Impact of Antipsychotic Therapy on Length of Stay and Excitement Symptoms in Patients with Schizophrenia
DOI:
10.29303/jppipa.v11i9.12125Published:
2025-09-25Downloads
Abstract
Schizophrenia is a complex psychiatric disorder treated primarily with antipsychotics, yet their impact on clinical outcomes such as hospital stay and excitement symptoms, measured by the Positive and Negative Syndrome Scale–Excitement Component (PANSS-EC), remains uncertain. This study examined the association between antipsychotic therapy, hospital stay duration, and PANSS-EC scores in patients with schizophrenia. A retrospective, cross-sectional analysis was conducted on 271 patients. Sociodemographic data were analyzed descriptively, and the Kruskal–Wallis test was applied for bivariate analysis across treatment groups. The results showed that patients were predominantly male (72.7%), most frequently diagnosed with paranoid-type schizophrenia (42.8%), and commonly aged 26–35 years (33.9%). No significant differences were found in hospital stay or PANSS-EC scores among the antipsychotic treatment groups. However, gender was significantly associated with PANSS-EC score changes, and schizophrenia subtype correlated with hospital stay duration. Antipsychotic therapy demonstrated no direct association with hospital stay or PANSS-EC outcomes. Instead, demographic and clinical factors, particularly gender and schizophrenia subtype, influenced treatment outcomes. These findings underscore the need for further investigation into patient-specific variables to optimize therapeutic strategies in schizophrenia care.
Keywords:
Antipsychotic agents Length of stay PANSS-EC Psychiatric SchizophreniaReferences
Ahmed, S., Khan, A. M., Mekala, H. M., Venigalla, H., Ahmed, R., Etman, A., Esang, M., & Qureshi, M. (2017). Combined use of electroconvulsive therapy and antipsychotics (both clozapine and non-clozapine) in treatment resistant schizophrenia: A comparative meta-analysis. Heliyon, 3(11). https://doi.org/10.1016/j.heliyon.2017.e00429
Aleman, A., Kahn, R. S., & Selten, J.-P. (2003). Sex Differences in the Risk of Schizophrenia. Archives of General Psychiatry, 60(6), 565. https://doi.org/10.1001/archpsyc.60.6.565
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596
Buchy, L., Makowski, C., Malla, A., Joober, R., & Lepage, M. (2017). Longitudinal trajectory of clinical insight and covariation with cortical thickness in first-episode psychosis. Journal of Psychiatric Research, 86, 46–54. https://doi.org/10.1016/j.jpsychires.2016.11.008
Campos, R. N., Angst, J., Cordas, T. A., & Moreno, R. A. (2011). ESPECTRA: Searching the Bipolar Spectrum in Eating Disorder patients. BMC Psychiatry, 11(1), 59. https://doi.org/10.1186/1471-244X-11-59
Cañas, F., Alberich, S., & Díaz-Marsá, M. (2013). Length of hospital stay in schizophrenia and related disorders: A critical review. Actas Españolas de Psiquiatría, 41(5), 269–278.
Hariyanto, Putri, R. A., & Untari, E. K. (2016). Different Type of Antipsychotic Therapies on Length of Stay of Acute Schizophrenia Patients in Sungai Bangkong Regional Mental Hospital Pontianak. Indonesian Journal of Clinical Pharmacy, 5(2), 115–122. https://doi.org/10.15416/ijcp.2016.5.2.115
Howes, O. D., Kapur, S., & A. (2009). The dopamine hypothesis of schizophrenia: Version III—the final common pathway. Schizophrenia Bulletin, 35(3), 549–562. https://doi.org/10.1093/schbul/sbp006Jablensky
Julaeha, Ananda, V. D., & Pradana, Di. A. (2016). Gambaran Efek Samping Antipsikotik Pada Pasien Skizofrenia Pada Bangsal Rawat Inap Di Rs. Grhasia Yogyakarta. Farmasains, 3(1), 35–41. Retrieved from https://journal.uhamka.ac.id/index.php/farmasains/article/view/122/103
Kapur, S., & Mamo, D. (2003). Half a century of antipsychotics and still a central role for dopamine D2 receptors. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 27(7), 1081–1090. https://doi.org/10.1016/j.pnpbp.2003.09.004
Kementerian Kesehatan Republik Indonesia. (2023). Survei Kesehatan Indonesia (SKI) 2023: Laporan utama Badan Kebijakan Pembangunan Kesehatan. Retrieved from https://kemkes.go.id
Lachenbruch, P. A., Lwanga, S. K., & Lemeshow, S. (1991). Sample Size Determination in Health Studies: A Practical Manual. Journal of the American Statistical Association, 86(416), 1149. https://doi.org/10.2307/2290547
