Efficacy of high vs. low-potency first-generation antipsychotics for schizophrenia

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Laurence Palfreyman summarises 3 recent Cochrane reviews, which investigate high-potency versus low-potency first-generation antipsychotic drugs for schizophrenia. The reviews find little difference in efficacy between the high-potency antipsychotics Trifluoperazine, Haloperidol, Fluphenazine, and low-potency typical antipsychotics.

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Helping young people with psychosis return to work: early intervention services need to do more

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Stephen Wood summarises a recent cluster RCT of vocational rehabilitation in early psychosis, which finds that early intervention services need to do more to help young people with psychosis return to work.

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Meta-review presents the risks of all-cause and suicide mortality in mental disorders

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This recent and well-conducted meta-review concludes that the impact on mortality and suicide of mental disorders is substantial, and probably poorly appreciated as a public health problem. Raphael Underwood’s blog summarises the data for all-cause and suicide mortality in mental disorders.

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Joint crisis plans: cost-effective for whom?

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Chris Sampson looks at the economic outcomes of a recent RCT of joint crisis plans to reduce compulsory treatment for people with psychosis. The study reports the potential for gains specifically among Black patients.

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Childhood abuse and adverse life events interact synergistically to produce a high risk for psychotic experiences

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This recent study concludes that childhood abuse creates an enduring vulnerability to psychosis that is realised in the event of exposure to further stressors and risk factors, such as separation, bereavement, or being involved in an accident or physical attack.

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Shared decision making in antipsychotic prescribing: the perspective of psychiatrists

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Shared decision making is now commonplace, but will this approach ever be fully embraced in relation to antipsychotic prescribing? Liz Hughes reports on a recent qualitative study of consultant psychiatrists’ experiences that sheds some light on the issue.

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Antipsychotics and mood stabilisers may reduce violent crime

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John Baker reports on the first population based report of the positive effects of antipsychotic medication and mood stabilisers on reducing the risk of a conviction for violent crime, published in the Lancet in May.

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Art therapy for schizophrenia: an effective add-on treatment?

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The MATISSE trial in 2012 concluded that group art therapy did no better than standard care at improving symptoms for people with schizophrenia. A new critique of that RCT from the British Association of Art Therapists says the therapy can be more useful.

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Acute and transient psychotic disorders: the ‘third psychosis’ and its relation to schizophrenia

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Raphael Underwood reports on routinely collected data from the Scottish Morbidity Record, which suggests that 1 in 8 people with first-ever diagnosed acute and transient psychotic disorders will develop schizophrenia within 3–5 years. Researchers conclude that those at high risk of transition may benefit from monitoring for possible diagnostic change.

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We don’t know if general health advice improves physical health for patients with serious mental illness

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For me, one of the most infuriating aspects of health care is the relegation of mental health problems, and mental health services, as secondary to physical health. There are a myriad of examples of this, from the classic stigma that people with mental health problems receive compared to those with physical health problems (fantastically illustrated [read the full story...]