Atypical antipsychotics no better than typicals for adolescents with psychosis, but atypicals may have fewer short-term side effects

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Schizophrenia is a serious neurodevelopmental disorder that often starts during adolescence. Current treatment guidelines (NICE, 2013) recommend atypical antipsychotics for adolescents with this condition, but this is based largely on studies of adults with the condition. The Cochrane Schizophrenia Group conducted this systematic review to synthesise the current evidence base for atypical antipsychotic medication in [read the full story…]

Estimating heritability in 5 psychiatric disorders: a 21st Century family study

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It has long been established that psychiatric disorders have a genetic component. In the early days of genetic research, twin and family studies were used to estimate heritability (the proportion of variance explained by genetic factors). The Psychiatric Genetics Consortium has recently published a paper in Nature Genetics to assess the heritability and co-inheritability (relationship between [read the full story…]

If I pay you, will you have your injection?

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Getting patients to take their medication as prescribed is notoriously difficult. Regardless of condition only about 50% of patients adhere to prescribed regimes. This is particularly the case in chronic or complex conditions worldwide and improving this problem has the potential to save considerable health burden and costs. Adherence in mental health is no different. [read the full story…]

Newer antipsychotics may increase the risk of pneumonia in schizophrenia

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Because of a more favourable side effects profile (not necessarily clinical superiority), second-generation antipsychotics (SGAs) are today the most commonly used drugs to treat psychotic disorders such as schizophrenia (Jones et al., 2006). While rather frequent adverse reactions, including weight gain, diabetes or sedation, are largely recognised, recent studies point at increased risk of pneumonia [read the full story…]

Do antipsychotics cause progressive brain changes in schizophrenia?

People with schizophrenia taking antipsychotics saw a reduction in grey matter

For over 30 years researchers have found that people with a diagnosis of schizophrenia have, on average, differences on brain scans compared to people without.  Not everybody with a diagnosis of schizophrenia will have these differences and it has not yet been possible to use brain scanning as a test to work out whether someone [read the full story…]

#MindfulnessMonday – Mindfulness moderately effective for reducing symptoms of psychosis, though controlled studies less convincing

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Last week, Elly O’Brien blogged about mindfulness-based cognitive therapy (MBCT) for various physical and psychological disorders. Today, another paper from the same authors, looking at the more broadly defined ‘mindfulness interventions’ for psychosis. Elly talked about the use of mindfulness to escape the “emotional quicksand” of negative thoughts, and the authors here again focus on [read the full story…]

Systematic review of fluphenazine for schizophrenia: 50 years of learning not that much

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Antipsychotic medications are often the first line of treatment for schizophrenia and have been effective at treating florid symptoms such as delusions and hallucinations. Fluphenazine was one of the first antipsychotics to become available on the market and has now been appearing on prescriptions for over 5 decades. Despite the arrival of newer generations of [read the full story…]

Adherence therapy no more cost-effective than health education for people with schizophrenia

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When two interventions are demonstrably equivalent in terms of clinical outcomes, it is unclear which should be provided. One obvious decision rule in this case is to implement the intervention that is least costly and therefore most cost-effective. A recent economic evaluation by Patel and colleagues estimates the cost-effectiveness of adherence therapy for people with [read the full story…]

Can assessing and acting on quality of life scores improve patient satisfaction? New study concludes yes, but the results actually say no

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For mental health patients, quality of life (QoL) can include many things like self-esteem, autonomy, satisfaction with the care they’re receiving and the staff who are caring from them, reduced symptoms, minimal side-effects from treatment and good overall functioning. Measuring QoL can pick up on difficulties a patient is having that wouldn’t have otherwise come [read the full story…]

Systematic review: which anti-psychotic medication is the best?

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Schizophrenia is considered a chronic long-term debilitating condition, affecting about 1% of the population. There has been considerable debate about which of the anti-psychotic medications are the best treatments. The debate has usually been structured around typical (older) and atypical (newer) anti-psychotic medications. The revised NICE guidelines (2009) moved towards a more neutral stance between [read the full story…]