Editorial Credits/ Crédits éditorials

CLINICAL PRACTICE GUIDELINES
Treatment of Schizophrenia
(Complete PDF)

Contents
(PDF)

I. Introduction
(PDF)

II. Assessments
(PDF)

III. Pharmacotherapy
(PDF)

IV. Psychosocial Interventions
(PDF)

V. Service Delivery
(PDF)

VI. Special Issues (PDF)

List of Abbreviations (PDF)

Bibiliography
(PDF)

Appendices
(PDF)

Acknowledgements

CLINICAL PRACTICE GUIDELINES Treatment of Schizophrenia

References

1. Institute of Medicine. Clinical practice guidelines: directions for a new program. Washington (DC): National Academy Press; 1990.

2. Goldner EM, Hsu L, Waraich P, Somers JM. Prevalence and incidence studies of schizophrenic disorders: a systematic review of the literature. Can J Psychiatry 2002;47:833–43.

3. Goeree R, O’Brien BJ, Goering P, Blackhouse G, Agro K, Rhodes A, and others. The economic burden of schizophrenia in Canada. Can J Psychiatry 1999;44:464–72.

4. Newman SC, Bland RC. Mortality in a cohort of patients with schizophrenia: a record linkage study. Can J Psychiatry 1991;36:239–45.

5. The AGREE Collaboration. Appraisal of Guidelines for Research & Evaluation [AGREE] Instrument. Available: www.agreecollaboration.org/instrument/. Accessed 2005 Aug 31.

6. Working Group for the Canadian Psychiatric Association and the Canadian Alliance for Research on Schizophrenia. Canadian clinical practice guidelines for the treatment of schizophrenia. Can J Psychiatry 1998;43 Suppl.

7. ISI Research. Reference Manager. Version 10.0. London (UK): ISI Research; 2001.

8. Portney L, Watkins M. Foundations of clinical research: applications to practice. 2nd ed. Upper Saddle River (NJ): Prentice Hall Health; 2000.

9. Coryell W, Keller M, Lavori P, Endicott J. Affective syndromes, psychotic features, and prognosis. I. Depression. Arch Gen Psychiatry 1990;47:651–7.

10. Coryell W, Keller M, Lavori P, Endicott J. Affective syndromes, psychotic features, and prognosis. II. Mania. Arch Gen Psychiatry 1990;47:658–62.

11. Coryell W, Lavori P, Endicott J, Keller M, VanEerdewegh M. Outcome in schizoaffective, psychotic, and nonpsychotic depression. Course during a six- to 24-month follow-up. Arch Gen Psychiatry 1984;41:787–91.

12. Addington J, Leriger E, Addington D. Symptom outcome 1 year after admission to an early psychosis program. Can J Psychiatry 2003;48:204–7.

13. Addington J, Addington D. Neurocognitive and social functioning in schizophrenia. Schizophr Bull 1999;25:173–82.

14. Norman RM, Malla AK, McLean T, Voruganti LP, Cortese L, McIntosh E, and others. The relationship of symptoms and level of functioning in schizophrenia to general wellbeing and the Quality of Life Scale. Acta Psychiatr Scand 2000;102:303–9.

15. Breier A, Schreiber JL, Dyer J, Pickar D. National Institute of Mental Health longitudinal study of chronic schizophrenia. Prognosis and predictors of outcome. Arch Gen Psychiatry 1991;48:239–46.

16. Green MF. What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 1996;153:321–30.

17. Norman RM, Malla AK, Cortese L, Cheng S, Diaz K, McIntosh E, and others. Symptoms and cognition as predictors of community functioning: a prospective analysis. Am J Psychiatry 1999;156:400–5.

18. McGlashan TH. A selective review of recent North American long-term followup studies of schizophrenia. Schizophr Bull 1988;14:515–42.

19. Robinson DG, Woerner MG, McMeniman M, Mendelowitz A, Bilder RM. Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry 2004;161(3):473–9.

20. Loebel AD, Lieberman JA, Alvir JM, Mayerhoff DI, Geisler SH, Szymanski SR. Duration of psychosis and outcome in first-episode schizophrenia. Am J Psychiatry 1992;149:1183–8.

21. Malla AK, Norman RM, Manchanda R, Ahmed MR, Scholten D, Harricharan R, and others. One year outcome in first episode psychosis: influence of DUP and other predictors. Schizophr Res 2002;54:231–42.

22. Yung AR, Phillips LJ, Yuen HP, McGorry PD. Risk factors for psychosis in an ultra high-risk group: psychopathology and clinical features. Schizophr Res 2004;67(2–3):131–42.

23. Green MF, Nuechterlein KH, Gold JM, Barch DM, Cohen J, Essock S, and others. Approaching a consensus cognitive battery for clinical trials in schizophrenia: the NIMH-MATRICS conference to select cognitive domains and test criteria. Biol Psychiatry 2004;56(5):301–7.

24. de Vries PJ, Honer WG, Kemp PM, McKenna PJ. Dementia as a complication of schizophrenia. J Neurol Neurosurg Psychiatry 2001;70:588–96.

25. Murphy KC. Schizophrenia and velo-cardio-facial syndrome. Lancet 2002;359:426–30.

26. Horowitz A, Shifman S, Rivlin N, Pisante A, Darvasi A. A survey of the 22q11 microdeletion in a large cohort of schizophrenia patients. Schizophr Res 2005;73(2–3):263–7.

27. Bassett AS, Hodgkinson K, Chow EW, Correia S, Scutt LE, Weksberg R. 22q11 deletion syndrome in adults with schizophrenia. Am J Med Genet 1998;81:328–37.

28. Wiehaln GJ, Bosch GP, du Preez RR, Pretorius HW, Karayiorgou M, Roos JL. Assessment of the frequency of the 22q11 deletion in Afrikaner schizophrenic patients. Am J Med Genet (Neuropsychiatric Genet) 2005;129B:20–2.

29. Gewirtz G, Squires-Wheeler E, Sharif Z, Honer WG. Results of computerised tomography during first admission for psychosis. Br J Psychiatry 1994;164:789–95.

30. Lubman DI, Velakoulis D, McGorry PD, Smith DJ, Brewer W, Stuart G, and others. Incidental radiological findings on brain magnetic resonance imaging in first-episode psychosis and chronic schizophrenia. Acta Psychiatr Scand 2002;106:331–6.

31. Katzman GL, Dagher AP, Patronas NJ. Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. JAMA 1999; 82:36–9.

32. Smith GN, MacEwan GW, Ancill RJ, Honer WG, Ehmann TS. Diagnostic confusion in treatment-refractory psychotic patients. J Clin Psychiatry 1992;53:197–200.

33. Honer WG, Smith GN, MacEwan GW, Kopala L, Altman S, Yorkston N, and others. Diagnostic reassessment and treatment response in schizophrenia. J Clin Psychiatry 1994;55:528–32.

34. Caldwell CB, Gottesman II. Schizophrenics kill themselves too: a review of risk factors for suicide. Schizophr Bull 1990;16:571–89.

35. Addington D, Addington J, Maticka-Tyndale E. Specificity of the Calgary Depression Scale. Schizophr Res 1994;11:239–44.

36. Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, and others. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA 1990;264:2511–8.

37. Addington J, el Guebaly N, Campbell W, Hodgins DC, Addington D. Smoking cessation treatment for patients with schizophrenia. Am J Psychiatry 1998;155:974–6.

38. Newman SC, Bland RC. Mortality in a cohort of patients with schizophrenia: a record linkage study. Can J Psychiatry 1991;36:239–45.

39. Morgan MG, Scully PJ, Youssef HA, Kinsella A, Owens JM, Waddington JL. Prospective analysis of premature mortality in schizophrenia in relation to health service engagement: a 7.5-year study within an epidemiologically complete, homogeneous population in rural Ireland. Psychiatry Res 2003;117:127–35.

40. Marder SR, Essock SM, Miller AL, Buchanan RW, Casey DE, Davis JM, and others. Physical health monitoring of patients with schizophrenia. Am J Psychiatry 2004;161(8):1334–49.

41. Committee CDACPGE. Canadian clinical practice guidelines for the prevention and management of diabetes in Canada. Canadian Journal of Diabetes 2003;27(Suppl. 2):S1–S152.

42. Kane JM, Marder SR, Schooler NR, Wirshing WC, Umbricht D, Baker RW and others. Clozapine and haloperidol in moderately refractory schizophrenia: a 6-month randomized and double-blind comparison. Arch Gen Psychiatry 2001;58:965–72.

43. Bilder RM, Goldman RS, Volavka J, Czobor P, Hoptman M, Sheitman B, and others. Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients with chronic schizophrenia or schizoaffective disorder. Am J Psychiatry 2002;159:1018–28.

44. Ritchie CW, Chiu E, Harrigan S, Hall K, Hassett A, Macfarlane S, and others. The impact upon extra-pyramidal side effects, clinical symptoms and quality of life of a switch from conventional to atypical antipsychotics (risperidone or olanzapine) in elderly patients with schizophrenia. Int J Geriatr Psychiatry 2003;18:432–40.

45. Levinson DF, Umapathy C, Musthaq M. Treatment of schizoaffective disorder and schizophrenia with mood symptoms. Am J Psychiatry 1999;156:1138–48.

46. Correll CU, Leucht S, Kane JM. Lower risk for tardive dyskinesia associated with second-generation antipsychotics: a systematic review of 1-year studies. Am J Psychiatry 2004;161(3):414–25.

47. Allison DB, Casey DE. Antipsychotic-induced weight gain: a review of the literature. J Clin Psychiatry 2001;62(Suppl 7):22–31.

48. Kane JM, Eerdekens M, Lindenmayer J-P, Keith SJ, Lesem M, Karcher K. Long-acting injectable risperidone: efficacy and safety of the first long-acting atypical antipsychotic. Am J Psychiatry 2003;160:1125–32.

49. Kinon BJ, Hill AL, Liu H, Kollack-Walker S. Olanzapine orally disintegrating tablets in the treatment of acutely ill non-compliant patients with schizophrenia. Int J Neuropsychopharmacol 2003;6:97–102.

50. Murray M, Bullard M, Grafstien EftCaCNG. Revisions to the Canadian Emergency Department Triage and Acuity Scale Implementation Guidelines. Can J Emerg Med 2004;6(6):421–7.

51. Currier GW, Simpson GM. Risperidone liquid concentrate and oral lorazepam versus intramuscular haloperidol and intramuscular lorazepam for treatment of psychotic agitation. J Clin Psychiatry 2001;62:153–7.

52. Battaglia J, Moss S, Rush J, Kang J, Mendoza R, Leedom L, and others. Haloperidol, lorazepam, or both for psychotic agitation? A multicenter, prospective, double-blind, emergency department study. Am J Emerg Med 1997;15:335–40.

53. Canadian Pharmacists Association. Compendium of Pharmaceuticals and Specialties. Ottawa (ON): Canadian Pharmacists Association; 2004.

54. Breier A, Meehan K, Birkett M, David S, Ferchland I, Sutton V, and others. A double-blind, placebo-controlled dose–response comparison of intramuscular olanzapine and haloperidol in the treatment of acute agitation in schizophrenia. Arch Gen Psychiatry 2002;59:441–8.

55. Wright P, Birkett M, David SR, Meehan K, Ferchland I, Alaka KJ and others. Double-blind, placebo-controlled comparison of intramuscular olanzapine and intramuscular haloperidol in the treatment of acute agitation in schizophrenia. Am J Psychiatry 2001;158:1149–51.

56. Currier GW, Chou JC, Feifel D, Bossie CA, Turkoz I, Mahmoud RA, and others. Acute treatment of psychotic agitation: a randomized comparison of oral treatment with risperidone and lorazepam versus intramuscular treatment with haloperidol and lorazepam. J Clin Psychiatry 2004;65(3):386–94.

57. Fenton M, Coutinho ESF, Camplbell C. Zuclopenthixol acetate in the treatment of acute schizophrenia and similar serious mental illnesses. Cochrane Database of Systematic Reviews 2004; (1).

58. Addington J, van Mastrigt S, Hutchinson J, Addington D. Pathways to care: help seeking behaviour in first episode psychosis. Acta Psychiatr Scand 2002;106:358–64.

59. Norman RM, Malla AK. Duration of untreated psychosis: a critical examination of the concept and its importance. Psychol Med 2001;31:381–400.

60. Lieberman JA, Tollefson G, Tohen M, Green AI, Gur RE, Kahn R, and others. Comparative efficacy and safety of atypical and conventional antipsychotic drugs in first-episode psychosis: a randomized, double-blind trial of olanzapine versus haloperidol. Am J Psychiatry 2003;160:1396–404.

61. Kopala LC, Good KP, Honer WG. Extrapyramidal signs and clinical symptoms in first-episode schizophrenia: response to low-dose risperidone. J Clin Psychopharmacol 1997;17:308–13.

62. Davis JM, Chen N, Glick I. A meta-analysis of the efficacy of second-generation antipsychotics. Arch Gen Psychiatry 2003;60:553–64.

63. Correll CU, Malhotra AK, Kaushik S, McMeniman M, Kane JM. Early prediction of antipsychotic response in schizophrenia. Am J Psychiatry 2003;160:2063–5.

64. Chengappa KN, Parepally H, Brar JS, Mullen J, Shilling A, Goldstein JM. A random-assignment, double-blind, clinical trial of once- vs twice-daily administration of quetiapine fumarate in patients with schizophrenia or schizoaffective disorder: a pilot study. Can J Psychiatry 2003;48:187–94.

65. Malla AK, Norman RM, Voruganti LP. Improving outcome in schizophrenia: the case for early intervention. CMAJ 1999;160:843–6.

66. McGorry PD, Edwards J, Mihalopoulos C, Harrigan SM, Jackson HJ. EPPIC: an evolving system of early detection and optimal management. Schizophr Bull 1996;22:305–25.

67. Lieberman JA, Jody D, Geisler S, Alvir J, Loebel AD, Szymanski SR, and others. Time course and biologic correlates of treatment response in first-episode schizophrenia. Arch Gen Psychiatry 1993;50:369–76.

