human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Rationale The relative effectiveness of the atypical antipsychotic drugs and conventional agents in patients with early-stage schizophrenia has not been comprehensively determined . Objectives The aim of our study was to evaluate the efficacy and safety of seven antipsychotic drugs for the maintenance treatment in patients with early-stage schizophrenia . Methods In a 12-month open-label , prospect i ve observational , multicenter study , 1,133 subjects with schizophrenia or schizophreniform disorder within 5 years of onset were monotherapy with chlorpromazine , sulpiride , clozapine , risperidone , olanzapine , quetiapine , or aripiprazole . The primary measure was the rate of treatment discontinuation for any reason . Secondary outcomes included measures for clinical and functional outcomes and tolerability . Results The percentage of patients discontinued treatment within 12 months was 41.4 % for chlorpromazine , 39.5 % for sulpiride , 36.7 % for clozapine , 40.2 % for risperidone , 39.6 % for olanzapine , 46.9 % for quetiapine , and 40.2 % for aripiprazole , a nonsignificant difference ( p = 0.717 ) ; there were no significant differences among these seven treatments on discontinuation due to relapse , intolerability , patient decision , or nonadherence ( all p values ≥ 0.260 ) . Extrapyramidal symptoms were more prominent in chlorpromazine and sulpiride treatment groups . Anticholinergic side effects were most common with clozapine and chlorpromazine . Weight gain was most common with olanzapine and clozapine . Conclusions The efficacy of seven antipsychotic medications for the maintenance treatment appeared similar in early-stage schizophrenia . With regard to the high dropout rate and side effects , special programs are needed to keep efficacy and safety of antipsychotics maintenance treatment for schizophrenia with early Introduction The initially postulated superior neurocognitive effectiveness of second-generation antipsychotics is currently under debate . Methods A prospect i ve , r and omized , open-label study was carried out to compare the long-term neurocognitive effectiveness of haloperidol , olanzapine , and risperidone in the first episode of schizophrenia spectrum disorders . A final sample of 79 patients r and omized to haloperidol ( N = 28 ) , olanzapine ( N = 23 ) , or risperidone ( N = 28 ) who completed clinical and cognitive evaluations at baseline and 3-year follow-up was included in the final analysis . Forty-one healthy individuals were also included in the final analysis . The main outcome measure was cognitive changes at 3-year follow-up . Due to the fact that some of the patients had switched their initially prescribed antipsychotic medication during the course of the study ( 6 out of 28 in haloperidol group , 18 out of 23 in olanzapine group , and 24 out of 28 in risperidone group continued with the initial study drug at 3-year assessment ) , we have also conducted a per protocol analysis . Results Overall , cognitive changes were similar in the three treatment groups and controls , although a greater improvement in Rey Auditory Verbal Learning Test , Digit Symbol , and Iowa Gambling Test was found in the treatment groups . The better performance observed on Rey Auditory Verbal Learning Test and Digit Symbol in olanzapine treatment group was likely explained by the lower prevalence of use of antimuscarinic drugs . These results were essentially similar to those found in the intention-to-treat analysis . Conclusions The major conclusion of this study is that haloperidol , olanzapine , and risperidone have not demonstrated substantial neurocognitive effectiveness , improving cognitive deficits present in the early phases of the illness . The study also underscores the importance of exploring new drugs for the treatment of cognitive impairments and associated functional disabilities in schizophrenia Purpose The aim of this study was to investigate the correlation between changes in symptoms and changes in self-reported quality of life among Chinese patients with schizophrenia who were switched from a typical antipsychotic to olanzapine during usual outpatient care . Patients and methods This post hoc analysis was conducted using data from the Chinese subgroup ( n=475 ) of a multicountry , 12-month , prospect i ve , noninterventional , observational study . The primary publication previously reported the efficacy , safety , and quality of life among patients who switched from a  typical antipsychotic to olanzapine . Patients with schizophrenia were included if their symptoms were inadequately controlled with a typical antipsychotic and they were switched to olanzapine .  