INTRODUCTION:

Psychiatric illnesses are fundamentally no different from mental illness. Historically illness in which there was a prominent disturbance of psychological function or behaviors and no obvious pathology came to be regarded as psychiatric. We know that there is demonstratably altered brain function in many psychiatric disorders and the psychological disturbances are common in medical illness. Hence regarding psychiatric illness as mental as opposed to physical is incorrect. Psychiatric illness is no less real or less deserving of care than medical conditions.

Diagnosis in psychiatry, as much of medicine is based mainly on identifying recognized patterns of subjective symptoms. These symptoms involve abnormalities of behavior, mood, perceptions, thinking and intellectual functions. Many psychiatric ill patients are socially isolated and this often appears to be Contributory factor in their illness.¹

Recent epidemiological studies have provided data on the number of people with mental and addictive disorders. Many of these people receive their care in the general medical care sector. This has important implications for diagnosis and treatment of mental and addictive disorders².

Nearly 14% of the consultations in general practice are wholly or largely for psychological reasons. schizophrenias are prevalent psychiatric illness present in 15 to 20% of the medical clinic patients. 20% of the patients present with mood, anxiety or substance abuse disorders, the most common being panic disorders.75% of the patients with panic disorders are prone to major depression. Panic disorder is most prevalent in 43% of the patients with chest pain.³

A common and serious mental disorder characterized by loss of contact with reality (psychosis), delusion (false beliefs), abnormal thinking, flattened affect (restricted range of emotion), and diminished motivation and disturbed work and social functioning⁴. The purpose of this study is to assess the efficacy of olanzapine and risperidone prescribed (to newly diagnosed patients), and their personality changes in a Multi Specialty Hospital.

METHOD

The study was carried out at Sree Siddartha Medical college Hospital; Tumkur. This is a 500-bedded modernized, multi specialty Hospital. It excels in various fields of medicine and surgery. It has a full-fledged Psychiatry Department. It involves a psychiatrist, followed by two clinical psychologists. It caters to the needs of both out patients and in patients.

Table: 1 AGE DISTRIBUTION AMONG THE STUDY GROUP

Age in years	Number of patients	Percentage
<20	2	2
21-30	12	12
31-40	58	58
41-50	24	24

Table: 2 Gender Distributions Among The Study Group

Gender	Number of patients	Percentage
MALE	62	62
FEMALE	38	38

An assessment was made in newly diagnosed patients with schizophrenia to study the efficacy of olanzapine and respiridone prescribed to them, and personality changes. 100 patients were included in this study, conducted over a period of 6 months between June to November in the academic year 2008.

Psychiatric rating scales were used to assess the efficacy and personality changes of the patients. A standard Schizotypal Personality Questionnaire (SPQ) Scale and was used to evolve the efficacy and personality changes. The scores for the same were taken initially and at 1-month, 3 months, 6 months intervals. From the mean values of these scorings, the efficacy of the drugs was assessed.

RESULTS:

The age range of our patients varies from 18 to 50 years. 2% were in the age group < 20, 12% were in the age range of 21-30, 58% were in the age range of 31-40, 24% were in the age range of 41-50 years. Most of the patients’ falls between 31 to 40 years of age (see Tab: 1). this result has controversy from the study conducted in University of Nebraska in the year 1999 which says that youth in the age range of 18-25 were more affected compared to adult¹¹.

Data were collected for 100 patients, in which 62% were female and 38% were male (See Tab: 2). It was noted that men received more drugs than women. This can be compared with the results of other study^6,7.

According to the marital status, only 1 patient is single and the others are married. Regarding the social habits, 8% were smokers, 4% were alcoholics, 2% were using tobacco, 84% were not having any habits (See Tab: 3). However no literature was available for this study, which correlates with the social habits.When the occupation was recorded, 58% were jobless, 34% were in business, 4% were office workers, 2% were student and 2% had no occupation. (See Tab: 4). However no literature was available for this study, which correlates with the occupation.Regarding the drug regimens among the study group, 50% were under olanzapine therapy and 50% were under respiridone therapy (See Tab: 5).

Table: 3 SOCIAL HABITS AMONG THE STUDY GROUP

Social habit	Number of patients	Percentage
SMOKERS	8	8
ALCOHOLICS	4	4
TOBACCO CHEWERS	2	2
NIL	84	84

Occupation	Number of patients	Percentage
BUSINESS	34	34
JOBLESS	58	58
OFFICE WORKERS	4	4
STUDENT	2	2
NIL	2	2

Table: 4 Occupational Distributions Among The Study Group

Table: 5 DRUG REGIMENS AMONG THE STUDY GROUP

Drugs	Mean difference
OLANZAPINE	9.33
RESPIRIDONE	7.08

TABLE: 6. MEAN DIFFERENCES OF DRUGS EFFICACY AMONG THE STUDY GROUP

Drugs	Mean difference
OLANZAPINE	10.06
RESPIRIDONE	8.5

Drugs	Number of patients	Percentage
OLANZAPINE	50	50
RESPIRIDONE	50	50

Table: 7. Mean differences for personality changes among the study group

Paired t test analysis of Schizotypal Personality Questionnaire (SPQ) Scale showed a significant improvement (P=0.001) for both the drugs. Further it is confirmed that the treatments were effective with both the drugs therapy. The scorings for Schizotypal Personality Questionnaire (SPQ) shows significant positive difference from initial to review values.

The pre and post treatment mean value of olanzapine group is 11.9 (±2.37SD) and 2.57 (±1.02SD) respectively, hence Mean Difference is 9.33 and in respiridone group for is 10.0 (±3.02SD) and 2.92 (±1.16SD) respectively, hence Mean Difference is 7.08 (See Tab: 6).

The pre and post mean value of olanzapine group for personality changes is 12.2 (±2.67SD) and 2.14 (±1.30SD) respectively, hence Mean Difference is 10.06 and in respiridone group for Depression is 11.0 (±1.21SD) and 2.50 (±1.09SD) respectively, hence Mean Difference is 8.5 (See Tab: 7).

DISCUSSION:

Olanzapine and risperidone, both second-generation antipsychotic agents, represent two different pharmacologic strategies. Although they share some in vitro properties, they differ by virtue of their chemical structure, spectrum of receptor binding affinities, animal neuropharmacology, pharmacokinetics, and in vivo neuroimaging profile. Based on such differences, it was hypothesized that the two compounds would show distinct safety and/or efficacy characteristics. Above mean values confirm that, in individual drug therapy we can find that patients of olanzapine group have more efficacies and better personality changes than risperidone group.

CONCLUSION:

Schizophrenia is a huge threat for the public. If left untreated, the majority of patients with anxiety develop depression where as large numbers of depressed patients suffer from anxiety, if not an overt anxiety. As a conclusion, the results of the study indicated that both olanzapine and risperidone were safe and effective in the management of psychotic symptoms. However, olanzapine demonstrated significantly greater efficacy (Schizotypal Personality Questionnaire (SPQ) Scale summary score), as well as overall personality changes. Furthermore, a statistically significantly greater proportion of the olanzapine-treated than risperidone-treated patients maintained their response at 6 months.

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Received on 14.09.2009 Modified on 16.10.2009

Research J. Pharm. and Tech. 3(1): Jan.-Mar. 2010; Page 224-226