68. Coldham EL, Addington J, Addington D. Medication adherence of individuals with a first episode of psychosis. Acta Psychiatr Scand 2002;106:286–90.

69. Koreen AR, Siris SG, Chakos MH, Alvir J, Mayerhoff D, Lieberman JA. Depression in first-episode schizophrenia. Am J Psychiatry 1993;150:1643–8.

70. Addington D, Addington J, Patten S. Depression in people with first-episode schizophrenia. Br J Psychiatry Suppl 1998;172(33):90–2.

71. Dixon LB, Lehman AF, Levine J. Conventional antipsychotic medications for schizophrenia. Schizophr Bull 1995;21:567–77.

72. Bhanji NH, Chouinard G, Margolese HC. A review of compliance, depot intramuscular antipsychotics and the new long-acting injectable atypical antipsychotic risperidone in schizophrenia. Eur Neuropsychopharmacol 2004;14(2):87–92.

73. Crow TJ, Macmillan JF, Johnson AL, Johnstone EC. The Northwick Park Study of first episodes of schizophrenia. II A randomised controllled trial of prophylactic neuroleptic treatment. Br J Psychiatry 1986;148:120–7.

74. Ram R, Bromet EJ, Eaton WW, Pato C, Schwartz JE. The natural course of schizophrenia: a review of first-admission studies. Schizophr Bull 1992;18:185–207.

75. Kinon BJ, Basson BR, Gilmore JA, Malcolm S, Stauffer VL. Strategies for switching from conventional antipsychotic drugs or risperidone to olanzapine. J Clin Psychiatry 2000;61:833–40.

76. Kane JM, Honigfeld G, Singer J, Meltzer HY. Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry 1988;45:789–96.

77. Kane JM, Marder SR, Schooler NR, Wirshing WC, Umbricht D, Baker RW, and others. Clozapine and haloperidol in moderately refractory schizophrenia: a 6-month randomized and double-blind comparison. Arch Gen Psychiatry 2001;58:965–72.

78. Chakos M, Lieberman J, Hoffman E, Bradford D, Sheitman B. Effectiveness of second-generation antipsychotics in patients with treatment-resistant schizophrenia: a review and meta-analysis of randomized trials. Am J Psychiatry 2001;158:518–26.

79. Stahl SM, Grady MM. A critical review of atypical antipsychotic utilization: comparing monotherapy with polypharmacy and augmentation. Curr Med Chem 2004;11(3):313–27.

80. Chanpattana W, Chakrabhand ML, Sackeim HA, Kitaroonchai W, Kongsakon R, Techakasem P, and others. Continuation ECT in treatment-resistant schizophrenia: a controlled study. J ECT 1999;15:178–92.

81. Tiihonen J, Hallikainen T, Ryynanen OP, Repo-Tiihonen E, Kotilainen I, Eronen M, and others. Lamotrigine in treatment-resistant schizophrenia: a randomized placebo-controlled crossover trial. Biol Psychiatry 2003;54:1241–8.

82. Tharyan P, Adams CE. Electroconvulsive therapy for schizophrenia. Cochrane Database of Systematic Reviews 2004;(1).

83. Buchanan RW, Breier A, Kirkpatrick B, Ball P, Carpenter WT Jr. Positive and negative symptom response to clozapine in schizophrenic patients with and without the deficit syndrome. Am J Psychiatry 1998;155:751–60.

84. Davis JM, Chen N. The effects of olanzapine on the 5 dimensions of schizophrenia derived by factor analysis: combined results of the North American and international trials. J Clin Psychiatry 2001;62:757–71.

85. Davis JM, Chen N. Clinical profile of an atypical antipsychotic: risperidone. Schizophr Bull 2002;28:43–61.

86. Sands JR, Harrow M. Depression during the longitudinal course of schizophrenia. Schizophr Bull 1999;25:157–71.

87. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington (DC): American Psychiatric Association; 1994.

88. Levinson DF, Umapathy C, Musthaq M. Treatment of schizoaffective disorder and schizophrenia with mood symptoms. Am J Psychiatry 1999;156:1138–48.

89. Siris SG. Suicide and schizophrenia. J Psychopharmacol 2001;15:127–35.

90. American Psychiatric Association. Practice guideline for the assessment and treatment of patients with suicidal behaviors. Am J Psychiatry 2003;160(Suppl 11):1–60.

91. Meltzer HY, Alphs L, Green AI, Altamura AC, Anand R, Bertoldi A, and others. Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT). Arch Gen Psychiatry 2003;60:82–91. [erratum appears in Arch Gen Psychiatry.2003;60:735].

92. Lindqvist P, Skipworth J. Evidence–based rehabilitation in forensic psychiatry. Br J Psychiatry 2000;176:320–3.

93. Hector RI. The use of clozapine in the treatment of aggressive schizophrenia. Can J Psychiatry 1998;43:466–72.

94. Seeman MV. Gender differences in the prescribing of antipsychotic drugs. Am J Psychiatry 2004;161(8):1324–33.

95. Halbreich U, Kahn LS. Hormonal aspects of schizophrenias: an overview. Psychoneuroendocrinology 2003;28(Suppl 2):1–16.

96. Patton SW, Misri S, Corral MR, Perry KF, Kuan AJ. Antipsychotic medication during pregnancy and lactation in women with schizophrenia: evaluating the risk. Can J Psychiatry 2002;47:959–65.

97. Wirshing DA, Marshall BD Jr, Green MF, Mintz J, Marder SR, Wirshing WC. Risperidone in treatment-refractory schizophrenia. Am J Psychiatry 1999;156:1374–9.

98. Kinon BJ, Basson BR, Gilmore JA, Tollefson GD. Long-term olanzapine treatment: weight change and weight-related health factors in schizophrenia. J Clin Psychiatry 2001;62:92–100.

99. Basson BR, Kinon BJ, Taylor CC, Szymanski KA, Gilmore JA, Tollefson GD. Factors influencing acute weight change in patients with schizophrenia treated with olanzapine, haloperidol, or risperidone. J Clin Psychiatry 2001;62:231–8.

100. Malhotra S, McElroy SL. Medical management of obesity associated with mental disorders. J Clin Psychiatry 2002;63(Suppl 4):24–32.

101. Littrell KH, Hilligoss NM, Kirshner CD, Petty RG, Johnson CG. The effects of an educational intervention on antipsychotic-induced weight gain. Journal of Nursing Scholarship 2003;35:237–41.

102. Wirshing DA, Pierre JM, Erhart SM, Boyd JA. Understanding the new and evolving profile of adverse drug effects in schizophrenia. Psychiatr Clin North Am 2003;26:165–90.

103. Casey DE. Dyslipidemia and atypical antipsychotic drugs. J Clin Psychiatry 2004;65(Suppl 18):27–35.

104. Consensus development conference on antipsychotic drugs and obesity and diabetes. J Clin Psychiatry 2004;65(2):267–72.

