Consortium Psychiatricum
2024. Том 5. № 4. С. 16–38
doi:10.17816/CP15567
ISSN: 2712-7672 / 2713-2919 (online)
Динамика клинико-психопатологических проявлений и качества социального функционирования пациентов с шизофренией, получающих палиперидон пальмитат в разных лекарственных формах: неинтервенционное наблюдательное исследование
Резюме
ВВЕДЕНИЕ: За последние семь лет в России отмечается заметный рост применения пролонгированных форм антипсихотиков. В частности, в Москве с 2016 по 2021 годы доля инъекционных форм пролонгированных антипсихотиков увеличилась более чем в 7 раз (с 3% до 23%). Исследования показали, что правильный выбор целевых групп для такой терапии может уменьшить частоту рецидивов с госпитализацией, снизить затраты на стационарную помощь и сместить акцент терапевтической помощи от многоразового приема препаратов к психосоциальной работе.
ЦЕЛЬ: Изучение динамики психосоциального функционирования и клинико-психопатологических проявлений у пациентов с шизофренией в период становления ремиссии на фоне терапии различными формами палиперидона: пероральной формой палиперидона (ПО), палиперидона пальмитатом для введения один раз в месяц (ПП1М) и палиперидона пальмитатом для введения раз в три месяца (ПП3М).
МЕТОДЫ: В наблюдение были включены 155 пациентов: 54 пациента после лечения другим антипсихотиком второго поколения получали палиперидон для перорального применения (ПО), 50 пациентам после лечения другим антипсихотиком были назначены инъекции ПП1М, 51 пациенту после купирования обострения и 4 месяцев лечения ПП1М назначались инъекции ПП3М. Период наблюдения составил 12 месяцев. Оценка личностного и социального функционирования проводилась пять раз: до начала лечения, спустя 3, 6, 9 и 12 месяцев.
РЕЗУЛЬТАТЫ: Терапия во всех группах привела к статистически значимому снижению выраженности позитивных симптомов (p <0,001). При этом более чувствительными к терапии оказались галлюцинации (p <0,001), тогда как остаточный бред оставался более устойчив к терапии. В группе ПП1М и ПП3М больше пациентов полностью завершили программу исследования (n=24, 48,0% и n=30, 58,8% соответственно) по сравнению с группой ПО (n=11, 20,4%). При этом в группе ПП3М отмечалось наилучшее следование назначенной схеме терапии, максимальное число пациентов, полностью завершивших исследование, равное с другими группами количество случаев обострений или недостаточной эффективности.
ЗАКЛЮЧЕНИЕ: Терапия различными лекарственными формами палиперидона обеспечивает примерно равный темп и интенсивность редукции общей тяжести шизофрении, позитивных и негативных симптомов. В группе ПП3М наблюдалось лучшее соблюдение назначенной схемы терапии и наибольшее количество пациентов, полностью завершивших исследование.
Общая информация
Ключевые слова: палиперидона пальмитат, шизофрения, ремиссия, социальное функционирование, антипсихотик
Рубрика издания: Исследования
Тип материала: научная статья
DOI: https://doi.org/10.17816/CP15567
Финансирование. This article was written with the support of Johnson & Johnson
Поступила в редакцию 26.08.2024
Принята к публикации
Опубликована
Для цитаты: Резник, А.М., Карпенко, О.А., Шумакова, Е.А., Мудрак, А.В., Соколов, А.В., Назимова, С.В., Сайфулина, А.М., Елисеенко, А.М., Матвиевская, Т.К., Ханнанова, А.Н., Ревенко, В.И., Щербаков, Д.В., Мартынюк, Ю.Л., Арбузов, А.Л., Яценко, О.А., Алексеева, П.Н., Бердалин, А.Б., Бурыгина, Л.А. (2024). Динамика клинико-психопатологических проявлений и качества социального функционирования пациентов с шизофренией, получающих палиперидон пальмитат в разных лекарственных формах: неинтервенционное наблюдательное исследование. Consortium Psychiatricum, 5(4), 16–38. https://doi.org/10.17816/CP15567
Лицензия: Creative Commons NonCommercial-NonDerivates 4.0 International (CC BY-NC-ND 4.0)