Symptom severity was measured using the Brief Psychiatric Rating Scale ( BPRS ) and the Clinical Global Impressions-Severity scale ( CGI-S ) . Health-Related Quality of Life ( HRQOL ) was assessed using the World Health Organization Quality of Life – Abbreviated ( WHOQOL-BREF ) . Paired t-tests were performed to assess changes from baseline to endpoint . Pearson ’s correlation coefficients ( r ) were used to assess the correlations between change in symptoms ( BPRS and CGI-S scores ) and change in HRQOL ( WHOQOL-BREF scores ) . Results Symptoms and HRQOL both improved significantly over the 12 months of treatment ( P<0.001 ) . Significant correlations were observed between changes from baseline to end of study on the BPRS and the CGI-S and each of the WHOQOL-BREF four domain scores and two overall quality -of-life questions . The correlation coefficients ranged from r=−0.45 to r=−0.53 for the BPRS and WHOQOL-BREF . The correlation coefficients were slightly smaller between the CGI-S and WHOQOL-BREF , ranging from r=−0.33 to r=−0.40 . Conclusion For patients with schizophrenia , assessing quality of life has the potential to add valuable information to the clinical assessment that takes into account the patient ’s own perspective of well-being BACKGROUND In China and other middle-income countries , neuropsychiatric conditions are the most important cause of ill health in men and women , but efforts to scale up mental health services have been hampered by the absence of high- quality , country-specific data for the prevalence , treatment , and associated disability of different types of mental disorders . We therefore estimated these variables from a series of epidemiological studies that were done in four provinces in China . METHODS We used multistage stratified r and om sampling methods to identify 96 urban and 267 rural primary sampling sites in four provinces of China ; the sampling frame of 113 million individuals aged 18 years or older included 12 % of the adult population in China . 63 004 individuals , identified with simple r and om selection methods at the sampling sites , were screened with an exp and ed version of the General Health Question naire and 16,577 were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders by a psychiatrist . FINDINGS The adjusted 1-month prevalence of any mental disorder was 17.5 % ( 95 % CI 16.6 - 18.5 ) . The prevalence of mood disorders was 6.1 % ( 5.7 - 6.6 ) , anxiety disorders was 5.6 % ( 5.0 - 6.3 ) , substance abuse disorders was 5.9 % ( 5.3 - 6.5 ) , and psychotic disorders was 1.0 % ( 0.8 - 1.1 ) . Mood disorders and anxiety disorders were more prevalent in women than in men , and in individuals 40 years and older than in those younger than 40 years . Alcohol use disorders were 48 times more prevalent in men than in women . Rural residents were more likely to have depressive disorders and alcohol dependence than were urban residents . Among individuals with a diagnosable mental illness , 24 % were moderately or severely disabled by their illness , 8 % had ever sought professional help , and 5 % had ever seen a mental health professional . INTERPRETATION Substantial differences between our results and prevalence , disability , and treatment rate estimates used in the analysis of global burden of disease for China draw attention to the need for low-income and middle-income countries to do detailed , country-specific situation analyses before they scale up mental health services . FUNDING China Medical Board of New York , WHO , and Sh and ong Provincial Bureau of Health Improved drug therapy for schizophrenia may represent the best strategy for reducing the costs of schizophrenia and the recurrent chronic course of the disease . Olanzapine and risperidone are atypical antipsychotic agents developed to meet this need . We report a multicenter , double-blind , parallel , 30-week study design ed to compare the efficacy , safety , and associated re source use for olanzapine and risperidone in Australia and New Zeal and . The study sample consisted of 65 patients who met DSM-IV criteria for schizophrenia , schizoaffective disorder , or schizophreniform disorder .  