Temporal trends in psychotic symptoms: Repeated cross-sectional surveys of the population in England 2000–14

Shoham, Natalie; Cooper, Claudia; Lewis, Gemma; Bebbington, P; McManus, Sally

doi:10.1016/j.schres.2020.11.057

Cited by 11 publications

(10 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although detrimental effects of long-term use (⩾ 2 years) of antipsychotics (AP) and antidepressants (AD) have raised critical debates (Maslej et al, 2017; Murray et al, 2016), their long-term prescriptions are continuing to rise (e.g. Mars et al 2017; Shoham, Cooper, Lewis, Bebbington, & McManus, 2021; Yu, Zhang, Zheng, & Yu, 2020). Some of these prescriptions lack an evidence-base altogether (Mangin et al, 2018; Piek, Kollen, van der Meer, Penninx, & Nolen, 2014), but even for conditions that are assumed to benefit from maintenance therapy beyond the acute phase, i.e.…”

Section: Introductionmentioning

confidence: 99%

Predictors of successful discontinuation of antipsychotics and antidepressants

et al. 2021

View full text Add to dashboard Cite

Background To offer support for patients who decide to discontinue antipsychotic and antidepressant medication, identifying which potentially modifiable factors correlate with discontinuation success is crucial. Here, we analyzed the predictive value of the professional support received, circumstances prior to discontinuation, a strategy of discontinuation, and use of functional and non-functional coping strategies during discontinuation on self-reported discontinuation success and on objective discontinuation. Methods Patients who had attempted discontinuing antipsychotics (AP) and/or antidepressants (AD) during the past 5 years (n = 316) completed an online survey including questions on subjective and objective discontinuation success, sociodemographic, clinical and medication-related factors, and scales to assess the putative predictors. Results A regression model with all significant predictors explained 20–30% of the variance in discontinuation success for AD and 30–40% for AP. After controlling for baseline sociodemographic, clinical and medication-related factors, the most consistent predictor of subjective discontinuation success was self-care behavior, in particular mindfulness, relaxation and making use of supportive relationships. Other predictors depended on the type of medication: For AD, good alliance with the prescribing physician predicted higher subjective success whereas gradual tapering per se was associated with lower subjective success and a lower chance of full discontinuation. In those tapering off AP, leaving time to adjust between dose reductions was associated with higher subjective success and fewer negative effects. Conclusions The findings can inform evidence-based clinical guidelines and interventions aiming to support patients during discontinuation. Further studies powered to take interactions between variables into account are needed to improve the prediction of successful discontinuation.

show abstract

Section: Introductionmentioning

confidence: 99%

Predictors of successful discontinuation of antipsychotics and antidepressants

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Despite these specifications, as already described, a contributing factor to the rise in APD use seems to be their increased off-label use for non-psychotic indications, such as dementia, insomnia, obsessive–compulsive disorder, and generalized anxiety disorder ( 119 ). Survey data from England over the period from 2000 to 2014 found that while psychotic symptoms in the population had increased only slightly over this period, prescription of APDs had doubled ( 120 ).…”

Section: Strategies For Minimizing and Managing Tdmentioning

confidence: 99%

Tardive dyskinesia in Asia— current clinical practice and the role of neurologists in the care pathway

Bhidayasiri,

Phokaewvarangkul,

Shang

et al. 2024

Front. Neurol.