Литература
- Kurmyshev MV, Zaytseva MS, Kuzmenko AYu, et al. [The use of long acting antipsychotics in outpatient care]. Zhurnal nevrologii I psikhiatrii im. S.S. Korsakova. 2020;120(62):77-81. Russian. doi: 10.17116/jnevro202012006277
- Correll CU, Citrome L, Haddad PM, et al. The Use of Long-Acting Injectable Antipsychotics in Schizophrenia: Evaluating the Evidence. J Clin Psychiatry, 2016;77(suppl 3):1-24. doi: 10.4088/JCP.15032su1
- Fang SC, Liao DL, Huang CY, et al. The effectiveness of long- acting injectable antipsychotics versus oral antipsychotics in the maintenance treatment of outpatients with chronic schizophrenia. Human Psychopharmacol. 2020;35(3):e2729. doi: 10.1002/hup.2729
- Kane JM, Schooler NR, Marcy P, et al. Effect of Long-Acting Injectable Antipsychotics vs Usual Care on Time to First Hospitalization in Early-Phase Schizophrenia: A Randomized Clinical Trial. JAMA Psychiatry. 2020;77(12):1217-1224. doi: 10.1001/jamapsychiatry.2020.2076
- Lin CH, Chen FC, Chan HY, et al. Time to Rehospitalization in Patients With Schizophrenia Receiving Long-Acting Injectable Antipsychotics or Oral Antipsychotics. Int J Neuropsychopharmacol. 2019;22(9):541-547. doi: 10.1093/ijnp/pyz035
- Lin CH, Chen FC, Chan, HY, et al. A Comparison of Long-Acting Injectable Antipsychotics with Oral Antipsychotics on Time to Rehospitalization Within 1 Year of Discharge in Elderly Patients with Schizophrenia. Am J Geriatr Psychiatry. 2020;28(1):23-30. doi: 10.1016/j.jagp.2019.08.005
- Magliocco F, de Filippis R, Aloi M, et al. Second-generation long- acting injections anti-psychotics improve executive functions in patients with schizophrenia: a 12-month real-world study. Int J Psychiatry Clin Pract. 2020;24(2):201-207. doi: 10.1080/13651501.2020.1737134
- Maestri TJ, Mican LM, Rozea H, et al. Do Long-Acting Injectable Antipsychotics Prevent or Delay Hospital Readmission? Psychopharmacol Bull. 2018;48(3):8-15.
- Medrano S, Abdel-Baki A, Stip E, et al. Three-Year Naturalistic Study On Early Use Of Long-Acting Injectable Antipsychotics In First Episode Psychosis. Psychopharmacol Bull. 2018;48(4):25-61.
- Olayinka O, Oyelakin A, Cherukupally K, et al. Use of Long-Acting Injectable Antipsychotic in an Inpatient Unit of a Community Teaching Hospital. Psychiatry J. 2019;2019:8629030 doi: 10.1155/2019/8629030
- Shah A, Xie L, Kariburyo F, et al. Treatment Patterns, Healthcare Resource Utilization and Costs Among Schizophrenia Patients Treated with Long-Acting Injectable Versus Oral Antipsychotics. Adv Ther. 2018;35(11):1994-2014. doi: 10.1007/s12325-018-0786-x
- Teitelbaum A, Kodesh A. [Long-acting injectable antipsychotics in schizophrenia]. Harefuah. 2019;158(7):453-457. Hebrew.
- Berezantsev AYu, Burygina LA, Levin ME. [Some current trends in the use of prolonged injectable antipsychotics in the conditions of modernization of the psychiatric service]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2020;120(62):61-67. Russian. doi: 10.17116/jnevro202012006261
- Burygina LA, Grigorieva DD, Golubev SA, et al. [Clinical and social characteristics, quality of life, adherence to therapy in IPA patients with schizophrenia spectrum disorders: a crosssectional study]. Psihiatriya. 2023;21(24):27-41. Russian doi: 10.30629/2618-6667-2023-21-4-27-41
- Kostyuk GP, Kurmyshev MV, Zajceva MS, et al. [Long-acting risperidone: analysis of 24 months of therapy in patients with frequent hospitalizations]. Social’naya i klinicheskaya psihiatriya. 2017;24(4):53-58. Russian.
- Lyubov EB, Chapurin SA, Churilin YuYu, et al. [Clinical, social and economic effectiveness of paliperidone palmitate in patients with the first episode of schizophrenia]. Social’naya i klinicheskaya psihiatriya. 2019;29(1):60-72. Russian.