Lanfumey, L., Mongeau, R., & Hamon, M. (2013). Biological rhythms and melatonin in mood disorders and their treatments. Pharmacology & Therapeutics, 138(2), 176–184. https://doi.org/10.1016/j.pharmthera.2013.01.005
Lanzi, R., Menculini, G., Bachetti, M. C., Moretti, P., & Tortorella, A. (2020). Differential gender severity expression of symptoms in patients with dual diagnosis: An in-patient observational study. Psychiatria Danubina, 32, S70–S74. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32890366/
Lee, S.-Y., Lee, S.-J., Han, C., Patkar, A. A., Masand, P. S., & Pae, C.-U. (2013). Oxidative/nitrosative stress and antidepressants: Targets for novel antidepressants. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 46(2), 224–235. https://doi.org/10.1016/j.pnpbp.2012.09.008
Leucht, S., Cipriani, A., Spineli, L., Mavridis, D., Örey, D., Richter, F., Samara, M., Barbui, C., Engel, R. R., Geddes, J. R., Kissling, W., Stapf, M. P., Lässig, B., Salanti, G., & Davis, J. M. (2013). Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. The Lancet, 382(9896), 951–962. https://doi.org/10.1016/S0140-6736(13)60733-3
Leucht, S., Tardy, M., Komossa, K., Heres, S., Kissling, W., Salanti, G., & Davis, J. M. (2013). Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: A systematic review and meta-analysis. The Lancet, 382(9893), 2203–2211. https://doi.org/10.1016/S0140-6736(13)62670-7
Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., Keefe, R. S. E., Davis, S. M., Davis, C. E., Lebowitz, B. D., Severe, J., & Hsiao, J. K. (2005). Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia. New England Journal of Medicine, 353(12), 1209–1223. https://doi.org/10.1056/NEJMoa051688
Masturoh, I., & Nauri, T. A. (2018). Health Research Methodology. Jakarta: Ministry of Health of the Republic of Indonesia.
Meena, S. Z., Rahman, M. A., Bagga, P., & Mujahid, M. (2018). Hepatoprotective activity of Tamarindus indica Linn stem bark ethanolic extract against hepatic damage induced by co-administration of antitubercular drugs isoniazid and rifampicin in Sprague Dawley rats. Journal of Basic and Clinical Physiology and Pharmacology, 30(1), 131–137. https://doi.org/10.1515/jbcpp-2017-0173
Miyamoto, S., Miyake, N., Jarskog, L. F., Fleischhacker, W. W., & Lieberman, J. A. (2012). Pharmacological treatment of schizophrenia: a critical review of the pharmacology and clinical effects of current and future therapeutic agents. Molecular Psychiatry, 17(12), 1206–1227. https://doi.org/10.1038/mp.2012.47
Purwandityo, A. G., Febrianti, Y., Sari, C. P., Ningrum, V. D. A., & Sugiyarto, O. P. (2018). The Influence of Antipsychotic to Decrease the Score of The Positive and Negative Syndrome Scale-Excited Component. Indonesian Journal of Clinical Pharmacy, 7(1), 19–29. https://doi.org/10.15416/ijcp.2018.7.1.19
Rabinowitz, J., Levine, S., & Garmezy, N. (2011). Subscription. Schizophrenia Bulletin, 37(6). https://doi.org/10.1093/schbul/sbr159
Saucedo Uribe, E., Carranza Navarro, F., Guerrero Medrano, A. F., García Cervantes, K. I., Álvarez Villalobos, N. A., Acuña Rocha, V. D., Méndez Hernández, M., Millán Alanís, J. M., Hinojosa Cavada, C. M., Zúñiga Hernández, J. A., & Fernández Zambrano, S. M. (2020). Preliminary efficacy and tolerability profiles of first versus second-generation Long-Acting Injectable Antipsychotics in schizophrenia: A systematic review and meta-analysis. Journal of Psychiatric Research, 129, 222–233. https://doi.org/10.1016/j.jpsychires.2020.06.013
Tiihonen, J., Mittendorfer-Rutz, E., Majak, M., Mehtälä, J., Hoti, F., Jedenius, E., Enkusson, D., Leval, A., Sermon, J., Tanskanen, A., & Taipale, H. (2017). Real-World Effectiveness of Antipsychotic Treatments in a Nationwide Cohort of 29 823 Patients With Schizophrenia. JAMA Psychiatry, 74(7), 686. https://doi.org/10.1001/jamapsychiatry.2017.1322
Wollina, U., Schmidt, N., Schönlebe, J., Vojvodic, A., Hansel, G., Koch, A., & Lotti, T. (2019). Large B - Cell Lymphoma of the Leg – Unfavourable Course with Rituximab/Bendamustin. Open Access Macedonian Journal of Medical Sciences, 7(18), 3006–3008. https://doi.org/10.3889/oamjms.2019.565
Wright, K. M. (2015). Maternalism: a healthy alliance for recovery and transition in eating disorder services. Journal of Psychiatric and Mental Health Nursing, 22(6), 431–439. https://doi.org/10.1111/jpm.12198
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