Murtada Alsaif reports on a nationwide Swedish cohort study that explores the real-world effectiveness of oral and depot antipsychotics for schizophrenia.
Schizophrenia is a complex, heterogeneous disorder, with highly variable treatment outcomes, and relatively little is known about what is important to patients. The aim of the study was to understand treatment outcomes informal carers perceive to be important to people with schizophrenia.
The Normalisation Process Theory (NPT) has been used to understand the implementation of physical health care interventions. The current study aims to apply the NPT model to a secondary mental health context, and test the model using exploratory factor analysis. This study will consider the implementation of a brief cognitive behaviour therapy for psychosis (CBTp) intervention.
Auditory Hallucinations may arise from people confusing their own inner speech with external spoken speech. People with visual hallucinations (VH) may similarly confuse vivid mental imagery with external events. This paper reports two experiments exploring confusion between internal and external visual material. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
This study aimed to determine whether the rate of clozapine use, an indicator of refractoriness in schizophrenia, is associated with the season of birth and age at onset in patients with schizophrenia based on nationwide data. To read the full article, log in using your SSSFT NHS OpenAthens details.
Despite clinical guidelines recommendations, many relatives of people with psychosis or bipolar disorder do not currently receive the support they need. Online information and support may offer a solution.
Open Access Article
Open access. Cannabis use following the onset of first-episode psychosis has been linked to both increased risk of relapse and non-adherence with antipsychotic medication. Whether poor outcome associated with cannabis use is mediated through an adverse effect of cannabis on medication adherence is unclear.
Comment. In The Lancet Psychiatry, Schoeler and colleagues present a study1 describing the mediating effect of medication adherence on the association between continued cannabis use and relapse risk in patients with first-episode psychosis. They have previously reported a relapse rate of 36% in this patient group over a 2-year period.2 Acknowledging the potential risk of psychosis relapse related to the high proportion of patients continuing cannabis use after the onset of psychosis, the current study1 investigates the same patient group consisting of 245 patients, obtaining retrospective data on active cannabis use and medication adherence shortly after illness onset, as well as risk of relapse at 2-year follow-up. The authors find that relapse of psychosis associated with continued cannabis use is partly mediated through non-adherence to prescribed antipsychotic medication. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Our primary objective was to identify cognitive behavioural therapy (CBT) delivery for people with psychosis (CBTp) using an automated method in a large electronic health record database. We also examined what proportion of service users with a diagnosis of psychosis were recorded as having received CBTp within their episode of care.
Open Access Article
Novel treatment strategies for cognitive dysfunctions may prevent long-term disability in patients with schizophrenia, and polyphenolic compounds might be a promising strategy. Bergamot (Citrus bergamia), a citrus fruit characterized by a high amount of flavonoids and flavonoid glycosides, may represent a potential nutraceutical approach to cognitive dysfunction. The present study was aimed to explore the efficacy of bergamot polyphenolic fraction (BPF) supplementation on cognitive/executive functioning in a sample of patients with schizophrenia receiving second-generation antipsychotics. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Deficits in N-methyl-D-aspartate receptor (NMDAR) function contribute to symptoms and cognitive dysfunction in schizophrenia and are associated with impaired generation of event-related potential measures including auditory mismatch negativity. Parallel studies of the NMDAR agonist D-serine have suggested that sensitivity of these measures to glutamate-based interventions is related to symptomatic and cognitive response. Bitopertin is a selective inhibitor of glycine transport. This study investigates effects of bitopertin on NMDAR-related event-related potential deficits in schizophrenia. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Negative symptoms and cognitive impairments tend to co-occur in people with schizophrenia. If their association with each other is due, in part, to shared pathophysiology, then this suggests that a single drug could potentially be effective for both domains. The current study was designed to examine this hypothesis. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Conclusions: Diagnosis appears to differentially impact on reconviction, readmission and mortality rates. Services could tailor pathways to prioritise symptom management and promoting healthy lifestyles for patients with MI, and reducing reoffending for patients with PD. Login using your SSSFT NHS OpenAthens details for full text.
Ecological momentary assessment (EMA) and ecological momentary intervention (EMI) are technologies used to track fluctuations in experiences and prompt behavioral responses within the context of a person’s daily life. Most commonly delivered via smartphone, EMA and EMI have potential to provide simple, cost-effective, and user-led treatment for psychotic disorders. This systematic review aimed to synthesize current research exploring the feasibility, acceptability, and clinical outcomes of EMA and EMI in the treatment of psychotic disorders. Login at top right hand side of page using your SSSFT NHS Athens for full text.