View full text Add to dashboard Cite

Tardive dyskinesia (TD) is a movement disorder that can arise as a side effect of treatment with dopamine receptor-blocking agents (DRBAs), including antipsychotic drugs (APDs) used to manage psychotic illnesses. Second-generation APDs (SGAs) are often preferred to first-generation drugs due to their lower propensity to cause TD, however many SGAs-treated patients still develop the condition. Although TD is a global health concern, evidence regarding the occurrence of TD and how it is managed in Asian countries is currently limited. This article reports the results of a systematic review of the published literature on TD focusing on its prevalence, types of patients, knowledge of the condition, causative factors, and usual treatment pathways in clinical practice in Asian countries. Epidemiological data suggest that the prevalence of TD is increasing globally due to an overall rise in APD use, contributing factors being polypharmacy with multiple APDs, the use of higher than necessary doses, and off-label use for non-psychotic indications. Although exact prevalence figures for TD in Asian countries are difficult to define, there is a similar pattern of rising APD use which will result in increasing numbers of TD patients in this region. These issues need to be addressed and strategies developed to minimize TD risk and manage this disabling condition which impacts patients' quality of life and daily functioning. To date, both research into TD has been predominantly psychiatry focused and the perspectives from neurologists regarding the clinical management of this challenging condition are scarce. However, neurologists have an essential role in managing the movement disorders manifestations that characterize TD. Optimum management of TD, therefore, should ideally involve collaboration between psychiatrists and neurologists in joint care pathways, wherever practical. Collaborative pathways are proposed in this article, and the challenges that will need to be addressed in Asian countries to improve the care of people with TD are highlighted, with a focus on the neurologist's viewpoint and the implications for the management of TD globally.

show abstract

“…Other studies have highlighted this discrepancy between prescription rates for antipsychotics and diagnoses of psychosis, noting that rates of antipsychotic prescribing have been rising faster than psychosis incidence. 19 A UK cohort study also found high rates of antipsychotic prescribing to patients without psychosis and concluded that this reflected psychotropic management of conditions such as depression or anxiety, despite national guidelines recommending that antipsychotics are not clinically indicated for such disorders. 20,21 Clinicians in routine practice may be prescribing antipsychotics (often at low dose) to exert a tranquillising effect and control general features of mental health presentations such as agitation, poor sleep and anxiety.…”

Section: Comparison With Previous Literaturementioning

confidence: 99%

Measuring the impact of therapy on medication use: data-linkage study

Jordan,

Elliott,

Mongan

et al. 2023

Br J Psychiatry

View full text Add to dashboard Cite

Background The psychological therapies service (PTS) in the Northern Health and Social Care Trust, in Northern Ireland, provides therapies to adults with moderate or severe mental health difficulties. Psychometric outcomes data are routinely collected to assess if a patient demonstrates significant improvement in their main presenting problem area following therapy. The wider impact of therapy is not fully measured in the outcomes database as this would be disproportionately burdensome for both patient and therapist. The present study, to our knowledge, is the first to use data linkage to link patient therapy outcomes data with prescriptions data. Aims To widen our understanding of patient medication use before and after therapy. Method Using Health and Care Number as a unique identifier, the Psychological Therapies Service – Routine Outcome Measurement Database (n = 3625) and data from 72 500 controls were linked with data from the Enhanced Prescribing Database (EPD). The EPD data were sourced from the Honest Broker Service. Results Key findings from the study were: (a) the odds of PTS clients using antipsychotics in the year before therapy were 25 times greater compared with controls (odds ratio (OR) = 24.53, 95% CI 20.16–29.84); (b) in the 1st year post discharge, PTS clients who clinically improved post therapy discharge were more likely than ‘non-engagers’ and ‘non-improvers’ to come off antianxiety medication (OR = 0.61, 95%, CI 0.38–0.98); and (c) therapy did not have an impact on antidepressant use. Conclusions The results highlight the need for discussion between therapy services, GPs and psychiatry about whether more engagement and collaboration is needed to plan phased reduction in medication.

show abstract

Temporal trends in psychotic symptoms: Repeated cross-sectional surveys of the population in England 2000–14

Cited by 11 publications

References 33 publications

Predictors of successful discontinuation of antipsychotics and antidepressants

Predictors of successful discontinuation of antipsychotics and antidepressants

Tardive dyskinesia in Asia— current clinical practice and the role of neurologists in the care pathway

Measuring the impact of therapy on medication use: data-linkage study

Contact Info

Product

Resources

About