105. Newcomer JW, Haupt DW, Fucetola R, Melson AK, Schweiger JA, Cooper BP, and others. Abnormalities in glucose regulation during antipsychotic treatment of schizophrenia. Arch Gen Psychiatry 2002;59:337–45.

106. Lindenmayer JP, Czobor P, Volavka J, Citrome L, Sheitman B, McEvoy JP, and others. Changes in glucose and cholesterol levels in patients with schizophrenia treated with typical or atypical antipsychotics. Am J Psychiatry 2003;160:290–6.

107. Meyer JM. A retrospective comparison of weight, lipid, and glucose changes between risperidone- and olanzapine-treated inpatients: metabolic outcomes after 1 year. J Clin Psychiatry 2002;63:425–33.

108. Hennessy S, Bilker WB, Knauss JS, Margolis DJ, Kimmel SE, Reynolds RF, and others. Cardiac arrest and ventricular arrhythmia in patients taking antipsychotic drugs: cohort study using administrative data. BMJ 2002;325:1070.

109. Cutler AJ. Sexual dysfunction and antipsychotic treatment. Psychoneuroendocrinology 2003;28(Suppl 1):69–82.

110. Dickson RA, Glazer WM. Neuroleptic-induced hyperprolactinemia. Schizophr Res 1999;35(Suppl):S75–S86.

111. Abraham G, Halbreich U, Friedman RH, Josiassen RC. Bone mineral density and prolactin associations in patients with chronic schizophrenia. Schizophr Res 2003;59:17–8.

112. Knegtering H, van der Moolen AE, Castelein S, Kluiter H, van den Bosch RJ. What are the effects of antipsychotics on sexual dysfunctions and endocrine functioning? Psychoneuroendocrinology 2003;28(Suppl 2):109–23.

113. Atmaca M, Kuloglu M, Tezcan E, Canatan H, Gecici O. Quetiapine is not associated with increase in prolactin secretion in contrast to haloperidol. Arch Med Res 2002;33:562–5.

114. Serretti A, De Ronchi D, Lorenzi C, Berardi D. New antipsychotics and schizophrenia: a review on efficacy and side effects. Curr Med Chem 2004;11(3):343–58.

115. Kinon BJ, Gilmore JA, Liu H, Halbreich UM. Hyperprolactinemia in response to antipsychotic drugs: characterization across comparative clinical trials. Psychoneuroendocrinology 2003;28(Suppl 2):69–82.

116. Velligan DI, Miller AL. Cognitive dysfunction in schizophrenia and its importance to outcome: the place of atypical antipsychotics in treatment. J Clin Psychiatry 1999;60(Suppl 23):25–8.

117. Harvey PD, Meltzer H, Simpson GM, Potkin SG, Loebel A, Siu C, and others. Improvement in cognitive function following a switch to ziprasidone from conventional antipsychotics, olanzapine, or risperidone in outpatients with schizophrenia. Schizophr Res 2004;66(2–3):101–13.

118. Raggi MA, Mandrioli R, Sabbioni C, Pucci V. Atypical antipsychotics: pharmacokinetics, therapeutic drug monitoring and pharmacological interactions. Curr Med Chem 2004;11:279–96.

119. Oosthuizen PP, Emsley RA, Maritz JS, Turner JA, Keyter N. Incidence of tardive dyskinesia in first-episode psychosis patients treated with low-dose haloperidol. J Clin Psychiatry 2003;64:1075–80.

120. Awad AG, Voruganti LN. Neuroleptic dysphoria: revisiting the concept 50 years later. Acta Psychiatr Scand Suppl 2005;427:6–13.

121. Ananth J, Parameswaran S, Gunatilake S, Burgoyne K, Sidhom T. Neuroleptic malignant syndrome and atypical antipsychotic drugs. J Clin Psychiatry 2004;65(4):464–70.

122. Miller DD. Review and management of clozapine side effects. J Clin Psychiatry 2000;61(Suppl 8):14–7.

123. Zygmunt A, Olfson M Boyer CA, Mechanic D. Interventions to improve medication adherence in schizophrenia. Am J Psychiatry 2002;159:1653–64.

124. Lacro JP, Dunn LB, Dolder CR, Leckband SG, Jeste DV. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. J Clin Psychiatry 2002;63:892–909.

125. Amador XF, Strauss DH, Yale SA, Gorman JM. Awareness of illness in schizophrenia. Schizophr Bull 1991;17:113–32.

126. Mintz AR, Dobson KS, Romney DM. Insight in schizophrenia: a meta-analysis. Schizophr Res 2003;61:75–88.

127. Corrigan PW, Liberman RP, Engel JD. From noncompliance to collaboration in the treatment of schizophrenia. Hosp Community Psychiatry 1990;41:1203–11.

128. Dolder CR, Lacro JP, Leckband S, Jeste DV. Interventions to improve antipsychotic medication adherence: review of recent literature. J Clin Psychopharmacol 2003;23:389–99.

129. Fenton WS, Blyler CR, Heinssen RK. Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull 1997;23:637–51.

130. Thieda P, Beard S, Richter A, Kane J. An economic review of compliance with medication therapy in the treatment of schizophrenia. Psychiatr Serv 2003;54:508–16.

131. Nose M, Barbui C, Gray R, Tansella M. Clinical interventions for treatment non-adherence in psychosis: meta-analysis. Br J Psychiatry 2003;183:197–206.

132. Pekkala E, Merinder L. Psychoeducation for schizophrenia. Cochrane Database of Systematic Reviews 2004;(1).

133. Mueser KT, Corrigan PW, Hilton DW, Tanzman B, Schaub A, Gingerich S, and others. Illness management and recovery: a review of the research. Psychiatr Serv 2002;53:1272–84.

134. Heinssen RK. Improving medication compliance of a patient with schizophrenia through collaborative behavioral therapy. Psychiatr Serv 2002;53:255–7.

135. Crowther R, Marshall M, Bond G, Huxley P. Vocational rehabilitation for people with severe mental illness. Cochrane Database of Systematic Reviews 2004;(1).

136. Lehman A. Vocational rehabilitation in schizophrenia. Schizophr Bull 1995;21:645–56.

137. McCreadie RG. The Nithsdale schizophrenia surveys. An overview. Soc Psychiatry Psychiatr Epidemiol 1992;27:40–5.

138. Bailey EL, Ricketts SK, Becker DR, Xie H, Drake RE. Do long-term day treatment clients benefit from supported employment? Psychiatr Rehabil J 1998;22:24–9..

139. Bond GR, Dietzen LL, McGrew JH, Miller LD. Accelerating entry into supported employment for persons with severe psychiatric disabilities. Rehabil Psychol 1995;40:75–94..

140. Chandler D, Meisel J, Hu T, McGowen M, Madison K. A capitated model for a cross-section of severely mentally ill clients: employment outcomes. Community Ment Health J 1997;33:501–16.

141. Drake RE, Becker DR, Biesanz JC, Wyzik PF, Torrey WC. Day treatment versus supported employment for persons with severe mental illness: a replication study. Psychiatr Serv 1996;47:1125–7.

