Antipsychotics, brain morphology and duration of untreated illness in schizophrenia
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1 Antipsychotics, brain morphology and duration of untreated illness in schizophrenia Antipsychotica, hersenmorfologie en de onbehandelde ziekteduur bij schizofrenie Geartsje Boonstra
2 ISBN Printed by: Proefschriftmaken.nl Printyourthesis.com Published by: Uitgeverij BOXPress, Oisterwijk
3 Antipsychotics, brain morphology and duration of untreated illness in schizophrenia Antipsychotica, hersenmorfologie en de onbehandelde ziekteduur bij schizofrenie (met een samenvatting in het Nederlands) Proefschrift ter verkrijging van de graad van doctor aan de Universiteit Utrecht op gezag van de rector magnificus, prof. dr. G.J. van der Zwaan, ingevolge het besluit van het college voor promoties in het openbaar te verdedigen op dinsdag 12 april 2011 des ochtends te uur door Geartsje Boonstra geboren op 28 december 1973 te Amersfoort
4 Promotoren: Prof. dr. R.S. Kahn Prof. dr. D.E. Grobbee Co-promotoren: Dr. H. Burger Dr. N.E.M. van Haren
5 Opgedragen aan Mijn moeder Leni en mijn vader Jan Tante Annie
6 Ik weet niet hoe ik beginnen moet, zei hij. De eekhoorn leunde achterover in zijn stoel en keek de kraai ernstig aan. De kraai zag er somber uit. Zijn veren waren dof en verfomfaaid en er was weinig glans in zijn ogen. Dat geeft niet, zei de eekhoorn vriendelijk. Begin anders maar middenin. Nou ja, zei de kraai, als er een blaadje van de boom valt denk ik dat het op mij wil vallen, en ik denk dat ze me willen storen als ik slaap, want ik word telkens wakker en dan hoor ik een gebonk en gesuis. Vlak bij mijn oor! Ik heb zoveel argwaan, eekhoorn! De eekhoorn legde zijn vingertoppen tegen elkaar en deed alsof hij de kraai goed begreep. Argwaan, dacht hij, wat is argwaan? Zou het een soort soep zijn? Het klinkt als een zwart soort soep met hompen van het een of ander erin... (Toon Tellegen; Misschien wisten zij alles) 6
7 Table of contents Chapter 1. Introduction 9 Chapter 2. Antipsychotic prophylaxis is needed after remission from a first psychotic episode in schizophrenia patients: results from an aborted randomised trial and mini meta-analysis. 25 Chapter 3. Chapter 4. Brain volume changes after withdrawal of atypical antipsychotics in first-episode schizophrenia patients 43 Resolution of side-effects after discontinuation with antipsychotic treatment. A small observational study. 67 Chapter 5. Duration of untreated illness in schizophrenia is not associated with 5-year brain volume change 81 Chapter 6. Initiation of antipsychotic treatment by general practitioners. A case-control study. 103 Chapter 7. General discussion 119 Hoofdstuk 8. Nederlandse samenvatting 135 Dankwoord 153 Publication List 161 Curriculum Vitae 165 7
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9 Publication list
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11 Publication list 1. Boonstra G., Burger H., Grobbee D.E. et al. Poster (and abstract) at the XIIIth Biennial Winter Workshop on Schizophrenia Research, Davos, Switzerland, February 4-10, Antipsychotic prophylaxis is needed after remission from a first psychotic episode in schizophrenia patients: results from a randomized trial. Schizophr Res 2006;81 Suppl: Boonstra G., Hulshoff Pol H.E., van Haren N.E.M. et al. Poster (and abstract) at the International Congress on Schizophrenia Research 28 March-1 April 2007, Colorado Springs. Does brain volume change after withdrawal of antipsychotic medication in first-episode schizophrenia? Schizophrenia Bulletin 2007;33(2): Boonstra G., Hak E., Burger H. et al. [Poster (and abstract) at the 35th Congress of the Netherlands