during brain development) [3] the interest for finding therapeutic targets within the immune system for psychotic disorders is also increasing. Methods Three patients diagnosed with both schizophrenia spectrum disorders (schizophrenia n=2, or schizoaffective disorder, depressive type n=1), female, mean age 43.7, with a history of psychotic disorder for at least one year, were monitored during 6 months using Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF), Clinical Global Impressions – Severity (CGI-S), Columbia-Suicide Scale for Schizophrenia (CSSRS), Calgary Depression Scale (CDS), Multiple Sclerosis Severity Scale (MSSS), and the Extrapyramidal Symptom Rating Scale (ESRS). None of these patients presented other organic or psychiatric co-morbidity, and they were on active treatment for their multiple sclerosis throughout the 6-month duration of psychiatric evaluation. All patients were initiated on a new antipsychotic, because of the lack of efficacy of the previous agents, or due to their lack of therapeutic adherence. A patient was initiated on olanzapine 15 mg/day, while the other two received risperidone 4 mg/day. The antipsychotic doses were flexible during the 6 months of the treatment, with olanzapine between 10 and 20 mg daily, and risperidone between 3–6 mg daily. The initial PANSS mean score was 92.2, with a GAF of 35.3 and a CGI-S of 5.1. Results All patients reached the week 24 visit of their evaluation, and the overall tolerablity of the antipsychotic treatment was good. All patients had lower PANSS scores at week 24 (the mean decrease was -25.6 points compared to baseline), higher GAF scores (+27.7 points), and lower CGI-S (-2.5 points). CSSRS did not change significantly during the 6 months, the score remained at minimum value, and the CDS scores also remained constantly under 3. ESRS recorded transient increments, but at week 12 they were not significantly increased reported at the baseline values, and no corrective medication was recommended throughout the 6 months for extrapyramidal symptoms. MSSS mean score did not change significantly at week 12 compared to its baseline values. Discussion Atypical antipsychotics are efficient and well tolerated in patients with schizophrenia and multiple sclerosis dual diagnosis. The positive effects of atypical antipsychotics maintained during the 6 months of monitoring and they had no significant impact over the multiple sclerosis symptoms. References
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».