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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Black patients’ first contact with mental health services is more likely to be coercive

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It is well documented that there are differences in how patients are treated, depending on their ethnicity. Previous inquiries in the UK have suggested that the NHS is institutionally racist (Blofeld et al, 2003). Some groups, for example those from African Caribbean or Aboriginal descent, experience more coercive care and poor outcomes, including higher doses of [read the full story...]

Psychosis and schizophrenia in adults: updated NICE guidance for 2014

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While the organisation’s name may change frequently, currently National Institute for Health and Care Excellence (NICE), its role remains constant – to provide clear published guidance on the role of treatment options within the NHS. The publication of new NICE guidance represents a significant event as clinical recommendations shape the nature of provided care nationally [read the full story...]

Long term maintenance treatment with antipsychotics: a cautionary note from recent research

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The support of individuals with experience of psychosis is complex and relies on a combination of psychopharmacology (antipsychotic drugs), psychological therapies and social interventions. Antipsychotics will often be the first line treatment offered, with the intention of reducing psychotic symptom burden. Following the resolution of immediate symptoms the role of antipsychotics becomes less clear; should [read the full story...]

Meta-analysis finds that pituitary volume is not affected in people with first episode psychosis or schizophrenia

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* Declaration; I have published articles with two of the authors of this article, including on this topic, and know most of them professionally One influential model of the onset of psychotic disorders such as schizophrenia is the stress-vulnerability model, first put forward by Zubin and Spring in 1977. This model proposes that people at [read the full story...]

Identifying risk factors in first episode psychosis: results from two new meta-analyses

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A first episode of psychosis is a higher risk time for acts of self-harm and of violence, and a chance to engage people, modify risk factors and change outcomes. Two related meta-analyses by Large, Neilssen and Challis are presented in a letter in the Australian and New Zealand Journal of Psychiatry.  They summarise two studies [read the full story...]

Schizophrenia Commission report highlights what we can all do to improve care and understanding

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The research and campaigns relating to life outcomes for people with schizophrenia and psychosis are truly shocking. It seems unbelievable that people with schizophrenia face a lifespan 15-20 years shorter than the general population and that only 7% are able to hold down a job. Paul Jenkins from Rethink Mental Illness sums it up nicely: [read the full story...]

New systematic review shows how the incidence of schizophrenia and other psychoses has changed since 1950

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This is one in a series of 5 systematic reviews commissioned by the Department of Health, which seek to establish a comprehensive understanding of the distribution and pattern of psychotic disorders in England, between 1950 and 2009. All mental health professionals, commissioners and health planners will find this research relevant to their work. It’s well [read the full story...]

The most effective treatments for preventing relapse in first episode psychosis: a new systematic review and meta-analysis

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Patients with first episode psychosis often relapse after initial remission, so it is perhaps surprising that treatment guidelines for the condition are generally based on poor quality evidence. Antipsychotic drugs are frequently discontinued, but clinicians don’t have ready access to information that shows how to determine which patients can be successfully tapered off of antipsychotic [read the full story...]