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

doi:10.3109/08039488.2015.1074285

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

17 Citations (Scopus)

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.

Original language	English
Journal	Nordic Journal of Psychiatry
Volume	70
Issue number	3
Pages (from-to)	231-40
Number of pages	10
ISSN	0803-9488
DOIs	https://doi.org/10.3109/08039488.2015.1074285
Publication status	Published - 2 Apr 2016

Keywords

Journal Article
Research Support, Non-U.S. Gov't

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3109/08039488.2015.1074285

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Baandrup, L., Østrup Rasmussen, J., Klokker, L., Austin, S., Bjørnshave, T., Fuglsang Bliksted, V., Fink-Jensen, A., Hedegaard Fohlmann, A., Peter Hansen, J., Kristine Nielsen, M., Sandsten, K. E., Schultz, V., Voss-Knude, S., & Nordentoft, M. (2016). Treatment of adult patients with schizophrenia and complex mental health needs: A national clinical guideline. Nordic Journal of Psychiatry, 70(3), 231-40. https://doi.org/10.3109/08039488.2015.1074285

Baandrup, L, Østrup Rasmussen, J, Klokker, L, Austin, S, Bjørnshave, T, Fuglsang Bliksted, V, Fink-Jensen, A, Hedegaard Fohlmann, A, Peter Hansen, J, Kristine Nielsen, M, Sandsten, KE, Schultz, V, Voss-Knude, S & Nordentoft, M 2016, 'Treatment of adult patients with schizophrenia and complex mental health needs: A national clinical guideline', Nordic Journal of Psychiatry, vol. 70, no. 3, pp. 231-40. https://doi.org/10.3109/08039488.2015.1074285

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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.",

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T2 - A national clinical guideline

AU - Baandrup, Lone

AU - Østrup Rasmussen, Jesper

AU - Klokker, Louise

AU - Austin, Stephen

AU - Bjørnshave, Thomas

AU - Fuglsang Bliksted, Vibeke

AU - Fink-Jensen, Anders

AU - Hedegaard Fohlmann, Allan

AU - Peter Hansen, Jens

AU - Kristine Nielsen, Malene

AU - Sandsten, Karl Erik

AU - Schultz, Vilhelm

AU - Voss-Knude, Susanne

AU - Nordentoft, Merete

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N2 - 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.

AB - 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.

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

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DO - 10.3109/08039488.2015.1074285

M3 - Review

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SN - 0803-9488

VL - 70

SP - 231

EP - 240

JO - Nordic Journal of Psychiatry

JF - Nordic Journal of Psychiatry

IS - 3

ER -

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

Abstract

Keywords

UN SDGs

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