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Heres S, Cordes J, Feyerabend S, Schmidt-Kraepelin C, Musil R, Riedel M, Spellmann I, Langguth B, Landgrebe M, Fran E, Petcu C C, Hahn E, Ta TMT, Matei V, Dehelean L, Papava I, Leweke FM, van der List T, Tamasan SC, Lang FU, Naber D, Ruhrmann S, Wolff-Menzler C, Juckel G, Ladea M, Stefanescu C, Lautenschlager M, Bauer M, Zamora D, Horowitz M, Davis JM, Leucht S. Changing the Antipsychotic in Early Nonimprovers to Amisulpride or Olanzapine: Randomized, Double-Blind Trial in Patients With Schizophrenia. Schizophr Bull 2022; 48:1273-1283. [PMID: 35857811 PMCID: PMC9673269 DOI: 10.1093/schbul/sbac068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Meta-analyses have shown that the majority of patients with schizophrenia who have not improved after 2 weeks of treatment with an antipsychotic drug are unlikely to fully respond later. We hypothesized that switching to another antipsychotic with a different receptor binding profile is an effective strategy in such a situation. STUDY DESIGN In total, 327 inpatients with an acute exacerbation of schizophrenia were randomized to double-blind treatment with either olanzapine (5-20 mg/day) or amisulpride (200-800 mg/day). Those patients who had not reached at least 25% Positive-and-Negative-Syndrome-Scale (PANSS) total score reduction from baseline after 2 weeks (the "non-improvers") were rerandomized double-blind to either staying on the same compound ("stayers") or to switching to the other antipsychotic ("switchers") for another 6 weeks. The primary outcome was the difference in the number of patients in symptomatic remission between the combined "switchers" and the "stayers" after 8 weeks of treatment, analyzed by logistic regression. STUDY RESULTS A total of 142 nonimprovers were rerandomized at week two. 25 (45.5 %) of the 'stayers' compared to 41 (68.3 %) of the "switchers" reached remission at endpoint (p = .006). Differences in secondary efficacy outcomes were not significant, except for the PANSS negative subscore and the Clinical-Global-Impression-Scale. "Switchers" and "stayers" did not differ in safety outcomes. CONCLUSIONS Switching "non-improvers" from amisulpride to olanzapine or vice-versa increased remission rates and was safe. The superiority in the primary outcome was, however, not paralleled by significant differences in most secondary efficacy outcomes and the effect was only apparent at the last visit making replications of longer duration necessary.
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Affiliation(s)
- Stephan Heres
- To whom correspondence should be addressed; Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine Kbo-Klinik für Psychiatrie und Psychotherapie Nord, Schwabing, kbo-Tagesklinik und Institutsambulanz Nord des Isar-Amper-Klinikums München Ost Kölner Platz 1, Haus 7 80804 Munich, Germany, tel: 49 (0) 89 412 006 158, fax: 49 (0) 89 412 006 172, e-mail:
| | - Joachim Cordes
- Department of Psychiatry and Psychotherapy, LVR-Clinic Düsseldorf, Medical Faculty, Heinrich-Heine-University, Duesseldorf NW, Germany,Department of Psychiatry and Psychotherapy, Kaiserswerther Diakonie, Florence Nightingale Hospital, Düsseldorf NW, Germany
| | - Sandra Feyerabend
- Department of Psychiatry and Psychotherapy, LVR-Clinic Düsseldorf, Medical Faculty, Heinrich-Heine-University, Duesseldorf NW, Germany,Department of Psychiatry and Psychotherapy, Kaiserswerther Diakonie, Florence Nightingale Hospital, Düsseldorf NW, Germany
| | - Christian Schmidt-Kraepelin
- Department of Psychiatry and Psychotherapy, LVR-Clinic Düsseldorf, Medical Faculty, Heinrich-Heine-University, Duesseldorf NW, Germany,Department of Psychiatry and Psychotherapy, Kaiserswerther Diakonie, Florence Nightingale Hospital, Düsseldorf NW, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University of Munich, Munich, Germany
| | - Michael Riedel
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University of Munich, Munich, Germany,Marion von Tessin Memory-Zentrum GmbH, Munich BY, Germany
| | - Ilja Spellmann
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University of Munich, Munich, Germany,Klinikum Stuttgart, Zentrum für Seelische Gesundheit, Stuttgart BW, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg BY, Germany
| | - Michael Landgrebe
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg BY, Germany,Department of Psychiatry and Psychotherapy, kbo Lech-Mangfall-Hospital Agatharied, St.-Agatha-Str. 1a, 83734 Hausham BY, Germany
| | - Elmar Fran
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg BY, Germany
| | - Camelia Petcu C
- Psychiatry Department, University of Medicine and Pharmacy ”Carol Davila” Bucharest, ”Prof. Dr. Alexandru Obregia” Psychiatric Hospital, Berceni Str 10-12, Bucharest, Romania