Although outpatient care within 30 days of mental health hospital discharge is an established quality indicator, little is known about the clinical implications of not receiving such care. This study evaluated whether receipt of outpatient care within 30 days of discharge was associated with a reduced risk of readmission during days 31–120 postdischarge among adult inpatients with schizophrenia or bipolar disorder. Login at top right hand side of page using your SSSFT NHS Athens for full text.
Geoff Davies publishes his debut elf blog about a recent systematic review and meta-analysis looking at age at onset and the outcomes of schizophrenia.
To determine the effects of the glucagon-like peptide-1 receptor agonist liraglutide added to clozapine or olanzapine treatment of schizophrenia spectrum disorders. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
This database study uses a nationwide cohort to examine the comparative real-world effectiveness of antipsychotic treatments for patients with schizophrenia. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
This meta-analysis compares the multiple pharmacologic combination strategies that have been studied for suboptimal treatment responses in schizophrenia....Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
This Viewpoint discusses the benefits and limitations of clinical high risk for psychosis services and suggests strategies for improvement. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
In general, the results suggest considerable overlap between paranoid ideation, predisposition to hallucinations, and OCD and metacognitive beliefs in a non-clinical sample. Further experimental- and clinical studies are needed in order to explore metacognitive models of OCD and psychosis.
We report a case of a patient experiencing wearing-off symptoms with aripiprazole LAI who benefited from switching to aripiprazole lauroxil. Pharmacogenetic testing revealed normal activity for relevant metabolism pathways but a DRD2 -141C variant that may influence brain D2 expression and antipsychotic responsiveness.
Antipsychotics may possess immunological properties that may be involved in immune-mediated conditions, such as psoriatic rash. Further studies are warranted to determine causality and mechanism.
The therapeutic benefits achieved by the extended, 3-year early intervention were not sustainable after termination of the specialised service. To read the full article, log in using your SSSFT NHS OpenAthens details
Patients with schizophrenia are at a significantly increased risk of cancer mortality compared with the general population or individuals without schizophrenia. To read the full article, log in using your SSSFT NHS OpenAthens details
Many people with schizophrenia do not achieve a satisfactory treatment response with their initial antipsychotic drug treatment. Sometimes a second antipsychotic, in combination with the first, is used in these situations.
Living in a city could make young people more vulnerable to psychotic experiences, according to a UK study.
To read the full article, log in using your SSSFT NHS OpenAthens details
Laoise Renwick on a systematic review of barriers and facilitators to implementing family support and education in early psychosis intervention programmes.
Antipsychotic drug sensitivity in very late-onset schizophrenia-like psychosis (VLOSLP) is well documented, but poorly understood. This study aimed to investigate blood drug concentration, D2/3 receptor occupancy and outcome in VLOSLP during open amisulpride prescribing, and compare this with Alzheimer's disease (AD). Login using your SSSFT NHS OpenAthens details for full text.
Objectives To evaluate the usability of a neuropsychological screening instrument and two observation scales of everyday behaviour to describe cognitive and functional capacity of patients with multiepisode schizophrenia and considerable care needs, who frequently refuse to participate in cognitive testing or performance-based functional measurement.
Open Access Article
Schizophrenia is a neurological disease characterized by alterations to patients’ cognitive functions and emotional expressions. Relevant studies often use magnetic resonance imaging (MRI) of the brain to explore structural differences and responsiveness within brain regions. However, as this technique is expensive and commonly induces claustrophobia, it is frequently refused by patients. Thus, this study used non-contact infrared thermal facial images (ITFIs) to analyze facial temperature changes evoked by different emotions in moderately and markedly ill schizophrenia patients.
The study examined six-month follow-up results and the impact of length of illness on treatment outcomes of recovery-oriented cognitive therapy (CT-R). Login at top right hand side of page using your SSSFT NHS Athens for full text.
Safety-seeking behaviours are responses employed to protect against perceived threat. In relation to anxiety disorders, safety-seeking behaviours have been implicated in both the formation and maintenance of distress. Several studies have highlighted similar findings in relation to psychosis; however, this literature has not yet been synthesized. This review is, therefore, being conducted in order to synthesize the literature on safety seeking in people with psychosis to increase the understanding of this relationship. Login using your SSSFT NHS OpenAthens details for full text.
We’ve just heard that SSOTP will not be renewing their agreement with SSSFT LKS for library services for this financial year. Because of this we will be reviewing our Be Aware bulletins. Sadly we won’t be accepting any new sign-ups from SSOTP staff and will be withdrawing some of the physical healthcare bulletins that we…
People with schizophrenia who are treated with long acting injectable antipsychotics have a 20-30% lower risk of relapse requiring readmission to hospital than people treated with equivalent oral formulations, a nationwide study assessing the real world effectiveness of these drugs has found.
