Schizophrenia: The NICE Guideline on Core Interventions in the Treatment and Management of Schizophrenia in Adults in Primary and Secondary Care(NICE Guidelines)

This guideline on Schizophrenia, commissioned by NICE and developed by the National Collaborating Centre for Mental Health, sets out clear, evidence- and consensus-based recommendations for healthcare staff on how to manage and treat schizophrenia in adults. This guideline is an update of the previous guidance (full guideline published 2003), which was the first guideline that NICE ever produced and which was judged to be superior to other schizophrenia guidelines in an international survey. This updated guideline provides new clinical and economic evidence about the use of psychological and psychosocial interventions and antipsychotic drugs and new reviews of early intervention services, primary care and treatment for physical health problems. There are also new chapters on access and engagement for minority ethnic groups and on service user and carer experience of treatment and care for schizophrenia. NICE Mental Health Guidelines These guidelines from NICE set out clear recommendations, based on the best available evidence, for health care professionals on how to work with and implement physical, psychological and service-level interventions for people with various mental health conditions. The book contains the full guidelines that cannot be obtained in print anywhere else. It brings together all of the evidence that led to the recommendations made, detailed explanations of the methodology behind their preparation, plus an overview of the condition covering detection, diagnosis and assessment, and the full range of treatment and care approaches. The accompanying free CD-ROM contains all the data used as evidence, including: * Included and excluded studies. * Profile tables that summarise both the quality of the evidence and the results of the evidence synthesis. * All meta-analytical data, presented as forest plots. * Detailed information about how to use and interpret forest plots.

Table of Contents:
Full Contents 1. PREFACE 1.1 National guideline 1.2 The national schizophrenia guideline 2. SCHIZOPHRENIA 2.1 The disorder 2.2 Incidence and prevalence 2.3 Possible causes of schizophrenia 2.4 Assessment 2.5 Engagement, consent and therapeutic alliance 2.6 Language and stigma 2.7 Issues for families and carers 2.8 Treatment and management of schizophrenia in the NHS 2.9 The economic cost of schizophrenia 3. METHODS USED TO UPDATE THIS GUIDELINE 3.1 Overview 3.2 The scope 3.3 The guideline development group 3.4 Clinical questions 3.5 Systematic clinical literature review 3.6 Health economics methods 3.7 Stakeholder contributions 3.8 Validation of the guideline 4. EXPERIENCE OF CARE 4.1 Introduction 4.2 Methodology 4.3 Personal accounts from people with schizophrenia 4.4 Personal accounts from carers 4.5 Summary of themes from service users' and carers' experiences 4.6 Recommendations 5. ACCESS AND ENGAGEMENT 5.1 Introduction 5.2 Early intervention 5.3 Access and engagement to service-level interventions 6. PHARMACOLOGICAL INTERVENTIONS IN THE TREATMENT AND MANAGEMENT OF SCHIZOPHRENIA 6.1 Introduction 6.2 Initial treatment with antipsychotic medication 6.3 Oral antipsychotics in the treatment of the acute episode 6.4 Promoting recovery in people with schizophrenia that is in remission - pharmacological relapse prevention 6.5 Promoting recovery in people with schizophrenia whose illness has not responded adequately to treatment 6.6 Treatment with depot/long-acting injectable antipsychotic medication 6.7 Side effects of antipsychotic medication 6.8 Effectiveness of antipsychotic medication 6.9 Health economics 6.10 From evidence to recommendations 6.11 Recommendations 7. ECONOMIC MODEL - COST EFFECTIVENESS OF PHARMACOLOGICAL INTERVENTIONS FOR PEOPLE WITH SCHIZOPHRENIA 7.1 Introduction 7.2 Economic modelling methods 7.3 Results 7.4 Discussion of findings - limitations of the analysis 7.5 Conclusions 8. PSYCHOLOGICAL THERAPY AND PSYCHOSOCIAL INTERVENTIONS IN THE TREATMENT AND MANAGEMENT OF SCHIZOPHRENIA 8.1 Introduction 8.2 Adherence therapy 8.3 Arts therapies 8.4 Cognitive behavioural therapy 8.5 Cognitive remediation 8.6 Counselling and supportive therapy 8.7 Family intervention 8.8 Psychodynamic and psychoanalytic therapies 8.9 Psychoeducation 8.10 Social skills training 8.11 Recommendations (Across all treatments) 9. SERVICE-LEVEL INTERVENTIONS IN THE TREATMENT AND MANAGEMENT OF SCHIZOPHRENIA 9.1 Introduction 9.2 Interface between primary and secondary care 9.3 Community mental health teams 9.4 Assertive outreach (Assertive community treatment) 9.5 Acute day hospital care 9.6 Vocational rehabilitation 9.7 Non-acute day hospital care 9.8 Crisis resolution and home treatment teams 9.9 Intensive case management 10. SUMMARY OF RECOMMENDATIONS 10.1 Care across all phases 10.2 Initiation of treatment (First episode) 10.3 Treatment of the acute episode 10.4 Promoting recovery 10.5 Research recommendations 11. APPENDICES 12. REFERENCES 13. ABBREVIATIONS

About the Author :
The National Collaborating Centre for Mental Health (NCCMH) was established in 2001 by the UK-based National Institute for Health and Clinical Excellence (NICE) to develop guidance on the appropriate treatment and care of people with mental health problems and then write the clinical guidelines. The NCCMH is a partnership between the Royal College of Psychiatrists and the British Psychological Society.