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany
| | - Tam M T Ta
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany
| | - Valentin Matei
- Psychiatry Department, University of Medicine and Pharmacy ”Carol Davila” Bucharest, ”Prof. Dr. Alexandru Obregia” Psychiatric Hospital, Berceni Str 10-12, Bucharest, Romania
| | - Liana Dehelean
- Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara TS, Romania,Centre for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara TS, Romania,Center for Translational Research, and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara TS, Romania,Center for Studies in Preventive Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara TS, Romania
| | - Ion Papava
- Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara TS, Romania,Centre for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara TS, Romania
| | - F Markus Leweke
- Brain and Mind Centre, The University of Sydney, 94 Mallet St, Camperdown NSW 2050, Sydney, Australia,Central Institute of Mental Health, Heidelberg University I5, 68159 Mannheim BW, Germany
| | - Till van der List
- Central Institute of Mental Health, Heidelberg University I5, 68159 Mannheim BW, Germany,Practise for Psychiatry and Psychotherapie Nowackanlage 15, 76137 Karlsruhe BW, Germany
| | - Simona C Tamasan
- Liaison Psychiatry, “Pius Branzeu” County Emergency Hospital, Timisoara TS, Romania
| | - Fabian U Lang
- Department of Psychiatry II, Ulm University, Ulm BW, Germany
| | - Dieter Naber
- Department of Psychiatry and Psychotherapy, University of Hamburg, Hamburg, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne NW, Germany
| | - Claus Wolff-Menzler
- Klinik für Psychiatrie und Psychotherapie Universitätsmedizin Göttingen, Göttingen, Germany
| | - Georg Juckel
- Department of Psychiatry, LWL University Hospital, Psychotherapy and Preventive Medicine Ruhr University, Bochum, Germany
| | - Maria Ladea
- DMU IMPACT (Departement Medico-Universitaire de Psychiatrie et d'Addictologie) Groupe Hospitalier Henri MONDOR, Créteil, France
| | | | - Marion Lautenschlager
- ZfP Südwürttemberg, Bad Schussenried, Germany,Charité University Medicine, Campus Mitte, Berlin BE, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Dresden, Germany
| | - Daisy Zamora
- Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich, Germany,Department of Psychiatry, UNC School of Medicine, 321 S Columbia St, Chapel Hill, NC 27599, USA
| | - Mark Horowitz
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | - John M Davis
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich, Germany
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Nguyen VT, Braun A, Kraft J, Ta TMT, Panagiotaropoulou GM, Nguyen VP, Nguyen TH, Trubetskoy V, Le CT, Le TTH, Pham XT, Heuser-Collier I, Lam NH, Böge K, Hahne IM, Bajbouj M, Zierhut MM, Hahn E, Ripke S. Increasing sample diversity in psychiatric genetics - Introducing a new cohort of patients with schizophrenia and controls from Vietnam - Results from a pilot study. World J Biol Psychiatry 2022; 23:219-227. [PMID: 34449294 DOI: 10.1080/15622975.2021.1951474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Genome-Wide Association Studies (GWAS) of Schizophrenia (SCZ) have provided new biological insights; however, most cohorts are of European ancestry. As a result, derived polygenic risk scores (PRS) show decreased predictive power when applied to populations of different ancestries. We aimed to assess the feasibility of a large-scale data collection in Hanoi, Vietnam, contribute to international efforts to diversify ancestry in SCZ genetic research and examine the transferability of SCZ-PRS to individuals of Vietnamese Kinh ancestry. METHODS In a pilot study, 368 individuals (including 190 SCZ cases) were recruited at the Hanoi Medical University's associated psychiatric hospitals and outpatient facilities. Data collection included sociodemographic data, baseline clinical data, clinical interviews assessing symptom severity and genome-wide SNP genotyping. SCZ-PRS were generated using different training data sets: (i) European, (ii) East-Asian and (iii) trans-ancestry GWAS summary statistics from the latest SCZ GWAS meta-analysis. RESULTS SCZ-PRS significantly predicted case status in Vietnamese individuals using mixed-ancestry (R2 liability = 4.9%, p = 6.83 × 10-8), East-Asian (R2 liability = 4.5%, p = 2.73 × 10-7) and European (R2 liability = 3.8%, p = 1.79 × 10-6) discovery samples. DISCUSSION Our results corroborate previous findings of reduced PRS predictive power across populations, highlighting the importance of ancestral diversity in GWA studies.