- Joo SW, Shon SH, Choi G, et al. Continuation of schizophrenia treatment with three long-acting injectable antipsychotics in South Korea: A nationwide population-based study. Eur Neuropsychopharmacol. 2019;29(9):1051-1060. doi: 10.1016/j.euroneuro.2019.07.138
- Marcus SC, Zummo J, Pettit AR, et al. Antipsychotic Adherence and Rehospitalization in Schizophrenia Patients Receiving Oral Versus Long-Acting Injectable Antipsychotics Following Hospital Discharge. J Manag Care Spec Pharm. 2015;21(9):754-768. doi: 10.18553/jmcp.2015.21.9.754
- Miura G, Misawa F, Kawade Y, et al. Long-Acting Injectables Versus Oral Antipsychotics: A Retrospective Bidirectional Mirror-Image Study. J Clin Psychopharmacol. 2019;39(5):441-445. doi: 10.1097/JCP.0000000000001082
- Olfson M, Marcus SC, Ascher-Svanum H. Treatment of schizophrenia with long-acting fluphenazine, haloperidol, or risperidone. Schizophr Bull. 2007;33(6):1379-1387. doi: 10.1093/schbul/sbm033
- Rubio JM, Taipale H, Correll CU, et al. Psychosis breakthrough on antipsychotic maintenance: results from a nationwide study. Psychol Med. 2020;50(8):1356-1367. doi: 10.1017/S0033291719001296
- Weiser M, Davis JM, Brown CH, et al. Differences in Antipsychotic Treatment Discontinuation Among Veterans with Schizophrenia in the U.S. Department of Veterans Affairs. Am J Psychiatry. 2021;178(10):932-940. doi: 10.1176/appi.ajp.2020.20111657
- Alphs L, Bossie CA, Sliwa JK, et al. Onset of efficacy with acute long-acting injectable paliperidone palmitate treatment in markedly to severely ill patients with schizophrenia: post hoc analysis of a randomized, double-blind clinical trial. Ann Gen Psychiatry. 2011;10(1):12. doi: 10.1186/1744-859X-10-12
- Bossie CA, Sliwa JK, Ma YW, et al. Onset of efficacy and tolerability following the initiation dosing of long-acting paliperidone palmitate: post-hoc analyses of a randomized, double-blind clinical trial. BMC Psychiatry. 2011;11:79. doi: 10.1186/1471-244X-11-79
- Bozzatello P, Bellino S, Mancini I, et al. Effects on Satisfaction and Service Engagement of Paliperidone Palmitate Compared with Oral Paliperidone in Patients with Schizophrenia: An Open Label Randomized Controlled Trial. Clin Drug Investig. 2019;39(2):169-178. doi: 10.1007/s40261-018-0734-1
- Brown B, Turkoz I, Mancevski B, et al. Evaluation of paliperidone palmitate long-acting injectable antipsychotic therapy as an early treatment option in patients with schizophrenia. Early Interv Psychiatry. 2020;14(4):428-438. doi: 10.1111/eip.12868
- Cai Q, Patel C, Kim E, et al. Factors Associated with the Initiation of Long-Acting Injectable Paliperidone Palmitate Versus Aripiprazole Among Medicaid Patients with Schizophrenia: An Observational Study. Adv Ther. 2019;36(4):858-869. doi: 10.1007/s12325-019-00913-w
- Carpiniello B, Pinna F. Critical appraisal of 3-monthly paliperidone depot injections in the treatment of schizophrenia. Drug Des Devel Ther. 2016;10:1731-1742. doi: 10.2147/DDDT.S86301
- Fernandez-Miranda JJ, Diaz-Fernandez S, De Berardis D, et al. Paliperidone Palmitate Every Three Months (PP3M) 2-Year Treatment Compliance, Effectiveness and Satisfaction Compared with Paliperidone Palmitate-Monthly (PP1M) in People with Severe Schizophrenia. J Clin Med. 2021;10(7):1408. doi: 10.3390/jcm10071408
- Garcia-Carmona JA, Simal-Aguado J, Campos-Navarro MP, et al. Evaluation of long-acting injectable antipsychotics with the corresponding oral formulation in a cohort of patients with schizophrenia: a real-world study in Spain. Int Clin Psychopharmacol. 2021;36(1):18-24. doi: 10.1097/YIC.0000000000000339