To read the full article, log in using your SSSFT NHS OpenAthens details
Randomized controlled trials in adults with severe mental illness indicate that, compared with standard care, intensive case management (ICM) improves retention in treatment and may reduce hospitalization but other positive effects of ICM are unclear.
Open access. The majority of patients respond to antipsychotic monotherapy at standard doses, but a subset of patients will require more heroic measures that include antipsychotic polypharmacy and high-dose monotherapy. Indeed, research has shown that roughly 30% of patients with psychosis are prescribed multiple antipsychotic medications. We discuss the potential benefits and challenges of these approaches and provide a rationale for why and when they should be utilised.
Open access. The STEPWISE trial (STructured lifestyle Education for People WIth SchizophrEnia, schizoaffective disorder and first episode psychosis) is currently evaluating a lifestyle education programme in addition to usual care. However, it is difficult to define what constitutes ‘usual care’. We aimed to define ‘usual care’ for lifestyle management in people with schizophrenia, schizoaffective disorder and first-episode psychosis in STEPWISE study sites. Ten National Health Service (NHS) mental health trusts participated in a bespoke survey based on the National Institute for Health and Care Excellence (NICE) guidance.
Lithium is the third element in the periodic table, and although lithium is present in the natural environment and is used to make batteries, it is perhaps best known as a therapeutic drug. Lithium in various forms was used to treat neuropsychiatric disorders before falling into disuse because of concerns over toxicity. The Australian psychiatrist John Cade rediscovered lithium for the treatment of mania in 1949 and the Danish psychiatrist Mogens Schou did one of the first randomised controlled trials in mania in 1954 assessing lithium use, also suggesting the potential for use of lithium as a prophylactic drug for depressive illness. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Head-to-head trials to guide antipsychotic treatment choices for paediatric psychosis are urgently needed because extrapolations from adult studies might not be implementable. In this superiority trial with two-sided significance testing, we aimed to compare the efficacy and safety of quetiapine-extended release (quetiapine-ER) versus aripiprazole in children and adolescents with first-episode psychosis, to determine whether differences between the two treatments were sufficient to guide clinicians in their choice of one drug over the other. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Patients with schizophrenia constitute a substantial proportion of patients hospitalized in forensic psychiatry. Antipsychotic medication is an essential part of evidence-based treatment and can significantly improve both the medical and legal prognosis. In this study, we compared psychopathological features, psychopharmacological treatment, and the neurologic and metabolic side effects of treatment in demographically comparable in-patients with schizophrenia being treated in either forensic or general psychiatry...Assembling the pieces of a systematic review: a guide for librarians
Editorial. Login at top right hand side of page using your SSSFT NHS Athens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
The objective of the study was to investigate whether a combined intervention composed of early detection plus integrated care (EDIC) enhances outcomes in patients with early psychosis compared to standard care (SC). Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Current approaches to stratify patients with psychiatric disorders into groups on the basis of violence risk are limited by inconsistency, variable accuracy, and unscalability. To address the need for a scalable and valid tool to assess violence risk in patients with schizophrenia spectrum or bipolar disorder, we describe the derivation of a score based on routinely collected factors and present findings from external validation......Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Although most individuals with severe mental illness such as schizophrenia are neither antisocial nor violent, the risk of committing a homicide for people with schizophrenia is higher than that for those in the general population.1 Thus, a paradox typifies many psychiatric conditions for which a specific disorder is associated with increased risk of violence, despite a low prevalence of violence among those with the disorder. Seena Fazel and colleagues'2 new study in The Lancet Psychiatry seeks to clarify this paradox by identifying low risk of committing violent crime among a national cohort of 75 158 Swedish individuals......Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Staff representing the Health Foundation visited NELFT recently to see the PHCP project (Physical Health Care for Patients with psychosis via community pharmacy).
Hypoactive delirium tends to capture less clinical attention than hyperactive delirium. Like all delirium, it can occur in a variety of patients and settings and will consequently be encountered by many groups of doctors. It can be more difficult to recognise, and is associated with worse outcomes, than hyperactive delirium. This article outlines when to suspect, assess, and appropriately manage patients with hypoactive delirium.
To read the full article, log in using your NHS OpenAthens details
Evidence supports the use of long-acting injectable (LAI) antipsychotics in the treatment and prevention psychosis, but these formulations remain under-used in the UK. Overall, LAIs offer many advantages and the advent of second-generation LAIs increased interest in injectables as these newer drugs offer similar benefits to their oral equivalents. LAIs should be one of the options discussed with patients requiring long-term treatment.To read the full article, log in using your NHS OpenAthens details