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Affiliation(s)
- V T Nguyen
- Department of Psychiatry, Hanoi Medical University, Hà Nội, Việt Nam.,National Institute of Mental Health, Bach Mai Hospital, Hà Nội, Việt Nam
| | - A Braun
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany
| | - J Kraft
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany
| | - T M T Ta
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, BIH Academy, Clinician Scientist Program, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - G M Panagiotaropoulou
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany
| | - V P Nguyen
- Department of Psychiatry, Hanoi Medical University, Hà Nội, Việt Nam
| | - T H Nguyen
- Department of Psychiatry, Hanoi Medical University, Hà Nội, Việt Nam.,Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - V Trubetskoy
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany
| | - C T Le
- Department of Psychiatry, Hanoi Medical University, Hà Nội, Việt Nam.,National Institute of Mental Health, Bach Mai Hospital, Hà Nội, Việt Nam
| | - T T H Le
- Department of Psychiatry, Hanoi Medical University, Hà Nội, Việt Nam.,National Institute of Mental Health, Bach Mai Hospital, Hà Nội, Việt Nam
| | - X T Pham
- Department of Psychiatry, Hanoi Medical University, Hà Nội, Việt Nam
| | - I Heuser-Collier
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - N H Lam
- Hanoi Mental Hospital, Hà Nội, Việt Nam
| | - K Böge
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - I M Hahne
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - M Bajbouj
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - M M Zierhut
- Berlin Institute of Health, Charité - Universitätsmedizin Berlin, BIH Academy, Clinician Scientist Program, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - E Hahn
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - S Ripke
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
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Ferrari S, Burian R, Hahn E, Chaudhry N, Chaudhry IB, Husain N, Ta TMT, Diefenbacher A, Qureshi A, Berardi D, Braca M, Tarricone I. Somatization among ethnic minorities and immigrants: Why does it matter to Consultation Liaison Psychiatry? J Psychosom Res 2015; 79:85-6. [PMID: 25840950 DOI: 10.1016/j.jpsychores.2015.02.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 01/29/2015] [Accepted: 02/16/2015] [Indexed: 11/24/2022]
Affiliation(s)
- S Ferrari
- Department of Diagnostic-Clinical Medicine and Public Health, Section of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy.
| | - R Burian
- Department of Psychiatry, Psychotherapy and Psychosomatics, Evangelical Hospital Königin Elisabeth Herzberge, Berlin, Germany.
| | - E Hahn
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Campus Benjamin Franklin, Germany.
| | - N Chaudhry
- University of Manchester, Lancashire Care Early Intervention Service, Manchester, UK.
| | - I B Chaudhry
- University of Manchester, Lancashire Care Early Intervention Service, Manchester, UK.
| | - N Husain
- University of Manchester, Lancashire Care Early Intervention Service, Manchester, UK.
| | - T M T Ta
- Department of Psychiatry, Psychotherapy and Psychosomatics, Evangelical Hospital Königin Elisabeth Herzberge, Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Campus Benjamin Franklin, Germany.
| | - A Diefenbacher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Evangelical Hospital Königin Elisabeth Herzberge, Berlin, Germany
| | - A Qureshi
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - D Berardi
- Bologna Trans-cultural Psychosomatic Team, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy.
| | - M Braca
- Bologna Trans-cultural Psychosomatic Team, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - I Tarricone
- Bologna Trans-cultural Psychosomatic Team, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy.
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