Olanzapine-treated patients showed a significantly greater reduction in Positive and Negative Syndrome Scale ( PANSS ) total , Brief Psychiatric Rating Scale ( BPRS ) total , and PANSS General Psychopathology scores at endpoint compared to the risperidone-treated patients . Response rates through 30 weeks showed a significantly greater proportion of olanzapine-treated patients had achieved a 20 % or greater improvement in their PANSS total score compared to risperidone-treated patients . Olanzapine and risperidone were equivalent in their improvement of PANSS positive and negative scores and Clinical Global Impression-Severity of Illness scale ( CGI-S ) at endpoint . Using generic and disease-specific measures of quality of life , olanzapine-treated patients showed significant within-group improvement in most measures , and significant differences were observed in favor of olanzapine over risperidone in Quality of Life Scale ( QLS ) Intrapsychic Foundation and Medical Outcomes Study Short Form 36-item instrument ( SF-36 ) Role Functioning Limitations -Emotional subscale scores . Despite the relatively small sample size , our study suggests that olanzapine has a superior risk : benefit profile compared to risperidone OBJECTIVE Newer antipsychotic drugs have shown promise in ameliorating neurocognitive deficits in patients with schizophrenia , but few studies have compared newer antipsychotic drugs with both clozapine and conventional agents , particularly in patients who have had suboptimal response to prior treatments . METHOD The authors examined the effects of clozapine , olanzapine , risperidone , and haloperidol on 16 measures of neurocognitive functioning in a double-blind , 14-week trial involving 101 patients . A global score was computed along with scores in four neurocognitive domains : memory , attention , motor function , and general executive and perceptual organization . RESULTS Global neurocognitive function improved with olanzapine and risperidone treatment , and these improvements were superior to those seen with haloperidol . Patients treated with olanzapine exhibited improvement in the general and attention domains but not more than that observed with other treatments . Patients treated with risperidone exhibited improvement in memory that was superior to that of both clozapine and haloperidol . Clozapine yielded improvement in motor function but not more than in other groups . Average effect sizes for change were in the small to medium range . More than half of the patients treated with olanzapine and risperidone experienced " clinical ly significant " improvement ( changes in score of at least one-half st and ard deviation relative to baseline ) . These findings did not appear to be mediated by changes in symptoms , side effects , or blood levels of medications . CONCLUSIONS Patients with a history of suboptimal response to conventional treatments may show cognitive benefits from newer antipsychotic drugs , and there may be differences between atypical antipsychotic drugs in their patterns of cognitive effects OBJECTIVE The authors sought to compare the effects of olanzapine , quetiapine , and risperidone on neurocognitive function in patients with early psychosis . METHOD In a 52-week double-blind , multicenter study , 400 patients early in the course of psychotic illness ( < 5 years ) were r and omly assigned to treatment with olanzapine ( 2.5 - 20 mg/day ) , quetiapine ( 100 - 800 mg/day ) , or risperidone ( 0.5 - 4 mg/day ) . The mean modal daily dose was 11.7 mg ( SD=5.3 ) for olanzapine , 506 mg ( SD=215 ) for quetiapine , and 2.4 mg ( SD=1.0 ) for risperidone . A total of 224 patients completed neurocognitive assessment s at baseline and at 12 weeks , and 81 patients also completed them at 52 weeks . Neurocognitive composite scores were calculated from the neurocognitive battery used in the Clinical Antipsychotic Trials of Intervention Effectiveness ( CATIE ) and from the Brief Assessment of Cognition in Schizophrenia . RESULTS At week 12 , there was significant improvement in neurocognition for each treatment ( p<0.01 ) , but no significant overall difference between treatments . Composite z score improvements on the CATIE neurocognitive battery were 0.17 for olanzapine , 0.33 for quetiapine , and 0.32 for risperidone .  Composite z score improvements on the Brief Assessment of Cognition in Schizophrenia were 0.19 for olanzapine , 0.34 for quetiapine , and 0.22 for risperidone . Statistically significant relationships between improvements in neurocognition and functional outcome were observed at weeks 12 and  
    Output:
    
agent
Findings related to effectiveness ( treatment discontinuation , quality of life , and neurocognitive improvements ) were generally consistent with those observed in non-Chinese population s. No new safety signals specific for Chinese population s were raised for olanzapine .