142. Lehman AF, Goldberg R, Dixon LB, McNary S, Postrado L, Hackman A, and others. Improving employment outcomes for persons with severe mental illnesses. Arch Gen Psychiatry 2002;59:165–72.

143. Twamley EW, Jeste DV, Lehman AF. Vocational rehabilitation in schizophrenia and other psychotic disorders: a literature review and meta-analysis of randomized controlled trials. J Nerv Ment Dis 2003;191(8):515–23.

144. Bond GR, Resnick SG, Drake RE, Xie H, McHugo GJ, Bebout RR. Does competitive employment improve nonvocational outcomes for people with severe mental illness? J Consult Clin Psychol 2001;69:489–501.

145. Lehman A. Vocational rehabiliation in schizophrenia (Review). Database of Abstracts of Reviews of Effectiveness 2002. Volume 2. June 2002.

146. McFarlane WR, Dushay RA, Deakins SM, Stastny P, Lukens EP, Toran J, and others. Employment outcomes in family-aided assertive community treatment. Am J Orthopsychiatry 2000;70:203–14.

147. Fuller TR, Oka M, Otsuka K, Yokoyama N, Liberman RP, Niwa SI. A hybrid supported employment program for persons with schizophrenia in Japan. Psychiatr Serv 2000;51:864–6.

148. Mueser KT, Becker DR, Torrey WC, Xie H, Bond GR, Drake RE, and others. Work and nonvocational domains of functioning in persons with severe mental illness: a longitudinal analysis. J Nerv Ment Dis 1997;185:419–26.

149. Torrey WC, Mueser KT, McHugo GH, Drake RE. Self-esteem as an outcome measure in studies of vocational rehabilitation for adults with severe mental illness. Psychiatr Serv 2000;51:229–33.

150. Campbell A, McCreadie RG. Occupational therapy is effective for chronic schizophrenic day-patients. British Journal of Occupational Therapy 1983;46:327–9.

151. Heinssen RK, Liberman RP, Kopelowicz A. Psychosocial skills training for schizophrenia: lessons from the laboratory. Schizophr Bull 2000;26:21–46.

152. Penn DL, Mueser KT. Research update on the psychosocial treatment of schizophrenia. Am J Psychiatry 1996;153:607–17.

153. Pilling S, Bebbington P, Kuipers E, Garety P, Geddes J, Martindale B, and others. Psychological treatments in schizophrenia: II. Meta-analyses of randomized controlled trials of social skills training and cognitive remediation. Psychol Med 2002;32:783–91.

154. Robertson L, Connaughton J, Nicol M. Life skills programmes for chronic mental illnesses. Cochrane Database of Systematic Reviews 2004;(1).

155. Bellack AS, Turner SM, Hersen M, Luber RF. An examination of the efficacy of social skills training for chronic schizophrenic patients. Hosp Community Psychiatry 1984;35:1023–8.

156. Hogarty GE, Anderson CM, Reiss DJ, Kornblith SJ, Greenwald DP, Javna CD, and others. Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. I. One-year effects of a controlled study on relapse and expressed emotion. Arch Gen Psychiatry 1986;43:633–42.

157. Liberman RP, Wallace CJ, Blackwell G, Kopelowicz A, Vaccaro JV, Mintz J. Skills training versus psychosocial occupational therapy for persons with persistent schizophrenia. Am J Psychiatry 1998;155:1087–91.

158. Slade M, Priebe S. Are randomised controlled trials the only gold that glitters? Br J Psychiatry 2001;179:286–7.

159. Dickerson FB. Cognitive behavioral psychotherapy for schizophrenia: a review of recent empirical studies. Schizophr Res 2000;43(2–3):71–90.

160. Norman RM, Townsend LA. Cognitive-behavioural therapy for psychosis: a status report. Can J Psychiatry 1999;44:245–52.

161. Pilling S, Bebbington P, Kuipers E, Garety P, Geddes J, Orbach G, and others. Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy. Psychol Med 2002;32:763–82.

162. Rector NA, Beck AT. Cognitive behavioral therapy for schizophrenia: an empirical review. J Nerv Ment Dis 2001;189:278–87.

163. Jones C, Cormac I, Campbell C, Silveira da Mota Neto J. Cognitive behaviour therapy for schizophrenia. Cochrane Database of Systematic Reviews 2004;(1).

164. Gumley A, O’Grady M, McNay L, Reilly J, Power K, Norrie J. Early intervention for relapse in schizophrenia: results of a 12-month randomized controlled trial of cognitive behavioural therapy. Psychol Med 2003;33:419–31.

165. Bechdolf A, Knost B, Kuntermann C, Schiller S, Klosterkotter J, Hambrecht M, and others. A randomized comparison of group cognitive-behavioural therapy and group psychoeducation in patients with schizophrenia. Acta Psychiatr Scand 2004;110(1):21–8.

166. Turkington D, Kingdon D, Turner T. Effectiveness of a brief cognitive-behavioural therapy intervention in the treatment of schizophrenia. Br J Psychiatry 2002;180:523–7.

167. Kuipers E, Fowler D, Garety P, Chisholm D, Freeman D, Dunn G, and others. London – East Anglia randomised controlled trial of cognitive-behavioural therapy for psychosis. III: Follow-up and economic evaluation at 18 months. Br J Psychiatry 1998;173:61–8.

168. Cochrane JJ, Goering PN, Rogers JM. The mental health of informal caregivers in Ontario: an epidemiological survey. Am J Public Health 1997;87:2002–7.

169. Baronet AM. Factors associated with caregiver burden in mental illness: a critical review of the research literature. Clin Psychol Rev 1999;19:819–41.

170. Mueser KT, Webb C, Pfeiffer M, Gladis M, Levinson DF. Family burden of schizophrenia and bipolar disorder: perceptions of relatives and professionals. Psychiatr Serv 1996;47:507–11.

171. Runions J, Prudo R. Problem behaviours encountered by families living with a schizophrenic member. Can J Psychiatry 1983;28:382–386.

172. Pitschel-Walz G, Leucht S, Bauml J, Kissling W, Engel RR. The effect of family interventions on relapse and rehospitalization in schizophrenia—a meta-analysis. Schizophr Bull 2001;27:73–92.

173. Hazel NA, McDonell MG, Short RA, Berry CM, Voss WD, Rodgers ML, and others. Impact of multiple-family groups for outpatients with schizophrenia on caregivers’ distress and resources. Psychiatr Serv 2004;55:35–41.

174. Mullen A, Murray L, Happell B. Multiple family group interventions in first episode psychosis: enhancing knowledge and understanding. Int J Ment Health Nurs 2002;11:225–32.

175. McFarlane WR, Dixon L, Lukens E, Lucksted A. Family psychoeducation and schizophrenia: a review of the literature. Journal of Marital and Family Therapy 2003;29:223–45.

176. Barrowclough C, Tarrier N, Lewis S, Sellwood W, Mainwaring J, Quinn J, and others. Randomised controlled effectiveness trial of a needs-based psychosocial intervention service for carers of people with schizophrenia. Br J Psychiatry 1999;174:505–11.

