Browsing by Author "Danaci, AE"
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Item Postnatal depression in Turkey: epidemiological and cultural aspectsDanaci, AE; Dinç, G; Deveci, A; Sen, FS; Içelli, IBackground in some periods of a womans life the risk of depression increases and the postnatal period is one of these. The prevalence and the risk factors of postnatal depression are not systematically studied in Turkey. The aim of this study is to investigate the epidemiological aspects and the cultural factors that may affect postnatal depression in our country. Method According to the records of ten primary health care centres in Manisa, a city in western Turkey, there were 1,337 women who had given birth in the previous 6 months. A sample group of 317 mothers were randomised among these women and 257 (81.7%) of the sample group could be reached. Data were collected by use of the Edinburgh Postnatal Depression Scale and a questionnaire on sociodemographic variables designed for this study. Results The mean depression score was found to be 7.54 +/- 4.66. When the cut-off point was taken into consideration, 14% of mothers had a syndromal depression. The factors which affected the prevalence of depression were the number of living children, living in a shanty, being an immigrant, serious health problems in the baby, previous psychiatric history, psychiatric disorder in the spouse, and having bad relations with the spouse and his parents. Conclusion These findings revealed that the prevalence of postnatal depression in the Manisa province and the factors affecting it were very similar to other studies; but the negative impact of bad relations of the mother with her family-in-law on postnatal depression seems to be a distinguishing aspect of Turkish culture.Item Developing a quality of life instrument in patients with psoriasisInanir, I; Aydemir, Ö; Gündüz, K; Danaci, AE; Türel, ABackground and design Psoriasis is a chronic skin disease which causes psychological, social and physical problems and affects quality of life. The aim of this study was to develop a quality of life instrument for patients with psoriasis which is suitable for Islamic populations. Materials and methods The psychosocial and daily life problems defined by 75 patients with psoriasis, their relatives and physicians were used to construct a questionnaire, the reliability and validity of which were determined in a group of 156 patients with psoriasis. Results For reliability, Chronbach's alpha coefficient was 0.87, and item-total correlations were between 0.37 and 0.60 for internal consistency. There was high test-retest reliability (r = 0.98, P < 0.001). For validity, three factors were extracted in the principal components method for construct validity. The maximum factor loadings of each item were between 0.456 and 0.681. For convergent validity, all patients' self-ratings and Psoriasis Area and Severity Index (PASI) were correlated with the questionnaire score (P < 0.001). Conclusions The questionnaire consisting of 17 items was found to be suitable for both epidemiologic and clinical trials.Item Reliability and Validity of the Turkish Version of the Social Adaptation Self-Evaluation Scale (SASS)Akkaya, C; Sarandöl, A; Danaci, AE; Sivrioglu, EY; Kaya, E; Kirli, SObjective: SASS is a new self-evaluation scale that assesses the level of social functioning in depressed patients for clinical research purposes. The aim of this study was to investigate the validity and reliability of the Turkish version of SASS. Method: Data were obtained from 2 different sample groups that hod no physical disturbances that could impair social functioning; healthy participants between the ages of 18 and 65 years (n = 66) and patients (n = 227) diagnosed with major depressive disorder (MDD). Assessment tools used in the study were SASS, Hamilton Depression Rating Scale, 17-item version, and Global Assessment of Functioning Scale. Results: In the reliability analysis of both groups combined and the MDD group Cronbach's alpha values for the internal consistency of the scale were 0.90 and 0.87, respectively. Item-total score correlations were between 0.22 and 0.66 for both groups combined, and between 0.21 and 0.59 for the MDD group. The correlation coefficient of the scale's test-retest reliability was 0.770 (P < 0.0001) and the SASS value rose from 29.4 +/- 8.1 to 37.8 +/- 8.1 following treatment of depression (P < 0.0001). Four factors with Eigen values > 1 were obtained from the factor analysis. Factor 1, with an