Preventing serious adverse outcomes in schizophrenia

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People diagnosed with schizophrenia are 7.4 times more likely to be convicted of violent offences, 8.1 times more likely to die prematurely, and 20.7 times more likely to kill themselves.

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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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Paliperidone Palmitate is no better than Haloperidol Decanoate at preventing relapse or controlling psychotic symptoms

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Alex Langford summarises a relatively large and pragmatic study, which provides firm evidence that the newer antipsychotic, Paliperidone, is no better at preventing relapse or controlling psychotic symptoms than its decades-old comparator, Haloperidol.

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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...]

A new model for schizophrenia?

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Schizophrenia is a complex disorder (or, more likely, group of disorders) that has reality distortion at its core. Efforts to establish the cause of schizophrenia have been ongoing for more than a century, and many models have come and gone in that time (not for nothing has schizophrenia been called ‘the graveyard of neuropathologists’ (Plum, [read the full story...]

Spoilt for choice? Four new Cochrane reviews on antipsychotics for schizophrenia

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Schizophrenia is a crippling condition characterised by psychotic experiences such as delusions and hallucinations. It can be hugely debilitating for the patient and their family and it can also be an enormous challenge for psychiatrists and other health and social care professionals who are responsible for providing care and support to the service user. Currently, [read the full story...]

“Psychokiller, qu’est-ce que c’est”. The risk of violent re-offending among prisoners with psychotic experiences

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In England and Wales, the Mental Health Act (1983, revised 2007) allows for the detention of individuals to hospital for a period of assessment (Section 2) or treatment (Section 3) if it is deemed that they suffer with a mental disorder of a nature or degree sufficient to warrant admission to hospital and it is necessary [read the full story...]

Drug treatment of refractory schizophrenia remains a major challenge, but clozapine continues to be gold standard

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Schizophrenia is a crippling condition that often (in about 20-30% of patients) shows an inadequate response to first-line antipsychotic drugs. Because it is associated with significant, often devastating reductions in quality of life, the management of refractory cases of schizophrenia represents a major challenge to psychiatry. As pharmacotherapy is the treatment of choice, stringent guidelines [read the full story...]