Treatment as Prevention: Improving the Outcome of Schizophrenia-View Presentation Slides

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The document, an advanced presentation by Dr. Oliver Freudenreich, MD, addresses improving treatment outcomes for schizophrenia, emphasizing prevention, early intervention, and innovative therapies. It highlights a stage-based approach to schizophrenia care, detailing strategies for early treatment and relapse prevention. The document discusses the use of long-acting injectable antipsychotics (LAIs) over oral pills, as these have been shown to reduce relapse risk and possibly improve adherence due to their consistent administration. Early diagnosis and rapid treatment initiation, particularly with clozapine for treatment-resistant schizophrenia, are crucial steps. The document stresses timely intervention, especially since untreated psychosis duration (DUP) significantly affects long-term outcomes. The importance of psychosocial interventions like coordinated specialty care and efforts to improve quality of life through vocational and psychosocial rehabilitation is underscored.<br /><br />The document further analyzes medical aspects related to schizophrenia, notably antipsychotic-induced weight gain. It suggests proactive measures such as using GLP-1 agonists to tackle obesity, alongside behavioral interventions and possibly metformin, to mitigate associated health risks. It also touches on the importance of addressing smoking cessation and promoting vaccine uptake to improve overall health and reduce mortality risks in schizophrenia patients.<br /><br />A significant emphasis is placed on addressing systemic barriers to effective care, such as the underutilization of clozapine and LAIs, and ensuring patient-centered treatment delivery. The document concludes with a broader public health perspective, advocating for reverse care integration and addressing social and environmental factors affecting health, such as the impacts of climate change on vulnerable populations.<br /><br />Overall, the text forwards an integrative model that combines early psychosis intervention, continual medical monitoring, and environmental health awareness to holistically improve both the immediate and long-term outcomes for patients with schizophrenia.

Keywords

schizophrenia

early intervention

long-acting injectables

clozapine

psychosocial interventions

antipsychotic-induced weight gain

GLP-1 agonists

smoking cessation

reverse care integration

climate change