Eigen value of 7.169 explained 35.8% of the total variance and represented the entire scale alone. Conclusions: The Turkish version of SASS, as the original scale, demonstrated adequate validity and reliability for the measurement of loss of social functioning in MDD patients and demonstrated that scores changed in accordance with treatment for depression.Item Retinal abnormalities and their relationship with social cognition in patients with schizophrenia and their healthy siblingsAkin, F; Danaci, AE; Kayikcioglu, RO; Tasci, MYObjective: This study aimed to investigate retinal abnormalities and their relationship with social cognitive function, and to assess whether retinal changes could be observed in the healthy siblings of patients with schizophrenia in a similar manner, suggesting their potential as an endophenotype. Method: The study included 28 patients with schizophrenia, 28 of their siblings, and 28 healthy control subjects. Social cognition tests were administered, and measurements of the retinal nerve fiber layers (RNFL), ganglion cell layer plus inner plexiform layer (GCL+IPL), and cup volumes were obtained using optical coherence tomography (OCT). Results: Analyses revealed no differences between the groups in RNFL thickness. The cup volume was significantly larger in both eyes of the patient group compared to the control group. The mean thickness of the GCL+IPL in the left eye was significantly lower in the patient group compared to the healthy control group, with a similar difference also observed between the siblings of patients and the control group. A statistically significant difference was found among all groups in the total scores of social cognition tests. A weak correlation was identified between retinal layer thicknesses and social cognition test scores in both the patient and sibling groups. Conclusion: These findings suggest that GCL+IPL thickness can be a useful endophenotype for the early diagnosis of schizophrenia. While retinal changes do not predict cognitive symptoms in patients with schizophrenia, they may play an important role in identifying high-risk groups.Item Relationship of sexuality with psychological and hormonal features in the menopausal periodDanaci, AE; Oruç, S; Adigüzel, H; Yildirim, Y; Aydemir, ÖWomen may experience some mental and sexual problems between the ages of 40 years and 60 years due to serious changes in the hormonal system. The aim of this study was to examine the relationships between the changes in sex hormones, sexual behaviours, depression and anxiety levels of women who were in either the premenopausal, perimenopausal or postmenopausal period The subjects of this cross-sectional study consisted of 324 women who attended the Gynaecology and Obstetrics Out-Patient Ward of Celal Bayar University Hospital. Of this group, 37.0% (n = 124) were postmenopausal, 27.2% (n = 84) perimenopausal and 35.8% (n = 116) premenopausal. Beck Depression Inventory (BDI), State and Trait Anxiety Inventories (STAI-I and II) and a questionnaire on sexual behaviour which was prepared for this study by the authors, were applied to all of the attendees and serum sex hormone levels were analyzed Beck Depression Anxiety, STAI-I and STAI-II scores and sexual behaviours did not show any statistically significant difference among these three groups. The frequency of sexual intercourse was lower in women with high BDI scores. The rate of painful intercourse was higher in women with high STAI-I scores. The frequency of sexual intercourse, sexual desire and orgasm decreased and painful intercourse increased in women with high STAI-Il scores. The frequency of sexual intercourse decreased significantly as the age or follicle stimulating hormone level of women increased These findings have revealed that the menopausal state did not affect the sexual behaviour, and psychological state of women between the ages of 40 and 60 years, but the increase in anxiety and depression scores affected the sexual life in a negative manner.Item Towards an integrative approach to understanding quality of life in schizophrenia: the role of neurocognition, social cognition, and psychopathologyTas, C; Brown, E; Cubukcuoglu, Z; Aydemir, O; Danaci, AE; Brüne, MThe term schizophrenia refers to a debilitating group of disorders that usually results in a severely impaired quality of life (QoL). Symptomatology appears to have a substantial role in determining QoL, although the relationship between QoL and specific psychotic symptoms is still unclear and has demonstrated