177. Twamley EW, Jeste DV, Bellack AS. A review of cognitive training in schizophrenia. Schizophr Bull 2003;29:359–82.

178. Green MF, Kern RS, Braff DL, Mintz J. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the “right stuff”? Schizophr Bull 2000;26:119–36.

179. Goldberg TE, Weinberger DR. Schizophrenia, training paradigms, and the Wisconsin Card Sorting Test redux. Schizophr Res 1994;11:291–6.

180. Kurtz MM, Moberg PJ, Gur RC, Gur RE. Approaches to cognitive remediation of neuropsychological deficits in schizophrenia: a review and meta-analysis. Neuropsychol Rev 2001;11:197–210.

181. Bark N, Revheim N, Huq F, Khalderov V, Ganz ZW, Medalia A. The impact of cognitive remediation on psychiatric symptoms of schizophrenia. Schizophr Res 2003;63:229–35.

182. Velligan DI, Bow-Thomas CC. Two case studies of cognitive adaptation training for outpatients with schizophrenia. Psychiatr Serv 2000;51:25–9.

183. Hayes RL, McGrath JJ. Cognitive rehabilitation for people with schizophrenia and related conditions. Cochrane Database of Systematic Reviews 2004;(1).

184. Krabbendam L, Aleman A. Cognitive rehabilitation in schizophrenia: a quantitative analysis of controlled studies. Psychopharmacology 2003;169:376–82.

185. Wykes T, van der GM. Is it time to develop a new cognitive therapy for psychosis—cognitive remediation therapy (CRT)? Clin Psychol Rev 2001;21:1227–56.

186. Mead S, Copeland ME. What recovery means to us: consumers’ perspectives. Community Ment Health J 2000;36:315–28.

187. Anthony WA. A recovery-oriented service system: setting some system level standards. Psychiatr Rehabil J 2000;24:159–68.

188. Chamberlin J, Rogers ES, Ellison ML. Self-help programs: description of their characteristics and their members. Psychiatric Rehabilitation Journal 1996;19(3):33–42.

189. Soloman P, Draine J. The state of knowledge of the effectiveness of consumer provided services. Psychiatr Rehabil J 2001;25:20–7.

190. Felton CJ, Stastny P, Shern DL, Blanch A, Donahue SA, Knight E, and others. Consumers as peer specialists on intensive case management teams: impact on client outcomes. Psychiatr Serv 1995;46:1037–44.

191. Soloman P. Peer support/peer provided services underlying processes, benefits, and critical ingredients. Psychiatric Rehabilitation Journal 2004;27(4):392–401.

192. Corrigan PW, Garman AN. Considerations for research on consumer empowerment and psychosocial interventions. Psychiatr Serv 1997;48:347–52.

193. Davidson L, Chinman M, Kloos B, Weingarten R, Stayner D, Tebes JK. Peer support among individuals with severe mental illness: a review of the evidence. Clin Psychol Sci Pract 1999;6:165–87.

194. Resnick SG, Rosenheck RA, Lehman AF. An exploratory analysis of correlates of recovery. Psychiatr Serv 2004;55(5):540–7.

195. Leung D, De Sousa L. A vision and mission for peer support-stakeholder perspectives. International Journal of Psychosocial Rehabilitation 2002;7:5–12.

196. Link BG, Struening EL, Neese-Todd S, Asmussen S, Phelan JC. Stigma as a barrier to recovery: the consequences of stigma for the self-esteem of people with mental illnesses. Psychiatr Serv 2001;52:1621–6.

197. Corrigan P, Thompson V, Lambert D, Sangster Y, Noel JG, Campbell J. Perceptions of discrimination among persons with serious mental illness. Psychiatr Serv 2003;54(8):1105–10.

198. Corrigan PW, Lundin R. Don’t call me nuts! Coping with the stigma of mental illness. Tinley Park (IL): Recovery Press; 2001.

199. Corrigan PW, River LP, Lundin RK, Penn DL, Uphoff-Wasowski K, Campion J, and others. Three strategies for changing attributions about severe mental illness. Schizophr Bull 2001;27:187–95.

200. Addington DD, Azorin JM, Falloon IR, Gerlach J, Hirsch SR, Siris SG. Clinical issues related to depression in schizophrenia: an international survey of psychiatrists. Acta Psychiatr Scand 2002;105:189–95.

201. Craig T, Hwang MY, Bromet EJ. Obsessive–compulsive and panic symptoms in patients with first-admission psychosis. Am J Psychiatry 2002;159:592–8.

202. Mueser KT, Salyers MP, Rosenberg SD, Ford JD, Fox L, Carty P. Psychometric evaluation of trauma and posttraumatic stress disorder assessments in persons with severe mental illness. Psychol Assess 2001;13:110–7.

203. Norman RM, Malla AK, Cortese L, Diaz F. Aspects of dysphoria and symptoms of schizophrenia. Psychol Med 1998;28:1433–41.

204. Delespaul P, deVries M, van Os J. Determinants of occurrence and recovery from hallucinations in daily life. Soc Psychiatry Psychiatr Epidemiol 2002;37:97–104.

205. Huppert JD, Weiss KA, Lim R, Pratt S, Smith TE. Quality of life in schizophrenia: contributions of anxiety and depression. Schizophr Res 2001;51:171–80.

206. Power PJ, Bell RJ, Mills R, Herrman-Doig T, Davern M, Henry L, and others. Suicide prevention in first episode psychosis: the development of a randomised controlled trial of cognitive therapy for acutely suicidal patients with early psychosis. Aust N Z J Psychiatry 2003;37:414–20.

207. Trower P, Birchwood M, Meaden A, Byrne S, Nelson A, Ross K. Cognitive therapy for command hallucinations: randomised controlled trial. Br J Psychiatry 2004;184:312–20.

208. Kingsep P, Nathan P, Castle D. Cognitive behavioural group treatment for social anxiety in schizophrenia. Schizophr Res 2003;63:121–9.

209. Norman RM, Malla AK, McLean TS, McIntosh EM, Neufeld RW, Voruganti LP, and others. An evaluation of a stress management program for individuals with schizophrenia. Schizophr Res 2002;58:293–303.

210. Addington J, Addington D. Effect of substance misuse in early psychosis. Br J Psychiatry Suppl 1998;172(33):134–6.

211. Weiser M, Reichenberg A, Grotto I, Yasvitzky R, Rabinowitz J, Lubin G, and others. Higher rates of cigarette smoking in male adolescents before the onset of schizophrenia: a historical-prospective cohort study. Am J Psychiatry 2004;161:1219–23.

212. Arseneault L, Cannon M, Witton J, Murray RM. Causal association between cannabis and psychosis: examination of the evidence. Br J Psychiatry 2004;184:110–7.

213. Rosenberg SD, Drake RE, Wolford GL, Mueser KT, Oxman TE, Vidaver RM, and others. Dartmouth Assessment of Lifestyle Instrument (DALI): a substance use disorder screen for people with severe mental illness. Am J Psychiatry 1998;155:232–8.

214. Ziedonis DM, Trudeau K. Motivation to quit using substances among individuals with schizophrenia: implications for a motivation-based treatment model. Schizophr Bull 1997;23:229–38.

