Towards a pragmatic and operational definition of relapse in schizophrenia: A Delphi consensus approach

San, Luís; Serrano, Manuel; Cañas, Fernando; Romero, Samuel Leopoldo; Sánchez-Cabezudo, Ángeles; Villar, Mariano

doi:10.3109/13651501.2014.1002501

Cited by 20 publications

(17 citation statements)

References 29 publications

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“…There are numerous previous studies in which the investigators review the literature and seek the counsel of experts to develop definitions and clarify terminology. Most of these relate to clinical or physiological definitions [ 54 – 56 ]. A few explorations of definitions relate to concepts such as quality of life [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework

et al. 2016

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We describe a framework for defining pilot and feasibility studies focusing on studies conducted in preparation for a randomised controlled trial. To develop the framework, we undertook a Delphi survey; ran an open meeting at a trial methodology conference; conducted a review of definitions outside the health research context; consulted experts at an international consensus meeting; and reviewed 27 empirical pilot or feasibility studies. We initially adopted mutually exclusive definitions of pilot and feasibility studies. However, some Delphi survey respondents and the majority of open meeting attendees disagreed with the idea of mutually exclusive definitions. Their viewpoint was supported by definitions outside the health research context, the use of the terms ‘pilot’ and ‘feasibility’ in the literature, and participants at the international consensus meeting. In our framework, pilot studies are a subset of feasibility studies, rather than the two being mutually exclusive. A feasibility study asks whether something can be done, should we proceed with it, and if so, how. A pilot study asks the same questions but also has a specific design feature: in a pilot study a future study, or part of a future study, is conducted on a smaller scale. We suggest that to facilitate their identification, these studies should be clearly identified using the terms ‘feasibility’ or ‘pilot’ as appropriate. This should include feasibility studies that are largely qualitative; we found these difficult to identify in electronic searches because researchers rarely used the term ‘feasibility’ in the title or abstract of such studies. Investigators should also report appropriate objectives and methods related to feasibility; and give clear confirmation that their study is in preparation for a future randomised controlled trial designed to assess the effect of an intervention.

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Section: Discussionmentioning

confidence: 99%

Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework

et al. 2016

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“…Parenting strategies for reducing the risk of adolescent depression and anxiety disorders (Yap et al, 2014) Improve cultural competence Culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent (Chalmers et al, 2014) Develop policy How tertiary education institutions can support students with a mental illness (Reavley et al, 2013) Develop a health economic model Cost-effectiveness of 3 antidepressants in major depressive disorder in the UK (LenoxSmith et al, 2009) Define a concept Definition of relapse in schizophrenia (San et al, 2015) Develop a scale Item content for a geriatric depression inventory appropriate to Chinese culture (Xie et al, 2015) Improve classification or diagnosis Clinical subtypes of core premenstrual disorders (Ismail et al, 2013) Determine epidemiology (prevalence, risk factors)…”

Section: Type Of Use Examplementioning

confidence: 99%

Using the Delphi expert consensus method in mental health research

Jorm

2015

Aust N Z J Psychiatry

521

628

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Objective: The article gives an introductory overview of the use of the Delphi expert consensus method in mental health research. It explains the rationale for using the method, examines the range of uses to which it has been put in mental health research, and describes the stages of carrying out a Delphi study using examples from the literature. Method:To ascertain the range of uses, a systematic search was carried out in PubMed. The article also examines the implications of 'wisdom of crowds' research for how to conduct Delphi studies. Results:The Delphi method is a systematic way of determining expert consensus that is useful for answering questions that are not amenable to experimental and epidemiological methods. The validity of the approach is supported by 'wisdom of crowds' research showing that groups can make good judgements under certain conditions. In mental health research, the Delphi method has been used for making estimations where there is incomplete evidence (e.g. What is the global prevalence of dementia?), making predictions (e.g. What types of interactions with a person who is suicidal will reduce their chance of suicide?), determining collective values (e.g. What areas of research should be given greatest priority?) and defining foundational concepts (e.g. How should we define 'relapse'?). A range of experts have been used in Delphi research, including clinicians, researchers, consumers and caregivers. Conclusion:The Delphi method has a wide range of potential uses in mental health research.

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“…87,89 Conversely, we sought to define the duration of a stable condition prior to relapse, and this suggested that a period of 6 months was more favorable than a period of 12 months, which is consistent with the findings of other studies. 5 Few respondents agreed that an increase in the level (frequency) in the frequency of psychiatric consultations.…”

Section: Relapsementioning

confidence: 99%

“…The core characteristics of relapse are identified as follows: the reappearance of schizophrenia symptoms in patients who have been symptom-free after an initial episode (there is need to consider a minimum period of time for reappearance of schizophrenia symptoms), worsening of clinical status severity, worsening of functioning, and reappearance of positive symptoms. 5 Recovery, the ultimate goal of treatment, should include functional recovery as well as symptomatic improvement. Recovery is defined as adequate function and not impeded social and occupational function social and occupational function, but no clear consensus on the definition of recovery exists either.…”

Section: Introductionmentioning

confidence: 99%

“…2 Although several studies have attempted to derive definitions of the numerous treatment outcomes, objective and clear definitions of treatment response, remission, relapse, and recovery in the treatment of FEP have yet to be established. [3][4][5] This ambiguity hampers comparisons between study results and has Objective For the proper treatment of first-episode psychosis, assessment of treatment response, remission, relapse, and recovery is important. Therefore, the present study aimed to develop operational definitions of clinical outcomes in first-episode psychosis.…”

mentioning

confidence: 99%

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Defining Treatment Response, Remission, Relapse, and Recovery in First-Episode Psychosis: A Survey among Korean Experts

Lee

Kim

et al. 2020

Psychiatry Investig

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Objective For the proper treatment of first-episode psychosis, assessment of treatment response, remission, relapse, and recovery is important. Therefore, the present study aimed to develop operational definitions of clinical outcomes in first-episode psychosis.Methods A questionnaire was developed by a panel of experts and underwent three revisions. The final survey was presented to 150 psychiatrists who were members of the Korean Society for Schizophrenia Research. Respondents selected factors that they believed were important to consider while defining treatment response, remission, relapse, and recovery using a 6-point Likert scale. Selected factors that constituted each definition were statistically extracted, and operational definitions were developed.Results A total of 91 experts responded to the survey. The extent of reduction in psychopathology, socio-occupational functioning, and duration of each state were the core factors of each definition. Outcomes obtained from discussions and consultations by experts have been summarized and proposed.Conclusion The criteria developed in this survey tended to be somewhat stricter than those used by other studies. The fundamental reason for this is that this survey focused on first-episode psychosis. A better understanding of each definition in first-episode psychosis is necessary to improve effective treatment outcomes.

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Towards a pragmatic and operational definition of relapse in schizophrenia: A Delphi consensus approach

Abstract: A better understanding of the definition of relapse in schizophrenia is necessary to improve effective prevention strategies.

Cited by 20 publications

References 29 publications

Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework

Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework

Using the Delphi expert consensus method in mental health research

Defining Treatment Response, Remission, Relapse, and Recovery in First-Episode Psychosis: A Survey among Korean Experts

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