Schizophrenia – Treatment Principles

In most patients the formal onset of Schizophrenia is preceded by a period of symptoms, known as the prodromal period.^{[Lieberman et al., 2001]} Symptoms in this stage can include mood disturbances and cognitive symptoms.^{[Lieberman et al., 2001; McGlashan, 1996]} Treatment w…

In most patients, the formal onset of schizophrenia is preceded by a period of symptoms, known as the prodromal period.^{[Lieberman et al., 2001]} Symptoms in this stage can include mood disturbances and cognitive symptoms, as well as positive symptoms.^{[Lieberman et al., 200…}

Key message: Treatment outcomes can be optimised for an individual by skilful utilisation and coordination of pharmacological, psychosocial, and educational resources.

Background

A clinically effective treatment is characterised by:^{[Tandon et al., 2006]}

• long-term reducti…

Key message: Psychosocial interventions should be tailored to the carefully assessed goals, needs, abilities, and circumstances of individuals rather than assuming a ‘one size fits all’ approach.

Background

• Psychosocial interventions work synergistically with medication …

The slide summarises the main phases of schizophrenia, and the frequency of patients transitioning between phases based on a wide-ranging literature review.^{[Carbon & Correll, 2014]} After reviewing the literature, the authors conclude that a key problem in understanding th…

According to the American Psychiatric Association guidelines on the treatment of schizophrenia, the goals of treatment are adapted to the stage of the illness.^{[Lehman et al., 2010]}

Acute phase
The goals of treatment during the acute phase of a psychotic exacerbation are …

Because schizophrenia is a chronic illness that influences virtually all aspects of life of the affected persons, treatment planning has three goals:^{[Lehman et al., 2010]}

1. reduce or eliminate symptoms
2. maximise quality of life and adaptive functioning
3. promote and maintain …

As shown on the slide, there are many functional consequences of relapse, including long-term disability, an increased risk of suicide, decline in cognitive function, and decreased quality of life.^{[Ascher-Svanum et al., 2010; Birchwood et al., 2000; Briggs et al., 2008; L…}

A systematic review and meta-analysis, published in 2012, identified 116 reports from 65 trials of antipsychotic therapy in patients with schizophrenia.^{[Leucht et al., 2012]} This information amounted to data for 6,493 patients.^{[Leucht et al., 2012]} The results demonstrate…

Key message: Continuous maintenance treatment is more effective than targeted intermittent treatment in preventing relapse.

Background

This randomised controlled trial investigated the impact of continuous maintenance treatment versus targeted intermittent treatment afte…

Key message: Some patients with schizophrenia may achieve recovery with effective treatment. Social functioning, medication adherence, and type of antipsychotic, are important predictors of recovery.

Background

In a 3-year observational study of adults with schizophrenia …