Contents
I. INTRODUCTION
7S Rationale
8S Guideline Development Process
8S Table 1 Criteria for rating quality of published evidence
in individual articles reviewed
9S Literature Search
9S Screening Process
9S Table 2 Evidence level summary for rating evidence
10S Quality-Rating Process
II. ASSESSMENTS
11S General Principles
11S Acute Phase
12S Table 3 Assessments for patients with schizophrenia
13S Stabilization Phase
13S Stable Phase
14S Relapse and Adherence to Treatment
14S Table 4 Recommendation
15S Specific Clinical Situations and Assessments
15S First Episode
15S Neuropsychological Assessment
15S Genetic Assessment
16S Neuroimaging
16S Poorly Responsive or “Refractory” Illness
16S Comorbid Conditions
16S Physical Health Monitoring
17S Dual Diagnosis (Mental Retardation)
III. PHARMACOTHERAPY
19S Medications
19S General Principles
19S Second-Generation Antipsychotics
20S Pharmacologic Strategies for Phase-Specific Treatment
20S Acute Phase
21S Table 5 Second-generation antipsychotic dosages and titration
22S Stabilization Phase
22S Stable Phase
25S Management of Side Effects
25S Weight Gain and Abdominal Obesity
25S Impairment in Glucose Regulation and Diabetes
25S Dyslipidemia
25S QT Prolongation
25S Endocrine and Sexual Side Effects
26S Cognitive Side Effects and Sedation
26S Extrapyramidal Side Effects
26S Neuroleptic Dysphoria
26S Neuroleptic Malignant Syndrome
27S Clozapine Side Effect Profile
27S Table 6 Recommendations
28S Drug–Drug Interactions
IV. PSYCHOSOCIAL INTERVENTIONS
29S General Principles
29S Medication Adherence and Psychoeducation
30S Vocational Interventions
30S Skills Training
30S Cognitive-Behavioural Interventions
31S Family Interventions
32S Cognitive Remediation
32S Peer Support, Self-Help, and Recovery
33S Stigma
33S Associated Features and Special Situations
33S Treatment of Comorbid Symptoms
33S Substance Use
33S Prenatal Planning
34S Psychosocial Interventions Across Illness Phases
34S Acute Phase
34S Stabilization Phase
34S Stable Phase
35S Table 7 Recommendations
V. SERVICE DELIVERY
37S Service Delivery and the Treatment System
37S General Principles
37S Access
38S Availability
38S Coordination and Continuity of Care
38S Service Delivery Components
38S Early Psychosis Treatment Services
38S Acute Inpatient Care
38S Day Hospitals
39S Home-Based Acute Care
39S Mobile Crisis Service
39S Outpatient and Community Mental Health Services
39S Case Management
40S Residential Care
41S Table 8 Recommendations
VI. SPECIAL ISSUES
43S The Prodromal Phase of Schizophrenia
43S Table 9 Recommendations
LIST OF ABBREVIATIONS
REFERENCES
APPENDICES
53S Appendix I Jadad Scale for Rating Clinical Trials
54S Appendix II Algorithm A. Pharmacotherapy. Acute
Emergent Phase: The Severely Aggressive and (or)
Agitated Patient
55S Appendix III Algorithm B. Pharmacotherapy:
Stabilization and Stable Phase
56S Appendix IV Schema of Psychosocial Interventions:
Stabilization and Stable Phase
ACKNOWLEDGEMENTS
|
