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Latest & greatest articles for schizophrenia
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Individual differences in schizophrenia Whether there are distinct subtypes of schizophrenia is an important issue to advance understanding and treatment of schizophrenia.To understand and treat individuals with schizophrenia, the aim was to advance understanding of differences between individuals, whether there are discrete subtypes, and how first-episode patients (FEP) may differ from multiple episode patients (MEP).These issues were analysed in 687 FEP and 1880 MEP with schizophrenia using (...) the Positive and Negative Syndrome Scale for (PANSS) schizophrenia before and after antipsychotic medication for 6 weeks.The seven Negative Symptoms were correlated with each other and with P2 (conceptual disorganisation), G13 (disturbance of volition), and G7 (motor retardation). The main difference between individuals was in the cluster of seven negative symptoms, which had a continuous unimodal distribution. Medication decreased the PANSS scores for all the symptoms, which were similar in the FEP
Treatment for Adults With Schizophrenia Comparative Effectiveness Review Number 198 Treatments for Schizophrenia in Adults: A Systematic Review eComparative Effectiveness Review Number 198 Treatments for Schizophrenia in Adults: A Systematic Review Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-00009-I Prepared by: Pacific Northwest Evidence-based Practice Center (...) Portland, OR Investigators: Marian S. McDonagh, Pharm.D. Tracy Dana, M.L.S. Shelley Selph, M.D., M.P.H. Emily B. Devine, Pharm.D., Ph.D., M.B.A. Amy Cantor, M.D., M.P.H. Christina Bougatsos, M.P.H. Ian Blazina, M.P.H. Sara Grusing, B.A. Rochelle Fu, Ph.D. Sarah L. Kopelovich, Ph.D. Maria Monroe-DeVita, Ph.D. Daniel W. Haupt, M.D. AHRQ Publication No. 17(18)-EHC031-EF October 2017 Key Messages Purpose of Review To evaluate treatments for schizophrenia. Key Messages • Olanzapine, aripiprazole
Morphology of the corpus callosum and schizophrenia: A case-control study in Kashan, Iran Corpus Callosum (CC) plays a significant role in hemispheric communication and in lateralized brain function and behaviors. Structural abnormalities in the corpus callosum of schizophrenic patients were reported. However, previous studies regarding the relationship between morphology of CC in patients with schizophrenia and healthy people are controversial.To evaluate the morphological differences (...) group was splenial bulbosity. The length and area of the CC in patients with schizophrenia were less than those of the control group and were greater in men compared with women in both groups. Although there was a significant difference in the surface area of the CC between the schizophrenic and control groups (p<0.001), no significant difference was seen regarding the anteroposterior length of CC (p=0.75). Moreover, a significant correlation was found between the surface area and anteroposterior
Different communication strategies for disclosing a diagnosis of schizophrenia and related disorders. Delivering the diagnosis of a serious illness is an important skill in most fields of medicine, including mental health. Research has found that communication skills can impact on a person's recall and understanding of the diagnosis, treatment options and prognosis. People may feel confused and perplexed when information about their illness is not communicated properly. Sharing information (...) diagnoses to people; however, little is known specifically for delivering a diagnosis of schizophrenia.To evaluate evidence from randomised controlled trials (RCTs) for the efficacy of different communication strategies used by clinicians to inform people about the diagnosis and outcome of schizophrenia compared with treatment as usual and to compare efficacy between different communication strategies.On 22 June 2015 and 29 June 2016, we searched the Cochrane Schizophrenia Group's Study-Based Register
A Review of Clinical and Economic Evaluations Applied to Psychotropic Therapies Used in the Treatment of Schizophrenia in Argentina Schizophrenia is considered a serious mental disorder that affects over 21 million people worldwide, and is associated with disability that frequently affects the patient's educational and working performance. In Argentina, two of the most widely used antipsychotics in the treatment of this disorder are haloperidol and risperidone. Both are provided free (...) to patients without health coverage in public healthcare facilities. In this paper we seek to review the clinical and economic benefits of prescribing psychotropic therapies based on haloperidol (a first-generation antipsychotic that is part of the butyrophenone group of drugs) versus risperidone [an atypical or second-generation antipsychotic (neuroleptic) drug] in adult patients who have been diagnosed with schizophrenia. To achieve this objective, an exhaustive search of relevant articles published
Obesity in individuals with schizophrenia: a case controlled study in Scotland Despite extensive clinical concern about rates of obesity in patients with schizophrenia, there is little evidence of the extent of this problem at a population level.To estimate levels of obesity in a national population sample by comparing patients with schizophrenia with matched controls.We calculated levels of obesity for each patient with schizophrenia from the national Primary Care Clinical Informatics Unit (...) database (n=4658) matched with age, gender and neighbourhood controls.We demonstrated a significant increased obesity hazard for the schizophrenia group using Cox regression analysis, with odds ratio (OR) of 1.94 (95% CI 1.81-2.10) (under the assumption of missing body mass index (BMI) indicating non-obesity) and OR=1.68 (95% CI 1.55-1.81) where no assumptions were made for missing BMI data.People with schizophrenia are at increased risk of being obese compared with controls matched by age, gender