- Gutiérrez-Rojas L, Sanchez-Alonso S, Garcia Dorado M, et al. Impact of 3-Monthly Long-Acting Injectable Paliperidone Palmitate in Schizophrenia: A Retrospective, Real-World Analysis of PopulationBased Health Records in Spain. CNS Drugs. 2022;36(5):517-527. doi: 10.1007/s40263-022-00917-1
- Kishimoto T, Hagi K, Kurokawa S, et al. Long-acting injectable versus oral antipsychotics for the maintenance treatment of schizophrenia: a systematic review and comparative meta-analysis of randomised, cohort, and pre-post studies. Lancet Psychiatry. 2021;8(5):387-404. doi: 10.1016/S2215-0366(21)00039-0
- Marti'nez-Andrés JA, Garcia-Carmona JA. Switching from clozapine to paliperidone palmitate-3-monthly improved obesity, hyperglycemia and dyslipidemia lowering antipsychotic dose equivalents in a treatment-resistant schizophrenia cohort. Int Clin Psychopharmacol. 2020;35(3):163-169. doi: 10.1097/YIC.0000000000000300
- Najarian D, Sanga P, Wang S, et al. A Randomized, Double-Blind, Multicenter, Noninferiority Study Comparing Paliperidone Palmitate 6-Month Versus the 3-Month Long-Acting Injectable in Patients With Schizophrenia. Int J Neuropsychopharmacol. 2022;25(3);238-251. doi: 10.1093/ijnp/pyab071
- Petrie D, Racki V, Gaco N, et al. Retrospective Analysis of the Effectiveness and Tolerability of Long-Acting Paliperidone Palmitate Antipsychotic in Adolescent First-Episode Schizophrenia Patients. J Child Adolesc Psychopharmacol. 2019;29(3):197-204. doi: 10.1089/cap.2018.0044
- Saglam Aykut D. Comparison of Paliperidone Palmitate and Second-Generation Oral Antipsychotics in Terms of Medication Adherence, Side Effects, and Quality of Life. J Clin Psychopharmacol. 2019;39(1):57-62. doi: 10.1097/JCP.0000000000000993
- Segarra R, Recio-Barbero M, Saenz-Herrero M, et al. Oral and Palmitate Paliperidone Long-Acting Injectable Formulations’ Use in Schizophrenia Spectrum Disorders: A Retrospective Cohort Study from the First Episode Psychosis Intervention Program (CRUPEP). Int J Neuropsychopharmacol. 2021;24(9):694-702. doi: 10.1093/ijnp/pyab021
- Schneider-Thoma J, Chalkou K, Dörries C, et al. Comparative efficacy and tolerability of 32 oral and long-acting injectable antipsychotics for the maintenance treatment of adults with schizophrenia: a systematic review and network meta-analysis. Lancet. 2022;399(10327):824-836. doi: 10.1016/S0140-6736(21)01997-8
- Alphs L, Bossie CA, Fu DJ, et al. Onset and persistence of efficacy by symptom domain with long-acting injectable paliperidone palmitate in patients with schizophrenia. Expert Opin Pharmacother. 2014;15(7):1029-1042. doi: 10.1517/14656566.2014.909409
- Kim S, Kim S, Koh M, et al. Effects of Long-Acting Injectable Paliperidone Palmitate on Clinical and Functional Outcomes in Patients With Schizophrenia Based on Illness Duration. J Clin Psychiatry 2021;82(1):20m13446. doi: 10.4088/JCP.20m13446
- Savitz AJ, Xu H, Gopal S, et al. Paliperidone palmitate 3-month treatment results in symptomatic remission in patients with schizophrenia: a randomized, multicenter, double-blind, and noninferiority study. Int Clin Psychopharmacol. 2017;32(6):329-336. doi: 10.1097/YIC.0000000000000190
- Kane JM, Kishimoto T, Correll CU. Assessing the comparative effectiveness of long-acting injectable vs. oral antipsychotic medications in the prevention of relapse provides a case study in comparative effectiveness research in psychiatry. J Clin Epidemiol. 2013;66(8 Suppl):S37-S41. doi: 10.1016/j.jclinepi.2013.01.012
