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- W4236951417 abstract "The Royal Australian and New Zealand College of Psychiatrists is co-ordinating the development of clinical practice guidelines (CPGs) in psychiatry, funded under the National Mental Health Strategy (Australia) and the New Zealand Health Funding Authority. This paper presents CPGs for schizophrenia and related disorders. Over the past decade schizophrenia has become more treatable than ever before. A new generation of drug therapies, a renaissance of psychological and psychosocial interventions and a first generation of reform within the specialist mental health system have combined to create an evidence-based climate of realistic optimism. Progressive neuroscientific advances hold out the strong possibility of more definitive biological treatments in the near future. However, this improved potential for better outcomes and quality of life for people with schizophrenia has not been translated into reality in Australia. The efficacy-effectiveness gap is wider for schizophrenia than any other serious medical disorder. Therapeutic nihilism, under-resourcing of services and a stalling of the service reform process, poor morale within specialist mental health services, a lack of broad-based recovery and life support programs, and a climate of tenacious stigma and consequent lack of concern for people with schizophrenia are the contributory causes for this failure to effectively treat. These guidelines therefore tackle only one element in the endeavour to reduce the impact of schizophrenia. They distil the current evidence-base and make recommendations based on the best available knowledge.A comprehensive literature review (1990-2003) was conducted, including all Cochrane schizophrenia reviews and all relevant meta-analyses, and a number of recent international clinical practice guidelines were consulted. A series of drafts were refined by the expert committee and enhanced through a bi-national consultation process.This guideline provides evidence-based recommendations for the management of schizophrenia by treatment type and by phase of illness. The essential features of the guidelines are: (i) Early detection and comprehensive treatment of first episode cases is a priority since the psychosocial and possibly the biological impact of illness can be minimized and outcome improved. An optimistic attitude on the part of health professionals is an essential ingredient from the outset and across all phases of illness. (ii) Comprehensive and sustained intervention should be assured during the initial 3-5 years following diagnosis since course of illness is strongly influenced by what occurs in this 'critical period'. Patients should not have to 'prove chronicity' before they gain consistent access and tenure to specialist mental health services. (iii) Antipsychotic medication is the cornerstone of treatment. These medicines have improved in quality and tolerability, yet should be used cautiously and in a more targeted manner than in the past. The treatment of choice for most patients is now the novel antipsychotic medications because of their superior tolerability and, in particular, the reduced risk of tardive dyskinesia. This is particularly so for the first episode patient where, due to superior tolerability, novel agents are the first, second and third line choice. These novel agents are nevertheless associated with potentially serious medium to long-term side-effects of their own for which patients must be carefully monitored. Conventional antipsychotic medications in low dosage may still have a role in a small proportion of patients, where there has been full remission and good tolerability; however, the indications are shrinking progressively. These principles are now accepted in most developed countries. (vi) Clozapine should be used early in the course, as soon as treatment resistance to at least two antipsychotics has been demonstrated. This usually means incomplete remission of positive symptomatology, but clozapine may also be considered where there are pervasive negative symptoms or significant or persistent suicidal risk is present. (v) Comprehensive psychosocial interventions should be routinely available to all patients and their families, and provided by appropriately trained mental health professionals with time to devote to the task. This includes family interventions, cognitive-behaviour therapy, vocational rehabilitation and other forms of therapy, especially for comorbid conditions, such as substance abuse, depression and anxiety. (vi) The social and cultural environment of people with schizophrenia is an essential arena for intervention. Adequate shelter, financial security, access to meaningful social roles and availability of social support are essential components of recovery and quality of life. (vii) Interventions should be carefully tailored to phase and stage of illness, and to gender and cultural background. (viii) Genuine involvement of consumers and relatives in service development and provision should be standard. (ix) Maintenance of good physical health and prevention and early treatment of serious medical illness has been seriously neglected in the management of schizophrenia, and results in premature death and widespread morbidity. Quality of medical care for people with schizophrenia should be equivalent to the general community standard. (x) General practitioners (GPs)s should always be closely involved in the care of people with schizophrenia. However, this should be truly shared care, and sole care by a GP with minimal or no specialist involvement, while very common, is not regarded as an acceptable standard of care. Optimal treatment of schizophrenia requires a multidisciplinary team approach with a consultant psychiatrist centrally involved." @default.
- W4236951417 created "2022-05-12" @default.
- W4236951417 date "2005-01-01" @default.
- W4236951417 modified "2023-10-14" @default.
