Erasmia I. Koiliari
Medical School of the University of Crete, GreecePresentation Title:
Injectable antipsychotic medication with main action as partial D2 and 5HT1A receptors agonist. Patients with comorbidity of neurodevelopmental diseases and substance use disorders, who are medically monitored on a regular basis in the Hospital and patients incarcerated in the Greek Penitentiary System
Abstract
Importance: Aripiprazole, as partial D2 and 5HT1A receptors agonist, is proposed to enhance prefrontal cortex (PFC) (Dorso-lateral and Ventro-medial prefrontal Cortex) dopamine function and serotonergic function, improving working memory and emotional reaction to stress and GABA transmission, which supports social functioning. Long-acting injectable antipsychotics (LA) improve patient compliance with treatment, leading to enhanced long-term effects in improving the patient's clinical picture.
Objective: To evaluate whether aripiprazole LAI treatment improves general functioning, quality of life, and reduces hospitalizations in psychotic patients, both in community settings and within incarcerated populations.
Design, settings, and participants: The study included 98 patients, with 68 from the community and 30 incarcerated at a prison in Southeastern Greece (Neapolis). The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) and the Clinical Global Impression-Severity (CGI-S) scale were used to assess outcomes. Comparisons were made between pretreatment and post-treatment periods, with a minimum follow-up of six months.
Results:
• Demographics: Community Patients (n=68): 70.59% male, mean age 40.66 ± 13.91 years, 35.29% with F20.0, 82.35% with Cluster C personality, 40.9% with psychoactive substance use. 80.88% in LAI Aripiprazole. Incarcerated Patients (n=30): All male, mean age 38.73 ± 8.75 years, all with F29.0, 53.3% with Cluster B personality, 100% with psychoactive substance use. All (100%) in LAI Aripiprazole. Differences were noted between groups in some demographic and medical history parameters, except for traumatic brain injury and mental retardation.
• Hospitalizations: Community patients’ hospitalizations decreased from 1.01 ± 1.54 to 0.01 ± 0.12 (p<<<0.001), a mean reduction of 1.2 ± 1.9. Incarcerated patients’ hospitalizations fell from 0.77 ± 1.72 to 0.0 ± 0.0 (p=0.066), a mean reduction of 0.7 ± 1.9.
• CGI-S: Community patients’ CGI-S scores improved from 5.72 ± 0.88 to 2.94 ± 1.33 (p<0.001), a mean reduction of 2.1 ± 1.3. Incarcerated patients’ scores improved from 5.4 ± 0.77 to 2.17 ± 1.26 (p<0.001), a mean reduction of 2.1 ± 1.2, with no significant intergroup difference (p<0.001).
• Quality of Life: Community patients’ quality-of-life scores increased from 0.57 ± 0.53 to 3.35 ± 0.84 (p<0.001), a mean gain of 2.4 ± 1.0. Incarcerated patients’ scores rose from 0.7 ± 0.53 to 3.6 ± 0.67 (p<0.001), a mean gain of 2.1 ± 0.9.
Conclusions: Both groups of patients experienced reduced hospitalizations and improvements in CGI-S scores and quality of life following ALAI administration. Community patients showed a greater reduction in hospitalizations, while clinical and quality-of-life improvements were comparable across groups.
Biography
Erasmia I. Koiliari was born in Athens, Greece, and is a medical doctor, graduated from the Medical School of the University of Patras. She holds a Postgraduate Diploma from the Medical School of the University of Crete and earned her PhD in Genetics of the Central Nervous System from the same institution. She serves as a Post-Doctoral Lecturer at a Greek Medical School, where she has developed extensive research in Genetic Medicine and Forensic Psychiatry. She is the head of an international research initiative based at the Medical School in Greece. Additionally, she serves as Head of the country’s National Health System (NHS) and National Mental Health System for the continued education of physicians across all specialties, and she is the General Manager of the European Union programs supporting the training and exchange of medical students between participating countries.
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