The Management of Schizophrenia ===================== Contributing author: Dr John Blenkinsopp, senior research fellow, Medicines Management, School of Pharmacy, Keele University ---------------------- GOAL : To provide pharmacists with an overview of the management of an individual with schizophrenia. OBJECTIVES: After completing this module you should be able to: • Discuss the updated NICE guideline and its implications • Describe the different ‘positive’ and ‘negative’ symptoms of schizophrenia • Explain which antipsychotic medicines are currently used, their effect on symptoms and their side-effects. ================================ Introduction ======== Schizophrenia is a complex condition involving disturbance of thinking, perception, affect and social behaviour. It is the most commonly diagnosed major mental health problem yet, according to the World Health Organization, more than 50 per cent of individuals with schizophrenia are not receiving appropriate care. In 2009 NICE issued an updated clinical guideline on schizophrenia and its management(nice.org.uk/nicemedia/live/11786/43607/43607.pdf). The guideline covers incidence and diagnosis of schizophrenia, treatment with antipsychotics, psychological therapies and psychosocial interventions. Recent research has focused on the biological aspects of schizophrenia and includes genetic studies and radiological investigations as well as biochemical and neuropathological studies of the brain. The body of knowledge gathered over the years has led researchers to describe schizophrenia as a “disorder of the brain”, although its exact aetiology is yet to be determined. There is no one identified cause for schizophrenia and it is likely to be the result of a combination of factors. More than 80 per cent of patients with schizophrenia have parents who do not have the disorder. Mortality among people with schizophrenia is approximately 50 per cent above that of the general population, partly as a result of an increased incidence of suicide (about 10 per cent die by suicide) and violent death, and partly as a result of an increased risk of a wide range of physical health problems. These include those illnesses associated with cigarette smoking, obesity and diabetes. Self-assess your learning needs: =================== • What are the key points of last year’s NICE guideline on schizophrenia? • What are the potential barriers to treatment adherence? • What extrapyramidal symptoms are common in patients treated with typical antipsychotics? ========================== Reflection exercise 1 Identify one patient with schizophrenia in your pharmacy practice and check his/her patient medication record for adherence to medication. If there is non-compliance, how would you approach this? Reflection exercise 2 How aware are you of support services, including psychological therapies, for patients with schizophrenia in your locality? Are they included in your ‘signposting’ list? Check the recommended patient/professional websites listed on page vii of this module and create a list of reference sources and self-help groups. Read the article PDF ==============
Posted on: Mon, 17 Mar 2014 07:48:43 +0000
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