- Basu A, Benson C, Alphs L. Projecting the Potential Effect of Using Paliperidone Palmitate Once-Monthly and Once-Every-3- Months Long-Acting Injections Among Medicaid Beneficiaries with Schizophrenia. J Manag Care Spec Pharm. 2018;24(8):759-768. doi: 10.18553/jmcp.2018.24.8.759
- Bell Lynum KS, Turkoz I, Kim E. Paliperidone palmitate once-every- 3-months in adults with early illness schizophrenia. Early Interv Psychiatry. 2019;13(3):667-672. doi: 10.1111/eip.12685
- Berwaerts J, Liu Y, Gopal S, et al. Efficacy and Safety of the 3-Month Formulation of Paliperidone Palmitate vs Placebo for Relapse Prevention of Schizophrenia: A Randomized Clinical Trial. JAMA Psychiatry. 2015;72(8):830-839. doi: 10.1001/jamapsychiatry.2015.0241
- Brasso C, Bellino S, Bozzatello P, et al. Role of 3-monthly long-acting injectable paliperidone in the maintenance of schizophrenia. Neuropsychiatr Dis Treat. 2017;13:2767-2779. doi: 10.2147/NDT.S150568
- Huhn M, Nikolakopoulou A, Schneider-Thoma J, et al. Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. Lancet. 2019;394(10202):939-951. doi: 10.1016/S0140-6736(19)31135-3
- Weiden PJ, Kim E, Bermak J, et al. Does Half-Life Matter After Antipsychotic Discontinuation? A Relapse Comparison in Schizophrenia With 3 Different Formulations of Paliperidone. J Clin Psychiatry. 2017;78(7):e813-e820. doi: 10.4088/JCP.16m11308
- Marder SR, Davis J M, Chouinard G. The effects of risperidone on the five dimensions of schizophrenia derived by factor analysis: combined results of the North American trials. J Clin Psychiatry. 1997;58(12):538-546. doi: 10.4088/jcp.v58n1205
- Nash AI, Turkoz I, Savitz AJ, et al. Predictors of achieving remission in schizophrenia patients treated with paliperidone palmitate 3-month formulation. Neuropsychiatr Dis Treat. 2019;15:731-737. doi: 10.2147/NDT.S194264
- Mathews M, Nuamah I, Savitz AJ, et al. Time to onset and time to resolution of extrapyramidal symptoms in patients with exacerbated schizophrenia treated with 3-monthly vs once- monthly paliperidone palmitate. Neuropsychiatr Disease Treat. 2018;14:2807-2816. doi: 10.2147/NDT.S175364
- Garcia-Portilla MP, Llorca PM, Maina G, et al. Symptomatic and functional outcomes after treatment with paliperidone palmitate 3-month formulation for 52 weeks in patients with clinically stable schizophrenia. Ther Adv Psychopharmacol. 2020;10:2045125320926347. doi: 10.1177/2045125320926347
- Garcia-Portilla MP, Benito Ruiz A, Gômez Robina F, et al. Impact on functionality of the paliperidone palmitate three- month formulation in patients with a recent diagnosis of schizophrenia: a real-world observational prospective study. Expert Opin Pharmacother. 2022;23(5):629-638. doi: 10.1080/14656566.2021.2023496
- Emond B, Joshi K, Khoury ACE, et al. Adherence, Healthcare Resource Utilization, and Costs in Medicaid Beneficiaries with Schizophrenia Transitioning from Once-Monthly to Once- Every-3-Months Paliperidone Palmitate. Pharmacoecon Open. 2019;3(2):177-188. doi: 10.1007/s41669-018-0089-9
- Joshi K, Muser E, Xu Y, et al. Adherence and economic impact of paliperidone palmitate versus oral atypical antipsychotics in a Medicare population. J Comp Eff Res. 2018;7(8):723-735. doi: 10.2217/cer-2018-0003
- Stahl S. Long-acting injectable antipsychotics: Shall the last be first? CNS Spectr. 2014;19(1):3-5. doi: 10.1017/S1092852913001016
- Morosini PL, Magliano L, Brambilla L, et al. Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatr Scand. 2020;101(4):323-329.