Chinese and non-Chinese population s with schizophrenia or bipolar disorder treated with olanzapine display broadly similar responses .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Rationale The relative effectiveness of the atypical antipsychotic drugs and conventional agents in patients with early-stage schizophrenia has not been comprehensively determined . Objectives The aim of our study was to evaluate the efficacy and safety of seven antipsychotic drugs for the maintenance treatment in patients with early-stage schizophrenia . Methods In a 12-month open-label , prospect i ve observational , multicenter study , 1,133 subjects with schizophrenia or schizophreniform disorder within 5 years of onset were monotherapy with chlorpromazine , sulpiride , clozapine , risperidone , olanzapine , quetiapine , or aripiprazole . The primary measure was the rate of treatment discontinuation for any reason . Secondary outcomes included measures for clinical and functional outcomes and tolerability . Results The percentage of patients discontinued treatment within 12 months was 41.4 % for chlorpromazine , 39.5 % for sulpiride , 36.7 % for clozapine , 40.2 % for risperidone , 39.6 % for olanzapine , 46.9 % for quetiapine , and 40.2 % for aripiprazole , a nonsignificant difference ( p = 0.717 ) ; there were no significant differences among these seven treatments on discontinuation due to relapse , intolerability , patient decision , or nonadherence ( all p values ≥ 0.260 ) . Extrapyramidal symptoms were more prominent in chlorpromazine and sulpiride treatment groups . Anticholinergic side effects were most common with clozapine and chlorpromazine . Weight gain was most common with olanzapine and clozapine . Conclusions The efficacy of seven antipsychotic medications for the maintenance treatment appeared similar in early-stage schizophrenia . With regard to the high dropout rate and side effects , special programs are needed to keep efficacy and safety of antipsychotics maintenance treatment for schizophrenia with early Introduction The initially postulated superior neurocognitive effectiveness of second-generation antipsychotics is currently under debate . Methods A prospect i ve , r and omized , open-label study was carried out to compare the long-term neurocognitive effectiveness of haloperidol , olanzapine , and risperidone in the first episode of schizophrenia spectrum disorders . A final sample of 79 patients r and omized to haloperidol ( N = 28 ) , olanzapine ( N = 23 ) , or risperidone ( N = 28 ) who completed clinical and cognitive evaluations at baseline and 3-year follow-up was included in the final analysis . Forty-one healthy individuals were also included in the final analysis . The main outcome measure was cognitive changes at 3-year follow-up . Due to the fact that some of the patients had switched their initially prescribed antipsychotic medication during the course of the study ( 6 out of 28 in haloperidol group , 18 out of 23 in olanzapine group , and 24 out of 28 in risperidone group continued with the initial study drug at 3-year assessment ) , we have also conducted a per protocol analysis . Results Overall , cognitive changes were similar in the three treatment groups and controls , although a greater improvement in Rey Auditory Verbal Learning Test , Digit Symbol , and Iowa Gambling Test was found in the treatment groups . The better performance observed on Rey Auditory Verbal Learning Test and Digit Symbol in olanzapine treatment group was likely explained by the lower prevalence of use of antimuscarinic drugs . These results were essentially similar to those found in the intention-to-treat analysis . Conclusions The major conclusion of this study is that haloperidol , olanzapine , and risperidone have not demonstrated substantial neurocognitive effectiveness , improving cognitive deficits present in the early phases of the illness . The study also underscores the importance of exploring new drugs for the treatment of cognitive impairments and associated functional disabilities in schizophrenia Purpose The aim of this study was to investigate the correlation between changes in symptoms and changes in self-reported quality of life among Chinese patients with schizophrenia who were switched from a typical antipsychotic to olanzapine during usual outpatient care . Patients and methods This post hoc analysis was conducted using data from the Chinese subgroup ( n=475 ) of a multicountry , 12-month , prospect i ve , noninterventional , observational study . The primary publication previously reported the efficacy , safety , and quality of life among patients who switched from a  typical antipsychotic to olanzapine . Patients with schizophrenia were included if their symptoms were inadequately controlled with a typical antipsychotic and they were switched to olanzapine .  