215. Mueser KT, Noordsy DL, Drake RE, Fox L. Integrated treatment for dual disorders: a guide to effective practice. New York: Guilford Press; 2003.

216. Graeber DA, Moyers TB, Griffith G, Guajardo E, Tonigan S. A pilot study comparing motivational interviewing and an educational intervention in patients with schizophrenia and alcohol use disorders. Community Ment Health J 2003;39:189–202.

217. Drake RE, Mueser KT, Brunette MF, McHugo GJ. A review of treatments for people with severe mental illnesses and co-occurring substance use disorders. Psychiatr Rehabil J 2004;27(4):360–74.

218. Carey KB, Maisto SA, Carey MP, Gordon CM, Correia CJ. Use of legal drugs by psychiatric outpatients: benefits, costs, and change. Cognitive and Behavioral Practice 1999;6:15–22.

219. McEvoy J, Freudenreich O, McGee M, VanderZwaag C, Levin E, Rose J. Clozapine decreases smoking in patients with chronic schizophrenia. Biol Psychiatry 1995;37:550–2.

220. Greer LA, Weerasekera P, Linder B, Goldberg JO. Couples communication skills training for schizophrenia. Can J Psychiatry 1997;42:666–7.

221. Greer LA, Goldberg JO, Weerasekera P. Prenatal planning for people with schizophrenia: Integrating individual and couple-level interventions. Psychiatr Rehabi Skills 1997;2(1):37–48.

222. Feinleib M. A dictionary of epidemiology. 4th ed. Last JM, Spasoff RA, Harris SS, editors. [book review] Am J Epidemiol 2001;154(1):93–4.

223. Wyatt RJ. Neuroleptics and the natural course of schizophrenia. Schizophr Bull 1991;17:325–51.

224. Remington G, Kapur S, Zipursky RB. Pharmacotherapy of first-episode schizophrenia. Br J Psychiatry Suppl 1998;172(33):66–70.

225. Lieberman JA, Tollefson G, Tohen M, Green AI, Gur RE, Kahn R, and others. Comparative efficacy and safety of atypical and conventional antipsychotic drugs in first-episode psychosis: a randomized, double-blind trial of olanzapine versus haloperidol. Am J Psychiatry 2003;160(8):1396–404.

226. Lehman AF, Steinwachs DM. Evidence-based psychosocial treatment practices in schizophrenia: lessons from the patient outcomes research team (PORT) project. J Am Acad Psychoanal Dyn Psychiatry 2003;31:141–54.

227. Wolff N. Using randomized controlled trials to evaluate socially complex services: problems, challenges and recommendations. J Ment Health Policy Econ 2000;3:97–109.

228. Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q 1996;74:511–44.

229. Norman RM, Malla AK. Duration of untreated psychosis: a critical examination of the concept and its importance. Psychol Med 2001;31:381–400.

230. Gater R, de Almeida e Sousa, Barrientos G, Caraveo J, Chandrashekar CR, Dhadphale M, and others. The pathways to psychiatric care: a cross-cultural study. Psychol Med 1991;21:761–74.

231. Cougnard A, Kalmi E, Desage A, Misdrahi D, Abalan F, Brun-Rousseau H, and others. Pathways to care of first-admitted subjects with psychosis in South-Western France. Psychol Med 2004;34(2):267–76.

232. Norman RM, Malla AK, Verdi MB, Hassall LD, Fazekas C. Understanding delay in treatment for first-episode psychosis. Psychol Med 2004;34(2):255–66.

233. Addington D, el Guebaly N, Chandarana P, Atkinson M. Canadian clinical practice guidelines for the treatment of schizophrenia: adherence and awareness. Can Psychiatr Assoc Bull 2000; 32(6):164–7.

234. Reda S, Makhoul S. Prompts to encourage appointment attendance for people with serious mental illness. Cochrane Database of Systematic Reviews 2004;(2).

235. Edwards J, Harrigan SM, McGorry PD, Amminger PG. Duration of untreated psychosis (DUP) and outcome in schizophrenia. Psychol Med 2002;32:563–4.

236. Malla A, Norman R, McLean T, Scholten D, Townsend L. A Canadian programme for early intervention in non-affective psychotic disorders. Aust N Z J Psychiatry 2003;37:407–13.

237. Pelosi AJ, Birchwood M. Is early intervention for psychosis a waste of valuable resources? Br J Psychiatry 2003;182:196–8.

238. Birchwood M, Smith J, MacMillan F, Hogg B, Prasad R, Harvey C, and others. Predicting relapse in schizophrenia: the development and implementation of an early signs monitoring system using patients and families as observers, a preliminary investigation. Psychol Med 1989;19:649–56.

239. Harrison G, Hopper K, Craig T, Laska E, Siegel C, Wanderling J, and others. Recovery from psychotic illness: a 15- and 25-year international follow-up study. Br J Psychiatry 2001;178:506–17.

240. Norman RM, Townsend L, Malla AK. Duration of untreated psychosis and cognitive functioning in first-episode patients. Br J Psychiatry 2001;179:340–5.

241. Craig TK, Garety P, Power P, Rahaman N, Colbert S, Fornells-Ambrojo M, and others. The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ 2004;329(7474):1067.

242. Scholten DJ, Malla AK, Norman RM, McLean TS, McIntosh EM, McDonald CL, and others. Removing barriers to treatment of first-episode psychotic disorders. Can J Psychiatry 2003;48:561–5.

243. Melle I, Larsen TK, Haahr U, Friis S, Johannessen JO, Opjordsmoen S, and others. Reducing the duration of untreated first-episode psychosis: effects on clinical presentation. Arch Gen Psychiatry 2004;61:143–50.

244. Malla AM, Norman RM. Treating psychosis: is there more to early intervention than intervening early? Can J Psychiatry 2001;46:645–48.

245. Kuipers E, Holloway F, Rabe-Hesketh S, Tennakoon L. An RCT of early intervention in psychosis: Croydon Outreach and Assertive Support Team (COAST). Soc Psychiatry Psychiatr Epidemiol 2004;39(5):358–63.

246. Thornicroft G, Tansella M. Components of a modern mental health service: a pragmatic balance of community and hospital care: overview of systematic evidence. Br J Psychiatry 2004;185:283–90.

247. Quirk A, Lelliott P. What do we know about life on acute psychiatric wards in the UK? A review of the research evidence. Soc Sci Med 2001;53:1565–74.

248. Tomov T. Mental health reforms in Eastern Europe. Acta Psychiatr Scand Suppl 2001;410:21–6.

249. Marshall M, Crowther R, Almaraz-Serrano A, Creed F, Sledge W, Kluiter H, and others. Systematic reviews of the effectiveness of day care for people with severe mental disorders: (1) acute day hospital versus admission; (2) vocational rehabilitation; (3) day hospital versus outpatient care. Health Technol Assess 2001;5:1–75.

250. Marshall M, Crowther R, Almaraz-Serrano AM, Tyrer P. Day hospital versus out-patient care for psychiatric disorders. Cochrane Database of Systematic Reviews 2004;(1).

