The new guideline, titled ‘Core interventions in the treatment and management of schizophrenia in adults in primary and secondary care’, focuses on five principal areas of care:
- Access and engagement – the guideline specifies the desired competencies for healthcare professionals working with people with schizophrenia and makes recommendations regarding joint working between mental health services and local stakeholders.
- Primary care and physical health – NICE recommends that GPs and other primary healthcare professionals should monitor the physical health of people with schizophrenia on at least an annual basis, bearing in mind the increased risk of cardiovascular disease in this patient group.
- Psychological interventions – NICE recommends that cognitive behavioural therapy (CBT) be offered to all people with schizophrenia and that family intervention be offered to all families of people with schizophrenia who live with or who are in close contact with the patient.
- Pharmacological interventions – the guideline states that oral antipsychotic medication should be offered to people with newly diagnosed schizophrenia, with the choice of drug made following discussion of the benefits and side effect profile of the available options.
- Interventions for people whose illness has not responded adequately to treatment – in this situation NICE recommends reviewing the diagnosis, checking adherence to treatment, reviewing the use of psychological treatments, and considering other causes of non-response (eg, alcohol misuse). Clozapine should be offered to people with schizophrenia who have not responded adequately to treatment despite the sequential use of adequate doses of at least two different antipsychotics, at least one of which should be a non-clozapine second-generation antipsychotic.
To view the full guideline visit the NICE website.