Outcomes of Treatment of Schizophrenia in a North-East Scottish Mental Hospital

Mcwalter, H. S.; Mercer, Ramona T.; Sutherland, Melissa A.; Watt, Alberta S. J. van der

doi:10.1176/ajp.118.6.529

Cited by 15 publications

(12 citation statements)

References 9 publications

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“…Twenty-one studies that did not have appropriate exposure data to clearly define the comparison groups were eliminated, and one natural history report that only reported on mortality rates was eliminated. In total 18 reports were deemed eligible by the research team (Bockoven & Solomon, 1975; Boonstra, Burger, Grobbee, & Kahn, 2011; Carpenter, Heinrichs, & Hanlon, 1987; Crow, MacMillan, Johnson, & Johnstone, 1986; Engelhardt, Rosen, Freedman, & Margolis, 1967; Harrow, Jobe, & Faull, 2012; Hogarty, Goldberg, Schooler, & Ulrich, 1974; May, Tuma, Dixon, Thiele, & Kraude, 1981; McWalter, Mercer, Sutherland, & Watt, 1961; Moilanen et al, 2013; Mosher & Menn, 1978; Nishikawa, Tsuda, Tanaka, Koga, & Uchida, 1982; Odegard, 1964; Pietzcker et al, 1993; Pritchard, 1967; Rappaport, Hopkins, Hall, Belleza, & Silverman, 1978; Tiihonen, 2006; Wunderink, Nieboer, Wiersma, Sytema, & Nienhuis, 2013). …”

Section: Evidence Reviewmentioning

confidence: 99%

Weighing the evidence for harm from long-term treatment with antipsychotic medications: A systematic review.

Sohler¹,

Barnes²,

Cohen³

et al. 2016

American Journal of Orthopsychiatry

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Research findings supporting the use of antipsychotic medication for acute treatment of schizophrenia are relatively consistent and undisputed. However, the rationale for recommending long-term antipsychotic medication treatment - the current standard of care treatment strategy-- is unclear. A controversial hypothesis proposed recently suggests people with schizophrenia who are exposed to long-term treatment with antipsychotic medications have worse outcomes than people with schizophrenia who are not exposed to these medications. We tested whether a systematic appraisal of published literature would produce data consistent with this hypothesis. We reviewed the published literature to identify studies of patients with psychotic disorders who were followed for at least two years that compared outcomes in patients who received antipsychotic medication during the follow-up with patients who did not receive antipsychotic medication at follow-up. We included all English language articles published through 2013 in this review. Our process for selecting studies and documenting study findings included a consensus decision of two members of the research team. We found the published data to be inadequate to test this hypothesis. By extension, these data were also inadequate to conclusively evaluate whether long-term antipsychotic medication treatment results in better outcomes on average. We conclude that careful re-appraisal of existing data is useful to ensure standard of care treatment strategies are indeed evidence-based. In the case of long-term use of antipsychotic medications, new data may be needed to establish a sufficient evidence base to understand its benefit/risk balance for patients with schizophrenia.

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Section: Evidence Reviewmentioning

confidence: 99%

Weighing the evidence for harm from long-term treatment with antipsychotic medications: A systematic review.

Sohler¹,

Barnes²,

Cohen³

et al. 2016

American Journal of Orthopsychiatry

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“…Improvement between pre-, and post-antipsychotic periods McWalter et al (1961) p=0.003 Ødegård (1964) p<0.06 Peterson & Olson (1964) p<0.001 Astrup & Noreik (1966) p=0.003 Pritchard (1967a, b) Non-significant Shimazono (1973) p=0.03 Murakami (1971) p=0.22 Huber et al (1979Huber et al ( , 1980 p<0.001 Watt et al (1983) Non-significant Data adapted from Astrup & Noreik (1966) and Wyatt (1991). Table 3 Results of the author's analysis or reanalyzed (Wyatt, 1991) Szymanski et al (1996) p=0.0001 * Patients were chronically ill but the difference appears to be related to prolonged delay in treatment.…”

Section: Studymentioning

confidence: 99%

The effects of early and sustained intervention on the long-term morbidity of schizophrenia

Wyatt

Henter

1998

Journal of Psychiatric Research

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By examining the literature concerning early intervention with antipsychotic medications, and how it affects long-term morbidity, this article will review the concept that early intervention with antipsychotic medications improves the long-term course of schizophrenia. It also looks at the potential long-term effects of discontinuing antipsychotic medications early in the course of schizophrenia. It appears that early intervention with antipsychotic medications decreases some of the long-term morbidity associated with schizophrenia. Some of the implications of this finding are discussed in the context of both clinical practice and clinical research."For simple weak-mindedness, which signifies a kind of recovery with defect, it is distinctly enlightening and often confirmed by experience that, sooner or later, a fresh exacerbation of the disease may follow and bring about a higher degree and another form of dementia." (Kraepelin,

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“…The development of neuroleptic medication contributed significantly to deinstitutionalization by allowing a faster stabilization period but did not prove to be superior when compared to previous interventions in preventing hospitalization at 1 year post-discharge [126]_ENREF_65_ENR-EF_65_ENREF_65_ENREF_65_ENREF_65 or clearly improving long-term course or prognosis. Torgalsboen and Rund [127], reported that only half of the patients diagnosed with remission 10 years before maintained a recovery diagnosis.…”

Section: Discussionmentioning

confidence: 95%

“…To illustrate, out of a group of patients with frequent hospitalizations over a period of 4 years, those offered In terms of the stability of improvement, McWalter et al [126] reports that 46% of patients in the pre-neuroleptic era and 49% of patients in post-neuroleptic era were not readmitted during the year following discharge. Although a shorter duration of symptoms is noted with neuroleptic therapy, the time to rehospitalization is not significantly increased, when most of other factors are the same.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Course of Schizophrenia

Bota¹,

Preda²

2011

CPSR

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Background: Understanding the course of schizophrenia is essential to improve prophylaxis, early diagnosis, diagnostic validity, and prognosis. Method:We completed a comprehensive literature search for longitudinal, prospective and retrospective studies of schizophrenia. As studies span over almost a century and use different diagnostic criteria to decrease the effect of studies heterogeneity we reviewed the data organized according to historical periods (institutionalization and deinstitutionalization, pre and post neuroleptic periods)Results: The majority of the longitudinal studies of schizophrenia report that up to 30-50% of patients present with a stable or favorable course. Interestingly, this moderately positive outcome is de-emphasized in the literature, which most times focuses on the bleaker outcome of the rest of the patients (50-70%). A number of putative course predictors at the time of the initial diagnosis have been proposed. However, the current level of evidence about risk and protective factor is putative rather than clear and convincing.

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Outcomes of Treatment of Schizophrenia in a North-East Scottish Mental Hospital

Cited by 15 publications

References 9 publications

Weighing the evidence for harm from long-term treatment with antipsychotic medications: A systematic review.

Weighing the evidence for harm from long-term treatment with antipsychotic medications: A systematic review.

The effects of early and sustained intervention on the long-term morbidity of schizophrenia

Longitudinal Course of Schizophrenia

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