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Vocational rehabilitation in schizophrenia and other psychotic disorders: a literature review and meta-analysis of randomized controlled trials

This review investigated the effects of vocational rehabilitation for individuals with severe mental illness. The authors concluded that supported employment programmes have produced consistently better rates of employment than traditional vocational rehabilitation. A lack of information on the review methodology and quality of the included studies makes it difficult to assess the reliability of the evidence underlying the authors' conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Antipsychotic-induced weight gain in chronic and first-episode psychotic disorders: a systematic critical reappraisal

The authors concluded that antipsychotic-induced weight gain was 3-fold to 4-fold greater in young patients with first-episode psychosis, in both long-term and short-term medications, compared to patients with chronic psychotic disorders. The review process was limited by methodological flaws in the areas of study selection and quality assessment; therefore the authors' conclusions may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

A systematic review of psychological interventions for excessive alcohol consumption among people with psychotic disorders

This review found that psychological interventions were effective in decreasing alcohol use in patients diagnosed with psychotic disorders. The paucity of available data and the limited quality of some of the included trials means the reliability of the authors' conclusions is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Effectiveness of psychoeducation for relapse, symptoms, knowledge, adherence and functioning in psychotic disorders: a meta-analysis

Psychoeducation (PE) for schizophrenia and other psychotic disorders is widely adopted but insufficiently evaluated. So far, meta-analytic data has demonstrated efficacy for PE when interventions include family members. Whether PE directed solely at patients is also effective remains unclear. The current meta-analysis evaluates short- and long-term efficacy of PE with and without inclusion of families with regard to relapse, symptom-reduction, knowledge, medication adherence, and functioning. Randomized controlled trials comparing PE to standard care or non-specific interventions were included. A literature search in the Cochrane Library, PsycINFO and Medline retrieved 199 studies for closer examination, of which 18 studies, reporting on 19 comparisons, met the inclusion criteria. These studies were coded with regard to methodology, participants, interventions and validity. Effect sizes were integrated using the fixed effects model for homogeneous effects and the random effects model for heterogeneous effects. Independent of treatment modality, PE produced a medium effect at post-treatment for relapse and a small effect size for knowledge. PE had no effect on symptoms, functioning and medication adherence. Effect sizes for relapse and rehospitalization remained significant for 12 months after treatment but failed significance for longer follow-up periods. Interventions that included families were more effective in reducing symptoms by the end of treatment and preventing relapse at 7-12 month follow-up. Effects achieved for PE directed at patients alone were not significant. It is concluded that the additional effort of integrating families in PE is worthwhile, while patient-focused interventions alone need further improvement and research.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Changes in insight during treatment for psychotic disorders: a meta-analysis

OBJECTIVE: Poor insight, or awareness of illness, has a negative impact on the outcome of the psychosis, and is therefore a logical target for treatment. A meta-analysis of the effect of psychological and pharmacological treatments on insight in psychosis was conducted to give a comprehensive overview of effective interventions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Efficacy of community treatments for schizophrenia and other psychotic disorders: a literature review

BACKGROUND: In Chile, the clinical guidelines "for the treatment of people from first episode of schizophrenia" aim to support individuals with schizophrenia to live independently, establishment occupational goals, and gain an adequate quality of life and social interaction. This requires the implementation of a treatment model that integrates psychosocial and pharmacological dimensions. Community intervention strategies ensure the achievement of these goals.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

E-mental health self-management for psychotic disorders: state of the art and future perspectives

OBJECTIVE: The aim of this review was to investigate to what extent information technology may support self-management among service users with psychotic disorders. The investigation aimed to answer the following questions: What types of e-mental health self-management interventions have been developed and evaluated? What is the current evidence on clinical outcome and cost-effectiveness of the identified interventions? To what extent are e-mental health self-management interventions oriented toward the service user?