Symptom severity was measured using the Brief Psychiatric Rating Scale ( BPRS ) and the Clinical Global Impressions-Severity scale ( CGI-S ) . Health-Related Quality of Life ( HRQOL ) was assessed using the World Health Organization Quality of Life – Abbreviated ( WHOQOL-BREF ) . Paired t-tests were performed to assess changes from baseline to endpoint . Pearson ’s correlation coefficients ( r ) were used to assess the correlations between change in symptoms ( BPRS and CGI-S scores ) and change in HRQOL ( WHOQOL-BREF scores ) . Results Symptoms and HRQOL both improved significantly over the 12 months of treatment ( P<0.001 ) . Significant correlations were observed between changes from baseline to end of study on the BPRS and the CGI-S and each of the WHOQOL-BREF four domain scores and two overall quality -of-life questions . The correlation coefficients ranged from r=−0.45 to r=−0.53 for the BPRS and WHOQOL-BREF . The correlation coefficients were slightly smaller between the CGI-S and WHOQOL-BREF , ranging from r=−0.33 to r=−0.40 . Conclusion For patients with schizophrenia , assessing quality of life has the potential to add valuable information to the clinical assessment that takes into account the patient ’s own perspective of well-being BACKGROUND In China and other middle-income countries , neuropsychiatric conditions are the most important cause of ill health in men and women , but efforts to scale up mental health services have been hampered by the absence of high- quality , country-specific data for the prevalence , treatment , and associated disability of different types of mental disorders . We therefore estimated these variables from a series of epidemiological studies that were done in four provinces in China . METHODS We used multistage stratified r and om sampling methods to identify 96 urban and 267 rural primary sampling sites in four provinces of China ; the sampling frame of 113 million individuals aged 18 years or older included 12 % of the adult population in China . 63 004 individuals , identified with simple r and om selection methods at the sampling sites , were screened with an exp and ed version of the General Health Question naire and 16,577 were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders by a psychiatrist . FINDINGS The adjusted 1-month prevalence of any mental disorder was 17.5 % ( 95 % CI 16.6 - 18.5 ) . The prevalence of mood disorders was 6.1 % ( 5.7 - 6.6 ) , anxiety disorders was 5.6 % ( 5.0 - 6.3 ) , substance abuse disorders was 5.9 % ( 5.3 - 6.5 ) , and psychotic disorders was 1.0 % ( 0.8 - 1.1 ) . Mood disorders and anxiety disorders were more prevalent in women than in men , and in individuals 40 years and older than in those younger than 40 years . Alcohol use disorders were 48 times more prevalent in men than in women . Rural residents were more likely to have depressive disorders and alcohol dependence than were urban residents . Among individuals with a diagnosable mental illness , 24 % were moderately or severely disabled by their illness , 8 % had ever sought professional help , and 5 % had ever seen a mental health professional . INTERPRETATION Substantial differences between our results and prevalence , disability , and treatment rate estimates used in the analysis of global burden of disease for China draw attention to the need for low-income and middle-income countries to do detailed , country-specific situation analyses before they scale up mental health services . FUNDING China Medical Board of New York , WHO , and Sh and ong Provincial Bureau of Health Improved drug therapy for schizophrenia may represent the best strategy for reducing the costs of schizophrenia and the recurrent chronic course of the disease . Olanzapine and risperidone are atypical antipsychotic agents developed to meet this need . We report a multicenter , double-blind , parallel , 30-week study design ed to compare the efficacy , safety , and associated re source use for olanzapine and risperidone in Australia and New Zeal and . The study sample consisted of 65 patients who met DSM-IV criteria for schizophrenia , schizoaffective disorder , or schizophreniform disorder .  