Canadian guidelines for the assessment and diagnosis of patients with schizophrenia spectrum and other psychotic disorders The objective of this article is to identify best practices in the diagnosis and assessment of patients with schizophrenia spectrum and other psychotic disorders. The diagnosis and assessment may occur in a range of situations from the emergency room to the outpatient clinic and at different stages of the disorder. The focus may be on acute exacerbations of illness (...) , residual symptoms, levels of function, or changes in the response to treatment.A systematic search was conducted for guidelines published in the last 5 years for schizophrenia and schizophrenia spectrum disorders. The guidelines were rated by at least 2 raters, and recommendations adopted on the diagnosis and assessment were primarily drawn from the American Psychiatric Association practice guidelines for the psychiatric evaluation of adults and the National Institute for Health and Care Excellence
Canadian guidelines for the pharmacological treatment of schizophrenia spectrum and other psychotic disorders in children and youth Schizophrenia spectrum and other psychotic disorders often have their onset in adolescence. The sequelae of these illnesses can negatively alter the trajectory of emotional, cognitive, and social development in children and youth if left untreated. Early and appropriate interventions can improve outcomes. This article aims to identify best practices (...) in the pharmacotherapy management of children and youth with schizophrenia spectrum disorders.A systematic search was conducted for published guidelines for schizophrenia and schizophrenia spectrum disorders in children and youth (under age 18 years). Recommendations were drawn from the National Institute for Health and Care Excellence guidelines on psychosis and schizophrenia in children and youth (2013 and 2015 updates). Current guidelines were adopted using the ADAPTE process, which includes consensus ratings
Canadian practice guidelines for comprehensive community treatment for schizophrenia and schizophrenia spectrum disorders The objective of this review is to identify the features and components of a comprehensive system of services for people living with schizophrenia. A comprehensive system was conceived as one that served the full range of people with schizophrenia and was designed with consideration of the incidence and prevalence of schizophrenia. The system should provide access (...) to the full range of evidence-based services, should be recovery oriented, and should provide patient-centred care.A systematic search was conducted for published guidelines for schizophrenia and schizophrenia spectrum disorders. The guidelines were rated by at least 2 raters, and recommendations adopted were primarily drawn from the National Institute for Clinical Excellence (2014) Guideline on Psychosis and Schizophrenia in adults and the Scottish Intercollegiate Guidelines Network guidelines
Canadian schizophrenia guidelines: schizophrenia and other psychotic disorders with coexisting substance use disorders Persons with schizophrenia and other psychotic disorders frequently have coexisting substance use disorders that require modifications to treatment approaches for best outcomes. The objectives of this review were to identify evidence-based practices best practices that improve outcomes for individuals with schizophrenia and substance used disorders.We reviewed guidelines (...) that were published in the last 5 years and that included systematic reviews or meta-analyses. Most of our recommendations came from 2 publications from the National Institute for Health and Care Excellence (NICE): the 2011 guidance titled Coexisting Severe Mental Illness (Psychosis) and Substance Misuse: Assessment and Management in Healthcare Settings and the 2014 guidance titled Psychosis and Schizophrenia in Adults: Prevention and Management. We placed these recommendations into the Canadian context
Canadian treatment guidelines on psychosocial treatment of schizophrenia in adults It is generally recognised that psychosocial interventions are essential components of the effective treatment of schizophrenia in adults. A considerable body of research is being published regarding the effectiveness of such interventions. In the current article, we derive recommendations reflecting the current state of evidence for their effectiveness.Recommendations were formulated on the basis of a review (...) be provided with education about the nature of schizophrenia and its treatment. Several recent innovative psychosocial approaches to treatment are awaiting more thorough evaluation.There continues to be strong evidence for the effectiveness of several psychosocial interventions in improving outcomes for adults with schizophrenia. In the past decade, innovative interventions have been described, several of which are the subject of ongoing evaluative research.
Canadian treatment guidelines on psychosocial treatment of schizophrenia in children and youth A panel of experts, including researchers, clinicians and people with lived experience, was brought together to develop the new Canadian schizophrenia guidelines for the psychosocial treatment of children and youth with schizophrenia or psychotic disorders.The ADAPTE process, which relies on adapting existing high-quality guidelines, was used. Existing guidelines for children and youth (mostly from (...) treatment of children and youth with schizophrenia or psychotic disorders report evidence-based treatments as well as important considerations for providers who work with this clientele. More studies with children and youth with schizophrenia and psychotic disorders are warranted. If followed, these guidelines should facilitate the recovery of children and youth with schizophrenia or psychotic disorders as well as the recovery of their families.