- Opler M, Fu DJ. Comments on the scoring guideline of the personal and social performance scale (PSP). Schizophr Res. 2014;152(1):304. doi: 10.1016/j.schres.2013.10.039
- Nafees B, van Hanswijck de Jonge P, Stull D, et al. Reliability and validity of the Personal and Social Performance scale in patients with schizophrenia. Schizophr Res. 2012:140(1-3):71-76. doi: 10.1016/j.schres.2012.06.013
- Lee SC, Tang SF, Lu WS, et al. Minimal detectable change of the Personal and Social Performance scale in individuals with schizophrenia. Psychiatry Res. 2016;246:725-729. doi: 10.1016/j.psychres.2016.10.058
- Jelastopulu E, Giourou E, Merekoulias G, et al. Correlation between the Personal and Social Performance scale (PSP) and the Positive and Negative Syndrome Scale (PANSS) in a Greek sample of patients with schizophrenia. BMC Psychiatry. 2014;14:197. doi: 10.1186/1471-244X-14-197
- Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013. p. 743-744.
- Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington: American Psychiatric Publishing; 2022.
- First MB. Diagnostic and statistical manual of mental disorders, 5th edition, and clinical utility. J Nerv Ment Dis. 2013;201(9):727-729. doi: 10.1097/NMD.0b013e3182a2168a
- First MB, Gaebel W, Maj M, et al. An organization- and categorylevel comparison of diagnostic requirements for mental disorders in ICD-11 and DSM-5. World Psychiatry. 2021;20(1):34-51. doi: 10.1002/wps.20825
- Berendsen S, van der Veen NM, van Tricht MJ, et al. Psychometric properties of the DSM-5 Clinician-Rated Dimensions of Psychosis Symptom Severity. Schizophr Res. 2020;216:416-421. doi: 10.1016/j.schres.2019.10.059
- Liemburg E, Nienhuis F, Veling W. M95. DSM-5 Clinician-Rated Dimensions of Psychosis Symptom Severity: Psychometric Properties. Schizophr Bull. 2020;46(Suppl 1):S170-S171. doi: 10.1093/schbul/sbaa030.407
- Jeong JH, Kim SW, Lee BJ, et al. The factor structure and clinical utility of clinician-rated dimensions of psychosis symptom severity in patients with recent-onset psychosis: Results of a 1-year longitudinal follow-up prospective cohort study. Psychiatry Res. 2022;310:114420. doi: 10.1016/j.psychres.2022.114420
- Keeley JW, Gaebel W. Symptom rating scales for schizophrenia and other primary psychotic disorders in ICD-11. Epidemiol Psychiatr Sci. 2018;27(3):219-224. doi: 10.1017/S2045796017000270
- Guy W. Clinical Global Impressions. In: ECDEU Assessment Manual for Psychopharmacology: Revised, 1976. Rockville: U.S. Department of Health, Education and Welfare, et al; 1976. p. 217-222.
- Berk M, Ng F, Dodd S, et al. The validity of the CGI severity and improvement scales as measures of clinical effectiveness suitable for routine clinical use. J Eval Clin Pract. 2008;14(6):979-983. doi: 10.1111/j.1365-2753.2007.00921.x
- Dunlop BW, Gray J, Rapaport MH. Transdiagnostic Clinical Global Impression Scoring for Routine Clinical Settings. Behav Sci (Basel). 2017;7(3):40. doi: 10.3390/bs7030040
- Alphs LD, Summerfelt A, Lann H, et al. The negative symptom assessment: a new instrument to assess negative symptoms of schizophrenia. Psychopharmacol Bull. 1989;25(2):159-163.
- Axelrod BN, Goldman RS, Alphs LD. Validation of the 16-item Negative Symptom Assessment. J Psychiatr Res. 1993;27(3):253-258. doi: 10.1016/0022-3956(93)90036-2
- Alphs L, Morlock R, Coon C, et al. The 4-Item Negative Symptom Assessment (NSA-4) Instrument: A Simple Tool for Evaluating Negative Symptoms in Schizophrenia Following Brief Training. Psychiatry (Edgmont). 2010;7(7):26-32.
Информация об авторах
Метрики
Просмотров web
За все время: 138
В прошлом месяце: 15
В текущем месяце: 9
Скачиваний PDF
За все время: 24
В прошлом месяце: 2
В текущем месяце: 1
Всего
За все время: 162
В прошлом месяце: 17
В текущем месяце: 10