mixed results. Due to the intrinsic importance of social functioning in QoL, and the mediating effect of social cognition on social functioning, the aim of this study was to try to investigate QoL in schizophrenia, not only in terms of symptomatology, but also in consideration of potential neurocognitive and social cognitive contributing factors. Methods: Twenty-eight clinically stable patients with schizophrenia performed a broad range of neurocognitive and social cognitive assessments, and also participated in a semi-structured interview of QoL, assessing four partially independent subdomains of QoL. A stepwise regression model was used to determine the best predictors of QoL, and additionally a mediator analysis was performed to test for the mediating power of social cognition on QoL. Results: Negative symptoms, intelligence, executive functioning and social cognition all had some power in predicting QoL in schizophrenia. Though most interestingly, mental state reasoning was specifically found to be most strongly related with the Intrapsychic Foundation subdomain of QoL, whereas neurocognition and symptom severity were associated with other subdomains of QoL. Conclusions: The association between mental state reasoning and the more internal aspects of QoL in schizophrenia may reflect a specific role for social cognition in introspective and subjective judgments of one's own QoL, whereas neurocognition and negative symptomatology may be more predictive of the external or extrinsic aspects of QoL. In conclusion, social cognitive skills appear to play a crucial role in the experience of one's own subjective well-being, which could help to explain previous inconsistencies in the literature investigating QoL in schizophrenia. (C) 2013 Elsevier Inc. All rights reserved.Item HOW SEPARABLE ARE THE DOMAINS OF SOCIAL COGNITIVE DEFICITS IN SCHIZOPHRENIA?Brown, EC; Tas, C; Danaci, AE; Brüne, MItem THE VALIDATION OF TURKISH VERSION OF PERSONAL AND SOCIAL PERFORMANCE SCALE (PSP)Aydemir, O; Ucok, A; Danaci, AE; Sariöz, F; Canpolat, T; Karadayi, G; Emiroglu, BItem Impact of family involvement on social cognition training in clinically stable outpatients with schizophrenia - A randomized pilot studyTas, C; Danaci, AE; Cubukcuoglu, Z; Brüne, MRecovery of social functioning is a largely unattained goal in schizophrenia rehabilitation. In the recent past, new neurocognitive and social cognitive training approaches have been introduced to improve functioning in various domains of patients' social life. These programs have neglected, to some degree, the social environment in which the training takes place. Accordingly, the present study sought to examine if family-assisted social cognitive training could improve quality of life, social functioning and social cognition in schizophrenia patients as compared to a social stimulation approach. In a randomized, controlled, parallel group trial design with two groups, one receiving family-assisted social cognitive training once a week (F-SCIT) and the other, social stimulation once every three weeks (SS), both for 14-weeks period, patients were assessed at baseline, before randomization and 16 weeks after randomization. Participants were recruited from Celal Bayar University Psychosis Unit and were in a clinically stable condition. Patients who received F-SCIT significantly improved in quality of life, social functioning and social cognition, whereas the SS group worsened in nearly all outcome variables. Family-assisted SCIT is effective in improving quality of life, social functioning and social cognition. (C) 2011 Elsevier Ireland Ltd. All rights reserved.Item 2Relationship between childhood trauma and aggression in bipolar disorderAydin, O; Çökmüs, FP; Balikçi, K; Aydin, PU; Danaci, AEObjective: This research was conducted to define the relationship of childhood trauma and aggression in bipolar disorder. Methods: This study was conducted between December 2015 and March 2016 in Manisa Mental Health Diseases Hospital. The study population consisted of 449 patients. The minimum sample size of the universe is calculated 209 with 95% confidence interval and 5% standard deviation using the known formula. The data, is collected using Information Form, Childhood Trauma Questionnaire (CTQ-28), Buss-Durkee, and the Aggression Scale. The data was evaluated by number, percentage, t test, one-way analysis of variance, Mann-Whitney, Kruskal-Wallis and the Pearson's correlation coefficient in SPSS 22.0 program. Results: The average age of the patients is 34.71 +/- 11.16 (range: 18-65). 