Guidelines for the pharmacotherapy of schizophrenia in adults The present guidelines address the pharmacotherapy of schizophrenia in adults across different stages, phases, and symptom domains.Guidelines were developed using the ADAPTE process, which takes advantage of existing guidelines. Six guidelines were identified for adaptation, with recommendations extracted from each. For those specific to the pharmacotherapy of schizophrenia in adults, a working group selected between guidelines (...) and recommendations to create an adapted guideline.Recommendations can be categorized into 6 areas that include 1) first-episode schizophrenia, 2) acute exacerbation, 3) relapse prevention and maintenance treatment, 4) treatment-resistant schizophrenia, 5) clozapine-resistant schizophrenia, and 6) specific symptom domains. For each category, recommendations are made based on the available evidence, which is discussed and linked to other established guidelines.In most cases, evidence-based recommendations are made
Physical health and drug safety in individuals with schizophrenia While antipsychotic medications are the mainstay of therapy for individuals with schizophrenia and psychotic disorders, their use is associated with adverse effects on physical health that require the attention and care of prescribers.We used the ADAPTE process to adapt existing guideline recommendations from the National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN
Mortality and Self-Harm in Association With Clozapine in Treatment-Resistant Schizophrenia This study evaluated rates of all-cause mortality and self-harm in association with clozapine treatment in individuals with treatment-resistant schizophrenia.A population-based cohort of 2,370 individuals with treatment-resistant schizophrenia after Jan. 1, 1996, was followed until death, first episode of self-harm, emigration, or June 1, 2013. Time to all-cause death and time to first episode of self (...) : 1.45, 95% CI: 0.86-2.45). Excess mortality was observed in the year after clozapine discontinuation (hazard ratio: 2.65, 95% CI: 1.47-4.78). The rate of self-harm was higher for nonclozapine antipsychotics than for clozapine (hazard ratio: 1.36, 95% CI: 1.04-1.78).The results demonstrate a nearly twofold higher mortality rate among individuals with treatment-resistant schizophrenia not treated with clozapine compared with clozapine-treated individuals. Furthermore, the results suggest a harmful
Latuda (lurasidone) - schizophrenia Latuda (lurasidone) × Insert searchphrase to search the website Insert searchphrase to search the website > > > Latuda (lurasidone) Conclusion Latuda contains lurasidone, which is a 2nd generation antipsychotic authorised for the treatment of schizophrenia in adults aged 18 years and over. Lurasidone efficacy in the PANSS total score is on a par with other 2nd generation antipsychotics, but has been demonstrated to be different from the other antipsychotics (...) , there are minimal effects on metabolic parameters as well as the QT interval. A line of antipsychotics with a similar efficacy profile are already sold on the market as generic products, which makes them significantly cheaper than Latuda. It is IRF's overall assessment that Latuda should not be a first-line treatment for schizophrenia in adults, but it could be relevant in cases where the minimisation of metabolic and cardiovascular effects is of utmost importance or in patients who are extremely concerned
Quality of Care and Outcomes of Heart Failure Among Patients With Schizophrenia in Denmark Research on the association between schizophrenia and the quality of care and clinical outcomes of heart failure (HF) remains sparse. This nationwide study compared the quality of care and clinical outcomes of HF among Danish patients with and without schizophrenia. In a population-based cohort study, we identified 36,718 patients with incident HF with hospital contacts, including 108 with schizophrenia (...) , using Danish registries between 2004 and 2013. High quality of HF care was defined as receiving ≥ 80% guideline-recommended process-performance measures of care. Potential predictors of HF care among patients with schizophrenia included patient-specific factors (age, gender, Global Assessment of Functioning [GAF] score, alcohol or drug abuse, duration of schizophrenia); provider-specific factors (quality of schizophrenia care); and system-specific factors (patient-volume defined as hospital
Postinjection delirium/sedation syndrome in patients with schizophrenia receiving olanzapine long-acting injection: results from a large observational study Postinjection delirium/sedation syndrome (PDSS) has been reported uncommonly during treatment with olanzapine long-acting injection (LAI), a sustained-release formulation of olanzapine.The primary aim of the study was to estimate the incidence per injection and per patient of PDSS events in adult patients with schizophrenia who were (...) receiving olanzapine LAI in real-world clinical practice. Secondary aims were to further characterise the clinical presentation of PDSS events, to identify potential risk factors associated with PDSS events and to characterise hospitalisations at baseline and post-baseline.A prospective observational study of adult patients with schizophrenia receiving olanzapine LAI from 24 countries. Data were collected on patient characteristics, olanzapine LAI treatment and any adverse events (AEs). All AEs were
Effect of Liraglutide Treatment on Prediabetes and Overweight or Obesity in Clozapine- or Olanzapine-Treated Patients With Schizophrenia Spectrum Disorder: A Randomized Clinical Trial Compared with the general population, patients with schizophrenia have a 2- to 3-fold higher mortality rate primarily caused by cardiovascular disease. Previous interventions designed to counteract antipsychotic-induced weight gain and cardiometabolic disturbances reported limited effects.To determine the effects (...) of the glucagon-like peptide-1 receptor agonist liraglutide added to clozapine or olanzapine treatment of schizophrenia spectrum disorders.This randomized clinical double-blind trial enrolled participants at 2 clinical sites in Denmark. Of 214 eligible participants with a schizophrenia spectrum disorder, 103 were randomized to liraglutide or placebo. Participants received stable treatment with clozapine or olanzapine, were overweight or obese, and had prediabetes. Data were collected from May 1, 2013, through