251. Audini B, Marks IM, Lawrence RE, Connolly J, Watts V. Home-based versus out-patient/in-patient care for people with serious mental illness. Phase II of a controlled study. Br J Psychiatry 1994;165:204–10.

252. Knapp M, Beecham J, Koutsogeorgopoulou V, Hallam A, Fenyo A, Marks IM, and others. Service use and costs of home-based versus hospital-based care for people with serious mental illness. Br J Psychiatry 1994;165:195–203.

253. Marks IM, Connolly J, Muijen M, Audini B, McNamee G, Lawrence RE. Home-based versus hospital-based care for people with serious mental illness. Br J Psychiatry 1994;165:179–94.

254. Durbin J, Goering P, Cochrane J, Macfarlane D, Sheldon T. Needs-based planning for persons with schizophrenia residing in board-and-care homes. Schizophr Bull 2004;30(1):123–32.

255. Hugo M, Smout M, Bannister J. A comparison in hospitalization rates between a community-based mobile emergency service and a hospital-based emergency service. Aust N Z J Psychiatry 2002;36:504–8.

256. Von Korff M, Goldberg D. Improving outcomes in depression. BMJ 2001;323:948–9.

257. Tyrer P, Coid J, Simmonds S, Joseph P, Marriott S. Community mental health teams (CMHTs) for people with severe mental illnesses and disordered personality. Cochrane Database of Systematic Reviews 2004;(1).

258. Burns T, Fioritti A, Holloway F, Malm U, Rossler W. Case management and assertive community treatment in Europe. Psychiatr Serv 2001;52:631–6.

259. Simmonds S, Coid J, Joseph P, Marriott S, Tyrer P. Community mental health team management in severe mental illness: a systematic review. Br J Psychiatry 2001;178:497–502.

260. Kanter J. Clinical case management: definition, principles, components. Hosp Community Psychiatry 1989;40:361–8.

261. Rapp CA. Theory, principles and methods of the strengths model of case management. In: Harris MBH, editor. Case management for mentally ill patients: theory and practice. Langhorne (PA): Harwood Academy Publishers, 1993. p 143–64.

262. Anthony WA, Cohen M, Farkas M, Cohen BF. The chronically mentally ill case management—more than a response to a dysfunctional system. Community Ment Health J 1988;24:219–28.

263. Mueser KT, Bond GR, Drake RE, Resnick SG. Models of community care for severe mental illness: a review of research on case management. Schizophr Bull 1998;24:37–74.

264. Scott JE, Dixon LB. Assertive community treatment and case management for schizophrenia. Schizophr Bull 1995;21:657–68.

265. Lauriello J, Bustillo J, Keith SJ. A critical review of research on psychosocial treatment of schizophrenia. Biol Psychiatry 1999;46:1409–17.

266. Latimer EA. Economic impacts of assertive community treatment: a review of the literature. Can J Psychiatry 1999;44:443–54.

267. Marshall M, Lockwood A. Assertive community treatment for people with severe mental disorders. Cochrane Database of Systematic Reviews 2004;(1).

268. Surles RC, Blanch AK, Shern DL, Donahue SA. Case management as a strategy for systems change. Health Aff (Millwood ) 1992;11:151–63.

269. Marshall M, Gray A, Lockwood A, Green R. Case management for people with severe mental disorders. Cochrane Database of Systematic Reviews 2004;(1).

270. Tempier R, Pawliuk N, Perreault M, Steiner W. Satisfaction with clinical case management services of patients with long-term psychoses. Community Ment Health J 2002;38:51–9.

271. Lesage AD, Gelinas D, Robitaille D, Dion E, Frezza D, Morissette R. Toward benchmarks for tertiary care for adults with severe and persistent mental disorders. Can J Psychiatry 2003;48:485–92.

272. Trainor JN, Morrell-Bellai TL, Ballantyne R, Boydell KM. Housing for people with mental illnesses: a comparison of models and an examination of the growth of alternative housing in Canada. Can J Psychiatry 1993;38:494–501.

273. McHugo GJ, Bebout RR, Harris M, Cleghorn S, Herring G, Xie H, and others. A randomized controlled trial of integrated versus parallel housing services for homeless adults with severe mental illness. Schizophr Bull 2004;30(4):969–82.

274. Friedrich RM, Hollingsworth B, Hradek E, Friedrich HB, Culp KR. Family and client perspectives on alternative residential settings for persons with severe mental illness. Psychiatr Serv 1999;50:509–14.

275. Shepherd G, Murray A. Residential care. Textbook of community psychiatry. Oxford (UK): Oxford University Press; 2001. p 309–20.

276. Thornicroft G, Bebbington P. Deinstitutionalisation—from hospital closure to service development. Br J Psychiatry 1989; 155:739–53.

277. Leff J. Aiding resocialization of the chronic psychotic patient. Int Clin Psychopharmacol 1997;12(Suppl 4):S19–S24.

278. Malla AK, Norman RM. Prodromal symptoms in schizophrenia. Br J Psychiatry 1994;164:487–93.

279. Herz MI, Lamberti JS. Prodromal symptoms and relapse prevention in schizophrenia. Schizophr Bull 1995;21:541–51.

280. Norman RM, Malla AK. Prodromal symptoms of relapse in schizophrenia: a review. Schizophr Bull 1995;21:527–39.

281. Phillips LJ, Yung AR, Yuen HP, Pantelis C, McGorry PD. Prediction and prevention of transition to psychosis in young people at incipient risk for schizophrenia. Am J Med Genet 2002;114:929–37.

282. Yung AR, Phillips LJ, Yuen HP, Francey SM, McFarlane CA, Hallgren M, and others. Psychosis prediction: 12-month follow up of a high-risk (“prodromal”) group. Schizophr Res 2003;60(1):21–32.

283. McGorry PD, Yung AR, Phillips LJ, Yuen HP, Francey S, Cosgrave EM, and others. Randomized controlled trial of interventions designed to reduce the risk of progression to first-episode psychosis in a clinical sample with subthreshold symptoms. Arch Gen Psychiatry 2002;59:921–8.

284. McGlashan TH. Commentary: progress, issues, and implications of prodromal research: an inside view. Schizophr Bull 2003;29(4):851–8.

285. McGlashan TH, Zipursky RB, Perkins D, Addington J, Miller TJ, Woods SW, and others. The PRIME North America randomized double-blind clinical trial of olanzapine versus placebo in patients at risk of being prodromally symptomatic for psychosis. I. Study rationale and design. Schizophr Res 2003;61:7–18.

286. Miller TJ, Zipursky RB, Perkins D, Addington J, Woods SW, Hawkins KA, and others. The PRIME North America randomized double-blind clinical trial of olanzapine versus placebo in patients at risk of being prodromally symptomatic for psychosis. II. Baseline characteristics of the “prodromal” sample. Schizophr Res 2003;61:19–30.

287. Morrison AP, Renton JC, Williams S, Dunn H, Knight A, Kreutz M, and others. Delivering cognitive therapy to people with psychosis in a community mental health setting: an effectiveness study. Acta Psychiatr Scand 2004; 110(1):36–44.

288. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, and others. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996;17:1–12.