NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE. Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care Guidance on the use of the newer (atypical) antipsychotic drugs for the treatment of schizophrenia John Rawlinson Andy Carberry. Context. CPA 1990,
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Can we make them a reality ?
(1% lifetime risk in general population across all cultures)
Frangou and Murray 1996, Mason et al 1996 in NICE2002
Frangou and Murray 1996
All people with suspected or newly diagnosed schizophrenia presumed diagnosis of schizophrenia - assessment by a Consultant Psychiatrist.
Early Intervention Services
Where needs of the user exceeds capacity, referral to crisis resolution/ home treatment/ acute day services/ inpatient services
Oral atypical antipsychotic drugs choice of first time treatments at the lower end of the standard dose range.
Support a decision by a service users to seek a second opinion
Early Post acute period
Promoting Recovery - Primary and Secondary services
Preventing Relapse - ongoing psychological and pharmacological intervention
Relapse prevention – oral antipsychotic
Relapse Prevention – depot antipsychotic
Treatment – Resistant Schizophrenia
Insufficient evidence -
Overall there is good evidence that CBT reduces symptoms for people with schizophrenia at up to 1 year follow up when compared to ‘standard care’ and other treatments. The evidence is stronger when CBT is used for the treatment of persisting psychotic symptoms rather than for acute symptoms.
Family sessions with a specific supportive or treatment function based on systemic, cognitive behavioural or psychoanalytic principles which must contain at least 1 of the following -