Reviewer's report
Title:Prevalence and severity of antipsychotic related constipation in patients
with schizophrenia: a retrospective descriptive study.
Version: 1Date:18 December 2010
Reviewer: Takefumi Suzuki
Reviewer's report:
Review of “Prevalence and severity of antipsychotic related constipation in
patients with schizophrenia: a retrospective descriptive study.” by Drs. Marc De
Hert et al.
Constipation in patients with schizophrenia frequently associated with
antipsychotic (and anticholinergic) medications is a potentially serious problem
although it has not gained adequate attention in the literature. The authors
examined 273 patients with schizophrenia to investigate prevalence of
constipation, to find that 36.3% needed a pharmacological intervention to
counteract the problem. The topic is certainly relevant in clinical practice but
retrospective nature of the study is an obvious limitation (as acknowledged by the
authors) and the following issues warrant a serious consideration.
Please indicate the actual ingredients (or medically universal names) of each
bowel medication (instead of showing the market names such as Movicol).
If available, the dose of anticholinergic agents may appear in Results. Also, in
supplementary Table 1, it is informative to describe the dosage of each
antipsychotic if data are available.
A failure to examine outpatient population would be regarded a limitation. This is
because inpatients are more likely treated with higher dose of antipsychotics
(and possibly anticholinergics) than outpatients, which may render the former
population more susceptible to intestinal motility problems.
Differences among antipsychotics in liability to cause constipation may be briefly
noted in Discussion (possibly in relation with anticholinergic properties).
In discussion, “In our study with a younger population of patients with
schizophrenia constipation rates were higher than in general population
samples.” This needs appropriate citation.
“The true prevalence in patient samples may be even higher since we only
obtained data on patients who were either referred to the somatic department or
who received treatment for constipation.” This appears contradictory to “There
were no other in–(inclusion) or exclusion criteria.” in Method.
Potential problems associated with long-term use of bowel preparations may be
briefly commented on in Discussion, since the authors found that constipation is
frequently a chronic issue in this population.
Finally, it would be important to comment on a possibility that antipsychotic dose
reduction can be a useful strategy where at all appropriate (Suzuki et al., J Clin
Pharm Ther 2007;32(5):525-7).
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Reviewer's report
Title:Prevalence and severity of antipsychotic related constipation in patients
with schizophrenia: a retrospective descriptive study.
Version: 1Date:18 December 2010
Reviewer: Takefumi Suzuki
Reviewer's report:
Review of “Prevalence and severity of antipsychotic related constipation in
patients with schizophrenia: a retrospective descriptive study.” by Drs. Marc De
Hert et al.
Constipation in patients with schizophrenia frequently associated with
antipsychotic (and anticholinergic) medications is a potentially serious problem
although it has not gained adequate attention in the literature. The authors
examined 273 patients with schizophrenia to investigate prevalence of
constipation, to find that 36.3% needed a pharmacological intervention to
counteract the problem. The topic is certainly relevant in clinical practice but
retrospective nature of the study is an obvious limitation (as acknowledged by the
authors) and the following issues warrant a serious consideration.
Please indicate the actual ingredients (or medically universal names) of each
bowel medication (instead of showing the market names such as Movicol).
If available, the dose of anticholinergic agents may appear in Results. Also, in
supplementary Table 1, it is informative to describe the dosage of each
antipsychotic if data are available.
A failure to examine outpatient population would be regarded a limitation. This is
because inpatients are more likely treated with higher dose of antipsychotics
(and possibly anticholinergics) than outpatients, which may render the former
population more susceptible to intestinal motility problems.
Differences among antipsychotics in liability to cause constipation may be briefly
noted in Discussion (possibly in relation with anticholinergic properties).
In discussion, “In our study with a younger population of patients with
schizophrenia constipation rates were higher than in general population
samples.” This needs appropriate citation.
“The true prevalence in patient samples may be even higher since we only
obtained data on patients who were either referred to the somatic department or
who received treatment for constipation.” This appears contradictory to “There
were no other in–(inclusion) or exclusion criteria.” in Method.
Potential problems associated with long-term use of bowel preparations may be
briefly commented on in Discussion, since the authors found that constipation is
frequently a chronic issue in this population.
Finally, it would be important to comment on a possibility that antipsychotic dose
reduction can be a useful strategy where at all appropriate (Suzuki et al., J Clin
Pharm Ther 2007;32(5):525-7).
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Please review this paper.
user
Reviewer's report
Title:Prevalence and severity of antipsychotic related constipation in patients
with schizophrenia: a retrospective descriptive study.
Version: 1Date:18 December 2010
Reviewer: Takefumi Suzuki
Reviewer's report:
Review of “Prevalence and severity of antipsychotic related constipation in
patients with schizophrenia: a retrospective descriptive study.” by Drs. Marc De
Hert et al.
Constipation in patients with schizophrenia frequently associated with
antipsychotic (and anticholinergic) medications is a potentially serious problem
although it has not gained adequate attention in the literature. The authors
examined 273 patients with schizophrenia to investigate prevalence of
constipation, to find that 36.3% needed a pharmacological intervention to
counteract the problem. The topic is certainly relevant in clinical practice but
retrospective nature of the study is an obvious limitation (as acknowledged by the
authors) and the following issues warrant a serious consideration.
Please indicate the actual ingredients (or medically universal names) of each
bowel medication (instead of showing the market names such as Movicol).
If available, the dose of anticholinergic agents may appear in Results. Also, in
supplementary Table 1, it is informative to describe the dosage of each
antipsychotic if data are available.
A failure to examine outpatient population would be regarded a limitation. This is
because inpatients are more likely treated with higher dose of antipsychotics
(and possibly anticholinergics) than outpatients, which may render the former
population more susceptible to intestinal motility problems.
Differences among antipsychotics in liability to cause constipation may be briefly
noted in Discussion (possibly in relation with anticholinergic properties).
In discussion, “In our study with a younger population of patients with
schizophrenia constipation rates were higher than in general population
samples.” This needs appropriate citation.
“The true prevalence in patient samples may be even higher since we only
obtained data on patients who were either referred to the somatic department or
who received treatment for constipation.” This appears contradictory to “There
were no other in–(inclusion) or exclusion criteria.” in Method.
Potential problems associated with long-term use of bowel preparations may be
briefly commented on in Discussion, since the authors found that constipation is
frequently a chronic issue in this population.
Finally, it would be important to comment on a possibility that antipsychotic dose
reduction can be a useful strategy where at all appropriate (Suzuki et al., J Clin
Pharm Ther 2007;32(5):525-7).
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
assistant