Pathways to Recovery: A case for adoption of systematic pathways in psychosis

Imperial College Health Partners, September 2015

This joint briefing paper published with Wessex AHSN, sets out how ICHP have developed new, integrated care pathways for mental health that prescribe time frames around clinical interventions and service delivery.  These new psychosis pathways aim to reduce the impact of disease and promote recovery by ensuring that every individual gets the best evidence based care at the right time and in the right place. The approach has used a robust methodology which can be adopted for use across the wider NHS. This document describes the approach used in developing the pathways and provides a guide for patients, carers, provider organisations and commissioners on adoption and implementation.

Click here for further information and to download the briefing paper.

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Psychosis and schizophrenia in adults

NICE, February 2015

 NICE quality standards describe high-priority areas for quality improvement in a defined care or service area. Each standard consists of a prioritised set of specific, concise and measurable statements. They draw on existing guidance, which provides an underpinning, comprehensive set of recommendations, and are designed to support the measurement of improvement.

This quality standard covers the treatment and management of psychosis and schizophrenia (including related psychotic disorders such as schizoaffective disorder, schizophreniform disorder and delusional disorder) in adults (18 years and older) with onset before the age of 60 years in primary, secondary and community care. It will not cover adults with transient psychotic symptoms.

Click here to view the guidance.

‘Skunk-like cannabis’ increases risk of psychosis, study suggests

BBC News, 16 February 2015

Smoking potent cannabis was linked to 24% of new psychosis cases analysed in a study by King’s College London.  The research suggests the risk of psychosis is three times higher for users of potent “skunk-like” cannabis than for non-users….

Click here to read the full article.

Alcohol confounds relationship between cannabis misuse and psychosis conversion in a high-risk sample

Acta Psychiatrica Scandinavica, January 2015

Objective:
Cannabis use has been examined as a predictor of psychosis in clinical high-risk (CHR) samples, but little is known about the impact of other substances on this relationship.

Method:
Substance use was assessed in a large sample of CHR participants (N = 370, mean age = 18.3) enrolled in the multisite North American Prodrome Longitudinal Study Phase 1 project. Three hundred and forty-one participants with cannabis use data were divided into groups: No Use (NU, N = 211); Cannabis Use without impairment (CU, N = 63); Cannabis Abuse/Dependence (CA/CD, N = 67). Participants (N = 283) were followed for ≥2 years to determine psychosis conversion.

Results:
Alcohol (45.3%) and cannabis (38.1%) were the most common substances. Cannabis use groups did not differ on baseline attenuated positive symptoms. Seventy-nine of 283 participants with cannabis and follow-up data converted to psychosis. Survival analysis revealed significant differences between conversion rates in the CA/CD group compared with the No Use (P = 0.031) and CU group (P = 0.027). CA/CD also significantly predicted psychosis in a regression analysis, but adjusting for alcohol use weakened this relationship.

Conclusion:
The cannabis misuse and psychosis association was confounded by alcohol use. Non-impairing cannabis use was not related to psychosis. Results highlight the need to control for other substance use, so as to not overstate the cannabis/psychosis connection.

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Understanding Psychosis and Schizophrenia: Why people sometimes hear voices, believe things that others find strange, or appear out of touch with reality, and what can help

The British Psychological Society, 27 November 2014

The British Psychological Society’s Division of Clinical Psychology have published a report challenging received wisdom about the nature of mental illness. 

‘Understanding Psychosis and Schizophrenia: Why people sometimes hear voices, believe things that others find strange, or appear out of touch with reality, and what can help’ has been written by a group of eminent clinical psychologists drawn from eight universities and six NHS trusts, together with people who have themselves experienced psychosis. 

It provides an accessible overview of the current state of knowledge, and its conclusions have profound implications both for the way we understand ‘mental illness’ and for the future of mental health services. 

Click here to download the full report.

Click here to read the press release and for further information.