Management of Treatment Refractory Schizophrenia

Morrison, Denis

doi:10.1192/s0007125000298577

Cited by 16 publications

(9 citation statements)

References 34 publications

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“…In such cases, the risk of non-compliance during oral medication is increased and regular appointments in outpatient treatment are more likely to be missed after discharge from hospital. Home-based outpatient treatment has been shown both to increase compliance and reduce the number of relapses compared with conventional individual outpatient treatment [10,18,21,23]. On the other hand, despite efforts to maintain continuity in treatment, schizophrenia is often associated with an increased risk of premature death [3].…”

Section: Introductionmentioning

confidence: 99%

Four-year outcome in non-compliant schizophrenia patients treated with or without home-based ambulatory outpatient care

et al. 2003

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Non-compliance in neuroleptic maintenance treatment is a major concern in schizophrenia. Home-based outpatient care has been shown both to improve medication compliance and reduce relapse frequency. We analysed the need for hospitalisation, levels of functioning and mortality rate during the de-institutionalisation process in 41 schizophrenia patients with repeated hospitalisations and prolonged history of non-compliance. Eighteen of the patients received ambulatory outpatient care (AOC) after discharge. This treatment procedure focuses on enduring neuroleptic maintenance treatment. One of the hospital nurses takes care of home visits every 2-4 weeks. In the 4-year follow-up, half of the patients in the AOC group did not need hospitalisation at all and the number of days of hospitalisation in the whole group diminished by almost four-fifths compared with the previous 4 years. In the non-AOC group, there was a more limited decrease in the number of days of hospitalisation during the corresponding follow-up period. The mortality rates showed a slight tendency towards a better outcome in the AOC group. There was no change in the levels of functioning in the AOC group. This treatment can be carried out with limited resources. It clearly reduces the need for hospitalisation in a subgroup of schizophrenia patients having problems with compliance and recurrent relapse. The effectiveness of AOC on the mortality rates of schizophrenia patients needs further examination.

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Section: Introductionmentioning

confidence: 99%

Four-year outcome in non-compliant schizophrenia patients treated with or without home-based ambulatory outpatient care

et al. 2003

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“…For patients diagnosed with schizophrenia, compliance with medication becomes central to achieve predicted length of stay outcomes on the care pathway. Non-compliance is high within this group of patients with the presence of unpleasant side-effects given as the main reason (Morrison 1996). Kemp et al (1996) found that in-patient compliance and attitudes to medication improved with 4-6 contact sessions compared to a control group and this effect lasted for 6 months post treatment.…”

Section: Nature and Disease Progression Of Schizophreniamentioning

confidence: 80%

Managed mental health care: problems and possibilities

Jones

Norman

1998

Psychiatric Ment Health Nurs

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Case management has become an established organizational approach to mental health care. However, a recent development of case management, known as 'managed care' has received only limited attention in the UK and this has been confined to acute medical or surgical hospital care. The potential of managed care as applied to mental health care is uncertain. This paper clarifies the nature of managed care and discusses its relevance to mental health care, in particular to the care of people suffering from schizophrenia. The high incidence and heavy resource demands of this user group makes these people an ideal focus for managed care. However, there are conceptual and practical problems hindering its development and implementation, including: the variability and unpredictability of the disease process of schizophrenia; challenges of outcome measurement; and problems relating to the current organization of mental health care.

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“…Currently, mental illness is often managed primarily through medications, but many patients in psychiatric hospitals often prove treatment-resistant to pharmaceutical intervention [5]. However, individualized care in psychiatry is able to significantly improve outcomes in patients [6-7]. What must be further studied and remedied are the institutional and economic problems that in actual practice tend to prevent patients from receiving individualized care.…”

Section: Discussionmentioning

confidence: 99%

A Kyojo's Delirium: Insights into the Inner Mind of a Young Asian Female Patient

Curtis-Shanley¹

2019

Cureus

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A young Asian female in her early twenties suffered selective mutism, emotional lability, and delusions during a period of personal crisis. The patient experienced brief intermittent periods of clarity during her psychosis of unknown origin, and wrote “Please save me” on a piece of paper during her first meeting with the author of this report. Her confabulations and delusions are analyzed, along with the family and social circumstances that prevented her from receiving adequate treatment.

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Management of Treatment Refractory Schizophrenia

Cited by 16 publications

References 34 publications

Four-year outcome in non-compliant schizophrenia patients treated with or without home-based ambulatory outpatient care

Four-year outcome in non-compliant schizophrenia patients treated with or without home-based ambulatory outpatient care

Managed mental health care: problems and possibilities

A Kyojo's Delirium: Insights into the Inner Mind of a Young Asian Female Patient

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