61.7% of the patients are male, 50.2% of patients are single, 34.0% of patients are primary school graduates. Income status of patients; 48.8% of patients the income is less than expenses. Socio-demographic characteristics such as the income situation of the patient, marital status, education level, parents' education, place of residence, immigration status, self-harm state with childhood trauma scale total score and Buss-Durkee Aggression Scale was found a statistically significant correlation between subdomains. Conclusion: Our results are suggest that there can a relationship between childhood trauma and aggression levels in bipolar disorder.Item The Perceived Burden of Care and its Correlates in SchizophreniaGülseren, L; Çam, B; Karakoç, B; Yigit, T; Danaci, AE; Çubukçuoglu, Z; Tas, C; Gülseren, S; Mete, LObjective: The present study aimed to investigate the perceived level of burden of care and its correlates in family members of schizophrenia patients. Method: The study included 239 schizophrenic patients that were followed-up at the psychiatric outpatient clinics of Izmir Ataturk Education and Research Hospital, and Celal Bayar University Medical School, and 239 of their primary caregivers. Patients were assessed using the Positive and Negative Syndrome Scale (PANNS), Global Assessment of Functioning Scale (GAF), Social Functioning Scale (SFS), Brief Cognitive State Examination (BCE), and UKU Side Effect Rating Scale. Their primary caregivers were assessed using the Perceived Family Burden Scale (PFBS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BM). Results: Caregiver PFBS scores ere correlated with male patients, female caregivers, inadequate social support, economic difficulty, the presence of chronic physical disorder in the caregivers, patient violence toward the caregivers, total duration of illness, the number of patient hospitalizations, PANNS total and subscale scores, and SFS, BDI, and BAI scores. Perceived burden of care was Predicted by the severity of the patients' positive symptoms, SFS independence/competence and interpersonal functioning subscale scores, and caregivers' anxiety and depression levels. Conclusion: In order to decrease the burden of care in schizophrenia we recommend effective management of patient symptoms, enhancement of patient social functioning, interventions that target caregivers with high levels anxiety and depression, and social support provided by healthcare professionals.Item Serum Brain-Derived Neurotrophic Factor Levels in Pain Syndromes: A Comparative Study with Major DepressionTaskin, EO; Aydemir, Ö; Deveci, A; Taneli, F; Selçuki, D; Cerrahoglu, L; Danaci, AEObjective: In this study, it is aimed to compare the level of Brain-Derived Neurotrophic Factor (BDNF) of patients with migraine and fibromyalgia to that of depressive patients and healthy subjects in order to answer the question whether stress is related to pain syndromes. Methods: In the migraine group 27 patients and in the fibromyalgia group 19 patients without any previous antidepressant treatment and psychiatric diagnosis were included. In the depression group, 24 patients with at least eight weeks of antidepressant-free period were invited to the study. In the depression group no co-morbid diagnosis in the first axis was made. Twenty-six subjects without any previous psychiatric diagnosis and psychiatric treatment consisted the control group. For making diagnosis of depression and other first axis disorders Structured Clinical Interview for DSM-IV (SCID-1) was used in all study groups. For the assessment of the severity of depression Hamilton Depression Rating Scale (HAM-D) was applied. The diagnosis of migraine was made according to the criteria of International Headache Society. For the diagnosis of the fibromyalgia the criteria of American College of Rheumatology was used. The severity of pain was assessed with visual analogue scale (VAS) in the migraine and fibromyalgia groups. Serum BDNF was kept at -70 degrees C before testing, and assayed with an ELISA Kit (Promega; Madison, WI, USA), after dilution with the Block and Sample solution provided with the kit. The data were subjected to Kruskal Wallis Test in the comparison of serum BDNF levels. Results: The serum BDNF level of the depression group (21.2 +/- 11.3 ng/ml) was statistically lower (p < 0.0001) than the level of the migraine group (32.2 +/- 10.1 ng/ml), fibromyalgia group (30.7 +/- 8.9 ng/ml) and the control group (31.4 +/- 8.8 ng/ml). The level of BDNF was