Treatment of adult patients with schizophrenia and complex mental health needs - A national clinical guideline

Lone Baandrup, Jesper Østrup Rasmussen, Louise Klokker, Stephen Austin, Thomas Bjørnshave, Vibeke Fuglsang Bliksted, Anders Fink-Jensen, Allan Hedegaard Fohlmann, Jens Peter Hansen, Malene Kristine Nielsen, Karl Erik Sandsten, Vilhelm Schultz, Susanne Voss-Knude, Merete Nordentoft

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstract

    BACKGROUND AND AIM: The Danish Health and Medicines Authority assembled a group of experts to develop a national clinical guideline for patients with schizophrenia and complex mental health needs. Within this context, ten explicit review questions were formulated, covering several identified key issues.

    METHODS: Systematic literature searches were performed stepwise for each review question to identify relevant guidelines, systematic reviews/meta-analyses, and randomized controlled trials. The quality of the body of evidence for each review question was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Clinical recommendations were developed on the basis of the evidence, assessment of the risk-benefit ratio, and perceived patient preferences.

    RESULTS: Based on the identified evidence, a guideline development group (GDG) recommended that the following interventions should be offered routinely: antipsychotic maintenance therapy, family intervention and assertive community treatment. The following interventions should be considered: long-acting injectable antipsychotics, neurocognitive training, social cognitive training, cognitive behavioural therapy for persistent positive and/or negative symptoms, and the combination of cognitive behavioural therapy and motivational interviewing for cannabis and/or central stimulant abuse. SSRI or SNRI add-on treatment for persistent negative symptoms should be used only cautiously. Where no evidence was available, the GDG agreed on a good practice recommendation.

    CONCLUSIONS: The implementation of this guideline in daily clinical practice can facilitate good treatment outcomes within the population of patients with schizophrenia and complex mental health needs. The guideline does not cover all available interventions and should be used in conjunction with other relevant guidelines.

    OriginalsprogEngelsk
    Sider (fra-til)231-40
    Antal sider10
    TidsskriftNordic journal of psychiatry
    Vol/bind70
    Udgave nummer3
    DOI
    StatusUdgivet - 2016

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