- W4236951417 title "Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines for the Treatment of Schizophrenia and Related Disorders" @default.
- W4236951417 cites W104003269 @default.
- W4236951417 cites W105133888 @default.
- W4236951417 cites W10562547 @default.
- W4236951417 cites W1206579674 @default.
- W4236951417 cites W1270515817 @default.
- W4236951417 cites W134775781 @default.
- W4236951417 cites W1499727415 @default.
- W4236951417 cites W1523531092 @default.
- W4236951417 cites W153652483 @default.
- W4236951417 cites W1616286551 @default.
- W4236951417 cites W1964040992 @default.
- W4236951417 cites W1964391934 @default.
- W4236951417 cites W1964616687 @default.
- W4236951417 cites W1964927909 @default.
- W4236951417 cites W1965111165 @default.
- W4236951417 cites W1967439067 @default.
- W4236951417 cites W1967674108 @default.
- W4236951417 cites W1975323478 @default.
- W4236951417 cites W1978251978 @default.
- W4236951417 cites W1978752073 @default.
- W4236951417 cites W1980174047 @default.
- W4236951417 cites W1981639800 @default.
- W4236951417 cites W1985472130 @default.
- W4236951417 cites W1987547553 @default.
- W4236951417 cites W1989113721 @default.
- W4236951417 cites W1996254896 @default.
- W4236951417 cites W1997079708 @default.
- W4236951417 cites W1997205347 @default.
- W4236951417 cites W2000269219 @default.
- W4236951417 cites W2001478878 @default.
- W4236951417 cites W2014022579 @default.
- W4236951417 cites W2017457759 @default.
- W4236951417 cites W2021747099 @default.
- W4236951417 cites W2024643973 @default.
- W4236951417 cites W2026981656 @default.
- W4236951417 cites W2036215425 @default.
- W4236951417 cites W2036563231 @default.
- W4236951417 cites W2038344802 @default.
- W4236951417 cites W2041474698 @default.
- W4236951417 cites W2041486022 @default.
- W4236951417 cites W2046493983 @default.
- W4236951417 cites W2049907076 @default.
- W4236951417 cites W2050958586 @default.
- W4236951417 cites W2051543041 @default.
- W4236951417 cites W2053702128 @default.
- W4236951417 cites W2055540161 @default.
- W4236951417 cites W2057156751 @default.
- W4236951417 cites W2059917054 @default.
- W4236951417 cites W2064163179 @default.
- W4236951417 cites W2066357241 @default.
- W4236951417 cites W2069947866 @default.
- W4236951417 cites W2071671065 @default.
- W4236951417 cites W2074311597 @default.
- W4236951417 cites W2075098245 @default.
- W4236951417 cites W2078717479 @default.
- W4236951417 cites W2081069399 @default.
- W4236951417 cites W2081235876 @default.
- W4236951417 cites W2082452572 @default.
- W4236951417 cites W2083002964 @default.
- W4236951417 cites W2084200905 @default.
- W4236951417 cites W2084315910 @default.
- W4236951417 cites W2087687048 @default.
- W4236951417 cites W2088281647 @default.
- W4236951417 cites W2088572669 @default.
- W4236951417 cites W2089182563 @default.
- W4236951417 cites W2090778982 @default.
- W4236951417 cites W2096613914 @default.
- W4236951417 cites W2096635847 @default.
- W4236951417 cites W2098132738 @default.
- W4236951417 cites W2099920076 @default.
- W4236951417 cites W2101762862 @default.
- W4236951417 cites W2103593066 @default.
- W4236951417 cites W2103851709 @default.
- W4236951417 cites W2107406184 @default.
- W4236951417 cites W2107544837 @default.
- W4236951417 cites W2108069427 @default.
- W4236951417 cites W2109179110 @default.
- W4236951417 cites W2110924939 @default.
- W4236951417 cites W2111838308 @default.
- W4236951417 cites W2112325533 @default.
- W4236951417 cites W2114258247 @default.
- W4236951417 cites W2115383849 @default.
- W4236951417 cites W2115837597 @default.
- W4236951417 cites W2116442861 @default.
- W4236951417 cites W2117718508 @default.
- W4236951417 cites W2121181713 @default.
- W4236951417 cites W2122512681 @default.
- W4236951417 cites W2122775094 @default.
- W4236951417 cites W2122780895 @default.
- W4236951417 cites W2123691314 @default.
- W4236951417 cites W2126287712 @default.
- W4236951417 cites W2126288513 @default.
- W4236951417 cites W2127679160 @default.