not significantly different in the migraine, fibromyalgia and control groups. There was no significant correlation between serum BDNF levels, and age and gender. In pain syndromes there was no signification correlation between serum BDNF levels, and mean scores of HAM-D and VAS (r= 0.085; p= 0.579 and r= 0.191; p= 0.204 respectively). Similarly there was no significant correlation between serum BDNF levels and HAM-D scores in the depression group (r=0.122; p= 0.579). Conclusions: Even though the pain syndromes were suggested to be associated with stress, in this present work, serum BDNF level as one of the markers of stress does not support this hypothesis. This might be related to the factor that in pain syndromes such as fibromyalgia or migraine, serum BDNF level may be affected by the alteration in peripheral platelet functions. Furthermore in a limited chronic stress serum BDNF levels tend to be not affected and this may play a significant role in our results.Item Case reportYüksel, EG; Taskin, EO; Ovali, GY; Karaçam, M; Danaci, AECarbon monoxide (CO) intoxication is usually a serious condition, which can result in neurological disturbances or death. In some patients with CO intoxication, but not usually, a biphasic pattern can be seen. In this condition, after antitoxic treatment, patients may completely recover and after a short recovery period, neurological and/or psychiatric symptoms appear again. This condition is known as delayed encepholopathy and its ocurrence rote is between 0.06% and 11.8%. Herein, we report a case with delayed encephalopathy after CO intoxication, which began with neurological symptoms and continued with obsessive-compulsive disorder, depression, kleptomania, and psychotic disorder. The 41-year-oldfemale patient had no psychiatric or neurological symptoms or disorders prior to CO intoxication. Increased signal intensity changes in the basal region of the left temporal lobe (including the cortex and subcortical white matter), globus pallidus (bilateral), and cerebellar cortical and subcortical white matter (bilaterally symmetrical) was detected on axial T2-weighted magnetic resonance imaging (MRI). In addition, there were atrophic changes in both cerebellar hemispheres. To the best of our knowledge, this is the first case of kleptomania described after CO intoxication in the literature. We discuss the organic etiology of kleptomania and the other psychiatric symptoms of this patient in the light of recent research. We concluded that the kleptomania seen in this patient was related to concurrent lesions in the temporal lobe and globus pallidus, in other words, her kleptomania may have been related to dysfunction simultaneously seen in both the temporolimbic and frontal-subcortical circuits.Item The Effect of Medical Education on Attitudes Towards Schizophrenia: A Five-Year follow-Up StudyDanaci, AE; Balikci, K; Aydin, O; Cengisiz, C; Uykur, ABObjective: It has been widely acknowledged that the community and health professionals hold negative attitudes toward patients with impaired mental health. This constitutes a major obstacle for those patients in coping with their disease, managing their care, and hence regulating their lives. Although studies carried out in Turkey document the presence of stigma, they provide limited information about the ways for solving this problem. Drawing on the litrature, the present study investigated the effect of medical education on stigmatization. Method: During 2008/2009 academic year, 106 freshmen who were majoring in the Medical School at Celal Bayar University volunteered to participate in the present study. Participants have not yet received any theoretical or practical training on psychiatry. At the beginning of the study, they were informed about the purpose of the study and accordingly requested to fill a consent form. The 32-item schizophrenia subscale of the Attitude Questionnaire developed by Psychiatric Investigations and Education Center (PAREM) was administered to the participants. Along with the questionnaire, they were also requested demographic information. After 5 years, the participants who completed their psychiatry internship were reassessed with the same instrument. Results: 106 volunteers participated in the present study. The majority of the participants were females (54.7%) with equal balance of income and expidentures (65.1%) having a mental disease percentage of 5.6%. Findings showed that students' attitudes towards schizophrenic patients changed significantly positive as they