Society of Psychiatry, April 2007, Maastricht. Het starten van behandeling met antipsychotica door de huisarts. Een patiënt-controleonderzoek.] Starting antipsychotic treatment in general practice. A case control study. Tijdschr Psychiatr 2007;49(Suppl 1): Boonstra G., Burger H., Grobbee D.E. et al. Antipsychotic prophylaxis is needed after remission from a first psychotic episode in schizophrenia patients: Results from an aborted randomised trial. International Journal of Psychiatry in Clinical Practice 2010;E-Pub online publication: Boonstra G., van Haren N.E.M., Schnack H.G. et al. Poster (and abstract) at the 2nd Biennial Schizophrenia International Research Conference, Florence, Italy, April Brain volume changes after withdrawal of atypical antipsychotics in first-episode schizophrenia patients. Schizophr Res 2010;117(2-3): Boonstra G., Grobbee D.E., Hak E. et al. Initiation of antipsychotic treatment by general practitioners. A case-control study. J Eval Clin Pract 2011;17(1):
12
13 Curriculum Vitae
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15 Curriculum Vitae Geartsje Boonstra was born on December 28th, 1973 in Amersfoort, the Netherlands. In 1986 she started secondary school at the Bogerman College in Sneek, the Netherlands and finished her secondary school in 1992, by graduating at the Alkwin Kollege in Uithoorn, the Netherlands. She studied Medicine at Leiden University, the Netherlands. In 1996 she performed epidemiological research in Bolgatanga, Ghana with the Department of Parasitology under supervision of dr. A. M. Polderman. She did her internship Neurology in Edinburgh at the Western General Hospital, Scotland. In 1999 she obtained the title of Medical Doctor. She worked in the Groene Hart Ziekenhuis in Gouda as a resident Internal Medicine and subsequently as a resident Pediatrics at the Maaslandziekenhuis in Sittard, the Netherlands. She began a PhD program in Neurosciences and a specialisation in Psychiatry in 2001 at the University Medical Centre Utrecht under the supervision of Prof. dr. R. S. Kahn. For the PhD program she was also supervised by Prof. Dr. D.E. Grobbee. She finished a Master of Science in Clinical Epidemiology in 2005 at the Erasmus University in Rotterdam. She finished her specialisation in Psychiatry on the 1 st of March She currently works as teampsychiatrist at Altrecht GGZ in an Assertive Community Treatment team in Utrecht, the Netherlands. Geartsje Boonstra is geboren op 28 december 1973 te Amersfoort. Ze deed 4 jaar gymnasium aan het Bogerman Collega in Sneek en behaalde in 1992 haar V.W.O. diploma aan het Alkwin Kollege te Uithoorn. Ze studeerde Geneeskunde aan de Universiteit Leiden en behaalde in 1999 haar artsexamen. Tijdens de doctoraal fase van haar studie deed ze epidemiologisch en parasitologisch onderzoek in Bolgatanga, Ghana onder supervisie van dr. A. M. Polderman. Ze deed haar co-schap neurologie in Edinburgh, in het Western General Hospital. Ze werkte na haar artsexamen als basisarts bij de Interne Geneeskunde in het Groene Hart Ziekenhuis te Gouda en bij de Kindergeneeskunde in het Maaslandziekenhuis te Sittard. Ze startte met haar promotieonderzoek en specialisatie tot psychiater in 2001 aan de Universiteit Utrecht onder supervisie van Prof. Dr. R. S. Kahn en voor de promotie tevens Prof. Dr. D.E. Grobbee. Ze verkreeg de titel Master of Science in de Klinische Epidemiologie in 2005 aan de Erasmus Universiteit te Rotterdam. Ze rondde haar specialisatie tot psychiater met succes af op 1 maart Op dit moment werkt ze als teampsychiater bij Altrecht GGZ bij een Assertive Community Treatment team in Utrecht stad. 167
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