title: Hostility in schizophrenia: An integrated analysis of the combined Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) and the European First Episode Schizophrenia Trial (EUFEST) studies.
abstract: Phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study enrolled a sample of 1493 chronic schizophrenia patients. The European First Episode Schizophrenia Trial (EUFEST) enrolled 498 patients. We have combined these two samples to study the effects of hostility on study discontinuation as well as to examine correlates and predictors of hostility. Individual data from 1154 patients with complete data were used for analyses. Survival analysis demonstrated that higher hostility was associated with earlier all-cause treatment discontinuation. Furthermore, regression analysis indicated that increased hostility was associated with more severe positive symptoms, lower adherence to pharmacological treatment, younger age, impaired insight, and more drug or alcohol consumption. The clinical implications of the results point to the importance of establishing therapeutic alliance while managing patient's symptoms of hostility with antipsychotics such as olanzapine combined with psychosocial interventions to improve insight and reduce substance use.
authors.affiliation: Department of Psychiatry, New York University School of Medicine, New York, NY, PO Box 160663, Big Sky, MT 59716, USA. Electronic address: janvolavka@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Volavka
authors.affiliation: Behavioral Health Epidemiology Program, RTI International, 3040 E. Cornwallis Road, PO Box 12194 Research Triangle Park, NC 27709-2194, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Van Dorn
authors.affiliation: Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, 11 Medical Park Drive, Suite 106, Pomona, NY 10970, USA.
authors.forename: L
authors.initials: L
authors.lastname: Citrome
authors.affiliation: Brain Center Rudolf Magnus, University Medical Center Utrecht (UMC), PO box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: R S
authors.initials: RS
authors.lastname: Kahn
authors.affiliation: Biological Psychiatry Division Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: W W
authors.initials: WW
authors.lastname: Fleischhacker
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, 1083 Budapest, Balassa u. 6, Budapest, Hungary.
authors.forename: P
authors.initials: P
authors.lastname: Czobor
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D005060:Europe; D005260:Female; D006791:Hostility; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D000077152:Olanzapine; D011237:Predictive Value of Tests; D012107:Research Design; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine
keywords: Antipsychotics; Hostility; Schizophrenia