proceed from first year to the fifth year. Results demonstrated that as students move through the years they report more positive attitudes in the areas of etiology of schizophrenia (p<0.01), treatment options (p<0.01), approach to schizophrenic patients (p<0.01), and social interactions (p<0.01). Conclusion: We claim that the development of positive attitudes should be integrated in to the mental health curriculum not only in particular years but also throughout the whole years of education. Along this continuum, we believe that students would become more aware of the needs of the schizophrenic patients and gain an on going intuition toward the difficulties that the patients encounter. Viewed together, at the stage of acquiring medical/psychological skills students should be given the opportunity to have direct contact with patients in order to give adequate response to patients' needs and thus observe the improvement at the end of the treatment.Item The Early Warning Signs in SchizophreniaDeveci, A; Danaci, AEThe aim of this paper is to review the literature on the recognition of the early warning signs of schizophrenia. The occurence of psychotic relapse is characteristic of schizophrenia. Preventing psychotic relapse is important in the treatment for patients with schizophrenia. Identifying early warning signs can reduce the incidence of psychotic relapse. It is important to make a clear conceptual distinction between early warning signs and psychotic symptoms. Studies indicate that between 50% to 70% of people experience early warning signs over a period of one to four weeks prior to a relapse. Early warning signs of schizophrenia show a mixture of psychotic and non-psychotic symptoms. Early warning signs were identified as hallucinations, suspiciousness, change in sleep, anxiety, anger-hostility, disruptive inappropriate behaviour, depression, suicidal ideas, nervousness, increased tension, cognitive inefficiency. Systematic monitoring of early warning signs is an important part of the treatment strategy. The time interval between the first early warning signs and psychotic relapse is long enough to give sufficient opportunity to apply early intervention strategies.Item Oxytocin and social cognition in patients with schizophrenia: comparison with healthy siblings and healthy controlsBalikci, K; Aydin, O; Tas, C; Danaci, AEObjective: There is substantial evidence from animal research indicating a key role of the neuropeptide oxytocin (OT) in the regulation of complex social cognition and behaviour. Social cognition is indispensable for social relationships for the whole of human society, and numerous studies have shown impaired social cognition in schizophrenia (SCH) and unaffected first-degree relatives also seem to be impaired, albeit to a lesser extent. Because of that, this study focuses on the role of OT in social cognition in SCH. Methods: Twenty-seven patients with SCH, 27 healthy siblings (HS) of these patients, and 27 psychologically healthy controls (HC) were included in the study. Blood samples were collected through a peripheral venous catheter. Differences in the socio-demographical and WAIS-R were tested by chi-square and one way-ANOVA. To explore the relationships between social cognition and blood samples we performed Pearson correlations. MANCOVA (gender and WAIS-R as covariates) test was performed to investigate the effect of gender on blood levels of OT and WAIS-R on social cognition. Results: Significant differences were found in neurocognitive and social cognitive capacity but not in OT levels. In the healthy control group, there was a positive correlation between blood OT levels and RMET. There is a statistically significant difference between high and low OT groups with regard to social cognition in all subtests of the RMET. Conclusions: In the current study, we found that patients had deficits in social cognition and neurocognition. Lower endogenous OT levels are also predictive for poor social cognitive functioning in HS and HC.Item The examination of the oxytocin and vasopressin effects on social functioning among individuals with schizophreniaÇökmüs, FP; Aydin, O; Balikçi, K; Aydin, PÜ; Danaci, AEItem Reasons for clozapine discontinuation in patients with treatment-resistant schizophreniaUcok, A; Yagcioglu, EA; Yildiz, M; Kaymak, SU; Saka, MC; Tasdelen, R; Danaci, AE; Senol, SHAlthough clozapine is more effective than other antipsychotics in the treatment of schizophrenia, the rate of its discontinuation is also high. The aim of this