Zhang 2010.
| Methods | Allocation: randomised. Blindness: no further information. Duration: 8 weeks. Setting: not stated. |
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| Participants | Diagnosis: Schizophrenia CCMD‐3. N = 65 (or 66). Age: aripiprazole 64.6 ± 1.8; perphenazine 62.5 ± 3.1 years. Sex: F34, M32 (aripiprazole M16, F17; perphenazine M16, F17) History: length of illness ‐ aripiprazole 0.5 ± 1.1; perphenazine 0.8 ± 1.2 years. Included: schizophrenia CCMD‐3; age > 60, no history of taking antipsychotic drugs; BPRS > 35. Exclusion: severe physical disease; drug abuse. Consent: not stated. |
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| Interventions | 1. Perphenazine: start dose 2‐4 mg/day, maximum dose 16 mg/day, average 11.2 ± 3.8mg/day, n = 33. 2. Aripiprazole: 5 mg tablet, start dose 5 mg/day maximum dose 30 mg/ day, average 23.5 ± 1.7mg/day, n = 32. | |
| Outcomes | Mental state: PANSS. Clinical effect: decreased rate of BPRS score ≥ 75%‐‐recovery; ≥ 50% markedly improved; ≥ 25% improved; < 25% no effect (measured at 1, 2 ,4 ,6, 8 weeks before and after treatment) BPRS. TESS (skew). |
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| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Randomised – no further details. |
| Allocation concealment (selection bias) | Unclear risk | No details. |
| Blinding (performance bias and detection bias) All outcomes | Unclear risk | No further details. |
| Incomplete outcome data (attrition bias) All outcomes | High risk | One participant not included in results nor accounted for. |
| Selective reporting (reporting bias) | High risk | Not all adverse events reported by group – unable to include some missing group data. No data reported using BPRS or TESS scales. |
| Other bias | Unclear risk | No details as to funding or who administered rating scales. |
General abbreviations: CNS – central nervous system ECG ‐ electrocardiogram IQ ‐ intelligence quotient ITT ‐ intention to treat LOCF – Last Observation Carried Forward mg ‐ milligram N = number of participants SD ‐ standard deviation SGOT ‐ serum glutamic oxaloacetic transaminase SGPT ‐ serum glutamic‐pyruvic transaminase t.i.d. ‐ three times daily (Latin: ter in die)
Diagnostic tools: CCMD‐2‐R – Chinese Classification of Mental Disorders, Second Edition, Revised CCMD‐3 – Chinese Classification of Mental Disorders, Third Edition DSM‐III‐R ‐ Diagnostic and Statistical Manual of Mental disorders, Third edition, Revised DSM‐IV – Diagnostic and Statistical Manual, Fourth Edition ICD‐9 ‐ International Classification of Diseases, ninth revision RDC – Research Diagnostic Criteria
Global effect scales: GCJ ‐ Global comparative judgement CGI ‐ Clinical Global Impression CGI‐I – Clinical Global Impression ‐ Improvement CGI‐S –Clinical Global Impression ‐ Severity GIR ‐ General Improvement Rating PGI ‐ Patient Global Impression
Mental state scales: AMDP, AMP ‐ Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie BPRS ‐ Brief Psychiatric Rating Scale CEPS ‐ Clinical Estimate of Psychiatric Rating Scale CPRS ‐ Comprehensive Psychopathological Rating Scale IMPS ‐ Inpatient Multidimensional Psychiatric Scale MMPI ‐ Minnesota Multiphase Personality Inventory MSRPP ‐ Multidimensional Scale for Rating Psychiatric Patients PANSS ‐ Positive and Negative Syndrome Scale for Schizophrenia PES ‐ Psychiatric Evaluating Scale
Behaviour scales: MACC ‐ Behavioural Adjustment Scale NOSIE ‐ Nurses Obsrevation Scale for Inpatient Evaluation PRP ‐ Psychotic Reaction Profile
Side effect scales: AIMS ‐ Abnormal Involuntary Movement Scale BAS ‐ Barnes Akathisia Scale EPS – Extrapyramidal Symptoms ESRS ‐ Extrapyramidal Symptoms Rating Scale SAS ‐ Simpson and Angus Scale TESS –Treatment Emergent Symptom Severity UKU ‐ Side Effect Rating Scale
Quality of life scales: QoL – Quality of Life Scale QLS ‐ Quality of Life Scale