The Schizophrenia Patient Outcomes Research Team (PORT): Updated Treatment Recommendations 2003

Abstract

Since publication of the original Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations in 1998, considerable scientific advances have occurred in our knowledge about how to help persons with schizophrenia. Today an even stronger body of research supports the scientific basis of treatment. This evidence, taken in its entirety, points to the value of treatment approaches combining medications with psychosocial treatments, including psychological interventions, family interventions, supported employment, assertive community treatment, and skills training. The most significant advances lie in the increased options for pharmacotherapy, with the introduction of second generation antipsychotic medications, and greater confidence and specificity in the application of psychosocial interventions. Currently available treatment technologies, when appropriately applied and accessible, should provide most patients with significant relief from psychotic symptoms and improved opportunities to lead more fulfilling lives in the community. Nonetheless, major challenges remain, including the need for (1) better knowledge about the underlying etiologies of the neurocognitive impairments and deficit symptoms that account for much of the disability still associated with schizophrenia; (2) treatments that more directly address functional impairments and that promote recovery; and (3) approaches that facilitate access to scientifically based treatments for patients, the vast majority of whom currently do not have such access.

Subjective and objective quality of life in schizophrenia

“…Future intervention studies should incorporate QOL as an outcome measure to assess the effects of treatment on QOL. Mounting evidence suggests that psychosocial treatments (e.g., cognitive behavioral therapy, supported employment, social skills training, assertive community treatment, and cognitive training) are a necessary adjunct to antipsychotic medications (Granholm et al, 2005;Lehman et al, 2004;Twamley et al, 2003a;Twamley et al, 2003b). With aggressive use of adjunctive treatments to target depression and negative symptoms, QOL in schizophrenia may be improved.…”

A Web-Based Program to Empower Patients Who Have Schizophrenia to Discuss Quality of Care With Mental Health Providers

“…They also received a brochure written in lay language that presents five schizophrenia treatment recommendations addressed by the Web-based tool, including maintenance dose of antipsychotic medication, prophylactic antiparkinson medication, antidepressant treatment, family intervention, and supported employment (7). The combination of brochure and video mirrored the information content of the Web-based intervention but without the personalized feedback or video clips role-modeling discussion of treatment issues provided online.…”

“…This study furthered this line of work by developing an Internet-based interactive computer tool to educate patients with schizophrenia about evidence-based treatment guidelines and to compare their care to guidelines and receive feedback (7). The design of the intervention was also motivated by a study that found disparities between the evidence-based treatment recommendations of the Schizophrenia Patient Outcomes Research Team, known as PORT, and the services received by persons with schizophrenia (8,9).…”

Using neuroscience as an outcome measure for behavioral interventions in Autism spectrum disorders (ASD): A review

“…We hypothesize this is due to the fact that largely accepted "first line" treatments for both of this conditions are medication rather than behavioral therapy, or medication in adjunct with behavioral therapy (although this is not the case for pre-school children diagnosed with ADHD due to the risks of stimulant medication in that age group) (American Academy of Pediatrics, 2011;Buchanan et al, 2009;Lehman, Kreyenbuhl et al, 2004;Lehman, Liebermanet al, 2004;Kutcher et al, 2004).…”