title: QTc prolongation in schizophrenia patients in Asia: clinical correlates and trends between 2004 and 2008/2009.
abstract: OBJECTIVE
  Little is known about the pattern of QT interval (QTc) prolongation in Asian patients with schizophrenia. This study examined trends of QTc prolongation in schizophrenia inpatients in six Asian countries and territories between 2004 and 2008/2009 and its independent demographic and clinical correlates.
  
  
  METHODS
  Data on 3482 hospitalized schizophrenia patients (2004 = 1826 and 2008/2009 = 1656) in six Asian countries and territories were collected by either chart review or interviews during a 1-month period. Patients' sociodemographic and clinical characteristics, prescriptions of psychotropic drugs, and QTc interval were recorded using a standardized protocol and data collection procedure.
  
  
  RESULTS
  The frequency of QTc prolongation (>456 ms) was 2.4% in the whole sample, decreasing from 3.1% in 2004 to 1.6% in 2008/2009 (p = 0.004) with wide intercountry variations. However, this decreased trend was driven by decreased QTc prolongation detected in China and Hong Kong (both p-values < 0.05). Multiple logistic regression analysis of the whole sample revealed that patients having more likely to have an illness lasting longer than 5 years and received antipsychotics classified as list-1 drugs according to the Arizona Centre for Education and Research on Therapeutics. Compared with 2004, patients in 2008/2009 were less likely to have QTc prolongation. Thioridazine caused QTc prolongation most frequently (odds ratio (OR) 4.4; 95% confidence interval (CI) 1.2-15.2), followed by sulpiride (OR 2.4; 95% CI 1.3-4.5), clozapine (OR 2.4; 95% CI 1.4-4.2), and chlorpromazine (OR 1.9; 95% CI 1.07-3.5).
  
  
  CONCLUSIONS
  Frequency of QTc prolongation was low in Asian patients with schizophrenia. QTc prolongation in schizophrenia decreased in China and Hong Kong between 2004 and 2008/2009 but increased in Taiwan over the same period, remaining low in the other countries.
authors.affiliation: Faculty of Health Sciences, University of Macau, Macao, Special Administrative Region, China; Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China.
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Xiang
authors.forename: Helen F K
authors.initials: HF
authors.lastname: Chiu
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.forename: Kelly Y C
authors.initials: KY
authors.lastname: Lai
authors.forename: Chuan-Yue
authors.initials: CY
authors.lastname: Wang
authors.forename: Tian-Mei
authors.initials: TM
authors.lastname: Si
authors.forename: Edwin H M
authors.initials: EH
authors.lastname: Lee
authors.forename: Yan-Ling
authors.initials: YL
authors.lastname: He
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Yang
authors.forename: Mian-Yoon
authors.initials: MY
authors.lastname: Chong
authors.forename: Ee-Heok
authors.initials: EH
authors.lastname: Kua
authors.forename: Senta
authors.initials: S
authors.lastname: Fujii
authors.forename: Kang
authors.initials: K
authors.lastname: Sim
authors.forename: Michael K H
authors.initials: MK
authors.lastname: Yong
authors.forename: Jitendra K
authors.initials: JK
authors.lastname: Trivedi
authors.forename: Eun-Kee
authors.initials: EK
authors.lastname: Chung
authors.forename: Pichet
authors.initials: P
authors.lastname: Udomratn
authors.forename: Kok-Yoon
authors.initials: KY
authors.lastname: Chee
authors.forename: Norman
authors.initials: N
authors.lastname: Sartorius
authors.forename: Chay-Hoon
authors.initials: CH
authors.lastname: Tan
authors.forename: Naotaka
authors.initials: N
authors.lastname: Shinfuku
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects; D001208:Asia / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D007391:International Cooperation; D016015:Logistic Models; D008133:Long QT Syndrome / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D014150:Antipsychotic Agents
keywords: Asia; QTc prolongation; Schizophrenia; inpatients