Confirmations, advances and recommendations for the daily care of schizophrenia based on the French national FACE-SZ cohort.

Activities of Daily Living / psychology Antipsychotic Agents / therapeutic use Cohort Studies Cross-Sectional Studies Follow-Up Studies France / epidemiology Humans Mental Health Services / trends Metabolic Syndrome / epidemiology Multicenter Studies as Topic / methods Psychiatric Status Rating Scales Quality of Life / psychology Schizophrenia / epidemiology Schizophrenic Psychology Tobacco Smoking / adverse effects

Cohort Daily practice FACE-SZ Recommendations Schizophrenia

Journal

Progress in neuro-psychopharmacology & biological psychiatry

ISSN: 1878-4216

Titre abrégé: Prog Neuropsychopharmacol Biol Psychiatry

Pays: England

ID NLM: 8211617

Informations de publication

Date de publication:
13 07 2020

Historique:

received: 26 12 2019

revised: 11 03 2020

accepted: 11 03 2020

pubmed: 17 3 2020

medline: 5 6 2021

entrez: 17 3 2020

Statut: ppublish

Résumé

The National FondaMental Centers of Expertise (FACE) for Schizophrenia (SZ) have been created to shorten the gap between research and clinical practice. To synthetize in a review the 10-year findings issued from the FACE-SZ cohort analyses. More than 1000 patients were evaluated in 10 expert centers since 2010 with a 2-day long comprehensive standardized battery including neuropsychological testes and physical health assessment and followed-up for 3 years. 1. The phase 0 cross-sectional analyses have confirmed well-known data: over-prescription of first-generation antipsychotics, antipsychotic polytherapy and long-term benzodiazepine and under-prescription of clozapine, 13% of drug-induced parkinsonism, 18% of akathisia, a mean duration of untreated psychosis of 18 months, one third of poorly-adherent patients, 24% of metabolic syndrome and 52% of current tobacco smokers with poor care for physical illnesses; a yearly mean financial cost of 15,000 euro/patient. 2. FACE-SZ also yielded additional data in insufficiently explored area: a half of major depression issues (among them one third of undiagnosed major depression and 44% of treated patients with unremitted depression), major depression having a strong impact on Quality of Life independently of negative symptoms, 22% of moderated to severe untreated physical pain. 3. FACE-SZ has explored emerging fields of research, including development of 4 stages- model of schizophrenia, chronic low-grade peripheral inflammation, latent Toxoplasma infection, hypovitaminosis D, and a model for relapse prediction at 2 years. The associated factors and implications for public health programs were discussed. Based on the FACE-SZ findings and literature, the FACE-SZ group has yielded recommendations to improve daily care for schizophrenia and for future research.

Sections du résumé

BACKGROUND

The National FondaMental Centers of Expertise (FACE) for Schizophrenia (SZ) have been created to shorten the gap between research and clinical practice.

OBJECTIVES

To synthetize in a review the 10-year findings issued from the FACE-SZ cohort analyses.

METHODS

More than 1000 patients were evaluated in 10 expert centers since 2010 with a 2-day long comprehensive standardized battery including neuropsychological testes and physical health assessment and followed-up for 3 years.

RESULTS

1. The phase 0 cross-sectional analyses have confirmed well-known data: over-prescription of first-generation antipsychotics, antipsychotic polytherapy and long-term benzodiazepine and under-prescription of clozapine, 13% of drug-induced parkinsonism, 18% of akathisia, a mean duration of untreated psychosis of 18 months, one third of poorly-adherent patients, 24% of metabolic syndrome and 52% of current tobacco smokers with poor care for physical illnesses; a yearly mean financial cost of 15,000 euro/patient. 2. FACE-SZ also yielded additional data in insufficiently explored area: a half of major depression issues (among them one third of undiagnosed major depression and 44% of treated patients with unremitted depression), major depression having a strong impact on Quality of Life independently of negative symptoms, 22% of moderated to severe untreated physical pain. 3. FACE-SZ has explored emerging fields of research, including development of 4 stages- model of schizophrenia, chronic low-grade peripheral inflammation, latent Toxoplasma infection, hypovitaminosis D, and a model for relapse prediction at 2 years.

DISCUSSION

The associated factors and implications for public health programs were discussed. Based on the FACE-SZ findings and literature, the FACE-SZ group has yielded recommendations to improve daily care for schizophrenia and for future research.

Identifiants

DOI: 10.1016/j.pnpbp.2020.109927 PMID: 32173456

pubmed: 32173456

pii: S0278-5846(19)31090-5

doi: 10.1016/j.pnpbp.2020.109927

pii:

doi:

Substances chimiques

Antipsychotic Agents 0

Types de publication

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

Langues

eng

Sous-ensembles de citation

Pagination

109927

Informations de copyright

Déclaration de conflit d'intérêts

Declaration of Competing Interest None declared.