Olanzapine-treated patients showed a significantly greater reduction in Positive and Negative Syndrome Scale ( PANSS ) total , Brief Psychiatric Rating Scale ( BPRS ) total , and PANSS General Psychopathology scores at endpoint compared to the risperidone-treated patients . Response rates through 30 weeks showed a significantly greater proportion of olanzapine-treated patients had achieved a 20 % or greater improvement in their PANSS total score compared to risperidone-treated patients . Olanzapine and risperidone were equivalent in their improvement of PANSS positive and negative scores and Clinical Global Impression-Severity of Illness scale ( CGI-S ) at endpoint . Using generic and disease-specific measures of quality of life , olanzapine-treated patients showed significant within-group improvement in most measures , and significant differences were observed in favor of olanzapine over risperidone in Quality of Life Scale ( QLS ) Intrapsychic Foundation and Medical Outcomes Study Short Form 36-item instrument ( SF-36 ) Role Functioning Limitations -Emotional subscale scores . Despite the relatively small sample size , our study suggests that olanzapine has a superior risk : benefit profile compared to risperidone OBJECTIVE Newer antipsychotic drugs have shown promise in ameliorating neurocognitive deficits in patients with schizophrenia , but few studies have compared newer antipsychotic drugs with both clozapine and conventional agents , particularly in patients who have had suboptimal response to prior treatments . METHOD The authors examined the effects of clozapine , olanzapine , risperidone , and haloperidol on 16 measures of neurocognitive functioning in a double-blind , 14-week trial involving 101 patients . A global score was computed along with scores in four neurocognitive domains : memory , attention , motor function , and general executive and perceptual organization . RESULTS Global neurocognitive function improved with olanzapine and risperidone treatment , and these improvements were superior to those seen with haloperidol . Patients treated with olanzapine exhibited improvement in the general and attention domains but not more than that observed with other treatments . Patients treated with risperidone exhibited improvement in memory that was superior to that of both clozapine and haloperidol . Clozapine yielded improvement in motor function but not more than in other groups . Average effect sizes for change were in the small to medium range . More than half of the patients treated with olanzapine and risperidone experienced " clinical ly significant " improvement ( changes in score of at least one-half st and ard deviation relative to baseline ) . These findings did not appear to be mediated by changes in symptoms , side effects , or blood levels of medications . CONCLUSIONS Patients with a history of suboptimal response to conventional treatments may show cognitive benefits from newer antipsychotic drugs , and there may be differences between atypical antipsychotic drugs in their patterns of cognitive effects OBJECTIVE The authors sought to compare the effects of olanzapine , quetiapine , and risperidone on neurocognitive function in patients with early psychosis . METHOD In a 52-week double-blind , multicenter study , 400 patients early in the course of psychotic illness ( < 5 years ) were r and omly assigned to treatment with olanzapine ( 2.5 - 20 mg/day ) , quetiapine ( 100 - 800 mg/day ) , or risperidone ( 0.5 - 4 mg/day ) . The mean modal daily dose was 11.7 mg ( SD=5.3 ) for olanzapine , 506 mg ( SD=215 ) for quetiapine , and 2.4 mg ( SD=1.0 ) for risperidone . A total of 224 patients completed neurocognitive assessment s at baseline and at 12 weeks , and 81 patients also completed them at 52 weeks . Neurocognitive composite scores were calculated from the neurocognitive battery used in the Clinical Antipsychotic Trials of Intervention Effectiveness ( CATIE ) and from the Brief Assessment of Cognition in Schizophrenia . RESULTS At week 12 , there was significant improvement in neurocognition for each treatment ( p<0.01 ) , but no significant overall difference between treatments . Composite z score improvements on the CATIE neurocognitive battery were 0.17 for olanzapine , 0.33 for quetiapine , and 0.32 for risperidone .  Composite z score improvements on the Brief Assessment of Cognition in Schizophrenia were 0.19 for olanzapine , 0.34 for quetiapine , and 0.22 for risperidone . Statistically significant relationships between improvements in neurocognition and functional outcome were observed at weeks 12 and  
    Output:
    