[Quality of life of patient with schizophrenia treated by conventional and atypical neuroleptics]

BACKGROUND

the quality of life of patients suffering from schizophrenia was extensively studied but it seems that impact on quality of life of neuroleptics, particularly atypical antipsychotic treatment was not clearly elucidated.

AIMS

In this study we have compared the impact on quality of life of atypical antipsychotic versus classic neuroleptics.

METHODS

We have enrolled, prospectively, all patients with schizophrenia as confirmed by DSM-IV TR. These patients intakes antipsychotics for unless 6 months. We excluded patients with acute schizophrenia, mental deficiency and severe organic disease. Evaluation of clinical features is based on the PANSS scale (Positive And Negative Syndrome Scale). The quality of life is evaluated using the MOS-SF36 scale (Medical Outcomes Study 36-item Short Form). Extra pyramidal symptoms were evaluated by the Chouinard scale.

RESULTS

We have enrolled 65 patients; 35 under classic neuroleptics and 30 under atypical antipsychotics. Clinical features were similar in the two groups. Patients with atypical antipsychotics were less hospitalized (2.4 +/- 3.2 vs. 4.5 +/- 4.2; p = 0.02) and needing less anti cholinergic treatment (26.6% vs. 88.6%; p < 0.0001). Adverse effects were more common with classic neuroleptics (Pakinsonism score: 6.1 +/- 7 vs. 10.8 +/- 8.6; P = 0.01); global clinical dyskinesia 1.22 +/- 0.8 vs. 1.90 +/- 1.7; p = 0.04; global clinical judgement of parkinsonism (2.41 +/- 2.1 vs. 3.72 +/- 2.4; p = 0.02). Quality of life was better in patients with atypical antipsychotics on the basis of vitality (76.7 +/- 27.8 vs. 62 +/- 29.6; p = 0.04) and social function (53.3 +/- 33 vs. 36.9 +/- 27.5; p = 0.03) we found a negative correlation between adverse effects and quality of life in patients with classic neuroleptics.

CONCLUSION

Quality of life of patients suffering from schizophrenia with atypical antipsychotics is better than in those with classic neuroleptics and this may be due to the frequency of adverse effects particularly extra pyramidal symptoms.

[Ménétrier disease associated with a gastric adenocarcinoma. Apropos of 2 cases]

Two new cases of Menetrier's disease with gastric adenocarcinoma in two men aged 62 and 81 years, respectively, are reported. In both cases, the diagnosis was established by histologic examination of the operative specimen. Emphasis is placed on diagnostic difficulties and on the risk of malignant transformation of Menetrier's disease, which should be viewed as a precancerous gastric lesion.

[Rupture of a hydatid cyst of the liver into the peritoneal cavity. Value of computed tomography]

The authors report one case of a intraperitoneal rupture of an hydatic cyst. The diagnosis of rupture was performed pre-operatively by tomodensitometry which has demonstrated the rupture and an intraperitoneal epanchement.

[Cystic lymphangioma of the spleen. An exceptional site]

The authors report a case of cystic lymphangiomatosis of the spleen. Study of this case and a review of the literature confirm the rarity of this site and problems of differential diagnosis with hydatid disease. Treatment remains surgical and the prognosis is good.