Psychosis and schizophrenia in adults (update)
Summary[Anticipated publication date March 2014]
The draft scope is available for download here.
This guidance is a partial upate of earlier guidance published in 2009.
Key issues that will be covered:
- Recognition of schizophrenia and criteria for diagnosis, including the recognition and management of at-risk mental states and early Psychosis and schizophrenia in children and young people: final scope 8 psychosis before a formal diagnosis of schizophrenia has been made.
- Psychological or psychosocial interventions: CBT cognitive remediation counselling and supportive psychotherapy family interventions (including family therapy) psychodynamic psychotherapy and psychoanalysis psychoeducation social skills training arts therapies.
- All antipsychotics licensed for the treatment of schizophrenia in the UK, including considerations related to the age of the child or young person, such as modifications to the dose. Note that guideline recommendations will not normally fall outside licensed indications. Exceptionally, and only if clearly supported by evidence, use outside a licensed indication may be recommended (for this guideline a number of drugs will be reviewed that are licensed for adults with schizophrenia but not for children or young people). The guideline will assume that prescribers will use a drug’s summary of product characteristics to inform decisions made with individual service users.
- Starting treatment with antipsychotic medication and/ or a psychological or psychosocial intervention.
- Treatment of an acute psychotic episode with antipsychotic medication and/ or a psychological or psychosocial intervention.
- Promoting recovery after an acute psychotic episode, using antipsychotic medication and/ or a psychological or psychosocial intervention.
- Assessment and management (for example, routine blood tests and physical monitoring) of known side effects of antipsychotic medication, and of the child or young person’s physical health.
- Treatment options if antipsychotic medication and/ or a psychological intervention is ineffective and/ or not tolerated.
- The organisation and integration of services, outlining a care pathway including primary care, CAMHS, EIS, and tertiary CAMHS (inpatient services).
- Ways to improve access to, and engagement with, mental health services for children and young people and particularly those from black and minority ethnic groups.
- Recommendations categorised as good practice points in NICE clinical guideline 82 will be reviewed for their relevance to children and young people with schizophrenia (including issues around consent and advance directives).
Issues that will not be covered:
- Validity of diagnosis.
- Primary prevention (although management of at-risk mental states and early psychotic symptoms prior to a diagnosis of schizophrenia will be covered; see 4.1.1 b).
- Management of violence in children and young people with schizophrenia.
Consultation documents[Consultation on draft guideline: 11 October 2010 - 8 November 2010; Anticipated publication date 25 May 2011]
Registered stakeholders for the Common mental health disorders: identification and care pathways guideline are invited to submit comments on the scope and may suggest clinical questions that could be answered in the guideline. Individuals and organisations not registered as stakeholders are not able to comment, we recommend that you register as a stakeholder or you contact the registered stakeholder organisation that most closely represents your interests and pass your comments to them [please refer to the NICE website for more information on how to submit comments on the provisional recommendations set out in the above documents].