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Ziprasidone for psychotic disorders: a meta-analysis and systematic review of the relationship between pharmacokinetics, pharmacodynamics, and clinical profile

This review found that treatment with ziprasidone in patients with psychoses was associated with higher levels of treatment discontinuation than with olanzapine and risperidone. Some methodological limitations in the conduct of the review means the reliability of the authors' conclusions is unclear and the results should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Primary care-based educational interventions to decrease risk factors for metabolic syndrome for adults with major psychotic and/or affective disorders: a systematic review

Bibliographic details: Nover C, Jackson SS.  Primary care-based educational interventions to decrease risk factors for metabolic syndrome for adults with major psychotic and/or affective disorders: a systematic review. Systematic Reviews 2013; 2: 116

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Antipsychotic agents for the treatment of substance use disorders in patients with and without comorbid psychosis

The review objective appeared to be to determine the effectiveness of atypical antipsychotic agents in treating substance use disorders in people with and without comorbid psychosis. The authors concluding that atypical antipsychotics may decrease alcohol and drug disorders in patients with comorbid psychosis. Due to uncertain study quality and variability and poor review process reporting, the conclusions should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Meta-analysis of the efficacy of the acetonic kava-kava extract WS 1490 in patients with non-psychotic anxiety disorders

INTRODUCTION: The herbal medicinal product kava-kava, used for treating anxiety disorders, was assessed positively by the Cochrane Review. However, it was withdrawn from the market in Switzerland and Germany due to cases of liver failure and 'unproven' efficacy.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Efficacy and safety of second-generation antipsychotics in children and adolescents with psychotic and bipolar spectrum disorders: comprehensive review of prospective head-to-head and placebo-controlled comparisons

OBJECTIVE: To review data on efficacy and safety of second-generation antipsychotics (SGAs) in children and adolescents with psychotic and bipolar spectrum disorders.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Initiatives to shorten duration of untreated psychosis: systematic review

This review found promising evidence for intensive public awareness campaigns to enhance early detection of first-time psychosis. The review was well conducted and the authors' cautious conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Psychosocial treatment, antipsychotic postponement, and low-dose medication strategies in first-episode psychosis: a review of the literature

This review concluded that initial psychosocial treatment combined with time-limited postponement of antipsychotic medications may reduce long-term medication dependence and help to discriminate between similar (but pathophysiologically different) diagnostic entities for patients with early-episode schizophrenia. As the authors' conclusions were based on small varied studies of unclear quality and possible publication bias, they should be considered with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Weight gain in antipsychotic-naive patients: a review and meta-analysis

This review concluded that weight gain associated with first exposure to antipsychotic drugs occured rapidly in the first few weeks and continued during the following months. The authors' conclusions were broadly in line with the evidence presented, but variation within the review and limitations in the review methods suggest that the findings should be applied with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

ECT in pregnancy: a review of the literature from 1941 to 2007

The review examined the safety and efficacy of electroconvulsive therapy (ECT) during pregnancy. The authors concluded that although data were limited, ECT seemed an effective treatment of severe mental illness with low risks to mother and baby. Limitations in reporting of the review methods and reliance on case reports mean that these conclusions, although cautious, may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Interventions to improve antipsychotic medication adherence: review of recent literature

This review assessed interventions aimed at improving antipsychotic adherence in patients with schizophrenia. Greatest improvements in adherence were found for combinations of educational, behavioural and affective interventions. It was unclear whether results reported as 'improved' were statistically significant results since the intervention and control groups were not compared using statistical tests. The conclusions are suggestive rather than definitive.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Clinical interventions for treatment non-adherence in psychosis: meta-analysis

This review assessed interventions used by community psychiatric services to reduce nonadherence with medication and appointments in patients with psychosis or schizophrenia. The authors concluded that community psychiatric services can provide effective clinical interventions to reduce patient non-adherence. The lack of a validity assessment and the poor reporting of the review process make it difficult to comment on the strength of the evidence or the authors' conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care

This guideline has been developed to advise on the treatment and management of bipolar disorder. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, patients and guideline methodologists after careful consideration of the best available evidence. It is intended that the guidelines will be useful to clinicians and service commissioners in providing and planning high quality care for those with bipolar disorder while also emphasising the importance of the experience of care for patients and carers.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2006
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Interventions for psychotic symptoms concomitant with epilepsy

Little evidence to inform the treatment of psychosis in people with epilepsy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Medical Encyclopedia

  • Brief psychotic disorder
    Brief psychotic disorder is a sudden, short-term display of psychotic behavior, such as hallucinations or delusions, which occurs with a stressful event.
  • Schizoaffective disorder
    Schizoaffective disorder is a mental condition that causes both a loss of contact with reality (psychosis) and mood problems (depression or mania).
  • Paranoid personality disorder
    Paranoid personality disorder is a mental health condition in which a person has a long-term pattern of distrust and suspicion of others, but does not have a full-blown psychotic disorder such as schizophrenia.
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