retrospective chart-review study was to investigate the causes of clozapine discontinuation in patients with treatment-resistant schizophrenia. This study included a total of 396 patients with schizophrenia, 240 still on clozapine therapy and 156 who discontinued clozapine, and compared their clinical characteristics. Those who discontinued clozapine had a longer history of illness and more hospitalizations before clozapine and tended to be older. Inadequate response was more common among clozapine discontinuers compared to continuers. The most common reason for discontinuation was the side-effects associated with clozapine (49%). Discontinuation from patient decision or by the psychiatrist due to noncompliance was the second (29.7%) and discontinuation due to lack of efficacy was the third most frequent reason (21.3%). The patients who discontinued clozapine because of cardiac side effects were younger, had shorter duration of clozapine use, and had lower maximum clozapine dose compared to the other discontinuers. Our findings point out the importance of enhancing psychiatrists' ability to handle manageable side effects to minimize discontinuations and maximize the benefits of clozapine in patients with treatment-resistant schizophrenia.Item The developmental origins of metacognitive deficits in schizophreniaAydin, O; Balikci, K; Tas, C; Aydin, PU; Danaci, AE; Brüne, M; Lysaker, PHThe deficits in metacognition have been observed in schizophrenia but developmental roots of impaired metacognition are not well understood. Accordingly, this study compared metacognitive abilities of patients with schizophrenia and healthy group and examined the relationship between childhood trauma, attachment style and caregiver attitudes with metacognitive capacity which might contribute to metacognitive deficits in patient group. 35 patients with schizophrenia and 35 healthy people were included in the study. Metacognitive capacity was measured using the Metacognition Assessment Scale Abbreviated (MAS-A). This scale comprises four domains: self-reflectivity, understanding other's mind, decentration and mastery. Group comparisons revealed that schizophrenia patients had greater deficits in metacognitive ability. We found that the report of childhood emotional abuse, a pattern of anxious attachment and over protection by caregivers were uniquely related to metacognitive capacity. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Item Efficacy and tolerability of switching to ziprasidone from olanzapine, risperidone or haloperidol: an international, multicenter studyAlptekin, K; Hafez, J; Brook, S; Akkaya, C; Tzebelikos, E; Ucok, A; El Tallawy, H; Danaci, AE; Lowe, W; Karayal, ONTo compare the effectiveness of a switch from haloperidol (N=99), olanzapine (N=82), or risperidone (N=104) to 12 weeks of treatment with 80-160 mg/day ziprasidone in patients with stable schizophrenia or schizoaffective disorder. Stable outpatients with persistent symptoms or troublesome side effects were switched using one of three 1-week taper/switch strategies as determined by the investigator. Efficacy was assessed using the Brief Psychiatric Rating Scale score, Clinical Global Impression, Positive and Negative Symptom Scale, Montgomery-Asberg Depression Rating Scale, and the Global Assessment of Functioning Scale, and tolerability by using standard measures of weight change, extrapyramidal symptoms, and laboratory findings, Suboptimal efficacy was the primary reason for switching. The preferred switch strategy was immediate discontinuation, and the preferred dosing regimen was 120 mg/day. Completer rates were 68, 60, and 86% in the haloperidol, risperidone, and olanzapine pre-switch groups, respectively. At week 12, a switch to ziprasidone resulted in statistically significant improvement from baseline on the Brief Psychiatric Rating Scale score, Clinical Global Impression-improvement, Positive and Negative Symptom Scale, and Global Assessment of Functioning scales, reduction in extrapyramidal symptoms and a neutral impact on metabolic parameters. Switch from olanzapine and risperidone resulted in weight reduction and from haloperidol in some weight increase. In conclusion, oral ziprasidone of 80-160 mg/day with food was a clinically valuable treatment option for stable patients with schizophrenia or schizoaffective disorder experiencing suboptimal efficacy or poor tolerability with haloperidol, olanzapine, or risperidone. Int Clin Psychopharmacol 24:229-238 (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.