Valutazione del funzionamento psicosociale di pazienti in terapia con paliperidone. Confronto con aloperidolo nel "real world".

Aims: endpoints of psychotic patients treatments changed a lot in the last years, just as the way of evaluate their efficacy. This happened especially because of the introduction of new psychotropic drugs, able to improve many aspects concerning with psychotic disease. From the ’90s was clear that an improvement only in symptoms could not be identified with a clinical success; actually, interpersonal abilities, quality of life and psychosocial functioning were indicated as the real endpoints of a psychiatric treatment. Paliperidone is an antipsychotic recently introduced in the market. It is a second generation antipsychotic. Many first generation antipsychotics are still widely used in clinical practice, especially haloperidol. A comparison between these two drugs, in terms of social functioning, has been short investigated. First aim of the study is the comparison between patients treated with paliperidone and patients treated with haloperidol, evaluating their social functioning with PSP (Personal and Social Performace Scale). The second aim concerns with symptomatic improvement, evaluated with PANSS (Positive and Negative Syndrome Scale). Methods: This is a study related to patients from Operative Unity of Psychiatry I and II of Varese. Inclusion methods are a diagnosis of Schizophrenia or other Psychotic Disorders according to DSM IV-TR, and the beginning of a treatment with paliperidone (3-12 mg/day) or haloperidol (2-10 mg/day). Personal data and rating scales scores are marked. Symptomatic recrudescence leading to a new psychiatric hospital admission must not be present in the last three months. Patients are followed up for 6 months. Risults: 34 patients have been investigated for 6 months (17 treated with paliperidone, 17 treated with haloperidol). The general trend is concerning with a psychosocial and a clinical improvement, both with paliperidone and haloperidol, but no statistically significant difference was found. Conclusions: Treatment with paliperidone didn’t show a better outcome than haloperidol about psychosocial functioning and symptomatic improvement in psychotic patients.