Long-Term Metabolic Effects in French-Canadian Children and Adolescents Treated with Second-Generation Antipsychotics in Monotherapy or Polytherapy: A 24-Month Descriptive Retrospective Study
Bibliographic record
Abstract
AbstractObjective:To compare weight and glucose changes of long-term second-generation antipsychotic (SGA) monotherapy versus polytherapy (switching or combining SGAs) in children and adolescents.Methods:This is a 24-month retrospective study conducted between November 2005 and June 2013. From 147 antipsychotic-naive patients selected (mean age, 12.8 years; 95% confidence interval [CI], 9.8-15.9), 116 (78.9%) received SGA monotherapy and 31 (21.1%) SGA polytherapy for up to 24 months. Height, weight, and fasting glucose (FG) were measured at baseline and 1, 3, 6, 12, and 24 months. Linear mixed-model analysis was used to compare weight, body mass index z score (BMI z score), and glucose changes between the 2 SGA treatment groups, with the repeated factor being the time relative to baseline at 1, 3, 6, 12, and 24 months.Results:Overall, after 24 months of SGA treatment, mean weight increased significantly by 12.8 kg (95% CI, 10.4-15.0), BMI z score by 0.44 (95% CI, 0.21-0.68), and FG levels by 0.29 mmol/L (95% CI, 0.11-0.47). Incidence of overweight/obesity was 22.6%, BMI z score increase over 0.5 was 9.4%, impaired fasting glucose was 9.4%, and type 2 diabetes mellitus was 3.1%. Regarding metabolic effects, no significant difference was found between the subjects taking a single SGA and those exposed to an SGA polytherapy.Conclusion:Our study confirms the significant increase of metabolic complications during 24 months of SGA treatment without excluding or confirming a difference between the 2 groups of treatment (mono vs. poly). RésuméObjectif:Comparer le poids et les changements de glucose de la monothérapie à long terme par antipsychotique de deuxième génération (ADG) par rapport à la polythérapie (changer ou combiner les ADG) chez des enfants et des adolescents.Méthodes:Il s’agit d’une étude rétrospective de 24 mois menée entre novembre 2005 et juin 2013. Sur les 147 patients choisis n’ayant jamais pris d’antipsychotiques, (moyenne d’âge 12,8; IC à 95% 9,8 à 15,9), 116 (78,9%) ont reçu des ADG en monothérapie et 31 (21,1%) des ADG en polythérapie pour jusqu’à 24 mois. La taille, le poids et le glucose à jeun (GJ) ont été mesurés au départ, puis à 1, 3, 6, 12 et 24 mois. L’analyse de modèle mixte linéaire a servi à comparer le poids, le score z de l’indice de masse corporelle (score z IMC) et les changements de glucose entre les deux groupes de traitement par ADG, le facteur répété étant le temps relativement au départ à 1, 3, 6, 12 et 24 mois.Résultats:Généralement, après 24 mois de traitement par ADG, le poids moyen augmentait significativement de 12,8 kg (IC à 95% 10,4 à 15,0), le score z IMC de 0,44 (IC à 95% 0,21 à 0,68), et les taux de GJ de 0,29 mmol/L (IC à 95% 0,11 à 0,47). L’incidence de surpoids/obésité était de 22,6%, l’augmentation du score z IMC au-dessus de 0,5 était de 9,4%, l’hyperglycémie modérée à jeun était de 9,4% et le diabète de type 2 était de 3,1%. En ce qui concerne les effets métaboliques, aucune différence significative n’a été observée entre les sujets prenant un seul ADG et ceux exposés à une polythérapie d’ADG.Conclusion:Notre étude confirme l’augmentation significative de complications métaboliques durant les 24 mois d’un traitement par ADG sans exclure ou confirmer une différence entre les 2 groupes du traitement (mono c. poly).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".